bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of hearing loss on cognitive function in community-dwelling older adults: serial mediation of self-rated health and depressive anxiety symptoms
Authors: Chen Fenghui , Chen Yingying , Jiang Xin , Li Xiaoyang , Ning Hongting , Hu Mingyue , Jiang Wenxin , Zhang Nan , Feng Hui , Yan Ping 
Published: December 2023

BackgroundHearing loss can exacerbate cognitive decline; therefore, exploring the mechanisms through which hearing loss affects cognitive function is crucial. The current study aimed to investigate the impact of hearing loss on cognitive function and the mediating role played by self-rated health and depressive anxiety symptoms.MethodsUsing stratified whole-group random sampling, the study employed a cross-sectional design and included 624 participants aged ≥65 years from three communities in Urumqi, China. Cognitive function was assessed using the Mini-Mental State Examination. Hearing function and self-rated health were determined by self-report. The 15-item Geriatric Depression Scale and the 7-item Generalized Anxiety Disorder Scale were used to assess depressive anxiety symptoms. Serial mediation analysis was performed using AMOS 26.0.ResultsHearing loss can not only negatively affect cognitive function in older adults directly (direct effect = −0.106; SE = 0.045; 95% confidence interval (CI): −0.201 to −0.016), but also indirectly affect the relationship between hearing loss and cognitive function through self-rated health and depressive anxiety symptoms. The results of the serial mediation analysis showed that the total indirect effect of self-rated health and depressive anxiety symptoms was −0.115 (95% CI: −0.168 to −0.070), and the total effect of the model was −0.221 (95% CI: −0.307 to −0.132), with the total indirect effect accounting for 52.04% of the total effect of the model.ConclusionOur study discovered that there is a partial mediation of the relationship between hearing loss and cognitive function by self-rated health and depressive anxiety symptoms. It is suggested that by enhancing self-rated health and ensuring good mental health, the decline in cognitive function among older adults with hearing loss can be delayed.
Establishment of a lysosome-related prognostic signature in breast cancer to predict immune infiltration and therapy response
Authors: Su Hairong , Chen Ying , Lin Fengye , Li Wanhua , Gu Xiangyu , Zeng Weijie , Liu Dan , Li Man , Zhong Shaowen , Chen Qianjun , Chen Qubo 
Published: December 2023

BackgroundLysosomes are instrumental in intracellular degradation and recycling, with their functional alterations holding significance in tumor growth. Nevertheless, the precise role of lysosome-related genes (LRGs) in breast cancer (BC) remains elucidated. This study aimed to establish a prognostic model for BC based on LRGs.MethodsEmploying The Cancer Genome Atlas (TCGA) BC cohort as a training dataset, this study identified differentially expressed lysosome-related genes (DLRGs) through intersecting LRGs with differential expression genes (DEGs) between tumor and normal samples. A prognostic model of BC was subsequently developed using Cox regression analysis and validated within two Gene Expression Omnibus (GEO) external validation sets. Further analyses explored functional pathways, the immune microenvironment, immunotherapeutic responses, and sensitivity to chemotherapeutic drugs in different risk groups. Additionally, the mRNA and protein expression levels of genes within the risk model were examined by utilizing the Gene Expression Profiling Interactive Analysis (GEPIA) and Human Protein Atlas (HPA) databases. Clinical tissue specimens obtained from patients were gathered to validate the expression of the model genes via Real-Time Polymerase Chain Reaction (RT-PCR).ResultsWe developed a risk model of BC based on five specific genes (ATP6AP1, SLC7A5, EPDR1, SDC1, and PIGR). The model was validated for overall survival (OS) in two GEO validation sets (p=0.00034 for GSE20685 and p=0.0095 for GSE58812). In addition, the nomogram incorporating clinical factors showed better predictive performance. Compared to the low-risk group, the high-risk group had a higher level of certain immune cell infiltration, including regulatory T cells (Tregs) and type 2 T helper cells (Th2). The high-risk patients appeared to respond less well to general immunotherapy and chemotherapeutic drugs, according to the Tumor Immune Dysfunction and Exclusion (TIDE), Immunophenotype Score (IPS), and drug sensitivity scores. The RT-PCR results validated the expression trends of some prognostic-related genes in agreement with the previous differential expression analysis.ConclusionOur innovative lysosome-associated signature can predict the prognosis for BC patients, offering insights for guiding subsequent immunotherapeutic and chemotherapeutic interventions. Furthermore, it has the potential to provide a scientific foundation for identifying prospective therapeutic targets.
Differences in the attitudes towards resuscitation of extremely premature infants between neonatologists and obstetricians: a survey study in China
Authors: Wang Dan , Li Li , Ming Bo-Wen , Ou Chun-Quan , Han Tao , Cao Jingke , Xie Wenyu , Liu Changgen , Feng Zhichun , Li Qiuping 
Published: December 2023

ObjectivesNeonatologists and obstetricians are crucial decision-makers regarding the resuscitation of extremely preterm infants (EPIs). However, there is a scarcity of research regarding the differing perspectives on EPI resuscitation between these medical professionals. We aim to determine the differences and influential factors of their attitudes towards EPIs resuscitation in China.MethodsThis cross-sectional study was conducted in public hospitals of 31 provinces in Chinese mainland from June to July 2021. Influential factors of binary variables and those of ordinal variables were analyzed by modified Poisson regression models and multinomial logistic regression models due to the invalid parallel line assumption of ordinal logistic regression models.ResultsA total of 832 neonatologists and 1,478 obstetricians who were deputy chief physicians or chief physicians participated. Compared with obstetricians, neonatologists delivered a larger proportion of infants of &lt;28-week gestational age (87.74% vs. 84.91%) and were inclined to think it inappropriate to use 28 weeks as the cutoff of gestational age for providing full care to premature infants [63.34% vs. 31.60%, adjusted prevalence ratio = 1.61 (95% CI: 1.46–1.77)], and to suggest smaller cutoffs of gestational age and birth weight for providing EPIs resuscitation. Notably, 46.49% of the neonatologists and 19.01% of the obstetricians believed infants ≤24 weeks' gestation should receive resuscitation.ConclusionsIn China, notable disparities exist in attitudes of neonatologists and obstetricians towards resuscitating EPIs. Strengthening collaboration between these two groups and revising the pertinent guidelines as soon as possible would be instrumental in elevating the resuscitation rate of EPIs.
Work-related burnout and its associated factors among midwives working at public hospitals in northwest Ethiopia: a multi-centered study
Authors: Mengistie Berihun Agegn , Azene Zelalem Nigussie , Haile Tsion Tadesse , Abiy Saron Abeje , Abegaz Marta Yimam , Taye Eden Bishaw , Alemu Haymanot Nigatu , Demeke Muluken , Melese Mihret , Tsega Nuhamin Tesfa , Aragaw Getie Mihret 
Published: December 2023

IntroductionWork-related burnout (WRB) is defined as the degree of physical and psychological fatigue and exhaustion that is perceived by the person as related to work. Midwives are vulnerable to work-related burnout due to their physically and emotionally demanding nature of their job. It affects the health of professionals and the quality of care provided. However, there is limited evidence on the burden and predictors associated with work-related burnout among midwives in developing countries, including Ethiopia. This study investigated the burden and contributing factors of work-related burnout among midwives in northwest Ethiopia.MethodsA facility-based cross-sectional study was conducted from February 7 to April 30, 2022. A simple random sampling method was used to enroll 640 study participants. The Copenhagen burnout inventory tool was used to assess the magnitude of work-related burnout. A self-administered questionnaire was used to collect data, which was then entered into Epi Data 4.6 software and exported to SPSS version 25 for analysis. A multivariable logistic regression analysis model was fitted to identify factors associated with work-related burnout. The Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) was reported to declare the factors that are significantly associated with work-related burnout.ResultsThe prevalence of work-related burnout was found to be 60.47% (95% CI = 56.6–64.2). Workplace violence (AOR = 3.33, CI: 2.02, 5.48), working hours over 60 h a week (AOR = 4.55, CI: 2.78, 7.43), emotional demand of the job (AOR = 8.85, 95% CI: 4.48, 17.47), exposure to blood and body fluids/sharp injuries (AOR = 5.13, CI: 3.12, 7.13), good superior support (AOR = 0.38, CI: 0.23, 0.63), Job rotation of ≤6 months (AOR = 2.30, CI: 1.28, 4.14) and being stressed (AOR = 2.64, CI: 1.63, 4.26) were all found to be strongly linked to work-related burnout.Conclusion and recommendationThis study found a significant level of work-related burnout among midwives working in public hospitals. Experiencing workplace violence, a job rotation of less than or equals to six months, working hours over 60 h a week, good superior support, exposure to blood and body fluids or needle stick injuries and experiencing stress were significant factors that influenced work-related burnout. Therefore, reducing prolonged working hours, promoting supportive management, creating a safe working environment, and applying effective stress prevention strategies are some of the interventions to prevent or alleviate work-related burnout.
A geospatial web-based integrative analytical tool for the water-energy-food nexus: the iWEF 1.0
Authors: Taguta Cuthbert , Nhamo Luxon , Kiala Zolo , Bangira Tsitsi , Dirwai Tinashe Lindel , Senzanje Aidan , Makurira Hodson , Jewitt Graham P. W. , Mpandeli Sylvester , Mabhaudhi Tafadzwanashe 
Published: December 2023

IntroductionThe water-energy-food (WEF) nexus has evolved into an important transformative approach for facilitating the timely identification of trade-offs and synergies between interlinked sectors for informed intervention and decision-making. However, there is a growing need for a WEF nexus tool to support decision-making on integrated resources management toward sustainable development.MethodsThis study developed a geospatial web-based integrative analytical tool for the WEF nexus (the iWEF) to support integrated assessment of WEF resources to support resilience building and adaptation initiatives and strategies. The tool uses the Analytic Hierarchy Process (AHP) to establish numerical correlations among WEF nexus indicators and pillars, mainly availability, productivity, accessibility, and sufficiency. The tool was calibrated and validated with existing tools and data at varying spatio-temporal scales.ResultsThe results indicate the applicability of the tool at any spatial scale, highlighting the moderate sustainability in the management of WEF resources at various scales. The developed iWEF tool has improved the existing integrative WEF nexus analytical tool in terms of processing time and providing geospatial capabilities.DiscussionThe iWEF tool is a digital platform that automatically guides policy and decision-making in managing risk from trade-offs and enhancing synergies holistically. It is developed to support policy and decision-making on timely interventions in priority areas that could be showing signs of stress.
Clinical and radiological outcomes of n-HA/PA66 cages in anterior spine reconstruction following total en bloc spondylectomy for tumors
Authors: Luo Yuanrui , Xiu Peng , Chen Hua , Zeng Jiancheng , Song Yueming , Li Tao 
Published: December 2023

ObjectiveThis retrospective monocentric study was conducted to evaluate the clinical and radiological outcomes of the nano-hydroxyapatite/polyamide66 (n-HA/PA66) cage in reconstructing the anterior column of the spine following total en bloc spondylectomy (TES).MethodsA cohort of 24 patients, 20 diagnosed with primary malignant tumors and 4 with metastatic malignancies, was selected based on specific inclusion criteria. All were subjected to TES and anterior column reconstruction with the n-HA/PA66 cage from January 2013 to July 2023 at a single institution. Pre-operative embolization was performed on all patients. Documented factors included operation duration, intraoperative blood loss, length of hospital stay, treatment history, and involved level. Mechanical complications and radiological parameters such as the local kyphotic angle (LKA), anterior vertebral height (AVH), posterior vertebral height (PVH), cage subsidence, and bone fusion time were evaluated. Quality of life and neurological function were gauged using tools like the Visual Analog Scale (VAS), Eastern Cooperative Oncology Group (ECOG) performance score, Karnofsky Performance Score (KPS) scale, and American Spinal Injury Association (ASIA) grading.ResultsAll patients were followed up for 12–127 months, with an average period of 39.71 months. An average operation time of approximately 8.57 h and a blood loss volume of about 1,384 ml were recorded. No instances of tumor recurrence or multiple organ metastases were reported, though recurrence was detected in 2 living patients. Solid fusion was achieved in all patients at a mean time of 6.76 ± 0.69 months. Cage breakage or migration was not observed. Subsidence into the adjacent vertebral bodies was identified in 3 patients but was deemed clinically irrelevant. Significant improvements in VAS, ECOG performance score, KPS scale, and ASIA scores were noted from pre- to post-surgery (P &lt; 0.05). A marked enhancement in the AVH was observed from before surgery to immediately after (P &lt; 0.05). LKA, AVH, and PVH values between postoperative and final follow-up showed no significant variance (P &gt; 0.05).ConclusionThe integration of TES and the n-HA/PA66 cage was found to yield promising clinical and radiological outcomes in anterior column spine reconstruction. The use of this material did not hinder oncological care, including the provision of adjuvant treatments (chemo/radiotherapy), ultimately contributing to the enhanced long-term quality of life for spinal tumor patients.
Donor Proteinuria and Allograft Function in Kidney Transplantation: Short- and Long-Term Results From a Retrospective Cohort Study
Authors: Pollmann Nicola Sariye , Vogel Thomas , Pongs Caroline , Katou Shadi , Morgül Haluk , Houben Philipp , Görlich Dennis , Kneifel Felicia , Reuter Stefan , Pollmann Lukas , Pascher Andreas , Becker Felix 
Published: December 2023

Donor proteinuria (DP) is a common but rarely evaluated aspect of today’s kidney transplant allocation process. While proteinuria after kidney transplantation is a risk factor for impaired graft function and survival, the long-term effects of DP in kidney transplantation have not yet been evaluated. Therefore, this study aims to investigate the impact of DP on the long-term outcome after kidney transplantation. A total of 587 patients were found to be eligible and were stratified into two groups: (1) those receiving a graft from a donor without proteinuria (DP−) and (2) those receiving a graft from a donor with proteinuria (DP+). At 36 months, there was no difference in the primary composite endpoint including graft loss and patient survival (log-rank test, p = 0.377). However, the analysis of DP+ subgroups showed a significant decrease in overall patient survival in the group with high DP (p = 0.017). DP did not adversely affect patient or graft survival over 36 months. Nevertheless, this work revealed a trend towards decreased overall survival of patients with severe proteinuria in the subgroup analysis. Therefore, the underlying results suggest caution in allocating kidneys from donors with high levels of proteinuria.
Pharmacist-led interventions in optimising the use of oral anticoagulants in patients with atrial fibrillation in general practice in England: a retrospective observational study
Authors: Sharma Raman , Hasan Syed Shahzad , Gilkar Ishtiaq A , Hussain Waheed F , Conway Barbara R , Ghori Muhammad Usman 
Published: December 2023

Background
Oral anticoagulation (OAC) is the mainstay of treatment for the prevention of strokes in patients with atrial fibrillation (AF). Direct oral anticoagulants (DOACs) account for increasing OAC in patients with AF. However, prescribing DOACs for patients with established AF poses various challenges and general practice pharmacists may have an important role in supporting their management.

Aim
To investigate the effectiveness of pharmacist-led interventions in general practice in optimising the use of OAC therapies in AF.

Design & setting
A retrospective observational study in general practices in Bradford.

Method
The data were collected retrospectively from 1 November 2018–31 December 2019 using electronic health record data. The data were analysed: 1) to identify patients with AF not on OAC; 2) to describe inappropriate DOAC prescriptions; and 3) to calculate HAS-BLED scores.

Results

Overall, 76.3% (
n
= 470) of patients with AF received OAC therapy, and of these, 63.4% received DOACs. Pharmacist-led interventions increased DOAC prescribing by 6.0% (
P =
0.03). Inappropriate DOAC use was identified in 24.5% of patients with AF, with underdosed and overdosed identified in 9.7% and 14.8%, respectively. Post-intervention, inappropriate prescribing was reduced to 1.7%. The mean HAS-BLED score decreased from 3.00 to 2.22 (
P
<0.01). Successful transition from vitamin K antagonist (VKA) therapy to DOACs was achieved in 25.7% of patients.

Conclusion
Pharmacist-led interventions have successfully improved the use of OAC therapies in patients with AF, and effectively managed the bleeding risks and transition from VKA to DOAC therapy, in line with guidelines.
Visual Elements in Logos of Gift Shop Companies in Bali Province
Authors: Dewi Rizky Andriana , Maulina Rini 
Published: December 2023

Bali Province is a very popular tourist island in Indonesia. Everyone around the world can recognize Bali because of its distinctiveness that is easily recognizable, it becomes Bali's identity. Bali with its uniqueness makes Bali with a province that has many visual identities, these identities are important as the promotion of culture. It is also stated in the Regional Regulation of Bali Province that the utilization of cultural promotion objects can be carried out through socio-economic activities. One of these utilizations is using Balinese identity on elements in the social and economic fields. As a place of tourism, there are many souvenir shops in Bali. The souvenir shop companies in Bali Province use logos as their corporate identity, but whether Balinese identity is used on the logos of souvenir shop companies. based on this, this study aims to examine the visual elements in the logos of souvenir shop companies in Bali Province, to find Balinese identity. This research uses a qualitative method. The data sources used in this research are observation, literature study and interviews. Observations were made of the logos of souvenir shop companies in Bali Province. Based on data analysis, the logos have Balinese identity, including the name Bali, Balinese color, Jepun Flower, Udeng, Temple, and Legong Dance. The results of this research are expected to add and develop knowledge and serve as a reference for research on logos.
Keywords: Bali; Logo; Strengthening and Promoting Balinese Culture
Color Analysis of Warak Ngendhog in Semarang Dugderan Tradition
Authors: Rasyidu De Hafizh Kumara , Maulina Rini 
Published: December 2023

The emergence of color in human life has a significant role to play in all aspects. In culture, colors are used as symbols of courage, strength, or nationalism. The various colors in the Dugderan tradition illustrate the distinctive cultural identity of Semarang City and the spirit of togetherness in celebrating important events. In the Dugderan tradition, the Warak Ngendhog festival is displayed with a combination of bright and striking colors used in the Dugderan tradition. This research can help describe and classify the colors of Warak Ngendhog based on the types that exist, so as to strengthen the unique cultural identity and there has been no research that discusses the colors of Warak Ngendhog in the Semarang Dugderan tradition. It is necessary to conduct research on the color of Warak in the Dugderan tradition in Semarang. The method used is descriptive to obtain a description and classification of the colors on Warak Ngendhog, data collection through literature and observation of the existing Warak Ngendhog. observation plays an important role to find information based on facts through documentation of Warak Ngendhog in the Dugderan tradition in Semarang. The purpose of this research is to describe and classify the colors of Warak Ngendhog based on the existing types and make detailed observations of the colors of Warak Ngendhog. The result of the research is that the dominant colors of Warak Ngendhog consist of red, yellow, and green and are the colors of the unity of the three ethnicities of Java, China, and Arabia. In addition to these three colors, every year the community is creative in the color of Warak Ngendhog.
Keywords: Dugderan, Semarang, Traditional, Warak Ngendhog, Color.
Analisa QoS Jaringan 5G Analisa QoS Jaringan 5G Provider X Dan Y Untuk Aplikasi Vidio Streaming Resolusi 4K (Studi Kasus Di Kota Pekanbaru)
Authors: Mahmudi Muhamad Nur 
Published: December 2023

Abstrak - Penelitian ini bertujuan untuk menganalisis kualitas layanan jaringan 5G dari Provider X dan Y dalam konteks aplikasi video streaming resolusi 4K di Kota Pekanbaru. Penelitian ini menggunakan metode pengukuran dengan menggunakan perangkat lunak Wireshark untuk mengumpulkan data throughput, packet loss, delay, dan jitter. Data yang dikumpulkan kemudian dianalisis untuk membandingkan kualitas jaringan 5G antara Provider X dan Y. Hasil pengukuran menunjukkan bahwa Provider X memiliki throughput sebesar 1410 bps, sedangkan Provider Y memiliki throughput sebesar 4062.140109 bps. Tingkat packet loss pada Provider X sebesar 0,0246%, sedangkan pada Provider Y sebesar 0,0027%. Delay yang terukur pada Provider X adalah 5,8670 ms, sedangkan pada Provider Y adalah 1,9694 ms. Jitter yang terukur pada Provider X adalah 5,8672 ms, sedangkan pada Provider Y adalah 1,9691 ms. Berdasarkan hasil pengukuran dan standarisasi yang diberikan oleh ITU-T, dapat disimpulkan bahwa Provider Y memiliki performa yang lebih baik dalam hal throughput, packet loss, delay, dan jitter dibandingkan dengan Provider X. Hasil ini dapat menjadi landasan bagi penyedia layanan telekomunikasi untuk meningkatkan kualitas jaringan 5G mereka dan membantu pengguna dalam memilih provider yang sesuai dengan kebutuhan mereka.

Kata kunci : QoS, 5G, Wireshark, throughput, packet loss, delay, jitter, video streaming, resolusi 4K, Pekanbaru.