bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors to identify the indication for regional nodal irradiation in T1-2N1M0 breast cancer: A joint analysis of 4,243 real-world cases from two institutions
Authors: Sun Guang-Yi , Wen Ge , Zhang Yu-Jing , Tang Yu , Jing Hao , Fang Hui , Wang Jian-Yang , Zhang Jiang-Hu , Zhao Xu-Ran , Chen Si-Ye , Song Yong-Wen , Jin Jing , Liu Yue-Ping , Tang Yuan , Qi Shu-Nan , Li Ning , Chen Bo , Lu Ning-Ning , Li Ye-Xiong , Wang Shu-Lian 
Published: December 2022

PurposeThe aim of this study is to evaluate the role of regional nodal irradiation (RNI) in patients with T1-2N1M0 breast cancer and to identify the subgroup that could benefit from RNI.Methods and materialsA total of 4,243 women with pT1-2N1M0 breast cancer treated at two institutions in China were retrospectively reviewed. Survival rates were calculated by the Kaplan–Meier method and compared by the log-rank test. The association of risk factors with survival outcomes was evaluated using multivariable proportional hazards regression.ResultsA total of 932 patients (22.0%) received RNI. At a median follow-up of 5.9 years, the 5-year locoregional recurrence (LRR), distant metastasis (DM), disease-free survival (DFS), and overall survival (OS) rates were 4.0% and 7.2% (P = 0.001), 13.2% and 10.6% (P = 0.465), 85.0% and 84.7% (P = 0.131), and 93.9% and 92.8% (P = 0.004) in the RNI and non-RNI groups, respectively. Multivariate analysis revealed that RNI was an independent prognostic factor for lower LRR (P = 0.001) and longer DFS (P = 0.013). Patients were stratified into low-, intermediate-, and high-risk groups based on the eight non-therapeutic risk factors. RNI significantly decreased the 5-year LRR (2.2% vs. 7.0%, P = 0.001) and improved the 5-year DFS (88.8% vs. 84.9%, P = 0.015) and OS (95.8% vs. 93.9%, P = 0.010) in the intermediate-risk group. However, neither the low-risk group nor the high-risk group had survival benefit from RNI.ConclusionT1-2N1M0 breast cancer is a heterogeneous disease. We found that RNI only improved survival in the intermediate-risk group. It might be omitted in low-risk patients, and the role of RNI in high-risk patients needs further study.
Dose-response relationship between iTBS and prefrontal activation during executive functioning: A fNIRS study
Authors: Zhang Bella B. B. , Kan Rebecca L. D. , Giron Cristian G. , Lin Tim T. Z. , Yau Suk-Yu , Kranz Georg S. 
Published: December 2022

IntroductionIntermittent theta-burst stimulation (iTBS) is a non-invasive brain stimulation paradigm that has demonstrated promising therapeutic benefits for a variety of neuropsychiatric disorders. It has recently garnered widespread favor among researchers and clinicians, owing to its comparable potentiation effects as conventional high-frequency repetitive transcranial magnetic stimulation (rTMS), but administered in a much shorter time frame. However, there is still a lack of agreement over the optimal stimulation intensity, particularly when targeting the prefrontal regions. The objective of this study was to systematically investigate the influence of different stimulation intensities of iTBS, applied over the left dorsolateral prefrontal cortex (DLPFC), on brain activity and executive function in healthy adults.MethodsTwenty young healthy adults were enrolled in this randomized cross-over experiment. All participants received a single session iTBS over the left DLPFC at intensities of 50, 70, or 100% of their individual resting motor threshold (RMT), each on separate visits. Functional near-infrared spectroscopy (fNIRS) was used to measure changes of hemoglobin concentrations in prefrontal areas during the verbal fluency task (VFT) before and after stimulation.ResultsAfter stimulation, iTBS to the left DLPFC with 70% RMT maintained the concentration change of oxyhemoglobin (HbO) in the target area during the VFT. In contrast, 50% [t(17) = 2.203, P = 0.042, d = 0.523] and 100% iTBS [t(17) = 2.947, P = 0.009, d = 0.547] significantly decreased change of HbO concentration, indicating an inverse U-shape relationship between stimulation intensity and prefrontal hemodynamic response in healthy young adults. Notably, improved VFT performance was only observed after 70% RMT stimulation [t(17) = 2.511, P = 0.022, d = 0.592]. Moreover, a significant positive correlation was observed between task performance and the difference in HbO concentration change in the targeted area after 70% RMT stimulation (r = 0.496, P = 0.036) but not after 50 or 100% RMT stimulation.ConclusionThe linear relationship between stimulation intensity and behavioral outcomes reported in previous conventional rTMS studies may not be translated to iTBS. Instead, iTBS at 70% RMT may be more efficacious than 100% RMT.
Case report: Carbohydrate malabsorption in inpatients with anorexia nervosa
Authors: Buck Patrizia , Goebel-Stengel Miriam , Mack Isabelle , Zipfel Stephan , Stengel Andreas 
Published: December 2022

BackgroundGastrointestinal (GI) complaints are frequently observed in patients who suffer from anorexia nervosa (AN). These symptoms may hamper treatment and weight regain and are often perceived as the cause, not the consequence, of the disease. Since carbohydrate malabsorption also produces these symptoms, this might underly or contribute to these complaints. So far, the role of carbohydrate malabsorption (fructose malabsorption and lactose intolerance) in AN has not yet been investigated.MethodsFor this case series, inpatients with AN of restrictive type (n = 3), purging type (n = 3), and atypical AN (n = 1) conducted hydrogen breath tests with 25 g of fructose and 50 g of lactose to investigate carbohydrate malabsorption. Results were then analyzed in association with body mass index (BMI) and patient-reported outcomes (disordered eating, body image disturbances, anxiety, depressive symptoms, perceived stress, and GI complaints).ResultsBased on the hydrogen breath test results, three of the seven female patients were classified as lactose intolerant and one presented fructose malabsorption. Both hydrogen curves for fructose (r = –0.632, p &lt; 0.001) and lactose (r = –0.704, p &lt; 0.001) showed a negative correlation with BMI. No association was observed between hydrogen values and patient-reported outcomes.ConclusionIn patients with AN, GI symptoms caused by intolerance of common monosaccharides and disaccharides may be an underestimated burden and should be considered in the diagnosis and therapy of patients with AN. Due to the observed correlation with BMI, GI complaints after ingestion of fructose or lactose likely develop with decreasing body weight and are potentially reversible with weight regain.
Facial emotion identification impairments in Chinese persons living with schizophrenia: A meta-analysis
Authors: Xu Yan-Min , Deng Fang , Zhong Bao-Liang 
Published: December 2022

BackgroundFacial emotion identification (FEI) deficits are associated with impaired social functioning in persons living with schizophrenia (PLwS), but the research on emotion-specific FEI deficits remains inconclusive. Furthermore, existing studies on FEI deficits are limited by their small sample sizes. We performed a meta-analysis of studies comparing the FEI abilities between Chinese PLwS and healthy controls in terms of the six basic facial emotions (happiness, sadness, fear, disgust, anger, and surprise), as well as contempt, calmness, and neutral facial expressions.MethodsMajor Chinese- and English-language databases were searched to retrieve case-control studies that compared the FEI task performance between Chinese PLwS and healthy controls (HCs) and reported the emotion-specific correct identification scores for PLwS and HCs. The Joanna Briggs Institute Critical Appraisal Checklist for Case-control Studies (“JBI checklist,” hereafter) was used to assess the risk of bias (RoB) of the included studies. Statistical analysis was performed using the “meta” package of R 4.1.2.ResultsTwenty-three studies with a total of 28 case-control cohorts and 1,894 PLwS and 1,267 HCs were included. The RoB scores of the included studies ranged from two to seven. PLwS had statistically significantly lower FEI scores than HCs and the corresponding emotion-specific pooled standard mean differences (95% confidence intervals) were −0.69 (−0.88, −0.50) for happiness, −0.88 (−1.12, −0.63) for sadness, −1.44 (−1.83, −1.06) for fear, −1.18 (−1.60, −0.76) for disgust, −0.91 (−1.24, −0.57) for anger, −1.09 (−1.39, −0.78) for surprise, −0.26 (−0.51, −0.01) for contempt, −0.31 (−0.52, −0.09) for calmness, and −0.42 (−0.65, −0.18) for neutral. In the analyses of sources of heterogeneity, drug-naïve status, clinical setting, positive and negative psychotic symptoms, and RoB were significant moderators of the magnitudes of FEI deficits.ConclusionsChinese PLwS have significant FEI impairments in terms of recognizing the six basic facial emotions, contempt, calmness, and neutral emotions, and the magnitude of impairment varies depending on the type of emotion, clinical characteristics, and the level of RoB of the study. It is necessary to consider the characteristics of FEI deficits and the clinical moderators in the FEI deficits to develop remediation strategies targeting FEI deficits in schizophrenia.
Prevalence and predictors of pornography exposure during the third wave of the COVID-19 pandemic: A web-based cross-sectional study on students in Bangladesh
Authors: Hossain Md. Tanvir , Ahammed Benojir , Jahan Nusrat , Islam Md. Akhtarul , Rahman Md. Mostafizur , Khan Bayezid , Sarker Md. Juwel Ahmed , Nibir Md. Mahdi-Al-Muhtasim , Hasan Mahamudul , Hasib Mir , Rahman Rumana , Islam Md. Nazrul 
Published: December 2022

BackgroundPornography exposure, particularly among students, in Bangladesh, has increased in the twenty-first century. However, pornography exposure during the COVID-19 pandemic, when people were compelled to “stay at home” and relied extensively on the internet for all forms of activities, including academia, socializing, and communication, has remained unexplored. The present study aimed to assess the prevalence of pornography exposure among students during the third wave of the COVID-19 pandemic and to determine the associated predictors.MethodsA web-based cross-sectional study was carried out among students with certain specifications, i.e., current students at high school/college/university with access to the internet and valid social media accounts. By administering a semi-structured e-questionnaire using Google Forms, a total of 646 valid responses were retained for this study. The data were analyzed in two phases by Pearson's Chi-square and multiple logistic regression model, using IBM SPSS Statistics, version 25. The results were expressed as an adjusted odds ratio (AOR) with a 95% confidence interval (95% CI).ResultsThe findings suggest that 75.9% of students were exposed to pornography during the third wave of the COVID-19 pandemic and preferred to watch the amateur/professional genre of pornography. Pornography exposure was significantly associated with age and relationship status, as students aged 22–24 years (95% CI: 1.01–2.41; p = 0.045) and over 25 years (95% CI: 1.61–10.03; p = 0.003) were more likely to watch pornography, while married students and those in relationships (95% CI: 1.24–3.49; p = 0.006) also watched pornography during the pandemic. In contrast, students who were living alone (95% CI: 0.38–0.92; p = 0.021), were living in the Khulna division (95% CI: 0.16–0.52; p &lt; 0.001) or had a negative attitude toward pornography (95% CI: 0.94–0.99; p = 0.002) were less likely to be exposed to pornography.ConclusionPornography exposure was higher among students in Bangladesh during the COVID-19 pandemic, and religiosity and disapproving attitudes toward pornography negatively influenced the pornography exposure. For a better understanding of the complex dynamics of socio-demographic issues with pornography exposure among students, extensive research is required for policymakers to devise appropriate strategies and interventions to ensure healthy and safe sex life for the younger population.
Tinjauan Yuridis Sanksi Pidana Delik Perbuatan Cabul terhadap Anak dalam Undang-Undang Nomor 35 Tahun 2014 tentang Perlindungan Anak dan Undang-Undang Nomor 12 Tahun 2022 tentang Tindak Pidana Kekerasan Seksual
Authors: Adabi Muhammad Ikhwan , Djusfi Apri Rotin , Aulia Eza , Thariq Phoenna Ath , Darusman Chandra , Maulana Jefrie 
Published: December 2022

This study focuses on sexual crimes in the form of obscene acts against children. According to R. Soesilo, obscene acts are all acts that violate decency or decency, or can also constitute a heinous act that is included in the environment of sexual lust. The problem lies in the criminal sanctions regulated between the two regulations. Criminal sanctions regulated in the PA Law and the PKS Law have differences in terms of the length of the sentence, the amount of the fine, and others. Then there will also be a test of the PA Law and the TPKS Law against the theory of the purpose of punishment. The research method used is a normative research method, namely research conducted with reference to the principles, legal concepts, legal norms contained in the legislation. The results of this research are that in terms of the comparison of the length of imprisonment or the number of fines, the PA Law is more effective than the TPKS Law. There are also articles regulated in the PA Law that are not regulated in the TPKS Law, such as Articles 76D and 76E. In the article, it is more specific how to commit obscene acts, namely by means of "threats of violence and violence." Both the PA Law and the TPKS Law adhere to a combined theory. In the PA Law and the TPKS Law, the main punishments regulated are imprisonment, fines and payment of restitution to victims. If it is related to the combined theory, then the PA Law and the TPKS Law have fulfilled the purpose of the combined theory. However, in the TPKS Law, in addition to stipulating the main punishment, it also regulates additional crimes, namely revocation of child custody or revocation of guardianship, announcement of the identity of the perpetrator and/or confiscation of profits and/or assets obtained from criminal acts of sexual violence. With the provision of additional penalties in the TPKS Law, it can be seen that the types of criminal sanctions in the TPKS Law provide more complete understanding of the combined theory. So that it can be concluded that the TPKS Law in terms of types of criminal sanctions is more comprehensive in its arrangement.
Analisis Kebijakan Mutu Fasilitas Kesehatan TNI AU Timika dalam Rangka Peningkatan Kelas Pelayanan
Authors: Nugraha Albertus , Ratag Gustaaf A. E , Mantjoro Eva M. , Surya Welong S. 
Published: December 2022

Abstract: Clinics and other health services are important parts of a social and health organization functioning to provide comprehensive, disease healing (curative) and disease prevention (preventive) services to the community. This study aimed to analyze the quality policy at the health service facilities of TNI AU Timika. This was a qualitative study. The results showed that the reliability of services was not in accordance with the standard operating procedure (SOP); responsiveness, namely the lack of health workers, therefore, the services were not optimal; assurance, namely that all health workers had licenses to practice, and treated the patients carefully and thoroughly; empathy, namely treating the patients according to their needs and responding to complaints open heartedly, such as accepting criticism and suggestions directly as well as through suggestion boxes and other communication media; physical evidence (tangibles), namely the completeness of the infrastructure was not optimal. In conclusion, Timika TNI AU clinic needs to improve and complete its facilities to achieve increased health service standards in order to provide stability and be able to support the military defense of Eastern Indonesian region in the health sector.
Keywords: health facility; reliability of services; responsiveness; assurance; empathy; tangibles

Abstrak: Klinik dan layanan kesehatan lainnya merupakan bagian penting dari suatu organisasi sosial dan kesehatan yang berfungsi untuk menyediakan pelayanan paripurna (komprehensif), penyembuhan penyakit (kuratif) dan pencegahan penyakit (preventif) kepada masyarakat. Penelitian ini bertujuan untuk menganalisis kebijakan mutu di fasilitas pelayanan kesehatan TNI AU Timika. Jenis penelitian ialah kualitatif. Hasil penelitian menunjukkan bahwa reliabilitas pelayanan belum sesuai SOP; daya tanggap, yaitu masih kurangnya jumlah petugas kesehatan sehingga pelayanan tidak maksimal; jaminan, yaitu semua tenaga kesehatan telah memiliki izin praktek dan melakukan tindakan kepada pasien secara hati-hati dan teliti; empati, yaitu menangani pasien sesuai dengan kebutuhannya serta menanggapi keluhan secara terbuka, dan menerima kritik dan saran secara lang-sung, melalui kotak saran dan media komunikasi lainnya; bukti fisik, yaitu sarana prasarana masih kurang lengkap. Simpulan penelitian ini ialah klinik TNI AU Timika perlu membenahi dan meleng-kapi fasilitasnya untuk mencapai peningkatan kelas standar pelayanan kesehatan agar memberikan stabilitas dan dapat mendukung pertahanan militer wilayah Timur Indonesia di bidang kesehatan.
Kata kunci: fasilitas kesehatan; reliabilitas pelayanan; daya tanggap; jaminan; empati; bukti fisik
Antecedents of Outpatient Satisfaction in Internal Medicine Polyclinic during Covid-19 Pandemic Era (Empirical Study At Hospital X)
Authors: Elim Meidy C. , Antonio Ferdi 
Published: December 2022

Abstract: There is high competition among private hospitals in seeking the quality of health services provided that meets consumer needs. The largest service unit in the hospital is the outpatient unit; one of the polyclinics is Internal Medicine unit. Patients coming for treatment in this unit during the COVID-19 pandemic expect the best health services. A variety of factors can affect patient satisfaction but only a few studies are focused on outpatient satisfaction in the COVID-19 pandemic era so far. This research aimed to evaluate the effects of environment and facilities, professional competence, caring attitudes and emotional support, perceived compliance of COVID-19 protocol, communication and information, and waiting time on patient’s satisfaction. There were 164 samples obtained by purposive sampling from respondents that filled out the online questionnaires. Data were analyzed by using the PLS-SEM. The results showed that the independent and mediating variables had significant positive effects on general satisfaction. The strongest effect was from environment and facilities and professional competence, while the direct effect on general satisfaction was found to be the strongest from waiting time. In conclusion, the results confirmed the theory of patient satisfaction with health services. Therefore, this research model has strong predictive accuracy and large predictive relevance to be used and developed in further research.
Keywords: satisfaction; outpatient; COVID-19; private hospitals
The Heavy Burden of Being Ordinary. Considerations on Robert Schneiderʼs Novel Die Offenbarung
Authors:   Universitatea de Vest din Timișoara, Roxin Maria 
Published: December 2022

The Austrian writer Robert Schneider had significant success with his first novel Schlafes Bruder/ Brother of Sleep, which sold about one million copies and was translated into over 36 languages. The following novels were not nearly as successful, although they had a favourable reception from the reading public. This paper explores how Schneider describes the destructive dimensions of ideals in his sixth and so far latest novel, Die Offenbarung/ The Revelation. Whereas most of Schneider’s characters are usually geniuses and thus outsiders or misfits, Jakob Kemper, the protagonist of the novel Die Offenbarung, is characterized precisely by the lack of any feature that could take him out of anonymity. Kemperʼs fear of being ordinary generates an endless number of failures. His whole existence is described as a long chain of humiliating personal and professional situations, defeats, and rejections. At the same time, this novel represents Robert Schneider’s attempt to reply with self-irony and disarming humour to his vocal critics, who often placed his works at the edge of trivial literature.
Konsep Pencegahan dan Peningkatan Permukiman Kumuh
Authors: Jabir B Ibrahim , Latief Rudi , Taking Idris 
Published: December 2022

Abstract. The purpose of this study was to analyze the level of slums and formulate the concept of prevention and improvement of the quality of slum settlements in the Cimpu area, Suli District, Luwu Regency. This type of research is a mix method research. To analyze the level of slums in the Cimpu area, Suli sub-district, Luwu district using a baseline scoring analysis tool, while to formulate the concept of preventing and improving the quality of slum settlements in the Cimpu area, a technical design is used in the form of three dimensions (3D). The main conclusion in this study is that based on the results of the baseline scoring analysis, it shows that the level of slums in the Cimpu area, Suli District, Luwu Regency is in the medium slum category and the concept of prevention and improvement of slum settlements in the Cimpu Area, Suli District, Luwu Regency consists of two, namely prevention and improvement quality. The concept of prevention is implemented through a pattern of supervision, control, and community empowerment, while the concept of quality improvement is implemented through a pattern of restoration, rejuvenation, and resettlement.

Abstrak. Tujuan dari penelitian ini ialah untuk menganalisis tingkat kekumuhan dan merumuskan konsep pencegahan dan peningkatan kualitas permukiman kumuh di Kawasan Cimpu, Kecamatan Suli, Kabupaten Luwu.
Jenis penelitian ini merupakan penelitian mix method. Untuk menganalisis tingkat kekumuhan di Kawasan Cimpu, Kecamatan Suli, Kabupaten Luwu menggunakan alat analisis skoring baseline sedangkan untuk merumuskan konsep pencegahan dan peningkatan kualitas permukiman kumuh di Kawasan Cimpu menggunakan desain teknis dalam bentuk tiga dimensi (3D).
Kesimpulan utama dalam penelitian ini yaitu Berdasarkan hasil analisis skoring baseline menunjukkan bahwa tingkat kekumuhan di Kawasan Cimpu, Kecamatan Suli, Kabupaten Luwu masuk dalam kategori kumuh sedang dan konsep pencegahan dan peningkatan permukiman kumuh di Kawasan Cimpu, Kecamatan Suli, Kabupaten Luwu terdiri atas dua, yaitu pencegahan dan peningkatan kualitas. Konsep pencegahan dilaksanakan melalui pola pengawasan, pengendalian, dan pemberdayaan masyarakat, sedangkan konsep peningkatan kualitas dilaksanakan melalui pola pemugaran, peremajaan, dan pemukiman kembali.