bluuebunny/crossref_metadata_2025_split huggingface dataset:
Motivation, work environment, job satisfaction, and job performance among nurses: An inferential analysis
Authors: Mukhofi Lutfi , Peristiowati Yuly , Prasetyo Joko , Sasmito Priyo , Prasetya Fika Indah 
Published: September 2024

Background: Many researchers have studied performance, but lack has combined the influence of work motivation, work environment, and job satisfaction on nurse performance simultaneously.
Purpose: To analyze the influence of Motivation, work environment, job satisfaction, and job performance among nurses
Method: An observational study with a cross sectional approach involving nurses in 15 units at a hospital in Jember, Indonesia. The data taken were demographic, work motivation, work environment, job satisfaction, and nurse performance using various validated questionnaire. Data were analyzed descriptively and inferential analysis using the Partial Least Square (PLS) method using the smart PLS version 3.0 program.
Results: A total of 111 respondents were involved in this research. The majority of respondents were female (67/60.4%), aged 21-30 years (67/60.4%), had a bachelor's degree in nursing (50/45.0%), married (67/60.4%) and have worked for ≤ 5 years (70/63.1%). work motivation (3.6-3.8), perception of the work environment (3.5-4.0), job satisfaction (3.3-3.7), and nurse performance (3.7-3.9) were obtained in the high/good score range category. all variables produced a loading factor of more than 0.5 and an Average Variance Extracted (AVE) of more than 0.4. Cronbach's Alpha was greater than 0.6 for all variables and had a composite reliability value of more than 0.7. The Q2 value was 0.180 (>0) and R2 0.242. Partially, the work motivation and job satisfaction variables have a p value of 0.007 and 0.000 < α 0.05 on nurse performance. Meanwhile, the work environment has a p value of 0.451 > α 0.05. Simulaneously, work motivation, work environment, and job satisfaction have F statistics value of 11.39 with a p value of 0.000 < α 0.05 on nurse performance.
Conclusion: This study has valid and reliable indicators. Independently, work motivation and job satisfaction have a significant correlation with nurse performance, while work environment does not have a significant relationship. However, simultaneously work motivation, work environment and job satisfaction have a positive and significant influence on the performance of nurses in hospitals by 24.2%. In order to improve the performance of nurses in the hospital, it is expected to increase work motivation and job satisfaction.
Stunting among children under 5 years of age in Surakarta City, Central Java
Authors: Dewi Indria Aulia , Arifah Siti 
Published: September 2024

Background: Stunting is defined as the growth of a child below the expected level for his or her age. It can occur during pregnancy, breastfeeding, and up to the first 1000 days (about 2 and a half years) of life. Stunting affects the brain development of the children, physical-motor growth, and has long-term implications for their future. The causes of stunting in children are multifaceted and can range from long-term inadequate nutrition to genetic and psychosocial factors.
Purpose: To investigate demographics data of stunting among children under 5 years of age in Surakarta City, Central Java.
Method: A quantitative design and descriptive analytical approach were used. The data were collected from a population of stunted children in the work area of the Pajang Community Health Centre between November and December of 2023. The research used purposive sampling and involved 93 respondents.
Results: Finding characteristics of both children and mothers with specifically, 71% of the stunted children were categorized as short, 52.7% were male, and the majority had a normal birth length. Most mothers of stunted children are aged between 20 and 35 years, 50.5% of mothers are taller than 155 cm (about 5.09 ft), 52.5% of mothers have a high school education and 74.2% of mothers are unemployed.
Conclusion: The characteristics of children and mothers about stunting are complex and interrelated. Therefore, health service providers should provide the best interventions with particular attention to both community and family-centered care.
White blood cell counts can predict 4-year cardiovascular disease risk in patients with stable coronary heart disease: a prospective cohort study
Authors: Jiang Wencai , Huang Gang , Du Jinfeng , Yang Hanxuan , Zhou Shiheng , Dai Dayin , Tang Kai , Fang Lingxiao , Wang Xiao , Deng Xuejun 
Published: September 2024

BackgroundThe prevalence of cardiovascular disease has increased sharply in the Asian population, and evaluation of the risk of cardiovascular events with stable coronary heart disease remains challenging. The role of white blood cell (WBC) count in assisting clinical decision-making in this setting is still unclear.ObjectivesThis study sought to evaluate the prognostic meaning of WBC count among patients with stable coronary heart disease.MethodsThis study included Asian participants (n = 1,933) from the prospective STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial, which involved 15,828 patients with stable coronary heart disease with 3–5 years of follow-up on optimal secondary preventive treatment. WBC count was measured at baseline. Associations between WBC count and cardiovascular outcomes were evaluated by Cox regression analyses with multivariable adjustments. Hematologic emergencies in patients may introduce potential bias.ResultsIn the lower WBC count quartiles, patients had lower-risk clinical profiles. Higher WBC counts were associated with greater event probabilities for cardiovascular death, major cardiovascular events, or all-cause death. In Cox regression models, WBC counts were an independent predictor of major adverse cardiovascular events (OR = 2.445, 95% CI 1.427–4.190, P = 0.001) for the primary outcomes. For the secondary outcomes, including the composite of all-cause death, cardiovascular death, myocardial infarction, stroke, and hospitalization for heart failure, WBC counts were significantly predictive of events with similar magnitude (OR = 1.716, 95% CI 1.169–2.521, P = 0.006).ConclusionsIn patients with stable coronary heart disease, higher WBC counts were associated with a heightened risk for the primary or secondary outcomes.
Registrationhttps://clinicaltrials.gov/; Unique identifier NCT00799903.
Surmounting the summit: tackling cerebral malperfusion in AMDS-treated acute deBakey I dissections. A case report
Authors: de Manna Nunzio Davide , Helms Florian , Deniz Ezin , Kaireit Till Frederik , Abu-Fares Omar , Schmack Bastian , Ruhparwar Arjang , Weymann Alexander , Popov Aron Frederik 
Published: September 2024

BackgroundAcute Type A aortic dissection (ATAAD) with supra-aortic branch (SAB) malperfusion remains a formidable clinical challenge, often resulting in high mortality and complex treatment dilemmas. The introduction of the AMDS represents a significant innovation, designed to stabilize the aortic arch, and manage malperfusion effectively.MethodsThis case study evaluates the utility of AMDS in the treatment of a 63-year-old male with hypertension, who presented with severe, acute chest pain. Diagnosed with a DeBakey type I ATAAD involving SAB, the patient underwent cardiopulmonary bypass, aortic root replacement, aortic arch repair with AMDS implantation, and subsequent endovascular stenting for severe left common carotid artery malperfusion that developed postoperatively. The AMDS was instrumental in facilitating crucial aortic arch reconstruction and addressing the initial severe malperfusion. Despite postoperative cerebral malperfusion, targeted endovascular stenting resulted in a rapid and substantial neurological recovery. The patient was discharged to a rehabilitation facility on postoperative day 20, free of neurological deficits.ConclusionsThe use of AMDS in managing ATAAD with SAB involvement is transformative, enabling less invasive surgical techniques and offering immediate, effective correction of malperfusion. This case underscores the essential role of integrating advanced endovascular strategies to enhance outcomes in high-risk aortic surgeries, marking a pivotal advancement in the therapeutic approach to complex aortic dissections.
Higher serum phosphate within the normal range is associated with the development of calcified aortic valve disease
Authors: Kim Kyung An , Jung Hae-Ok , Kim Mi-Jeong , Lee So-Young , Ahn Yuran , Jung Mi-Hyang , Chung Woo-Baek , Lee Dong-Hyeon , Youn Ho-Joong , Chang Hyuk-Jae 
Published: September 2024

BackgroundDespite the essential role of ectopic osteogenic calcium-phosphate metabolism in the development of calcific aortic valve disease (CAVD), the implications of high serum phosphate levels in CAVD development are not fully understood.MethodsAsymptomatic individuals who underwent health screening using serial cardiac computed tomography (CT) and echocardiography were selected from a multicenter registry. CAVD was identified and quantified on CT images using the aortic valve calcification (AVC) score. The associations between initial serum phosphate levels and the presence of baseline CAVD, development of new CAVD, and the AVC score progression rate were investigated using multivariable regression models.ResultsA total of 736 individuals were selected for analysis, and the median interscan duration was 36.4 months. On initial CT, 83 (13.7%) participants had baseline CAVD, while 52 (7.0%) individuals developed new CAVD during follow-up. Serum phosphate levels were not associated with a higher probability of baseline CAVD but were predictive of newly developed CAVD (odds ratio per 1 mg/dl, 1.05; 95% confidence interval, 1.01–1.10; p = 0.02). Higher phosphate levels were also associated with a faster AVC score progression in those with baseline CAVD (regression coefficient per 1 mg/dl, 15.55 Agatston units/year; 95% confidence interval, 6.02–25.07; p &lt; 0.01), an association which remained significant when the analysis was extended to include newly developed CAVD.ConclusionEven slight elevations in serum phosphate are associated with accelerated CAVD progression from an early stage. Further studies are needed to investigate whether the regulation of phosphate metabolism can slow the progression of CAVD to aortic stenosis.
From melting ice to green shipping: navigating emission reduction challenges in Arctic shipping in the context of climate change
Authors: Liu Huirong , Mao Zhengkai , Zhang Zhijun 
Published: September 2024

The effects of global climate change have accelerated the melting of glaciers and the decline of sea ice coverage in the Arctic. In tandem with advancements in icebreaker and other shipping technologies, the navigability of Arctic shipping routes has dramatically improved. Given the geographical advantages of the Arctic region in terms of shipping routes and resource potential, various countries have implemented initiatives to secure a foothold in the Arctic shipping industry. However, the current shipping industry has not yet achieved the ideal state of net-zero emissions, and the rapid increase in Arctic shipping has brought serious and even irreversible negative impacts on the Arctic environment. The study employs document and policy analyses to conduct an in-depth examination of legal and policy documents related to Arctic shipping, especially those from the past 5 years, systematically outlining the relevant legal and policy frameworks, as well as their historical context. At the same time, interdisciplinary research methods are utilized to comprehensively assess the new challenges. It is concluded that against the backdrop of the Arctic region’s unique and fragile environment, the International Maritime Organization (IMO) and the Arctic Council are introducing increasingly stringent regulations for Arctic shipping, posing a complex array of challenges for the industry. Not only must it navigate the mounting pressure of emission reduction policies and intensifying public scrutiny but it must also overcome a multitude of complex technical and operational hurdles. Consequently, the joint efforts of the international community are essential to promote the sustainable development and emission reduction goals of the Arctic shipping industry.
A comprehensive analysis of genes associated with hypoxia and cuproptosis in pulmonary arterial hypertension using machine learning methods and immune infiltration analysis: AHR is a key gene in the cuproptosis process
Authors: Chen Zuguang , Song Lingyue , Zhong Ming , Pang Lingpin , Sun Jie , Xian Qian , Huang Tao , Xie Fengwei , Cheng Junfen , Fu Kaili , Huang Zhihai , Guo Dingyu , Chen Riken , Sun Xishi , Huang Chunyi 
Published: September 2024

BackgroundPulmonary arterial hypertension (PAH) is a serious condition characterized by elevated pulmonary artery pressure, leading to right heart failure and increased mortality. This study investigates the link between PAH and genes associated with hypoxia and cuproptosis.MethodsWe utilized expression profiles and single-cell RNA-seq data of PAH from the GEO database and genecad. Genes related to cuproptosis and hypoxia were identified. After normalizing the data, differential gene expression was analyzed between PAH and control groups. We performed clustering analyses on cuproptosis-related genes and constructed a weighted gene co-expression network (WGCNA) to identify key genes linked to cuproptosis subtype scores. KEGG, GO, and DO enrichment analyses were conducted for hypoxia-related genes, and a protein–protein interaction (PPI) network was created using STRING. Immune cell composition differences were examined between groups. SingleR and Seurat were used for scRNA-seq data analysis, with PCA and t-SNE for dimensionality reduction. We analyzed hub gene expression across single-cell clusters and built a diagnostic model using LASSO and random forest, optimizing parameters with 10-fold cross-validation. A total of 113 combinations of 12 machine learning algorithms were employed to evaluate model accuracy. GSEA was utilized for pathway enrichment analysis of AHR and FAS, and a Nomogram was created to assess risk impact. We also analyzed the correlation between key genes and immune cell types using Spearman correlation.ResultsWe identified several diagnostic genes for PAH linked to hypoxia and cuproptosis. PPI networks illustrated relationships among these hub genes, with immune infiltration analysis highlighting associations with monocytes, macrophages, and CD8 T cells. The genes AHR, FAS, and FGF2 emerged as key markers, forming a robust diagnostic model (NaiveBayes) with an AUC of 0.9.ConclusionAHR, FAS, and FGF2 were identified as potential biomarkers for PAH, influencing cell proliferation and inflammatory responses, thereby offering new insights for PAH prevention and treatment.
The association between the dietary inflammatory index and cardiorespiratory fitness in United States young adults: a cross-sectional study from the National Health and Nutrition Examination Study, 1999–2004
Authors: Wu Bo , Qiu Lanlan , Lin Yun , Lin Qian , Pan Yuxiong 
Published: September 2024

BackgroundCardiorespiratory fitness (CRF) is a vital indicator of overall health and cardiovascular efficiency. Systemic inflammation significantly impacts CRF, and reducing systemic inflammation may serve as an effective strategy to improve CRF. Diet plays a crucial role in systemic inflammation, but daily dietary intake typically involves multiple elements rather than a single nutrient. The Dietary Inflammatory Index (DII) provides an overall assessment of dietary inflammation on the basis of the anti-inflammatory and pro-inflammatory effects of the nutrients consumed. However, the relationship between DII and CRF is not yet well understood.AimsTo examine the association between the DII and CRF.MethodThis study analyzed 3,087 participants from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2002. The study subjects were divided into three distinct groups by DII tertile: T1 (n = 1,027), T2 (n = 1,029), and T3 (n = 1,031). The associations between DII levels and CRF were examined via logistic regression analysis and restricted cubic splines (RCSs).ResultsElevated DII scores were significantly linked to low CRF levels. Compared with those in the lowest tertile, participants in the highest DII tertile exhibited a greater prevalence of low CRF (T1: 10.85%, T2: 16.32%, T3: 19.31%). In the model with full adjustments, elevated scores on the DII were consistently linked with a heightened likelihood of low CRF (OR: 1.17, 95% CI: 1.07–1.28; P &lt; 0.001). Compared with those in the T1 group, participants with higher DIIs had an increased risk of lower CRF (T2: OR: 1.42, 95% CI: 1.01–2.01, P = 0.046; T3: OR: 1.71, 95% CI: 1.22–2.40, P = 0.003). Additionally, a significant interaction (P = 0.045) between sex and the DII for low CRF was observed within the population.ConclusionA higher DII score is linked to an elevated risk of low CRF. Moreover, sex can impact CRF, with women being more prone to low CRF.
PD-1 expression in tumor infiltrating lymphocytes as a prognostic marker in early-stage non-small cell lung cancer
Authors: Dan Asaf , Aricak Ozan , Rounis Konstantinos , Montero-Fernandez M. Angeles , Guijarro Ricardo , Ekman Simon , Ortiz-Villalón Cristian , De Petris Luigi 
Published: September 2024

IntroductionProgrammed death ligand – 1 (PD-L1) expression is a well-established predictive biomarker for immunotherapy in non-small cell lung cancer (NSCLC). Programmed death – 1 (PD-1) serves as the target protein to PD-L1 and their interaction serves as a crucial pathway for immune evasion. This study aimed to investigate the expression pattern of PD-1 on Tumor-infiltrating lymphocytes (TILs) in early-stage NSCLC, and its potential role as prognostic biomarker.Materials &amp; methodsPD-1 was evaluated in 474 surgical resected early-stage NSCLC specimens, using Tissue microarray and immunohistochemical staining. Expression was scored as negative (&lt;1%) or positive. Positive PD-1 expression was further divided into low (&lt;10%) and high (≥10%). None of the patients had received treatment with PD-1/PD-L1 inhibitors.ResultsPD-1 expression ≥1% in TILs was observed in 83.5% of cases and was associated with pT stage (p=0.02), grade 3 (p=0.004), and adenocarcinoma subtype (p=0.05). Individuals with high PD-1 expression (≥10%) experienced reduced 10-year overall survival (Log-Rank test = 0.005). In addition, high PD-1 expression emerged as an independent factor associated with reduced survival on multivariate analysis (HR: 1.328 (95% CI: 1.074-1.641).ConclusionsPatients with early-stage NSCLC who exhibited PD-1 expression of ≥10% on TILs had an unfavorable 10-year OS rate. These findings indicate that elevated PD-1 expression on TILs can be associated with immune evasion during the early stages of malignancy evolution in the NSCLC setting and further research is required to further delineate the role of PD-1/PD-L1 pathway on tumor immune senescence. These results underline the potential role of PD-1/PD-L1 inhibitors in the treatment of early-stage NSCLC.
Molecular genetic characterization of myeloid neoplasms with idic(X)(q13) and i(X)(q10)
Authors: Brunetti Marta , Andersen Kristin , Trøen Gunhild , Micci Francesca , Spetalen Signe , Lenartova Andrea , Tandsæther Maren Randi , Panagopoulos Ioannis 
Published: September 2024

Background/AimIsodicentric [idic(X)(q13)] and isochromosome [i(X)(q10)] are infrequent aberrations in neoplastic diseases. The former is mainly reported in elderly women with myelodysplastic syndrome (MDS) and acute myeloid leukemia (AML), whereas the latter is mostly found as a secondary aberration or part of complex karyotypes in various types of neoplasms, including MDS and AML. Here, we present the molecular genetics and clinical features of six patients with myeloid neoplasia and the above-mentioned aberrations.Patients and MethodsArray comparative genome hybridization (aCGH) and next-generation sequencing (NGS) myeloid panel were used to examine genetic alterations in five bone marrow samples containing neoplastic cells carrying idic(X)(q13) and one sample with i(X)(q10).ResultsThe breakpoints of idic(X)(q13) were clustered within a 200 kbp region encompassing FAM236B, DMRTC1B, and DMRTC1. The breakpoint of i(X)(q10) was identified within a 112 kbp region on sub-band p11.22 containing SSX2, SSX2B, and SPANXN5. Pathogenic variants of TET2 were identified in four cases, SF3B1 in three cases, ASXL1 and SRSF2 in two cases each, whereas STAG2, RUNX1, U2AF1, and TP53 pathogenic variants were detected in only single cases.ConclusionsThe breakpoints of idic(X)(q13) are within a 200kbp. i(X)(q10) in our study turned out to be a cryptic idic(X)(p11) aberration, reported for the first time here. TET2, SF3B1, ASXL1, or SRSF2 were highly prevalent in patients with idic(X)(q13)/i(X)(q10) abnormalities and were often associated with a worse prognosis.
Identifying and quantifying initial post-discharge needs for clinical review of sick, newborns in Kenya based on a large multi-site, retrospective cohort study
Authors: Wainaina John , Lee Esther , Irimu Grace , Aluvaala Jalemba , English Mike ,   The Clinical Information Network Author Group
Published: September 2024

BackgroundProgress in neonatal care has resulted in a 51% decrease in global neonatal mortality rates from 1990 to 2017. Enhanced survival will put pressure on health care systems to provide appropriate post-discharge, follow-up care but the scale of need for such care is poorly defined.MethodsWe conducted a retrospective cohort study of newborns discharged from 23 public hospital neonatal units (NBUs) in Kenya between January 2018 and June 2023 to identify initial follow-up needs. We first determined pragmatic follow-up categories based on survivors’ clinical conditions and morbidities. We then used individual phenotypes of individual babies to assign them to needing one or more forms of specialized clinical follow-up. We use descriptive statistics to estimate proportions of those with specific needs and patterns of need.FindingsAmong 136,249/159,792 (85.3%) neonates discharged, around one-third (33%) were low birth weight (&lt;2,500 g), and a similar 33.4% were preterm (&lt;37 weeks). We estimated 131,351 initial episodes of follow-up would be needed across nine distinct follow-up categories: general pediatrics, nutrition, growth &amp; development (40.4%), auditory screening (38.8%), ophthalmology for retinopathy of prematurity (9.6%), neurology (8.0%), occupational therapy (1.3%), specialized nutrition (0.9%), surgery (0.8%), cardiology (0.2%), and pulmonary (&lt;0.1%). Most neonates met the criteria for two (52.3%, 28,733), followed by three (39.6%, 21,738) and one follow-up episodes (5.6%, 3,098). In addition to prematurity and very low birth weight (≤1,500 g), severe infections with extended gentamicin treatment, severe jaundice managed with phototherapy, and hypoxic-ischemic encephalopathy (HIE) contributed substantially to the pattern of need for post-discharge follow-up.ConclusionsAlmost half of surviving NBU infants have multiple specialty post-discharge follow-up needs. More urgent attention needs to be focused on healthcare planning now to guide strategies to address the varied medical and developmental needs that we outline in resource-constrained contexts like Kenya.