bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using multiple outcomes in intervention studies: improving power while controlling type I errors
Authors: Bishop Dorothy V. M. 
Published: January 2023

Background The CONSORT guidelines for clinical trials recommend using a single primary outcome, to guard against excess false positive findings when multiple measures are considered. However, statistical power can be increased while controlling the familywise error rate if multiple outcomes are included. The MEff statistic is well-suited to this purpose, but is not well-known outside genetics. Methods Data were simulated for an intervention study, with a given sample size (N), effect size (E) and correlation matrix for a suite of outcomes (R). Using the variance of eigenvalues from the correlation matrix, we compute MEff, the effective number of variables that the alpha level should be divided by to control the familywise error rate. Various scenarios are simulated to consider how MEff is affected by the pattern of pairwise correlations within a set of outcomes. The power of the MEff approach is compared to Bonferroni correction, and a principal component analysis (PCA). Results In many situations, power can be increased by inclusion of multiple outcomes. Differences in power between MEff and Bonferroni correction are small if intercorrelations between outcomes are low, but the advantage of MEff is more evident as intercorrelations increase. PCA is superior in cases where the impact on outcomes is fairly uniform, but MEff is applicable when intervention effects are inconsistent across measures. Conclusions The optimal method for correcting for multiple testing depends on the underlying data structure, with PCA being superior if outcomes are all indicators of a common underlying factor. Both Bonferroni correction and MEff can be applied post hoc to evaluate published intervention studies, with MEff being superior when outcomes are moderately or highly correlated. A lookup table is provided to give alpha levels for use with Meff for cases where the correlation between outcome measures can be estimated.
Integrasi kemampuan berpikir kritis dalam rubric pengetahuan majalah bobo dan implementasinya pada pembelajaran bahasa Indonesia SD
Authors: Novita Sari Diah Hayu , Yulisetiani Septi 
Published: January 2023

Penelitian ini bertujuan untuk mendeskripsikan konten dalam majalah Bobo edisi 2021 yang dapat mengembankan kemampuan berpikir kritis peserta didik sekolah dasar. UNESCO menetapkan kompetensi untuk hidup pada abad 21 yaitu salah satunya adalah kemampuan berpikir kritis. Untuk itu, komponen berpikir kritis menjadi penting untuk dikembangkan sejak dini. Indicator kemampuan berpikir kritis yang terkandung dalam rubrik pengetahuan Majalah Bobo edisi bulan juni 2021. Indikator berpikir kritis yang dimaksud merupakan indikator modifikasi yaitu merumuskan masalah, memberikan argumen, membuat premis dan menarik kesimpulan. Pendekatan yang digunakan adalah kualitatif. Jenis penelitian yang digunakan adalah deskriptif kualitatif dengan metode analisis konten. Objek penelitiannya yaitu rubrik pengetahuan yang terdapat dalam Majalah Bobo edisi 10,11,12 dan 13 bulan juni 2021. Penelitian ini menggunakan instrumen berupa lembar analisis dokumen yang disusun berdasarkan landasan teori tentang indikator berpikir kritis. Teknik analisis data dimulai dengan data yang sudah dikumpulkan, direduksi, dideskripsikan, diinterpretasikan, dianalisis, kemudian disimpulkan. Hasil penelitian menunjukkan bahwa rubrik pengetahuan dari Majalah Bobo edisi bulan juni 2021 memuat pengetahuan tentang energy listrik dari sampah memenuhi 3 indikator, cara hewan berkamuflase memenuhi 4 indikator, sejarah singkat patung di Jakarta memenuhi 3 indikator dan terowongan panjang di dunia memenuhi 2 indikator. Bahan bacaan pada rubrik pengetahuan memenuhi empat indikator kemampuan berpikir kritis yaitu merumuskan masalah, memberikan argument, membuat premis dan menarik kesimpulan. Terlihat setelah membaca kritis peserta didik dapat menyerap informasi 5W+1H yang ada pada bacaan rubric pengetahuan. Muatan rubrik pengetahuan ini cocok untuk membangun kemampuan berpikir kritis peserta didik dengan menjadikan rubrik pengetahuan sebagai bahan ajar pendamping pembelajaran bahasa Indonesia.
DESEMPENHO DE COTISTAS DAS IFES NO ENADE EM PERSPECTIVA COMPARADA
Authors: Meireles Everson , Santana Luciana Alaíde Alves , Carvalho José Jorge , Nacif Paulo Gabriel Soledade 
Published: January 2023

Resumo: O objetivo deste estudo foi o de comparar o desempenho de cotistas e não cotistas no Exame Nacional de Desempenho dos Estudantes (Enade), edições de 2015 a 2017. Foram utilizados microdados do Enade disponibilizados pelo Inep, especificamente informações sobre: perfil social dos/as estudantes, modalidade de ingresso nas Instituições Federais de Ensino Superior (IFES), curso de graduação, nota no Enade e participação em programas acadêmicos e de assistência estudantil. Foram incluídos 171.275 estudantes de 86 diferentes cursos de graduação. Diferenças significativas de desempenho de cotistas e não cotistas foram observadas para 47,7% dos cursos, com tamanhos de efeito baixo-desprezíveis. Melhores desempenhos foram observados entre os/as que participaram de programas com bolsas acadêmicas.Palavras-chave: Enade. Cotistas. Comparação. Bolsas acadêmicas. Abstract: The objective of the study was to compare the performance of quota holders and non-quota holders in the National Student Performance Exam (Enade), editions from 2015 to 2017. Enade microdata made available by Inep were used, specifically information on: social profile of students, admission modality in Federal Institutions of Higher Education (IFES), graduation course, grade in Enade and participation in academic and student assistance programs. 171,275 students from 86 different undergraduate courses were included. Important differences in the performance of quota students and non-quota students were observed for 47.7% of the courses, with low-negligible effect sizes. Better performances were observed among those who participated in programs with academic scholarships.Keywords: Enade. Shareholders Students. Comparation. Academic scholarships.
Allied health professional confidence in giving prehospital fascia iliaca blocks
Authors: Fordyce Eve 
Published: January 2023

Background: Fascia iliaca blocks (FIBs) are an efficacious form of prehospital regional anaesthesia for patients with neck of femur fracture. Current prehospital use is limited. Aims: The primary aim of this study was to assess procedural confidence among allied health professionals. The secondary aim was to examine concerns related to prehospital use of FIB. Methods: This was a qualitative study that analysed semi-structured interviews. Two recognised groups were involved: paramedics and advanced practitioners. Results: A total of 12 semi-structured interviews were conducted. Four factors were found to contribute to procedural confidence. All practitioners felt confident to perform the FIB. In its secondary aim, to identify concerns related to FIBs, the study found three major themes: risk of doing harm; receiving adequate training; and procedural governance. Conclusions: Procedural confidence was high. Training and governance were highlighted as barriers to procedural expansion. Research is required to assess feasibility.
Effects of simulation training on student confidence in de-escalation skills
Authors: Downs Simon , Drew Laurence , Shore Colin B 
Published: January 2023

Background: There is increasing demand for access to mental health support services both for ongoing care and at time of crisis. Preparation of undergraduate students for encounters with those with ongoing mental health care and/or at a time of psychological distress/crisis remains sporadic and difficult to encompass. Simulation gives students opportunities to develop technical and non-technical skills through the recreation of an experience that is as close to reality as possible. Method: An exploratory evaluation of teaching practice of student self-perceptions of self-awareness and self-regulation in encountering clinical situations with persons in high states of arousal and potential conflict was conducted. To evaluate the exercise and its value, students were asked to self-evaluate their confidence and knowledge both prior to and subsequent to the teaching exercise. Results: There was a positive shift in self-awareness and self-regulation post training. Confidence in being able to de-escalate a situation was reported as the key outcome to take from the session, along with techniques on how to de-escalate a scenario. Conclusion: While it is not possible at this stage to definitively measure the impact of the teaching on practice or draw firm conclusions for education providers, the evaluation exercise does evidence individual impact and enjoyment. The teaching approach may prepare the future workforce with the skills and knowledge needed to provide high-quality care.
Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old
Authors: Nishida Keiichiro , Nasu Yoshihisa , Hashizume Kenzo , Okita Shunji , Nakahara Ryuichi , Saito Taichi , Ozaki Toshifumi , Inoue Hajime 
Published: January 2023

Aims There are concerns regarding complications and longevity of total elbow arthroplasty (TEA) in young patients, and the few previous publications are mainly limited to reports on linked elbow devices. We investigated the clinical outcome of unlinked TEA for patients aged less than 50 years with rheumatoid arthritis (RA). Methods We retrospectively reviewed the records of 26 elbows of 21 patients with RA who were aged less than 50 years who underwent primary TEA with an unlinked elbow prosthesis. The mean patient age was 46 years (35 to 49), and the mean follow-up period was 13.6 years (6 to 27). Outcome measures included pain, range of motion, Mayo Elbow Performance Score (MEPS), radiological evaluation for radiolucent line and loosening, complications, and revision surgery with or without implant removal. Results The mean MEPS significantly improved from 47 (15 to 70) points preoperatively to 95 (70 to 100) points at final follow-up (p < 0.001). Complications were noted in six elbows (23%) in six patients, and of these, four with an ulnar neuropathy and one elbow with postoperative traumatic fracture required additional surgeries. There was no revision with implant removal, and there was no radiological evidence of loosening around the components. With any revision surgery as the endpoint, the survival rates up to 25 years were 78.1% (95% confidence interval 52.8 to 90.6) as determined by Kaplan-Meier analysis. Conclusion The clinical outcome of primary unlinked TEA for young patients with RA was satisfactory and comparable with that for elderly patients. A favourable survival rate without implant removal might support the use of unlinked devices for young patients with this disease entity, with a caution of a relatively high complication rate regarding ulnar neuropathy. Level of Evidence: Therapeutic Level IV Cite this article: Bone Jt Open 2023;4(1):19–26.
Phytochemical, GC-MS analysis and antioxidant activities of leaf methanolic extract of Lai (Durio kutejensis), the endemic plant of Kalimantan, Indonesia
Authors: MANURUNG HETTY , SUSANTO DWI , KUSUMAWATI EKO , ARYANI RETNO , NUGROHO RUDY A. , KUSUMA RATNA , RAHMAWATI ZULFIKA , SARI RISKA D. 
Published: January 2023

Abstract. Manurung H, Susanto D, Kusumawati E, Aryani R, Nugroho RA, Kusuma R, Rahmawati Z, Sari RD. 2022. Phytochemical, GC-MS analysis and antioxidant activities of leaf methanolic extract of Lai (Durio kutejensis), the endemic plant of Kalimantan, Indonesia. Biodiversitas 23: 5587-5594. Lai (Durio kutejensis Hassk. Beck) is a fruit plant species endemic to Kalimantan, Indonesia. The leaves are traditionally used to treat several diseases. Currently, there is no scientific validation of the phytochemical content, bioactive compounds, and biological activities of leaf extracts of this plant from the East Kalimantan Province of Indonesia. So, this study aimed to determine the phytochemical compounds, bioactive compounds, and antioxidant activity of crude leaf methanol extract of D. kutejensis. Gas chromatography-mass spectrometry (GC-MS) analysis was performed to determine the bioactive compounds of lai leaf methanol extract. DPPH (2,2-diphenyl-1-picrylhydrazyl) was used to evaluate antioxidant activity. Screening of phytochemical compounds of the leaf methanol extract showed the presence of alkaloids, flavonoids, phenolics, saponins, and steroids. The leaf extract of lai contains total phenolic (104,55 µg GAE g-1 extract) and total flavonoid (281,41 µg QE g-1extract). The extract has weak antioxidant activity with an IC50 of 163,849 ppm. GC-MS analysis confirmed the presence of 43 identified compounds in the crude leaf methanolic extract of D. kutenjesis such as; 2-(1,1-dimethyl ethyl)-Phenol; 4-(3-hydroxy-1-propenyl)-2-methoxy-Phenol (Coniferyl alcohol); E7-Decenylacetate; Octadecanoic acid (Stearic acid); 1,3,6-Octatriene, 3,7-dimethyl-, (Z)-; Palmitaldehyde, diisopentyl acetal; Ledol; Estran-3-one, 17-(acetyloxy)-2-methyl-, (2.alpha.,5.alpha.,17.beta.)-. This study revealed that the leaf methanol extract of D. kutejensis is a good resource of many bioactive compounds that justifies the traditional usage of this species.
Molecular identification of Oncomelania hupensis lindoensis, snail intermediate hosts of Schistosoma japonicum from Central Sulawesi, Indonesia
Authors: Sutrisnawati Sutrisnawati , Ramadhan Achmad , Trianto Manap 
Published: January 2023

Abstract. Sutrisnawati, Ramadhan A, Trianto M. 2022. Molecular identification of Oncomelania hupensis lindoensis, snail intermediate hosts of Schistosoma japonicum from Central Sulawesi, Indonesia. Biodiversitas 23: 5989-5994. Schistosomiasis is a zoonotic parasitic disease with Oncomelania hupensis lindoensis, intermediate snail hosts of Schistosoma japonicum. The spread of O. hupensis lindoensis snail habitat was found in the three areas of the Napu, Bada, and Lindu Highlands with an infection rate above 1%. Oncomelania hupensis lindoensis is primarily cryptic species that are morphologically difficult to identify and distinguish from other species. Consequently, it can be confused with the naming of species. One of the molecular approaches that can be used to identify the Oncomelania spp. quickly and accurately is DNA barcoding using the COI mitochondrial gene. However, the research on identifying Oncomelania spp. in Indonesia is still very limited. Therefore, this study aimed to identify six Oncomelania spp. from Napu and Lindu, Central Sulawesi using COI mitochondrial gene as a molecular marker for DNA barcoding. The method used in this study was a Polymerase Chain Reaction (PCR) method with universal primers, LCO-F and HCO-R. The data obtained were then analyzed using GeneStudio, DNASTAR, BLAST, Identification Engine, Mesquite, MEGAX, and BEAST. The analysis was conducted to obtain similarity, genetic distance and reconstruct a phylogenetic tree. The result revealed that all six samples of Oncomelania spp. collected from Napu and Lindu were identified in one species, namely Oncomelania hupensis lindoensis. This research is very important to be carried out regularly periodically so that it can be used as a basis for Schistosomiasis control program data and related sectors to eradicate snails effectively, efficiently, and on target.
Usual source of care and access to care in the US: 2005 vs. 2015
Authors: Lee De-Chih , Shi Leiyu , Wang Jing , Sun Gang 
Published: January 2023

IntroductionThe study examined the association of usual source of care (USC) and healthcare access using a series of access indicators including both positive and negative measures for the US population in 2005 and 2015 while controlling for individual sociodemographic and socioeconomic characteristics. Results of the study would help advance the knowledge of the relationship between USC and access to care and assist decisionmakers in targeted interventions to enhance USC as a strategy to enhance access.MethodsThe household component of the US Medical Expenditure Panel Survey (MEPS-HC) in 2005 and 2015 were used for the study. To estimate the relative risk of having USC on access to care, odds ratios (ORs) and their 95% confidence intervals (CIs) were used with unconditional logistic regression and adjusted for socioeconomic and demographic characteristics.ResultsThose with USC were significantly more likely to have better access to care compared to those without USC. The USC-access connection remains significant and strong even after controlling for socioeconomic and demographic characteristics. Regarding subpopulations likely to lack USC, two notable findings are that racial/ethnic minorities (Black, Asian, and Hispanic) are more likely than White to lack USC and that those uninsured are more likely to lack USC.ConclusionThe study contributes to the literature on USC and access to care and has significant policy and practical implications. For example, having a USC is critical to accessing the health system and is particularly important as a tool to addressing racial disparities in access.
Coping strategy among the women with metastatic breast cancer attending a palliative care unit of a tertiary care hospital of Bangladesh
Authors: Islam Nashid , Bhuiyan A. K. M. Motiur Rahman , Alam Afroja , Chowdhury Mostofa Kamal , Biswas Jheelam , Banik Palash Chandra , Molla Md. Maruf Ahmed , Kowshik Mostofa Monwar , Sarker Mridul , Ahmed Nezamuddin 
Published: January 2023

Background
Breast cancer is one of the leading cancers among the Bangladeshi women. Coping helps these patients to adjust with this life-changing disease. Each individual has unique and different coping mechanism. But we know a little regarding their coping strategies. This study aims to explore the different coping strategies adopted by the women with metastatic (stage IV) breast cancer attending the palliative care unit and their relationship with the common mental health issues like anxiety and depression.

Methods
This cross-sectional study was conducted among 95 patients with metastatic (stage IV) breast cancer attending the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Bangladesh from April 2021 to September 2021. Data was collected by face-to-face interview using a structured questionnaire adapted from Hospital Depression and Anxiety Scale (HADS), Brief COPE inventory and Eastern Cooperative Oncology Group (ECOG) performance scale. Pearson correlation test was used to find the relationships between various domains of coping strategies and psychological variables. Correlation matrix was done to observe the internal correlation among different coping strategies. Kruskal-Wallis H test was done to find the relationship between different coping strategies and ECOG performance status.

Result
The mean age of the respondents was 48.9 ± 9.9 years. Most of them were married (94.7%), Muslim (92.6%) and homemakers (82.1%). Commonly used coping strategies by the patients were: acceptance (median 10; IQR 10), religion (median 9; IQR 8–10) and instrumental support (median 9; IQR 6–10). Significantly strong positive correlation was found between emotional and instrumental support (R = 0.7; p = 0.01), planning, acceptance and active coping (R = 0.7; p = 0.01); behavioral disengagement, self distraction and denial (R = 0.5; p = 0.01). Significantly fair negative correlation was observed between active coping and depression (R = -0.4, p <0.001). Patients with better performance status on ECOG scale (Grade 0–2) leaned more on the positive coping strategies like instrumental support, emotional support, positive reframing and venting.

Conclusion
Different coping strategies, especially positive coping helps the patients to adapt with their disease over time. All women suffering from breast cancer should be routinely screened and assessed for psychological distress and ensure early intervention and management to promote a better quality of life.
Investigating the evolution of undergraduate medical students’ perception and performance in relation to an innovative curriculum-based research module: A convergent mixed methods study launching the 8A-Model
Authors: Otaki Farah , AlHashmi Deena , Khamis Amar Hassan , Azar Aida Joseph 
Published: January 2023

Background
Embedding into undergraduate medical programs experiential research curricula, based on holistic theories of education which emphasize participation in the social world, remains uncommon. The purpose of this study was to investigate the journey of undergraduate medical students in relation to an innovative compulsory curriculum-based research module, which has a prominent experiential learning component.

Methods
A convergent mixed methods study design was adapted to develop a systemic understanding of the experience of the undergraduate medical students throughout the respective research module. As such, the students’ perception of the experience was qualitatively explored using thematic analysis (n = 15). In parallel, the students’ performance data were quantitatively analyzed using multi-repeated ANOVA (n = 158). The findings from both types of analyses (i.e., qualitative and quantitative study components) were then mapped onto each using joint display analysis.

Findings
The exploration generated four themes that correspond to sequential steps that the students go through to effectively integrate the scientific research method. These themes include: 1- Attend-Acquire, 2- Accumulate-Assimilate, 3- Apply-Appreciate, and 4-Articulate-Affect. Quantitatively, two distinct clusters of mean Grade Point Average were revealed (p<0.01). Joint display analysis enabled integrating the qualitative and quantitative findings, generating the 8A-Model.

Conclusion
The evidence-driven 8A-Model, generated by this study, highlights that medical students’ understanding of the true value of research seems to increase as they progress in the module. They begin expressing appreciation of the significance of the experience when they start implementing what they are learning as part of their own research studies. It is recommended for such a research module, with a firm experiential learning component, to be integral to undergraduate medical programs. This is expected to improve the future physicians’ research competences, and in turn add value in terms of quality of care and patient outcomes.