bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors influencing survival outcomes in patients with stroke at three tertiary hospitals in Zimbabwe: A 12-month longitudinal study
Authors: Kaseke Farayi , Gwanzura Lovemore , Musarurwa Cuthbert , Gori Elizabeth , Nyengerai Tawanda , Kaseke Timothy , Stewart Aimee 
Published: December 2024

Background
In this longitudinal study, we aimed to determine factors influencing survival outcomes among patients with stroke at three tertiary hospitals over a 12-month period. The investigation sought to uncover influential determinants to enhance the precision of prognostic assessments and inform targeted interventions for individuals affected by stroke.

Methods
Employing a longitudinal study design, participants were observed for 12 months from baseline, censoring survivors at the endpoint. The dataset originated from a comprehensive study involving stroke patients treated at three referral hospitals in Zimbabwe: Parirenyatwa, Sally Mugabe, and Chitungwiza Central Hospitals. The primary outcome variable, the duration of survival until death, was measured in days from the initiation of stroke treatment. Gompertz parametric regression analysis was utilized for data modeling following AFT model diagnostics.

Results
In our study, 188 stroke patients were enrolled at baseline. However, 51 patients were excluded from the analysis due to either missing information or loss to follow-up. Among the remaining 137 patients who were tracked over a 12-month period, 42% were censored, and 58% were deceased. Individuals utilizing ’Free Service (older than 65/pensioners/retirees/social welfare)’ hospital bill payment methods showed a decreased risk of death, (adjusted hazard ratio; aHR: 0.4, 95% CI: 0.20, 0.80), suggesting a protective effect compared to cash paying patients. Those who had attained a secondary school level education displayed a significantly lower risk of death (aHR: 0.4, 95% CI: 0.24, 0.79) compared to those with primary level education. Age was a significant risk factor, with individuals aged 45–65 and those over 65 years showing higher adjusted hazard ratios 3.4 (95% CI: 1.42, 8.36) and 3.7(95%CI:1.44, 9.36), respectively, relative to those below 45 years of age. Housing status revealed a protective effect for those residing with parents/relatives (aHR: 0.4, 95% CI: 0.20, 0.64). Total functional outcome demonstrated significantly lower hazards for individuals with mild or moderate (aHR: 0.2, 95% CI: 0.09, 0.40) and severe outcomes (aHR: 0.2, 95% CI: 0.10, 0.46) compared to those with very severe outcomes.

Conclusion
The study findings demonstrate that hospital bill payment methods, housing status and staying with relatives, educational attainment, functional outcome, and age significantly affect survival outcomes among stroke patients. This highlights the need to consider socio-demographic and clinical variables in the development of prognostic assessments and targeted interventions for individuals recovering from stroke.
SARS-CoV-2 risk factors among symptomatic vaccinated adults attending community testing locations in the Netherlands from June 2021 till February 2022
Authors: Laarman Claudia , Hahné Susan J. , de Melker Hester E. , Knol Mirjam J. 
Published: December 2024

Introduction
Most studies on risk factors for a SARS-CoV-2 infection were conducted in the pre-vaccination era with many non-pharmaceutical prevention measures in place. We investigated risk factors for symptomatic SARS-CoV-2 infections in vaccinated persons in a period with a varying degree of prevention measures.

Methods
In a test-negative case control study among vaccinated adults attending community COVID-19 testing locations between June 1st 2021 till February 28th 2022, we compared symptomatic cases with symptomatic controls (to study risk factors specific for SARS-CoV-2) and with asymptomatic controls (to study risk factors that could apply to respiratory infections in general). We examined potential risk factors including household composition and mitigation behaviour by logistic regression, adjusting for age, sex, and week of testing.

Results
Risk factors for a positive SARS-CoV-2 test when symptomatic cases were compared to symptomatic controls were: having a household size of more than 4 (adjusted odds ratio: 1.47; 95% CI 1.14–1.92), being a healthcare worker (1.27;1.18–1.47), and visiting busy locations outside (1.49;1.19–1.87). When symptomatic cases were compared to asymptomatic controls, a household size of more than 4 members (1.71;1.25–2.33), living with children aged 0–12 (1.59;1.12–2.26), visiting busy locations outside (1.64;1.24–2.17) were independent risk factors for a positive SARS-CoV-2 test. Risk factors for separate periods and waves differed from the study period as a whole.

Conclusion
This study was conducted in a period with a varying degree of prevention measures. Among vaccinated individuals, we identified several SARS-CoV-2 specific risk factors and SARS-CoV-2 risk factors that could be more general for respiratory infections. For SARS-CoV-2 transmission more attention could be given to visiting busy outdoor locations, having a household size that consists of more than 4 persons, being a healthcare worker, and living with children aged 0–12. Risk factors varied with different phases in the pandemic, emphasizing the importance of repeated assessment of risk factors.
The invisible enemy: A systematic review and meta-analysis of maternal smokeless tobacco use as a risk factor for low birth weight
Authors: Mahajan Akanksha , Gupta Bhawna , Tong Michael 
Published: December 2024

Introduction
Smokeless tobacco use is a growing public health concern, with potential adverse implications for foetal outcomes if consumed during pregnancy. Birth weight is an important predictive measure for health outcomes of a child throughout their lifespan. Despite extensive literature, it is unclear whether smokeless tobacco consumption during pregnancy has an adverse effect on birth weight. Hence, this review was conducted to determine whether an association exists between maternal smokeless tobacco consumption during pregnancy and birth weight of infants.

Methods
Systematic literature search was performed in Medline (via PubMed), Embase, Scopus, and CINAHL with no restrictions on language or time until May 2024. All observational studies that examined the relationship between maternal smokeless tobacco use and low birth weight of infants were eligible for inclusion. Methodological quality of included studies was assessed using the Newcastle Ottawa Scale.

Results
Thirty-three studies were eligible for the review, including twenty-eight cohort, three case-control and two cross-sectional studies. A statistically significant association between use of smokeless tobacco and low birth weight was reported in thirteen studies. Eleven studies reported a statistically significant reduction in mean birth weight in maternal smokeless tobacco users. Pooled estimates of eighteen studies with 733,061 participants showed that there was a statistically significant association (OR = 2.25 [1.63, 3.11] P<0.001); between maternal smokeless tobacco use during pregnancy and low birth weight. Subgroup analysis found a significant association between mishri consumption during pregnancy and low birth weight (n = 646 participants, OR = 10.98 [2.03, 59.34], P = 0.005), but not betel nut (n = 8007 participants, OR = 1.02 [0.84, 1.25]), betel quid (n = 483 participants, OR = 1.51 [0.47, 4.89]) or khat (n = 475 participants, OR = 1.41 [0.64–3.09]).

Conclusions
This review presents an association between maternal smokeless tobacco use and low birth weight, and reduction in mean birth weight. It is suggested that cessation and reduction of maternal smokeless tobacco use should receive specific attention within routine prenatal care.

Implications
The results of this study highlight the need for further preventive public health campaigns to create awareness about detrimental effects of smokeless tobacco on foetal outcomes. Patient education in the primary care setting will aid in promoting smokeless tobacco cessation prior to pregnancy.
Acetaminophen administration reduces acute kidney injury risk in critically ill patients with Clostridium difficile infection: A cohort study
Authors: Liao Yue , Wang Yulong , Li Daxue , Qiu Xuewen 
Published: December 2024

Background
Acetaminophen serves as a standard antipyretic and analgesic agent in the intensive care unit (ICU). However, the association between its administration and acute kidney injury (AKI) among critically ill patients remains controversial, particularly lacking research in patients with Clostridioides difficile infection (CDI). Our aim was to explore the potential relationship between early acetaminophen administration and AKI in critically ill patients with concurrent CDI.

Methods
Using data from the Medical Information Mart for Intensive Care (MIMIC) IV version 2.2 database, we performed a retrospective cohort study. AKI within 7 days of ICU admission was the main outcome that was measured. We utilized multivariable logistic regression models adjusted for potential confounders based on statistical significance and clinical relevance, to investigate the association between acetaminophen exposure and the risk of AKI in patients with CDI. Additionally, subgroup analyses and sensitivity analysis were conducted to assess the robustness of our primary findings.

Results
The average age of 984 participants was 66.8 ± 16.5 years, and 52.7% (519) were male. The overall proportion of patients who developed AKI was 75.4% (742/984). In patients without and with acetaminophen administration, AKI rates were 79.8% (380/476) and 71.3% (362/508), respectively. Compared to the non-acetaminophen administration group, the risk of AKI was lower in the acetaminophen administration group (absolute risk difference: -8.5%, 95%CI: -13.83%∼-3.17%, P < 0.01).After adjusting for potential confounders, acetaminophen administration was associated with a 32% reduction in the risk of AKI (OR = 0.68, 95%CI:0.48∼0.96, P = 0.027).

Conclusion
Our study suggests that early acetaminophen administration may offer renal protection by reducing the risk of AKI in critically ill patients with CDI. Prospective, multicenter randomized controlled studies are needed to verify this finding.
ANALYSIS OF TAKEOFF BEHAVIOR OF A320 AND B738 AIRCRAFT AT SULTAN HASANUDDIN INTERNATIONAL AIRPORT BASED ON UNSUPERVISED LEARNING
Authors: Passarella Rossi , Ubaya Huda , Sutarno Sutarno 
Published: December 2024

This research aims to enhance aviation safety in Indonesia by examining the impact of takeoff speed on flight incidents. Specifically, we investigate the relationship between abnormal takeoff speeds and runway exit or other accident risks for A320 and B738 aircraft at Sultan Hasanuddin International Airport.
Employing a quantitative research design, we analyzed a dataset of 4,550 flights over 91 days. Due to data quality constraints, only 14% of the data (628 flights) was suitable for analysis. The dataset was further divided into three classes using the elbow method to identify patterns in takeoff speeds. These classes included low, medium, and high takeoff speeds, allowing us to assess the correlation between each category and the incidence of runway exits or accidents. Preliminary findings suggest that flights with abnormal takeoff speeds are significantly associated with increased risks, highlighting the need for improved monitoring and intervention strategies at the airport.
Our findings will contribute to a better understanding of the factors influencing flight safety, particularly in relation to takeoff speeds. By identifying potential risks and developing targeted interventions, this research can help improve aviation safety standards in Indonesia. In addition, collaboration between airlines, regulatory bodies, and airport authorities will be essential in implementing these strategies effectively. Future studies may also explore the impact of weather conditions and pilot training on takeoff performance and further enhance safety measures in the aviation sector.
Atorvastatin-Induced Liver Injury With Concurrent Rhabdomyolysis After a Positive Rechallenge
Authors: Singh Harjit , Khalaf Adam , Kunkle Bryce F. , Gholami Sherry , Lewis James H. , Rangnekar Amol S. 
Published: December 2024

ABSTRACT
Statin-induced liver injury has been widely described. However, cases of clinically significant liver injury are rare. We present a 56-year-old woman who developed atorvastatin-induced grade III acute liver injury with concurrent rhabdomyolysis that worsened after rechallenging, which highlighted the need for pharmacovigilance with statins. The Roussel Uclaf Causality Assessment Method and Revised Electronic Causality Assessment Method both showed that atorvastatin was highly probable in causing hepatotoxicity. To our knowledge, this is the first reported case of concurrent drug-induced liver injury and rhabdomyolysis after a positive rechallenge with atorvastatin.
Sustaining teaching during a crisis
Authors: Dixson Marcia D , Saam Julie 
Published: December 2024

Given the increasing demands on faculty in higher education, it is imperative that we better understand how to support faculty across their careers and in all areas of faculty life. This study looks specifically at what it takes to support teaching during the added stress of a global crisis. An exploratory survey of 66 faculty at midwestern campuses indicates that Satisfaction with teaching as a career, Passion for teaching, and Quality of teaching require different things. Specifically, Satisfaction with teaching requires motivation. Passion for teaching needs time. Quality of teaching, on the other hand, requires motivation, support, and time. What these concepts consist of and how we might use this information to support our own and our colleagues’ teaching is discussed.
Study of microwave-assisted extraction of polyphenol from Phyllanthus urinaria
Authors: Ngo Dat Trinh Tac , Tran Ngoc Hieu , Hoang Kim Anh 
Published: December 2024

ABSTRACTBackground: Phyllanthus urinaria, found extensively in tropical Asian countries, possesses numerous biological activities attributed to its polyphenol compounds.Objective: This study aims to optimize polyphenol extraction from Phyllanthus urinaria using microwave assistance.Materials and Methods: First, the effects of parameters including ethanol concentration (used as the solvent) (40–80% v/v), material-to-solvent ratio (1:10–1:50 w/v), extraction time (30–150 minutes), and extraction temperature (30–70°C) on conventional extraction were investigated. Subsequently, the effects of microwave pretreatment prior to extraction during the microwave-assisted extraction (MAE) process, including microwave power (100–700 W) and irradiation time (1–9 minutes), were evaluated. Optimal extraction conditions were determined based on total flavonoid content (TFC), total phenolic content (TPC), and antioxidant activity (DPPH scavenging assay) of the extract. The second-order kinetic model was also used to compare the efficiency of extraction methods.Results: Results indicated that a microwave power of 250 W and irradiation time of 3 minutes were optimal for material pretreatment prior to extraction. Subsequent extraction parameters included ethanol concentration of 60% (v/v), solvent-to-material ratio of 1:40 (w/v), extraction temperature of 50°C, and extraction time of 60 minutes. Under these conditions, the extract exhibited maximum levels of TPC (277.99 ± 5.47 mgGAE/gDW), TFC (38.90 ± 0.58 gQE/gDW), and TEAC (280.08 ± 0.75 µmolTE/gDW), which were 22.5%, 36.1%, and 29.4% higher, respectively, compared to the control without microwave treatment.Conclusion: Furthermore, the second-order kinetic model demonstrated higher initial extraction rate (h), extraction rate constant (k), and extraction capacity (Ce) for MAE compared to conventional extraction.Keywords: Antioxidant capacity; kinetic model; microwave-assisted extractio; phyllanthus urinaria; polyphenol
Larvae-Free Rate Aedes sp: The Effect of Temperature, Humidity and Rainfall in Bengkulu City, Indonesia
Authors: Gunasari Lala Foresta Valentine , Aladdawiyah Zahara Septika , Suwarsono Suwarsono , Triana Dessy 
Published: December 2024

Abstract Background: Bengkulu's tropical climate is very suitable for Ae. aegypti and Ae. albopictus mosquito breeding. Temperature, humidity and rainfall affect mosquito breeding and dengue virus proliferation in mosquitoes, which in turn had an effect on the dengue infections. Dengue prevention strategy currently focuses on vector control with the Larvae Free Rate (LFR) parameter. This study aimed to determine environmental factors affecting the LFR in 2022 in Bengkulu City, Indonesia.Methods: This research used a cross-sectional study design with time series analysis. Time series was used to analyze and interpret sequential data points collected over the interval of time. Secondary data about LFR was obtained from the Bengkulu City Health Service, and climate variables from the Climatology Station of the Bengkulu Meteorology, Climatology, and Geophysics Agency. Data analysis was conducted through simple linear regressions.Results: The average of LFR in Bengkulu City in 2022 was 78.13% (below the national target), with the highest in December (87.85%) and the lowest in May (68.53%). The average temperature, humidity, and rainfall were 26.88°C (moderate), 83.5% (moderate), and 328.96% (high), respectively. The simple linear regression analysis showed that the effect of temperature, humidity, and rainfall was significant to LFR with the respective p-values of 0.010; 0.612, and 0.173).Conclusion: Temperature influenced the LFR by 58,5% but humidity and rainfall have no effect on LFR of Aedes spp. in Bengkulu City in 2022. High temperatures will increase the risk of transmission of dengue virus infection by 3-5%.
Factors Associated to the Incidence of Anemia Among Adolescent Girls in Muaragembong District Bekasi Regency
Authors: Fitriyanti Nisa , Achadi Anhari 
Published: December 2024

AbstractIntroduction: Anemia is still a major health problem among adolescent girls. The prevalence of anemia among adolescent girls in Muaragembong District Bekasi Regency in 2022 reached 68.7%, so Muaragembong Health Center triggered intervention through innovation programs in iron supplements. This study aimed to analyze factors related to the incidence of anemia among adolescent girls in Muaragembong District Bekasi Regency.Methods: This was a quantitative study with a cross-sectional study design. The subjects were 150 adolescent girls of grade XII from 5 schools in Muaragembong District. The sampling method used was probability sampling with clustered random sampling technique. Hemoglobin (Hb) levels was measured by Hemocue Hb meter device. Data on food consumptions were collected through Food Frequency Questionnaires (FFQ). Data analysis was conducted through Chi square tests.Results: Based on the results, 26% of adolescent girls sufferred from anemia. The factors of anemia incidence were thin nutritional status (p=0.0001), abnormal menstrual patterns (p=0.0001), non hand-washing behavior (0.016), unbalanced food consumption patterns (p=0.002), and iron supplement consumption <4x/ month (p=0.0001). The results of multiple logistic regression tests showed that abnormal menstrual patterns (OR=22.07; 95% CI: 3.24-150.51), iron supplement consumption<4times/mo (OR=10.83, 95% CI: 1.30-89.88), thin nutritional status (OR=4.23, 95%CI: 1.44-12.40), and balanced food consumption patterns (OR=0.27, 95% CI: 0.09-0.84) were related to the incidence of anemia in adolescent girls.Conclusion: The dominant factor of anemia in adolescent girls was abnormal menstrual pattern. However, other factors: iron supplement consumption and balanced food consumptions were also important factors related to anemia.
Leveraging Delphi Technique to Develop Breastfeeding Support Modules in East Java, Indonesia
Authors: Kowara Mellysa , Lubis Dinar Saurmauli , Crosita Yessi , Octaviana Betty , Kurnianingsih I Desak Ketut Dewi Satiawati , Januraga Pande Putu 
Published: December 2024

Improving knowledge and skills are crucial factors in increasing the commitment of health facility staff to support exclusive breastfeeding. This study presents the steps to formulate the modules using Delphi technique and implemented those modules in the training. This study used a mix-methods method consisting of four stages, namely literature review, qualitative study, module validity and module implementation. The modules were validated by 14 lactation experts to assess reliability, feasibility, and linguistics. The study was conducted from 2020-2021 in 5 regions in East Java Province. A pre-post-test measurement with 493 health works and non-health workers was conducted to assess the effectiveness of the modules. The first round of Delphi showed agreement proportion between 80-100% on the three aspects. In the second round of Delphi, the strong consensus stated that the modules can be implemented in training was achieved with percentage of feasibility (79.4%), reliability (44.4%) and linguistics (44.4%). The results of the training using the modules showed a significant improvement in knowledge between 6-26 points in 5 areas (p-value0.000). In conclusion, three modules have been developed and validated successfully. The modules were effectively used to improve the breastfeeding knowledge and practice among health and non-health workers.
Aggressiveness Level of Martial Arts Participants in Children
Authors: Fadillah Hafni Nur'aini  , Muhammad Nur Alif  , Anin Rukmana  
Published: December 2024

This study aims to determine the existence of martial arts concerning the level of aggressiveness in children. This study used quantitative methods with a comparative ex post facto causal design. The population in this study is children aged 10-12 years who live in West Java with categories of martial arts participants including taekwondo, pencak silat, and karate and the non-martial arts category. The study sample amounted to 118 from each group. Sampling techniques using purposive sampling by determining research needs criteria. The data collection technique uses a questionnaire totaling 29 questions with 4 components of aggressiveness, namely: physical aggressiveness, verbal aggressiveness, anger, and hostility. Data analysis techniques use SPSS by conducting descriptive statistical tests, normality tests, homogeneity tests, and Wilcoxon tests. Wilcoxon test results obtained significance values (sig. 2-tailed) of 0.000 < 0.05, so H0 was accepted. So, there is an average difference between martial arts participants and non-martial arts participants in terms of aggressiveness. There is a difference in the level of aggressiveness between martial arts participants and non-martial arts participants as evidenced by the average score of pencak silat participants being relatively high compared to the average score of non-pencak silat participants. The type of aggressiveness that is greatest among martial arts participants is hostile aggressiveness and the type of martial arts that gives rise to the greatest hostile aggressiveness is pencak silat martial arts. This can be seen from the descriptive statistics of the average scores of the two groups which state that the highest aggressiveness in pencak silat participants is hostile attitudes.