bluuebunny/crossref_metadata_2025_split huggingface dataset:
The minutes until the emergency physician arrives at the scene – Do paramedics face an ethical dilemma when caring for advanced incurably ill and cardiac arrest patients? – a prospective questionnaire - based study
Authors: Mühe Karin , Nauck Friedemann , Alt-Epping Bernd 
Published: August 2023

Abstract

Backgound: In Germany, prehospital emergency medicine implies a “rendezvous” system where paramedics and an emergency physician arrive at the scene separately. If paramedics arrive first, they are obliged to perform all possible actions in order to save the patient´s life. But due to a legally contradictory situation, this may lead to moral distress and an ethical dilemma, so far hardly considered scientifically, when comfort care might be more appropriate than aggressive life-saving measures for patients with an advanced incurable disease and cardiac arrest.
Methods: A mixed method approach was used to explore the experiences and attitudes of German paramedics by using a newly designed, piloted questionnaire which is based on the limited existing literature and exploratory expert interviews.
Results: 295 paramedics participated and 283 questionnaires could be included for analysis. Nearly 80% of the paramedics experienced moral distress when performing cardiopulmonary resuscitation (CPR) or providing medical care to patients with an advanced incurable disease. In approximately one-third of such first-at-scene situations, the respondents decided to refrain from CPR on their own responsibility or not to intervene with extended medical measures. In these first-at-scene situation most of the participating respondents also felt that they were acting outside their prescribed legal competence. The respondents listed the patient´s (actual or presumed) will, previous involvement of palliative home care, estimated overall prognosis, a suggested dying process, and the relatives´ perception and wishes as criteria for refraining from emergency measures. 71.4% of the respondents claimed to have sufficient expertise for making a CPR decision on their own responsibility, 64.0% supported a concept that extends the legal responsibility of paramedics in case of CPR. 50.9% of paramedics felt sufficiently competent in independently administering care to advanced incurably patients, 57.6% of respondents advocated a transfer of (legal) competence.
Conclusion: Despite legal uncertainties, aggressive measures were foregone in one third of first-at-scene situations, based on criteria-driven decisions. Extending legal competencies to paramedics while at the same time optimizing training and providing further conceptual and structural support (such as palliative home care, crisis intervention teams and implementation of advance care planning) could help solve these dilemmas.
Scenario simulation of ecological risk based on land use/cover change under SSP-RCP scenarios : A case study of Xinjiang
Authors: Zhang Yue , Zhang Kun , Lv Jing 
Published: August 2023

Abstract
Taking Xinjiang as the research area, this paper constructed an ecological risk model based on data of Land use/cover Quality Index (LQI), Climate Quality Index (CQI), and Soil Quality Index (SQI) to simulate the ecological risk of Xinjiang and predict it under different scenarios (Shared Socioeconomic Pathways SSPs) at 2100. There are five conclusions drawn:(1) the land use/land cover have changed no obvious from 2020 to 2100. Grassland and farmlands have change the most. Unused land was stable, while forest and water areas have declined significantly. (2) In 2100, after reviewing different scenarios in Xinjiang, it can be seen that the LULCC risk level is dominated by the medium-quality risk level. The areas with medium-quality risk level account for about 70% of the total area of Xinjiang. (3) In 2100, the high-quality climatic and ecological risk areas of different SSPs in Xinjiang are mainly distributed in mountains, desert, and other regions. The medium-quality climatic and ecological risk areas are mainly distributed in the central and eastern regions of Xinjiang. (4) Under different scenarios in 2100, the spatial distribution of ecological risk levels in Xinjiang is mainly dominated by areas with low and medium ecological risk levels, accounting for nearly 70% of the total area. (5) From 2020 to 2100, the ecological risk levels of different scenarios show a decreasing trend in sequence. Typically, from 2020 to SSP370 (2100), most areas change from being at a previous medium ecological risk level to being at a relatively high/high ecological risk level. Under the SSP585 scenario, a large area of areas has changed from the original low ecological risk level to the current high ecological risk level. Only a small area of areas is showing an opposite area change.
Analysis of research hotspots and visualizations of nurses' professional quality of life
Authors: Wang Limei , Zhang Jing 
Published: August 2023

Abstract
Objective To explore which key countries, institutions, and authors have conducted professional quality of life research for nurses and further explore the collaborative networks and elements of cooperation between them. In addition, co-occurrence analysis was used to identify influential countries, institutions, and authors. Keyword frequency analysis, co-occurrence analysis, keyword clustering analysis, and visual representation were used to analyze the current status, hotspots, and trends of research in this field, and predict future research directions.
Methods The data source of the literature related to nurses’ professional quality of life (ProQOL) in the Web of Science Core Collection (WoSCC) database over the past ten years was analyzed using Excel and CiteSpace version 6.2 R2 analysis tools for the number of publications, institutions, countries, keywords, literature co-citation, and clustering.
Results Screening within the search to include 181 pieces of literature related to nurses’ ProQOL revealed that the overall volume of publications is a fluctuating growth trend, mainly in the United States, China, and other countries, and the key institutions are Chung Ang University and Sichuan University. According to the cluster analysis presenting ten clusters, the research hotspots of the study in the past decade were mainly compassionate fatigue, compassionate satisfaction, and secondary trauma response.
Conclusion The future direction of research on nurses’ professional quality of life may be to explore the balance between compassion fatigue (CF) and compassion satisfaction (CS), and the relevant influences and interventions on professional quality of life.
Body Fat Distribution Contributes to Defining the Relationship between Insulin Resistance and Obesity in Human Diseases
Authors: Adeva-Andany María M. , Domínguez-Montero Alberto , Adeva-Contreras Lucía , Fernández-Fernández Carlos , Carneiro-Freire Natalia , González-Lucán Manuel 
Published: August 2023

Abstract:The risk for metabolic and cardiovascular complications of obesity is defined by body fat distribution rather than global adiposity. Unlike subcutaneous fat, visceral fat (including hepatic steatosis) reflects insulin resistance and predicts type 2 diabetes and cardiovascular disease. In humans, available evidence indicates that the ability to store triglycerides in the subcutaneous adipose tissue reflects enhanced insulin sensitivity. Prospective studies document an association between larger subcutaneous fat mass at baseline and reduced incidence of impaired glucose tolerance. Case-control studies reveal an association between genetic predisposition to insulin resistance and a lower amount of subcutaneous adipose tissue. Human peroxisome proliferator-activated receptor-gamma (PPAR-γ) promotes subcutaneous adipocyte differentiation and subcutaneous fat deposition, improving insulin resistance and reducing visceral fat. Thiazolidinediones reproduce the effects of PPAR-γ activation and therefore increase the amount of subcutaneous fat while enhancing insulin sensitivity and reducing visceral fat. Partial or virtually complete lack of adipose tissue (lipodystrophy) is associated with insulin resistance and its clinical manifestations, including essential hypertension, hypertriglyceridemia, reduced HDL-c, type 2 diabetes, cardiovascular disease, and kidney disease. Patients with Prader Willi syndrome manifest severe subcutaneous obesity without insulin resistance. The impaired ability to accumulate fat in the subcutaneous adipose tissue may be due to deficient triglyceride synthesis, inadequate formation of lipid droplets, or defective adipocyte differentiation. Lean and obese humans develop insulin resistance when the capacity to store fat in the subcutaneous adipose tissue is exhausted and deposition of triglycerides is no longer attainable at that location. Existing adipocytes become large and reflect the presence of insulin resistance.
Training of Pelvic Floor Muscle Training Improves the Severity and
Quality of Urine Incontinence and Increases Social Participation of Older
Women in Southern Iran
Authors: Hoseini Somayeh Sheikh , Ghahremani Leila , Khorasani Fahimeh , Yarelahi Mahsa , Asadollahi Abdolrahim 
Published: August 2023

Background:
Aging and gender are risk factors for urine incontinence, which can lead
to psychological, physical, and social complications.

Objective:
This community-based study investigates the effectiveness of pelvic floor muscle training
on the severity and quality of urine incontinence and social participation of older women.

Methods:
This quasi-experimental community-based study was performed with the participation of
60 older women referring to the Public Health Center in Kerman City, southern Iran. The experiment
group was trained with pelvic floor muscle training in 7 training sessions with distance health
education in the second half of 2021. Before and after the intervention, data were collected based
on: demographic, severity and quality of urine incontinence, and social participation inventories.
Data were analyzed using a t-test and ANOVA (P ≤ 0.05).

Results:
The mean scores of severity and quality of urine incontinence and social participation in
the experiment and control groups before receiving the intervention were not statistically significant
(P ≥ 0.05). But after that, a statistically significant difference was observed between the
groups (P <0.05), which showed an improvement in the severity and quality of urine incontinence
scores as well as SP in the experiment group.

Conclusions:
Tele-training of the Kegel exercise, even during the pandemic, can play an important
role in improving incontinence and social participation in older women. Therefore, this training can
be used to prevent and improve urine incontinence in public health centers in the community.
Uncredited intravascular large B cell lymphoma involving central nervous system: a great masquerader
Authors: Hon Shu Ann , See Jie Siang , Wee Jack Son , Tee Yu Jin , Jamian Ehram , Achok Hamdi , Lim Soo Min 
Published: August 2023

Background:
Intravascular large B-cell lymphoma (IVLBCL) is infrequent and aggressive, clinically depicted by an almost exclusive growth of large cells within the lumen of blood vessels of all sizes. The clinical manifestations are diverse, encompassing many non-specific signs and symptoms such as fever of unknown origin, neurological symptoms, and skin lesions.

Case Presentation:
We report a case of a 49-year-old lady with unusual IVLBCL of the central nervous system. She presented with rapidly progressive dementia preceded by seizures and a short history of altered sensorium. There were no cutaneous lesions. Plain computed tomography brain showed no significant abnormalities. Cerebrospinal fluid analysis was normal except for mildly raised protein. Antinuclear antibody was positive 1:320 but the remaining autoimmune workups were negative. Electroencephalogram showed cortical dysfunction with occasional sharp wave at the right frontoparietal region. Other dementia workups were unremarkable. Magnetic resonance imaging brain revealed non-enhanced biparietal gyri hyperintensities which may represent encephalitis changes. She was empirically treated for viral encephalitis, however, there were still recurrent seizures despite adequate anti-seizure medications with minimal improvement of symptoms. Subsequent admissions noticed bicytopenia with elevated lactate dehydrogenase. Bone marrow aspirations and trephine biopsy disclosed High-Grade Mature B Cell Lymphoma germinal center B-cell Type. She was subsequently managed by the hematology team and started with conventional rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy. Fortunately, she is currently on the road to recovery.

Conclusion:
High index of suspicion is warranted to diagnose early in order to have a better prognosis.
Pemberdayaan Masyarakat dalam Upaya Menurunkan Angka Kejadian Berulang Ruam Kulit Balita di Desa Mranggen Demak
Authors: Soesanto Edy , Sulistyawati Erna , Amalia Nur Ulfa , Julistyanissa Dian , Wati Astiani Nur Kharisma , Sari Rita Nur Mulya , Udayanti Dyah Retno 
Published: August 2023

Masalah kulit yang banyak dialami balita yaitu miliaria atau biang keringat yang mengakibatkan terjadinya ruam kulit. Tujuan kegiatan ini adalah untuk menurunkan angka kejadian berulang ruam kulit balita melalui pendidikan kesehatan perilaku hidup bersih dan sehat ke ibu yang memiliki balita di posyandu balita Jatikusuma 2 dan 3 Desa Mranggen Demak. Kegiatan ini melibatkan pemerintah desa, tokoh masyarakat, kader kesehatan dan para ibu dengan balita di wilayah kerja posyandu balita Jatikusuma 2 dan 3 Desa Mranggen, Demak. Kegiatan ini dilakukan tiga tahap yaitu perencanaan, pelaksanaan, evaluasi, dan tindak lanjut. Perencanaan dilakukan untuk mengedukasi ibu dengan anak usia 0-5 tahun tentang pentingnya PHBS guna mencegah terjadinya kejadian berulang ruam kulit. Pelaksanaan pendidikan kesehatan dilakukan dengan metode small group discussion yaitu dengan membagi tiap ibu setelah pemeriksaan posyandu menjadi kelompok kecil terdiri dari 3 penyaji data dan 5 ibu yang memiliki balita. Kegiatan dilaksanakan dengan baik dan mendapat respon kooperatif, antusias, dan aktif setiap kegiatan dilakukan.
Peningkatan Kesehatan Reproduksi Remaja Melalui Pembentukan Pos Bimbingan Dan Pelayanan Kelompok Kader Sebaya
Authors: Rejeki Sri , Warsono Warsono , Khayati Nikmatul , Hidayati Eni 
Published: August 2023

Berdasarkan data hasil survei pada remaja Kabupaten Kendal tahun 2019 diperoleh 52 % remaja merokok, menonton gambar porno 95 %, 16 % remaja miras dan narkoba serta 7 % pergaulan bebas/ sex pra nikah dan lain-lain. Banyaknya remaja menganggur dan sering bergerombol dengan teman sebaya. Hal ini sangat memprihatinkan. Sudah banyak pihak yang berupaya untuk menangani permasalahan remaja, namun penangananya tidak secara komprehensif bersifat fragmented dan parsial. Sehingga penanganan tersebut tidak optimal.Permasalahan remaja yang disebutkan di atas berkaitan erat dengan kesehatan reproduksi, dan seringkali berakar dari kurangnya informasi dan pemahaman serta kesadaran untuk mencapai sehat secara reproduksi. Akses untuk mendapatkan informasi bagi remaja banyak yang tertutup. Dengan memperluas akses informasi tentang kesehatan reproduksi remaja yang benar dan jujur bagi remaja akan membuat remaja makin sadar terhadap tanggung jawab perilaku reproduksinya. Meski Puskesmas sebagai tempat Klinik Reproduksi Remaja (Klinik Peduli Remaja) sudah dicanangkan pemerintah, namun akses remaja terhadap tempat layanan tersebut sangatlah rendah. Beberapa data mengungkapkan bahwa setting ruangan, pola pelayanan, pola pakaian yang serba putih, terbatasnya jam buka, dan nilai-nilai normatif tenaga provider yang tidak gaul menjadi penyebab utama enggannya remaja datang ke tempat pelayanan tersebut.Dengan demikian remaja sangat membutuhkan adanya edukasi dan pendampingan remaja yang berfungsi memberikan informasi kesehatan khususnya kesehatan reproduksi dan segala permaslahanya, deteksi sederhana masalah kesehatan. Selain itu juga dibutuhan tenaga (kader) yang siap meberikan konsultasi yang mudah di jangkau dan selalu siap yang dapat diambil dari kalangan remaja itu sendiri (Kader Sebaya) yang dapat berperan sebagai konselor sebaya dalam dalam penyelesaian masalah-masalah yang berdampak pada kesehatan reproduksi.
REDUPLIKASI DALAM BAHASA MELAYU AMBON (KAJIAN MORFOLOGI)
Authors: Sopacua Valensia Febrima , Da Costa Romilda A. , Pesiwarissa Leonora F. 
Published: August 2023

Reduplikasi sebagai proses morfologis memiliki keunikan dari segi performa karena tidak semua kata yang berulang dapat digolongkan kata ulang. Artinya, ada kata-kata yang kelihatannya seperti pengulangan bunyi yang merupakan reduplikasi semu. Selain itu, ada reduplikasi yang terjadi pada bentuk dasar yang merupakan reduplikasi morfologis baik secara utuh/penuh, sebagian/parsial, ataupun dengan perubahan bunyi/variasi fonem. Reduplikasi inilah yang ditemukan dalam BMA. Jadi, data penelitian ini berupa tuturan atau kalimat yang mengandung reduplikasi dalam bahasa Melayu Ambon dengan menggunakan teknik observasi, teknik simak, dan teknik intuisi, dan dianalisis secara deskritif. Bentuk-bentuk reduplikasi morfologis yang dihasilkan prosesnya dapat berupa pengulangan utuh (verba, nomina, adjektiva, adverbia, dan numeralia), pengulangan berimbuhan (ba-, ta-, ma-, dan baku-), pengulangan sebagian berimbuhan (ba-, ta-, dan baku-), serta pengulangan berubah bunyi dan reduplikasi fonologis, berlangsung terhadap dasar yang bukan akar, status bentuk yang diulang tidak jelas dan reduplikasinya tidak menghasilkan makna gramatikal, melainkan makna leksikal.
BENTUK LINGUAL IDIOM DALAM BAHASA MELAYU AMBON
Authors: Sasabone Carolina , Aipassa Sulistyawati , Tabelessy Novita 
Published: August 2023

Secara umum, idiom dalam bahasa Melayu Ambon tidak jauh berbeda dengan idiom dari bahasa-bahasa lain di Indonesia, akan tetapi dalam pemakaian dan penyebutannya disesuaikan dengan budaya masyarakat. Idiom adalah gabungan kata yang maknanya tidak dapat dijadikan patokan untuk mengungkapkan suatu hal yang sebenarnya dapat diungkapkan dengan bentuk lain yang bukan idiom. Pemakaian unsurnya tidak selalu dapat diterangkan secara logis. Dalam Bahasa Melayu Ambon, banyak idiom yang berbentuk kata majemuk. Penelitian ini menggunakan metode deskriptif kualitatif. Yakni dengan mendeskripsikan temuan berdasarkan keadaan yang sebenarnya. Prosedur pengumpulan data dilakukan dengan observasi langsung, dimana peneliti menjadi instrument kunci. Dalam bahasa Melayu Ambon terdapat banyak idiom kata majemuk yang dibentuk dari kata organ tubuh manusia. Masalah dalam penelitian ini adalah bagaimana bentuk dan makna idiom kata majemuk organ tubuh dalam bahasa Melayu Ambon. Dilhat dari bentuk kategori, idiom kata majemuk organ tubuh bahasa melayu Ambon dapat diklasifikasikan sebagai berikut: (a) Bentuk nomina + nomina, (b) Bentuk nomina + verba, (c) Bentuk nomina + adjektiva. Sedangkan yang berkaitan dengan makna ditemukan: (a) Bentuk Idiom kata majemuk organ tubuh bahasa melayu Ambon yang memiliki persamaan makna dan perbedaan makna, (b) Idiom kata majemuk organ tubuh bahasa melayu Ambon bentuk kategori sama dan berbeda memiliki makna idiomatik yang sama.
Kemajuan Seni Suara Dalam Tradisi Bani Umayyah
Authors: Mustaqim Ahmad 
Published: August 2023

<p>This study is entitled about the Progress of Sound Art in the Bani Umayyah Tradition, the focus of this research is the beginning of the tradition of sound art in theBani Umayyah , the initiator of the art of music and the existence of the genre of sound art and the culmination of the progress of sound art. This research is a historical research using a historical approach and data corruption data that leads to the interpretation of the interpretation of the facts as a whole. And the method used in this research is the Library Reserch method which takes data from books, journals, and other scientific works. The results obtained from this study can be concluded several kinds, namely, the art of sound or music has existed since the time of Rasullullah, and the very dominant figure in developing the art of sound is Ziryab, then the peak of the existence of the art of music during the Dynasty Umayyah was in Andalusia, precisely Umayyah II.</p><p> <strong>Kata Kunci :</strong> Dynasty Umayyah , Sound Art, Music Art, Ziryab.</p>
An application programming interface implementing Bayesian approaches for evaluating effect of time-varying treatment with R and Python
Authors: Chen Chen , Huang Bin , Kouril Michal , Liu Jinzhong , Kim Hang , Sivaganisan Siva , Welge Jeffrey A. , DelBello Melissa P. 
Published: August 2023

IntroductionMethods and tools evaluating treatment effect have been primarily developed for binary type of treatment. Yet, treatment is rarely binary outside the experimental setting, varies by dosage, frequency and time. Treatment is routinely adjusted, initiated or stopped when being administered over a period of time.MethodsBoth Gaussian Process (GP) regression and Bayesian additive regression tree (BART) have been used successfully for handling complex setting involving time-varying treatments that is either adaptive or non-adaptive. Here, we introduce an application programming interface (API) that implements both BART and GP for estimating averaged treatment effect (ATE) and conditional averaged treatment (CATE) for the two-stage time-varying treatment strategies.ResultsWe provide two real applications for evaluating comparative effectiveness of time-varying treatment strategies. The first example evaluates an early aggressive treatment strategies for caring children with newly diagnosed Juvenile Idiopathic Arthritis (JIA). The second evaluates the persistent per-protocol treatment effectiveness in a large randomized pragmatic trial. The examples demonstrate the use of the API calling from R and Python, for handling both non-adaptive or adaptive treatments, with presences of partially observed or missing data issues. Summary tables and interactive figures of the results are downloadable.
The role of vaccination route with an adenovirus-vectored vaccine in protection, viral control, and transmission in the SARS-CoV-2/K18-hACE2 mouse infection model
Authors: Dickson Alexandria , Geerling Elizabeth , Stone E. Taylor , Hassert Mariah , Steffen Tara L. , Makkena Taneesh , Smither Madeleine , Schwetye Katherine E. , Zhang Jianfeng , Georges Bertrand , Roberts M. Scot , Suschak John J. , Pinto Amelia K. , Brien James D. 
Published: August 2023

IntroductionVaccination is the most effective mechanism to prevent severe COVID-19. However, breakthrough infections and subsequent transmission of SARS-CoV-2 remain a significant problem. Intranasal vaccination has the potential to be more effective in preventing disease and limiting transmission between individuals as it induces potent responses at mucosal sites.MethodsUtilizing a replication-deficient adenovirus serotype 5-vectored vaccine expressing the SARS-CoV-2 RBD (AdCOVID) in homozygous and heterozygous transgenic K18-hACE2, we investigated the impact of the route of administration on vaccine immunogenicity, SARS-CoV-2 transmission, and survival.ResultsMice vaccinated with AdCOVID via the intramuscular or intranasal route and subsequently challenged with SARS-CoV-2 showed that animals vaccinated intranasally had improved cellular and mucosal antibody responses. Additionally, intranasally vaccinated animals had significantly better viremic control, and protection from lethal infection compared to intramuscularly vaccinated animals. Notably, in a novel transmission model, intranasal vaccination reduced viral transmission to naïve co-housed mice compared to intramuscular vaccination.DiscussionOur data provide convincing evidence for the use of intranasal vaccination in protecting against SARS-CoV-2 infection and transmission.