bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstacles and Challenges Affecting Quality Indicators in a Complex Tertiary Emergency Center
Authors: Jaber Mohammad J. , Bindahmsh Alanoud A. , Abu Dawwas Mohammad A. , du Preez Susanna E. , Alshodukhi Abeer M. , Alateeq Ismail S. , Binti Abd Rahman Norah S. 
Published: July 2024

ABSTRACT

Introduction
Hospital performance is significantly affected by external factors (political and economic) rather than internal factors (effectiveness and efficiency). Emergency department (ED) overcrowding is a significant issue for emergency care services globally, characterized by a rising number of visits and persistent unsolved issues, resulting in increased challenges faced by ED staff and decreased patient satisfaction. This study aimed to explore the obstacles and challenges that cause variation in ED quality indicators (QIs) based on five domains: infrastructure, population, workflow, workforce, and administration.

Methods
A tertiary emergency center in Saudi Arabia administered a questionnaire with standardized measures to 180 nurses, using a cross-sectional descriptive design.

Results
Most nurses (75.5%) believed that crowded waiting rooms in the ED were the most influential factor affecting QIs. Many other challenges were identified, including bed capacity, triage area/workflow, increased volume during peak periods, demand for nonemergency visits, staff and shortages. Significant differences in nurses’ responses were found on the basis of education level (for infrastructure only, p = 0.004), specialty (for nursing administration only, p = 0.052), and ED experience (for all variables, p = 0.008–0.039).

Conclusion
The analysis uncovered various critical aspects of infrastructure, workflow, population, workforce, and nursing administration that have a major effect on patient flow in the ED.Comprehending these aspects will greatly affect the quality measures of ED performance and assist policymakers in formulating strategic plans to enhance ED performance. Therefore, successful implementation and optimization of ED resources depend greatly on considering the right decision variables and resource restrictions.
Effect of Cold Temperature on the Severity of Allergic Rhinitis Based on Visual Analog Scale (VAS) Score Among Medical Students of Malikussaleh University
Authors: Zuhra Farianti , Rahayu Mulyati Sri , Putri Baluqia Iskandar 
Published: July 2024

BACKGROUND: Allergic rhinitis is a common condition caused by inflammation of the nasal mucosa after exposure to allergens and is mediated by Immunoglobulin E (IgE). Cold temperatures can aggravate the symptoms of allergic rhinitis. Allergic rhinitis is not fatal, but it can cause a decrease in the patient's quality of life if the symptoms are severe. The severity of allergic rhinitis symptoms is difficult to measure as it should match patient's perception, so VAS is a quantitative measurement tool used. Although VAS is a simple and easy-to-use tool, its use as self-monitoring for AR patients is still infrequent to minimize symptom exacerbations and maintain control of allergic rhinitis.
AIMS: This study aims to examine the effect of cold temperature on the severity of allergic rhinitis based on VAS score.
METHOD: This research is an experimental with a one-group pretest-posttest study. The study samples involved 75 students suffering from allergic rhinitis assessed with the Score for Allergic Rhinitis (SFAR) questionnaire assessment from the class of 2020, 2021, and 2022. Subjects’ pain level was measured before and after the intervention. The intervention was in the form of cold temperature exposure for 15 minutes in a room with a temperature of 18℃. Data were analyzed using the Wilcoxon test.
RESULT: The results showed that the mean VAS score before the intervention was 0 while after the intervention was 38.61 ± 24.07. This shows that the mean VAS score after the intervention is higher than the mean VAS score before the intervention (p-value = 0.00 <0.05).
CONCLUSION: The results of this study indicate that the effect of cold temperature can increase the severity of allergic rhinitis.
Analisis Penawaran Produk Hortikultura Di Kabupaten Manggarai
Authors: Dep Aventus Purnama , Modesta Aswinda  , Piran Ronaldus Don , Ippi Viktorianus 
Published: July 2024

Tanaman hortikultura dapat memberikan keuntungan bagi yang membudidayakan, yaitu menjadi sumber pendapatan dan memiliki keunggulan berupa nilai jual tinggi serta potensi serapan pasar di dalam negeri dan internasional yang terus meningkat. Penelitian dilaksanakan di Kabupaten Manggarai, Nusa Tenggara Timur. Tujuan penelitian adalah menganalisis rata-rata dan persentase rata-rata penawaran, rata-rata perubahan dan persentase perubahan jumlah penawaran, menentukan fungsi penawaran dan menganalisis elastisitas penawaran. Penelitian Penelitian ini dilaksanakan pada bulan November 2020 sampai September 2022 di Kabupaten Manggarai. Data yang digunakan dalam penelitian ini adalah data non-empirik, dalam hal ini digunakan data sekunder. Teknik analisis data yang digunakan adalah analisis rata-rata, analisis persentase, analisis fungsi penawaran dan analisis elastisitas penawaran. Penawaran produk hortikultura (ton) di Kabupaten Manggarai Tahun 2015-2019, yaitu produk terung panjang sebanyak 362,57 ton, mentimun sebanyak 275,83 ton tomat sebanyak 1183,77 ton, Buncis sebanyak 525,57 ton dan bawang merah sebanyak 2024,8 ton. Rerata penawaran tahun 2015-2019 adalah produk terung panjang sebanyak 90,6425 ton, mentimun sebanyak 68,9575 ton, tomat sebanyak 295,9425 ton, buncis sebanyak 131,3925 dan bawang merah sebanyak 506,2 ton. Perubahan penawaran tahun 2015-2019, yaitu terung panjang 32, 83 ton, mentimun -51,43 ton, tomat 86,23 ton, buncis 122,13 ton dan bawang merah 64,5 ton. Total harga per Kg produk hortikultura (ton) menurut Provinsi NTT tahun 2015-2019 adalah, produk terung panjang Rp.18.997, mentimun Rp.14.832, tomat Rp. 26.896,00, buncis Rp. 20.478 dan bawang merah Rp.63.789. Rerata elastisitas penawaran produk hortikultura di Kabupaten Manggarai tahun 2015-2019 yaitu, produk terung panjang 85,1 (Elastisitas), mentimun 63,6 (Elastisitas), tomat 6,8 (Elastisitas), buncis 5,1 (Elastisitas) dan bawang merah 236,0 (Elastisitas).
Respon Komponen Hasil Kedelai (Glycine max. L(MERR) Varietas Anjasmoro terhadap Pemberian Kompos Jerami
Authors: Haim Kristina , Seratu Filomena , Liana Devi 
Published: July 2024

Tanaman kedelai termasuk tanaman yang peka terhadap kondisi lingkungan tumbuh sehingga berpengaruh terhadap komponen hasil kedelai. Tujuan dari penelitian ini adalah untuk mengetahui respon komponen hasil kedelai terhadap pemberian kompos jerami padi. Penelitian ini dilaksanakan di Kelurahan Tenda Kecamatan Langke Rembong, Kabupaten Manggarai. Lahan yang dipakai untuk melakukan penelitian ini merupakan lahan milik Kampus Unika Santu Paulus Ruteng. Penelitian dilaksanakan pada bulan Maret- Juli 2021. Rancangan yang digunakan dalam penelitian ini adalah Rancangan Acak Kelompok (RAK) faktor tunggal yang terdiri dari empat perlakuan yaitu kontrol, kompos jerami padi 240 g/polybag, kompos jerami 480 g/polybag dan kompos jerami 720 g/polybag, yang terdiri dari tiga ulangan. Hasil penelitian menunjukkan bahwa respon komponen hasil kedelai terhadap pemberian kompos jerami padi tidak berbeda nyata dengan komponen hasil kedelai kontrol (tanpa perlakuan). Hal tersebut dipengaruhi oleh kondisi lingkungan tumbuh yang kurang optimal sehingga komponen hasil kedelai tidak berbeda nyata.
HUBUNGAN PENGETAUAN, MASA KERJA DAN PENGAWASAN TERHADAP PERILAKU PEMILAHAN LIMBAH MEDIS PADA TENAGA KESEHATAN DI RUMAH SAKIT HERMINA DEPOK TAHUN 2023
Authors: Salamah Nurul Pitriani , Nina Nina , Yaser Mohammad 
Published: July 2024

Pendahuluan: Memilah limbah dilakukan mulai dari sumber yang menghasilkan limbah, limbah benda tajam dikumpulkan dalam satu wadah dengan mempertimbangkan apakah terkontaminasi atau tidak, dan limbah medis padat digunakan kembali melalui proses sterilisasi. Tujuan dari penelitian ini adalah Untuk Mengetahui Hubungan Pengetauan, Masa Kerja Dan Pengawasan Terhadap Perilaku Pemilahan Limbah Medis Pada Tenaga Kesehatan Di Rumah Sakit Hermina Depok Tahun 2023 . Metode: Penelitian ini merupakan penelitian kuantitatif dengan menggunakan pendekatan cross sectional . Populasi dalam penelitian ini yaitu tenaga kesehatan seperti perawat , bidan dan farmasi yang bekerja di Rumah Sakit Umum Hermina Depok dengan jumlah 201 tenaga kesehatan dan menggunakan pengambilan sampel yang digunakan dalam penelitian ini menggunakan teknik Accidental Sampling dan diperoleh sampel tenaga kesehatan sebanyak 134 responden. Hasil: penelitian menunjukkan ada hubungan pengetahuan dengan p value sebesar 0,003 (p<0,05) dan OR=2,958 , tidak ada hubungan masa kerja dengan p value sebesar 0,181 (p>0,05), dan ada hubungan antara pengawasan dengan p value sebesar 0,001 (p>0,05) dengan perilaku pemilahan limbah medis pada tenaga kesehatan. Kesimpulan: keseluruhan dapat disimpulkan bahwa kondisi Tenaga Kesehatan di RSU Hermina Depok mengenai pengetahuan perlu mendapatkan pelatihan atau sosialisasi yang memadai tentang memilah limbah medis. Pelatihan ini harus mencakup prosedur, peraturan, dan pedoman yang berlaku untuk memilah dan pengelolaan limbah medis. Hal ini mengakibatkan dari kurangnya pengetahuan tenaga kesehatan dalam memilah limbah di rumah sakit dapat sangat serius dan berdampak negatif pada lingkungan salah satu dampak utama dari memilah limbah yang kurang baik adalah pencemaran lingkungan, resiko cedera, biaya tambahan pada rumah sakit. Berkaitan dengan pengawasan pada limbah medis bahwa pengawasan yang efektif terhadap memilah limbah medis di rumah sakit sangat penting untuk menetapkan bahwa proses pemilahan, penanganan, dan pengelolaan limbah medis berjalan sesuai aturan dan SOP yang berlaku.
Subjective Well-Being of Female Adolescents with Disability in Indonesia
Authors: Sylvia Nanda , Darmawati Darmawati , Marthoenis  
Published: July 2024

Background: Subjective well-being is vital for individuals with physical and intellectual disabilities to possess because it affects their future life development. Adolescents with physical disabilities are one of the groups considered to have low levels of Subjective Well Being.
Materials and Methods: A cross-sectional study was conducted among 139 female adolescents with disability in Indonesia. The data were collected by directly interviewing the students based on the questionnaire guide and reviewing the participant information through secondary data. The data collection instruments cover the socio-demographic data questionnaire and Satisfaction with Life Scale.
Results: The majority of the female adolescent with disability satisfy with their life (70.5%). Their satisfaction was associated with their family type and their age (p < 0.05), but not associated with age, parent occupation and their grade (p > 0.05).
Conclusion: Students from nuclear family seems to have better support to the disabled adolescent, so that they have better lafe satisfaction compared to their peer living in an extended family.
Differential online and offline effects of theta-tACS on memory encoding and retrieval
Authors: Paßmann Sven , Baselgia Sandrine , Kasten Florian H. , Herrmann Christoph S. , Rasch Björn 
Published: July 2024

AbstractTheta oscillations support memory formation, but their exact contribution to the communication between prefrontal cortex (PFC) and the hippocampus is unknown. We tested the functional relevance of theta oscillations as a communication link between both areas for memory formation using transcranial alternating current stimulation (tACS). Healthy, young participants learned two lists of Dutch-German word pairs and retrieved them immediately and with a 30-min delay. In the encoding group (N = 30), tACS was applied during the encoding of list 1. List 2 was used to test stimulation aftereffects. In the retrieval group (N = 23), we stimulated during the delayed recall. In both groups, we applied tACS bilaterally at prefrontal and tempo-parietal sites, using either individualized theta frequency or 15 Hz (as control), according to a within-subject design. Stimulation with theta-tACS did not alter overall learning performance. An exploratory analysis revealed that immediate recall improved when word-pairs were learned after theta-tACS (list 2). Applying theta-tACS during retrieval had detrimental effects on memory. No changes in the power of the respective frequency bands were observed. Our results do not support the notion that impacting the communication between PFC and the hippocampus during a task by bilateral tACS improves memory. However, we do find evidence that direct stimulation had a trend for negatively interfering effects during immediate and delayed recall. Hints for beneficial effects on memory only occurred with aftereffects of the stimulation. Future studies need to further examine the effects during and after stimulation on memory formation.
The Effect of Price Perception and Product Quality on Shoe Purchasing Decisions
Authors: Lipandi Muhammad Ikbal , Pranamulia Agus , Putra Mulyana Gustira 
Published: July 2024

This research was conducted with the aim of analyzing the influence of perceived price and quality of shoe products on purchasing decisions at PT Yonshoes. This research uses quantitative methods. The type of data used in this research is primary data. Primary data was obtained based on distributing questionnaires to 100 respondents. Data were analyzed using multiple linear regression analysis techniques.

Keywords: Price perception, Product quality, Buying decision
The Absolute Age of NGC 3201 Derived from Detached Eclipsing Binaries and the Hess Diagram
Authors: Ying Jiaqi (Martin) , Chaboyer Brian , Du Wenxin 
Published: July 2024

Abstract
We estimate the absolute age of the globular cluster NGC 3201 using 10,000 sets of theoretical isochrones constructed through Monte Carlo simulation using the Dartmouth Stellar Evolution Program. These isochrones take into consideration the uncertainty introduced by the choice of stellar evolution parameters. We fit isochrones with three detached eclipsing binaries and obtained an age independent of distance. We also fit isochrones with differential reddening corrected Hubble Space Telescope photometry data utilizing two different Hess diagram-based fitting methods. Results from three different methods analyzing two different types of data agree to within 1σ, and we find the absolute age of NGC 3201 = 11.85 ± 0.74 Gyr. We also perform a variable importance analysis to study the uncertainty contribution from individual parameters, and we find the distance is the dominant source of uncertainty in photometry-based analysis, while total metallicity, helium abundance, α-element abundance, mixing length, and treatment of helium diffusion are an important source of uncertainties for all three methods.
Determination of Surface Abundances for HD 129174 (π
1 Boo)
Authors: Monier Richard 
Published: July 2024

Abstract
The synthesis of the Hg ii line at 3983.93 Å, using published hyperfine structure and nuclear shifts, confirms a large overabundance of mercury in HD 129174, about +6.18 dex, which is actually slightly larger than the excess derived in earlier studies. The synthesis of 17 other lines close to the Hg ii line and in the spectral range 4400–4500 Å yields abundances for 9 elements. Helium and iron are found to be deficient by −1.12 and −0.097 dex. Magnesium, scandium, titanium, chromium are moderately enhanced by respectively +0.30 dex (Mg) and +1.0 dex (Sc, Ti and Cr). Yttrium and zirconium are very overabundant by +4.00, +2.48 dex respectively.
« Guerre » à Gaza et « génocide » : salvatrice froideur du droit dans le débat
Authors: Papaux Alain , Wyler Éric 
Published: July 2024

Dans la tourmente des bombes à Gaza et des accusations de propagande diabolisant le frère ennemi israélien ou palestinien, le droit international tente modestement de contenir la violence par les régulations du jus ad bellum et du jus in bello . S'agissant des exactions commises sur le terrain, seul le recours à un tribunal international impartial permettrait de les qualifier juridiquement . En effet, tout génocide supposant une « intention de détruire… un groupe national, ethnique, racial ou religieux (…) », comment, sans l'interprétation d'un juge de bonne foi, déterminer concrètement si Israël ou le Hamas (ou les deux) s'en est rendu coupable ? Encore faudrait-il un consensus pour saisir une juridiction…
Discordances temporelles. Réflexions sur le dialogue de roman au xixe siècle
Authors: Naïm Jérémy 
Published: July 2024

Depuis la généralisation de la poétique structuraliste, on a coutume d’analyser le dialogue de roman comme une « scène », c’est-à-dire comme un moment de coïncidence entre le temps des événements et le temps de la narration. Mais ce discours néglige deux choses : d’abord le fait que l’expérience temporelle n’est pas uniforme ; ensuite que l’illusion de coïncidence correspond à un régime historique du dialogue. Au cours de cet article, on s’efforce ainsi de montrer que dans le roman du xix e siècle, le dialogue représente aussi des formes de discordance temporelle, à mettre en lien avec les expériences modernes de la temporalité.
Calcitriol Impairs the Secretion of IL-4 and IL-13 in Th2 Cells via Modulating the VDR-Gata3-Gfi1 Axis
Authors: Biswas Biswajit , Chattopadhyay Shagnik , Hazra Sayantee , Goswami Ritobrata 
Published: July 2024

Abstract
Calcitriol, the bioactive form of vitamin D, exerts its biological functions by binding to its cognate receptor, the vitamin D receptor (VDR). The indicators of the severity of allergies and asthma have been linked to low vitamin D levels. However, the role of calcitriol in regulating IL-4 and IL-13, two cytokines pivotal to allergic inflammation, remained unclear. Our study observed diminished IL-4 and IL-13 secretion in murine and human Th2 cells treated with calcitriol. In murine Th2 cells, Gata3 expression was attenuated by calcitriol. However, the expression of the transcriptional repressor Gfi1, too, was attenuated in the presence of calcitriol. Ectopic expression of either Gfi1 or VDR impaired the secretion of IL-13 in Th2 cells. In murine Th2 cells, VDR interacted with Gata3 but not Gfi1. Gfi1 significantly impaired Il13 promoter activation, which calcitriol failed to restore. Conversely, calcitriol augmented Gfi1 recruitment to the Il13 promoter. Ecr, a conserved region between these two genes, which enhanced the transactivation of Il4 and Il13 promoters, is essential for calcitriol-mediated suppression of both the genes. Calcitriol augmented the recruitment of VDR to the Il13 promoter and Ecr regions. Gata3 recruitment was significantly impaired at the Il13 and Ecr loci in the presence of calcitriol but increased at the Il4 promoter. Furthermore, the recruitment of the histone deacetylase HDAC1 was universally increased at the promoters of Il4, Il13, and Ecr when calcitriol was present. Together, our data clearly elucidate that calcitriol modulates VDR, Gata3, and Gfi1 to suppress IL-4 and IL-13 production in Th2 cells.
C/EBPδ Mediates Immunity to Renal Autoinflammatory Disorders in a Stage-specific Manner
Authors: Dey Ipsita , Li Yang , Taylor Tiffany C , Peroumal Doureradjou , Asada Nariaki , Panzer Ulf , Biswas Partha S , Sterneck Esta , Gaffen Sarah L 
Published: July 2024

Abstract
Kidney disease represents a major medical and economic burden for which improved treatments are urgently needed. Emerging data have implicated Th17 cells and IL-17 signaling in the underlying pathogenesis of autoantibody-induced glomerulonephritis (AGN). However, the downstream transduction pathways mediated by IL-17 in autoimmunity are not well defined. In this article, we show that CCAAT/enhancer-binding protein (C/EBP) δ is elevated in kidney biopsies from multiple manifestations of human AGN. C/EBPδ is similarly upregulated in a mouse model of anti-glomerular basement membrane protein–mediated kidney disease, and Cebpd−/− mice were fully refractory to disease. Although C/EBPδ is expressed in a variety of cell types, C/EBPδ was required only in the radioresistant compartment to drive GN pathology. C/EBPδ induced expression of several IL-17–induced kidney injury markers and cytokines implicated in disease, including Il6 and Lcn2. Because mouse AGN models do not progress to fibrosis, we employed a nephrotoxic injury model using aristolochic acid I to assess the contribution of the IL-17–C/EBPδ pathway to renal fibrotic events. Surprisingly, deficiency of either C/EBPδ or the IL-17 receptor caused kidney fibrosis to be enhanced. Thus, C/EBPδ and IL-17 play divergent and apparently stage-specific roles in the pathogenesis of kidney disease.
Health-care Systems around the World: Diversity, Challenges, and Innovations
Authors: Kumbhar Smita Tukaram , Bhatia Manish , Patel Vipul 
Published: July 2024

Abstract
This study aims to explore the diversity of health-care systems globally, identify the challenges they face, and highlight innovative solutions being implemented to overcome these obstacles. By examining health-care models from various countries, the research seeks to understand how different systems can learn from each other to improve patient outcomes, efficiency, and sustainability. A comparative analysis was conducted across health-care systems in multiple countries, including high-income, middle-income, and low-income nations. Data were collected through a review of existing literature, health statistics, and case studies. Key metrics such as accessibility, quality of care, cost-effectiveness, and patient satisfaction were analyzed. In addition, interviews with health-care professionals and policymakers provided insights into the operational dynamics and innovation strategies within these systems. The findings reveal a wide spectrum of health-care models, from publicly funded systems to private insurance-based and mixed models. Common challenges identified include rising health-care costs, unequal access to services, and the burden of noncommunicable diseases. However, innovative practices such as digital health technologies, community-based health care, and integrated care models have shown promise in addressing these issues. The effectiveness of these innovations varied depending on the context of the health-care system in which they were implemented. In conclusion, the diversity of health-care systems worldwide presents both challenges and opportunities for innovation and improvement. While there is no one-size-fits-all solution, the successful strategies identified in this study emphasize the importance of adaptable, patient-centered care models that leverage technology and community resources. Policymakers and health-care providers should foster collaboration and learning across borders to enhance the resilience and efficiency of their health-care systems.
Pediatric Obstructive Sleep Apnea: An Updated Review
Authors: Shah Charmi , Bargale Seema , Lalwani Yash 
Published: July 2024

Abstract
Pediatric obstructive sleep apnea (OSA) is a prevalent sleep disorder characterized by recurrent upper airway obstruction during sleep, leading to disrupted breathing patterns and intermittent hypoxemia. This review synthesizes current literature on pediatric OSA, covering epidemiology, etiology, clinical presentation, diagnosis, and management. OSA affects 1%–5% of children, with adenotonsillar hypertrophy as a primary cause. The interplay of anatomical and neuromuscular factors contributes to OSA pathophysiology. Clinical manifestations include snoring, witnessed apneas, and daytime sleepiness, although diagnosis can be challenging due to varied symptoms. Diagnostic methods encompass clinical assessment and polysomnography, while management strategies range from adenotonsillectomy to continuous positive airway pressure therapy. Early recognition and intervention are crucial to prevent complications and optimize outcomes in pediatric OSA. Further research is needed to refine diagnostic approaches and enhance treatment efficacy for this significant pediatric health concern.