bluuebunny/crossref_metadata_2025 huggingface dataset:
Price and Location Trump Taste in Influencing Consumer Choices in Indonesia
Authors: Priamitra Caraka , Indayani Lilik
Published: October 2024

This study analyzes the impact of taste, price, and location on consumer buying interest in Devil Noodle Ponti Sidoarjo using a descriptive quantitative method. Data were gathered via questionnaires from 100 consumers using accidental sampling, and analyzed with multiple linear regression. The results show that while taste does not significantly affect buying interest, both price and location do. These findings suggest that strategic pricing and convenient location are crucial for attracting customers in the specialty noodle market. This research provides valuable insights for marketing strategies in the food industry.
Highlights:
1. Taste does not significantly impact consumer buying interest.2. Price and location significantly influence purchasing decisions.3. Strategic pricing and location are crucial for attracting customers.
Keywords: Consumer Buying Interest, Taste, Price, Location, Marketing Strategy
Quantifying Leadership and Cultural Impact on Workplace Behavior
Authors: Umma Habibatul , Firdaus Vera
Published: October 2024

This study investigates the collective influence of change management, leadership competence, and organizational culture on the work behavior of Tanggulangin sub-district office employees. Utilizing a descriptive quantitative research approach with purposive sampling, data was gathered from 100 employees in Sidoarjo Regency, East Java. Results indicate that while change management showed no significant impact, leadership competence and organizational culture significantly influenced work behavior. These findings highlight the crucial role of effective leadership and conducive organizational cultures in shaping employee behavior, particularly in local government settings. Efforts to enhance leadership competencies and foster positive organizational cultures can greatly improve employee performance and organizational effectiveness.
Highlight:

Leadership Impact: Competence shapes work behavior, crucial for organizational effectiveness.
Cultural Influence: Organizational culture crucially affects employee behavior, fostering productivity.
Local Government Implications: Findings guide leadership and culture initiatives for enhanced performance.

 
Keywoard: Change management, leadership competence, organizational culture, work behavior, local government.
Cashier App Revolutionizes Internal Controls in Global Enterprises
Authors: Pramudita Rifkiansyah Aryasatya , Abidin Fityan izza noor
Published: October 2024

This study evaluates the effectiveness of cashier application-based cash receipt systems as internal controls in small-scale enterprises, focusing on Lugo Coffee House in Tulungagung, Indonesia. Through qualitative analysis of interviews, observations, and document reviews, the study examines the functionality and integration of internal controls within these systems. Findings indicate that while the systems demonstrate efficiency in transaction processing and record-keeping, deficiencies such as the absence of task segregation pose potential risks. Nonetheless, the overall sufficiency of these systems in mitigating financial risks is affirmed. The study highlights the importance of optimizing cashier application-based systems to enhance financial management practices and minimize risks associated with cash transactions in similar organizational contexts.
Highlights:
1. Assessing cashier app systems in small enterprises.2. Identifying internal control strengths and weaknesses.3. Optimizing financial management to minimize risks.
Keywords: Cashier application, Internal controls, Small-scale enterprises, Financial management, Risk mitigation.
Empowering Organizational Performance through Budgeting Dynamics in Indonesia
Authors: Pribadi Moch Ayub Johan , Biduri Sarwendah
Published: October 2024

This quantitative study investigates the impact of budget preparation participation and budget target clarity on the performance of regional apparatus organizations (OPDs) in Sidoarjo Regency, Indonesia, with organizational commitment as a moderating variable. Utilizing SmartPLS version 3.0, data was collected from 78 respondents across 26 OPDs using purposive sampling. Findings reveal that both budget preparation participation and budget target clarity significantly influence OPD performance, while organizational commitment moderates the effect of budget target clarity but not budget preparation participation. The study underscores the importance of active participation in budgeting processes and clear budget targets in enhancing OPD performance, offering valuable insights for policymakers and organizational leaders aiming to optimize budgeting practices and bolster organizational effectiveness.
Highlights:

Budget involvement enhances OPD performance.
Organizational commitment moderates budget clarity's effect.
Findings inform policy for optimizing organizational effectiveness.

Keywords: Budgeting, Organizational Commitment, OPD Performance, SmartPLS, Sidoarjo Regency.
Emotional Intelligence Drives Employee Performance in Indonesia
Authors: Mayyora Elssya , Sumartik
Published: October 2024

This study aims to determine the impact of Emotional Intelligence, Self-Efficacy, and Work Stress on Employee Performance at PT. Harapan Sejahtera Karya Utama. Utilizing a quantitative approach, data were collected via questionnaires from 71 randomly sampled employees. Data analysis involved multiple linear regression using SPSS 25. The study found that Emotional Intelligence, Self-Efficacy, and Work Stress significantly affect employee performance (Fcount > Ftable = 6.694 > 3.134, Sig < 0.05 = 0.001). However, only Emotional Intelligence had a significant partial effect. Self-Efficacy and Work Stress did not significantly influence performance. Conducted in 2023 in Sidoarjo, this research used descriptive quantitative methods with 229 employees. The sample was determined using Slovin's formula with a 10% error rate. Data were gathered through Likert-scale questionnaires and observations. The study included validity, reliability tests, and multiple linear regression analysis. Classical assumption tests were conducted. The operational definitions involved Emotional Intelligence, Self-Efficacy, Work Stress as independent variables, and Employee Performance as the dependent variable. Results indicated a significant overall effect of the independent variables on performance, with Emotional Intelligence having a notable individual impact. Limitations include a focus on permanent production employees. Future research should broaden the sample for more comprehensive insights.
Highlight:

Significant Overall Effect: Combined factors significantly impact employee performance.
Partial Impact: Only Emotional Intelligence significantly affects performance.
Sample Limitation: Study focused on permanent production employees only.

 
Keywoard: Emotional Intelligence, Self-Efficacy, Work Stress, Employee Performance, Quantitative Research

 

 
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Reducing Employee Turnover Intention through Compensation, Support, and Engagement in Indonesia
Authors: Sahid Ahmad , Firdaus Vera
Published: October 2024

This study investigates the impact of compensation, organizational support, and work engagement on turnover intention at PT. Nugraha Ekakurir Line (JNE) Sidoarjo. Using a quantitative, descriptive method, data was collected via questionnaires from 114 respondents and analyzed with SPSS version 26. The results show that compensation, organizational support, and work engagement each have a negative and significant partial effect on turnover intention, and together they have a significant simultaneous effect. These findings suggest that enhancing compensation, organizational support, and work engagement can effectively reduce employee turnover.
Highlight:

Compensation, organizational support reduce turnover intention.
Data from 114 respondents analyzed using SPSS 26.
Enhancing these factors minimizes employee turnover.

 
Keywoard: Compensation, Organizational Support, Work Engagement, Turnover Intention, Quantitative Study
Pawnshop Marketing by Empowering Decisions through Equity and Promotion
Authors: Salsabilla Kania Savi , Detak Prapanca
Published: October 2024

This study investigates the impact of literacy empowerment, brand equity, and promotion on customer decisions regarding pawnshop products in Sidoarjo, Indonesia. Through a quantitative approach involving 96 respondents and regression analysis, the study reveals significant positive effects of these factors on customer decisions. Findings highlight the importance of enhancing literacy empowerment and promotional efforts in the pawnshop industry, while leveraging brand equity to bolster customer engagement. These insights offer valuable guidance for refining marketing strategies and fostering customer loyalty among pawnshop companies in Sidoarjo, suggesting avenues for future research to explore additional variables and expand sample sizes for a more comprehensive understanding of customer behavior in this context.
 
Highlighgt: 

Quantitative analysis: Regression with 96 respondents for pawnshop customer decisions.
Marketing strategy: Enhance literacy, promotion, leverage brand equity for customer engagement.
Future research: Explore variables, expand samples for Sidoarjo's pawnshop industry understanding.

 
 
Keyword:  Pawnshop industry, Customer decisions, Literacy empowerment, Brand equity, Promotion.
Increasing the Income of SMEs in Indonesia through the Power of Quality and Education
Authors: Farhansyah Rizky Fajar , Sriyono
Published: October 2024

This study explores the impact of product quality and the educational level of small and medium enterprise (SME) owners on SME income in Sidoarjo Regency, Indonesia. Using a quantitative approach with survey data from 52 SMEs, the analysis via SMARTPLS4 reveals that both product quality and education significantly influence SME income. The findings suggest that enhancing product quality and investing in education can lead to higher SME income, providing valuable insights for SME owners and policymakers to support economic growth in the region.
 
Highlight:  
 

Impact: Product quality and education level significantly influence SME income.
Method: Analyzed 52 SMEs in Sidoarjo using SMARTPLS4.
Recommendation: Improve product quality and education to boost SME income.

 
Keyword:  SMEs, product quality, education level, income, Sidoarjo Regency
Impression Management and Employee Commitment in Akwa-Ibom Tertiary Institutions
Authors: Agbonmwanre Omorogieva Anthony
Published: October 2024

General background: Employee commitment is crucial for organizational success, and impression management techniques may significantly influence this commitment. Specific background: Previous studies have examined the effects of impression management in organizational contexts, yet the specific dynamics in Nigerian tertiary institutions remain underexplored. Knowledge gap: The influence of exemplification, ingratiation, and self-promotion on different dimensions of employee commitment (affective, continuance, and normative) in Nigerian institutions has not been fully examined. Aims: This study aims to determine how these dimensions of impression management influence employee commitment and the moderating role of organizational culture. Results: Findings reveal a positive and significant relationship between impression management and employee commitment. Specifically, exemplification enhances affective commitment, ingratiation promotes continuance commitment, and self-promotion influences normative commitment. Organizational culture was found to strongly moderate these relationships. Novelty: This study provides new insights into the contextual effects of impression management on employee commitment in Nigerian tertiary institutions. Implications: The findings suggest that management should employ strategic impression management techniques to enhance employee commitment, fostering improved organizational performance and reduced turnover.
Highlights:

Impression management positively influences employee commitment in tertiary institutions.
Exemplification enhances affective commitment, ingratiation promotes continuance commitment.
Organizational culture strongly moderates the relationship between impression management and employee commitment.

Keywords: Impression Management, Employment Commitment, Exemplification, Ingratiation, Self-Promotion
Challenges and Opportunities in Transforming Rural Governance Through E-Government in Indonesia
Authors: Amiril Nur , Choiriyah Ilmi Usrotin
Published: October 2024

General Background: The adoption of E-Government systems is increasingly important in improving public services, particularly at the local government level, to enhance transparency and accessibility. Specific Background: In Indonesia, Village Information Systems (SID) have been introduced to streamline communication, resource management, and service delivery in rural areas. Sugihwaras Village in Sidoarjo Regency is one such location where SID has been implemented. Knowledge Gap: Despite its potential, the effectiveness of SID implementation remains underexplored, particularly in terms of communication, resources, and its impact on rural governance. Aims: This study aims to analyze and describe the implementation of E-Government through SID in Sugihwaras Village, focusing on the four indicators: communication, resources, disposition, and bureaucratic structure, using Edward III's policy implementation model. Results: The findings indicate that communication and resource allocation are the primary issues hindering SID effectiveness. Inadequate operator training and a lack of budget for operator fees have led to outdated information and diminished motivation. However, strong commitment from local government and adherence to standard operating procedures (SOPs) have ensured that the system continues to function. Novelty: This study highlights the crucial role of consistent training and budgetary support in enhancing E-Government systems at the village level, particularly in rural Indonesia. Implications: Strengthening operator skills and ensuring adequate financial support are essential for optimizing SID as a tool for public information transparency and service delivery, contributing to improved rural governance and E-Government effectiveness.
Highlights:
 

Communication gaps limit the Village Information System's efficiency.
Budget constraints reduce operator motivation and system updates.
Government commitment keeps the system operational despite obstacles.

 
Keywords: E-Government, Village Information System, rural governance, communication, resource allocation
The Rise of Solar Energy and Hybrid Power: Transforming Remote Regions
Authors: Likhov Ilya
Published: October 2024

This article explores the transformative potential of hybrid energy systems and AI in revolutionizing traditional energy grids. Despite the prevalent use of fossil fuels, traditional grids operate inefficiently, generating energy continuously without responding to demand fluctuations. This article highlights the limitations of such systems and contrasts them with hybrid energy infrastructures that integrate solar panels and energy storage solutions for more dynamic and sustainable energy management.

The article proposes several strategies for leveraging AI to optimize energy systems. By utilizing predictive analytics, AI can anticipate energy demands, optimize resource allocation, and reduce reliance on fossil fuels. This approach not only enhances grid stability and resilience but also facilitates the efficient use of renewable energy sources, such as solar power. Furthermore, AI empowers consumers with smart energy management tools, enabling informed decisions on energy usage that contribute to cost savings and environmental sustainability.

The convergence of hybrid energy systems and AI presents a promising pathway towards a sustainable energy future. By implementing AI-driven predictive capabilities, stakeholders can unlock new opportunities for efficiency, resilience, and environmental stewardship in the energy sector.
The oxidative balance score impacts serum FT4 levels and all-cause mortality in Euthyroid Participants
Authors: Xiao Qianqian , Zhang Zhanqin , Ji Shuman , Li Muzi , Zhang Bohua , Xu Qing , Xiao Chang , Guan Huaijin , Ma Lei , Mei Xiaopeng
Published: October 2024

Abnormal fluctuations in thyroid function within the reference range were strongly associated with increased all-cause mortality. This study aimed to analyze the association between oxidative balance score (OBS) and biomarkers of thyroid function in euthyroid adults and to further investigate whether oxidative balance status affects all-cause mortality by regulating these biomarkers. 5727 euthyroid adults were selected from the National Health and Nutrition Examination Survey (NHANES). Weighted linear regression investigated the potential association of OBS with free thyroxine (FT4) and thyrotropin (TSH). In addition, COX proportional hazard models and restricted cubic spline (RCS) were used to investigate the association between OBS, FT4, TSH, and all-cause mortality. Mediating analyses were performed to determine whether FT4 and TSH modulated the relationship between OBS and all-cause mortality. The results showed that OBS was negatively correlated with FT4 concentration in euthyroid adults. In addition, OBS and FT4 were significantly associated with all-cause mortality. Mediation analysis showed that serum FT4 level mediated the relationship between OBS and FT4 to a certain extent. Among euthyroid individuals, antioxidant OBS significantly correlates with lower FT4 levels. Adherence to an antioxidant diet and lifestyle may help maintain healthier serum FT4 levels, significantly reducing the risk of all-cause mortality.
Acute Myeloid Leukemia and Myelodysplastic Neoplasms: Clinical Implications of Myelodysplasia-Related Genes Mutations and TP53 Aberrations
Authors: Kim Hyunwoo , Lee Ja Young , Yu Sinae , Yoo Eunkyoung , Kim Hye Ran , Lee Sang-min , Lee Won Sik
Published: October 2024

Purpose
The fifth World Health Organization (WHO) classification (2022 WHO) and International Consensus Classification (ICC) of myeloid neoplasms have recently been published. We reclassified patients according to the revised classification and analyzed their prognosis to confirm the clinical utility of the new classifications.
Methods
We included 101 adult patients, including 77 with acute myeloid leukemia (AML) and 24 with myelodysplastic neoplasms (MDS), who underwent bone marrow aspiration and next-generation sequencing (NGS) between August 2019 and July 2023. We reclassified patients according to the revised criteria, then examined the differences and analyzed the prognosis using survival analysis.
Results
According to the 2022 WHO and ICC, 23 (29.9%) patients and 32 (41.6%) patients were reclassified into different groups, respectively, due to the addition of myelodysplasia-related (MR) gene mutations to the diagnostic criteria or the addition of new entities associated with TP53 mutations. The median overall survival (OS) of patients with AML and MR gene mutations was shorter than those of other AML group; however, the difference was not significant. Patients with AML and TP53 mutation had a significantly shorter OS than the other AML group (p = 0.0014, median OS 2.3 vs 10.3 months). They also had significantly shorter OS than the AML and MR mutation group (p = 0.002, median OS 2.3 vs 9.6 months).
Conclusion
The revised classifications allow for more detailed categorization based on genetic abnormalities, which may be helpful in predicting prognosis. AML with TP53 mutations is a new ICC category that has shown high prognostic significance in a small number of cases.
Building a Coronavirus Disease 2019 (COVID-19) healthcare registry in an evolving pandemic
Authors: Venkatachalam Indumathi , Conceicao Edwin Philip , Sim Jean Xiang Ying , Arora Shalvi , Yang Yue , Yee Shoon Jin , Xu Yingxi , Ong Marcus Eng Hock , Chan Sze Ling
Published: October 2024

Objective:
COVID-19 emerged in Wuhan, China in December 2019 and was declared a pandemic on March 11, 2020. As there were many unknowns about COVID-19, an immediate priority early in the pandemic was to collect high-quality data to understand disease characteristics and epidemiology to inform healthcare resource management. A COVID-19 registry was developed by Singapore Health Services (SingHealth) to support clinical, operational, and research needs. We describe the development process of the SingHealth COVID-19 registry.
Methods:
Patients diagnosed with COVID-19 and managed by the Singapore Health Services (SingHealth), the largest of three public healthcare clusters in Singapore that includes acute hospitals, national specialty centres, subacute hospitals, and primary health centres, were included in the registry. A combination of laboratory test results and nationally administered electronic disease tags were used to identify COVID-19 patients. A dashboard was built in the Electronic Health Intelligence System (eHIntS), the data repository within SingHealth, linking variables in a minimum data set (MDS) using patient identifiers. Healthcare utilization in different ward types was computed, and 19 comorbidities and 14 complications were derived and coded from raw data sources within eHints for hospitalized patients.
Results:
The COVID-19 registry contains more than 100 variables across 15 data domains, including raw data in long format (e.g. problem list, movement within hospital) and derived variables (e.g. comorbidities, complications, outcomes). As of December 31, 2023, the COVID-19 registry comprises of 156,262 unique patients of whom, 27,630 were admitted for COVID-19 at least once at one of the SingHealth hospitals. It has provided data for operational, clinical, and research purposes.
Conclusion:
The SingHealth COVID-19 registry is a model of how a low-cost, automated database can be developed amidst an evolving pandemic, leveraging on pandemic-necessitated standardized clinical workflows for pandemic operations, clinical management and research.
Multi-disciplinary Characterization of Embarrassment: Behavioral and Acoustic Modeling
Authors: Sipka Dajana , Vlasenko Bogdan , Stein Maria , Dierks Thomas , Magimai-Doss Mathew , Morishima Yosuke
Published: October 2024

Introduction: Embarrassment is a social emotion that shares many characteristics with social anxiety (SA). Most people experience embarrassment in their daily lives, but it is quite unattended in research. We characterized embarrassment in an interdisciplinary approach, introducing a behavioral paradigm and applying machine learning approaches, including acoustic analyses.
Methods:33 participants had to write about an embarrassing experience and had then, without knowing it prior, to read it out loud to the conductor. Embarrassment was then examined with two different approaches: Firstly, from a subjective view, with self-report measures from the participants. Secondly, from an objective, machine-learning approach, where trained models tested the robustness of our embarrassment data set (i.e., prediction accuracy), and then described embarrassment in a dimensional (i.e., dimension: valence, activation, dominance; VAD) and categorical (i.e., comparing embarrassment to other emotional states) way.
Results: The subjective rating of embarrassment was increased after participants read their stories out loud, and participants with higher SA scores experienced higher embarrassment than participants with lower SA scores. The state of embarrassment was predicted at 86.4% at the best of the unweighted average recall rate. While the simple VAD dimensional analyses did not differentiate between the state of embarrassment and the references, the complex emotional category analyses characterized embarrassment as closer to boredom, a neutral state, and less of sadness.
Conclusion: Combining an effective behavioral paradigm and advanced acoustic modeling, we characterized the emotional state of embarrassment, and the identified characteristics could be used as a biomarker to assess SA.
Economic Burden and Quality of Life of Maintenance Hemodialysis Patients in a Rural Area of South India: A Pharmacoeconomic Evaluation
Authors: Rajan Redlin Jani , Sultan Reema Mohammed , Saju Sanjana Mariam , Theivendren Panneerselvam , Raju Nithya
Published: October 2024

Objective
The intersection of economics and quality of life in hemodialysis patients with CKD-ESRD is complex. Hemodialysis is a life-saving treatment for patients with end-stage kidney disease (ESRD), but it is also a very expensive treatment and has a considerable influence on a patient's quality of life, both physically and emotionally. This study aims to predict the cost of illness and quality of life in maintenance dialysis patients in a rural area of South India.
Methods
Individuals from tertiary care hospitals (N = 55) were filtered to satisfy the study inclusion criteria. We used the cost of illness as a predictor to analyse patients’ direct cost, indirect cost and intangible cost using the KDQOL 36 for a period of 6 months. Costs were estimated in terms of Indian national rupees (INR; 1 USD ~ INR82.52).
Results
In our study, 76.3% had haemodialysis thrice a week. A total of 52.7% spent INR 100–200 for laboratory investigation monthly. A total of 47.2% had lost their wages of INR 1000–3000 per visit, and 52.7% of patient care takers had lost < INR 3000 of their wages due to this procedure. KDQOL-36 analysis showed significant (p value < 0.05) impact of physical and mental functioning, burden of kidney disease, symptoms, and effects of kidney disease on daily life in haemodialysis patients
Conclusion
The cost of maintenance haemodialysis significantly burdens patients and caregivers, particularly those from lower socioeconomic backgrounds in rural areas. This study emphasizes the need for improved access to hemodialysis treatment and support services for CKD-ESRD patients in rural areas. To address this, policy must expand rural hemodialysis centers, address resource constraints, and raise kidney disease awareness, and clinical care must prioritize patients, engage them in decision-making, and ensure safe hospital practices.
Development and validation of a risk prediction model for PICC-related venous thrombosis in patients with cancer: A prospective cohort study
Authors: Hu Zeyin , Luo Mengna , He Ruoying , Wu Zhenming , Fan Yuying , Li Jia
Published: October 2024

Objective: To develop and validate a risk prediction model for predicting the risk of Peripherally Inserted Central Catheter-Related venous thrombosis (PICC-RVT) in cancer patients with PICCs.
Method: A prospective cohort study of 281 cancer patients with PICCs was conducted from April 2023 to January 2024. Data on patient-, laboratory- and catheter-related risk factors were collected on the day of catheterization. Patients were investigated for PICC-RVT by Doppler sonography in the presence of PICC-RVT signs and symptoms. Univariate and multivariate regression analyses were used to identify independently associated risk factors of PICC-RVT and develop a risk prediction model.
Results: 275 patients were finally included for data analysis, and 18 (6.5%) developed PICC-RVT. Four risk factors were identified as key predictors of PICC-RVT, including “diabetes requiring insulin (OR:8.016; 95%CI:1.157-55.536), major surgery (within 1 month and operation time >45 minutes) (OR:0.023; 95%CI:1.296-30.77), reduced limb activities of the PICC arm (OR:6.687; 95%CI:2.024-22.09)” and “catheter material (OR:3.319; 95%CI:0.940-11.723)”. The nomogram model was developed and internally validated with an area under the receiver operating characteristics curve (AUC) of 0.796 (95%CI:0.707-0.885). The Hosmer–Lemeshow goodness-of-ft was 1.685 (p=0.194).
Conclusion: The nomogram prediction model had good predictive performance. This model could help identify patients at the highest risk for PICC-RVT to guide effective prophylaxis. Further external validation studies of this nomogram model on a large sample are required.
A combination of unexplained extreme fatigue and weight gain in a previously healthy middle-aged man with moderate alcohol habits, with later diagnosed hyperuricemia, hypertension, diabetes and large bilateral ulcerating heel tophi: a case report
Authors: Sato Rie , Halling Anders
Published: October 2024

Background: It is well-known that urate is a risk factor for gout but hyperuricemia is also a condition associated with common diseases such as hypertension, obesity and diabetes mellitus.
Case presentation: A caucasian male in his late 50’s who had developed a moderate drinking habit over 10 years (2-3 glasses of wine at weekends) from a previous habit of almost no alcohol use and no previous past medical history developed extreme general fatigue, which made movement increasingly difficult. This resulted in weight gain for 1.5 years before he developed numbness and about 4 years later ulcerating tophi in both of his heels. After the condition of his heels got worse, he consulted a private orthopedic surgeon who referred him to his GP where he was diagnosed with hyperuricemia, hypertension, diabetes mellitus, and obesity. Both heel tophi were removed surgically. After both the large heel tophi were surgically removed, lifestyle changes were made and medical treatment by his General Practitioner (GP) was initiated for his hyperuricemia, hypertension, and diabetes mellitus. Most of his laboratory tests and clinical symptoms such as fatigue and being overweight quickly improved, however it has been taking a longer time for inflammation to get normalized.
Conclusion: Hyperuricemia is a condition that is often untreated or undertreated, but it has been shown that hyperuricemia itself has a relationship in the development of diseases such as hypertension, diabetes mellitus and cardiovascular diseases, which could eventually be life-threatening. However, hyperuricemia can induce unexplainable extreme fatigue, which results in less movement and the development of weight gain and other lifestyle-related diseases e.g. hypertension and diabetes mellitus. Treatment for hyperuricemia should be considered even if the patient has not developed gout exacerbations, because hyperuricemia may not only cause gout, which reduces patients’ quality of life, but also has a relationship with life-threatening diseases.
SF-BARI Score for assessment of long-term results in patients with BMI ≥ 50 Kg/m2 submitted to Roux-en-Y Gastric Bypass or Sleeve Gastrectomy
Authors: Costa-Pinho André , Araújo-Teixeira João , Rodrigues Sara , Santos-Sousa Hugo , Resende Fernando , Preto John , Lima-Costa Eduardo
Published: October 2024

Introduction: To improve treatment of patients with BMI ≥ 50 Kg/m2, it is necessary to standardize reports and to assess long-term outcomes. The SF-BARI score was developed to provide a comprehensive evaluation of MBS outcomes. This article explores the long-term results of RYGB and SG in patients with BMI ≥ 50 Kg/m2 using the SF-BARI Score, and assesses variables that may influence this score.
Methods: Retrospective cohort study of patients with BMI ≥ 50kg/m2 submitted to Roux-en-Y Gastric Bypass (RYGB) or Sleeve Gastrectomy (SG) between January 2010 and September 2021, with more than 5 years of follow-up. Several data were collected, and the SF-BARI score was calculated and analyzed. Statistical analysis was performed to identify variables that influenced the score.
Results: We identified 89 patients with long-term follow-up (mean 96.6 months, SD 18.9) after RYGB or SG. The mean SF-BARI score was 94.2 (SD 29.5) with most patients’ outcomes categorized as Good. Seventy-six (85.4%) patients had %TWL ≥ 20, but only 34.8% patients had a final BMI < 35 kg/m². Statistical analysis revealed that younger patients have higher SF-BARI score related to comorbidities improvement.
Conclusion: Our findings suggest that both RYGB and SG lead to satisfactory long-term outcomes for treatment of patients with BMI above 50 kg/m², according to the SF-BARI Score. However only one third achieved a BMI below 35 kg/m². Younger patients seem to achieve better results, particularly comorbidity improvements. SF-BARI score is a comprehensive and intuitive web-based tool that may contribute for the standardization of reporting outcomes after MBS.
Mapping the social networks of key actors in the development of health technology assessment in Iran
Authors: Behzadifar Meysam , Bakhtiari Ahad , Azari Samad , Shahabi Saeed , Martini Mariano , Saran Maryam , Ehsanzadeh Seyed Jafar , Behzadifar Masoud
Published: October 2024

Background
Health Technology Assessment (HTA) plays a crucial role in informing health policy and ensuring the effective allocation of resources. In Iran, the development and implementation of HTA involve various key actors with differing levels of influence, interest, and support. Understanding the social networks and power dynamics among these actors is essential for optimizing HTA processes.
Methods
This study employed Social Network Analysis (SNA) to map the relationships and interactions among 27 identified stakeholders involved in HTA development in Iran. Data were collected through an online questionnaire distributed to 83 participants, assessing five dimensions: power, position, interest, influence, and support. Network metrics, including degree centrality, closeness centrality, betweenness centrality, and eigenvector centrality, were calculated to evaluate the roles and connections of each actor.
Results
The analysis revealed that the Ministry of Health and Medical Education, Food and Drug Administration, Insurance Organizations, and the Islamic Consultative Assembly (Parliament) are the most influential actors in the HTA network. The Plan and Budget Organization and National Institute of Health Research emerged as key connectors with high centrality metrics. Despite this, the network exhibited limited connectivity and sparse interactions among some actors, notably the Chamber of Commerce.
Conclusion
The study highlights the central roles of key institutions in HTA development while identifying gaps in stakeholder communication and connectivity. Enhancing collaboration and addressing these gaps are critical for improving HTA processes in Iran. Strengthening central coordination and stakeholder engagement will facilitate more effective HTA implementation and informed health policy decisions.
Differences in enrichment and soil safety thresholds of five vegetables grown in Cd-polluted soil of Chengdu Plain，China
Authors: Sun Xin , Gao Yang , Pan Shengwang
Published: October 2024

By analyzing the differences in the enrichment capacity of Cd in several vegetables, the health risks posed by the edible parts of vegetables to human beings under different levels of soil Cd contamination in Chengdu pain were assessed, and the corresponding vegetable-soil Cd safety thresholds were established. We compared and analyzed the enrichment capacity of various vegetable varieties for Cd under various soil Cd contamination levels (0.13, 0.20, 0.32, 0.73, and 1.02 mg kg− 1) using five commonly grown vegetable varieties (Lactuca sativa var longifoliaf. Lam(Romaine lettuce), Lactuca sativa var. ramosa Hort. (Cos lettuce), Brassica campestrisL.ssp.chinensis Makino var.communis Tsen et Lee(pakchoi), Raphanus sativus L. (oleander), and Lactuca sativa var. angustata(lettuce)) as research targets. We also assessed potential issues with food safety and health risks associated with Cd in vegetables using the Hazard Quotient (HQi) criterion for human health risk assessment. The possible hazards to food safety and health from lead (Cd) in vegetables were assessed using the HQi criteria, and the Cd safety levels for vegetable soil were definited. Results of the assessment of the health risk of food intake indicated that lettuce was more likely to pose a risk than the other four vegetables and that children were more likely to pose a risk than adults with the same intake of vegetables. The enrichment capacity of soil Cd in lettuce was found to be significantly higher than that of Romaine lettuce, Cos lettuce, pakchoi, and oleander(n = 5, P < 0.05). For the Chengdu Plain, the soil Cd safety thresholds were 0.32 mg kg− 1 for Romaine lettuce, Cos lettuce, pakchoi and oleander, and 0.20 mg kg− 1 for lettuce. These findings offer a scientific foundation for ensuring the quality and safety of vegetables, improving the environmental quality standards of Cd in farmland soils, and attaining the safe utilization of contaminated farmland.
Gestational age and Models for predicting Gestational Diabetes Mellitus
Authors: Murphy Aisling , Gornbein Jeffrey , Yin Ophelia , Koos Brian
Published: October 2024

Introduction
Gestational diabetes mellitus (GDM) is generally identified by measuring abnormal maternal glycemic responses to an oral glucose load in late pregnancy (> 0.6 term). However, our preliminary study suggests that GDM could be identified with a high predictive accuracy (96%) in the first trimester (< 0.35 term) by characteristic changes in the metabolite profile of maternal urine. (Koos and Gornbein, 2021) Due to the gestational rise in insulin resistance and the accompanying perturbations of the maternal metabolome, the urinary metabolite algorithm distinguishing GDM versus CON in early gestation likely differs from that in latter gestation.
Objectives
This study was carried out 1) to identify the metabolites of late-pregnancy urine that are independently associated with GDM, 2) to select a metabolite subgroup for a predictive model for the disorder, 3) to compare the predictive accuracy of this late pregnancy algorithm with the model previously established for early pregnancy, and 4) to determine whether the late urinary markers of GDM likely contribute to the late pregnancy decline in insulin sensitivity.
Methods
This observational nested case-control study comprised a cohort of 46 GDM patients matched with 46 control subjects (CON). Random urine samples were collected at ≥ 24 weeks’ gestation and were analyzed by a global metabolomics platform. A consensus of three multivariate criteria was used to distinguish GDM from CON subjects, and a classification tree of selected metabolites was utilized to compute a model that separated GDM vs CON.
Results
The GDM and CON groups were similar with respect to maternal age, pre-pregnancy BMI and gestational age at urine collection [GDM 30.8\(\:\pm\:\)3.6(SD); CON [30.5\(\:\pm\:3.0\:weeks]\). Three multivariate criteria identified eight metabolites simultaneously separating GDM from CON subjects, comprising five markers of mitochondrial dysfunction and three of inflammation/oxidative stress. A five-level classification tree incorporating four of the eight metabolites predicted GDM with an unweighted accuracy of 89%. The model derived from early pregnancy urine also had a high predictive accuracy (85.9%).
Conclusion
The late pregnancy urine metabolites independently linked to GDM were markers for diminished insulin sensitivity and glucose-stimulated insulin release. The high predictive accuracy of the models in both early and late pregnancy in this cohort supports the notion that a urinary metabolite phenotype may separate GDM vs CON across both early and late gestation. A large validation study should be conducted to affirm the accuracy of this noninvasive and time-efficient technology in identifying GDM.
BJ, Gornbein JA. Early pregnancy metabolites predict gestational diabetes mellitus: Implications for fetal programming. Am J Obstet Gynecol 2021;224(2):215.e1-215.e7.
Low incidence of acute kidney injury in very low birth weight infants with early caffeine treatment - a single center study
Authors: Schlesinger Noam , Tzvi-Behr Shimrit , Ben-Shalom Efrat , Frishberg Yaacov , Kasirer Yair
Published: October 2024

Background Acute kidney injury (AKI) is common in premature neonates and is associated with short term complications as well as a higher risk for future kidney damage. Caffeine was reported as associated with decreased AKI occurrence. This study aims to assess the incidence of AKI in a cohort of very low birth weight (VLBW) infants (under 1500 grams) routinely treated with early high dose caffeine.
Methods Charts of all VLBW preterm infants admitted to the Neonatal Intensive Care Unit at Shaare Zedek Medical Center between Jan. 1, 2017, and Dec. 31, 2019, were reviewed. Infants with missing creatinine or urine output data and those with major congenital abnormalities were excluded. AKI was defined according to the neonatal AKI kidney disease improving global outcomes classification. All VLBW preterm infants were treated with continuous high dose Caffeine infusion starting at the first hour of life. All maternal and infant data were retrieved from electronic medical records.
Results A total of 311 VLBW infants were reviewed and 301 met inclusion criteria. AKI was diagnosed in 41 infants (14%). The incidence of early onset AKI was 12/301 (4%) significantly lower than previously reported (p-value < 0.0001). Sixteen infants (5%) had more than one AKI episode. Seven infants (17%) had AKI stage 1 and seventeen (41%) had stage 2 or 3.
Conclusions In our cohort of VLBW infants treated with high dose caffeine starting at the first hour of life, the incidence of AKI, especially early onset AKI, was lower than previously reported.
Evaluation of Mronj Knowledge in Senior Dental and Medical Students
Authors: Develi Tuba , Akgök Merve Gaye , Wardak Madina
Published: October 2024

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a complication that occurs in patients receiving antiresorptive or antiangiogenic medical therapy. Treatment of MRONJ requires meticulous treatment planning and protocols. The aim of this study is to evaluate and compare the knowledge level of senior dentistry and medicine students about MRONJ.
Materials and Methods: A cross-sectional study was conducted on a total of 154 senior dentistry and medical faculty students. Data were collected using a structured electronic survey consisting of six sections. Data were entered and analyzed using SPSS version 23, and a P-value <0.05 was considered significant.
Results: More than half of the sample (66.7%) had knowledge about antiresorptive and antiangiogenic drugs; 76.4% of those who had knowledge had heard about it during their university education. The underlying diseases that antiresorptive and antiangiogenic drugs target were unknown to the majority. Almost half of the sample (45.2%) could not identify any antiresorptive or anti-angiogenic drugs, and 62.5% of senior students of the Faculty of Medicine and 15.9% of senior students of Dentistry did not know that these drugs could cause jaw necrosis.
Conclusion: Although the level of knowledge about MRONJ was higher among dental students for all departments in the survey, it was quite insufficient for both medical and dental students.
Clinical Relevance: Enhancing knowledge of dentistry students and medicine students about MRONJ will be an important step in reducing and even preventing this public health problem, which is quite common in society.
Association between the indicators of insulin resistance and periodontitis: A study using data from the National Health and Nutrition Examination Survey 2009–2014
Authors: Lang Yiyuan , Song Xin , Chen Yan , Mei Han , Wu Chengyu , Zhang Rui , Xue Changao
Published: October 2024

Background
The prevalence of obesity-associated insulin resistance (IR) is increasing along with greater obesity rates. To identify the best replacement index of IR, this study aimed to investigate the possible association between IR, which was assessed using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR), and the triglyceride–glucose (TyG) index and its derived indexes and periodontitis.
Methods
The association between the indicators of IR and periodontitis was assessed via multivariate-adjusted logistic regression analyses using data from the National Health and Nutrition Examination Survey (NHANES) 2009–2014. In addition, subgroup analyses and receiver operating characteristic curve analyses were conducted to explore possible influencing factors.
Results
Our study encompassed 1,588 participants, and 41.0% were diagnosed with periodontitis. Based on themultivariate logistic regression analysis, a higher TyG-waist-to-height ratio (WHtR)(odds ratio [OR] = 1.00, 95% confidence interval [CI]: 1.08–1.67, P = 0.0075) and HOMA-IR score (OR = 1.00, 95% CI: 1.00–1.00, P = 0.0130) were associated with an increased risk of periodontitis. Conversely, the TyG index, TyG-adjusted for body mass index, and TyG-adjusted for waist circumference (WC) were not associated with periodontitis. According to further subgroup analyses and interaction result analyses, sex affected the association between the TyG index, TyG-WC, and TyG-WHtR and periodontitis (P < 0.05 for interaction). Moreover, the influence of age regulated the association between periodontitis and both TyG and HOMA-IR score. In terms of diagnostic accuracy, the area under the receiver operating characteristic curve analysis revealed that HOMA-IR score and TyG-WHtR slightly outperformed the TyG index, TyG-body mass index, and TyG-WC. Thus, they can be robust markers for assessing IR-related periodontitis risk.
Conclusion
A consistent and positive association was found between HOMA-IR score and TyG-WHtR and the odds of periodontitis prevalence. Hence, HOMA-IR score and TyG-WHtR can be valid predictors for evaluating the association between periodontitis development and IR.
Does Introduction of a Taper-Slip Polished Cemented Stem Reduce Early Periprosthetic Fracture Risk with Anterior Approach Total Hip Arthroplasty?
Authors: Telias Alberto , Bourget-Murray Jonathan , Garceau Simon , Beaule Paul , Grammatopoulos George
Published: October 2024

Background
Anterior approach total hip replacement (AA-THA) is associated with higher periprosthetic fracture (PFF) risk. Cemented femoral fixation may reduce this risk. This study aims to 1) determine if using a cemented polished taper-slip (PTS) stem reduces PFF risk, 2) describe perioperative complications, and 3) identify factors associated with outcome.
Methods
This was a retrospective, case-matched cohort study from an academic center. The first 122 hybrid AA-THAs with a minimum 12-month follow-up were reviewed. These were matched (2:1) for age, sex, BMI, femoral and pelvic morphology with 244 AA-THAs using an uncemented, short, stem. Outcomes measured include PPF (Vancouver classification) rate, reoperation rate, complications, cement quality, and radiologic measurements.
Results
Nineteen PFFs (5.1%) occurred at a mean 14.5±23 days following surgery. There was no difference in PPF rate between groups (CS: 7/122, 5.7%, 5/7 Type-A and 2/7 Type-B2; US: 12/244, 4.9%, 7/12 Type-A, 4/12 Type-B2 and 1/12 Type-C; p=0.847). There was no difference in PPF risk between short (≤125 mm) and normal length (150 mm) stems (p=0.676). More uncemented stems subsided (CS: 1/122, 0.8%; US: 27/244, 11.1%; p<0.001). Suboptimum cementation was noted in 16 (13%) hips; two fractured and one subsided (risk-ratio [RR]: 3.9; p=0.035). A narrow ischial width and high ilio-ischial ratio were the only morphological parameters associated with risk of PPF and subsidence.
Conclusion
Hybrid AA-THA did not reduce PFF risk. Suboptimal cementation was associated with increased risk of subsidence or fracture. Current instruments do not accommodate the limited working window and steeper femoral angle during AA-THA.