bluuebunny/crossref_metadata_2025 huggingface dataset:
Quizlet Transforms Arabic Vocabulary Learning in Education
Authors: Agustine Rilla , Fauji Imam
Published: September 2024

This study explores the development of language vocabulary learning media for "Darsu Lughah Al Arabiyah" using the ADDIE model. With a focus on enhancing Arabic language education, we found a gap in effective vocabulary learning tools. We aimed to develop and evaluate a Quizlet-based vocabulary learning media. Through analysis, design, development, implementation, and evaluation stages, we transitioned from identifying the need for improved methods to implementing a technology-based solution. Results showed positive evaluations from media and material expert validators, with 88% and 96% approval rates, and 81.01% of students responded positively. Our findings suggest Quizlet media's suitability for Arabic vocabulary learning, with implications for future language education practices.
Highlight:

Enhanced Learning: Quizlet improves Arabic vocabulary acquisition in educational settings.
Structured Development: ADDIE model ensures systematic creation and evaluation of materials.
Positive Response: Students engage positively, indicating Quizlet's effectiveness in language learning.

Keywords: Arabic language education, Vocabulary learning media, ADDIE model, Quizlet, Educational technology
TPB Influence on Type 2 Diabetes Coding: Al-Islam H.M. Mawardi Hospital
Authors: Puspitasari Ayu Ferina , Cholifah Cholifah
Published: September 2024

This study applies the Theory of Planned Behavior (TPB) to qualitatively analyze the factors influencing coders' intentions in coding type 2 diabetes mellitus at a general hospital. Conducted from February to July 2023, data were collected through interviews and questionnaires with two outpatient coder officers. Findings indicate that coding background, officer acumen, workload, legibility of doctors' writing, availability of coding resources, data clarity, familial support, peer influence, and environmental factors significantly influence coders' intentions. Moreover, factors such as coder knowledge and experience, as well as opportunities for continuous learning, play pivotal roles. These findings underscore the importance of addressing various determinants to enhance coding accuracy and efficiency, thereby improving healthcare management and resource allocation.
Highlights :

Coders' intentions in coding T2DM elucidated through TPB analysis.
Influential factors include coding background, workload, and availability of resources.
Addressing determinants crucial for enhancing coding accuracy and healthcare efficiency.

Keywords: TPB analysis, type 2 diabetes mellitus, outpatient coders, coding behavior, healthcare management
Cash Assistance: Addressing COVID-19 Pandemic-induced Poverty
Authors: Khisbi Mochammad Alfalah , Rodiyah Isnaini
Published: September 2024

This study employs Edward III's policy implementation theory to examine the implementation of the Social Cash Assistance (BST) program in Gebang Village, Sidoarjo Regency. Utilizing a descriptive qualitative method with data gathered through observation, interviews, and documentation, the research identifies communication, resources, dispositions, and bureaucratic structure as critical factors. The findings reveal that the BST program in Gebang Village has been effectively executed, with robust communication facilitated through coordination meetings and outreach. Human resources, comprising village employees and supporting staff, demonstrate high commitment and operate within health protocol guidelines. Despite optimal implementation, challenges such as limited beneficiaries, social jealousy, and program discontinuation in 2022 are identified. The study underscores the need for addressing these challenges to enhance the program's sustainability and effectiveness.
Highlight :

The study employs Edward III's policy implementation theory to analyze the optimal execution of the Social Cash Assistance (BST) program in Gebang Village, Sidoarjo Regency.
Effective communication strategies, including coordination meetings and program outreach, contribute to the successful implementation of the BST program, ensuring high commitment from the village employees and supporting staff.
Identified challenges, such as limited beneficiaries, social jealousy, and the discontinuation of the BST program in 2022, underscore the importance of addressing obstacles for enhanced program sustainability and effectiveness.

Keywords: Social Cash Assistance, Implementation, Gebang Village, Policy, Challenges
Sustainable Organic Waste Management for Village SDGs
Authors: Ilalfiah Luluk , Agustina Isna Fitria
Published: September 2024

This study employs a qualitative descriptive analysis method to investigate the sustainable management of organic waste in Ketapang Village, aligning with the Sustainable Development Goals (SDGs). Utilizing observation and interviews, the research applies Haris's theory to analyze economic, social, and environmental sustainability aspects. Findings reveal three key aspects: economic sustainability through the development of fruit-picking tourism, environmental sustainability via ecosystem preservation, and social sustainability by enhancing community skills. The study provides valuable insights into organic waste management, offering a reference for improving its quality and contributing to the broader objectives of sustainable development.
Highlight :

Economic Empowerment: The study emphasizes the development of fruit-picking tourism as a means to generate employment and economic benefits, contributing to the financial sustainability of Ketapang Village.

Environmental Preservation: The research underscores the importance of organic waste management in preserving ecosystems, ensuring their sustainability to support present and future life in the village.

Community Skill Enhancement: The study highlights the social sustainability aspect, focusing on the improvement of community skills, indicating a positive impact on local human capital and community development.

Keywords: Sustainable Development Goals, Organic Waste Management, Ketapang Village, Economic Sustainability, Social and Environmental Impact.
Implementation of the SIPRAJA Program Towards E-Government-Based Public Services
Authors: Nisak Khoirun , Sukmana Hendra
Published: September 2024

This study explores the implementation of SIPRAJA, an e-government platform, in a rural Indonesian village. Using a qualitative approach and T.B. Smith's framework, we analyzed the interaction between policymakers, target groups, implementing organizations, and environmental factors influencing its adoption. Findings reveal positive community reception, highlighting SIPRAJA's potential to streamline public services. However, limited outreach and technical challenges raise concerns about inclusivity and sustainability. This research suggests targeted awareness campaigns and infrastructure improvements are crucial for bridging the rural-urban digital divide and maximizing the impact of e-government initiatives.
Highlight :

Positive community reception: SIPRAJA shows potential to improve public services in rural areas through streamlined access.
Limited outreach and technical challenges: Concerns remain regarding inclusivity and sustainability due to lack of awareness and infrastructure.
Bridging the digital divide: Targeted campaigns and infrastructure improvements are crucial for successful e-government initiatives in rural areas.

Keywords: e-government, rural Indonesia, SIPRAJA platform, digital divide, inclusivity
The Service of Trans Jatim Bus Transportation by means of Public Value Approarch
Authors: Rodiyah Isnaini , Ikhtiarini Eva Ilifiyah
Published: September 2024

This study investigates the public value of the Trans Java East bus rapid transit (BRT) system, implemented to address urban congestion in Indonesia. Employing descriptive research methods with data collected through observation, interviews, and literature review, the analysis finds that while Trans Java East meets public value criteria for accessibility, affordability, and comfort, it falls short in fully mitigating congestion. Recommendations for optimization include route expansion, improved integration with other modes of transport, and enhanced operational efficiency. The study concludes that regional BRT systems, despite limitations, offer attractive mobility alternatives and require continuous development to maximize their impact on urban transport challenges.
Highlight :

Reduces congestion: While not a complete solution, Trans Java East offers a more attractive alternative to private vehicles, potentially easing traffic in the region.
Public service fulfillment: Launched by the East Java government, this bus service aims to address the need for reliable and accessible public transportation, fulfilling a crucial responsibility.
Promising, but needs improvement: The research finds Trans Java East meets public value criteria in principle, but highlights areas for development, such as further optimization of routes and schedules

Keywords: East Java Trans Bus, public value, congestion, accessibility, improvement
Implementation of Family Hope Program (PKH)
Authors: Jannah Miftahul , Rodiyah Isnaini
Published: September 2024

This study examines the implementation of a conditional cash transfer program (CCT) in a rural Indonesian village using Charles O. Jones' model of policy execution. Qualitative data collected through observation, interviews, and documentation revealed the program's strengths and weaknesses. While organizational structures and policy interpretations aligned with central government guidelines, limitations emerged in program application. Key shortcomings included inadequate human resource allocation for participant monitoring, lack of access to necessary facilities, and insufficient community awareness. These findings highlight the importance of context-specific adjustments and improved resource allocation within CCT programs to maximize their impact.
Highlight :

Organizational structures and policy interpretations: The study found that the program's organizational structures and policy interpretations aligned with central government guidelines.
Limitations in program application: Key shortcomings included inadequate human resource allocation for participant monitoring, lack of access to necessary facilities, and insufficient community awareness.
Context-specific adjustments and improved resource allocation: The findings highlight the importance of context-specific adjustments and improved resource allocation within CCT programs to maximize their impact.

Keywords: Conditional Cash Transfer (CCT), Charles O. Jones' model, policy execution, rural Indonesian village, strengths, weaknesses.
Implementation of E-Government Through E-Buddy in Sidoarjo Regency
Authors: Nadila Difta Izza , Choiriyah Ilmi Usrotin
Published: September 2024

This study examined the implementation of E-Buddy, an electronic official letter system, in a rural Indonesian village. Using observation, interviews, and document analysis, we found that while legal and technological frameworks were in place, human infrastructure posed significant challenges. Officials lacked training and understanding of E-Buddy, hindering its effectiveness. This highlights the crucial role of user-centric design and capacity building in successful e-government initiatives, particularly in resource-constrained settings.
Highlight :

The implementation of E-Buddy, an electronic official letter system, faced challenges due to inadequate communication and technical guidance
The study revealed that the human resources, particularly the ability of village officials to adapt to the E-Buddy application, were not fully equipped for its implementation
The research emphasizes the importance of user-centric design and capacity building in e-government initiatives, especially in resource-constrained settings

Keywords: E-Government, E-Buddy, Implementation, Rural Village, Indonesia
Implementation of Sidoarjo People's Service System (SiPraja)
Authors: Ningtias Mala Nuraif Tri , Mursyidah Lailul
Published: September 2024

This study explores the implementation of the Sidoarjo People's Service System (SiPraja) in Boro Village, Tanggulangin District, Sidoarjo Regency, focusing on factors influencing its execution. Using purposive sampling, the research identifies communication, resources, disposition, and bureaucratic structure as key factors affecting policy implementation, in line with George Edward III's framework. Findings reveal that SiPraja has been effectively implemented, with bidirectional communication and sufficient human and infrastructural resources. However, challenges persist in the disposition, particularly in adapting to the SiPraja application, and the absence of a standard operating procedure in Boro Village. This study contributes to the understanding of innovative public service systems, emphasizing the need for addressing disposition challenges for enhanced effectiveness.
Highlight :

Effective Bidirectional Communication: SiPraja's success is attributed to robust bidirectional communication, fostering interaction between citizens and government officials.

Resource Sufficiency: Human resources, facilities, and infrastructure are deemed adequate, contributing to the seamless implementation of SiPraja.

Disposition Challenges: Despite overall success, challenges in user disposition towards the SiPraja application highlight the need for targeted interventions and training.

Keywords: SiPraja, Public Service Innovation, Policy Implementation, Bureaucratic Reform, Communication
Financial Performance, Dividend Policy, and Firm Value in Indonesian Consumer Goods Sector: 2019-2021 Study
Authors: Nurfitriana Yunnisa , Widodo Heri
Published: September 2024

This study investigates the nexus between return on assets (ROA), return on equity (ROE), dividend payout ratio (DPR), and firm value, represented by stock prices, within the consumer goods industry sector on the Indonesia Stock Exchange from 2019 to 2021. Utilizing a sample of 26 companies, employing Partial Least Square (PLS) analysis, the research reveals that neither ROA nor ROE significantly influences stock prices, and ROE exhibits no impact on DPR. Moreover, DPR fails to influence stock prices, and it cannot serve as an intervening variable between ROA or ROE and stock prices. These findings suggest a decoupling between financial performance metrics and market valuation within the consumer goods sector, urging a reconsideration of conventional wisdom regarding the determinants of stock prices in this industry
Highlights :

Limited Influence of ROA and ROE: The study reveals that return on assets (ROA) and return on equity (ROE) do not significantly impact stock prices in the consumer goods sector.
Mediation Role of DPR: Dividend payout ratio (DPR) fails to mediate the relationship between ROA or ROE and stock prices, indicating its limited influence on market valuation within the sector.
Implications for Market Valuation: The findings challenge traditional assumptions about the determinants of stock prices in the consumer goods industry, prompting a reevaluation of financial performance metrics' relevance in market valuation.

Keywords: Consumer Goods Sector, Stock Prices, ROA, ROE, DPR
Юқори тартибли эгри чизиқларни ҳосил бўлишида подерик алмаштиришлар усулининг қўлланиши
Authors: Каримович Муродов Шмидт , Хурсонали уґли Ортиков Азиз
Published: September 2024

Ушбу мақолада подерик алмаштиришлар усули билан 3 ва 4- тартибли ажойиб эгри чизиқларнинг хосил бўлиши ва ясалиши  ҳақида маьлумотлар келтирилади.
Some Reflections On The Historical Significance Of The Activities Of Mahmudhoja Behbudi
Authors: Ahmadov Sabriddin  , Mamataliyeva Surayyo Bobomuratovna
Published: September 2024

This article provides information about the activities of a prominent figure of the Jadid movement in Central Asia, Mahmudhoja Behbudi, in public and political life. Opinions will be expressed about the activities of Behbudi to popularize science and education in society, his work in this direction, his invaluable contribution to the development of culture and education, theater, etc.
The Hays Of Teaching Students To Creative Thinking Through Practical Courses
Authors: Niyozali Olimov  , Zamira  Karimova
Published: September 2024

This article describes the problem of increasing the self-activity of the assimilation of knowledge independent thinking by organizing self-education in higher educational institutions.
Challenging Problems Of Preparing Children For Preschool In Preschool Institutions
Authors: Ranokhon Ismoilova  , Sardorbek Kosimjon Ugli Gulomjonov
Published: September 2024

This article analyzes important aspects of preparing a child for school. Features such as independence, organization and discipline in the personal behavior of a child of adult preschool age are important in the implementation of moral and voluntary preparation for school. It is the ability to follow the rules of behavior that are inherent in independence, to use the right routines in the new environment, and to be willing to help.
Trajectories of Risk in Early Psychosocial Development: Children of Mothers Exposed to Intimate Partner Violence from Refugee and Non-Refugee Backgrounds in a High-Income Country.
Authors: Rees Susan , Fisher Jane , Whitten Tyson , Dean Kimberlie , Green Melissa , Hassoun Fatima , Moussa Batool , Nadar Nawal , Tay Alvin , Mccormack Clare , Steel Zachary , Silove Derrick
Published: September 2024

Early childhood exposure to maternal experiences of intimate partner violence is associated with a range of emotional and behavioural problems. Using five timepoints of annually collected data from the WATCH mental health cohort study of 870 mother-child dyads, half from refugee background, we prospectively examined the impact of maternal perinatal intimate partner violence exposure on children’s risk trajectories of social-emotional development from around two to five years of age. Maternal IPV exposure to physical abuse with or without psychological abuse at baseline was independently associated with 2.45 times greater odds of children following the “intermittent risk” development trajectory, and 4.90 times greater odds of children following the “high increasing risk” trajectory, compared to those in the “none or low risk” group. Children in the “high increasing risk” trajectory were more likely to be male, and mothers were more likely to be born in Australia, have no tertiary education, and experience social difficulties. The study contributes significantly to understanding the deleterious impact of IPV on child development over time, and the risk and protective factors relevant for safeguarding women and ensuring the optimal development of children.
Rotigotine-induced leukoderma; a case report and literature review
Authors: Bondariyan Niloofar , Golsorkhi Mohadese , Dashtipour Khashayar
Published: September 2024

Introduction:
Rotigotine is a dopamine receptor agonist commonly prescribed for Parkinson’s disease (PD) and restless leg syndrome. Although some common side effects have been previously reported, the rotigotine induced leukoderma is a very rare presentation.
Case Presentation:
Herein, we report a 37-year-old female with PD who developed depigmentation patches after one year of rotigotine application. Dermatology consultation reported drug-induced leukoderma, and topical steroid, narrow-band ultraviolet B, and ruxolitinib were administered. Her depigmentation spots started to improve while rotigotine was continued.
Conclusions
This case highlights the potential for ritogotine to induce skin depigmentation and emphasizes the need for continued observation and reporting of such adverse effects.
Novel Stent Graft Design to Reduce Access Site Puncture Diameter for Endovascular Repair of Infra-Renal Abdominal Aortic Aneurysms: First Two Cases
Authors: Adiarto Suko , Kang Sung Gwon , Taofan Taofan , Indriani Suci , Setiawan Moira , Kurnianingsih Novi , Dakota Iwan , Uberoi Raman
Published: September 2024

We report on an innovative approach in two patients to reduce the access size in the contralateral access which has the potential to reduce access site complications, particularly in patients with smaller femoral arteries. The device is developed by using a standard EVAR device with customized modification of its structure according to the patient’s anatomy. It comprises of a bifurcated stent graft. a proximal extension graft and a contra-lateral limb extension. In our first two cases, we demonstrated that our design, which include direct flow from the abdominal aorta to the ipsilateral limb and retrograde flow to contra-lateral limb worked very well in terms of sealing, with no endoleaks observed, as well as inflow in the stent graft. While long-term results and further refinement are awaited, this approach holds potential in reducing access-related complications and expanding the options for EVAR in patients with small femoral arteries.
Government Subsidies, Executive Incentives, and Firm Performance: A Tripartite Evolutionary Game Analysis
Authors: Jiang Chenxi , Luo Yiheng
Published: September 2024

This study delves into the mechanisms of effective collaboration among governments, enterprises, and executives to achieve the dual goals of environmental conservation and economic growth within the framework of oversight on environmental, social, and governance (ESG) performance. A tripartite game-theoretic model is developed, and a numerical simulation is carried out using MATLAB 2016a. The findings reveal that enterprises and executives may choose passive participation in environmental protection strategies or engaging in free-riding behaviors because of weak government supervision when the government’s regulatory benefits is less than the subsidy costs, primarily due to insufficient government punishment. Conversely, the positive participation is chosen when the incentives surpass the costs of active engagement among the trad. This suggests enhancement of government monitor and evaluation mechanisms to guarantee the effective allocation of subsidies, coupled with substantive environment actions by enterprises and executives. Forster a strategic shift towards sustainable development, thereby improving the company’s ESG performance.
Prevalence, rate, and predictors of virologic failure among adult HIV-Infected clients on second-line antiretroviral therapy (ART) in Tanzania (2018-2020): A retrospective cohort study
Authors: MWAVIKA ESTER TIMOTHY , Kunambi Peter Ponsian , Masasi Samuel Joseph , Lema Nsiande , Kamori Doreen , Matee Mecky
Published: September 2024

Background
Antiretroviral Therapy (ART) has been proven to be highly effective in reducing the impact of Human Immunodeficiency Virus (HIV) infection. However, as more people receive initial ART treatment, the risk of developing resistance and eventual treatment failure increases, leading to the need for second-line treatment regimens. Understanding the factors that contribute to virologic failure to second-line ART is crucial in preventing switching to the more expensive and toxic third-line regimens. This study provides information on the prevalence, rate, and predictors of virologic failure (VF) among clients on second-line ART in Tanzania.
Results
We followed 4,718 clients for 15,100 person-years (PY) of observations. Of them, 1,402 experienced virologic failure, equivalent to 29.72% at a rate of 92.85 per 1000 PY of observations (95% CI 88.11, 97.84). Factors that were associated with VF included: having a viral load count of ≥ 1000 copies/mL during first-line ART, with a hazard ratio (HR) (4.65 (95% CI 3.57, 6.07), using lopinavir (LPV/r) as a protease inhibitor during second-line ART (HR 4.20 (95% CI 3.12, 7.10), having a CD4 count < 200 cells/mm3 during second-line ART (HR 1.89 (95% CI 1.46, 2.44), and being on ART for 13–35 months (HR 8.22 (95% CI 2.21, 30.61). Paradoxically, having a CD4 count < 200 cells/mm3 during first-line ART treatment was associated with a reduced risk of virologic failure (HR 0.77 95% CI 0.60, 0.99).
Conclusions
In Tanzania, approximately 30% of the adult clients on second-line ART experience VF at a rate of 92.71 per 1000 person-years. This high virologic failure rate highlights the need for targeted interventions for HIV-infected clients on second-line ART to reduce the need for switching to the more costly and relatively more toxic third-line ART therapy and help to achieve the third UNAIDS goal of achieving viral suppression for 95% of those treated by 2030.
Opportunities to Advance Equity Through Implementation Strategy Design
Authors: HOSKINS KATELIN , Maye Melissa , Wright Leslie , Jager-Hyman Shari , Wolk Courtney Benjamin , Ahmedani Brian , Boggs Jennifer M , Johnson Christina , Linn Kristin , Quintana LeeAnn , Pappas Celeste , Beidas Rinad S
Published: September 2024

Background: Implementation strategies are potential tools for advancing equity goals in healthcare. Implementation scientists have increased attention to the integration of equity considerations into implementation research, but limited concrete guidance is available for developing implementation strategies to improve equity.
Main: In parallel to an active hybrid effectiveness-implementation trial in two large health systems, our research team explored potential inequities in implementation across four non-study clinics, developed equity focused audit and feedback procedures, examined the feasibility of our approach, and identified design insights that could be tested in future work to inform equitable program scale-up. Based on our experiences deploying these strategies in pilot format, our research team identified key complexities meriting further examination in future work. These considerations are vital given the dearth of guidance on delivering feedback to clinicians in efforts to improve equity. Key takeaways include the importance of understanding local data culture, engaging constituents in co-design for the full feedback cycle, leveraging feedback for shared discourse, and centering multi-level strategies as part of robust implementation approaches.
Conclusion: Prioritizing health equity in implementation science requires that research teams probe, interrogate, and innovate – and in doing so, grapple with central conceptual and pragmatic considerations that arise in the design of implementation strategies. Our work emphasizes the value of bidirectional and continuous learning.
Application of Buckling restrained braces as lateral strengthening method for on-slopping ground reinforced concrete frame structures under severe earthquake loads
Authors: Niyonyungu Ferdinand
Published: September 2024

Buckling restrained braces (BRB) have been proven to be one of the critical horizontal loads resisting structural elements due to their energy dissipation characteristics. Through numerical computational methods using finite element software ETABS, seismic characteristics of- slopping round reinforced concrete frames with different slopes were studied and buckling restrained braces ‘strengthening schemes against their irregularity were proposed. Response spectrum analysis has been used to study the characteristics of typical on-sloping ground frame structures located in regions with seismic intensity eight by using Chinese code for seismic design of building structures GB 2011-2010. It has been found that as the slope increases, the deflection increases, and the period of vibration decreases. It has also been determined that when the slope is only in one direction, the discrepancy between X and Y direction responses will increase as the angle of inclination increases; lastly, it has been found that this type of frame structure will suffer from stiffness irregularity with the severity that increases as the angle of inclination increases. Recent literature has also determined and confirmed that structures on the sloping ground will suffer uneven distribution of internal forces due to the constraints of the columns on the upper side of the slope. To correct all these characteristics, buckling restrained braces were proposed and compared with ordinary steel braces using nonlinear time history analysis. Our results demonstrate that BRB can handle safety issues associated with slopping ground-reinforced concrete frame structures.
Construction and validation of a predictive model for malignant tumors in patients with membranous nephropathy
Authors: Zhai Yaling , Sun Shuaigang , Zhang Wenhui , Tian Huijuan , Zhao Zhanzheng
Published: September 2024

Background
The association between membranous nephropathy (MN) and malignant tumor has long been focused. However, existing studies mostly focused on patients diagnosed of malignant tumors within a limited timeframe (typically defined as 1 year) before or after the diagnosis of MN. Actually, this represents only a subgroup of MN patients complicated with malignant tumors, and those complicated with malignant tumors without a limited period of time haven’t received attention and research. In this study, we aimed to explore the clinicopathologic characteristics of MN patients complicated with malignant tumors, and establish an effective predictive model for identifying the risk of malignant tumors in patients with MN.
Methods
A total of 194 MN patients with malignant tumors and 604 idiopathic MN patients without malignant tumors were retrospectively recruited in this study. All of the patients were then randomly separated (3:1) into the training cohort (n = 599) and the validation cohort (n = 199). A predictive model was constructed based on regression analysis and the model performance, calibration ability and clinical utility were subsequently assessed via the area under the ROC curve (AUC), calibration curve and decision curve analysis (DCA).
Results
A predictive model basedd on age, hemoglobin, degree of arteriole injury, glomerular IgG1, IgG2, IgG3, IgG4, and PLA2R deposition were constructed. The predictive model exhibited a diagnostic power of 0.890 and 0.960 in the training and validation cohorts, respectively, and was validated to demonstrate strong calibration capability and clinical utility.
Conclusion
In this largest cohort with MN and malignant tumors up to date, we constructed a model based on clinical and pathological parameters, to effectively estimate the risk of malignant tumors in patients with MN. This tool aims to assist clinicians in their decision-making process and improve the prognosis for high-risk MN patients by facilitating tumors screening at the time of initial diagnosis.
Title: Investigating Spontaneous Regression in Large Congenital Melanocytic Nevus: A Single-Cell Transcriptomic Study
Authors: Jin Jiamin , Lai Bohan , Gu Jieyu , Yang Ran , Wei Boxuan , Xie Feng
Published: September 2024

Background
Large congenital melanocytic nevus (LCMN) is a lifelong and potentially malignant skin melanocytic tumor. Case reports have documented spontaneous hypopigmentation of congenital melanocytic nevi, with histological evidence of immune cell infiltration in the lesions.
Objective
To explore the mechanism behind the spontaneous regression of LCMN.
Methods
Using Sanger sequencing and 10x Genomics single-cell RNA sequencing technology, we analyzed the genotype and cell population transformations during the spontaneous regression of LCMN.
Results
Our findings highlight the pivotal role of IFN-II in regressing LCMN by reversing immune evasion. IFN-II stimulates melanocytes, enhancing their antigen presentation function to recruit cytotoxic immune cells. Endothelial cells and fibroblasts further amplify the inflammatory response and help reconstruct the tumor microenvironment. The regressed LCMN displayed a marked reduction in melanocytes, increased immune cell infiltration, and remodeling of the tumor microenvironment, characterized by angiogenesis and fibroblast activity.
Conclusion
This study is the first to apply single-cell RNA sequencing technology to LCMN. Our unique sample provides novel insights into the tumor microenvironment of LCMN and its immune mechanisms, offering potential avenues for immunotherapy. Our findings suggest that IFN-II therapy, TIL therapy, and DC immunotherapy could be promising treatment options for LCMN, pending further validation in larger patient cohorts and transgenic animal models.
Investigating the Impact of Rotational Training Structures on Ownership in Public Health: A Qualitative Study
Authors: Taks N.J.L.M. , Rossum T.R. van , Warris L.T. , Reurslag E. , Sadrzadeh S.
Published: September 2024

Introduction: Postgraduate medical education (PGME) relies on structured training rotations and workplace-based learning (WBL) to provide comprehensive clinical training and professional development. Emphasizing WBL, PGME integrates theoretical knowledge with practical skills through direct patient care involvement, underscoring the pivotal role of training institutes in supporting these initiatives. While curricular changes in PGME have been extensively studied in clinical teaching hospitals, PGME programs in Public Health (PGME-PH) remain underexplored, yet their multidisciplinary nature post-COVID-19 underscores the urgency for effective curricular reforms. This study explores how training institutions offering PGME-PH navigate the adoption of structured training rotations by examining organizational perspectives to enhance sustainability and integration of educational innovations in this unique context.
Methods: Semistructured interviews were conducted with 14 participants from training institutions offing PGME-PH in the Netherlands between October and November 2022 to explore their experiences with the implementation of a rotational training structure. The interviews were guided by the Consolidated Framework for Implementation Research (CFIR).
Results: The analysis identified three pivotal themes influencing sustainable implementation and ownership: influence, communication, and motivation. Participants expressed concerns about reduced influence in organizing PGME-PH and noted significant communication challenges, such as ambiguity in roles, program frameworks, and financial aspects. Despite these obstacles, participants showed strong motivation for education and underscored the importance of collaboration and shared responsibility.
Conclusion: The successful implementation of structured training rotations was negatively impacted by training institutions’ experience of limited influence and communication challenges. This led to diminished ownership of the new PGME-PH curriculum, potentially affecting its long-term sustainability. Despite these challenges, participants maintain high motivation for educational delivery. Enhancing sustainable implementation requires fostering ownership, promoting collective responsibility, establishing clear communication channels, and nurturing motivation. These factors are crucial for ensuring the success and longevity of educational programs such as PGME-PH.
Investigating the gut microbiome in Schizophrenia cases versus controls: South Africa’s version
Authors: Rust Carlien , Asmal Laila , O'Hare Michaela , Pretorius Etheresia , Emsley Robin , Seedat Soraya , Hemmings Sian
Published: September 2024

Background
Schizophrenia (SCZ) is a chronic and severe mental disorder with a complex molecular aetiology. Emerging evidence indicates a potential association between the gut microbiome and the development of SCZ. Considering the under-representation of African populations in SCZ research, this study aimed to explore the association between the gut microbiome and SCZ within a South African cohort.
Methods
Gut microbial DNA was obtained from 89 participants (n = 41 SCZ cases; n = 48 controls) and underwent 16S rRNA (V4) sequencing. Data preparation and taxa classification were performed with the DADA2 pipeline in R studio followed by diversity analysis using QIIME2. Analysis of Compositions of Microbiomes with Bias Correction (ANCOM-BC) was utilised to identify differentially abundant taxa.
Results
No statistically significant differences were observed between SCZ patients and controls in terms of alpha-diversity (Shannon q = 0.09; Simpson q = 0.174) or beta-diversity (p = 0.547). Five taxa, namely Prevotella (p = 0.037), Faecalibacterium (p = 0.032), Phascolarctobacterium (p = 0.002), Dialister (p = 0.043), and SMB53 (p = 0.012), were differentially abundant in cases compared to controls, but this observation did not survive correction for multiple testing.
Conclusion
This exploratory study suggests a potential association between the relative abundance of Prevotella, Faecalibacterium, Phascolarctobacterium, Dialister, and SMB53 with SCZ case-control status. Given the lack of significance after correcting for multiple testing, these results should be interpreted with caution. Larger studies are warranted to confirm these findings and to better comprehend the associations between the gut microbiome and SCZ.
Mechanical ventilation and length of stay prediction using heart rate variability at ICU admission in Covid-19 patients in sitting position: a prospective study
Authors: FARIÑA-GONZÁLEZ Tomás Francisco , MARTINEZ-SAGASTI Fernando , HERNANDO María Elena , OROPESA Ignacio , NUÑEZ-REIZ Antonio , GONZÁLEZ-GALLEGO Miguel Ángel , LATORRE Julieta , QUINTANA-DIAZ Manuel
Published: September 2024

Background
heart rate variability (HRV) is an important part of cardiovascular response to stress. Literature about the utility of HRV to predict intubation and invasive mechanical ventilation (IMV) need in Covid-19 patients is scarce. We analysed if HRV metrics could be used to identify, in the first 24 hours from admission in the intensive care unit (ICU), those patients who were going to need IMV during their stay.
Methods
we conducted a prospective single-centre observational study. Adult patients admitted in the ICU with respiratory failure due to RT-PCR-confirmed SARS-CoV-2 but not under IMV were included. Electrocardiogram (EKG) was recorded at least for 15 minutes at 500 Hz during a stable sitting condition, in the morning time. Power spectrum was obtained using wavelets. We also analysed non-linear HRV dynamics.
Results
27 patients were included. We found no differences in HRV metrics between groups. However, in the linear regression model for ICU length-of-stay (ICU LOS), we found that DFA⍺2 (OR -64.16; 95% CI: -3.497–0.832, P = 0.013), Fi02 (OR 0.37; 95% CI: 0.032–0.71, P = 0.033) and temperature (OR 16.02; 95% CI: 3.537–28.5, P = 0.014) were associated with longer ICU LOS. When performing bivariate correlation in patients lately intubated (Spearman`s test, n = 15), only DFA⍺2 was correlated (r -5.11, p = 0.05) with ICU LOS.
Conclusion
We found that HRV on ICU admission did not discriminate patients that might require IMV. DFA⍺2 was the HRV variable with the strongest association with ICU LOS along with other easy-to-collect clinical variables. These results could be helpful for newer prognostication tools.
A Practical Example of the Relevance of Computational Psychometric Experiments in Clinical Scale Validation
Authors: Poli Alizée , Thiriet Jade , Altakroury Hamza , Ecosse Sarah , Mahdar-Recorbet Loann , Stortini Natacha , Duman Coralie , Koïdé Nami , Trognon Arthur
Published: September 2024

At the core of effective clinical diagnostics using psychometric instruments relies to a strong specificity of the target psychological constructs. Recent computational methods thus hold promises to significantly advance psychometrical validation paradigms. Using DSM-5-Tr criteria, we developed a scale to identify high-functioning autism, which was then administered to 110 high-functioning autism patients and 110 control subjects. Relevant items were selected using multiple regression procedures, and its psychometric properties were evaluated through measures of internal consistency, factor analysis, and a comparative computational experiment using several XGBoost-type algorithms. However, although traditional metric measurements were satisfactory, the subsequent comparative computational experiment was unable to demonstrate significantly superior performance of models trained with the study scale compared to models trained on comorbidity scales. These findings underscored the importance of computational psychometrics in confirming that the constructs measured by clinical scales are specific to the conditions they are intended to distinguish, providing a critical control step that might constitute a new canon in psychometric validation procedures.
The Role of Competition, Earned Money and Personal Characteristics in Climate Games
Authors: Mokos Judit , Vásárhelyi Zsóka , Kovács Zoltán , Král Adrienn , Kiss Hubert János , Scheuring István
Published: September 2024

Using different variants of the classic climate game, we investigate the role of competition and the source of endowment (windfall vs. earned). Participants completed a detailed personality test (including climate attitudes and economic preferences) before the experiment and were asked about their strategies afterwards. We find that competition did not significantly affect whether groups reached the target, even though the probability of achieving the common goal was lower in the presence of competition. Participants cooperated more when they had to earn the endowment. Based on the pre-experiment questionnaire, participants who viewed their personal actions as more important and effective in combating climate change were more likely to cooperate in the climate game, while the rest of the measured personality items did not exhibit a consistent pattern. Analysis of the post-experiment survey indicates that those who aimed to maximise earnings contributed less to the common pool. In contrast, those who believed the goal was achievable and aimed to achieve it contributed more to the common pool throughout the game.
miR-485-5p acts as a negative regulator of sepsis-associated acute kidney injury through targeting ICAM-1
Authors: Wang Rui , Wang Yongheng , Li Shuang , Zhang Yu , Qin Sisi , Chen Yulu , Cheng Aibin , Liu Nan , Cao Fuyuan , Bai Jing
Published: September 2024

Sepsis is a complex disease involving multiple organs, with high morbidity and mortality rates, and high patient admission rates to intensive care units. The pathogenesis of the kidney: a highly affected organ during sepsis, is markedly complex. Notably, an increase in levels of intercellular adhesion molecule-1 (ICAM-1) plays a key role in sepsis-associated acute kidney injury. During sepsis, the activation of neutrophils leads to a significant increase in ICAM-1 expression, particularly in renal tubular epithelial cells, leading to the continuous exposure of the renal unit to injury factors. The present study aimed to identify ICAM-1 as a target gene of microRNA (miR)-485-5p. Notably, results of the present study demonstrated that ICAM-1 expression was negatively associated with miR-485-5p in mice with sepsis. Moreover, following treatment with the miR-485-5p mimic, expression of ICAM-1 was inhibited and renal injury was mitigated. Collectively, results of the present study indicated that ICAM-1 inhibition via regulation of miR-485-5p expression may exhibit potential in the treatment of renal injury in sepsis.
Gas Production Characteristics of Small Intestinal Bacteria in Patients with Colorectal Cancers: A Study Using the Lactulose Breath Test
Authors: Chen Wei-Ran , Hu Dong-Xia , Liang Xiao-Feng , Zhong Hao-Jie , He Xing-Xiang
Published: September 2024

Background Colorectal cancers (CRC) have been suggested to be involved with coliform bacteria, while the association with small intestinal bacteria is not clear. The study objective was to investigate the relationship between patients with CRC and the gas production characteristics of small intestinal bacteria using the lactulose breath test (LBT).Methods Data on age, gender, body mass index (BMI), hydrogen and methane concentrations at various time points, and colonoscopy results of patients with bowel diseases were collected from 2017 through 2023. The gas production characteristics of small intestinal bacteria were analyzed in patients with functional and organic bowel diseases, particularly in those patients with polyps and CRC. Additionally, receiver operating characteristic (ROC) analysis was performed to differentiate between these conditions.Results A total of 274 patients with functional bowel diseases, 274 patients with organic bowel diseases, 214 patients with polyps, and 18 patients with CRC were included. Methane concentrations in patients with organic bowel diseases, whether polyps or CRC, were significantly higher than in those with functional bowel diseases. Conversely, hydrogen concentrations were significantly higher in patients with functional bowel diseases compared to those with organic bowel diseases and polyps at certain time points. The area under the curve (AUC) for the methane concentrations at the 60-minute mark in predicting CRC was 0.7104 (95% confidence interval, 0.6166–0.8042). Among patients with CRC, hydrogen concentrations were significantly higher in those with CRC compared to those with polyps.Conclusions There were distinct features of hydrogen and methane production in patients with organic bowel diseases compared to those with functional bowel diseases. Patients with CRC or polyps exhibited higher methane concentrations. Additionally, the LBT appears to be a promising tool for distinguishing functional bowel diseases and CRC.
Neutrophil extracellular traps enhance procoagulant activity and predict poor prognosis in patients with metastatic breast cancer
Authors: Gong Youwei , Chen Binjie , Huang Zhen , Qin Qinghong , Tan Qixing
Published: September 2024

Background
Neutrophil extracellular traps (NETs) are associated with poor prognosis and an increased risk of venous thromboembolism (VTE) in metastatic breast cancer (MBC). This study aims to determine whether NETs promote hypercoagulability and if NETs and plasma hypercoagulability markers are biomarkers of survival in MBC.
Methods
Circulating levels of neutrophil extracellular trap (NET) markers and hypercoagulability markers (TAT, fibrinogen, and D-dimer) were assessed in 112 MBC patients before treatment, compared to 55 healthy controls. Stratified by NET levels and plasma TAT, fibrinogen, and D-dimer, the correlation with overall survival was analyzed. The NET procoagulant activity was evaluated using fibrin and purified coagulation complex production assays, and by measuring coagulation time (CT).
Results
MBC patients exhibited significantly elevated plasma NET levels compared to healthy controls (all P < 0.05), circulating MPO-DNA and NE-DNA levels were positively correlated with plasma TAT, fibrinogen, D-dimer, CT, FVIIIa, and platelet (PLT) counts. Additionally, we observed a significant increase in NETs formation in control neutrophils exposed to MBC plasma compared to those exposed to control plasma. NETs from MBC neutrophils significantly increased the potency of control plasma to generate thrombin and fibrin, effects that were notably attenuated by DNase I. Plasma TAT and D-dimer levels were significantly higher in MBC patients who died within three years post-recruitment compared to those who survived beyond three year. Plasma TAT and D-dimer were inversely correlated with survival. High plasma levels of MPO-DNA were associated with significantly worse overall survival (OS) (HR: 2.445, 95% CI: 1.255–4.762, P = 0.007). MBC patients with both high D-dimer and high MPO-DNA had significantly reduced survival (HR: 2.450, 95% CI: 1.332–4.488, P = 0.002).
Conclusions
Our results highlight the increased release of NETs in MBC patients and reveal that NET formation enhances hypercoagulability and cancer progression. Targeting NETs may be a potential therapeutic strategy to inhibit MBC progression and mitigate thrombotic complications in MBC.