bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving The Competitiveness Of SMEs through the Capital Market: Literature Review and Discourse Network Analysis
Authors: Adityawati Septian , Yuliana Rr Retno Rizki Dini
Published: October 2024

This article examines the prevailing conditions of Small, and Medium Enterprises (SMEs) in Indonesia, assessing their potential access to the capital market as an alternative financing for SMEs. It also investigates the required criteria for SMEs to fulfill, the potential benefits of their participation in the capital market, the challenges for them to enter the capital market, and what strategies are available for SMEs to access the capital market. The methodology in this research involves secondary data, specifically a compilation of Scopus indexed journal articles and news sourced from various sources on online platforms. Using specific keywords related to SMEs accessing the capital market during 2010-2024. The data analysis process uses the Systematic Literature Review (SLR) method and Discourse Network Analysis (DNA) software. DNA analysis to produce a visual representation of a discourse network, with a focus on interactions between actors, concepts (such as agreement or disagreement regarding SMEs entering the capital market), and their interconnections. From the results of the analysis, it is known that there are SMEs in Indonesia that have entered the stock exchange, but their numbers are decreasing. By entering the stock exchange, SMEs are expected to increase capital, performance, business scale, competition and public trust. However, there are obstacles and prerequisites for SMEs to enter the stock exchange. Capital market conditions in other countries are similar to conditions in Indonesia. This can be overcome with several strategies and synergy between all stakeholders related to creating and protecting an investment ecosystem that is friendly for SMEs.
Analysis Of The Implementation Of Electronic Archive Data Transformation At The Coordinating Ministry For Humanitarian Development And Culture
Authors: Monica Jean  , Marsofiyati  , Adnan Kasofi
Published: October 2024

This research was conducted at the Coordinating Ministry for Human Development and Culture or better known as the Kemenko PMK. The results of this research aim to find out whether institutions in Indonesia still use conventional archives or already use electronic archive management. This research uses qualitative methods with 4 resource persons for data collection. The data collection process in research uses observation, interviews and documentation. The analysis in this research was prepared using descriptive analysis methods. The analysis techniques used are data reduction, data presentation, data verification, and drawing conclusions. The results of this research show that institutions in Indonesia have begun implementing digital transformation from conventional archives with a digital application called Srikandi. Implementation is underway and makes work more effective and efficient. However, it was stated that some human resources had not mastered the application, especially seniors who did not understand technology and had technical problems. Solutions to the challenges faced include coordinating with ANRI (National Archives of the Republic of Indonesia) for technical problems, preparing a draft SOP for using Srikandi, and conducting training for Srikandi users.
Spatial Analysis at PT ABC
Authors: Indriani Putri  , Susan Febriantina  , Susan Febriantina  , Terrylina Arvinta Monoarfa
Published: October 2024

This research aims to describe the influence of existing office layout at PT ABC. The type of research used is qualitative research, with a sample of 36 employees in the company. Data collection methods are literature study, observation, interviews and documentation. The data processing method uses data collection, data reduction and data presentation and drawing data conclusions. The aim of this research is to identify and analyze factors that influence spatial planning at PT ABC As well as to find out obstacles and solutions to obstacles that occur in spatial planning office
Analysis of ISO 9001:2015 Quality Management System Implementation at PT X
Authors: Dila Farah , Eryanto Henry , Suherdi
Published: October 2024

This study examines the implementation of the ISO 9001: 2015 Quality Management System at PT X, a construction consulting services company in Indonesia which has research objectives to find out and analyze the implementation process, supporting and inhibiting factors, and solutions to overcome obstacles in the implementation of the Quality Management System at the company. This research uses a qualitative research design and case study approach, using data collection techniques in the form of observation, interviews, and documentation.
The results of this study found that the implementation of the ISO 9001: 2015 Quality Management System at PT X is influenced by several supporting and inhibiting factors, which are supported by the commitment and policies of top management, awareness of employees, company culture that emphasizes the importance of quality improvement, digitalization of infrastructure that is quite capable, and standardization of well-documented procedures. The inhibiting factors are the lack of human resources and inconsistency and not overall understanding and awareness of the importance of implementing a Quality Management System.
This research is expected to be one of the input materials used for useful improvements to overcome obstacles in order to improve the quality and quality of the company in the future.
Generation Z Impulse Buying Analysis on Shopee in Special Region of Jakarta
Authors: Intan Kamila Khairunnisa  , Sholikhah  , Dewi Agustin Pratama Sari
Published: October 2024

The rise of e-commerce has made online shopping increasingly convenient, leading consumers to often make purchases driven by emotional factors rather than careful planning. This behavior is characterized as impulsive buying, where decisions are made spontaneously. Understanding the various categories of impulsive buying is essential for companies, as it enables them to tailor marketing strategies effectively. This study focuses on assessing the impulsive buying tendencies of Generation Z consumers in Jakarta's Special Capital Region while identifying their specific impulsive buying type categories. The research evaluates dimensions such as Pure Impulse Buying, Reminder Impulse Buying, Suggestion Impulse Buying, and Planned Impulse Buying, alongside Cognitive and Affective Aspects. Data was collected through an online questionnaire distributed via Google Forms, targeting 126 Generation Z Shopee users in Jakarta. A quantitative approach was employed, utilizing descriptive analysis, simple tabulation, and mean score calculations. Findings reveal that Generation Z's impulsive buying level on Shopee is rated as "Agree" and "High." Most respondents fall into the Suggestion Impulse Buying and Planned Impulse Buying categories, with their impulsive purchasing behavior significantly influenced by Affective Aspects. These insights are valuable for Shopee, as they highlight opportunities for developing targeted marketing strategies that can stimulate impulsive buying behavior and ultimately boost sales within this demographic. Understanding these dynamics is crucial for businesses aiming to enhance their engagement with young consumers in the competitive online marketplace.
Four Models of Wastewater-Based Monitoring for SARS-CoV-2 Complementing Individual Screening in Jail Settings
Authors: Kennedy Shanika S. , Saber Lindsay B. , Brown Victoria M. , Boehm Rachel A. , Olotu Amadin A. , Osei Jeffery , Pluznik Jacob A. , Riback Lindsey R. , Sidibeh Ebrima , Jordan Beth , O’Donovan Eleni , Mangla Anilkumar , Nzokou Christine , Elam Tracey L. , Gubser Jane , Koutoujian Peter J. , Siddiqi Kashif A. , Wilensky Steven , Phillips Victoria L. , Wurcel Alysse G. , Zawitz Chad J. , Akiyama Matthew J. , Spaulding Anne C.
Published: October 2024

Objectives. To describe 4 unique models of operationalizing wastewater-based surveillance (WBS) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in jails of graduated sizes and different architectural designs.

Methods. We summarize how jails of Cook County, Illinois (average daily population [ADP] 6000); Fulton County, Georgia (ADP 3000); Middlesex County, Massachusetts (ADP 875); and Washington, DC (ADP 1600) initiated WBS between 2020 and 2023.

Results. Positive signals for SARS-CoV-2 via WBS can herald a new onset of infections in previously uninfected jail housing units. Challenges implementing WBS included political will and realized value, funding, understanding the building architecture, and the need for details in the findings.

Conclusions. WBS has been effective for detecting outbreaks of SARS-CoV-2 in different sized jails, those with both dorm- and cell-based architectural design.

Public Health Implications. Given its effectiveness in monitoring SARS-CoV-2, WBS provides a model for population-based surveillance in carceral facilities for future infectious disease outbreaks. ( Am J Public Health. 2024;114(11):1232–1241. https://doi.org/10.2105/AJPH.2024.307785 )
Cognitive Difficulty in Middle Eastern and North African Adults Living in the United States Compared With Other Racial and Ethnic Categories, 2017–2021
Authors: Kindratt Tiffany B. , Smith Alexandra
Published: October 2024

Objectives. To estimate the odds of having cognitive difficulties among Middle Eastern and North African (MENA) American adults and compare these odds with those of White, Black, Hispanic/Latino, Asian, American Indian or Alaska Native (AI/AN), and Native Hawaiian/Other Pacific Islander adults nationally and in the 4 states with the largest MENA populations (California, New York, Michigan, and Texas) after adjusting for sociodemographic factors.

Methods. We analyzed 2017–2021 American Community Survey data (aged ≥ 45 years; n = 7 284 988), comparing presence of cognitive difficulties by race/ethnicity.

Results. MENA adults had greater odds of reporting cognitive difficulties than did White (odds ratio [OR] = 1.49; 95% confidence interval [CI] = 1.42, 1.56), Black (OR = 1.20; 95% CI = 1.14, 1.26), Hispanic (OR = 1.46; 95% CI = 1.39, 1.53), Asian (OR = 1.31; 95% CI = 1.25, 1.38), and AI/AN (OR = 1.07; 95% CI = 1.01, 1.14) adults. In all 4 states, odds of having cognitive difficulties were higher among MENA than Asian adults. Other racial/ethnic comparisons differed by state.

Conclusions. A separate checkbox for MENA Americans approved by the Office of Management and Budget is important so health outcomes can be studied in more detail and funds can be allocated for research and resources at state and national levels. ( Am J Public Health. 2024;114(11):1265–1274. https://doi.org/10.2105/AJPH.2024.307803 )
Role of Doulas in Improving Maternal Health and Health Equity Among Medicaid Enrollees, 2014‒2023
Authors: Falconi April M. , Ramirez Leah , Cobb Rebecca , Levin Carrie , Nguyen Michelle , Inglis Tiffany
Published: October 2024

Objectives. To assess the relationship between doula utilization and health outcomes of females enrolled in Medicaid-affiliated plans in the United States.

Methods. In this retrospective, observational cohort study, we used Medicaid claims data from a national health insurer to compare health outcomes between females who used and who did not use a doula (2014–2023). We conducted propensity score matching using a 1:1 case‒control match, without replacement, and fit logistic regressions to analyze the relative risks for maternal health outcomes.

Results. The study population included 722 matched pairs with and without a doula. Results indicate females with doulas had a 47% lower risk of cesarean delivery and a 29% lower risk of preterm birth, and were 46% more likely to attend a postpartum checkup (all differences P < .05).

Conclusions. Doula care is associated with improved health outcomes among Medicaid enrollees.

Public Health Implications. Doulas have garnered increasing interest from policymakers as a strategy to address increasing trends in maternal morbidity and persistent health disparities. This study provides evidence from Medicaid enrollees across the United States that doula care can improve maternal health. ( Am J Public Health. 2024;114(11):1275–1285. https://doi.org/10.2105/AJPH.2024.307805 )
Validation of Examination Maneuvers for Adolescent Idiopathic Scoliosis in the Telehealth Setting
Authors: Farid Alexander R. , Hresko M. Timothy , Ghessese Semhal , Linden Gabriel S. , Wong Stephanie , Hedequist Daniel , Birch Craig , Cook Danielle , Flowers Kelsey Mikayla , Hogue Grant D.
Published: October 2024

Background:

Telehealth visits (THVs) have made it essential to adopt innovative ways to evaluate patients virtually. This study validates a novel THV approach that uses educational videos and an instructional datasheet, enabling parents to use smartphones to measure their child’s scoliosis at home or in telehealth settings.

Methods:

We identified a prospective cohort of patients with adolescent idiopathic scoliosis (AIS) scheduled for follow-up care from March to July 2021. The angle of trunk rotation (ATR) was first measured at home by patients’ guardians using instructional video guidance and a smartphone application with internal accelerometer software. The second measurement was made during a THV examination performed by caregivers with supervision by trained associates via a telehealth appointment. Lastly, the clinician measured the child’s ATR during an in-person clinic visit. Intraclass correlation coefficients (ICCs) and interrater reliability were compared between in-person clinic measurements and (1) at-home and (2) THV measurements. Shoulder, lower back, and pelvic asymmetry were observed and quantified at home and virtually, and then were compared with in-person clinic evaluations using kappa values. Surveys were used to evaluate the experience of the patient/caregiver with the at-home and telehealth assessment tools.

Results:

Seventy-three patients were included (mean age, 14.1 years; 25% male). There was excellent agreement in the ATR measurements between THVs and in-person visits (ICC = 0.88; 95% confidence interval [CI] = 0.83 to 0.92). ATR agreement between at-home and in-person visits was also excellent, but slightly diminished (ICC = 0.76; 95% CI = 0.64 to 0.83). Agreement between THV and in-person measurements was significantly higher compared with that between at-home and in-person measurements (p = 0.04). There was poor agreement in lower back asymmetry between THV and in-person assessments (kappa = 0.37; 95% CI = 0.14 to 0.60); however, there was no significant agreement between at-home and in-person assessments (kappa = 0.06; 95% CI = −0.17 to 0.29). Patient/caregiver satisfaction surveys (n = 70) reported a median score of 4 (“good”) for comfort with use of the technology, and a score of 3 (“neutral”) for equivalence of THV and in-person evaluation.

Conclusions:

There was a high level of agreement between telehealth and in-person spine measurements, suggesting that THVs may be reliably used to evaluate AIS, thus improving access to specialized care.

Level of Evidence:

Diagnostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Pengaruh Media Pembelajaran 3D Piramida Hologram Terhadap Minat Belajar Siswa Pada Materi Vulkanisme Kelas X SMAN 54 Jakarta
Authors: Nurrahman Farah Adhiba , Aris Munandar  , Sucahyanto
Published: October 2024

This study aims to determine the effect of 3D Hologram Pyramid learning media on students' interest in learning about volcanism in class X at SMAN 54 Jakarta. The research method used is a quantitative approach with a quasi-experimental design, specifically a one-group pre-test post-test design. The sampling technique employed is random sampling, ensuring that all members of the population have an equal chance of being selected. The sample for this study consists of 36 students from class X-F. Data collection was conducted using a learning interest questionnaire administered before and after the treatment. The research instruments were found to be valid and reliable, and the data was determined to be normal and homogeneous. Based on the research results, the average score of the questionnaire after the treatment for the experimental class was 81%, categorized as "Excellent." Data analysis using the Paired Sample T-test revealed a significance value (sig) of 0.000 < 0.05, leading to the rejection of the null hypothesis (Ho) and the acceptance of the alternative hypothesis (Ha). Therefore, the use of 3D Hologram Pyramid learning media has a significant effect on students' interest in learning in class X at SMAN 54 Jakarta.
Does intervention with clindamycin and a live biotherapeutic drug containing Lactobacillus crispatus impact the reproductive outcome of IVF patients with abnormal vaginal microbiota: a randomised double-blind, placebo-controlled multicentre trial
Authors: Haahr Thor , Freiesleben Nina , Jensen Mette , Elbaek Helle , Alsbjerg Birgit , Laursen Rita , Praetorius Lisbeth , Nielsen Henriette , Pinborg Anja , Hartvig Vibeke , Pedersen Thomas , Skafte-Holm Axel , Jensen Jørgen , Humaidan Peter
Published: October 2024

The aim of the present randomised, double-blind, placebo-controlled trial was to investigate whether antibiotics and live lactobacilli would improve clinical pregnancy rates in IVF patients with abnormal vaginal microbiota (AVM) defined by high quantitative PCR loads of Fannyhessea vaginae and Gardnerella spp. IVF patients were randomised prior to embryo transfer into three parallel groups 1:1:1. Group one (CLLA) received clindamycin 300 mg ×2 daily for 7 days followed by vaginal Lactobacillus crispatus until the day of pregnancy scan, using the investigational drug LACTIN-V. Group two (CLPL) received clindamycin and placebo LACTIN-V, and finally, group three (PLPL) received an identical placebo of both drugs. A total of 1533 patients were screened, and 338 patients were randomised. The clinical pregnancy rate per embryo transfer was 42% (95%CI 32-52%), 46% (95%CI 36-56%) and 45% (95%CI 35-56%) in the CLLA, CLPL, PLPL groups respectively. Thus, treatment of AVM does not improve reproductive outcome.
The EudraCT (European Union Drug Regulating Authorities Clinical Trials Database) clinical trial identifier is 2016-002385-31; first registration day 2016-07-11.
Monofocal intraocular lenses with enhanced intermediate function provide more satisfaction in phaco-vitrectomy for the epiretinal membrane and cataracts
Authors: Ota Junya , Matsunaga Masaaki , Haga Fuminori , Suzumura Ayana , Yamada Kazuhisa , Shimizu Hideyuki , Kachi Shu , Ota Ichiro , Miyake Goichiro , Mokuno Kumiko , Inooka Daiki , Iwata Emi , Akahori Tomohiko , Nishiguchi Koji M , Kaneko Hiroki
Published: October 2024

A newly developed monofocal intraocular lens (IOL), known as Eyhance, features a continuously increasing refractive power from the periphery to the center of the lens, aiming to enhance intermediate vision. Our multicenter prospective, nonrandomized, comparative study in Japan aimed to compare the outcomes of phaco-vitrectomy for epiretinal membrane (ERM) and cataracts using Eyhance (DIB00V) versus a conventional monofocal intraocular lens (DCB00V). Sixty-two eyes implanted with Tecnis-1 and 79 eyes with Eyhance were analyzed. While there was no significant improvement in distance-corrected intermediate visual acuity with Eyhance (0.35 in logMAR) compared to DCB00V (0.39 in logMAR,p = 0.200), Rasch analysis of patient-reported outcomes using the Japanese modified Catquest-9SF Questionnaire revealed that Eyhance scored higher in patient general satisfaction (p = 0.0269). Subgroup analysis revealed a trend toward better postoperative distance-corrected intermediate visual acuity in patients with a certain degree of postoperative myopia. In conclusion, Eyhance may not provide superior immediate vision in phaco-vitrectomy for ERM compared to the conventional monofocal IOL, but it is not inferior. Furthermore, Eyhance could enhance postoperative satisfaction in patients with ERM and cataracts.
Role of Diet in Development of the Risk of Depression Among Geriatric Population: A Multicentric Cross-sectional Study in West Bengal
Authors: Talukdar Arunanshu , Chakraborty Arup , Talukdar Payel , Mukherjee Anindya , Chatterjee Ananya , Maity Suman , Banerjee Ankush , Roychoudhury Bhaskar , Mondal Partha , Das Himadri , Ghosh Sudip
Published: October 2024

Purpose
The scarcity of literature reviews from India to assess the prevalence of psychiatric distresses along with drastic spreading of Non-communicable diseases (NCDs) among frailty geriatric Indian population and the potential beneficial roles of dietary management helps to encourage for finding importance the purpose of this study.
Methods
Observational cross sectional study with analytic design was applied among the geriatric population (n = 400) to conduct this research. From the entire population, 300 were collected from community of three different Medical Colleges and Hospitals’ field practice area and another 100 were from hospital settings from Medical College and Hospital, Kolkata of West Bengal.
Results
In the socio-demographic scenario, majority were Hindu (78.5%), male (63.3%).The study participants were dispersed over several locations: 50.0% lived in hospital contexts, 21.5% lived in urban settings, and 28.3% lived in rural regions. With regard to NCDs, hypertension (p value *0.001), another cardiac outcome (p value *0.001) and diabetes mellitus (p value *0.004) were notably present in this population. In consideration with dietary pattern, the study findings indicate while depressive scores were significantly linked to vitamin C (chi square1.042,p value 0.001*),iron(chi square 0.942,p value < 0.001*) and calcium (chi square 1.184,p value 0.004*)intake.
Conclusion
Less intake of Vitamin C, iron and calcium are significantly associated with the development of depression among the geriatric population of West Bengal.
The Predictive Value of Trendelenburg Position and Neck Ultrasound for Fluid Responsiveness in Prone ARDS Patients with VV-ECMO
Authors: Zhao Junjie , Sun Yong , Tang Jing , Guo Kai , Zhuge Jiancheng , Fang Honglong
Published: October 2024

Background
In clinical practice, fluid administration is widely used to treat hypotension in patients undergoing veno-venous extracorporeal membrane oxygenation (VV-ECMO). However, volume expansion (VE) may aggravate acute respiratory distress syndrome (ARDS) and increase patient mortality, predicting fluid responsiveness is of great significance in the treatment of hypotension in patients undergoing VV-ECMO.
Methods
This prospective single-center study was conducted in a medical intensive care unit and included 51 VV-ECMO patients with ARDS in the prone position who required volume expansion due to hypotension. Stroke volume index variation (△SVI), carotid artery corrected flow time (FTc), and artery peak velocity variation (ΔVpeak) were taken before and during the Trendelenburg position or Volume expason is given. Fluid responsiveness was defined as a volume expansion-induced increase in ΔSVI of ≥ 15%.
Results
33 patients (64.7%) were identified as fluid responders. The area under the receiver operating characteristic curve (ROC) for FTc and ΔVpeak induced by the Trendelenburg position to predict fluid responsiveness were 0.866 (95% confidence interval [CI] 0.755–0.977) and 0.833 (95% CI 0.716–0.949), respectively. The sensitivity at the optimal threshold of 331.5 ms for FTc was 84.85% (95% CI 69.1–93.4%), with a specificity of 83.33% (95% CI 60.8–94.2%). For ΔVpeak, the sensitivity at the optimal threshold of 10.1% was 81.82% (95% CI 65.9–91.4%), with a specificity of 77.78% (95% CI 54.9–91.0%). The grey zone for FTc and ΔVpeak included 29% and 45% of patients, respectively.
Conclusions
Changes in FTc and ΔVpeak, monitored through neck ultrasound and induced by the Trendelenburg position, are reliable indicators for predicting fluid responsiveness in VV-ECMO patients with ARDS in the prone position. Furthermore, FTc demonstrates superior predictive value compared to ΔVpeak.
Classification of iPSC-Derived Cultures Using Convolutional Neural Networks to Identify Single Differentiated Neurons for Isolation or Measurement
Authors: Patel Purva , Ali Lina K. Mohammed , Kaushik Uma , Wright Mallory , Green Kaylee , Waligorski Jason E. , Kremitzki Colin L. , Bachman Graham W. , Elia Serena N. , Buchser William J.
Published: October 2024

Understanding neurodegenerative disease pathology requires a close examination of neurons and their processes. However, image-based single-cell analyses of neurons often require laborious and time-consuming manual classification tasks. Here, we present a machine learning (ML) approach leveraging convolutional neural network (CNN) classifiers capable of accurately identifying various classes of neuronal images, including single neurons. We developed the Single Neuron Identification Model 20-Class (SNIM20) which was trained on a dataset of induced pluripotent stem cell (iPSC)-derived motor neurons, containing over 12,000 images from 20 distinct classes. SNIM20 is built in TensorFlow and trained on images of neurons differentiated from iPSC cultures that were stained for nuclei and microtubules. This classifier demonstrated high predictive accuracy (AUC = 0.99) for distinguishing single neurons. Additionally, the 2-stage training framework can be used more broadly for cellular classification tasks. A variation was successfully trained on images of a human osteosarcoma cell line (U2OS) for single-cell classification (AUC = 0.99). While this framework was primarily designed for single-cell microraft-based identification and capture, it also works with cells in standard plate formats. We additionally explore the impact of fluorescent channels and brightfield images, class groupings, and transfer learning on the quality of the classification. This framework can both assist in high throughput neuronal or cellular identification and be used to train a custom classifier for the user’s specific needs.
99mTc-mercaptoacetyltriglycine renal scintigraphy can prevent unnecessary urinary drainage in patients with malignant ureteral obstruction
Authors: Ohtsu Akira , Arai Seiji , Onose-Kato Mai , Tsuji Yusuke , Sawada Tatsuhiro , Fujizuka Yuji , Nomura Masashi , Sekine Yoshitaka , Koike Hidekazu , Matsui Hiroshi , Higuchi Tetsuya , Suzuki Kazuhiro
Published: October 2024

Objective: Urinary drainage (ureteral stenting, percutaneous nephrostomy) is a standard treatment for malignant ureteral obstruction (MUO), but its exact indications have yet to be determined. 99mTc-mercaptoacetyltriglycine (MAG3) renal scintigraphy evaluates urinary obstruction using radioisotopes and may help to determine whether there is an indication for urinary drainage in patients with MUO. In this study, we investigated the ability of MAG3 scintigraphy to avoid unnecessary urinary drainage by following up patients who did not undergo urinary drainage after evaluation of residual renal function using this imaging modality.
Methods: Fifty patients who received MAG3 scintigraphy for MUO between April 2020 and January 2022 were included. These patients were classified according to the excretion pattern seen on MAG3 scintigraphy and followed up for renal function, development of pyelonephritis, and low back pain after 1, 2, 3, and 6 months.
Results: Fifteen patients received conservative treatment after evaluation by MAG3 scintigraphy. The median patient age was 72 years, and the median creatinine level was 0.79 mg/dl. Hydronephrosis was present on the left side in seven cases, the right side in seven cases, and on both sides in one case. The MAG3 pattern on the affected side was non-function in seven cases, delayed voiding in seven cases, and obstruction in one case. Three patients died as a consequence of their primary malignancy during follow-up. There were no instances of decreased renal function or development of pyelonephritis on conservative treatment. However, one patient underwent ureteral stenting for low back pain on the side contralateral to the nonfunctional kidney.
Conclusion: Fourteen of 15 patients with MUO who were treated conservatively after MAG3 scintigraphy did not experience troublesome renal events during up to 6 months of follow-up. MAG3 scintigraphy may be a valuable tool for preventing unnecessary urinary drainage. We would recommend conservative treatment for patients with a non-functional pattern.
Redeployment and Changes in Working Patterns of Healthcare Workers during COVID-19 in the UK: A Qualitative Study
Authors: Lal Zainab Zuzer , Gogoi Mayuri , Qureshi Irtiza , Al-Oraibi Amani , Chaloner Jonathan , Papineni Padmasayee , Lagrata Susie , Nellums Laura B , Martin Christopher A. , Woolf Katherine , Pareek Manish
Published: October 2024

Background
Redeployment was critical in addressing the increased demands of COVID-19 on the healthcare system. Previous research indicates that ethnic minority healthcare workers (HCWs), those on visas, and in junior roles, were more likely to be redeployed to COVID-19 duties compared to White UK-born HCWs. There is limited evidence on how redeployment was practically organized, preparedness of HCWs and the NHS for rapid changes, and the decision-making processes involved. This paper discusses HCWs’ redeployment experiences, their alignment with NHS policy for deploying staff safely, and potential links to staff attrition.
Methods
As part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes among Healthcare workers, we conducted a qualitative sub-study, between December 2020 and July 2021, consisting of interviews and focus groups with 164 HCWs from different ethnicities, genders, job roles, migration statuses, and UK regions. Sessions were conducted online or by telephone, recorded, transcribed and analysed with participants’ consent. We utilised the breadth-and-depth approach, initially identifying transcripts mentioning redeployment or changes in work patterns, followed by an in-depth thematic analysis.
Results
Of the 164 HCWs, 22 (13.4%) reported redeployment to a new role, while 42 (26.8%) reported changes in their working patterns. Redeployment experiences varied based on HCWs’ workplaces, skillsets, input into decisions, and perceived risks. Four themes were identified: 1. redeployment and the changing nature of work, 2. pandemic (un)preparedness, 3. redeployment decision-making, and 4. risk assessments in the context of redeployment. Our data revealed the practical realities of redeployment, including discrepancies between the NHS policy and actual practices, particularly early deployment without adequate training and supervision. The lack of planning and preparedness had an operational and emotional impact on HCWs, affecting their morale. Lastly, some HCWs felt disempowered and undervalued due to a lack of agency in redeployment decisions
Conclusion
This study highlights HCWs’ redeployment experiences during COVID-19, the conditions under which it occurred, and its impacts. The findings, although rooted in the pandemic, remain relevant for addressing staffing challenges in the healthcare workforce. We recommend future redeployment strategies prioritise HCWs' training and supervision, ensure strategic planning with clear communication and support for all staff, foster a sense of value among HCWs, and integrate an intersectional equity lens into workforce planning to improve staff retention and morale.
Application of driving-pressure-oriented mechanical ventilation in elderly patients undergoing posterior lumbar fusion surgery：A Pilot Feasibility Study
Authors: Gong Hongyan , Qu Liangchao , Cheng Liqin , Long Dingde , Liu Mei , Jiang Yao , Ouyang Ru
Published: October 2024

Background
Elderly patients undergoing posterior lumbar fusion surgery under general anesthesia are at increased risk of postoperative pulmonary complications (PPCs) due to decreased respiratory physiology. Driving pressure in mechanical ventilation is highly associated with occurrence of PPCs. Therefore, driving pressure-oriented ventilation strategy has attracted great attention. To explore the effects of driving pressure-oriented mechanical ventilation on occurrence rate of PPCs in elderly patients undergoing posterior lumbar interbody fusion, We conducted a pilot study in advance to confirm its safety and feasibility.
Methods
The pilot study was prepared to enroll 160 patients for eligibility assessment. Initially, elderly patients undergoing posterior lumbar interbody fusion were randomly divided into two groups: Group P and group C. Treatment of patients in Group P involved the use of driving pressure-oriented mechanical ventilation while conventional lung protective ventilation strategy was used for patients in Group C. Then, the perioperative ventilation and haemodynamic and blood oxygenation were determined.
Results
The minimum driving pressures for Groups C and P were 8.79 ± 1.44 and 7.47 ± 1.17 cm H2O, respectively (p < 0.05). Partial pressure for oxygen and oxygenation index for Group P at 20 min before the end of the surgery were significantly higher than those of Group C(p < 0.05).The incidences of postextubation hypoxemia for Groups C and P were 11.7% and 9.9%, respectively (p > 0.05).
Conclusions
Driving pressure-oriented mechanical ventilation improved intraoperative arterial oxygenation in elderly patients undergoing posterior lumbar fusion, but the incidence of postextubation hypoxemia was not affected.
Trial registration:
This pilot study is registered at www.medresman.org (ChiCTR2100054078), and the date of first registration was 08/12/2021 .
Terminal ileal intubation is not recommended in routine colonoscopy: data from a large-scale retrospective study
Authors: Shu Shunqing , Zhang Chen , Liu Liu , Shan Jing , Xiang Tong , Shu Tao , Sun Xiaobin
Published: October 2024

Background
Terminal ileal intubation (TII) demonstrates a complete colonoscopy, but whether it should be performed in routine colonoscopies remains uncertain. We aimed to explore the diagnostic yield of TII in routine colonoscopy and investigate the association of TII and the detection of lesion.
Methods
We conducted a retrospective study included patients who underwent colonoscopy with cecal intubation at our endoscopic center between November 1 2022 and July 31 2023. Macroscopic and histologic findings of terminal ileum were recorded. We used propensity score matching to adjust for differences between groups and further analyzed the difference of polyp detection rate (PDR), adenoma detection rate (ADR), sessile serrated lesion detection rate (SSDR) and right-sided lesion detection rate between patients underwent TII or not.
Results
There were 13372 patients with cecal intubation colonoscopy, including 7599 (56.8%) with TII and 5773 (43.2%) without TII. Abnormal endoscopic findings were observed in 150 of 7599 unselected individuals and only 7 of these cases were regarded as pathologically significant. Likewise, abnormal endoscopic findings were found in 20 of 1494 asymptomatic individuals with 19 nonspecific ileitis determined by histopathology. After PSM, there were no significant differences in PDR (51.5% vs 50.8%, P = 0.506), ADR (31.3% vs 30.0%, P = 0.156), SSDR (1.7% vs 1.8%, P = 0.613) and right-sided lesion detection rate (16.5% vs 16.5%, P = 1.000) between the two groups.
Conclusion
TII was not proposed in routine colonoscopy, owing to the limited diagnostic value and lack of superiority on lesion detection.
Preterm Preeclampsia Screening and Prevention: A Comprehensive Approach Integrating Precision Medicine in A Real-world Setting
Authors: Ronzoni Stefania , BSc Shamim Rashid , NP Aimee Santoro , Mei-Dan Elad , Barrett Jon , Okun Nanette , Huang Tianhua
Published: October 2024

Background
Preeclampsia significantly impacts maternal and perinatal health. Early screening using advanced models and primary prevention with low-dose acetylsalicylic acid for high-risk populations are crucial to reduce the disease’s incidence. This study assesses the feasibility of implementing first-trimester aneuploidy screening concurrent with preterm preeclampsia prevention by leveraging information from the former and integrating precision medicine in a real-world setting with spatial separation between laboratory and clinical sites.
Methods
A prospective cohort study involved pregnant individuals undergoing nuchal translucency scans between 11 and 14 weeks. Risk for preterm preeclampsia was assessed using the Fetal Medicine Foundation algorithm, which includes maternal risk factors, uterine artery Doppler, mean arterial pressure and serum markers. High-risk patients were offered low-dose acetylsalicylic acid prophylaxis. Feasibility outcomes, such as recruitment rates, protocol adherence, operational impact, integration with existing workflows, screening performance and pregnancy outcomes, were evaluated.
Results
Out of 974 participants, 15.6% were high-risk. The study achieved high recruitment (82.1%) and adherence rates, with 95.4% of high-risk patients prescribed low-dose acetylsalicylic acid. Screening performance, adjusted for low-dose acetylsalicylic acid use, showed a detection rate of 88.9–90% for preterm preeclampsia. High-risk patients had higher incidences of adverse outcomes, including preterm preeclampsia, preterm delivery, and low birth weight. The integration of preeclampsia screening had a minimal effect on the time required for aneuploidy screening, with results obtained within a rapid turnaround time.
Conclusions
The study confirms the feasibility of integrating comprehensive preeclampsia screening into clinical practice, notwithstanding spatial separation between laboratory and clinical settings. It underscores the need for broader adoption and enhanced infrastructure to optimize patient care and outcomes across diverse healthcare settings.
Trial registration:
Clinical trial: NCT04412681 (2020-06-02)
Dysregulation of the tumor suppressor Menin and its target Bach2 in HTLV-1 infection
Authors: Sejima Hiroe , Naito Tadasuke , Fukushima Takuya , Saito Mineki
Published: October 2024

Background
The tumor suppressor Menin, prone to mutations in both hereditary and sporadic endocrine tumors, along with its direct target Bach2, plays a crucial role in preventing autoimmunity by regulating CD4+ T cell senescence and maintaining cytokine homeostasis. Since human T-cell leukemia virus type 1 (HTLV-1) primarily infects CD4+ T cells, and its dysregulation contributes to both the hematological malignancy of adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP), we examined the involvement of the Menin-Bach2 pathway in HTLV-1 infection.
Methods
The mRNA expression of menin and bach2in HTLV-1-infected and uninfected human T-cell lines, peripheral blood mononuclear cells (PBMCs) from patients with ATL, HAM/TSP, and asymptomatic carriers were analyzed. Additionally, interactions between Menin or Bach2 and the Tax or HBZ; the subcellular localization of these proteins; the effect of knockdown of menin, tax, and HBZ genes; and the effects of interaction inhibitors between menin and its cofactor, mixed lineage leukemia (MLL), on the proliferation of HTLV-1-infected T cells were evaluated.
Results
The findings were as follows: (1) In all eight HTLV-1-infected T-cell lines tested, Menin protein was expressed, whereas Bach2 expression was absent in five of them; (2) the mRNA levels of both menin and bach2 significantly decreased in PBMCs from patients with HAM/TSP and ATL; (3) Tax and HBZ each physically interacted with both Menin and Bach2; (4) knockdown of tax, but not HBZ, downregulated Bach2, but not Menin expression in HTLV-1-transformed T-cell lines MT-2 and SLB-1; (5) knockdown of menin downregulated Bach2 expression in MT-2 but not in SLB-1; (6) A Menin-MLL interaction inhibitor suppressed cell growth of MT-2 but not in SLB-1; (7) HBZ and Menin exhibited different subcellular localization between MT-2 and SLB-1.
Conclusions
HTLV-1 infection alters the regulation of the Menin-Bach2 pathway, which controls cell proliferation. The Menin-MLL interaction inhibitor loses its effectiveness in suppressing cell proliferation when Menin loses control over Bach2 expression. Dysregulation of the Menin-Bach2 pathway may contribute to HTLV-1-associated disease pathogenesis.
Proinflammatory effect of telopeptides derived from collagen type II on articular cartilage of patients receiving total arthroplasty
Authors: Mao Jiamin , Wang Quanming , Lu Yubo , Chen Bowen , Xu Ruiyang , Ding Lei
Published: October 2024

Objective and design: To determine whether telopeptides of collagen type II could induce osteoarthritic cartilage damage via receptor for the native protein by using human articular cartilage.
Material or subjects: Cartilage slices were harvested from patients receiving total arthroplasty.
Treatment: Cartilage tissue cultures or primary chondrocyte cultures were treated with 30 µM N- or C-telopeptide (NT or CT) for 7 days or for 24 hrs.
Methods: Loss of proteoglycan (PG) from cartilage were evaluated with DMMB assay. Conditioned media or cell lysates were measured for levels of MMPs-3&13 or integrin beta1 (ITGB1) with Western blotting or real-time PCR.
Results: Both NT and CT could induce significant loss of PG from cartilage than controls (12.96 ± 5.38 µg PG/mg wet cartilage in CT group vs. 22.33 ± 7.75 µg PG/mg wet cartilage in scrambled CT group; P = 0.047). Up-regulation of MMPs-3 &13 was induced by either NT or CT at 24 hr (chondrocyte cultures) or Days 4 and 7 post-treatment (cartilage cultures). CT induced stronger expression of ITGB1 in chondrocytes than did NT.
Conclusions: Telopeptides of collagen type II could damage human articular cartilage and up-regulate MMPs-3 and -13. The proinflammatory effect of CT might be mediated by ITGB1.
Uptake of intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) in pregnancy and associated factors in a malaria endemic setting of Sub-Saharan Africa
Authors: Ajonina Marcelus U. , Ajonina-Ekoti Irene U. , Ngulefac John , Fosah Sharlot , Ware Kenric B. , Nche Clorinda M. , Nfor Carine K. , Ayim Martin , Apinjoh Tobias O.
Published: October 2024

Introduction: Malaria in pregnancy (MiP) is a public health issue that poses risks to maternal and fetal health. Although the World Health Organization recommends intermittent preventive treatment with sulfadoxine–pyrimethamine (IPTp-SP) to prevent MiP, its uptake remains low among endemic countries. This study aimed to evaluate IPTp-SP uptake and factors associated with its use at Bonassama District Hospital (BDH) in the Littoral Region of Cameroon.
Methods: A cross-sectional study was conducted at BDH from March to June 2022. Data were collected from antenatal care (ANC) attendees who were more than 30 weeks pregnant. Asymptomatic malaria infections were assessed using PfHRP2/pLDH diagnostic testing. Pearson Chi-square and Fisher’s Exact tests evaluated associations, while binary logistic regression assessed predictors of optimal IPTp-SP uptake, with statistical significance set at p < 0.05.
Results: Of the 393 participants, 273(69.5%, 95%CI: 64.7-74.0) received optimal IPTp-SP dosing. Predictors of IPTp-SP optimization were: level of education, religion, gravida, parity, gestational age at first ANC, number of ANC visits and maternal knowledge of optimal SP dose. Women who had taken at least three doses of IPTp-SP had less P. falciparum infections (aOR =2.6, 95% CI:1.65-4.14, p < 0.001). Primigravida women (aOR = 3.2, 95% CI: 1.69-5.98, p < 0.001), who started ANC during the first trimester of pregnancy (aOR = 28.5, 95% CI: 12.58-64.58, p <0.001), with ≥ 4 ANC visits (aOR = 16.7, 95% CI 7.9–35.3, p < 0.001) and had good knowledge of optimal SP dosing required during pregnancy (aOR =3.2, 95% CI: 2.0-5.22, p < 0.001) were more likely to receive optimal IPTp-SP dosing. IPTp-SP uptake was not associated with utilization of long-lasting insecticidal nets (LLINs) (p>0.05).
Conclusion: This study revealed that the optimal uptake of IPTp-SP was below the nationwide 80% coverage target set for 2030. This reinforces the urgency to promote early and frequent ANC visits. Additionally, there is a continuous need for health education highlighting the importance of IPTp-SP uptake and the use of LLINs as essential strategies to reduce MiP.
Disseminated Infection Characterization on FDG-PET/CT: Clinico-laboratory-radiological Correlation Unraveling the Complexity.
Authors: Sarwal Tanvi , Taywade Sameer , Majeed Althaf K , Kumar Rajesh , Kumar Bharat
Published: October 2024

18F FDG PET/CT is a hybrid imaging technique traditionally used for various oncological indications. Recent advances have broadened its use to various non-oncological indications, such as infections and inflammatory diseases. While FDG uptake indicates increased metabolic activity, however the uptake of FDG is not specific, and it is not possible to distinguish separate infections on the basis of FDG uptake alone. We present a case, wherein through critical analysis of PET/CTimages, and correlation with patient’s clinical and laboratory data, we were able to identify three distinct infections on FDG PET/CT.
Integrating Structured and Unstructured Data for Predicting Emergency Severity: A Combined Predictive and Association Study Using NLP Models
Authors: Zhang Xingyu , Wang Yanshan , Jiang Yun , Pacella Charissa B. , Zhang Wenbin
Published: October 2024

Background
Efficient triage in emergency departments (EDs) is critical for timely and appropriate care. Traditional triage systems primarily rely on structured data, but the increasing availability of unstructured data, such as clinical notes, presents an opportunity to enhance predictive models for assessing emergency severity and to explore associations between patient characteristics and severity outcomes.
Methods
This study utilized data from the National Hospital Ambulatory Medical Care Survey - Emergency Department (NHAMCS-ED) for the year 2021 to develop and compare models predicting emergency severity. The severity scores were categorized into two groups: urgent (scores 1–3) and non-urgent (scores 4–5). We employed both structured data (e.g., demographics, vital signs, medical history) and unstructured data (e.g., chief complaints) processed through a Transformer-based Natural Language Processing (NLP) model (BERT). Three models were developed: a structured data model, an unstructured data model, and two combined models integrating both data types. Additionally, we performed an association analysis to identify significant predictors of emergency severity.
Results
The study included 8,716 adult patients, of whom 74.6% were classified as urgent. Association analysis revealed significant predictors of emergency severity, including older age (OR = 2.13 for patients 65+), higher heart rate (OR = 1.56 for heart rates > 90 bpm), and specific chronic conditions such as chronic kidney disease (OR = 2.28) and coronary artery disease (OR = 2.55). The structured data model achieved an AUC of 0.70 and an accuracy of 0.63, while the unstructured data model using BERT showed improved performance with an AUC of 0.76 and an accuracy of 0.70. The combined model integrating structured and unstructured data demonstrated the highest performance, with an AUC of 0.79 and an accuracy of 0.73.
Conclusions
The integration of structured and unstructured data significantly enhances the prediction of emergency severity in ED settings and reveals important associations between patient characteristics and severity outcomes. This approach underscores the value of combining comprehensive data integration with association analysis to improve clinical decision support systems, ultimately enhancing patient outcomes and resource allocation in emergency care.