bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peningkatan Berkelanjutan dalam Pengelolaan Limbah Medis Padat COVID-19 Di Fasilitas Pelayanan Kesehatan : Systematic Review
Authors: Nugrahaeni Ardhini , Sulistiadi Wachyu 
Published: February 2024

AbstractHealth care facilities need to improve services continuously by implementing a Quality Management System, namely ISO 9000: 2015. ISO 9000: 2015 in its implementation is continuous quality improvement (CQI). Success in implementing this quality standard through continuous improvement can provide customer satisfaction and improve service performance. In an effort to improve quality, it is necessary to have quality indicators. One of the quality indicators is the management of solid medical waste(SMW) in accordance with regulations. During the COVID-19 pandemic, the number of cases increased resulting in the accumulation of solid medical waste to increase. Objective: to improve the management of COVID-19 SMW in health facilities. Method: PRISMA. This method is used to evaluate the management of COVID-19 SMW in health facilities so that new innovations are found. Barriers in Indonesia and abroad are the lack of infrastructure, knowledge, funds, storage, transportation, monitoring and evaluation. The buildup of COVID-19 SMW results in the transmission of the COVID-19 virus, so efforts are needed to improve it. The implementation requires top management commitment and is communicated and documented. Furthermore, supervision, monitored and evaluated. Barriers related to lack of facilities and knowledge of officers. Improvement efforts require commitment from top management. The recommendations provided are energy recovery facilities, Build-Operate-Transfer-Agreement, Electronic Scheduled Waste, complaint services, coaching clinic, and pyrolysisKeywords: continuous improvement, quality indicators, solid medical waste
FAKTOR-FAKTOR YANG BERHUBUNGAN DENGAN KEPATUHAN BIDAN DALAM KELENGKAPAN PENGISIAN BUKU KIA DI KABUPATEN BREBES
Authors: Hidayah Fika Nurul 
Published: February 2024

Angka Kematian Ibu (AKI) merupakan salah satu indikator untuk melihat derajat kesehatan perempuan. Pemanfaatan buku KIA melalui pencatatan yang lengkap tentang kesehatan ibu hamil oleh bidan diharapkan mempunyai kontribusi dalam penurunan AKI. Target kepatuhan membawa buku KIA sebesar 80%, sedangkan target kelangkapan pengisian buku KIA 60%. Cakupan K1 Puskesmas Kabupaten Brebes tahun 2014 sebesar 92% yang artinya pencapaian target K1 belum tercapai dan persebaran buku KIA belum memenuhi target. Tujuan penelitian ini untuk mengetahui faktot-faktor yang berhubungan dengan kepatuhan bidan dalam kelengkapan pengisian Buku KIA di kabupaten Brebes Penelitian kuantitatif dengan desain penelitian cross sectional digunakan untuk mengetahui hubungan Pengetahuan, Sikap, Ketersediaan buku KIA, Motivasi, Supervisi dengan kepatuhan bidan dalam pengisian Buku KIA. Sampel menggunakan Cluster Sampling didapatkan 118 bidan dari 492 bidan yang berada di 38 Puskesmas Kabupaten Brebes. Hasil penelitian Sebagian besar responden memiliki pengetahuan dan sikap yang baik, sebagian besar responden memiliki motivasi tinggi, sebagian responden memiliki persepsi terhadap supervisi baik ketersediaan Buku KIA ada dan baik. Variabel yang berhubungan secara signifikan adalah pengetahuan dan sikap dengan nilai p 0,000. Variabel yang berpengaruh secara bersama-sama dengan kepatuhan bidan dalam kelengkapan pengisian Buku KIA adalah pengetahuan dengan nilai OR (0,026), sedangkan sikap memiliki nilai OR (0,074) Kata Kunci : Kepatuhan, Buku KIA
Efektifitas Penggunaan Media Kotak Alfabet dan Gambar Terhadap Kemampuan Membaca Siswa Kelas II SDN 1 Kertayasa
Authors: Rita Kusumah  , Anisya Rachma 
Published: February 2024

Penelitian ini bertujuan untuk mengetahui Efektifitas Penggunaan Media Kotak Alfabet dan Gambar Terhadap Kemampuan Membaca Siswa Kelas II SDN 1 Kertayasa. Dimana membaca adalah salah satu kemampuan yang harus dimiliki siswa dalam proses pendidikan. Membaca dapat menjadi jembatan untuk siswa yang berkeinginan maju dan sukses baik dilingkungan keluarga, sekolah, dan masyarakat. Penelitian ini merupakan penelitian pre-eksperimen dengan desain One Group Pretest-Posttest. Populasi pada penelitian ini adalah seluruh siswa kelas II SD Negeri 1 Kertayasa yang berjumlah 26 siswa. Teknik pengambilan sampel dalam penelitian ini adalah total sampling. Teknik pengumpulan data yang dilakukan dalam penelitian ini adalah wawancara, observasi, tes, dan dokumentasi. Teknik analisis data yang digunakan dalam penelitian ini adalah menggunakan uji normalitas, uji homogenitas, dan uji hipotesis (wilcoxon). Hasil penelitian menunjukkan bahwa (1) Sebelum menggunakan Media Kotak Alfabet dan Gambar pada siswa kelas II SD Negeri 1 Kertayasa masih Kurang dengan nilai rata- rata 53,46. (2) Sesudah menggunakan Media Kotak Alfabet dan Gambar pada siswa kelas II SD Negeri
1 Kertayasa mengalami peningkatan dengan nilai rata-rata 83,46. (3) Terdapat Pengaruh dalam menggunakan Media Kotak Alfabet dan Gambar pada siswa kelas II SD Negeri 1 Kertayasa dengan nilai Asymp.Sig. (2-taied) 0,000.
A UTILIZAÇÃO DA METODOLOGIA LEAN STARTUP NA CRIAÇÃO E DESENVOLVIMENTO DE EMPREENDIMENTOS INOVADORES
Authors: Cardozo Becker da Silva Silvia , Veiga Ávila Lucas 
Published: February 2024

O presente artigo tem como objetivo realizar uma discussão sobre a metodologia Lean Startup, e como a sua aplicação na gestão e desenvolvimento de produtos e serviços inovadores podem elevar as chances de sucesso de um empreendimento. Trata-se exclusivamente de um artigo qualitativo e descritivo, que partiu do escopo de realizar uma revisão da literatura sobre a temática “Lean Startup”. A coleta de dados considerou artigos, livros e dissertações de maior relevância dos últimos anos, e teve como questões centrais responder as seguintes perguntas: Quais são as principais ferramentas e técnicas desta metodologia? Quais são os desafios e limitações de sua implementação? Quais são as maiores lacunas de pesquisa e oportunidades para estudos futuros sobre a Lean Startup? A partir desta pesquisa observou-se que a Lean Startup, apesar da sua popularidade no meio do empreendedorismo e inovação, possui diversas lacunas teóricas que evidenciam as dificuldades de sua aplicação, além da escassez de dados quantitativos que comprovem sua verdadeira contribuição para o sucesso e viabilidade das startups.
Palavras-Chave: Gestão da inovação. Lean Startup. Empreendedorismo.

Abstract: This article aims to discuss the Lean Startup methodology, and how its application in the management and development of innovative products and services can increase the chances of success of an enterprise. This is exclusively a qualitative and descriptive article, which departed from the scope of execute a literature review on the topic “Lean Startup”. Data collection considered the most relevant articles, books and dissertations from recent years, and its central questions were to answer the following questions: What are the main tools and techniques of this methodology? What are the challenges and limitations of its implementation? What are the most substantial research gaps and opportunities for future studies on Lean Startup? Throughout this research it was observed that Lean Startup, despite its popularity in the world of entrepreneurship and innovation, has several theoretical gaps that highlights the difficulties of its application, in addition to the scarcity of quantitative data that confirm its true contribution to the success and viability of startups.
Keywords: Innovation management. Lean Startup. Entrepreneurship.
The cardiomyopathy of cystic fibrosis: a modern form of Keshan disease
Authors: Segovia-Cubero Javier , Ruiz-Bautista Lorena , Maiz-Carro Luis , Girón-Moreno Rosa M. , Prados-Sánchez M. Concepción , Martínez-Martínez M. Teresa , González-Estecha Montserrat , Mingo-Santos Susana , Gómez-Bueno Manuel , Salas-Antón Clara , Cavero-Gibanel Miguel A. , Pastrana-Ledesma Miguel , García-Pavía Pablo , Laporta-Hernández Rosalía , Sánchez-Ortiz David , Alonso-Pulpón Luis 
Published: February 2024

IntroductionWe conducted a study to determine the prevalence of structural heart disease in patients with CF, the characteristics of a cardiomyopathy not previously described in this population, and its possible relationship with nutritional deficiencies in CF.MethodsWe studied 3 CMP CF patients referred for heart-lung transplantation and a prospective series of 120 adult CF patients. All patients underwent a clinical examination, blood tests including levels of vitamins and trace elements, and echocardiography with evaluation of myocardial strain. Cardiac magnetic resonance imaging (CMR) was performed in patients with CMP and in a control group. Histopathological study was performed on hearts obtained in transplant or necropsy.ResultsWe found a prevalence of 10% (CI 4.6%–15.4%) of left ventricular (LV) dysfunction in the prospective cohort. Myocardial strain parameters were already altered in CF patients with otherwise normal hearts. Histopathological examination of 4 hearts from CF CMP patients showed a unique histological pattern of multifocal myocardial fibrosis similar to Keshan disease. Four of the five CF CMP patients undergoing CMR showed late gadolinium uptake, with a characteristic patchy pattern in 3 cases (p &lt; 0.001 vs. CF controls). Selenium deficiency (Se &lt; 60 µg/L) was associated with more severe LV dysfunction, higher prevalence of CF CMP, higher NTproBNP levels, and more severe pulmonary and digestive involvement.Conclusion10% of adults with CF showed significant cardiac involvement, with histological and imaging features resembling Keshan disease. Selenium deficiency was associated with the presence and severity of LV dysfunction in these patients.
Effect of 10-year cumulative blood pressure exposure on atherosclerotic cardiovascular disease of different age groups: kailuan cohort study
Authors: Guo Lu , Tian Faming , Wang Jingyao , Xu Wenqi , Li Wenjuan , Hou Xiaoli , Zheng Mengyi , Yang Xuemei , Gao Lishu , Chen Shuohua , Zhang Nan , Wu Shouling 
Published: February 2024

BackgroundThe level at which cumulative blood pressure (BP) can increase the risk of ASCVD in different age groups remains unclear. This study aimed to investigate the association of 10-year cumulative BP levels with the long-term risk of ASCVD of different age groups.MethodsCumulative BP exposure was assessed using the time-weighted average (TWA) BP divided into four BP groups. The participants were also divided into four groups according to their baseline age (&lt;50, 50–59, 60–69, or ≥70 years). The association between TWA BP and the risk of ASCVD was assessed by age group using multivariate Cox models. The China-PAR prediction model was used to assess the ability of TWA BP to predict ASCVD.ResultsIn the group aged &lt;50 years, the hazard ratios and 95% confidence intervals for the risk of ASCVD were 2.66 (1.04–6.80), 3.38 (1.54–7.43), and 3.13 (1.36–7.24) for the elevated BP, stage 1 hypertension, and stage 2 hypertension groups, respectively, when compared with the normal BP group. There was a significant difference in the risk of ASCVD between the age groups, with participants aged &lt;50 years having the highest risk, followed by those aged 50–59, 60–69, and ≥70 years.ConclusionsThe risk of ASCVD with high cumulative BP exposure was age-dependent, with a gradual decrease in risk with increasing age.
Complexity of coronary artery disease and the release of cardiac biomarkers after CABG
Authors: Pölzl Leo , Lohmann Ronja , Sterzinger Philipp , Nägele Felix , Hirsch Jakob , Graber Michael , Engler Clemens , Eder Jonas , Abfalterer Hannes , Ulmer Hanno , Griesmacher Andrea , Grimm Michael , Bonaros Nikolaos , Ruttmann-Ulmer Elfriede , Holfeld Johannes , Gollmann-Tepeköylü Can 
Published: February 2024

ObjectiveIn patients with complex coronary artery disease (CAD) undergoing cardiac surgery, myocardial protection might be impaired due to microvascular obstruction, resulting in myocardial injury and subsequent biomarker release. Therefore, this study investigated the correlation between the complexity of CAD, reflected by the SYNTAX Score, and the release of cardiac biomarkers after CABG.MethodsIn a consecutive series of 919 patients undergoing isolated CABG SYNTAX scores I and II were calculated to assess the complexity of CAD. Levels of high sensitivity cardiac troponin T (hs-cTnT) and creatine kinase-myocardial band (CK-MB) were routinely measured once before and serially after surgery. Patients were divided into tertiles according to their SYNTAX Scores I and II. Spearman correlations and regression models were performed to measure the degree of association between the release of hs-cTnT and CK-MB and the SYNTAX Scores.ResultsPatients with a higher SYNTAX Score I had more comorbidities reflected in a higher EuroSCORE II. Preoperatively, higher levels of cardiac biomarkers were found in patients with higher SYNTAX Score II. No correlation was observed between hs-cTnT, CK-MB and SYNTAX Score I or II. Regression models did not show any association between cardiac biomarkers and the complexity of CAD.ConclusionThe complexity of CAD is not associated with the release of cardiac biomarkers after CABG. Factors influencing postoperative biomarker release need to be elucidated in future trials to include postoperative biomarker release into risk stratification models predicting outcome after cardiac surgery.
The association of Life’s Simple 7 and infertility among U.S. women
Authors: Wang Lixia , Chang Guangting , Cai Shu , Zou Xiaofang , Qin Meijiao , Tan Yingyao 
Published: February 2024

BackgroundThe Life’s Simple 7 (LS7) metric is a comprehensive measure of cardiovascular health (CVH) that encompasses seven distinct risk factors and behaviors associated with cardiovascular disease (CVD). Some studies have shown an association between infertility and CVD. The present study aimed to explore the potential association between the LS7 factors and infertility.MethodsA cross-sectional study was conducted on a sample of 3537 women aged 18-44 years from the National Health and Nutrition Examination Survey (NHANES) spanning the years 2013-2018. The LS7 metrics encompassed various factors including physical activity, smoking habits, body mass index, blood pressure levels, dietary patterns, blood glucose levels, and total cholesterol levels. We computed a 14-point LS7 score based on participants’ baseline data, classifying them as “inadequate” (3-6), “average” (7-10), or “ideal” (11-14). Infertility is defined as an affirmative answer to either of two questions on the NHANES questionnaire: “Have you tried to conceive for at least one year without success?” and “Have you sought medical help for your inability to conceive?” Logistic regression was utilized to estimate odds ratios (O.R.s) and 95% confidence intervals (C.I.s).ResultsIn total, 17.66% of participants were classified as individuals who reported experiencing infertility. In the continuous analysis, each one-unit increase in LS7 score was associated with a significantly decreased odds of infertility (OR=0.88 [0.77-0.89]). Analyzing the categorical representation of LS7 score, compared to individuals with poor scores, those with ideal scores exhibited a substantial 58% reduction in the odds of infertility (OR=0.42 [0.26-0.69]). Additionally, the observed interaction suggested that the influence of age on the relationship between LS7 and infertility is not consistent across different age groups (P for interaction &lt; 0.001). Among individuals aged 35 or younger, each unit increase in LS7 score was associated with a substantial 18% (OR=0.82 [0.76-0.89]) decrease in the odds of infertility. However, in the older age group (&gt;35), the association was attenuated and non-significant.ConclusionsOur research suggests a significant inverse association between LS7 scores and infertility. Age demonstrated a varying impact on this relationship, with a more pronounced impact observed among individuals aged 35 or younger.
Coffee and the risk of osteoarthritis: a two-sample, two-step multivariable Mendelian randomization study
Authors: Zhang Wenzheng , Lei Xuefeng , Tu Yihui , Ma Tong , Wen Tao , Yang Tao , Xue Long , Ji Jiazhong , Xue Huaming 
Published: February 2024

Purpose: To investigate the potential causal relationship between coffee consumption and osteoarthritis (OA), and to disentangle whether body mass index (BMI) and Bone mineral density (BMD) mediate this relationship.Methods: We performed two-sample and two-step Mendelian randomization (MR) analyses utilizing publicly available genome-wide association studies (GWAS) summary statistics to estimate the association between coffee intake and OA risk (including knee OA, hip OA, knee or hip OA, and total OA), as well as the possible mediating effects of BMI and BMD. In addition, data of different coffee types (decaffeinated coffee, instant coffee, ground coffee—including espresso, filter, etc., and other coffee types) were used to explore the effect of coffee type on the risk of OA.Results: In two-sample MR, coffee intake increased the risk of OA in various sites, with the most significant impact observed in knee osteoarthritis (KOA) (odds ratio [OR] 2.03, 95% confidence interval [CI] 1.57–2.61, p &lt; 0.001). The effect on self-reported OA was minimal (OR 1.03, 95% CI 1.01–1.05, p = 0.006). Further analysis of different types of coffee revealed that only decaffeinated coffee was causally associated with both KOA (OR 4.40, 95% CI 1.71–11.33, p = 0.002) and self-reported OA (OR 1.13, 95% CI 1.02–1.26, p = 0.022). In two-step MR, BMI explained over half of the coffee intake-all OA risk association, while BMD accounted for less than 5% of the mediation effect.Conclusion: Our study suggests that coffee intake increase the risk of OA, with BMI playing a significant mediating role. Decaffeinated coffee appears to have the greatest impact on OA risk compared to other types of coffee. Therefore, managing BMI and selecting appropriate types of coffee should be included in the health management of individuals who frequently consume coffee.
A nationwide analysis of the treatment patterns, survival, and medical costs in Korean patients with relapsed or refractory diffuse large B-cell lymphoma
Authors: Cho Jeong-Yeon , Jang Suk-Chan , Kang Dong-Won , Lee Eui-Kyung , Koh Hyein , Yoon Dok Hyun , Park Mi-Hai 
Published: February 2024

BackgroundApproximately one-third of patients with diffuse large B-cell lymphoma (DLBCL) are refractory to treatment or experience relapse after initial therapy. Unfortunately, treatment options for older patients and those who experience relapse or become refractory to hematopoietic stem cell transplantation (HSCT) are limited. This nationwide population-based study aimed to identify treatment patterns, survival times, and treatment costs in patients with relapsed/refractory DLBCL (R/R DLBCL).Materials and methodsBetween 2011 and 2020, data on patients with R/R DLBCL were retrieved from the Korean Health Insurance Review &amp; Assessment Service, encompassing the entire population. We identified the treatment patterns for each treatment line using a Sankey diagram and calculated the median time to the subsequent treatment in line. Median overall and progression-free survival times were estimated using the Kaplan–Meier survival curves. Finally, the medical costs incurred during DLBCL treatment were calculated for each treatment line and the costs related to HSCT were summarized at the episode level.ResultsA total of 864 patients with R/R DLBCL who received second-line treatment were identified, and a regimen of ifosfamide, carboplatin, and etoposide (ICE) was administered the most. Among them, 353 were refractory or relapsed cases that were treated with third-line treatments. The median times for second-line to third-line, third-line to fourth-line, fourth-line to fifth-line, and fifth-line to sixth-line treatment failures gradually decreased (3.93, 2.86, 1.81, and 1.38 months, respectively). The median overall survival time was 8.90 and 4.73 months following the second-line and third-line treatments, respectively. In the third-line treatment setting, the patients did not show a significant difference in survival time after HSCT. The median medical cost was $39,491 across all treatment lines including the cost of HSCT which was $22,054.ConclusionThe treatment patterns in patients with R/R DLBCL, especially at third-line treatments and thereafter, were complicated, and their prognosis was poor despite the high medical costs. Novel and effective treatment options are expected to improve the prognosis and alleviate the economic burden of patients with R/R DLBCL.
The functional decline of tomato plants infected by Candidatus Liberbacter solanacearum: an RNA-seq transcriptomic analysis
Authors: Chuan Jiacheng , Nie Jingbai , Cooper William Rodney , Chen Wen , Hale Lawrence , Li Xiang 
Published: February 2024

IntroductionCandidatus Liberibacter solanacearum (CLso) is a regulated plant pathogen in European and some Asian countries, associated with severe diseases in economically important Apiaceous and Solanaceous crops, including potato, tomato, and carrot. Eleven haplotypes of CLso have been identified based on the difference in rRNA and conserved genes and host and pathogenicity. Although it is pathogenic to a wide range of plants, the mechanisms of plant response and functional decline of host plants are not well defined. This study aims to describe the underlying mechanism of the functional decline of tomato plants infected by CLso by analyzing the transcriptomic response of tomato plants to CLso haplotypes A and B.MethodsNext-generation sequencing (NGS) data were generated from total RNA of tomato plants infected by CLso haplotypes A and B, and uninfected tomato plants, while qPCR analysis was used to validate the in-silico expression analysis. Gene Ontology and KEGG pathways were enriched using differentially expressed genes.ResultsPlants infected with CLso haplotype B saw 229 genes upregulated when compared to uninfected plants, while 1,135 were downregulated. Healthy tomato plants and plants infected by haplotype A had similar expression levels, which is consistent with the fact that CLso haplotype A does not show apparent symptoms in tomato plants. Photosynthesis and starch biosynthesis were impaired while starch amylolysis was promoted in plants infected by CLso haplotype B compared with uninfected plants. The changes in pathway gene expression suggest that carbohydrate consumption in infected plants was more extensive than accumulation. In addition, cell-wall-related genes, including steroid biosynthesis pathways, were downregulated in plants infected with CLso haplotype B suggesting a reduction in membrane fluidity, cell signaling, and defense against bacteria. In addition, genes in phenylpropanoid metabolism and DNA replication were generally suppressed by CLso infection, affecting plant growth and defense.DiscussionThis study provides insights into plants’ defense and functional decline due to pathogenic CLso using whole transcriptome sequencing and qPCR validation. Our results show how tomato plants react in metabolic pathways during the deterioration caused by pathogenic CLso. Understanding the underlying mechanisms can enhance disease control and create opportunities for breeding resistant or tolerant varieties.