bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic Effect of Microenvironment Phenotype in Triple-Negative Breast Cancer: Biomarker Analysis of a Prospective Trial
Authors: Zhu Si-Yuan , Ma Ding , Shao Zhi-Ming , Yu Ke-Da 
Published: September 2021

Background: The microenvironment of triple-negative breast cancer (TNBC) can be divided into three clusters based on bioinformatics-based immunogenomic analysis: the “immune-desert” cluster, the “innate immune-inactivated” cluster, and the “immune-inflamed” cluster. The immune-inflamed cluster is considered as “hot tumor” while the other two are considered as “cold tumor”.Methods: To investigate the prognostic effect of microenvironment phenotypes on TNBC, we compared relapse-free survival (RFS) of different phenotypes in 100 patients with RNA sequencing-based expression data from the PATTERN trial (NCT01216111, published in JAMA Oncol 2020), which indicated a superior efficacy of adjuvant paclitaxel-plus-carboplatin regimen compared to the regimen of cyclophosphamide/epirubicin/fluorouracil followed by docetaxel for TNBC. We also analyzed the efficacy of the two regimens for different immune phenotypes to explore potential treatment strategies.Results: No significant difference in RFS was observed between the “hot tumor” and the “cold tumor” (hazard ratio [HR] = 0.68, 95% confidence interval [CI] 0.28–1.66, P = 0.40). However, the “hot tumor” subtype was associated with significantly longer RFS in node-positive patients (HR = 0.27, 95%CI 0.07–0.97, P = 0.03). Consistently, a similar trend to improved RFS of the “hot tumor” phenotype was detected in patients with stage pT2-3 tumors (HR = 0.29, 95%CI 0.06–1.30, P = 0.08). Furthermore, no significant difference in RFS between the two treatment arms was observed in patients with “hot tumor” (HR = 0.39, 95% CI 0.08–2.01, P = 0.24) or “cold tumor” (HR = 1.05, 95% CI 0.39–2.82, P = 0.92).Conclusion: The microenvironment phenotype in TNBC might have prognostic significance to patients with a high risk of recurrence. The association of the microenvironment phenotypes with the efficacy of adjuvant chemotherapy for TNBC remains to be further studied.
Long-Term Effect of Non-Selective Beta-Blockers in Patients With Rheumatoid Arthritis After Myocardial Infarction—A Nationwide Cohort Study
Authors: Liu Sheng-Fu , Lee Chih-Kuo , Huang Kuan-Chih , Lin Lian-Yu , Hsieh Mu-Yang , Lin Ting-Tse 
Published: September 2021

Objectives: Rheumatoid arthritis (RA) is an independent nontraditional risk factor for incidence of myocardial infarction (MI) and post-MI outcome is impaired in the RA population. Use of beta-blockers improves the long-term survival after MI in the general population while the protective effect of beta-blockers in RA patients is not clear. We investigate the impact of beta-blockers on the long-term outcome of MI among RA patients.Methods: We identified RA subjects from the registries for catastrophic illness and myocardial infarction from 2003 to 2013. The enrolled subjects were divided into three groups according to the prescription of beta-blockers (non-user, non-selective, and β1-selective beta-blockers). The primary endpoint was all-cause mortality. We adjusted clinical variables and utilized propensity scores to balance confounding bias. Cox proportional hazards regression models were used to estimate the incidence of mortality in different groups.Results: A total of 1,292 RA patients with myocardial infarction were enrolled, where 424 (32.8%), 281 (21.7%), and 587 (45.5%) subjects used non-user, non-selective, and β1-selective beta-blockers, respectively. Use of beta-blockers was associated with lower risk of all-cause mortality after adjustment with comorbidities, medications (adjusted hazard ratio [HR] 0.871; 95% confidence interval [CI] 0.727–0.978), and propensity score (HR 0.882; 95% CI 0.724–0.982). Compared with β1-selective beta-blockers, treatment with non-selective beta-blockers (HR 0.856; 95% CI 0.702–0.984) was significantly related to lower risk of mortality. The protective effect of non-selective beta-blockers remained in different subgroups including sex and different anti-inflammatory drugs.Conclusion: Use of beta-blockers improved prognosis in post-MI patients with RA. Treatment with non-selective beta-blockers was significantly associated with reduced risk of mortality in RA patients after MI rather than β1-selective beta-blockers.
Tips for Effective Implementation of Virtual Reality Exposure Therapy in Phobias—A Systematic Review
Authors: Krzystanek Marek , Surma Stanisław , Stokrocka Małgorzata , Romańczyk Monika , Przybyło Jacek , Krzystanek Natalia , Borkowski Mariusz 
Published: September 2021

Background: The high incidence of phobias and the limited accessibility of psychotherapy are the reasons for the search for alternative treatments that increase the availability of effective treatment. The use of virtual reality (VR) technology is an option with the potential to overcome the barriers in obtaining an effective treatment. VR exposure therapy (VRET) is based on a very similar rationale for in vivo exposure therapy. The study aimed to answer the question of how to perform exposure therapy in a virtual reality environment so that it is effective.Methods: A systematic review of the literature, using PRISMA guidelines, was performed. After analysis of 362 records, 11 research papers on agoraphobia, 28 papers on social phobia and 10 about specific phobias were selected for this review.Results: VRET in agoraphobia and social phobia is effective when performed from 8 to 12 sessions, on average once a week for at least 15 min. In turn, the treatment of specific phobias is effective even in the form of one longer session, lasting 45–180 min. Head mounted displays are an effective technology for VRET. Increasing the frequency of sessions and adding drug therapy may shorten the overall treatment duration. The effectiveness of VRET in phobias is greater without concomitant psychiatric comorbidity and on the condition of inducing and maintaining in the patient an experience of immersion in the VR environment. Long-term studies show a sustained effect of VRET in the treatment of phobias.Conclusion: A large number of studies on in VR exposure therapy in phobias allows for the formulation of some recommendations on how to perform VRET, enabling the effective treatment. The review also indicates the directions of further VRET research in the treatment of phobias.
Trends of Antibiotic Use and Expenditure After an Intensified Antimicrobial Stewardship Policy at a 2,200-Bed Teaching Hospital in China
Authors: Qian Xiaodan , Pan Yuyan , Su Dan , Gong Jinhong , Xu Shan , Lin Ying , Li Xin 
Published: September 2021

Objective: This study aimed to evaluate the effects of intensified Chinese special rectification activity on clinical antibiotic use (CSRA) policy on a tertiary-care teaching hospital.Methods: A 48-month longitudinal dataset involving inpatients, outpatients, and emergency patients were collected. Study period included pre-intervention stage (adopting soft measures like systemic training) and post-intervention stage (applying antibiotic control system to intensify CSRA policy). Antibiotic use was evaluated by antibiotic use rate (AUR) or antibiotic use density (AUD). Economic indicator was evaluated by antibiotic cost in prescription or antibiotic expenditure in hospitalization. Data was analyzed by interrupted time series (ITS) analysis.Results: The medical quality indicators remained stable or improved during the study period. AUR of inpatients (AURI) declined 0.553% per month (P = 0.025) before the intervention and declined 0.354% per month (P = 0.471) after the intensified CSRA policy was implemented. AUD, expressed as defined daily doses per 100 patients per day (DDDs/100PD), decreased by 1.102 DDDs/100PD per month (P = 0.021) before and decreased by 0.597 DDDs/100PD per month (P = 0.323) thereafter. The ratio of antibiotic expenditure to medication expenditure (AE/ME) decreased by 0.510% per month (P = 0.000) before and fell by 0.096% (P = 0.000) per month thereafter. AE per patient decreased by 25.309 yuan per month (P = 0.002) before and decreased by 7.987 yuan per month (P = 0.053) thereafter. AUR of outpatient (AURO) decreased by 0.065% per month before (P = 0.550) and decreased by 0.066% per month (P = 0.994) thereafter. The ratio of antibiotic cost to prescription cost in outpatient (ACO/PCO) decreased by 0.182% per month (P = 0.506) before and decreased by 0.216% per month (P = 0.906) thereafter. AUR of emergency patient (AURE) decreased by 0.400% per month (P = 0.044) before and decreased by 0.092% per month (P = 0.164) thereafter. The ratio of antibiotic cost to prescription cost in emergency patient (ACE/PCE) decreased by 0.616% per month (P &lt; 0.001) before and decreased by 0.151% per month (P &lt; 0.001) thereafter.Conclusions: Implementation of CSRA policy was associated with declining antibiotic use and antibiotic expenditure in inpatients, outpatients, and emergency patients. However, it is also important to note that the declining trend of antibiotic consumption slowed due to the limited capacity for decline in the later stages of CSRA intervention.
ANALISIS BALANCE SCORECARD SEBAGAI ALAT PENGUKURAN KINERJA PERUSAHAAN X
Authors: Andika Ivan Albertus , Chandra Ivan Christian , Mario Stefanus 
Published: September 2021

PT X ini begerak di penjualan alat alat elektonik dalam peningkatan produktifitas manusia seperti komputer laptop dan lain â€“ lain yang berlokasi di Kota Palembang. Tujuan penelitian untuk menganalisis dan mengetahui bagaimana kinerja perusahaan dengan menggunakan balanced scorecard. Sumber data digunakan berupa data wawancara pimpinan perusahaan yaitu dengan dokumen perhitungan dari pimpinan perusahaan yang relevan dengan tujuan penelitian yang ada, berupa struktur organisasi perusahaan, laporan keuangan, catatan dan kuisioner yang dijadikan dasar perhitungan balanced scorecard. Indikator yang digunakan dalam balance score card ini seperti perspektif finansial, pelanggan, bisnis internal dan pertumbuhan dan pembelajaran. Hasil perhitungan balanced scorecard(BSC) diketahui bahwa kinerja Perusahaan X masih dikatakan kurang baik. Kinerja masih perlu diperbaiki lagi agar perusahaan mampu mencapai kinerja sangat baik. Sebaiknya perusahaan menerapkan balanced scorecard(BSC) untuk dapat membantu perusahaan dalam mengukur kinerjanya tidak hanya dari aspek keuangannya saja tetapi juga mempertimbangkan kinerja dari aspek nonkeuangan. Sehingga perusahaan dapat merumuskan strategi yang tepat sebelum melakukan tindakan jangka panjang.
Katakunci : perspektif finansial, pelanggan, bisnis internal, pertumbuhan dan pembelajaran,
Hubungan Antara Stimulasi Alat Permainan Edukatif Dengan Perkembangan Motorik Kasar Dan Halus Anak Usia Pre School Di Sekolah TK Kabupaten Tegal
Authors: Ariskha Feti , Putri Arista Adityasari , Iswanti Dwi Indah 
Published: September 2021

Kondisi Indonesia akhir tahun 2013, anak usia 4-6 tahun yang belum terlayani pendidikannya ada 13,0 juta (63,46%) dari 17,6 juta. Hasil penelitian / kajian yang dilakukan oleh pusat kurikulum, balitbangnas menunjukkan bahwa hamper seluruh aspek perkembangan anak yang masuk Taman Kanak-Kanak mempunyai kemampuan yang lebih tinggi dari pada anak yang tidak masuk Taman Kanak-Kanak di kelas 1 Sekolah Dasar. Tujuan penelitian ini untuk mengetahui hubungan antara Alat Permainan Edukatif dengan perkembangan motorik kasar dan halus anak usia pre school di sekolah TK Kabupaten Tegal. Penelitian ini menggunakan kuantitatif, desain case control dengan pendekatan restrospective. Populasi responden sebanyak 130 responden dengan teknik proportionate stratified random sampling, jumlah sampel sebanyak 30 responden. Data yang diperoleh dianalisis secara univariat dan bivariat menggunakan uji chi square. Hasil menunjukkan stimulasi Alat Permainan Edukatif dengan perkembangan motorik halus p-value fisher exact = 0,026 < 0,05 dan stimulasi Alat Permainan Edukatif dengan perkembangan motorik kasar p-value fisher exact = 0, 002 < 0,05. Ada hubungan antara stimulasi Alat Permainan Edukatif dengan perkembangan motorik halus dan kasar anak usia pre school. Kata Kunci : Alat Permainan Edukatif, Perkembangan, Motorik Kasar, Motorik Halus, Anak usia pre school RELATIONSHIP BETWEEN EDUCATIONAL GAME STIMULATING WITH GROUND AND FINE MOTOR DEVELOPMENT OF PRE SCHOOL AGE CHILDREN IN TK SCHOOL, TEGAL REGENCY ABSTRACT Indonesia condition late 2013, children aged 4-6 years who have not served their education there are 13.0 million (63,46%) from 17.6 million. Results of research / studies carried out by the central curriculum, balitbangnas shows that almost all aspect of child development that enter Kindergarten has a higher ability than children who do not attend kindergarten in grade 1 primary school. To determine the relationship between Games Educational tool with gross and fine motor development of pre-school age children in kindergarten Tegal. This study uses a quantitative, case control design with a retrospective approach. The population of respondents as many as 130 respondens with proportionate stratified random sampling, sample size of 30 respondents. Data were analyzed using univariate and bivariate using chi square test. Result showed stimulation games educational tool with fine motor development fisher exact p-value = 0.026<0.05 and stimulation games educational tool with gross motor development fisher exact p-value=0.002<0.05. there is a relationship between stimulation games educational tool with the development of fine and gross motor pre-school age childreen. Keywords : Games Educational Tool, Development, Motor Coarse, Fine motor skills, pre-school age children.
Hubungan Tingkat Stress Dengan Kepuasan Kerja Pada Masinis PT Kereta Api Indonesia Di UPT Crew Semarang Poncol
Authors: Annas Taufiq , Nurhayati Susi 
Published: September 2021

Tingkat stres kerja berlebihan dapat berdampak negatif terhadap prestasi kerja karyawan PT. KAI yang pada akhirnya dapat merugikan perusahaan. Apalagi jika stres kerja tersebut berada dalam taraf tinggi tentu akan memberikan dampak negatif. Tujuan penelitian ini adalah mengetahui hubungan antara stress kerja dengan kepuasan kerja pada masinis PT Kereta Api Indonesia di UPT Crew Semarang Poncol. Jenis penelitian adalah korelasi dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah seluruh masinis PT Kereta Api Indonesia UPT Crew Semarang Poncol sejumlah 223 orang. Teknik sampling yang digunakan adalah accidental sampling dengan jumlah 143 orang. Hasil penelitian didapatkan bahwa tingkat stres kerja yang dialami oleh responden sebagian besar adalah tinggi yaitu sebanyak 67,1%. Kepuasan kerja responden sebagian besar dalam kategori tidak puas yaitu sebanyak 78 orang (54,5%). Ada hubungan antara tingkat stress dengan kepuasan kerja pada masinis PT Kereta Api Indonesia di UPT Crew Semarang Poncol.Berdasarkan hasil tersebut PTKAI diharapkan dapat menambah jumlah masinis dengan pola shift kerja yang longgar sehingga masinis memiliki waktu isirahat yang cukup untuk mengurangi stress akibat jadwal kerja yang padat. Kata kunci : Stres Kerja, Kepuasan Kerja. STRESS LEVEL RELATIONSHIP WITH JOB SATISFACTIONAT INDONESIAN PT TRAIN ENGINEERING AT UPT CREW SEMARANG PONCOL Excessive work stress levels can have a negative impact on employee performance at PT. KAI which in the end can harm the company. Moreover, if the work stress is at a high level, it will certainly have a negative impact. The purpose of this study was to determine the relationship between job stress and job satisfaction at PT Kereta Api Indonesia machinists at UPT Crew Semarang Poncol. This type of research is correlation with cross sectional approach. The population in this study were all engineers of PT Kereta Api Indonesia UPT Crew Semarang Poncol totaling 223 people. The sampling technique used is accidental sampling with a total of 143 people. The results showed that the level of work stress experienced by most of the respondents was high as much as 67.1%. Most of the respondents' job satisfaction was in the dissatisfied category as many as 78 people (54.5%). There is a relationship between stress levels and job satisfaction at PT Kereta Api Indonesia's machinists at UPT Crew Semarang Poncol. Based on these results PTKAI is expected to increase the number of drivers with a loose work shift pattern so that the machinists have sufficient rest time to reduce stress due to a busy work schedule. . Keywords: Job Stress, Job Satisfaction.
Pengaruh Motivasi, Budaya Organisasi dan Komitmen Organisasi terhadap Organizational Citizenship Behavior di Universitas Tunas Pembangunan, Surakarta
Authors: Syofaah Lufty , Nuvriasari Audita 
Published: September 2021

Penelitian ini bertujuan untuk menganalisa pengaruh motivasi, budaya organisasi dan komitmen organisasi terhadap organizational citizenship behavior di Universitas Tunas Pembangunan, Surakarta. Penelitian ini dilakukan dengan pendekatan kuantitatif. Pengumpulan data primer dilakukan dengan menyebar kuesioner kepada sampel sebanyak 82 karyawan di Universitas Tunas Pembangunan, Surakarta. Analisa data yang digunakan pada penelitian ini adalah uji regresi linear berganda. Hasil penelitian menunjukkan bahwa secara parsial motivasi, budaya organisasi dan komitmen organisasi berpengaruh positif dan signifikan terhadap organizational citizenship behavior, dengan tingkat signifikansi motivasi sebesar 0,000 < 0,05; budaya organisasi sebesar 0,028 < 0,05 dan komitmen organisasi sebesar 0,008 < 0,05. Motivasi, budaya organisasi dan komitmen organisasi secara simultan berpengaruh positif dan signifikan terhadap organizational citizenship behavior. Dari uji determinasi diketahui bahwa besarnya persentase pengaruh motivasi, budaya organisasi dan komitmen organisasi sebesar 0,535 atau 53,50%, artinya variabel motivasi, budaya organisasi dan komitmen organisasi secara simultan berpengaruh terhadap organizational citizenship behavior sebesar 53,50% sedangkan sisanya sebesar 46,50% dipengaruhi oleh variabel lain diluar penelitian ini. Motivasi merupakan variabel yang paling dominan berpengaruh dengan nilai koefisien beta (β1) yang paling besar yaitu 0,435.
Romos Philyras’ “My Life in the Dromokaiteion”: an Early Pathography
Authors: Menelaou Iakovos 
Published: September 2021

This paper discusses My Life in the Dromokaiteion by the Greek poet Romos Philyras (1898-1942). Reading the text within the scope of the medical humanities, brings out Philyras’ work as an early example of pathography or autopathography. The story revolves around the poet’s admission to the psychiatric hospital and how he experienced his days there. He describes his emotions, the hospital environment, other patients, their treatment and the nursing staff. Philyras’ text is a first-person narrative on how people with mental health problems see their new social setting, but also how doctors and nurses see patients. My Life in the Dromokaiteion is an autobiographical account which eloquently describes not only the distance between the nursing staff and patients, but also the distance between inside society (the patients of the hospital) and outside society.
“SABERES DE PRUDÊNCIA”
Authors: Antunes Elenice Maria Oliveira 
Published: September 2021

A presente dissertação objetiva compreender como os chamados “saberes de prudência” - experiências e saberes acumulados ao longo de anos de atividade profissional dos trabalhadores da construção civil podem contribuir para a diminuição dos acidentes no setor. Embora a legislação preconize o uso de equipamentos de proteção individual e treinamentos de segurança do trabalho, os trabalhadores desenvolvem outras formas de seguridade, utilizando um conhecimento implícito, construído ao longo da vida profissional e compartilhado no ambiente de trabalho...
Elementary Teachers’ Perceptions about Stakeholders’ Attitude towards Non-assessed Subjects by Punjab Examination Commission
Authors: Nisa Zaib 
Published: September 2021

This study investigates the elementary teachers’ perceptions about stakeholders’ (parents, heads, students) attitude towards subjects not assessed by Punjab Examination Commission (PEC) in public elementary schools. The study focuses on the quantitative research method and survey research design. The study includes population of 254 elementary public schools of Sialkot. However, the researchers have chosen only 95 public elementary schools of Tehsil Sialkot as the target population. Likewise, the study has focused only 48 public elementary schools of Tehsil Sialkot as sample for this research using simple random technique. Similarly, the study deploys Self-tailored questionnaires for data collection. The study has analyzed the collected data on the theoretical framework of the descriptive (Mean, Frequency), inferential (t test), and p value. The study concluded that the respondents’ attitude towards non-assessed subjects in public elementary schools Sialkot has been at a low level. The study recommends that government must revise teachers’ evaluation policy, which is only based on students’ scores. The study suggests that the teachers’ evaluation criteria must be broadened in order to and some other factors may also be considered while evaluating teachers.
Keywords: Stakeholders’ attitude, teachers’ perception, Punjab Examination Commission, non-assessed subjects
Development of TOSRA (Test of Science Related Attitudes) Instrument for Science Related Attitude Studies in Sindh Province
Authors: Khatoon Zohra 
Published: September 2021

This study aims to explore the implementation of attitude measurement tool known as Test of Science-Related Attitudes (TOSRA) in Sindh. 1097 higher-secondary level students from Hyderabad division of Sindh participated in the study. The alpha reliability values of different scale of TOSRA were analysed and enhanced to acceptable and good level using statistical techniques. The alpha coefficients for adapted TOSRA scales were observed as; Social Implications of Science (0.707), Adoption of Scientific Attitudes (0.801), Classroom Enjoyment (0.779), Leisure Interest in Science (0.767) and Career Interest in Science (0.701). The overall alpha coefficient for adopted (five-scale) TOSRA questionnaire administered in this study was 0.912. Similarly, the values of discriminant validity of the scales were deduced using correlation techniques for these scales where mean correlation between the scales ranged from 0.49 to 0.57. The adopted version of TOSRA was developed based on the statistical analyses including Cronbach alpha, Pearson’s correlation, and factor analysis, and showed sufficient validity and reliability to be implemented in subsequent research to measure students’ attitude towards science in province of Sindh, Pakistan.
Keywords: Attitude towards Science, TOSRA, Instrument development, Science Education, Higher secondary students
A propósito del caminante
Authors: Quispe Arroyo Adolfo 
Published: September 2021

Puriq (caminante) promueve la reflexión crítica sobre diversos estudios científicos de humanidades. En el camino o en la dinámica del conocimiento se enraman el producto de las investigaciones desde diferentes paradigmas y enfoques de temas pedagógicos, éticos, políticos entre otros. Caminar implica dinámica, movimiento como un motor de la historia y del desarrollo en general con proyección al futuro, previo análisis del presente. Caminante es la traducción española de puriq de raíz quechua de esta parte del Perú (Ayacucho).