bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sociodemographic, clinical characteristics, and treatment patterns of endometrial cancer cases in Puerto Rico during the period 2009 to 2015: A retrospective study
Authors: Pagán Santana Yisel , Castañeda Ávila Maira , Ríos Motta Ruth , Ortiz Ortiz Karen J. 
Published: May 2024

Background
Over the past decades, the rising incidence rates of endometrial cancer have made it a significant public health concern for women worldwide. Treatment strategies for endometrial cancer vary based on several factors such as stage, histology, the patient’s overall health, and preferences. However, limited amount of research on treatment patterns and potential correlations with sociodemographic characteristics among Hispanics is available. This study analyzes the treatment patterns for patients diagnosed with endometrial cancer in Puerto Rico.

Methods
A secondary database analysis was performed on endometrial cancer cases reported to the Puerto Rico Central Cancer Registry-Health Insurance Linkage Database from 2009 to 2015 (n = 2,488). The study population’s sociodemographic and clinical characteristics were described, along with an overview of the therapy options provided to patients receiving care on the island. Logistic regression models were used to evaluate the association of sociodemographic/clinical characteristics with treatment patterns stratified by risk of recurrence.

Results
In our cohort, most patients were insured through Medicaid and had a median age of 60 years. Almost 90% of patients received surgery as the first course of treatment. Surgery alone was the most common treatment for low-risk patients (80.2%). High-risk patients were more likely to receive surgery with radiotherapy and chemotherapy (24.4%). Patients with Medicare insurance were five times (HR: 4.84; 95% CI: 2.45–9.58; p < 0.001) more likely to receive surgery when compared with patients insured with Medicaid. In contrast, those with private insurance were twice as likely to receive surgery (HR: 2.38; 95% CI: 1.40–4.04; p = 0.001) when compared to those with Medicaid.

Conclusion
These findings provide insight into the treatment patterns for endometrial cancer in Puerto Rico and highlight the importance of considering factors such as disease risk when making treatment decisions. Addressing these gaps in treatment patterns can contribute to effective management of endometrial cancer.
A patient-centered ‘test-drive’ strategy for ankle-foot orthosis prescription: Protocol for a randomized participant-blinded trial
Authors: Shuman Benjamin R. , Hendershot Brad D. , Morgenroth David C. , Russell Esposito Elizabeth 
Published: May 2024

Background
Ankle-foot orthoses (AFOs) are commonly used to overcome mobility limitations related to lower limb musculoskeletal injury. Despite a multitude of AFOs to choose from, there is scant evidence to guide AFO prescription and limited opportunities for AFO users to provide experiential input during the process. To address these limitations in the current prescription process, this study evaluates a novel, user-centered and personalized ‘test-drive’ strategy using a robotic exoskeleton (‘AFO emulator’) to emulate commercial AFO mechanical properties (i.e., stiffness). The study will determine if brief, in-lab trials (with emulated or actual AFOs) can predict longer term preference, satisfaction, and mobility outcomes after community trials (with the actual AFOs). Secondarily, it will compare the in-lab experience of walking between actual vs. emulated AFOs.

Methods and analysis
In this participant-blinded, randomized crossover study we will recruit up to fifty-eight individuals with lower limb musculoskeletal injuries who currently use an AFO. Participants will walk on a treadmill with three actual AFOs and corresponding emulated AFOs for the "in-lab” assessments. For the community trial assessment, participants will wear each of the actual AFOs for a two-week period during activities of daily living. Performance-based and user-reported measures of preference and mobility will be compared between short- and long-term trials (i.e., in-lab vs. two-week community trials), and between in-lab trials (emulated vs. actual AFOs).

Trial registration
The study was prospectively registered at www.clininicaltrials.gov (Clinical Trials Study ID: NCT06113159). Date: November 1st 2023. https://classic.clinicaltrials.gov/ct2/show/NCT06113159.
An assessment of turnaround times of infant Deoxyribonucleic acid–Polymerase Chain Reaction testing and the associated factors in Western Kenya: A mixed methods study
Authors: Omondi Maxwell Philip 
Published: May 2024

Introduction
The HIV/AIDS continues being a significant global public health priority in the 21st century with social and economic consequences Mother-to-child transmission (MTCT) occurs when an HIV-infected woman passes the virus to her infant and about 90% of these MTCT infections occurs in Africa where children and infants are still dying of HIV. Early definitive diagnosis using Deoxyribonucleic acid reaction of HIV infection in infants is critical to ensuring that HIV-infected infants receive appropriate and timely care and treatment to reduce HIV related morbidity and mortality.

Objective
To assess the Infant Deoxyribonucleic acid–Polymerase Chain Reaction (DNA-PCR) Turnaround Time (TAT) of dry blood spots and associated factors in Vihiga, Bungoma, Kakamega and Busia counties, in Kenya.

Method
A mixed methods study using a) retrospectively collected data from Ministry of Health Laboratory registers, Early Infant Diagnosis (EID) database from 28 health facilities and b) 9 key informant interviews with laboratory in-charges were conducted. A total of 2,879 HIV exposed babies’ data were abstracted from January 2012 to June 2013.

Results
The mean TAT from specimen collection and results received back at the facilities was 46.90 days, Vihiga county having the shortest mean duration at 33.7days and Kakamega county having the longest duration at 51.7days (p = 0.001). In addition, the mean transport time from specimen collection and receipt at Alupe Kenya Medical Research Institute (KEMRI) reference Laboratory was 16.50 days. Vihiga County had the shortest transport time at 13.01 days while Busia had the longest at 18.99 days (p = 0.001). Longer TAT was due to the batching of specimens at the peripheral health facilities and hubbing to the nearest referral hospitals.

Conclusion
The TAT for DNA-PCR specimen was 46.90 days with Vihiga County having the shortest TAT due to lack of specimen batching and hubbing.

Recommendation
Discourage specimen batching/hubbing and support point-of-care early infant diagnosis (EID) tests.
Application of concentrated growth factor in mandibular third molar extraction: A protocol for systematic review and meta-analysis
Authors: Zhang Hengxiao , Dong Jianyong , Wang Xiaoliang , Sun Xiaodong , Wang Jin 
Published: May 2024

Objective
We will perform the systematic review to evaluate the effect of applying concentrated growth factor (CGF) on relieving postoperative complications and promoting wound healing following mandibular third molar extraction.

Methods
The PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, China Biology Medicine Disc (CBM), and VIP Databases will be comprehensively searched up to May 31, 2024. Randomized controlled trials (RCTs) examining the application of CGF after mandibular third molar extraction will be included. The protocol was registered in PROSPERO, and the registration ID was CRD42023463234. Two reviewers will conduct the literature search, eligible study selection, data extraction, and bias risk assessment (using the Cochrane Risk of Bias 2.0 tool). Data analysis will be performed with RevMan software (version 5.4).

Results
The results of this study will be available in a peer-reviewed journal.

Conclusion
Our study will provide scientific evidence regarding the efficacy of applying CGF in mandibular third molar extraction.
Storytelling as a Pedagogic Method to Promote Cultural Humility at a Student-Run Free Clinic
Authors: Barnes Ryiah 
Published: May 2024

**Abstract**
This study explores the efficacy of training programs aimed at promoting cultural humility and lifelong learning among healthcare professionals, focusing on the context of Avicenna Community Health Center, a free clinic serving uninsured or underinsured adults in Champaign, IL. Specifically, it investigates the impact of H.E.A.L.E.R.© training on student volunteers and the effectiveness of storytelling as a pedagogic approach in continuing education for healthcare professionals.
The H.E.A.L.E.R.© training, led by Drs. Michelle Mao and Terán-García, is a mandated program for Avicenna volunteers, comprising activities such as self-identity exploration and case studies. Additionally, the study examines the role of storytelling in engaging staff nurses in continuing education, citing evidence that storytelling is more effective than traditional methods in fostering positive attitudes toward professional development among nurses.
Through thematic analysis of interview data from 10 participants, several key themes emerge. Firstly, the training and clinical experiences encourage self-reflection and awareness of biases among volunteers. Secondly, effective communication, particularly with non-English-speaking populations, is emphasized, emphasizing the importance of avoiding assumptions and judgments. Thirdly, the clinic's holistic approach to healthcare, including case management and lifestyle medicine, underscores the commitment to equity and equality in patient care. Finally, storytelling emerges as a powerful tool for fostering understanding and trust among healthcare professionals and patients alike.
Recommendations for future trainings include diversifying continuing education opportunities on cultural humility and incorporating interactive activities like storytelling and implicit bias exercises. However, the study acknowledges limitations inherent in qualitative research methods, such as small sample size and potential biases in participant responses.
Looking ahead, the study suggests expanding H.E.A.L.E.R.© training to other student-run free clinics and programs serving underrepresented groups, with the aim of further promoting cultural humility and enhancing the quality of care provided to marginalized communities.
Severe Drug-Induced Liver Injury Due to Self-administration of the Veterinary Anthelmintic Medication, Fenbendazole
Authors: Thakurdesai Aishwarya , Rivera-Matos Lucia , Nagra Navroop , Busch Brandon , Mais Daniel D. , Cave Matthew C. 
Published: May 2024

ABSTRACT
Fenbendazole is an anthelmintic agent approved for veterinary applications. Even though it is not approved by the US Food and Drug Administration for human use, such use appears to be increasing due to the popularization of fenbendazole's potential anticancer effects by social media. We describe the first case of histologically confirmed severe drug-induced liver injury, hepatocellular pattern, associated with the self-administration of fenbendazole in a 67-year-old woman who presented with 2 weeks of jaundice. Liver function tests normalized in 3 months after the cessation of fenbendazole.
Evaluation of Nutrition Education at Senior High Schools in Mamuju Regency West Sulawesi
Authors: Nurbaya Nurbaya , Najdah Najdah 
Published: May 2024

Abstract Introduction: The 2018 Basic Health Research showed a high prevalence of anemia (32%), Chronic Energy Deficiency (36.3%), and overweight and obesity (16.0%) among adolescents. Nutrition education is crucial to be taught to adolescents from an early age. However, there is a lack of research on content related to nutrition education in textbooks of school policies on nutrition and health. This study aimed to evaluate the nutrition education on senior high schools in Mamuju Regency.Methods: This qualitative study examined word by word of high school students textbooks’ content of nutrition and health education. The main study material was textbooks used by high school students in Mamuju Regency. The research informants were students and teachers. The analysis was done through content analysis by examining words and pictures in the textbooks. Data was classified into the same categories to answer the research objectives.Results: Only a small proportion of textbooks (0.17%) contain nutrition and health messages. The nutrition and health messages included the nutritional content of food, food labels, and physical activity such as how to do long jump. Informants did not get information on adolescent health and nutrition at school. In addition, there is currently no school policy regarding breakfast or healthy snacks in the school environment.Conclusion: Balanced nutrition messages had not been published in textbooks and delivered regularly in schools. Policy makers should review the school curriculum to include nutrition and health messages for adolescents in the textbooks used.
Factors Affecting The Incidence of Anemia in Third-Trimester Pregnant Women at Purwoharjo Primary Health Center, Pemalang District
Authors: Zaliyanti Vera , Herlambang Penggalih Mahardika , Fatmawati Widi 
Published: May 2024

AbstractIntroduction: Anemia in pregnancy occurs due to a lack of nutritional intake to meet the needs of the mother and fetus. According to Riskesdas, the prevalence of anemia in Indonesia is 48.9%. Anemia in pregnancy can occur due to various factors. The most common anemia in pregnancy is iron deficiency anemia which is caused by a lack of nutritional intake and foods that contain iron.Methods: This research uses a quantitative approach with descriptive observational, the sample was pregnant women in the third trimester, who had Hb levels <11 gr/dl and underwent ANC at Purwoharjo Primary Health Center. This research was conducted in August-October 2023 with a total of 62 respondents, analysis used univariate analysis.Results: The prevalence of anemia in third-trimester pregnant women at the Purwoharjo Primary Health Center is 43%. Various factors influence the incidence of anemia in pregnant women in the third trimester at Purwoharjo Primary Health Center.Conclusion: The prevalence of third-trimester pregnancy anemia at the Purwoharjo Primary Health Center is 43%, and the most influencing factors are nutritional status (61.3%) and non-compliance with iron supplement consumption (53.2%). Health officials have also made various efforts to reduce the incidence of anemia
SepHash: A Write-Optimized Hash Index On Disaggregated Memory via Separate Segment Structure
Authors: Min Xinhao , Lu Kai , Liu Pengyu , Wan Jiguang , Xie Changsheng , Wang Daohui , Yao Ting , Wu Huatao 
Published: May 2024

Disaggregated memory separates compute and memory resources into independent pools connected by fast RDMA (Remote Direct Memory Access) networks, which can improve memory utilization, reduce cost, and enable elastic scaling of compute and memory resources. Hash indexes provide high-performance single-point operations and are widely used in distributed systems and databases. However, under disaggregated memory, existing hash indexes suffer from write performance degradation due to high resize overhead and concurrency control overhead. Traditional write-optimized hash indexes are not efficient for disaggregated memory and sacrifice read performance.
In this paper, we propose SepHash, a write-optimized hash index for disaggregated memory. First, SepHash proposes a two-level separate segment structure that significantly reduces the bandwidth consumption of resize operations. Second, SepHash employs a low-latency concurrency control strategy to eliminate unnecessary mutual exclusion and check overhead during insert operations. Finally, SepHash designs an efficient cache and filter to accelerate read operations. The evaluation results show that, compared to state-of-the-art distributed hash indexes, SepHash achieves a 3.3X higher write performance while maintaining comparable read performance.
Surface modified molybdenum disulfide nanosheets for corrosion resistance improvement on polyurethane coatings
Authors: Zhou Guilin , Wang Jingchuan , Cheng Wenjie , Nan Hui , Zhao Xiaochong , Wei Haomin , Xue Caihong , Ma Yuehua , Yang Pan 
Published: May 2024

Abstract
Organic–inorganic hybrid coating has been applied on metallic corrosion protection effectively. Molybdenum disulfide (MoS2) nanosheets with graphene-like two-dimensional lamellar structure were an anticorrosion inorganic additive, rendering the organic coating better corrosion resistant. However, the aggregation and poor solubility are still current issues that should be addressed. Functionalization MoS2 nanosheets with surface modified by polydopamine (PDA) and silane coupling agent (KH560) were prepared in polyurethane (PU) composite coatings to obtain dense and intact multilayer network structure coatings for corrosion protection. KH560-PDA-MoS2/PU coating with crosslinked polymer network structure has a high impedance modulus, large contact angle, and strong hydrophobicity. The coating meets the national technical standards for salt spray testing and nitric acid (HNO3) titration testing, demonstrating excellent corrosion resistance.
A Compliance Return Method to Evaluate Different Approaches to Implementing Regulations: The Example of Food Hygiene Standards
Authors: Williamson David , Pugh Geoff , Akinbote Mayowa 
Published: May 2024

Abstract
We investigate how different approaches to the implementation of regulations affect compliance by evaluating the implementation of food hygiene standards in four English authorities. We draw upon regulatory theory in general together with specific literature on food hygiene standards to advance a new “compliance return” concept, which enables compliance outcomes and resource inputs to be considered jointly. We operationalize “compliance return” as part of a low-cost methodology for evaluating the relative effectiveness of different approaches to implementing food hygiene standards. We find that different approaches to implementation have significant impacts on food policy outcomes. Specifically, implementation ranged from a greater emphasis on deterrence to a greater emphasis on cooperation, with cooperation resulting in greater compliance and deterrence requiring less resource input. When compliance level is considered alongside resource input, to assess the overall “compliance return,” a stronger case emerges for a deterrence approach. The food policy implications are two-fold: (i) implementation affects policy outcomes, and (ii) the measure of “compliance return” developed and implemented in this article offers a low-cost approach to support the ex-post evaluation of implementation choices. The Compliance Return approach may be applicable more widely, especially where there is discretion regarding how regulations are to be implemented.
Comparative analysis of alpine agritourism in Trentino, Tyrol, and South Tyrol: Regional variations and prospects
Authors: Grillini Giulia , Streifeneder Thomas , Sacchi Giovanna , Fischer Christian 
Published: May 2024

Abstract
Agritourism is an increasingly popular form of tourism that entails visiting farms to engage in activities and gain insights into the farming way of life. This research explores the economic, social, and environmental dynamics of agritourism in the Tyrol–South Tyrol–Trentino Euroregion with a specific emphasis on the three distinct regional entities in Austria and Italy: the Austrian state of Tyrol (comprising North and East Tyrol) and the Italian autonomous provinces of South Tyrol and Trentino. It addresses two key research aims: uncovering regional distinctions among these Alpine provinces and understanding the motivations, challenges, and future plans of agritourism operators. A comprehensive review of existing literature frames the study, while data collection involves an online survey of agritourism farms in the region. Distinctive characteristics emerge, with Trentino emphasizing restaurant services, sustainability, and community engagement. South Tyrol prioritizes quality accommodations and work–life balance, while Tyrol aligns closer with South Tyrol’s focus. Notably, economic factors exert a substantial influence on their motivations to embrace agritourism, underscoring their pivotal role in this context. Despite facing challenges such as “time management and labour,” “meeting visitors’ expectations,” and “local permits and taxes,” most agritourism operators across the region display willingness to expand their activity in the future. Overall, agritourism in the study area is characterized by significant structural and operational differences resulting in different future public support and regulatory needs.
Die Bedeutung des Brexits für die Demokratie in Großbritannien
Authors: Chiocchetti Paolo , Dannemann Gerhard 
Published: May 2024

Abstract
On the one hand, Brexit has repatriated key competences from the EU to the UK, broadening the scope for political decisions which respond to national democratic preferences. On the other hand, it has highlighted traditional weaknesses of the British democracy, further concentrating powers in the hands of the British government and strengthening the role of the Prime Minister as the head of an “elective dictatorship” subject to few checks and balances. We explore these developments in light of constitutional law, political expert opinions, and mass surveys, showing that British democracy remains strong but is challenged by heightened popular expectations and widespread demands for reform.
Ökologischer Umbau von Wirtschaft und Gesellschaft: Kosten und Nutzen
Authors: Frondel Manuel 
Published: May 2024

Abstract
This article weighs up the costs and benefits of the expansion of renewable energy technologies for electricity generation in Germany. According to calculations of the German Ministry of Economic Affairs, this expansion has cost electricity consumers almost 300 billion euros since the introduction of the Renewable Energy Sources Act (EEG) in 2000. Moreover, payment obligations of a similar magnitude are already in place for the next two decades. However, with the accelerated expansion of renewables following Russia’s attack on Ukraine, politicians are accepting costs well in excess of this approximately 600 billion. Given the costs already incurred, a cost-benefit analysis is imperative, not least because further costs in the three-digit billion range are not included in the 600 billion figure, such as the costs for grid expansion, which would not be necessary to the same extent without the expansion of renewables. Against this backdrop, strict attention should be paid to cost discipline in the further expansion of renewables by ensuring that the Federal Network Agency only issues technology-neutral rather than technology-specific tenders for the expansion of renewables in future. This means that only the most cost-efficient renewable technologies will be installed. Consequently, there will be budgetary scope for future investments that could boost the growth potential of the German economy more than the expansion of renewable energies. Contrasting with the high costs, the benefits of expanding renewable energies are modest. For example, the share of renewables in primary energy consumption in 2022 was only around 17 %. With such a low share, achieving greenhouse gas neutrality in 2045 with renewables alone appears to be a tremendous challenge.