bluuebunny/crossref_metadata_2025_split huggingface dataset:
STRATEGI DINAS PARIWISATA DAN KEBUDAYAAN DALAM PENGELOLAAN PARIWISATA DI KABUPATEN PANGANDARAN TAHUN 2020-2021
Authors: Azizah Nisa , Deliarnoor Nandang Alamsah , Sagita Novie Indrawati 
Published: November 2023

Permasalahan di lapangan menunjukan bahwa strategi pengembangan dan penataan kawasan pariwisata yang dilakukan oleh Pemerintah Daerah Kabupaten Pangandaran masih belum efektif. Hal tersebut di tunjukan melalui penataan wisata yang dilakukan lebih khususnya destinasi paling favorit wisatawan. Yang mana para pedagang kaki lima yang kini ada di zona inti telah dipindahkan ke bagian belakang, namun karena pemindahan pedagang tidak mengikuti jalur lintas wisatawan, maka interaksi para pedagang dengan wisatawan sulit terjadi. Penelitian ini menggunakan metode deskriptif dengan pendekatan kaulitatif, dengan teknik pengumpulan data melalui studi pustaka dan studi lapangan yang mencakup wawancara, observasi dan dokumentasi dengan para informan baik dari internal Dinas Pariwisata dan Kebudayaan, pihak pengelolah tempat wisata, pengunjung tempat wisata, tokoh masyarakat, serta serta masyarakat yang ada di Kabupaten Panngandaran. Teknik analisis data dilakukan melalui pengumpulan data, penyajian data dan penarikan kesimpulan. Hasil penelitian ini menunjukan bahwa strategi Dinas Pariwisata dan Kabudayaan dalam pengelolaan wisata di Kabupaten Pangandaran tahun 2020-2021 masih belum efektif, hal ini dapat dilihat dari tiga dimensi berikut; (1) Strategi yang diterapkan oleh Dinas Pariwisata dan Kebudayaan dalam pengelolaan wisata di Kabupaten Pangandaran tahun 2020-2021 belum memenuhi indikator pertama yakni perumusan strategi. (2) Strategi yang diterapkan oleh Dinas Pariwisata dan Kebudayaan dalam pengelolaan wisata di Kabupaten Pangandaran tahun 2020-2021 belum memenuhi indikator kedua yakni penerapan srategi. (3) Strategi yang diterapkan oleh Dinas Pariwisata dan Kebudayaan dalam pengelolaan wisata di Kabupaten Pangandaran tahun 2020-2021 belum memenuhi indikator ketiga yakni penilaian srategi.

Kata kunci; Strategi, Dinas Pariwisata dan Kebudayaan, Pengelolaan Wisata.
Diabetes control is worse in children and young people with type 1 diabetes requiring interpreter support
Authors: Idkowiak Jan , Uday Suma , Elhag Sabba , Barrett Timothy , Dias Renuka , Kershaw Melanie , Mohamed Zainaba , Saraff Vrinda , Krone Ruth E. 
Published: November 2023

IntroductionLanguage barriers can pose a significant hurdle to successfully educating children and young people with type 1 diabetes (CYPD) and their families, potentially influencing their glycaemic control.MethodsRetrospective case-control study assessing HbA1c values at 0, 3, 6, 9, 12 and 18 months post-diagnosis in 41 CYPD requiring interpreter support (INT) and 100 age-, sex- and mode-of-therapy-matched CYPD not requiring interpreter support (CTR) in our multi-diverse tertiary diabetes centre. Data were captured between 2009-2016. English indices of deprivation for each cohort are reported based on the UK 2015 census data.ResultsThe main languages spoken were Somali (27%), Urdu (19.5%), Romanian (17%) and Arabic (12%), but also Polish, Hindi, Tigrinya, Portuguese, Bengali and sign language. Overall deprivation was worse in the INT group according to the Index of Multiple Deprivation (IMD [median]: INT 1.642; CTR 3.741; p=0.001). The median HbA1c was higher at diagnosis in the CTR group (9.95% [85.2 mmol/mol] versus 9.0% [74.9 mmol/mol], p=0.046) but was higher in the INT group subsequently: the median HbA1c at 18 months post diagnosis was 8.3% (67.2 mmol/mol; INT) versus 7.9% (62.8 mmol/mol; CTR) (p=0.014). There was no hospitalisation secondary to diabetes-related complications in either cohorts.Summary and conclusionsGlycaemic control is worse in CYPD with language barriers. These subset of patients also come from the most deprived areas which adds to the disadvantage. Health care providers should offer tailored support for CYP/families with language barriers, including provision of diabetes-specific training for interpreters, and explore additional factors contributing to poor glycaemic control. The findings of this study suggest that poor health outcomes in CYPD with language barriers is multifactorial and warrants a multi-dimensional management approach.
Mechanistic insight of Staphylococcus aureus associated skin cancer in humans by Santalum album derived phytochemicals: an extensive computational and experimental approaches
Authors: Hosen Md. Eram , Jahan Supti Sumaiya , Akash Shopnil , Rahman Md. Ekhtiar , Faruqe Md Omar , Manirujjaman M. , Acharjee Uzzal Kumar , Gaafar Abdel-Rhman Z. , Ouahmane Lahcen , Sitotaw Baye , Bourhia Mohammed , Zaman Rashed 
Published: November 2023

An excessive amount of multidrug-resistant Staphylococcus aureus is commonly associated with actinic keratosis (AK) and squamous cell carcinoma (SCC) by secreted virulence products that induced the chronic inflammation leading to skin cancer which is regulated by staphylococcal accessory regulator (SarA). It is worth noting that there is currently no existing published study that reports on the inhibitory activity of phytochemicals derived from Santalum album on the SarA protein through in silico approach. Therefore, our study has been designed to find the potential inhibitors of S. aureus SarA protein from S. album-derived phytochemicals. The molecular docking study was performed targeting the SarA protein of S. aureus, and CID:5280441, CID:162350, and CID: 5281675 compounds showed the highest binding energy with −9.4 kcal/mol, −9.0 kcal/mol, and −8.6 kcal/mol respectively. Further, molecular dynamics simulation revealed that the docked complexes were relatively stable during the 100 ns simulation period whereas the MMPBSA binding free energy proposed that the ligands were sustained with their binding site. All three complexes were found to be similar in distribution with the apoprotein through PCA analysis indicating conformational stability throughout the MD simulation. Moreover, all three compounds’ ADMET profiles revealed positive results, and the AMES test did not show any toxicity whereas the pharmacophore study also indicates a closer match between the pharmacophore model and the compounds. After comprehensive in silico studies we evolved three best compounds, namely, Vitexin, Isovitexin, and Orientin, which were conducted in vitro assay for further confirmation of their inhibitory activity and results exhibited all of these compounds showed strong inhibitory activity against S. aureus. The overall result suggests that these compounds could be used as a natural lead to inhibit the pathogenesis of S. aureus and antibiotic therapy for S. aureus-associated skin cancer in humans as well.
SciKit digital health package for accelerometry-measured physical activity: comparisons to existing solutions and investigations of age effects in healthy adults
Authors: Lin Wenyi , Karahanoglu F. Isik , Demanuele Charmaine , Khan Sheraz , Cai Xuemei , Santamaria Mar , Di Junrui , Adamowicz Lukas 
Published: November 2023

IntroductionAccelerometry has become increasingly prevalent to monitor physical activity due to its low participant burden, quantitative metrics, and ease of deployment. Physical activity metrics are ideal for extracting intuitive, continuous measures of participants’ health from multiple days or weeks of high frequency data due to their fairly straightforward computation. Previously, we released an open-source digital health python processing package, SciKit Digital Health (SKDH), with the goal of providing a unifying device-agnostic framework for multiple digital health algorithms, such as activity, gait, and sleep.MethodsIn this paper, we present the open-source SKDH implementation for the derivation of activity endpoints from accelerometer data. In this implementation, we include some non-typical features that have shown promise in providing additional context to activity patterns, and provide comparisons to existing algorithms, namely GGIR and the GENEActiv macros. Following this reference comparison, we investigate the association between age and derived physical activity metrics in a healthy adult cohort collected in the Pfizer Innovation Research Lab, comprising 7–14 days of at-home data collected from younger (18–40 years) and older (65–85 years) healthy volunteers.ResultsResults showed that activity metrics derived with SKDH had moderate to excellent ICC values (0.550 to 1.0 compared to GGIR, 0.469 to 0.697 compared to the GENEActiv macros), with high correlations for almost all compared metrics (&gt;0.733 except vs GGIR sedentary time, 0.547). Several features show age-group differences, with Cohen’s d effect sizes &gt;1.0 and p-values &lt; 0.001. These features included non-threshold methods such as intensity gradient, and activity fragmentation features such as between-states transition probabilities.DiscussionThese results demonstrate the validity of the implemented SKDH physical activity algorithm, and the potential of the implemented PA metrics in assessing activity changes in free-living conditions.
A pharmacogenetic study of perampanel: association between rare variants of glutamate receptor genes and outcomes
Authors: Lin Chih-Hsiang , Ho Chen-Jui , Chen Shih-Ying , Lu Yan-Ting , Tsai Meng-Han 
Published: November 2023

Introduction: The selection of antiseizure medication usually requires a trial-and-error process. Our goal is to investigate whether genetic markers can predict the outcome of perampanel (PER) use in patients with epilepsy.Method: The studied participants were selected from our previous epilepsy genetics studies where whole exome sequencing was available. We reviewed the medical records of epilepsy patients older than 20 years old treated with PER. The outcome of PER treatment included the response to PER, the occurrence of any adverse drug reaction (ADR), the presence of behavior ADR, and the ability to adhere to PER for more than 1 year. We investigated the association between the rare variants of the glutamate receptor genes and the outcomes of PER use.Result: A total of 83 patients were collected. The gene group burden analysis showed that enriched genetic variants of the glutamate receptor gene group were statistically significantly associated with the occurrence of ADR, while the glutamate ionotropic receptor delta type subunit had a nominal association with the occurrence of ADR. The gene collapse analysis found that GRID1 had a nominal association with the occurrence of ADR and GRIN3A had a nominal association with the occurrence of behavior ADR. However, these nominal associations did not remain statistically significant once adjusted for multiple testing.Discussion: We found that enriched rare genetic variants of the glutamate receptor genes were associated with the occurrence of ADR in patients taking PER. In the future, combining the results of various pharmacogenetic studies may lead to the development of prediction tools for the outcome of antiseizure medications.
Autophagy-mediated NKG2D internalization impairs NK cell function and exacerbates radiation pneumonitis
Authors: Wang Ruiqing , Ma Xinyue , Zhang Xinyu , Jiang Dizhi , Mao Hongyuan , Li Zerun , Tian Yu , Cheng Bo 
Published: November 2023

IntroductionRadiation pneumonitis is a critical complication that constrains the use of radiation therapy for thoracic malignancies, leading to substantial morbidity via respiratory distress and lung function impairment. The role of Natural killer (NK) cells in inflammatory diseases is well-documented; however, their involvement in radiation pneumonitis is not fully understood.MethodsTo explore the involvement of NK cells in radiation pneumonitis, we analyzed tissue samples for NK cell presence and function. The study utilized immunofluorescence staining, western blotting, and immunoprecipitation to investigate CXCL10 and ROS levels, autophagy activity, and NKG2D receptor dynamics in NK cells derived from patients and animal models subjected to radiation.ResultIn this study, we observed an augmented infiltration of NK cells in tissues affected by radiation pneumonitis, although their function was markedly diminished. In animal models, enhancing NK cell activity appeared to decelerate the disease progression. Concomitant with the disease course, there was a notable upsurge in CXCL10 and ROS levels. CXCL10 was found to facilitate NK cell migration through CXCR3 receptor activation. Furthermore, evidence of excessive autophagy in patient NK cells was linked to ROS accumulation, as indicated by immunofluorescence and Western blot analyses. The association between the NKG2D receptor and its adaptor proteins (AP2 subunits AP2A1 and AP2M1), LC3, and lysosomes was intensified after radiation exposure, as demonstrated by immunoprecipitation. This interaction led to NKG2D receptor endocytosis and subsequent lysosomal degradation.ConclusionOur findings delineate a mechanism by which radiation-induced lung injury may suppress NK cell function through an autophagy-dependent pathway. The dysregulation observed suggests potential therapeutic targets; hence, modulating autophagy and enhancing NK cell activity could represent novel strategies for mitigating radiation pneumonitis.
Efficacy and safety of definitive chemoradiotherapy with or without induction immune checkpoint inhibitors in patients with stage III non-small cell lung cancer
Authors: Yang Yin , Wang Jianyang , Zhang Tao , Zhou Zongmei , Wang Yu , Jiang Ying , Liu Wenyang , Xiao Zefen , Deng Lei , Feng Qinfu , Wang Xin , Lv Jima , Wang Wenqing , Xue Qi , Wang Jie , Li Ye-Xiong , Bi Nan 
Published: November 2023

BackgroundIn the era of immunotherapy, the optimal combination of immune checkpoint inhibitors (ICIs) and chemoradiotherapy (CRT) for stage III non-small cell lung cancer (NSCLC) is not defined. The current study investigated the efficacy and safety of definitive CRT(dCRT) plus consolidation ICIs with or without induction ICIs in stage III NSCLC.Methods123 consecutive patients treated with dCRT followed by consolidation ICIs at our institution from 2018 to 2022 were retrospectively reviewed. Failure patterns, survival outcomes, and toxicity profiles were analyzed.ResultsThe 1- and 2- year PFS rates were 75.3% and 56.9%, respectively, and median PFS was 30.83 months from the start of treatment. In-field failure (18.7%) was the most common failure pattern. The most common adverse event (AE) was pneumonitis caused by ICIs or RT. The incidence of Grade 3-4 and Grade 5 pneumonitis was 5.7% and 1.6%, respectively. Further analysis showed that the induction plus consolidation ICIs group has significantly lower cumulative incidence of distant metastasis rates (HR: 0.30, 95%CI: 0.09-1.00, p=0.043) and higher incidence of pneumonitis (p=0.039) compared with patients in the consolidation ICIs group.ConclusionsCombined CRT and consolidation ICIs achieved encouraging efficacy and manageable toxicity in patients with stage III NSCLC in China. Induction plus consolidation ICIs might reduce distant metastasis and deserve further investigation.
Enhancing mechanical performance of TiO2 filler with Kevlar/epoxy-based hybrid composites in a cryogenic environment: a statistical optimization study using RSM and ANN methods
Authors: Natrayan L. , Janardhan Gorti , Paramasivam Prabhu , Dhanasekaran Seshathiri 
Published: November 2023

This research aims to investigate the mechanical performance of the different weight proportions of nano-TiO2 combined with Kevlar fiber-based hybrid composites under cryogenic conditions. The following parameters were thus considered: (i) Kevlar fiber mat type (100 and 200 gsm); (ii) weight proportions of TiO2 nanofiller (2 and 6 wt%); and (iii) cryogenic processing time (10–30 min at −196°C). The composites were fabricated through compression molding techniques. After fabrication, the mechanical characteristics of the prepared nanocomposites—such as tensile, bending, and impact properties—were evaluated. The optimal mechanical strength of nanofiller-based composites was analyzed using response surface methodology (RSM) and artificial neural networks (ANNs). Compositions, such as four weight percentages of nano-TiO2 filler, 200 gsm of the Kevlar fiber mat, and 20 min of cryogenic treatment, were shown to produce the maximum mechanical strength (65.47 MPa of tensile, 97.34 MPa of flexural, and 52.82 J/m2 of impact). This is because residual strains are produced at low temperatures (cryogenic treatment) due to unstable matrices and fiber contraction. This interfacial stress helps maintain a relationship between the reinforcement and resin and improves adhesion, leading to improved results. Based on statistical evaluation, the ratio of correlation (R2), mean square deviation, and average error function of the experimental and validation data sets of the experimental models were analyzed. The ANN displays 0.9864 values for impact, 0.9842 for flexural, and 0.9764 for tensile. ANN and RSM models were used to forecast the mechanical efficiency of the suggested nanocomposites with up to 95% reliability.
Association between smoking status and handgrip strength in Korean male adults: based on Korea National Health and Nutrition Examination Survey 2016–2019
Authors: Cho Eunbyul , Soh Hi Sun , Lee Jae-Ryun , Yun Jieun , Bae Woo Kyung , Lee Hyejin 
Published: November 2023

BackgroundSmoking is a well-known risk factor of frailty. Handgrip strength (HGS) is highly representative of muscular strength and is used in the diagnosis of frailty; however, the relationship between smoking and HGS is not clear. We evaluated the relationship between smoking status and HGS.ObjectivesThis study aimed to evaluate the association between HGS and smoking status.MethodsWe enrolled adult males between the ages of 19 and 80 years who participated in the Korea National Health and Nutrition Examination Survey VII–VIII. A chi-square test and ANOVA were performed to compare the mean handgrip strength (mean HGS) between non-smokers, ex-smokers, and current smokers. Logistic regression analysis was performed to determine the association between the smoking status and mean HGS, and additional analyses were performed by dividing subgroups by age.ResultsA total of 7,649 participants were analyzed. When the mean HGS and mean dominant HGS were compared according to smoking status, HGS was higher in the right hand (value of p = 0.03) and left hand (value of p &lt; 0.001) in the order of current smokers, ex-smokers, and non-smokers. Comparing HGS of stronger hands, the mean HGS ex-smokers [aOR, (95% confidence interval): 0.61 (0.46–0.82)] and current smokers: 0.55 (0.38–0.78) was higher than that of non-smokers. When subgroup analysis was performed according to age, current smokers aged &gt;60 years had a higher grip strength than non-smokers.ConclusionCurrent smokers had a stronger mean HGS than that of ex-smokers and non-smokers. Current smokers older than 60 years appeared to have a stronger mean HGS than ex-smokers and non-smokers of the same age group.
Long-term outcomes and cost-effectiveness evaluation of robot-assisted stereotactic hematoma drainage for spontaneous intracerebral hemorrhage
Authors: Tan Ke , Peng Yutao , Li Jinping , Liu Chang , Tao Libo 
Published: November 2023

BackgroundTo investigate the long-term follow-up and economic estimation outcomes of hematoma drainage for spontaneous intracerebral hemorrhage (SICH) with the assistance of neurosurgical navigation and positioning planning system (referred to as robot).MethodsData were retrospectively obtained from consecutive patients with SICH who were admitted to our single-center between March 2019 and March 2022. Different minimally invasive surgery (MIS) procedures were performed according to the inclusion/exclusion criteria. The different groups were sampled and matched using the propensity score method, with age, sex, history of stroke, hypertension, bleeding volume and site of bleeding as matching variables, and matched with inverse probability weighting using R statistical analysis software. From the time of discharge up until 1 year after the surgery, records were gathered on clinical results and medical expenditures. An analysis was conducted to compare the costs and health outcomes of both robot-assisted stereotactic hematoma drainage and neuro-endoscopic surgery, considering both short-term and long-term effects. Health outputs were measured using modified Rankin scale (mRS) and quality adjusted life years (QALYs).ResultsOf the 142 patients, there were 77 patients in the robotic surgery group and 65 patients in the neuro-endoscopic surgery group. Propensity score sampling was matched, resulting in a balanced and comparable group of 37 patients in each, with the robotic surgery group [mean age (57.29 ± 12.74) years, 27 males (72.97%), hematoma volume (44.54 ± 10.49 ml), 22 deep location (59.46%)] and the neuro-endoscopic surgery group [mean age (57.27 ± 11.12) years, 27 males (72.97%), hematoma volume (44.70 ± 10.86 ml), 23 deep location (62.16%)]. At both three-month and one-year postoperative follow-up, the proportion of mRS scores ≤3 was higher in the robotic surgery group (45.95%,70.27%) than in the neuro-endoscopic surgery group (35.14%, 62.16%), but there was no statistically significant difference (P = 0.344, 0.461). One year after surgery, the robotic group demonstrated cost savings of ¥36,862.14 per individual and a gain of 0.062 QALYs compared to the neuro-endoscopic group.ConclusionOur calculations based on a model for SICH suggest that robotic-assisted stereotactic drainage offers health economic benefits due to its lower cost and higher effectiveness. However, to confirm these findings, more data from multicenter, prospective randomized controlled trials with larger sample sizes are needed.
Case report: prolonged durable clinical benefit and low toxicity from combination endocrine therapy in a patient with recurrent endometrial carcinoma
Authors: Cheng Joyce M. , Gaillard Stephanie , Beavis Anna L. , Rushton Tullia , Fader Amanda N. 
Published: November 2023

BackgroundEndometrial carcinoma is the most common gynecologic cancer, with increasing incidence and mortality. Combination endocrine therapy comprised of tamoxifen and progestational agents has demonstrated promising results in treating recurrent disease. This case report describes the prolonged clinical benefit of treatment with tamoxifen and megestrol acetate in a woman with recurrent, metastatic endometrial endometrioid carcinoma positive for estrogen (ER) and progesterone receptors (PR).CaseA 71-year-old gravida 1 para 1 woman presented with postmenopausal bleeding and vaginal discharge. Pelvic ultrasound and magnetic resonance imaging confirmed a 4.7 cm endometrial mass. The patient underwent a total laparoscopic hysterectomy, bilateral salpingo-oophorectomy, pelvic and para-aortic lymphadenectomy, and cystoscopy; pathology revealed a FIGO stage IA grade 1 ER/PR-positive endometroid endometrial adenocarcinoma. She continued under active surveillance for approximately 42 months until she experienced bone metastases in her pelvis, for which she received radiation therapy. Five months later, pulmonary metastases were detected, and she received six cycles of carboplatin and paclitaxel. She then started megestrol acetate and tamoxifen and has remained clinically stable with minimal side effects and reasonable quality of life for approximately 57 months.ConclusionOur case suggests that combination endocrine therapy has the potential to provide substantial long-term clinical benefit in women with recurrent endometrial cancer and bone metastases, despite multiple prior treatments, allowing patients to experience stable disease and quality of life. In patients with recurrent endometrioid, ER/PR-positive disease, endocrine therapy alone or in combination with other targeted therapies are regimens that may be considered due to their low overall toxicity.