bluuebunny/crossref_metadata_2025 huggingface dataset:
Capital Structure and Corporate Governance: Shaping Company Value through Dividends
Authors: Khorita Siti Arifatul , Widodo Heri
Published: October 2024

Background: The dynamic interplay between corporate financial strategies, particularly capital structure and dividend policies, significantly influences firm value in the manufacturing sector.Knowledge Gap: While previous research has explored the direct relationships between capital structure and firm value, less attention has been paid to the moderating effects of dividend policy, profitability, and Good Corporate Governance (GCG) in this context. Aims: This study aims to assess the moderating roles of dividend policy, profitability, and GCG on the relationship between capital structure and firm value. Results: The findings indicate that dividend policy, profitability, and GCG significantly moderate the relationship between capital structure and firm value, suggesting that firms must balance dividend distribution with their capital structure decisions. Novelty: This research contributes to the existing literature by integrating dividend policy and GCG into the analysis of capital structure's effect on firm value, addressing previously overlooked aspects. Implications: The study underscores the importance of prudent dividend policies and robust corporate governance in enhancing firm value, offering valuable insights for managers and investors aiming to optimize financial performance in the competitive food and beverage manufacturing sector.
Highlights :
 

Moderating Effects: Dividend policy, profitability, and GCG significantly moderate the relationship between capital structure and firm value.
Financial Balance: Firms must balance dividend distribution with capital structure decisions to enhance overall value.
Managerial Insights: The findings provide crucial insights for managers and investors to optimize financial performance in the food and beverage sector.

Keywords: capital structure, dividend policy, firm value, profitability, Good Corporate Governance
Key Determinants of the Comprehensive Neonatal Emergency Obstetric Services Policy
Authors: Cholifah Cholifah , Arcellya Rosalina Septi
Published: October 2024

Background: Effective implementation of comprehensive emergency obstetric and neonatal care programs is vital for improving maternal and neonatal health outcomes. Specific Background: At RSU Al-Islam H.M Mawardi, various factors—including communication, resources, disposition, and bureaucratic structure—affect program implementation. Knowledge Gap: Previous research has often neglected how these factors interact and their influence on healthcare policy implementation. Aims: This study evaluates the relationship between these factors and the implementation of the emergency obstetric and neonatal care program using a quantitative survey approach. Results: Analyzing data from 54 respondents revealed significant correlations between effective communication, resource allocation, and successful policy implementation (p < 0.05), with the questionnaire demonstrating high reliability (Cronbach's Alpha = 0.969). Novelty: This research contributes empirical evidence on the specific elements influencing healthcare policy implementation locally. Implications: Strengthening communication and resource management is essential for enhancing policy implementation effectiveness, ultimately improving community health outcomes.
Highlights :
 

Factor Influence: Effective communication and resource allocation significantly impact program success.
Research Contribution: The study provides empirical evidence on factors affecting healthcare policy implementation locally.
Health Outcomes: Strengthening implementation strategies is crucial for improving maternal and neonatal health outcomes.

Keywords: obstetric care, neonatal care, policy implementation, communication, healthcare resources
Assessing SIKS-NG for Poverty Data Management in Social Welfare
Authors: Aprilia Melly Nia Dwi , Choiriyah Ilmi Usrotin
Published: October 2024

The Specific background shows that although many E-Government applications have been implemented, the effectiveness of the next generation social welfare information system (SIKS-NG) in processing poverty data at the village level is still poorly understood. Knowledge gap raises questions about how SIKS-NG can be optimized to meet social welfare objectives. The aim of this study is to evaluate the performance of SIKS-NG as a poverty data processing application and identify the challenges faced in its implementation. Results of the study show that accuracy in determining program targets, lack of effective socialization, and inadequate monitoring are obstacles to the optimization of SIKS-NG. The novelty of this study lies in the descriptive qualitative approach that reveals the direct experiences of stakeholders in using the application. Implications of these findings suggest the need for improvements in program socialization and monitoring so that SIKS-NG can function optimally and provide maximum benefits to the community in managing poverty data and improving public services in the field of social welfare.
Highlights: 

Assessing the effectiveness of SIKS-NG in poverty data management.
Highlighting issues with accuracy, socialization, and monitoring.
Gathering direct experiences from users to inform improvements.

Keywords: E-Government, SIKS-NG, Poverty Data, Social Welfare, Implementation Challenges
Assessing Infrastructure Development in Kedungrejo Village Work Plan
Authors: Agustina Isna Fitria , Felani Herman
Published: October 2024

Background: Effective policy implementation is essential for achieving developmental goals, particularly in rural areas. Specific Background: This study examines the implementation of the Government Work Plan (RKP) in Kedungrejo, Jabon District, Sidoarjo. Knowledge Gap: There is limited research on the operational challenges of RKP implementation in rural Indonesia. Aims: The research analyzes RKP implementation, focusing on communication, resources, disposition, and bureaucratic structure per Edward III’s framework. Results: Findings reveal that village officials engage in monitoring infrastructure projects but lack Standard Operating Procedures (SOPs) and dedicated oversight teams. Novelty: This study offers empirical insights into the practical challenges faced in RKP implementation. Implications: Establishing SOPs and dedicated teams is recommended to improve coordination and accountability, enhancing governance and community participation in rural development efforts.
Highlights :
 

Lack of SOPs: Absence of Standard Operating Procedures hinders effective project oversight.
Community Engagement: Village officials emphasize the importance of involving the community in development efforts.
Bureaucratic Structure: The existing bureaucratic framework influences the coordination and success of RKP implementation.

Keywords: RKP, rural development, governance, implementation, community participation
Overcoming Infrastructure Challenges to Unlock Food Security in Rural Indonesia
Authors: Arifin Muhammad Zainul , Sukmana Hendra
Published: October 2024

General Background: Food security is a critical issue in rural areas, especially in developing countries, where sustainable agricultural practices and government support play a vital role in ensuring a stable food supply. Specific Background: In Sumorame Village, Candi District, Sidoarjo Regency, the local government has implemented a food security program aimed at improving agricultural productivity and community welfare. Knowledge Gap: Despite the program's significance, little is known about the specific factors influencing its success, particularly in the context of rural governance and local agricultural conditions. Aims: This study aims to describe and analyze the implementation of the food security program in Sumorame Village, focusing on four key factors: communication, resources, disposition, and bureaucratic structure. Results: The findings reveal that communication between the village government, farmers, and community groups has been effective through targeted socialization efforts. Human resources are competent, with strong collaboration among farmer groups. Financial resources have been allocated in accordance with regulations, but physical infrastructure remains inadequate due to limited agricultural land, unfavorable geographical conditions, and suboptimal hydroponic yields. Disposition among stakeholders is positive, with high commitment observed. The bureaucratic structure has been functioning in accordance with established Standard Operating Procedures (SOPs). Novelty: This study highlights the importance of resource optimization, particularly in agricultural infrastructure, and stresses the need for improved technological integration to enhance program outcomes. Implications: The results suggest that strengthening communication and addressing physical resource limitations are crucial for improving food security program effectiveness in rural areas. This study provides valuable insights for policymakers seeking to enhance rural food security initiatives.
Highlights:
 

Communication is crucial for successful food security program implementation.
Infrastructure limitations present significant challenges to agricultural productivity.
Collaboration and commitment among stakeholders enhance program effectiveness.

 
Keywords: Food security, rural governance, agricultural infrastructure, communication, resource optimization
The Hidden Forces Behind Employee Citizenship Behavior
Authors: Palupi Dian , Setyabudi Teguh Gunawan , Tegowati
Published: October 2024

This study aims to investigate the direct and indirect effects of perceived organizational support on work engagement and organizational citizenship behavior (OCB). A sample of 60 employees from a clinical laboratory in East Java was examined using a quantitative approach with probability sampling. Data was collected through online questionnaires and analyzed using SmartPLS 3.0 software. The findings reveal that 1) perceived organizational support significantly influences work engagement, 2) work engagement has a significant positive impact on OCB, and 3) perceived organizational support directly affects OCB. Additionally, work engagement mediates the relationship between perceived organizational support and OCB. These results highlight the importance of fostering organizational support to enhance work engagement and citizenship behavior, providing practical insights for improving employee commitment and performance.
Social Cognitive Career Theory on Entrepreneurial Intention of Vocational Students
Authors: Ambarita Nita , Butar Butar Senita
Published: October 2024

This study aims to examine the mediating role of outcome expectation and self-efficacy in the relationship between entrepreneurial knowledge and entrepreneurial intention among vocational students. Using a sample of 150 SMK students, data was collected via questionnaires and analyzed using the structural equation modeling (SEM) technique in Smart PLS 3.0, with Social Cognitive Career Theory (SCCT) as the theoretical framework. The results show that 1) entrepreneurial knowledge positively influences entrepreneurial intention, 2) self-efficacy mediates the relationship between entrepreneurial knowledge and entrepreneurial intention, and 3) outcome expectation also mediates this relationship. These findings contribute to the literature by validating SCCT in understanding entrepreneurial intention. The practical implications suggest the need for fostering an entrepreneurial ecosystem within the school environment as a strategy to increase entrepreneurial interest among vocational students.
Supply Chain Optimization Model for Fresh Cow's Milk to Reduce Carbon Emissions and Food Waste
Authors: Jeremi Nofariza Aulia , Vanany Iwan
Published: October 2024

The food and beverage industry occupies an important position in Indonesia, with growth in 5 (five) years, an average of 8.16%. In 2022, the food and beverage industry contributed more than one-third or 37.77% of the GDP of the non-oil and gas processing industry. However, growth considered positive for the economy is actually a threat to the environment. With the high demand for food, food waste and carbon emissions from all food supply chain (FSC) activities increase. This study raises a case of a dairy product processing supply chain in the West Java region with multiple milk suppliers (KUD Susu), a single processing production plant, multi distributors, and multi-consumer retail with multi-echelon, multi-period, and multi-product friendly conditions. Environment by considering food waste and carbon emissions as a function of the objective model. In solving this problem, the Mixed Integer Linear Programming (MILP) model is used in modeling supply chain processes to optimize total cost/TC, total food waste/TFW, and total carbon emissions/TCE. The results of the completion of the research showed a total cost of IDR 18,036,770,000, a total food waste/TFW of 21,734 liters, and a total carbon emission/TCE of 109,526 l.CO2-eq.
Increasing Production Capacity by Designing Facilities to Reduce Production Costs
Authors: Yudi Masyudi , Hery Hery Murnawan
Published: October 2024

This research discusses facility design in the lightweight brick manufacturing industry. Every year the production costs of making lightweight bricks continue to increase due to increases in raw material prices, increases in minimum wages and increases in several auxiliary materials. The increase in selling prices cannot offset the increase in production costs because price competition in the market is high. This research aims to plan to increase the production capacity of lightweight bricks from initially 679.4m³ per day to 794.7m³ per day by designing facilities at lightweight brick manufacturing companies. This research also calculated how much it costs to produce lightweight bricks before designing, namely with a capacity of 679.4 m³ per day and how much it costs to produce lightweight bricks after designing the facilities, namely 794.7 m³ per day. The results of this research are in the form of production capacity data from each production work floor, as well as production work floors where facilities were designed so that a production capacity of 794.7 m³ per day could be achieved. And also calculate how much production costs will be with a production capacity of 679.4m³ and 794.7m³ per day.
Design of Public Kitchen Facilities in Stamplat Village with Design Thinking Approach
Authors: Sarvia Elty , Soesilo Novi , Aji Pranata Yosafat , Dharmawan Ary
Published: October 2024

Stamplat Village is one of the tourist villages that has a public kitchen. Currently, the public kitchen facilities are still inadequate, resulting in a few problems that affect the comfort and productivity of its users. Therefore, this research aims to improve the functionality of kitchen facilities by applying the design thinking method, starting from an in-depth understanding of the problems faced by users to the development of prototypes that can be implemented. The design thinking method was chosen as the main approach to ensure that the solutions produced not only fulfill the functional aspects but can also answer the needs and desires of users. At the beginning of the research, observation, and interview methods were used to collect data from users to understand in detail their difficulties, needs, and expectations regarding kitchen facilities. Observations showed the inconvenience in ingredient preparation, cooking, and washing activities caused by the lack of a worktop. The placement of the stove on the wooden floor caused the wood to be perforated due to the heat from the stove. In addition, the squatting position when washing also causes user discomfort. The lack of storage areas such as cupboards and shelves means that food and kitchen utensils are at risk of being infested by insects and rodents. Furthermore, creative ideas were identified to become design solutions by taking into account the principles of ergonomics. The result of the research is the design of public kitchen facilities consisting of cabinets, shelves, and workbenches.
The Impact of Biotropic Weather on the Incidence and Severity of Aneurysmal Subarachnoid Hemorrhage: A Single-Center Observational Study
Authors: Albrecht Carolin , Graw Kathrin , Kehl Victoria , Hostettler Isabel Charlotte , Meyer Bernhard , Matzarakis Andreas , Wostrack Maria
Published: October 2024

Controversy surrounds seasonal variations in aneurysmal subarachnoid hemorrhage (aSAH) incidence and course. Investigating weather effects associated with weather fronts may provide more insights. Meteorological parameters are grouped into classes describing biotropic weather conditions influencing human health. Known as bio-synop classes, they impact human health by influencing biological processes. Our study explores the relationship between these classes and aSAH occurrence and severity using data from our neurovascular center and the German national weather registry. Data from 605 aSAH patients treated between 2006 and 2020 was analyzed. The Kruskal-Wallis Test was used to assess the incidence and severity of aSAH, classified by Hunt&Hess (HH) grades across bio-synop classes. Additionally, we explored seasonal clustering of aSAH events. While no significant difference in ASAH incidence across specific bio-synop classes was observed (p = 0.168), class 4 “Low-pressure with cold air advection” was significantly associated with a higher incidence of poorer HH grades (p = 0.022). Further, we observed a decrease in aSAH cases in June in month-to-month comparisons (May vs. June p < 0.001). Although bio-synop classes may not directly affect aSAH incidence, they appear linked to aSAH severity. The reduction in June aSAH cases suggests a potential seasonal influence, indicating a complex interplay of environmental factors warranting further investigation.
Machine learning method to derive serum chlorine in acute kidney injury with traumatic brain injury
Authors: Li Xia , Zhang Wenshu , Zhao Zhikun , Xu Fei , Yang Haichen
Published: October 2024

Background and purpose: Acute kidney injury (（AKI)） is a serious complication of traumatic brain injury (TBI), thatwhich affects the survival rate of patients with TBI patients. Hyperchloremia is an important factor leading to TBI-associated AKI and affects the prognosis of TBI patients with TBI; however,. but the The highest blood chlorine value is usually uselected to define it. However, the effectimpact of changes in the trajectory of early blood chlorine levels on the prognosis of patients with TBI-associated AKI remains unclear.
Methods: We used the Critical Medicine Database (MIME-IV) and eICU to include TBI patients with TBI and AKI admitted to the ICU. We used the potential class model to determine the AKI class inof athe blood chlorine trial of patients with TBI. The primary endpoint was 28 day all-cause mortality, and the secondary endpoints were the development of acute kidney disease (CAD) and 7 day all-cause mortality. Multivariate regression was used performed to assess the effect of classification based on blood chlorine levels, and external validation was performed using the eICU database.
Results: In 640 patients with TBI-associated AKI, we identified five categories based on blood chlorine trials with different characteristics. Compared with patients with slightly elevated blood chlorine levels late in life, those with rapidly elevated blood chlorine levels early in life had the highest risk of all-cause mortality at 28 days (HR: 2.47 (1.16, 5.65), P = 0.019), a higher risk of death at 7 days (HR: 3.18 (1.21-8.36), P = 0.019), and the highest adjusted risk of developing acute kidney disease (HR: 5.40 (1.44-20.22), P = 0.012). These associations were similar in external validation.
Conclusion: The stratification of early blood chlorine trajectories can be used as a prognostic indicator for TBI-associated AKI patients.
Albumin/Fibrinogen Ratio (AFR): A Significant Predictor of Postoperative Delirium in Older Patients Undergoing Non-Neurosurgical and Non-Cardiac Surgery
Authors: Huo Jiang , Song Yuxiang , Lu Jing , Dou Guijin , Chen Huixian , Mi Weidong , Yu Yingqun , Liu Yanhong
Published: October 2024

Objective
The purpose of this research was to evaluate the prognostic significance of preoperative albumin to fibrinogen (AFR) for postoperative delirium (POD) in older patients with non-neurosurgical and non-cardiac surgery.
Method
The retrospective cohort study included a group of patients aged 65 and above who underwent non-neurosurgical and non-cardiac surgery at the First Medical Center of Chinese PLA General Hospital from January 2014 to December 2021. AFR and POD correlation was evaluated through univariate and multivariable logistic regression analysis, as well as propensity score matching (PSM) and subgroup analysis.
Results
In our study, the occurrence of POD was 2.9% (1566/53,609), the occurrence of POD was 2.9% out of 53,609 patients, with the AFR threshold identified as 10.625 based on the ROC curve. The study identified AFR ≤ 10.625 as a significant predictor of POD in both univariate and multivariable regression analyses, and the odds ratios (OR) were 2.652 (2.397–2.934), 1.983 (1.785–2.205), 1.512 (1.343–1.703), 1.271 (1.126–1.434) and 1.318 (1.139–1.525) in four models and the PSM model.
Conclusion
AFR is a valuable predictor for predicting the development of POD in older patients receiving non-neurosurgical and non-cardiac procedures. This finding highlights the importance of preoperative assessment of AFR in these patients to better predict and manage the risk of POD.
Comprehensive Study of Rapid Capacity Fade in Prismatic Li-ion Cells with flexible packaging
Authors: Stravova Zuzana , Klvac Ondrej , Bana Jiri , Anothumakkool Bihag , Zikmund Tomas , Blazek Pavel , Kaiser Jozef , Kazda Tomas
Published: October 2024

Prismatic lithium-ion batteries (LIBs) are considered promising electric energy sources in electromobility applications due to their efficient space utilization. However, their sensitivity to external and internal influences and reduced durability lead to inflation risk and potential explosions throughout their lifecycle. These critical processes are strongly influenced by the inner construction of the cell, especially concerning the coating and mechanical fixation. This study subjects a commercially available prismatic LIB cell to comprehensive, correlative analysis employing various imaging techniques. The inner structure of the entire cell is visualized non-destructively by X-ray computed tomography (CT), enabling the identification of critical design flaws prior to electrochemical cycling. Electrochemical cycling simulates the battery lifecycle, and the cell is subsequently disassembled in the fully charged state. The usage of the inert-gas transfer system allowed the preparation of Broad Ion Beam (BIB) electrodes cross-sections in a fully native state and for the first time to observe the tearing of graphite particles due to over-lithiation. Established region labeling system allowed to use CT and scanning electron microscopy (SEM) correlatively to identify critical regions. After 100 cycles, a 40% capacity loss was observed and event diagram describing deagradation mechanisms, related both to the cell design and to the processes occurring at high load, was created.
Quantum Metric Third-Order Nonlinear Hall Effect in A Non-Centrosymmetric Ferromagnet
Authors: Yu Peng , Yu Hao , Bie Yaqing , Yang G.W.
Published: October 2024

Although Berry curvature in the imaginary part of quantum geometry has been confirmed to play a role in the nonlinear Hall effect of Weyl semimetals, exploration of the real component's influence on nonlinear Hall transport has primarily focused on second-order effects at lower temperatures. However, the potential impact of quantum metric on higher-order transport, particularly the room-temperature quantum metric nonlinear Hall effect, remains largely unexplored. In this study, we observed a significant third-order nonlinear Hall effect induced by quantum metric in non-centrosymmetric ferromagnetic Fe5GeTe2 at room temperature. This effect was confirmed through distinct scaling behaviors regardless of scattering time and a third-order signal dependent on the electron spin state. Notably, our Hall device exhibited an ultrahigh third-order conductivity of 72 μm·S·V-2, surpassing previous studies in Berry curvature-induced third-order nonlinear Hall effects by approximately tenfold, thus enhancing the device's third-order current conversion efficiency. Moreover, we extended the second-order quantum metric dipole scaling to derive a novel third-order equation (χ_xxy^("3" ω) = η_"2" σ^"2" +η_"0" ), offering a fresh perspective for studying third-order nonlinear Hall effects in emerging material platforms. Our findings lay the groundwork for the development of room-temperature, low-power quantum spintronic devices leveraging the third-order nonlinear Hall effect.
The epidemiological characteristics of respiratory infections and their association with air pollution and meteorological factors in China during 2004-2018: a cross-sectional study
Authors: Jiang Hui , Liu Fangchao , Tang Jia-Hong , Xu Xiaolong , Wu Zhaojun , Yin Jinfeng , Yuan Yuan , Wang Kehan , Zhao Na , Jian Hong-Lian , Li Weimin , Liu Shelan , Chan Ta-Chien
Published: October 2024

Background The changes of respiratory infectious diseases’ epidemiological characteristics, and the relationship between respiratory infectious diseases and meteorological conditions and pollutants rarely explored in recent 10 years in China. Methods The seven respiratory infectious diseases’ data were collected from the NNIDSS, meteorological data and air pollutants data were from the meteorological monitoring stations and national air quality monitoring stations, respectively. Descriptive analyses were used to present trends, and joinpoint regression models were used to examine changes in incidence and mortality for each respiratory infectious disease and to estimate average annual percentage changes (AAPCs). A Distributed Lag Non-Linear Model (DLNM) with relative risk was applied to analyze the impact of meteorological conditions and air pollutants on respiratory infectious diseases. We also applied a time-series decomposition approach based on LOESS (locally weighted regression) to present the seasonality of seven respiratory infectious diseases. Results A total of 23,444,640 cases and 45,291 deaths caused by seven respiratory infectious diseases were recorded in China, and the national mean age-standardized incidence and mortality were 115.87/100,000 and 0.23/100,000, respectively; the change of incidence and mortality differed by age groups. SO2and PM10in air pollutants and relative humidity and air pressure in climatic factors had significant effects on most respiratory diseases in this study. Additionally, meteorological factors had a stronger impact on respiratory infectious diseases with an acute and short-term lag effect compared with air pollutants. Conclusions In view of the large regional difference in environmental factors, air pollutants, and geographical location, the prevention and control strategies for respiratory infectious diseases need to be formulated based on their own characteristics.
Adherence to Radiation Protection Principles among Operating Room Students: Implications for Clinical Recommendations and Educational Interventions
Authors: Ghasemi Sina , Khosravi Hossein , Imani Behzad , Shabani Naeeme
Published: October 2024

Background
Due to the increasing use of ionizing radiation in the operating room environment, concerns about the potential risks of this type of radiation have increased. Therefore, this study aimed to investigate the level of knowledge, attitudes, and performance of last semester operating room nursing and anesthesia students toward radiation protection principles for their presence in the clinical educational environment.
Methods
This cross-sectional study was conducted at Hamadan University of Medical Sciences in 2024. In this study, students were selected via the census sampling method. The data related to the study were collected from valid questionnaires concerning the participants’ level of knowledge, attitudes, and performance toward ionizing radiation. Additionally, the data analysis was conducted at the descriptive and inferential statistics level via SPSS version 16 software.
Results
Students' knowledge, attitudes, and performance in both operating room nursing and anesthesia were moderate. Additionally, the mean attitude score toward protective principles was significantly greater among operating room nursing students than among anesthesia students (P value = 0.023). Furthermore, a positive and significant correlation was found between students' grade point average (GPA) and their scores on knowledge and attitudes toward protective principles (r = 0.449, P value = 0.000 and r = 0.648, P value = 0.000, respectively).
Conclusion
This study revealed an insufficient level of knowledge among the mentioned students regarding ionizing radiation. As a result, training courses should be conducted to increase students' knowledge and attitudes toward the risks of ionizing radiation, thereby improving their safety in the clinical educational environment.
Clinical Trial Number: Not applicable.
Relationship between changes in physical activity and physical and mental health in breast cancer survivors during the COVID-19 pandemic restrictions in Japan
Authors: Tamai Naomi , Kimura Yasutaka , Yoshizawa Ryuta , Kamizato Midori
Published: October 2024

Purpose
This study evaluated the relationship between changes in physical activity (PA) and mental and physical health in breast cancer survivors during the COVID-19 pandemic restrictions in Japan.
Methods
A questionnaire survey was conducted among 345 outpatient female breast cancer survivors aged between 29 and 69 years. The questionnaire was based on the International Physical Activity Questionnaire, the Patient Health Questionnaire-9, the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire, and the Fear of COVID-19 Scale, and also included patient characteristics, change in PA during the pandemic restrictions, and needs for exercise support. The analysis categorized PA changes into two groups according to activity levels. The relationship between changes in PA and physical and mental health was evaluated by logistic regression analysis.
Results
Patients with decreased PA accounted for 65.5% of the study population. Regardless of the activity level, these patients were aware of an increased susceptibility to COVID-19, showed a fear of the disease and a tendency for depression, and reported low life satisfaction and declined physical function. Of the patients who stopped exercising, 82.9% reported a decline in PA. Compared with those who had never exercised, those who stopped exercising saw their risk of depression increase by 15.6%. There was a high demand for personalized exercise support from healthcare professionals.
Conclusion
Regardless of the activity level, decreasing PA during the pandemic decreased mental health and physical function in breast cancer survivors. There was a higher risk of depression among patients who stopped exercising.
Denosumab administration in breast, prostate and lung cancer with chronic kidney disease – a retrospective multicenter Turkish Oncology Group (TOG) study
Authors: Ellez Halil İbrahim , Semiz Hüseyin Salih , Ekinci Ferhat , Erdoğan Atike Pınar , Kuş Fatih , Karataş Fatih , Bayram Ertuğrul , Karaboyun Kubilay , Çınkır Havva Yeşil , Yıldırım Nilgün , Eryılmaz Melek Karakurt , Bekmez Esma Türkmen , Alan Özkan , Özçelik Melike , Düzköprü Yakup , Şakalar Teoman , Ak Naziye , İlhan Yusuf , Yavuzşen Tuğba , Turhal Serdar
Published: October 2024

Background
Denosumab, a RANK-ligand inhibitor, is an effectivetreatmentforfor bone metastasesfromsolidtumors.Unlikethebisphosphonates, it is not excretedbythekidney. Little is known, however, aboutitsefficacyandsafety in patientswith severe chronickidneydisease (CKD).
Methods
This study is a retrospective observational study and was conducted as a multicenter study within the scope of the Turkish Oncology Group (TOG) project. Patients with breast, prostate and lung cancer who received denosumab between January 2011 and December 2022.Datacollectedincludedinformationaboutthefollowing: CKD stage, fracturehistory, serum calciumlevelspreand post denosumabtreatment, episodes of hypocalcemia, relevantmedicationsand adverse events.
Results
A total of 262 patients from 17 centers were included in the study. Toxicitygrade ≥ 3 was seen in a total of 18 patients. Of these 18 patients, 16 had hypocalcemia and the others had eGFR decline. In 42 patients, eGFR was < 60 ml/min. Grade ≥ 3 toxicity (eGFR decrease in 2, hypocalcemia in 11) was detected in 13 of these patients and was statistically significant (p < 0.01).In 6 of 21 patients with pathologic fractures, GFR was < 60 ml/min, which was statistically significant (p = 0.035). In 6 of 21 patients with pathologic fractures, GFR was < 60 ml/min and was found to be statistically significant (p = 0.035). In 4 of 8 patients who underwent bone surgery for SRE, GFR was below 60 ml/min and was significant (p = 0.012).
Conclusion
A high rate of severe hypocalcemiawasobserved in patientswithadvanced CKD treatedwithdenosumab. Ifdenosumab is used in patientswith severe CKD, closemonitoringandaggressivereplacement of calciumandcalcitriol is requiredtoavoidthedevelopment of hypocalcemia.
Severe bronchiolitis before and after the COVID-19 pandemic: A retrospective database analysis by the Italian Network of PICU Study group (TIPNet)
Authors: Izzo Francesca , Comoretto Rosanna I , Amigoni Angela , Daverio Marco , Zoia Elena , Diotto Veronica , Sacco Francesco , Nettuno Claudio , Tessari Anna , Picconi Enzo , Mondardini Maria Cristina , Bregant Gaia Milvia , Wolfler Andrea , Gregori Dario , Camporesi Anna
Published: October 2024

Background: The first post-COVID-19 pandemic year demonstrated an unusual bronchiolitis epidemic in both hemispheres and has been attributed to the removal of barriers implemented during SARS-CoV-2 infection. Several countries reported an increase in respiratory syncytial virus (RSV) bronchiolitis, with more hospitalizations and greater need for respiratory support. We aimed to evaluate the consequences of the COVID-19 pandemic on the epidemiology and management of severe bronchiolitis in Pediatric Intensive Care Units (PICUs) in Italy.
Methods: multicenter, retrospective, cohort database analysis. All children younger than 24 months admitted to 7 PICUs from October 2017 to April 2023 diagnosed with bronchiolitis were included. We compared patients from Pre-COVID and Post-COVID eras, excluding patients from the 2020-2021 season due to low numbers. Logistic regression models were used to assess the impact of Pre/Post-COVID period on the need for invasive ventilation.
Results: 715 patients were admitted to PICU during the study period, 451 patients Pre-COVID and 251 patients Post-COVID. Patients in the Post-COVID group were older, had more comorbidities and higher Pediatric Index of Mortality score at admission but the need for respiratory support was not significantly different. There was high variability in bronchiolitis management across Centers. Presenting Pre-COVID was protective against the risk of mechanical ventilation, adjusted for age and disease severity at admission (OR 0.38, 95% CI 0.16-0.89), while RSV infection increased the risk of intubation (OR 2.49, 95% CI 1.1-5.63).
Conclusions: PICUs have faced an unexpected peak of significantly more severe cases of bronchiolitis after the COVID-19 pandemic, but this didn’t require increased respiratory support.
Post dural puncture headache and its potential to obscure sinister pathologies: A case report
Authors: Hewawasam Bhagya , Sumithraarachchi Mihirinie , Ratnayake Ashani , Nanayakkara Saman , Samarasinghe Senani , Abeysundara Anura , Weerasinghe Sajitha , Gihan Champika , Sandaru Githmini
Published: October 2024

Background Cerebral venous sinus thrombosis (CVT) is a potentially fatal condition that can occur in postpartum period with the hypercoagulable state developed in pregnancy. Accidental dural puncture is found to be a risk factor for CVT. However, common occurrence of post-dural puncture headache (PDPH) following accidental dural puncture can mask the clinical presentation of other serious conditions such as CVT.Case Presentation We present a case of 29-year-old postpartum female who had accidental dural puncture during labour epidural insertion and managed for PDPH subsequently found to have CVT following further investigation due to persistent symptoms.Conclusions This case report would allow increasing awareness among perioperative clinicians to keenly exclude serious pathology in the presence of possible PDPH as this is a diagnosis of exclusion although there is a history of dural puncture.
Expression of stearoyl coenzyme A desaturase in neuronal cells facilitates pancreatic cancer progression
Authors: Liu Ye-Fu , Zhang Xue , Zhao Ling-Xiao , Cheng Si-Qi
Published: October 2024

Background:
Pancreatic adenocarcinoma (PDAC) is a fatal malignant tumor that focuses on men and the elderly (40–85 years) and is aggressive. Its surgical resection rate is only 10%-44%, and the rate of local recurrence in the retroperitoneum 1 year after surgery is as high as about 60%. The main reason for local recurrence in the majority of patients is that PDAC is perineural invasion (PNI) and the cancer cells infiltrate and grow along the peripancreatic nerve bundles. The identification of biomarkers associated with the diagnosis of PDAC may help to improve the current difficulty in early diagnosis of pancreatic cancer and guide clinical treatment. We constructed a co culture model of Schwann cells and PDCA cells, and determined that Stearoyl Coenzyme A Desaturase (SCD) is a key gene driving the progress of PDAC.
Methods:
Single-cell data files for PDAC were analyzed to compare cellular composition and subpopulation-specific gene expression between control (n = 4) and pancreatic cancer (n = 6). Among 36,277 cells, we obtained a total of 16 subpopulations, including a Neurons subpopulation, by UMAP analysis. Further screening by Mendelian randomization analysis yielded three pairs of genes corresponding to eQTL-positive outcome causally, the corresponding genes were, in order: the three genes COL18A1, RASSF4, and SCD. Among them, SCD was significantly positively correlated with Macrophages.M0 and so on, and significantly negatively correlated with Mast cells resting and so on. In this study, we further co-cultured Schwann cells and PDAC cells in a co-culture model, and knocked down the SCD of neuronal cells using CRISPR-Cas9 technology to detect the proliferation and migration ability of PDAC cells.
Results:
Three genes (COL18A1, RASSF4, SCD) showed significant correlation with PDAC. The identified SCD genes were positively correlated with the development of PDAC. We further demonstrated experimentally that SCD was overexpressed in PDAC tissues and that knockdown of SCD in neuronal cells reduced the proliferation and migration of PDAC cells.
Conclusion:
This study demonstrated that the upregulation of SCD expression level in neuronal cells is associated with the development of PDAC, and SCD may be a potential target for PDAC therapy.
Acute onset with fluctuating progression leading to death of dural arteriovenous fistula in the craniocervical junction region: a case report
Authors: Liu Yusha , lv Bin , Cao Xiangyu , Huang Dehui , Wu Lei
Published: October 2024

BACKGROUND
Spinal dural arteriovenous fistulas are rare vascular malformations predominantly affecting middle-aged and elderly males. The thoracolumbar region is the most common site, yet Spinal dural arteriovenous fistulas in the craniocervical junction region represents only 2% of cases. Patients with Spinal dural arteriovenous fistulas typically presented with subarachnoid hemorrhage and progressive myelopathy with chronic or subacute onset. However, brainstem dysfunction as the main clinical manifestation is rare, and it can easily be misdiagnosed as spondylitis, spinal cord tumor, or demyelination, resulting in incorrect treatment decisions and negative treatment outcomes, even life-threatening.
CASE DESCRIPTION:
A 60-year-old woman with an acute onset initially misdiagnosed as cerebral infarction and inflammatory demyelination.Despite receiving various glucocorticosteroids and medications, she experienced fluctuated clinical manifestations. The diagnosis of cerebrospinal arteriovenous fistula in the craniocervical junction region was confirmed by Digital Subtraction Angiography. Tragically, the patient experienced sudden respiratory and cardiac arrest and subsequently died the day after undergoing Digital Subtraction Angiography .
CONCLUSION
This case highlights a rare situation of Spinal dural arteriovenous fistulas in the craniocervical junction region that is characterized by brainstem dysfunction and acute onset. Importantly, the case illustrates a high level of vigilance is indicated to recognize spinal dural arteriovenous fistulas when observing symptomatic fluctuations related to steroid therapy and characteristic brain imaging findings such as increased vascularity or flow-voiding shadows.
Primary Care Quality of Primary Healthcare Institutions in China: Current Status and Influencing Factors
Authors: Zhan Kexin , Wan Chuchuan , Wang Ennan , Huang Yuankai
Published: October 2024

Objective
This study aims to assess the current state of primary care quality within Primary Healthcare Institutions (PHIs) in China and analyze potential factors that may influence the quality of primary care provided.
Methods
Employing convenience sampling, this research utilized the Chinese Primary Care Assessment Tool (PCAT-C) to gather cross-sectional data on patients' experiences with primary care during visits to PHIs across the country. A multivariate linear regression model was established to discuss the effects of various factors on the quality of primary care at PHIs.
Results
The study encompassed 2,063 valid cases, with an overall PCAT score of 71.31 (SD = 11). Among the different dimensions, the average score for the Comprehensiveness dimension was the highest at 77.78 ± 15.83, followed by Continuity (75.81 ± 10.68), Family-centered (75.67 ± 17.69), First Contact (69.46 ± 10.36), Coordination (69.39 ± 16.84), and the Community-orientation dimension with the lowest average score at 59.75 ± 16.93. The regression analysis (R2 = 0.0437, p < 0.000) indicated that the patient's area(Eastern, Middle or Western) (p < 0.001), region(Urban or Rural)(p = 0.026), presence of adult children (p = 0.008), working status (p = 0.003), family annual income (p = 0.007), participation in commercial medical insurance (p = 0.001), seeking medical attention for illness was sought (p = 0.014), the number of hospital beds per 10,000 population (p = 0.007), and per capita health expenditure as a percentage of GDP per capita (p = 0.021) significantly impact the quality of primary care at PHIs.
Conclusion
The quality of primary care for PHIs in China is still low and is affected by both micro and macro factors. The quality of primary care at PHIs in China is still relatively low, particularly in the Community-orientation dimension. Apart from being influenced by microscopic factors, the quality of primary care at PHIs is also affected by macro factors such as overall health expenditure and economic status. It is recommended that efforts be made to enhance the equity of the medical and health resource allocation mechanism, thereby promoting balanced regional development.
Correlation between the expression of BCMA/soluble BCMA and the efficacy of BCMA CAR-T cell therapy in relapsed/refractory multiple myeloma
Authors: Fu Mingwei , Li Zheng , Mu Juan , Gao Shuquan , Yuan Ting , An Gang , Cui Rui , Deng Qi
Published: October 2024

Anti-B cell maturation antigen (anti-BCMA) CAR T cell therapy has led to prolonged survival and response rates of 64-85% in patients with relapsed/refractory multiple myeloma (R/R MM). In a study of 29 R/R MM patients receiving anti-BCMA CAR T cell therapy, we aimed to identify predictors of pre-treatment efficacy and side effects. We observed multiple myeloma (MM) cells in bone marrow (BM), BCMA expression in MM cells, and soluble BCMA (sBCMA) levels in BM before and after therapy. Clinical response, CAR-T cell proportions, cytokine levels, and adverse events (AEs) were monitored during therapy. Twenty patients (68.97%) experienced an objective response rate (ORR) to the therapy. Before CAR-T cell therapy, there were no differences in the proportions of MM cells or BCMA expression between the ORR group and the MR+SD group, but sBCMA levels were higher in the MR+SD group compared to the ORR group. After therapy, BCMA and sBCMA expressions were lower in the ORR group than in the MR+SD group. In patients who achieved ORR, the peak levels of CAR-T cells correlated with the proportion of MM cells. IL-6 levels were correlated with the proportion of MM cells and sBCMA expressions. There were no differences in the proportion of MM cells, BCMA expressions, or sBCMA expressions between the grade 0-1 cytokine release syndrome (CRS) group and the grade 2-4 CRS group. The proportion of MM cells and BCMA expressions were lower in the grade 0 immune effector cell-associated neurotoxic syndrome (ICANS) group compared to the grade 1-3 ICANS group. There was no correlation between BCMA expression in MM cells and sBCMA levels in BM. Interestingly, high sBCMA levels in BM impacted efficacy, while the proportions of MM cells in BM and BCMA expression in MM cells did not. Therefore, we suggest that sBCMA levels in BM could be used as a predictor of the efficacy of anti-BCMA CAR T cell therapy, but further clinical verification is needed (ChiCTR2000033925).