bluuebunny/crossref_metadata_2025 huggingface dataset:
HUBUNGAN ANEMIA DENGAN KEJADIAN PENDARAHAN POSTPARTUM DI RSUD BIMA TAHUN 2024
Authors: Linda yulianti  , Tri Yubiah  , Muhd. Firmansyah
Published: January 2025

Anemia atau yang dikenal oleh masyarakat Indonesia dengan istilah kurang darah merupakan masalah kesehatan yang ditandai dengan penurunan kadar  hemoglobin dari batas normal. Angka Kematian Ibu di Indonesia masih tinggi dibandingkan dengan Negara ASEAN lainnya. Angka Kematia Ibu di negara-negara Asean sudah menempati posisi 40-60 per 100.000 kelahiran hidup. Sedangkan di Indonesia masih menempati posisi 305 per 100.000 kelahiran hidup (Survei Penduduk Antar Sensus 2020).  Untuk menganalisis hubungan Anemia dengan kejadian pendarahan postpartum di RSUD Bima tahun 2024. Jenis penelitian yang digunakan adalah penelitian Kuantitatif, rancangan penelitian deskriptif korelasional dengan menggunakan pendekatan Cross Sectional. Populasi pada penelitian ini adalah Ibu Postpartum di RSUD Bima tahun 2024 berjumlah 724 orang. Pengambilan sampel 88 ibu Postpartum menggunakan teknik purposive sampling, analisis bivariat menggunakan uji chi-square, dengan menggunakan p value < 0,05. Menunjukkan bahwa responden yang anemia sebanyak 66 responden (75%),  tidak anemia sebanyak 22 responden (25%), pendarahan sebanyak 68 responden (77.3%) dan tidak pendarahan sebanyak 20 responden (22.7%)  RSUD Bima tahun 2024. Berdasarkan Hasil analisa data dengan menggunakan uji Chi-squer diperoleh p value = 0,008 berarti lebih kecil dari α = 0,05 dengan demikian Ha diterima. Dalam hal ini dikatakan bahwa ada hubungan anemia dengan kejadian pendarahan postpartum di RSUD Bima tahun 2024.
HUBUNGAN PEKERJAAN DENGAN KECEMASAN IBU HAMIL DI PUSKESMAS MPUNDA KOTA BIMA
Authors: Bayti Jannah  , Cesa Septiana Pratiwi  , Mamnuah
Published: January 2025

Prevalensi kecemasan kehamilan bervariasi pada trimester kehamilan dengan tingkat yang tinggi pada trimester pertama dan ketiga. Tingkat kecemasan yang tinggi yaitu pada negara dengan penghasilan rendah dan sedang sebesar 20% atau lebih. Kecemasan antenatal berdampak negatif pada ibu maupun bayi. Dampak negatif kecemasan pada ibu yaitu perubahan perilaku ibu hamil seperti pola makan, gaya hidup atau aktifitas fisik, yang mengakibatkan penyulit persalinan. Dampaknya pada bayi baru lahir meliputi masalah seperti berat badan lahir rendah (BBLR), asfiksia, kelahiran prematur, dan perkembangan janin terhambat, yang dapat menyebabkan kematian bayi. Tujuan dari penelitian ini yaitu untuk mengetahui hubungan pekerjaan dengan kecemasan ibu hamil di Puskesmas Mpunda Kota Bima. Metode penelitian ini adalah kuantitatif dengan pendekatan cross-sectional. Populasi sebanyak 61 orang dengan sampel sebanyak 53 ibu hamil yang telah mengikuti perawatan antenatal di Puskesmas Mpunda. Teknik pengambilan sampel yang digunakan yaitu consecutive sampling. Kuesioner yang digunakan untuk mengukur kecemasan yaitu Perinatal Anxiety Screening Scale (PASS). Berdasarkan uji statistik menggunakan chi-square tingkat kecemasan wanita yang tidak bekerja dengan nilai-p value sebesar 0,018 (p <0,05). Diharapkan kepada tenaga kesehatan untuk memberikan informasi yang holistik kepada ibu hamil supaya meminimalisir kecemasan yang terjadi.
Implementasi Urgensi Pendidikan Islam dalam Interaksi Sosial di SMK Nurul Hikmah Sangatta Utara
Authors: Yasin Muhammad , W. Tukan Siti Aminah , Lestari Octaviani , Azikin Dian Nur
Published: January 2025

This research aims to explore and analyze the implementation of the urgency of Islamic education in social interactions at Nurul Hikmah Sangatta Utara Vocational School. A qualitative approach was used to gain an in-depth understanding of how Islamic values ​​are applied in the school environment and their impact on students' social interactions. Data was collected through in-depth interviews, participant observation, and document analysis. The research results show that Islamic education at Nurul Hikmah Vocational School does not only focus on cognitive aspects, but also on developing students' character and morals. The implementation of Islamic education has proven effective in forming harmonious, respectful and tolerant social interactions among students. Values ​​such as honesty, responsibility and empathy are taught through various curricular and extracurricular activities. This research concludes that the urgency of Islamic education in shaping social interaction at Nurul Hikmah Vocational School is very significant and can be used as a model for other Islamic-based schools. The recommendation for educators and school administrators is to continue to strengthen the integration of Islamic values ​​in all aspects of education in order to create a social environment that is conducive to the development of student character.
Analisis Jurnal “Model Pengendalian Strategi, Inovasi Dan Kewirausahaan Dalam Organisasi Perspektif Ekonomi Islam” Implementasi Terhadap Lembaga Dakwah
Authors: Pratama Lalu Muh Reza , Castrawijaya Cecep
Published: January 2025

This study analyzes the relationship between strategic control, innovation, and entrepreneurship in organizations based on an Islamic economic perspective, with a focus on its implementation in da'wah institutions. Using a qualitative method with a library research approach, this study collected secondary data from relevant literature such as current books and journals. The results show that strategic control in Islamic economics is not only based on managerial procedures, but also sharia values such as tawhid, amanah, and maqashid sharia. Islamic innovation emphasizes the principles of maslahah, blessings, and creativity in accordance with Islamic teachings, while Islamic entrepreneurship integrates a balance between profit, social benefits, and the application of Islamic business ethics. This integration between strategic control, innovation, and entrepreneurship creates an Islamic business ecosystem that is sustainable, provides benefits to society, and is able to compete globally. This research contributes to providing insights into Islamic values-based managerial models that are relevant to contemporary challenges, including digitalization and sustainability.
Penggunaan Tes Uraian Dalam Mereduksi Perilaku Mencontek Pada Pembelajaran PAI
Authors: Widyanti Eka , Indah Syari Nur Fadillah
Published: January 2025

The use of essay tests is a solution that can be done by a teacher in reducing cheating behaviour in Islamic religious education and morals subjects. The focus of the problem in this study is whether the use of essay tests can reduce students' cheating behaviour in class XI IPA 2 at SMA Negeri 1 Sangatta Selatan. The method used in this research is a class action research method by adopting the Kemmis and Taggart Spiral models. The purpose of this study was to determine the reduction of students' cheating behaviour through the use of an essay test in class XI IPA 2 SMA Negeri 1 Sangatta Selatan. The results showed that when viewed from a comparison of the cheating behaviour of XI IPA 2 students, the percentage of cheating behaviour in cycle 1 was 83% and decreased in cycle 2 by 33%, it can be said that the use of an essay test can reduce students' cheating behaviour in Islamic religious education subjects and manners of class XI IPA 2 SMAN 1 South Sangatta. Thus, learning by giving assignments based on descriptive tests has a significant impact on reducing or reducing students' cheating behaviour.
TEACHING AND LEARNING PROCESS IN GRADE VIIth OF TIRANUS WAMENA JUNIOR HIGH SCHOOL DURING THE COVID-19 PANDEMIC IN ACADEMIC YEAR 2020/2021
Authors: Paling Sepling , Weya Yosepina Otto
Published: January 2025

This research is a qualitative descriptive study. This research is conduct by researcher aims at seeing the differences in learning that occur in the teaching and learning process in grade 7th junior high school of Tiranus Wamena. the criteria for this study were chosen because of the Covid-19 pandemic outbreak, which has an impact on the learning system on the grade 7th junior high school of Tiranus Wamena. Data conducting by interview to Principel of Tiranus Junior High School, Teachers, and Students. The result of this study indicate that the teaching and learning process in grade 7th junior high school carry out quite well. This can be seen from the results of survey data and interviews conduct. The teaching and learning process is carry out quite well, because of the cooperation between teachers, students and parents in learning at home.
Récit de l’évolution du projet didactique d’une enseignante au sein d’un collectif œuvrant autour de l’enseignement-apprentissage des probabilités au primaire
Authors: Martin Vincent , Homier Marianne
Published: January 2025

Au Québec, l’enseignement-apprentissage des probabilités n’occupe généralement qu’une petite place au sein des classes. Plusieurs personnes enseignantes disent y rencontrer des défis, mais les voies de développement professionnel en lien avec l’enseignement-apprentissage des probabilités au primaire ne sont pas toujours évidentes. Afin de soutenir ce développement professionnel, nous avons formé un collectif de personnes enseignantes et chercheures. À la manière d’une Clinique didactique de l’activité (Benoit, 2022, 2024), nous avons conjointement réfléchi à des projets didactiques réalisés, empêchés ou souhaités pour cet enseignement-apprentissage. Nous présentons le cas d’une enseignante du collectif à travers une analyse de son processus , en montrant notamment que son activité d’enseignement, d’abord fortement ancrée dans l’approche théorique, fait progressivement place aux approches fréquentielle et subjective.
Mot éditorial
Authors: Comité éditorial
Published: January 2025

Le comité éditorial a le plaisir de vous proposer trois articles pour ce quatrième numéro régulier de la RQDM. Ces articles traitent de différents sujets, mais tous liés à l’enseignement des mathématiques à l'école primaire.
The association between intimate partner violence and cervical cancer screening among women of childbearing age in South Africa
Authors: Hollington M
Published: January 2025

Background. Cervical cancer is a major global public health concern, particularly in South Africa (SA), where it is the second most prevalent cancer among women. This prevalence can be attributed to several factors including poor screening rates and the prevalence of HIV. Objective. To examine the association between intimate partner violence (IPV) and cervical cancer screening (CCS) in SA, while considering the influence of other sociodemographic factors.
Methods. The study used cross-sectional data from the 2016 South Africa Demographic and Health Survey, focusing on women of childbearing age who underwent CCS. Bivariate analysis was conducted to investigate the relationship between CCS and each independent variable. A binary regression model was used to determine the association between intimate partner violence and CCS while controlling for other variables.
Results. The study found that 32% of women aged 15 to 49 years in SA had undergone CCS at least once in their lifetime. No significant association was established between IPV and CCS uptake (unadjusted odds ratio (uOR) 1.05, 95% CI 0.84 - 1.31; p>0.05 and adjusted odds ratio (aOR) 1.16, 95% CI 0.89 - 1.51; p>0.05 ). However, sociodemographic factors, including area of residence, age, education level, wealth, race and health insurance status, were significant predictors of CCS. Older women, those with higher education, wealthier individuals and those with health insurance were more likely to undergo screening.
Conclusion. In the present study, IPV was not a significant factor directly influencing CCS uptake. Instead, a complex interplay of sociodemographic factors was identified as predictors of CCS rates. These findings highlight the need for interventions that address the barriers to CCS, particularly in rural areas and among underprivileged and minority populations. Improving education, healthcare coverage and accessibility can potentially enhance screening rates and reduce the burden of cervical cancer in SA.
Decarbonization of the energy sector with reference to the transport sector
Authors: Glamočić Ljubo
Published: January 2025

The transition of the energy sector is largely reflected in transport, which is an important a link in the economy. The decarbonization process, which is an integral part of this entire transition of the energy sector, began much earlier by finding new fuels in order to replace the already well-known and well-established fossil fuels. In order to protect the environment, many scientific research institutions and manufacturers of transport vehicles are looking for alternatives to fossil fuels. The development and transition to means of transport whose power is carried out by electric motors, i.e. where the driver of these means of transport is electricity, accumulated in batteries, is not the optimal solution, which in return caused a rapid development of various technologies and models in the last decade whose primary objectives encompass obtaining hydrogen and its use in all types of transport from road, rail, naval to the air force.
Fernando y David: los escombros de una historia de amor
Authors: Musitano Julia
Published: January 2025

La reciente publicación de Escombros vuelve sobre algunos temas recurrentes de la narrativa de Fernando Vallejo (ruina, muerte, pérdida, amor y melancolía), pero con una mirada nueva: un terremoto que azota la ciudad de México –y la deja en ruinas– es responsable de la muerte de David, la pareja de Vallejo desde hace más de cuarenta años. La mezcla entre escritura biográfi ca y autobiográfi ca le habilita a transgredir la forma para encontrar un decir sobre otro en primera persona y para formular un espacio afectivo que reúna dos vidas. Ese decir despliega la forma amorosa de la biografía: el desplazamiento de lo propio a lo ajeno y del otro al yo. La hipótesis que orienta este trabajo entiende que Escombros formula un decir del amor desde la dedicatoria, el vocativo y el traslado de un yo al otro.
La erosión lingüística en profesores nativos de español en la República Checa
Authors: Rodríguez García Cristina
Published: January 2025

Este artículo se ocupa de la erosión lingüística en profesores nativos de español que viven y trabajan en la República Checa. El objetivo es investigar la experiencia personal de estos profesores con un posible proceso de erosión. Para ello, en primer lugar, se presenta un marco teórico que repasa las investigaciones disponibles sobre erosión lingüística. En segundo lugar, se expone la metodología del estudio, basada en un cuestionario con preguntas sociodemográfi cas y experienciales en el que han participado 43 docentes de español de la República Checa, con el fi n de compartir su proceso de desgaste lingüístico. En tercer lugar, se ofrecen y se discuten los resultados del análisis, con la conclusión de que la erosión lingüística es una parte inevitable del proceso migratorio que va unida a variables como la reducción del input en la L1 del hablante; el contacto con la lengua del país de acogida; el tiempo de residencia fuera del país de origen; así como la exposición continuada a los errores y a la interlengua de los aprendientes checos de español.
Synergistic effect of inhibiting CHK2 and DNA replication on cancer cell growth
Authors: Coquel Flavie , Ho Sing-Zong , Tsai Keng-Chang , Yang Chun-Yen , Aze Antoine , Devin Julie , Chang Ting-Hsiang , Kong-Hap Marie , Bioteau Audrey , Moreaux Jerome , Maiorano Domenico , Pourquier Philippe , Yang Wen-Chin , Lin Yea-Lih , Pasero Philippe
Published: January 2025

Cancer cells display high levels of oncogene-induced replication stress (RS) and rely on DNA damage checkpoint for viability. This feature is exploited by cancer therapies to either increase RS to unbearable levels or inhibit checkpoint kinases involved in the DNA damage response. Thus far, treatments that combine these two strategies have shown promise but also have severe adverse effects. To identify novel, better-tolerated anticancer combinations, we screened a collection of plant extracts and found two natural compounds from the plant, Psoralea corylifolia, that synergistically inhibit cancer cell proliferation. Bakuchiol inhibited DNA replication and activated the checkpoint kinase CHK1 by targeting DNA polymerases. Isobavachalcone interfered with DNA double-strand break repair by inhibiting the checkpoint kinase CHK2 and DNA end resection. The combination of bakuchiol and isobavachalcone synergistically inhibited cancer cell proliferation in vitro. Importantly, it also prevented tumor development in xenografted NOD/SCID mice. The synergistic effect of inhibiting DNA replication and CHK2 signaling identifies a vulnerability of cancer cells that might be exploited by using clinically approved inhibitors in novel combination therapies.
Synchronous processing of temporal information across the hippocampus, striatum, and orbitofrontal cortex
Authors: Shimbo Akihiro , Sekine Yukiko , Kashiwagi Saori , Fujisawa Shigeyoshi
Published: January 2025

Information processing for interval timing is supported by several brain regions, including the hippocampus, basal ganglia, and frontal cortical areas. However, little is known about the mechanism by which temporal information is processed cooperatively in the distributed brain network. Here, we investigated the neuronal processing of temporal information in the hippocampal CA1, dorsal striatum, and orbitofrontal cortex by simultaneously recording neuronal activity during a temporal bisection task. We found time cells representing elapsed time during the interval period across all three regions. Seeking a potential mechanism for the correlative representation of time, we found that theta oscillations were dominant in these areas and modulated the activity of these time cells. Moreover, the synchronization of the time cell pairs across the areas was also regulated by theta oscillations. Taken together, these results demonstrated the presence of synchronous activity of time cells across the three areas on a fine time scale, which was supported by theta oscillations. In addition, decoding analysis revealed that the activity of the time cells in these areas correlated with the rats’ decisions based on their internal time estimation, with the decoded time also showing correlations across the three regions. Thus, the cooperative activity of time-cell assemblies in the three regions reflected the recognition of elapsed time in the rats. In conclusion, these results demonstrate the pivotal role of neuronal synchronization of time cells in supporting temporal processing in the distributed brain network.
Relationships among COVID-19 causal factors perceived by children, basic psychological needs and social anxiety
Authors: González-García Higinio , Álvarez-Kurogi Leandro , Prieto Andreu Joel , Tierno Cordón Javier , Castro López Rosario , Salas Sánchez Jesús
Published: January 2025

Background

The pandemic caused by COVID-19 had a great impact on our society as the lives of children have been affected, as well as their psychological health and social anxiety.

Objective

To examine whether COVID-19 causal factors perceived by children predicted basic psychological needs and social anxiety, and if basic psychological needs predicted social anxiety.

Methods

A sample of 58 schoolchildren (Mage = 10.18; SD = 0.77; 36 boys, 22 girls) participated in the study and completed a series of self-report measures. The relationship between the study variables was examined using partial least square path modelling (PLS-PM).

Results

Social distancing and protection were found to significantly reduce competence satisfaction. Perceived psychological impact significantly negatively predicted relatedness satisfaction and significantly positively autonomy frustration and competence frustration. Perceived psychological impact significantly negatively predicted anxiety in the interaction with the opposite sex. Autonomy satisfaction significantly positively predicted anxiety in the interaction with the opposite sex. Autonomy frustration significantly positively predicted anxiety in public speaking interaction with teachers, significantly positively anxiety in the interaction with the opposite sex, significantly positively anxiety of being embarrassed or ridiculed and significantly positively anxiety in the interaction with strangers.

Conclusion

Perceived psychological impact was the causal factor that revealed a higher impact on basic psychological needs. As such, it is important to take measures with children in pandemic situations to minimize this variable. On the other hand, Autonomy frustration revealed a higher impact on social anxiety. Thus, it is necessary to emphasize autonomy in children respecting the restrictions imposed to minimize the impact of social anxiety.
A narrative review on the role of cognition, nutrition and energy availability in athletes of competitive sports to combat RED-S
Authors: M. Subalatha , Rachaveti Dhanush , S. Amutha , M. Ponpandi
Published: January 2025

Background

In the present scenario, competitive sports require athletes to achieve a phenomenal balance between cognitive abilities, motor skills, nutritional intake, and energy deficiencies. Such stability would enable the athletes to excel in their sporting field. Evidence shows that athletes develop specific cognitive abilities based on their sporting field. Nutrition is vital in creating an athlete’s cognitive ability and physical needs required to participate in competitive sports. The reduction in the intake of nutrients required before, after and during sports participation could result in relative energy deficiency in sports (RED-S), affecting the parts of the body.

Methods

The rationale behind the survey is to understand the role of nutrition and energy deficiency on the athletes’ cognitive abilities. The review’s research areas were identified as athletes’ cognition and nutrition in the context of RED-S. Search keywords were found based on the research area, such as “cognitive”, “nutrition”, and “energy deficiency/availability” in athletes. The search keywords were combined to form search queries (SQs). SQs were used to carry out the search on the Web of Science and Scopus databases.

Results

Sports play an important role in athletes’ cognitive abilities, such as decision-making, attention, memory, etc. Nutritional intakes, such as caffeinated, carbohydrate, alkaline, and protein-based supplements and diets, also significantly affect athletes’ cognitive and motor abilities. Low energy availability (LEA) causes cognitive and physical health problems in both female and male athletes.

Conclusion

The review identified that nutrition and LEA play crucial roles in athletes’ cognitive performance. Deficits in nutritional intake and energy availability lead to RED-S. Hence, cognitive performance could be used as an early indication to identify the nutritional and energy deficits in advance, enabling athletes to combat RED-S.
Exploring the Barriers to Proper Management of Personal Protective Equipment (PPE) During a Pandemic in Hospitals
Authors: Ajuwon Margaret , Chen Guangming
Published: January 2025

Background:   Effective   management   of   personal   protective   equipment (PPE) in healthcare settings is critical, especially during health crises like the COVID-19 pandemic. This study aims to identify barriers to effective PPE utilization and assess the impact of training frequency on PPE management.
Methods: Using quantitative and qualitative analyses, the study evaluated 100 survey responses and performed a chi-square test to examine associations between role types and training frequencies.
Results: Findings revealed that only 59% of respondents received yearly PPE training, with inadequate preparation, insufficient knowledge, and high costs identified as primary barriers.
Conclusion: Addressing these barriers through improved training and resource management is essential for enhancing PPE effectiveness and ensuring the safety of healthcare workers and patients.
Pylon of an Irregular Low Pylon Cable-Stayed Bridge: A Review
Authors: Cao Zhaoyang , Gao Yan , Li Linbing
Published: January 2025

Low-tower cable-stayed bridges, as an emerging type of bridge structure, have been widely applied in bridge engineering both domestically and internationally in recent years. This paper reviews the research status and development trends of low-tower cable-stayed bridges. Firstly, it introduces the characteristics of low-tower cable-stayed bridges and their importance in bridge engineering. Subsequently, it analyzes in detail the diversity of tower forms in low-tower cable-stayed bridges, including single-column, double-column, portal, and innovative forms such as inclined-leg portal, inverted V-shape, inverted Y-shape, H-shape, diamond, etc. These towers not only vary in shape but also possess complex load-bearing capabilities. Meanwhile, this paper also outlines the design features of low-tower cable-stayed bridges, such as their graceful appearance, excellent performance, and convenient construction. Finally, it summarizes the main advancements in research on low-tower cable-stayed bridges in recent years, including structural design, evolution of tower forms, analysis of spatial stress distribution, and other research achievements, and looks forward to their future development trends.
Affiliation Bias in Peer Review of Abstracts by a Large Language Model
Authors: von Wedel Dario , Schmitt Rico A. , Thiele Moritz , Leuner Raphael , Shay Denys , Redaelli Simone , Schaefer Maximilian S.
Published: December 2023

This study assesses affiliation bias in peer review of medical abstracts by a commonly used large language model.
Melanoma Incidence Rates Among Non-Hispanic American Indian/Alaska Native Individuals, 1999-2019
Authors: Townsend Julie S. , Melkonian Stephanie C. , Jim Melissa A. , Holman Dawn M. , Buffalo Melissa , Julian Anne K.
Published: December 2023

Importance

Non-Hispanic American Indian/Alaska Native people have the second highest incidence rate of invasive cutaneous melanoma in the US after non-Hispanic White people.

Objective

To examine invasive cutaneous melanoma incidence rates and trends over time among non-Hispanic American Indian/Alaska Native people.

Design, Setting, and Participants

This descriptive, observational cross-sectional study used population-based cancer registry data (US Cancer Statistics AI/AN Incidence Analytic Database) linked to the Indian Health Service administrative database to examine incidence rates by age, sex, region, histology, tumor site, stage, and other demographic and clinical characteristics. The study examined trends from 1999 to 2019 time period by age, sex, stage at diagnosis, and region. Non-Hispanic American Indian/Alaska Native people 15 years and older who received a diagnosis of invasive cutaneous melanoma from 1999 to 2019 who were members of federally recognized tribes and resided in Indian Health Service purchased/referred care delivery areas were included in this study to reduce racial misclassification and provide more accurate rates. The data were analyzed in 2022.

Exposures

Demographic and clinical characteristics, such as age, sex, geographic region, histology, stage, and tumor site.

Main Outcomes and Measures

Invasive cutaneous melanoma incidence rates by age group, sex, region, resident county characteristics (poverty level, rurality, education level, and socioeconomic status), stage at diagnosis, tumor site, and histology. Trends over time by age, sex, region, and stage.

Results

From 1999 to 2019, 2151 non-Hispanic American Indian/Alaska Native people (1021 female individuals [47.5%]) received a diagnosis of incident cutaneous melanoma (rate, 10.7 per 100 000; 95% CI, 10.3-11.2). Rates were higher among male than female individuals (13.0 [95% CI, 12.2-13.8] vs 9.2 [95% CI, 8.6-9.8]) and for people 55 years and older (24.2; 95% CI, 22.8-25.7) compared with those aged 15 to 39 years (3.5; 95% CI, 3.2-3.9). Rates were highest for male individuals 55 years and older (34.5; 95% CI, 31.8-37.3) and people living in the Southern Plains (male individuals: 23.8; 95% CI, 21.5-26.2; female individuals: 15.5; 95% CI, 14.0-17.2) and Pacific Coast region (male individuals: 16.5; 95% CI, 14.5-18.7; female individuals: 12.3; 95% CI, 10.9-13.9). Rates increased among female individuals from 1999 to 2019 (average annual percent change [AAPC], 2.5; P < .001); among regional/distant stage tumors (AAPC, 2.5; P = .01) and people 55 years and older (AAPC, 2.8; P = .001).

Conclusions and Relevance

The results of this study suggest that additional studies could potentially identify risk factors among non-Hispanic American Indian/Alaska Native people.
ED Visits for Schizophrenia Spectrum Disorders During the COVID-19 Pandemic at 5 Campus Health Systems
Authors: Singh Parvati , Nawaz Saira , Seiber Eric E. , Bryant Ian , Moon Kyle , Wastler Heather , Breitborde Nicholas J.
Published: December 2023

Importance

Although substantial research has reported grave population-level psychiatric sequelae of the COVID-19 pandemic, evidence pertaining to temporal changes in schizophrenia spectrum disorders in the US following the pandemic remains limited.

Objective

To examine the monthly patterns of emergency department (ED) visits for schizophrenia spectrum disorders after the onset of the COVID-19 pandemic.

Design, Setting, and Participants

This observational cohort study used time-series analyses to examine whether monthly counts of ED visits for schizophrenia spectrum disorders across 5 University of California (UC) campus health systems increased beyond expected levels during the COVID-19 pandemic. Data included ED visits reported by the 5 UC campuses from 2016 to 2021. Participants included persons who accessed UC Health System EDs had a diagnosis of a psychiatric condition. Data analysis was performed from March to June 2023.

Exposures

The exposures were binary indicators of initial (March to May 2020) and extended (March to December 2020) phases of the COVID-19 pandemic.

Main Outcomes and Measures

The primary outcome was monthly counts of ED visits for schizophrenia spectrum disorders. International Statistical Classification of Diseases and Related Health Problems, Tenth Revision diagnosis codes, categorized within Clinical Classification Software groups, were used to identify ED visits for schizophrenia spectrum disorders and all other psychiatric ED visits, from the University of California Health Data Warehouse database, from January 2016 to December 2021. Time-series analyses controlled for autocorrelation, seasonality, and concurrent trends in ED visits for all other psychiatric conditions.

Results

The study data comprised a total of 377 872 psychiatric ED visits, with 37 815 visits for schizophrenia spectrum disorders. The prepandemic monthly mean (SD) number of ED visits for schizophrenia spectrum disorders was 519.9 (38.1), which increased to 558.4 (47.6) following the onset of the COVID-19 pandemic. Results from time series analyses, controlling for monthly counts of ED visits for all other psychiatric conditions, indicated 70.5 additional ED visits (95% CI, 11.7-129.3 additional visits; P = .02) for schizophrenia spectrum disorders at 1 month and 74.9 additional visits (95% CI, 24.0-126.0 visits; P = .005) at 3 months following the initial phase of the COVID-19 pandemic in California.

Conclusions and Relevance

This study found a 15% increase in ED visits for schizophrenia spectrum disorders within 3 months after the initial phase of the pandemic in California across 5 UC campus health systems, underscoring the importance of social policies related to future emergency preparedness and the need to strengthen mental health care systems.
Low-Carbohydrate Diet Macronutrient Quality and Weight Change
Authors: Liu Binkai , Hu Yang , Rai Sharan K. , Wang Molin , Hu Frank B. , Sun Qi
Published: December 2023

Importance

The associations of low-carbohydrate diets (LCDs) with long-term weight management remains unclear, and the source and quality of macronutrients within LCDs are less explored.

Objectives

To prospectively examine associations between changes in LCD indices and weight change among US adults.

Design, Setting, and Participants

This prospective cohort study included initially healthy participants at baseline from the Nurses’ Health Study (NHS; 1986-2010), Nurses’ Health Study II (NHSII; 1991-2015), and Health Professionals Follow-up Study (HPFS; 1986-2018). Data analysis was performed between November 2022 and April 2023.

Exposures

Five LCD indices were examined: (1) a total LCD (TLCD) emphasizing overall lower carbohydrate intake; (2) an animal-based LCD (ALCD) that emphasized animal-sourced protein and fat; (3) a vegetable-based LCD (VLCD) that emphasized plant-sourced protein and fat; (4) a healthy LCD (HLCD) emphasizing less refined carbohydrates, more plant protein, and healthy fat; and (5) an unhealthy LCD (ULCD) emphasizing less healthful carbohydrates, more animal protein, and unhealthy fat.

Main Outcomes and Measures

The outcome of interest was 4-year changes in self-reported body weight.

Results

A total of 123 332 participants (mean [SD] age, 45.0 [9.7] years; 103 320 [83.8%] female) were included in this study. The median carbohydrate intake (as a percentage of energy) of the highest quintiles of TLCD score at baseline ranged from 38.3% in HPFS to 40.9% in NHSII. Mean weight gain over 4-year intervals among participants varied from 0.8 kg in the HPFS to 1.8 kg in the NHSII. After adjusting for demographics and baseline and concomitant changes of selected lifestyle factors, each 1-SD increase in TLCD score was associated with 0.06 (95% CI, 0.04-0.08) kg more weight gain over the 4-year periods. Similarly, participants gained 0.13 (95% CI, 0.11 to 0.14) kg per each 1-SD increase in ALCD score and 0.39 (95% CI, 0.37 to 0.40) kg per each 1-SD change in ULCD score. In contrast, each 1-SD increase in VLCD score was associated with 0.03 (95% CI, 0.01 to 0.04) kg less weight gain, and each 1-SD increase in HLCD score was associated with 0.36 (95% CI, 0.35 to 0.38) kg less weight gain. The associations were more pronounced among obese individuals (per 1-SD increase in HLCD score: BMI ≥30, 0.88 [95% CI, 0.80, 0.97] kg less weight gain; BMI <25, 0.23 [95% CI, 0.20, 0.26] kg less weight gain; P for interaction < .001).

Conclusions and Relevance

These findings suggest that the quality of LCDs may play a critical role in modulating long-term weight change. Only LCDs that emphasized high-quality protein, fat, and carbohydrates from whole grains and other plant-based foods were associated with less weight gain.
Comparison of Capture Rates of the National Cancer Database Across Race and Ethnicity
Authors: Satpathy Yasoda , Nam Percival , Moldovan Matthew , Murphy James D. , Wang Luke , Derweesh Ithaar , Rose Brent S. , Javier-DesLoges Juan
Published: December 2023

Importance

The National Cancer Database (NCDB) is an invaluable and widely used resource for cancer research, but the current state of representation of different racial and ethnic groups compared with the United States Cancer Statistics (USCS) database is unknown.

Objective

To examine whether Hispanic and American Indian or Alaska Native individuals have lower representation in the NCDB compared with the USCS database.

Design, Setting, and Participants

This multicenter, retrospective cohort study assessed individuals diagnosed with breast, colorectal, lung, and prostate cancer from January 1, 2004, to December 31, 2006, and January 1, 2017, to December 31, 2019, in the NCDB and USCS databases. Data analysis was performed from September 2022 to October 2023.

Exposure

Time.

Main Outcomes and Measures

The primary outcome was the absolute percentage change (APC) in capture rate across the study period.

Results

The cohort included 5 175 007 individuals (0.50% American Indian or Alaska Native, 3.10% Asian or Pacific Islander, 12.01% Black, 6.58% Hispanic, and 77.81% White) who were diagnosed with breast, colorectal, lung, and prostate cancer. Capture rates were the lowest for individuals who were Hispanic (40.83% in 2004-2006 and 54.75% in 2017-2019; P < .001) or American Indian or Alaska Native (20.72% in 2004-2006 and 41.41% in 2017-2019; P < .001). The APCs were positive for both racial categories across all 4 cancers. However, overall APCs for Hispanic individuals (13.92%) remained lower than the overall APCs of White individuals (22.23%; P < .001). The APCs were greater for American Indian or Alaska Native individuals than for White individuals for prostate (14.68% vs 11.57%) and breast (21.61% vs 17.90%) cancer (P < .001), but the APCs for American Indian or Alaska Native individuals were lower than for White individuals for lung cancer (24.54% vs 33.03%; P < .001).

Conclusions and Relevance

In this cohort study of individuals diagnosed with cancer in the NCDB, Hispanic and American Indian or Alaska Native individuals diagnosed with breast, colorectal, lung, and prostate cancer were undercaptured in the NCDB, but their representation improved over time. Increased study is needed to determine where these populations predominantly seek cancer care.
From Complexity to Precision—Charting Decision-Making Through Normative Modeling
Authors: Kumar Poornima , Dayan Peter , Wolfers Thomas
Published: December 2023

This Viewpoint synthesizes data-driven and theory-driven approaches to normative modeling.
Portal Vein Thrombosis After Transarterial Embolization for Hepatocellular Carcinoma
Authors: Schwab Marisa E. , Decker Hannah C. , Monto Alexander , Sawhney Rajiv , Corvera Carlos U.
Published: December 2023

This cross-sectional study assesses the association between venous thrombosis and embolization in patients with hepatocellular carcinoma.
Magnetic Seed vs Guidewire Breast Cancer Localization With Magnetic Lymph Node Detection
Authors: Pantiora Eirini , Jazrawi Allan , Hersi Abdi-Fatah , Abdsaleh Shahin , Ahlstedt Hanna , Molnar Eva , Wärnberg Fredrik , Eriksson Staffan , Karakatsanis Andreas
Published: December 2023

Importance

Guidewires have been the standard for breast lesion localization but pose operative and logistic challenges. Paramagnetic seeds have shown promising results, but to the authors’ knowledge, no randomized comparison has been performed.

Objective

To determine whether the combination of a paramagnetic seed and superparamagnetic iron oxide (SPIO) is equivalent to guidewire and SPIO for breast cancer localization and sentinel lymph node detection (SLND).

Design, Setting, and Participants

This was a phase 3, pragmatic, equivalence, 2-arm, open-label, randomized clinical trial conducted at 3 university and/or community hospitals in Sweden from May 2018 to May 2022. Included in the study were patients with early breast cancer planned for breast conservation and SLND. Study data were analyzed July to November 2022.

Interventions

Participants were randomly assigned 1:1 to a paramagnetic seed or a guidewire. All patients underwent SLND with SPIO.

Main Outcomes and Measures

Re-excision rate and resection ratio (defined as actual resection volume / optimal resection volume).

Results

A total of 426 women (median [IQR] age, 65 [56-71] years; median [IQR] tumor size, 11 [8-15] mm) were included in the study. The re-excision rate was 2.90% (95% CI, 1.60%-4.80%), and the median (IQR) resection ratio was 1.96 (1.15-3.44). No differences were found between the guidewire and the seed in re-excisions (6 of 211 [2.84%] vs 6 of 209 [2.87%]; difference, −0.03%; 95% CI, −3.20% to 3.20%; P = .99) or resection ratio (median, 1.93; IQR, 1.18-3.43 vs median, 2.01; IQR, 1.11-3.47; P = .70). Overall SLN detection was 98.6% (95% CI, 97.1%-99.4%) with no differences between arms (203 of 207 [98.1%] vs 204 of 206 [99.0%]; difference, −0.9%; 95% CI, −3.6% to 1.8%; P = .72). More failed localizations occurred with the guidewire (21 of 208 [10.1%] vs 4 of 215 [1.9%]; difference, 8.2%; 95% CI, 3.3%-13.2%; P < .001). Median (IQR) time to specimen excision was shorter for the seed (15 [10-22] minutes vs 18 [12-30] minutes; P = .01), as was the total operative time (69 [56-86] minutes vs 75.5 [59-101] minutes; P = .03). The experience of surgeons, radiologists, and surgical coordinators was better with the seed.

Conclusions and Relevance

The combination of SPIO and a paramagnetic seed performed comparably with SPIO and guidewire for breast cancer conserving surgery and resulted in more successful localizations, shorter operative times, and better experience.

Trial Registration

ISRCTN.org Identifier: ISRCTN11914537
Ayadgar i Jamaspig
Authors: Agostini Domenico
Published: December 2023

Ayadgar i Jamaspig
(“The memorial of Jamasp”) is a popular ninth‐ and tenth‐century Zoroastrian text in Middle Persian preserved in different manuscript traditions. The narrative structure constitutes a question–answer dialogue between the Kayanid king and protector of Zoroaster, Wishtasp, and the clairvoyant par excellence, Jamasp. The wide variety of topics covered range from the creation of the world, and mythical and historical geography, to royal genealogy, apocalyptic events, and the final resurrection and restoration of creation by Ohrmazd. This text was probably conceived as an encyclopedia for laymen who were looking for hope and answers in a moment of political and religious crisis following the Muslim conquest of Iran.
Capturing the Range of Disease Involvement in Localized Scleroderma: The Localized Scleroderma Total Severity Scale
Authors: Li Suzanne C. , Rabinovich C. Egla , Becker Mara L. , Torok Kathryn S. , Ferguson Polly J. , Dedeoglu Fatma , Hong Sandy , Sivaraman Vidya , Laxer Ronald M. , Stewart Katie , Ibarra Maria F. , Mason Thomas , Higgins Gloria , Pope Elena , Li Xiaohu , Lozy Tara , Fuhlbrigge Robert C. ,   for the CARRA Registry Investigators
Published: December 2023

Objective

Juvenile localized scleroderma (jLS) is a chronic autoimmune disease commonly associated with poor outcomes, including contractures, hemiatrophy, uveitis, and seizures. Despite improvements in treatment, >25% of patients with jLS have functional impairment. To improve patient evaluation, our workgroup developed the Localized scleroderma Total Severity Scale (LoTSS), an overall disease severity measure.

Methods

LoTSS was developed as a weighted measure by a consensus process involving literature review, surveys, case vignettes, and multicriteria decision analysis. Feasibility was assessed in larger Childhood Arthritis and Rheumatology Research Alliance groups. Construct validity with physician assessment and inter‐rater reliability was assessed using case vignettes. Additional evaluation was performed in a prospective patient cohort initiating treatment.

Results

LoTSS severity items were organized into modules that reflect jLS disease patterns, with modules for skin, extracutaneous, and craniofacial manifestations. Construct validity of LoTSS was supported by a strong positive correlation with the Physician Global Assessment (PGA) of severity and damage and weak positive correlation with PGA‐Activity, as expected. LoTSS was responsive, with a small effect size identified. Moderate‐to‐excellent inter‐rater reliability was demonstrated. LoTSS was able to discriminate between patient subsets, with higher scores identified in those with greater disease burden and functional limitation.

Conclusion

We developed a new LS measure for assessing cutaneous and extracutaneous severity and have shown it to be reliable, valid, and responsive. LoTSS is the first measure that assesses and scores all the major extracutaneous manifestations in LS. Our findings suggest LoTSS could aid assessment and management of patients and facilitate outcome evaluation in treatment studies.

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Temperature‐Dependent Relationship of Autophagy and Apoptotic Signaling During Cold‐Water Immersion in Young and Older Males
Authors: King Kelli E. , McCormick James J. , Kenny Glen P.
Published: December 2023

Autophagy is a crucial cytoprotective mechanism preventing the accumulation of cellular damage, especially during external stimuli such as cold exposure. Older adults poorly tolerate cold exposure and age‐related impairments in autophagy may contribute to the associated reductions in cold tolerance. The purpose of this investigation is to evaluate the effect of different intensities of in vivo cold‐water immersion and in vitro cold exposure on autophagic and apoptotic signaling in young and older males. Peripheral blood mononuclear cells (PBMCs) are isolated at baseline, end‐cold exposure, and after 3 h of thermoneutral recovery. Additionally, PBMCs are treated with rapamycin and bafilomycin prior to in vitro cold exposure equivalent to in vivo core temperatures (35–37 °C). Proteins associated with autophagy, apoptosis, the heat shock response, and inflammation are analyzed via Western blotting. Moderate cold stress (0.5 °C decrease in core temperature) increased autophagic and heat shock protein activity while high cold stress (1.0 °C decrease in core temperature) augmented apoptosis in young males. In older males, minimal autophagic activation during both cold‐water exposures are associated with increased apoptotic and inflammatory proteins. Although in vitro cold exposure confirmed age‐related dysfunction in autophagy, rapamycin‐induced stimulation of autophagic proteins underlie the potential to reverse age‐related vulnerability to cold exposure.
Asymmetric Coordination of Iron Single‐Atom Nanozymes with Efficient Self‐Cascade Catalysis for Ferroptosis Therapy
Authors: Liu Wendong , Chen Qian , Wu Jiaxin , Zhang Fanghua , Han Lu , Liu Jia , Zhang Hongyan , Hao Zhe , Shi Enyu , Sun Yuzhu , Zhang Ruizhong , Wang Yinsong , Zhang Libing
Published: December 2023

Single‐atom nanozymes (SAzymes) hold great promise in tumor therapy due to their maximized atomic utilization and well‐defined electronic structures. However, they still face challenges of activity, specificity, and targeting that impede therapeutic efficacy. Herein, a practical strategy is reported to construct asymmetric N, S‐coordinated Fe SAzymes (Fe‐S/N‐C). Benefiting from the regulatory influence of S atoms on the disruption of local charge symmetry of center Fe atoms, the Fe‐S/N‐C SAzymes exhibit significantly enhanced peroxidase (POD)‐ and glutathione oxidase (GSHOx)‐like activities, with catalytic efficiencies being 6.33 and 47.88 times higher than their symmetric Fe‐N4 counterparts, respectively. Theoretical calculations demonstrate that the asymmetric atomic interface configuration increases electron localization around center Fe sites, thus facilitating the adsorption and activation of H2O2 and O2. By camouflaging with macrophage membranes, the tumor‐targeting nanocatalytic agents (M@Fe‐S/N‐C) trigger enhanced self‐cascade catalysis in the tumor microenvironment for ferroptosis‐based tumor‐specific therapy. These results open up a promising avenue for addressing the limitations associated with current SAzymes‐based tumor therapies.
Heterogeneous Cobalt Phthalocyanine/Sulfur‐Modified Hollow Carbon Sphere for Boosting CO2 Electroreduction and Zn–CO2 Batteries
Authors: Wang Huijie , Zhu Jiaye , Ren Xuhui , Tong Yun , Chen Pengzuo
Published: December 2023

Tuning coordination environment of single‐atom catalysts (SACs) is widely applied for the electrochemical CO2 reduction reaction (CO2RR). However, the influence of the interaction between SACs and support on the catalytic performance are not comprehensive. Herein, taking cobalt phthalocyanine (CoPc) as a conceptual example, a hetero S‐atom doping strategy of hollow carbon sphere (S‐NHC) is put forward as a carrier, revealing the intrinsic relationship between microenvironment regulation and catalytic activity of single Co‐atom. The additional S doping may induce more carbon defect and increases the content of pyrrolic N in the S‐NHC sample, leading to stronger electronic interaction of heterogeneous CoPc/S‐NHC for boosting CO2RR performance. Remarkably, the catalyst achieves a highest CO selectivity of nearly 100% at −0.6 V, and the FECO are over 90% in a wide potential range from −0.4 to −0.8 V in a flow cell. The maximum power density is high as 2.68 mW cm−2 at 4.7 mA cm−2 for the Zn–CO2 battery with CoPc/S‐NHC cathode. In situ attenuated total reflection infrared (ATR‐IR) spectroscopy reveals the formation of key *COOH and *CO intermediates, while the calculation result confirm the optimized Gibbs free energy of these intermediates on CoPc/S‐NHC, suggesting the feasibility of the regulation strategy.