bluuebunny/crossref_metadata_2025_split huggingface dataset:
An evaluation of a quality improvement initiative examining benefits and enablers and challenges and barriers of implementing and embedding core clinical supervision in primary care
Authors: Goode Sarah , Cross Debbie , Hodge Gemma 
Published: September 2024

Background Core Clinical Supervision has become a valued activity that impacts on the culture and organisational delivery of healthcare. It embeds good practice to ensure that staff have a high skill set, desirable professional attitudes, and provide high quality evidence-based care. It also helps to support good clinical governance and enhances staff retention (CQC 2013). A supervision framework has been adopted and adapted from the ‘General Practice – Developing confidence, capability, and capacity. A Ten Point Action Plan for General Practice Nursing’ ( NHS England 2018 ) and applied at scale across Yorkshire and the Humber, with minimal impact on clinical capacity, quality, and safety. This initiative coincides with general practice (and the wider health service) being under enormous pressure managing the effects of the COVID-19 pandemic, with impact on staff wellbeing and retention. The main aims are to evaluate the impact of embedding the Core Supervision training across primary care practice and strengthen course content for future delivery. Methodology and Methods A quantitative approach using an online survey, was completed by multi-professional primary care staff who had completed the Core Supervision Training. Findings Practitioners indicated that they required protected time due to competing demands and visible senior buy in to undertake core supervision. Additionally, practitioners who had participated or supervised sessions felt the benefits on staff wellbeing and indicated that it improved patient care delivery. Conclusion and Implications Survey findings suggest further research on embedding core supervision within primary care and a focus on national and local strategies are required. Standardised learning outcomes across the regions to ensure transferability of supervision practice and review training in supervision processes, particularly around conducting a supervision session.
Zeitenwende und mehrfache Transformation in der Verteidigungsindustrie am Beispiel der Rheinmetall Air Defense AG
Authors: Uhl Axel , Oberholzer Markus , Honikel Marc 
Published: September 2024

Zusammenfassung
Die Rheinmetall Air Defence AG ist ein mittelständisches Unternehmen in der Schweiz und eine 100 % Tochter des internationalen Technologiekonzerns Rheinmetall AG.
Durch den Ukraine Krieg ist die Nachfrage für Verteidigungsgüter massiv angestiegen. Zusammen mit den Megatrends Digitalisierung und demographischer Wandel, sowie regulatorischen Vorschriften, wie z. B. Exportgesetzen von militärischen Gütern, ist ein hoher Veränderungsdruck entstanden.
Mittels dieser Fallstudie sollen exemplarisch die aktuellen Ziele, Herausforderungen, Lösungen und Risiken vieler, meist mittelständisch geprägter, Verteidigungsunternehmen aufgezeigt werden. Dabei wird dargestellt, wie das Unternehmen agiler, innovativer und digitaler werden soll und wie es den dafür erforderlichen Wandel zusammen mit den Führungskräften und Mitarbeitenden gestalten will.
Die Fallstudie erläutert u. a., wie mit den Effizienzsteigerungsprogrammen „12 Monats Challenge“ und „P A C E“ schon nach 1,5 Jahren erste Erfolge verbucht werden konnten. Darüber hinaus werden die noch anstehenden grossen Veränderungen in Forschung und Entwicklung, Produktdesign, Beschaffung, Produktion, Vertrieb und Service beschrieben. Hier kommen digitalen Lösungen wie IT-Kernsystemen, Künstlicher Intelligenz, Digital Twins, Gamification und Cyber Security grosse Bedeutung zu.
Auch organisatorische Veränderungen wie Forschungs- und Entwicklungskooperationen mit verschiedenen Marktteilnehmern werden angesprochen. Abschliessend werden die mit der Transformation verbundenen Risiken aufgezeigt.
External ear malformations and cardiac and renal anomalies: A systematic review and meta-analysis
Authors: Ghafari Arman , Alaniz Leonardo , Vu Cindy , Ibarra Alejandra , Vallurupalli Medha , Willens Sierra , Cordero Justin , J. Pfaff Miles 
Published: September 2024

Context
External Ear Malformations (EEM) continue to be a common malformation seen in the pediatric patient population. This study aims to further elucidate the correlation between EEM and cardiac and renal anomalies.

Objective
A systematic review and meta-analysis to study the incidence of cardiac and renal anomalies associated with syndromic and isolated (EEM).

Data sources
The literature search spanned multiple databases, including Google Scholar, PubMed, Scopus, Web of Science, and MEDLINE.

Study selection
Studies must be focused on EEM and cardiac and/or renal anomalies. Only articles written in English were included.

Data extraction
General study characteristics, number of EEM patients, number of cardiac and renal anomalies and whether cases were syndromic were extracted from the studies.

Results
Of 1,058 initial studies, 33 were included for meta-analyses. Mean JBI score for all included studies was 92.06%, indicating acceptable study quality. Interrater reliability was high, with a Cohen kappa score for all studies of 0.94. The resulting pooled prevalence of cardiac abnormalities was 20% [95% CI:13–28%], while renal abnormalities were 13% [95% CI: 7–20%]. The most common anomalies were VSD (3.725%) and renal agenesis (2.04%). The presence of syndrome data across studies was not a significant modifier of prevalence rates.

Limitations
Primary limitation is due to heterogeneity in individual study methodology and reporting standards.

Conclusions
These results highlight a higher prevalence of cardiac-related conditions than renal anomalies in patients with both syndromic and non-syndromic EEM in the included studies, underscoring the need for thorough clinical evaluations.
Impact of COVID-19 on myalgic encephalomyelitis/chronic fatigue syndrome-like illness prevalence: A cross-sectional survey
Authors: Wood Mariah S. , Halmer Nicole , Bertolli Jeanne , Amsden Laura B. , Nugent Joshua R. , Lin Jin-Mann S. , Rothrock Gretchen , Nadle Joelle , Chai Shua J. , Cope Jennifer R. , Champsi Jamila H. , Yang James , Unger Elizabeth R. , Skarbinski Jacek ,   for STOP-ME/CFS and COVID-SELECT
Published: September 2024

Background
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) can be triggered by infectious agents including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the impact of the coronavirus disease 2019 (COVID-19) pandemic on ME/CFS prevalence is not well characterized.

Methods
In this population-based cross-sectional study, we enrolled a stratified random sample of 9,825 adult participants in the Kaiser Permanente Northern California (KPNC) integrated health system from July to October 2022 to assess overall ME/CFS-like illness prevalence and the proportion that were identified following COVID-19 illness. We used medical record and survey data to estimate the prevalence of ME/CFS-like illness based on self-reported symptoms congruent with the 2015 Institute of Medicine ME/CFS criteria. History of COVID-19 was based on a positive SARS-CoV-2 nucleic acid amplification test or ICD-10 diagnosis code in the medical record, or self-report of prior COVID-19 on a survey.

Results
Of 2,745,374 adults in the eligible population, an estimated 45,892 (95% confidence interval [CI]: 32,869, 58,914) or 1.67% (CI 1.20%, 2.15%) had ME/CFS-like illness. Among those with ME/CFS-like illness, an estimated 14.12% (CI 3.64%, 24.6%) developed the illness after COVID-19. Among persons who had COVID-19, those with ME/CFS-like illness after COVID-19 were more likely to be unvaccinated and to have had COVID-19 before June 1, 2021. All persons with ME/CFS-like illness had significant impairment in physical, mental, emotional, social, and occupational functioning compared to persons without ME/CFS-like illness.

Conclusions
In a large, integrated health system, 1.67% of adults had ME/CFS-like illness and 14.12% of all persons with ME/CFS-like illness developed it after COVID-19. Though COVID-19 did not substantially increase ME/CFS-like illness in the KPNC population during the study time period, ME/CFS-like illness nevertheless affects a notable portion of this population and is consistent with estimates of ME/CFS prevalence in other populations. Additional attention is needed to improve awareness, diagnosis, and treatment of ME/CFS.
Surgical modeling of Chiari-like malformation in rats: Insights from canine morphology
Authors: Jung Jae-Hwan , Cho Chang-Hyeon , Shin Sang-Yoon , Chung Eun-Ji , Seo Da-Eun , Kim Woo-Suk , Yoon Hun-Young 
Published: September 2024

Background
Chiari-like malformation in dogs and Chiari malformation type 1 in humans are conditions characterized by a relatively small caudal cranial fossa, leading to cerebellar herniation. This study aimed to develop a rat model of Chiari-like malformation using surgical techniques based on morphological characteristics observed in dogs.

Methods
Endocranial magnetic resonance images of both normal dogs and dogs diagnosed with Chiari-like malformation were retrospectively analyzed. Measurements of the caudal cranial fossa volume, rostral and medial fossa volume, and volume index were taken. The differences in caudal cranial fossa volume and volume index between normal dogs and those diagnosed with Chiari-like malformation were then utilized to create a rat model of Chiari-like malformation through surgical intervention. The measurements were conducted on both the rat Chiari-like malformation models and normal rats, with each measurement taken twice and the mean values calculated.

Results
Significant differences were found between normal dogs and dogs diagnosed with Chiari-like malformation in terms of the volume of the caudal cranial fossa (27.62% reduction) and the volume index (23.36% reduction) (p<0.05). These differences were used to develop a rat model, which also showed significant reductions in both caudal cranial fossa volume (29.52%) and volume index (28.30%) compared to normal rats (p<0.05). The condition in the rat model was confirmed through magnetic resonance imaging, which revealed cerebellar herniation into the foramen magnum.

Conclusions
The study successfully established a rat model of Chiari-like malformation that accurately reproduces the morphological features observed in dogs. This model potentially serves as a valuable tool for investigating the pathological mechanisms and potential therapeutic approaches for Chiari-like malformation in veterinary medicine.
HIV-1 diversity in viral reservoirs obtained from circulating T-cell subsets during early ART and beyond
Authors: Zhang Yuepeng , Otte Fabian , Stoeckle Marcel , Thielen Alexander , Däumer Martin , Kaiser Rolf , Kusejko Katharina , Metzner Karin J. , Klimkait Thomas ,   and the Swiss HIV Cohort Study
Published: September 2024

Even during extended periods of effective immunological control, a substantial dynamic of the viral genome can be observed in different cellular compartments in HIV-1 positive individuals, indicating the persistence of active viral reservoirs. To obtain further insights, we studied changes in the proviral as well as in the viral HIV-1 envelope (Env) sequence along with transcriptional, translational and viral outgrowth activity as indicators for viral dynamics and genomic intactness. Our study identified distinct reservoir patterns that either represented highly sequence-diverse HIV-1 populations or only a single / few persisting virus variants. The single dominating variants were more often found in individuals starting ART during early infection phases, indicating that early treatment might limit reservoir diversification. At the same time, more sequence-diverse HIV reservoirs correlated with a poorer immune status, indicated by lower CD4 count, a higher number of regimen changes and more co-morbidities.
Furthermore, we noted that in T-cell populations in the peripheral blood, replication-competent HIV-1 is predominantly present in Lymph node homing TN (naïve) and TCM (central memory) T cells. Provirus genomes archived in TTM (transitional memory) and TEM (effector memory) T cells more frequently tended to carry inactivating mutations and, population-wise, possess changes in the genetic diversity.
These discriminating properties of the viral reservoir in T-cell subsets may have important implications for new early therapy strategies, underscoring the critical role of early therapy in preserving robust immune surveillance and constraining the viral reservoir.
BUDAYA “KAWIN KYAI”	Studi Terhadap Praktek Nikah Sirri Di Desa Sinarrancang, Kecamatan Mundu, Kabupaten Cirebon
Authors: Farabi Al 
Published: September 2024

Regulation about the registration of marriage has been around a long time. Active role of the state in aspect of registration of marriage started early independence. That role was confirmed by the Act. No. 1 of 1974 on Marriage and regulations for its implementation which requires every registration of marriage for the sake of order and legal certainty. However, in the village of Cirebon Sinarrancang Mundu are 59, 35 % of the 246 families who do not heed the regulation that marry with only religious well-known as "kawin kyai". "Kawin kyai" is caused by internal factors (lack of understanding about the registration of marriage , religious ideology, indifference, and complex procedures) and external factors (role of Kyai [lebe' and the prince of the non- official] lack of socialization, the difficulty to accessing official registrar, negligence of village officials, the cost of marriage registration, the views of society, and culture "kawin kyai" in society. Meanwhile, the process of legal institutionalization find constraints on each component of the legal system, especially from the aspect of means and pre-means and authorized apparatus.Regulasi tentang pencatatan perkawinan telah ada sejak lama. Peran aktif negara dalam aspek pencatatan perkawinan dimulai sejak awal kemerdekaan. Peran tersebut dipertegas melalui UU. No. 1 Tahun 1974 tentang Perkawinan dan peraturan pelaksanaanya yang mengharuskan pencatatan bagi setiap perkawinan demi ketertiban dan kepastian hukum. Namun, di Desa Sinarrancang Mundu Cirebon terdapat 59, 35% dari 246 keluarga yang tidak mengindahkan regulasi tersebut dengan menikah secara agama saja yang populer di kalangan mereka dengan “kawin kyai”. “Kawin kyai” dilatarbelakangi oleh faktor internal (rendahnya pemahaman tentang pencatatan perkawinan, paham keagamaan, sikap tidak acuh, dan prosedur yang rumit) dan faktor eksternal (peran Kyai [lebe’ dan penghulu non-resmi] minimnya sosialisasi, sulitnya mengakses pejabat pencatat, kelalaian aparat Desa, biaya pencatatan, pandangan masyarakat, dan budaya “kawin kyai” di tengah masyarakat. Sementara itu, proses pelembagaan hukum menemukan kendala pada setiap komponen dari sistem hukum, terutama dari aspek sarana dan pra sarana dan aparatur yang berwenang.]
KRITIK TEORI HUKUM FEMINIS TERHADAP UU NO. 1 TAHUN 1974 TENTANG PERKAWINAN: Suatu Upaya dalam Menegakkan Keadilan HAM Kaum Perempuan
Authors: Asnawi Habib Shulton 
Published: September 2024

In Indonesia, women still suffer discrimination and injustice. This is supported by the persistence of gender-biased laws not giving the protection of the rights of women, such as Law No. 1 of 1974 about Marriage. Women's issues that was settled in the line of traditional Islamic law (classical) tending to be conservative and literal in understanding religious messages and doctrines, such as the patriarchal culture which puts women as beings lower position than men. Patriarchal culture which is done with legism legalized legislation in its application to the gender bias that is highly detrimental for women. The marginalization of women then occurs and is caused by the differences and gender inequalities that cause woman discomfort and not free. Therefore, all forms of injustice is a violation to Human Rights (HAM), a crime against human dignity and a form of discrimination that must be abolished.[Di Indonesia, perempuan masih mengalami diskriminasi dan ketidakadilan. Hal ini didukung oleh masih adanya undang-undang bias gender yang belum memberikan perlindungan terhadap hak-hak perempuan, seperti UU No.1 Tahun 1974 tentang Perkawinan. Isu-isu perempuan yang dimapankan di dalam UU tersebut sejalan Islam tradisional (klasik) yang cenderung konservatif dan literal dalam memahami pesan-pesan keagamaan dan doktrin-doktrin yang ada, seperti budaya patriarkhis, yang menempatkan perempuan sebagai makhluk yang lebih rendah kedudukannya dari pada laki-laki. Budaya patriarkhis yang dilakukan dengan kecenderungan legisme itu telah melegalisir peraturan perundang-undangan bias gender ke dalam penerapannya yang sangat merugikan perempuan. Marginalisasi perempuan kemudian terjadi dan disebabkan oleh perbedaan dan ketidakadilan gender yang menyebabkan ketidaknyamanan serta terbelenggunya kebebasan perempuan. Karena itu, segala bentuk ketidakadilan merupakan pelanggaran Hak Asasi Manusia (HAM), kajahatan terhadap martabat kemanusiaan dan bentuk diskriminasi yang wajib dihapuskan.]
Evaluation of the RF depositions at 3T in routine clinical scans with respect to the SAR safety to improve efficiency of MRI utilization
Authors: Li Ruixin , Chen Xinlian , Liao Yupeng , Xin Sherman Xuegang 
Published: September 2024

Abstract

Objectives
This study explores the potential for improving of 3T MRI utilization by assessing and tailoring RF exposure in routine clinical scans while complying to standard safety limit.

Methods
Using two generic human body models, we evaluated pbSAR10g values at four landmark positions (knee, pelvis, thoracic spine, head) at different wbSAR levels. Specifically, we analyzed local SAR10g in different operating modes and computed the maximum safety wbSAR, ensuring compliance with IEC limits.

Results
In normal operating mode, the RF power deposition reached wbSAR limit before the pbSAR10g limit. In the first level controlled operating mode, pbSAR10g limit is reached before the wbSAR limit in the knee, thoracic spine scanning scenarios, while the wbSAR limit is reached first in the pelvis scanning scenarios, making it the most potential-releasing (up to 33.33 %) scanning scenario. For head exposure, the head SAR10g limit is reached before the wbSAR limit, highlighting the necessity for strict SAR control. Moreover, we calculated the minimum allowable TR for common imaging sequences for reference.

Conclusions
Different RF exposure setups are necessary to meet safety standards in various scenarios. By implementing careful RF exposure setups in routine clinical scans, the high potential capacity of 3T MRI can be fully released.
Three-objective optimization of micromixer with Cantor fractal structure based on Pareto genetic algorithm
Authors: Su Meishi , Yuan Jinliang , Yang Lixia , Chen Xueye 
Published: September 2024

Abstract
This paper introduces the multi-objective optimization process of the micromixer with Cantor fractal baffle. The combination of fractal principle and multi-objective optimization is a main feature of this article. The three-dimensional Navier–Stokes equation is used to numerically analyze the fluid flow and mixing. The proxy modeling and Pareto genetic algorithm are used to optimize the shape of the Cantor fractal micromixer. We choose three parameters related to the geometry of the Cantor fractal baffle as design variables, and choose the mixing index, pressure drop and mixing sensitivity at the outlet of the micromixer as three objective functions. For the parameter study of the design space, the Latin hypercube sampling (LHS) method is used to select design points in the design space. We use response surface function (RSA) as a proxy modeling to approximate the objective function. A multi-objective genetic algorithm is used to find the Pareto optimal solution. K-means clustering is used to classify the optimal solution set, and then select representative design variables from it. The representative optimal design is analyzed by using numerical analysis method. The optimization results show that the Cantor fractal baffle is beneficial to promote faster mixing of the two fluids. At the same time, the suitable goal can be weighed in the Pareto optimal solution set. The mixing index and mixing sensitivity are increased by 13.55  and 3.91 %, respectively, compared with the reference design of the micromixer. And we have also proved that this multi-objective optimization method is applicable to any Reynolds numbers (Res).
Data integrity cyber-attack mitigation using linear quadratic regulator based load frequency control in hybrid power system
Authors: Kapil Vivek , Prasad Sheetla 
Published: September 2024

Abstract
Hybrid power systems are the contemporary solution to meet the stiff climate change targets and also hold future for implementing distributed generation and microgrids. These systems have renewable sources as their key elements which in turn have high level of intermittency due to weather conditions and other reasons. At the same time, these hybrid power systems are also vulnerable to cyber threats owing to the intense adoption of various IoT Technologies (Internet of Things). Load frequency control (LFC) is a formidable task for the system operators under such scenario and robust control strategies are required to achieve the load frequency within tolerable limits. In this work Linear quadratic controller (LQR) has been proposed to address the challenges of hybrid power systems. Two area interconnected power systems are considered in this work with each one having different configuration with respect to source of power generation. Solar, wind, geo-thermal, electric vehicle charging infrastructure and pumped storage power plant are integrated together with conventional thermal power plant for showcasing the LQR based controller under data integrity cyber-attack scenario. The frequency response of the hybrid power system is demonstrated through MATLAB simulations.
Premature ovarian insufficiency in pediatric cancer patients: a 10 year Rady Children’s Hospital experience
Authors: Robinson Miranda , Meller Leo , Patterson Mary 
Published: September 2024

Abstract

Objectives
To highlight the occurrence of premature ovarian insufficiency in pediatric cancer patients and determine which patient characteristics or treatment modalities are associated with ovarian failure and recovery.

Methods
Between August 2011–August 2021, 36 of 2,661 patients with cancer were identified to have subsequent ovarian failure. Data collected included cancer type, diagnosis age, types of chemotherapy, bone marrow transplant or radiation treatment, peak follicle-stimulating hormone (FSH), peak anti-Mullerian hormone (AMH), gonadotropin releasing hormone agonist (GnRHa) treatment, type of hormone replacement therapy, and if ovarian function recovery occurred.

Results
The most common cancer type identified was ALL. The mean age of diagnosis was 8.5±4.3 years and mean age of peak FSH value was 12.6±2.8 years. Most patients (97.2 %) were treated with alkylating agents and 72.2 % received radiation. Most patients (72.2 %) received hormone therapy, and 15.8 % of patients received GnRHa Lupron. Ten patients (27.8 %) had ovarian function recovery. Diagnosis age and treatment type were recovery predictors in multivariate regression modeling. Each year older in age was associated with a 30 % decrease in odds of recovery (OR: 0.7, CI: 0.5–0.95, p=0.035), and alkylating agent treatment without transplant was associated with a 3-fold increase in odds of recovery (OR: 3, CI: 2.7–564, p=0.007).

Conclusions
This retrospective review demonstrates that POI can occur in pediatric cancer survivors, emphasizing the importance of educating patients on potential long-term effects of cancer treatment and importance of routine surveillance. This study confirmed that recovery of ovarian function is possible, especially when diagnosed at a younger age, making continued monitoring essential.