bluuebunny/crossref_metadata_2025_split huggingface dataset:
Metformin is Associated with Better Survival Rate of Localized Upper Tract Urothelial Carcinoma Patients with Type 2 Diabetes
Authors: Lin Chung-Yu , Wang Chien-Sheng , Jhan Jhen-Hao , Lee Hsiang-Ying , Yang Yi-Hsin , Chang Che-Wei , Ke Hung-Lung , Li Ching-Chia , Lee Yung-Chin 
Published: September 2023

Purpose:
Metformin, an antidiabetic drug, has been proposed to play a possible protective role in cancer recurrence and patient mortality. However, the exact mechanism and efficacy of metformin in urothelial cancer, especially upper tract urothelial carcinoma (UTUC), remain unknown. In this study, we conducted a population-based analysis to investigate whether metformin could improve the survival rate of patients with UTUC.

Materials and Methods:
Males ≥40 years diagnosed with UTUC were included in this retrospective population-based longitudinal cohort study. Data were collected from the registry of the Taiwan National Health Insurance database for patients with UTUC and type 2 diabetes mellitus (T2DM). Patients who had received at least two prescriptions of metformin were included in the study cohort as ever-users, and patients who had never used metformin were included in the control cohort as never-users. The hazard ratios (HRs) were calculated using Cox regression for ever-users and never-users.

Results:
Among the 781 enrolled patients, 439 and 342 patients were included as ever-users and never-users, respectively. The median survival time was 3.95 years in the never-user cohort compared to 6.90 years in the ever-user cohort, which remained statistically significant in both univariate and multivariate analyses (HR = 0.63 and 0.72, P = 0.0001 and 0.011, respectively). Furthermore, subgroup analysis showed that continuous usage of metformin before and after the diagnosis of UTUC was associated with a better survival in patients with UTUC (adjusted HR = 0.72, 95% confidence interval: 0.55–0.93).

Conclusion:
This study shows a relationship between metformin usage and better survival outcome in patients with localized UTUC. The result may contribute a favorable anticancer role of metformin in localized UTUC and suggests that continuous metformin usage improves all-cause mortality in patients with localized UTUC and T2DM.
SLA based Workflow Scheduling algorithm in Cloud Computing using Haris Hawks optimization
Authors: Mangalampalli Sudheer , Karri Ganesh Reddy , Pokkuluri Kiran Sree , RajKumar K Varada , Satish Ganti Naga 
Published: September 2023

Task Scheduling is crucial facet in cloud paradigm as virtual resources need to be provisioned to the variable requests coming onto cloud console from various users and more over that tasks are depends on each other which creates a workflow which is a difficult task for cloud service provider to provision these tasks over appropriate VMs. Inefficient mapping of tasks to VMs increases makespan and lead to violation of SLA between users, cloud provider. In this paper, we modeled a SLA based workflow scheduling algorithm focuses on minimization of makespan and SLA violations. This algorithm developed using Harris hawks optimization. Experimentation carried out using workflowsim. Random workload fed as input to algorithm and it is evaluated against existing baseline approaches and simulation results revealed that our proposed approach minimizes makespan and SLA violations over existing approaches by 40% and 43% respectively.
Health-Related Quality of Life and Service Barriers among Adults with Sickle Cell Disease in Saudi Arabia
Authors: Al Sayigh Nada Ahmed , Shafey Marwa Mahmoud , Alghamdi Amal Ali , Alyousif Ghada Fouad , Hamza Fatma Amer , Alsalman Zaenb Husain 
Published: September 2023

Background: The burden of sickle cell disease (SCD) is highin Saudi Arabia, with a significant impact on patients’ quality of life (QoL). This study aimed to assess the health-related quality of life (HRQoL) among adults with SCD.
Methods: A cross-sectional study was conducted among adults with SCD attending hematology clinics at Qatif Central Hospital in the Eastern Province of Saudi Arabia. The questionnaire included subsections to collect information from participants, including sociodemographic attributes, SCD characteristics, HRQoL based on SF-36, and opinions regarding barriers to service.
Results: Among 272 SCD patients, the highest mean score of HRQoL was observed in the social functioning (SF) domain (65.0±23.4), whereas the lowest score was observed in the role limitations due to physical health (RP) domain (47.2±40.4). The mean score for participants’ opinions regarding service provision was 19.27±4.68 (min-max:10–30), and only 24.6% had a positive opinion regarding the accessibility of service provision. A total of 38.6% of the respondents acknowledged shortcomings in the services offered by healthcare staff, and 43% identified weaknesses in communication with healthcare staff. Moreover, 40.1% agreed about feeling stigmatized about their condition. SCD patients who were <40 years old, males, had a university degree, had health insurance, waited <15 minutes before receiving health care, and had positive opinions regarding service provision were more likely to have better HRQoL scores.
Conclusion: Adults with SCD exhibited low HRQoL in general, and different factors were related to low HRQoL scores. Counselling, empowerment, and improvement of doctor-patient communication are important strategies to improve healthcare provision, and consequently, HRQoL among adults with SCD.
Colistin Susceptibility Testing by Colistin Broth Disk Elution MIC Method among Carbapenem-resistant Gram-negative Blood Culture Clinical Isolates in a Tertiary Care Setting, East Delhi, India
Authors: Nirmal Kirti , Singh Narendra Pal , Sarkar Krishna , Goyal Nisha , Gangar Seema , Dwivedi Aditya Nath 
Published: September 2023

Background: Antibiotic resistance is a growing concern for bloodstream infections (BSIs), especially with the emergence of multidrug- resistant (MDR) gram-negative bacteria. In this study, we aimed to assess the pattern of colistin susceptibility using the colistin broth disc elution (CBDE) method among carbapenem-resistant gram-negative clinical isolates from blood cultures in a high burden tertiary healthcare setting in East Delhi.
Methods: A total of 106 carbapenem-resistant gram-negative clinical isolates were tested. The most common isolates were Klebsiella pneumoniae, Escherichia coli, Enterobacter species, and Klebsiella oxytoca by CBDE method.
Results: All the carbapenem resistant gram- negative bacterial blood culture isolates showed intermediate colistin susceptibility. This was statistically significant by chi-square test (p<0.5).
Conclusion: This study highlights the need to monitor colistin resistance trends in the face of increasing antimicrobial resistance. Accurate surveillance of emerging colistin resistance is crucial for effective management of BSIs caused by carbapenem- resistant gram-negative bacteria.
Combination of Digital and Conventional Intervention for Sexually Transmitted Infections Prevention among Female Sex Workers
Authors: Sari Cindy Meilinda , Nurkristina Tri , Widjanarko Bagoes , Margawati Ani 
Published: September 2023

Background: Female sex workers (FSWs) are at a high risk of contracting sexually transmitted infection (STI). Mobile health (mhealth) is one intervention that is easily accessible to everyone online and offline, allowing two-way communication through the program. This study aimed to determine the effectiveness of m-health on STI prevention behavior among FSW.
Methods: The study was conducted using quasi-experimental design. It included the treatment group and the control group, each of which included fifty-four (54) FSWs selected by purposive sampling. The m-health intervention was conducted in the form of a short comedy movie on YouTube, combined with offline assertive communication training to improve skills in negotiating the use of condoms to the intervention group. Meanwhile, the control group received regular counseling from the local community health center. The Mann- Whitney test was used to compare the knowledge, attitudes, motivation, and behavior among the two study groups.
Results: Intervention for six months in the treatment group increased FSWs knowledge score by 4.0 (p=0.00), attitude by 3.9 (p=0.00), and motivation by 12 (p=0.00). The median knowledge, attitude, and motivation scores were 17.38 and 46, respectively. The model is effective onSTI-prevention behavior through motivational mediator variables with a p-value of 0.00. The condom consistency has the highest outer loading value in the STI-prevention behavior construct of 0.71 ≥ 0.4.
Conclusion: A combination of digital and conventional health promotion can improve STI prevention behavior by raising knowledge, attitudes, motivation, and condom consistency behavior.
PENGARUH EFIKASI DIRI TERHADAP HASIL BELAJAR PPKn SMK MUHAMMADIYAH 1 TANGERANG SELATAN
Authors: Masriah Imas , Atun Nur 
Published: September 2023

The research aims to determine the influence of self-efficacy on PPKn learning outcomes of students at SMK Muhammadiyah 1 Ciputat, South Tangerang City. The research method used is quantitative with a correlation approach. The total population is 629 students, the reach population is 217 students, and the sample is 86 students. The research results show: (1) the results of the self-efficacy normality test = 0.068 and Sig. =0.200 > 0.05, and PPKn learning outcomes = 0.092 and Sig.=0.069 > 0.05. Because all Sig. > 0.05, then the sample is normally distributed; (2) based on the Anova table, the Fhit value = 0.762 and Sig Deviation from Linearity = 0.803 > 0.05, so that H0 is accepted and the regression relationship between variables X and Y is linear; (3) based on the calculation of the regression line equation for the influence of X on Y, the contribution of self-efficacy to PPKn learning outcomes is 0.415 or 41.5%. This shows that the contribution of self-efficacy to Civics learning outcomes is 41.5%. So Ha is accepted while Ho is rejected, which means that there is a positive and significant influence of self-efficacy on Civics Learning Outcomes.
Adolescents’ and Adults’ Perceptions of Sensory-Based Interventions: A Qualitative Analysis
Authors: Miller Dana C. , Schoen Sarah A. , Schmitt Carolyn M. , Porter Lisa M. 
Published: September 2023

Abstract
Importance: Adolescents and adults report that their sensory integration and processing differences affect their occupational performance and quality of life, thus requiring effective sensory-focused interventions. Researchers have yet to investigate this population’s experience of occupational therapy interventions designed to remediate these challenges.
Objective: To explore the perceived experience of adolescents and adults with respect to (1) response to intervention, (2) strategies offered to manage sensory differences, and (3) need for services on completion of an intervention.
Design: Retrospective, qualitative study.
Setting: Zoom or phone call.
Participants: Eleven adolescents and adults with sensory integration and processing differences who had previously completed occupational therapy interventions.
Intervention: Sensory-based intervention based on the principles of Ayres Sensory Integration® (ASI) and the Sensory Therapies and Research Frame of Reference.
Outcomes and Measures: A semistructured interview to obtain data, followed by an in-depth analysis using an inductive coding process to group initial open codes into themes and common subthemes
Results: Open codes were grouped into three core themes: (1) therapist-related factors (what the therapist did in treatment); (2) client-related factors (what the client experienced); and (3) follow-up (future needs of the clients). Four main subthemes of the client–therapist relationship emerged: (1) therapeutic alliance; (2) education and knowledge; (3) strategies, tools, and resources; and (4) future needs.
Conclusions and Relevance: This study provides a perspective on the experience of adolescents and adults specific to the impact of a sensory-focused occupational therapy intervention on their daily lives. This will help occupational therapists when designing interventions for current and future clients.
What This Article Adds: This study highlights the need for further research addressing effective sensory-based interventions for adolescents and adults. It also captures which components of intervention clients deemed helpful and identifies potential targets for future intervention.
Volumetric apparent diffusion coefficient (ADC) histogram analysis of the brain in paediatric patients with hypoxic ischaemic encephalopathy
Authors: Nalbant Mustafa Orhan , Erdil Irem , Akcay Nihal , Inci Ercan , Palabiyik Figen 
Published: September 2023

PurposeTo evaluate the whole brain, hippocampus, thalamus, and lentiform nucleus by volumetric apparent diffusion coefficient (ADC) histogram analysis in paediatric patients with hypoxic-ischaemic encephalopathy (HIE).Material and methodsThis retrospective study included 25 patients with HIE and 50 patients as the control group. Diffusion-weighted imaging was obtained at b-values of 1000 mm²/s. The histogram parameters of ADC values, including the mean, minimum, maximum, 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles, as well as skewness, kurtosis, and variance were determined. The interclass correlation coefficient (ICC) was used to assess the inter­observer agreement.ResultsADC<sub>min</sub>, ADC<sub>mean</sub>, and ADC<sub>max</sub>, as well as the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ADC values for the HIE group were all lower than those of the control group (p < 0.001) in the volumetric histogram analysis of the hippocampus, thalamus, and lentiform nucleus. In the whole-brain histogram analysis, ADC min, and the 50th and 75th percentiles of ADC values did not differ significantly, while other parameters were lower in the HIE group. The ROC curve revealed that the ADC histogram parameters of the hippocampus provided the most accurate results for the diagnosis of HIE. The area under the curve (AUC) of the 95th percentile of ADC values was the highest (AUC = 0.915; cut-off 1.262 × 10-3 mm²/s; sensitivity 88% and specificity 84%).ConclusionsVolumetric ADC histogram analysis of the whole brain, hippocampus, thalamus, and lentiform nucleus with b-values of 1000 mm²/s can serve as an imaging marker for determining HIE.
Difelikefalin (Korsuva)
Authors: CADTH  
Published: September 2023

CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses difelikefalin (Korsuva), 50 mcg/mL, IV.
Indication: For the treatment of moderate-to-severe pruritus associated with chronic kidney disease in adult patients on hemodialysis.
Comment on “A universally applicable method of calculating confidence bands for ice nucleation spectra derived from droplet freezing experiments” by Fahy et al. (2022)
Authors: Vali Gabor 
Published: September 2023

Abstract. The analysis methods in Fahy et al. (2022) and their interpretation of experiments with water drops containing ice-nucleating particles raise some technical issues and prompt a discussion of the principles involved in the use of differential spectra.
Lava flow hazard modeling during the 2021 Fagradalsfjall eruption, Iceland: applications of MrLavaLoba
Authors: Pedersen Gro B. M. , Pfeffer Melissa A. , Barsotti Sara , Tarquini Simone , de'Michieli Vitturi Mattia , Óladóttir Bergrún A. , Þrastarson Ragnar Heiðar 
Published: September 2023

Abstract. The 6-month-long effusive eruption at the Fagradalsfjall volcano in 2021 is the most visited eruption site in Iceland to date (June 2023), and it needed intense lava flow hazard assessment. In this study we document how strategies for lava flow modeling were implemented using the stochastic model MrLavaLoba to evaluate hazards during this effusive event. Overall, the purposes were threefold: (a) pre-eruption simulations to investigate potential lava inundation of critical infrastructure, (b) syn-eruption simulations for short-term (2-week time frame) lava flow hazard assessment and (c) syn-eruption simulations for long-term (months to years) hazard assessments. Additionally, strategies for lava barrier testing were developed, and syn-eruption topographic models were incorporated into simulations in near real time. The model provided promising results that were shared regularly at stakeholder meetings with the monitoring personnel, scientists and civil-protection representatives helping to identify potential short-term and long-term lava hazards. This included evaluation of the timing of barrier overflow and the filling and spilling of lava from one valley to another. During the crisis the MrLavaLoba model was updated to increase functionality such as by considering multiple active vents. Following the eruption, the model was optimized substantially, decreasing the computational time required for the simulations and speeding up the delivery of final products.
Mentoring the mentor: Developing clinical instructor cross-cultural psychological capital to support culturally/linguistically diverse DPT students
Authors: Naidoo Keshrie , Fitzgerald Caitlin , Arrigo Monica , Wong Justin , McCarthy-Jacobson Anne 
Published: September 2023

Rationale: Cultural and social isolation, microaggressions, and few culturally and linguistically diverse (CLD) mentors contribute to a lack of belonging on clinical education experiences (CEEs) for CLD Doctor of Physical Therapy students. The purpose was to investigate whether a multiple mentor model including a CLD learner, their clinical instructor (CI), and CLD mentor could develop CI cross-cultural psychological capital (CC PsyCap) and mentoring skills to support CLD learners on CEEs.
Methods: Three CLD learners and their CIs were each matched with a CLD mentor. CIs completed online cross-cultural mentor training and met with the CLD student and mentor four times during the 10-week CEE. CIs completed the CC PsyCap survey to measure changes in CI cross-cultural self-efficacy before and after the CEE. Interview data from participants were thematically analyzed.
Results: All CIs demonstrated an increase in CC PsyCap scores over the study period. CIs gained insight into the unique needs of CLD learners, often subjected to bias and discrimination, and developed strategies to proactively support learners. CLD learners faced challenges related to race in the CEE and pressure to assimilate. They valued CLD mentors who role-modeled persistence and success and CIs who celebrated diversity and created a welcoming environment.
Clinical relevance: CIs play an important role in mentoring CLD learners on CEEs. This study highlighted that CI CC PsyCap can be developed through mentoring and coaching from CLD mentors, ultimately increasing support for CLD learners on CEEs.
Faktor-Faktor Yang Berhubungan Dengan Kejadian Persalinan Lama
Authors: Pera Mandasari  , Eka Juniarty  
Published: September 2023

Persalinan lama merupakan salah satu penyebab kematian ibu dan janin. Pada ibu dapat menyebabkan terjadinya infeksi, kehabisan tenaga, dehidrasi, dan perdarahan post partum. Pada janin dapat menyebabkan terjadinya infeksi, cedera dan asfiksia. Persalinan lama dipengaruhi oleh faktor ibu, faktor janin, dan faktor jalan lahir. Tujuan penelitian adalah untuk mengetahui faktor-faktor yang berhubungan dengan kejadian persalinan lama. Penelitian dilakukan di Rumah Sakit umum daerah kota prabumulih tahun 2021. Penelitian ini merupakan penelitian kuantitatif dengan desain penelitian cross sectional. Populasi dalam penelitian ini adalah seluruh ibu bersalin, penentuan sampel menggunakan tehnik random sampling dengan Jumlah sampel sebanyak 326 orang. Analisis data dilakukan secara univariat dan bivariat dengan uji chi–square. Hasil penelitian diperoleh bahwa terdapat hubungan usia dengan kejadian persalinan lama (Pvalue : 0,000) terdapat hubungan yang bermakna antara paritas dengan kejadian persalinan lama (Pvalue : 0,000) dan terdapat hubungan antara his dengan kejadian persalinan lama (Pvalue : 0,000).
Penggunaan KB Implant Dengan Kenaikan Berat Badan Dan Siklus Haid Pada Ibu
Authors: Desti Widya Astuti  , Gustika Anggriani  , Natasya Putri Adhalia  
Published: September 2023

Menurut World Helath Organization (WHO) Tahun 2020, Angka Kematian Ibu (AKI) masih sangat tinggi, sekitar 810 wanita meninggal akibat komplikasi terkait kehamilan atau persalinan di seluruh dunia setiap hari, dan sekitar 295.000 wanita meninggal selama dan setelah kehamilan dan persalinan. Angka Kematian Ibu di negara berkembang mencapai 462/100.000 kelahiran hidup, sedangkan di Negara maju sebesar 11/100.000 kelahiran hidup. Tujuan dari penelitian ini adalah untuk mengetahui hubungan penggunaan kb implant dengan kenaikan berat badan dan siklus haid pada ibu di bidan praktek mandiri umi kalsum kota prabumulih tahun 2022. Penelitian ini menggunakan metode Survey Analitik dengan pendekatan Corss Sectional. Populasi penelitian ini yaitu keseluruhan wanita usia subur yang menggunakan akseptor KB di BPM Umi Kalsum pada tahun 2022. Terdapat 180 jumlah populasi yang dijadikan sampel penelitian semuanya. Hasil analisa bivariat terdapat 65 pengguna KB implan yang mengalami ketidakteraturan siklus haid sebanyak 63 pengguna (35,0%) dan yang mengalami keteraturan siklus haid sebanyak 2 pengguna (1,1%). Hasil Uji statistic Chi-Square didapatkan p value = 0,003 artinya antara penggunaan implant dengan siklus haid ada hubungan yang bermakna. Simpulan dari penelitian ini adalah bahwa tidak ada hubungan yang bermakna antara kenaikan berat badan dan siklus haid dengan penggunaan KB implan di BPM Umi Kalsum Kota Prabumulih Tahun 2022.
Pemahaman Mahasiswa Keperawatan Tentang Fisiologi Manusia Dalam Mata Kuliah Ilmu Biomedik Dasar
Authors: Pranata Lilik 
Published: September 2023

Proses pembelajaran yang baik bertumpu pada hasil output dari apa yang di ajarkan, hal terpenting dalam pengajaran adalah pemahaman seorang peserta didik, salah satu bahan pembelajaran dalam jurusan keperawatan adalah ilmu biomedik dasar didalamnya terdapat topik tentang anatomi dan fisiologi. Bagian ini sangat penting di pahami oleh mahasiswa sebagai dasar dalam mempelajari ilmu keperawatan selajutnya. Proses pemahaman mahasiswa keperawatan akan mempermudah dalam melajutkan ke materi yang lebih spesifik berkaitan dengan keperawatan, maka perlunya adanya pemahaman mahasiswa keperawatan dalam mempelajari ilmu biomedik dasar. Tujuan penelitian ini untuk melihat sejauh mana pemahaman mahasiswa tentang fisiologi manusia yang terdapat dalam mata ajar ilmu biomedik dasar pada semester 1. Metode penelitian dengan desai survey deskritif. Dengan memebrikan intrumen penelitian berupa kuesiener kepada mahasiswa yang telah mengikuti proses perkuliahan selama 6 bulan. Proses pengambilan data dilakukan pada 10-15 Juli 2023, hasil penelitian menunjukan pada pemahaman yang baik sejumlah 17 orang (46%), cukup 19 orang (52%)dan kurang 1 orang (2%). Kesimpulan dari hasil penelitian menunjukan bahwa perlu adanya modifikasi dosen dalam memebrikan pendalam materi tentang ilmu biomedik dasar terkhusu adalah fisiologi manusia, memberikan evaluasi yang tepat kepada mahasiswa.sebelum dan setelah dilakukan perkuliahan