bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of micro-learning on learning and self-efficacy of nursing students: an interventional study
Authors: Zarshenas Ladan , Mehrabi Manoosh , karamdar Leila , Keshavarzi Mohammad Hasan , keshtkaran Zahra 
Published: September 2022

Abstract
Background
In the present age, e-learning has been playing a good role in educational and clinical settings along with face-to-face training. This study aimed to determine the effect of distance class using micro-learning contents on learning outcomes and self-efficacy in the clinical education of nursing students in 2021.

Methods
This research is a quasi-experimental pre-test-post-test study conducted at Shiraz University of Medical Sciences. The study population consisted of 46 nursing students who were recruited by the full census method. Students were randomly divided into two groups of intervention and control. Before and after educational interventions in both groups, students' learning and self-efficacy were evaluated using a questionnaire. Data Analysis was done using descriptive and analytical statistical methods and with SPSS software version 23.

Results
The results revealed a statistically significant difference in the mean score of clinical learning level of nursing students between the control and experimental groups after the intervention (p = 0.041). Also, the difference between the mean score of self-efficacy in the intervention group before and after the training was statistically significant (p = 0.001).

Conclusion
Micro-learning is an effective training method for raising learning outcomes and self-efficacy among nursing students, especially in internship units. This method is recommended since multimedia pays attention to all learning styles of learners and affects the learning outcomes and self-efficacy of learners.
Building leadership and managerial capacity for maternal and newborn health services
Authors: Tomblin Murphy Gail , Mtey Godfrey , Nyamtema Angelo , LeBlanc John , Rigby Janet , Abel Zabron , Mselle Lilian Teddy 
Published: September 2022

Abstract
Background
Strengthening leadership and management is important for building an effective and efficient health system. This paper presents the findings from a L&M capacity building initiative which was implemented as part of a larger study aimed at improving maternal and newborn outcomes within primary health facilities in the Morogoro, Tanzania.

Methods
The initiative, involving 30 stakeholders from 20 primary health facilities, 4 council health management teams and the regional health management team in the Morogoro region, provided leadership and managerial training through two 5-day in-person workshops, onsite mentoring, and e-learning modules. The initiative was evaluated using a pre-post design. Quantitative instruments included the ‘Big Results Now’ star-rating assessments and a team-developed survey for health providers/managers. The ‘Big Results Now’ star-rating assessments, conducted in 2018 (19 facilities) and 2021 (20 facilities), measured overall facility leadership and management capability, with comparisons of star-ratings from the two time-points providing indication of improvement. The survey was used to measure 3 key leadership indicators - team climate, role clarity/conflict and job satisfaction. The survey was completed by 97 respondents at baseline and 100 at follow up. Paired t-tests were used to examine mean score differences for each indicator. Triangulated findings from focus groups with 99 health providers and health management team members provided support and context for quantitative findings.

Results
Star-ratings increased in 15 (79%) of 19 facilities, with the number of facilities achieving the target of 3 plus stars increasing from 2 (10%) in 2018 to 10 (50%) in 2021, indicating improved organizational performance. From the survey, team climate, job satisfaction and role clarity improved across the facilities over the 3 project years. Focus group discussions related this improvement to the leadership and managerial capacity-building.

Conclusion
Improved leadership and managerial capacity in the participating health facilities and enhanced communication between the health facility, council and regional health management teams created a more supportive workplace environment, leading to enhanced teamwork, job satisfaction, productivity, and improved services for mothers and newborns. Leadership and managerial training at all levels is important for ensuring efficient and effective health service provision.
Experiences of family caregivers of patients with post-traumatic hydrocephalus from hospital to home: a qualitative study
Authors: Wang Jia-nan , Liu La-mei , Dela Rosa Ronnell , Sun Meng-jie , Qian Yu-meng , Sun Meng-yao Zhuan , Xu Tong-yao 
Published: September 2022

Abstract
Background
Post-traumatic hydrocephalus (PTH) is a complication of traumatic brain injury (TBI) that requires treatment and postoperative care. The shunt is one of the main treatments for PTH, which presents with dysfunction and infection. Considering brain injury, hydrocephalus shunt malfunction, and infection, family caregivers need to be responsible for caring for PTH patients, recognizing shunt malfunction and infection, and managing those patients accordingly from hospital to home. Understanding the experiences and needs of caregivers is beneficial for knowing their competency and quality of health care, ameliorating and ensuring future transition care. The study aimed to explore the feelings, experiences, and needs of family caregivers when caring for patients with TBI, PTH and shunts.

Methods
This was exploratory research of a purposive sample of 12 family caregivers of adult patients with TBI, PTH and shunts in five neurosurgery departments at a general hospital in Zhengzhou, Henan Province, China, using a semi-structured interview method. Data were collected from October 2021 to March 2022 before being analyzed by content analysis methods.

Results
Caregivers required professional and social knowledge and support in the areas of TBI, PTH and shunts, caregiving interventions, psychological care needs, and health insurance, just as caregivers do, but unlike other general caregivers, care for patients with TBI, PTH, and shunt is fraught with uncertainty and the need to manage shunt setting, and caregivers often experience 'complex emotional reaction' during the transitional period, where care needs and complex emotions may lead to a lack of caregiver confidence, which in turn may affect caregiving behaviors, and experiences that affect care may be mediated through caregiving confidence. The perceived availability of resources, particularly those that are still available to them when they return home, has a significant impact on participants' emotional response and sense of confidence.

Conclusions
The emotional response and the impact of stressor caregivers after TBI, PTH, and shunt was important, and sometimes confidence in care appeared to be an intermediate and useful factor that needed to be considered as health professionals prepared to develop care resources on how to manage and empower patients with TBI, PTH, and shunt. Meanwhile, there may be gaps and inequities in supportive care for patients diagnosed with TBI, PTH, and shunt in China.
Clinical management and acute exacerbations in patients with idiopathic pulmonary fibrosis in Spain: results from the OASIS study
Authors: Cano-Jiménez Esteban , Romero Ortiz Ana Dolores , Villar Ana , Rodríguez-Nieto María Jesús , Ramon Alba , Armengol Silvia 
Published: September 2022

Abstract
Background
Idiopathic pulmonary fibrosis (IPF) is a progressive disease associated with decline in lung function and poor prognosis entailing significant impairment in quality of life and high socioeconomic burden. The aim of this study was to characterize clinical management and resources utilization of patients with IPF in Spain, according to predicted forced vital capacity (FVC) % at baseline.

Methods
Prospective, non-interventional, multicentric real-world data study in patients with IPF in Spain with 12-months follow-up. Clinical management and resources utilization during study period were recorded and compared between groups. FVC decline and acute exacerbations occurrence and associated healthcare resource use were also analysed. FVC decline after 12 months was estimated as relative change.

Results
204 consecutive patients with IPF were included and divided according to baseline FVC % predicted value. At baseline, patients with FVC < 50% received significantly more pharmacological and non-pharmacological treatments, and more help from caregiver. During the 12-months follow-up, patients with FVC < 50% required more specialized care visits, emergency visits, hospitalizations, pulmonary functions tests, non-health resource use (special transportation), and pharmacological treatments (p < 0.05 for all comparisons). Moreover, patients with FVC < 50% at baseline experienced more AE-IPF (p < 0.05), requiring more health-related resources use (primary care visits, p < 0.05). FVC decline was observed in all groups over the 12 months. FVC decreased on average by 2.50% (95% CI: − 5.98 to 0.98) along the year. More patients experienced an FVC decline > 10% in the more preserved lung function groups than in the FVC < 50% group, because of their already deteriorated condition.

Conclusions
We observed a significantly higher annual IPF-related resource use in patients with more impaired lung function at baseline. Since FVC decreases irrespective of FVC% predicted at baseline, slowing IPF progression to maintain patients at early disease stages is relevant to improve IPF management and to optimize resource use.
Trial registration: EU PAS register number EUPAS19387 [June 01, 2017].
Primary melanoma of the bladder: case report and review of the literature
Authors: Dai Jin-Dong , He Ben , Liu Zhi-Hong , Shi Ming , Shen Peng-Fei 
Published: September 2022

Abstract
Background
Primary melanoma of the bladder is extremely rare and has been sporadically reported in case reports. Its incidence, diagnosis, treatment, and outcomes are still unclear.

Case presentation
We report a 67-year-old female patient who presented with hematuria and was diagnosed with primary melanoma of the bladder by transurethral resection. No distant metastasis was detected by fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT). After a multidisciplinary discussion, the patient received laparoscopic radical resection of the bladder tumor. There was no tumor recurrence or distant metastasis after 15 months of follow-up.

Conclusion
Primary melanoma of the bladder is easily confused with urothelium carcinoma in morphology. The immunohistochemical is crucial in diagnosis. Because of a lack of in-depth understanding of primary melanoma of the bladder, the “gold standard” treatment has not been set. We would like to provide some rare information about it and discuss the proper treatment strategy for this rare disease.
Enhanced photothermal heating and combination therapy of gold nanoparticles on a breast cell model
Authors: Faid Amna H. , Shouman Samia A. , Badr Yehia A. , Sharaky Marwa 
Published: September 2022

AbstractMulti-drug resistance (MDR) in addition to the damage to non-malignant normal cells are the most difficult in cancer treatment. Drug delivery and Plasmonic photothermal therapy based on the use of resonant metallic nanoparticles have developed as promising techniques to destroy cancer cells selectively. In the present work, gold nanoparticles (AuNPs) were synthesized using trisodium citrate. The prepared AuNPs have a small size of 14 ± 4 nm and exhibit high stability with Zeta potential − 18 mV, AuNPs showed higher photothermal heating efficiency compared to irradiation with a 532 nm laser alone on the breast cancer cell line (MCF-7). Treatment of MCF-7 cells with 0.125 mM AuNPs coupled with laser irradiation for 6 min was found to significantly reduce (34%) the cell viability compared to 5% obtained with AuNPs in the same concentration and 26% with laser irradiation for 6 min without AuNPs. Moreover, the prepared AuNPs were used as an anticancer drug carrier for Doxorubicin (Dox), upon loading Dox to AuNPs there was a slight increase in the particle size to 16 ± 2 nm, FT-IR spectroscopic results showing the binding of Dox to AuNPs was through the –NH group. The potential cytotoxicity of the DOX@AuNPs nanocomposite was significantly increased compared to free DOX on the MCF7 cell line with a decrease in IC50. All these results suggested the potential use of AuNPs as therapeutic photothermal agents and drug carriers in cancer therapy.
Association of device-measured physical activity and sedentary behaviour with cardiovascular risk factors, health-related quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees with coronary heart disease
Authors: Freene Nicole , McManus Margaret , Mair Tarryn , Tan Ren , Davey Rachel 
Published: September 2022

Abstract
Background
Few studies have considered the relationship between risk factors, physical activity and sedentary behaviour in people with heart disease. Here we examine the independent relationship of device-measured physical activity and sedentary behaviour on risk factors, quality-of-life and exercise capacity over 12-months in cardiac rehabilitation attendees.

Methods
Hospital-based phase II cardiac rehabilitation participants with coronary heart disease were assessed at the start and end of cardiac rehabilitation (6-weeks), 6 and 12-months. Physical activity (moderate-to-vigorous (MVPA), light-intensity (LIPA); min/day) and sedentary behaviour (min/day, bouts, breaks) were measured using an ActiGraph accelerometer. Risk factors included waist circumference, body mass index, systolic blood pressure (SBP), fasting blood lipid and glucose levels, anxiety and depression. Quality-of-life and exercise capacity were also collected. Associations were assessed with Generalized Estimating Equation modeling.

Results
Sixty-seven participants were included (mean age = 64 (SD 9) years; 81% male). An association was found between higher MVPA and lower high density lipoprotein (p ≤ 0.001). No significant (p ≤ 0.001) associations were found between sedentary behaviour variables and other outcomes. At p < 0.05 several associations were significant. Increased MVPA and LIPA were associated with decreased total cholesterol. Higher MVPA was associated with decreased SBP, whereas higher LIPA was associated with decreased waist circumference and body mass index. Higher sedentary behaviour bouts and breaks were associated with increased total cholesterol, anxiety and depression, and decreased SBP over time.

Conclusions
Any intensity of physical activity was associated with decreased total cholesterol. Increased LIPA was associated with improved measures of adiposity, while breaking up sedentary behaviour and increasing MVPA may decrease SBP over time. Further investigation of MVPA, LIPA and the distribution of sedentary behaviour is indicated in cardiac rehabilitation attendees to explore their relationship with risk factors.
Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12615000995572, http://www.ANZCTR.org.au/ACTRN12615000995572.aspx. Registered 22 September 2015.
Improving carboxymethyl cellulose edible coating using ZnO nanoparticles from irradiated Alternaria tenuissima
Authors: Anwar Mervat M. , Aly Sanaa S. H. , Nasr Essam H. , El-Sayed El-Sayed R. 
Published: September 2022

AbstractIn this paper, gamma-irradiation was successfully used to intensify the yield of Zinc oxide nanoparticles (ZnONPs) produced by the fungus Alternariatenuissima as a sustainable and green process. The obtained data showed that 500 Gy of gamma-irradiation increased ZnONPs’ yield to approximately four-fold. The synthesized ZnONPs were then exploited to develop active Carboxymethyl Cellulose films by casting method at two different concentration of ZnONPs 0.5% and 1.0%. The physicochemical, mechanical, antioxidant, and antimicrobial properties of the prepared films were evaluated. The incorporation of ZnONPs in the Carboxymethyl Cellulose films had significantly decreased solubility (from 78.31% to 66.04% and 59.72%), water vapor permeability (from 0.475 g m−2 to 0.093 g m−2 and 0.026 g m−2), and oxygen transfer rate (from 24.7 × 10–2 to 2.3 × 10–2 and 1.8 × 10–2) of the respective prepared films. Meanwhile, tensile strength (from 183.2 MPa to 203.34 MPa and 235.94 MPa), elongation (from 13.0% to 62.5% and 83.7%), and Yang's modulus (from 325.344 to 1410.0 and 1814.96 MPa) of these films were increased. Moreover, the antioxidant and antimicrobial activities against several human and plant pathogens the prepared of Carboxymethyl Cellulose-ZnONPs films were significantly increased. In conclusion, the prepared Carboxymethyl Cellulose-ZnONPs films showed enhanced activities in comparison with Carboxymethyl Cellulose film without NPs. With these advantages, the fabricated Carboxymethyl Cellulose-ZnONPs films in this study could be effectively utilized as protective edible coating films of food products.
Effect of modified Laprade technique on posterolateral ligament injury of knee
Authors: Fang Kaibin , Dai Zhangsheng , Lin Xiaocong 
Published: September 2022

Abstract
Purpose
To investigate the effect of modified Laprade technique on the reconstruction of posterolateral structure of knee and anterolateral ligament of knee in the treatment of posterolateral injury of knee.

Methods
From December 2013 to June 2020, multiple ligament injury patients who received surgery in our hospital were collected in this research. These patients underwent a modified Laprade technique for posterolateral structural reconstruction of the knee. Lysholm scores of patients pre- and post-operation were recorded.

Result
The operations of the observation group or the control group patients were completed. There were no significant differences in gender, age, preoperative knee range of motion and preoperative Lysholm score. At the time of follow-up 1 month after operation, there was no significant difference in knee range of motion, dial-up test angle and Lysholm score between the observation and the control group. When followed up 1 year after operation, the Lysholm score of the observation group was higher than that of the control group. The difference was statistically significant. The same situation occurred in the range of motion of the knee in both groups. However, there was still no significant difference between the two groups in the dial-up test 1 year after operation, whether the knee flexion was 30° or 90°.

Conclusion
For patients with posterolateral structure injury of knee, the modified Laprade technique is a feasible surgical technique.
Iranian EFL teachers’ perceptions of writing assessment literacy: a countrywide study
Authors: Sohrabi Zohre , Ghanbari Nasim , Abbasi Abbas 
Published: September 2022

AbstractDespite a surge of interest in language teacher assessment literacy, teachers’ writing assessment literacy (WAL) has received little attention. When considering the issue in the particular Iranian EFL context, it becomes more significant since exploring the context shows the lack of a countrywide and systematic study on EFL teachers’ WAL. Considering this gap, the present study sets out to investigate the Iranian EFL writing teachers’ knowledge, beliefs, and practices regarding writing assessment. To achieve this goal, an adapted version of Crusan’s et al (Assessing Writing 28:43-56, 2016) WAL questionnaire was sent out to writing teachers in ten major state universities in the country. Overall, the researchers received back 118 questionnaires. The analysis of the results illustrated that although writing instructors had a positive attitude toward writing assessment and were aware of some basic concepts of writing assessment, their level of assessment literacy was not reflected in their practice, particularly when it came to the use of assessment rubrics. The results further showed that the teachers need to develop sound and clear conceptual understanding of WAL as well as the ability to use the knowledge in practice in the actual context of their practice. Generally, it can be argued that in the absence of systematic pre-service and in-service writing assessment training programs, Iranian EFL writing teachers relied on their individual expertise developed throughout their years of practice. The study also provides several pedagogical implications for training writing teachers and improving EFL writing assessment in the long run.
Hygro-mechanical short-term behaviour of selected coatings: experiments and material modelling on vapour permeability and mechanical properties
Authors: Stöcklein Josef , Konopka Daniel , Grajcarek Gerald , Tietze Oliver , Oertel Silvia , Schulze Andreas , Kaliske Michael 
Published: September 2022

Abstract
Many pieces of fine art are made of wood that has been treated with coatings. Since wood is a very hygroscopic material, the moisture content strongly influences the deformation of wooden parts. Coatings often act as moisture barriers. Therefore, the moisture permeability of coatings must be considered for the evaluation of the structural behaviour. The mechanical properties are also relevant to evaluate the deformation of thin artwork like panel paintings as well as the damage of paintings and varnishes. Therefore, the mechanical properties and the permeability of selected coatings used for cultural wooden artwork are investigated and presented in the article at hand. In this study, coatings of three artworks are investigated: a Lusatian cupboard from the eighteenth century, an altarpiece by L. Cranach the Elder and a Russian icon from 1912. The coatings considered are white ground, colours, varnishes, glue and textile reinforced sizing. Mechanical tests are conducted to evaluate the stiffness and tensile strength of the Russian icon’s coating. Cup tests are made to identify the moisture permeability of the coatings. This test was conducted for single coatings as well as for coating systems consisting of different coatings to investigate both the moisture barrier of single coatings and the interaction of coatings. Exponential functions for the relative humidity-dependent permeability are fitted based on the experimental data. The results allow the quantification of permeability for all investigated coatings—from white ground with a high permeability to beeswax with a low permeability—and the magnitude of moisture dependency of the coating’s permeability. Furthermore, it is shown that the simple addition of the water vapour resistance of single coatings underrates the resistance of a total coating system. By the mechanical tests, the strength, ultimate strain and Young’s modulus are obtained. The permeability and the mechanical parameters are required as input for numerical simulations of the structural behaviour of coated wooden artwork. These results are a good step forward to assess the risk of damage of coated wooden artwork.