bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long term miscarriage-related hypertension and diabetes mellitus. Evidence from a United Kingdom population-based cohort study
Authors: Okoth Kelvin , Subramanian Anuradhaa , Chandan Joht Singh , Adderley Nicola J. , Thomas G. Neil , Nirantharakumar Krishnarajah , Antza Christina 
Published: January 2022

Background
Miscarriages affect up to a fifth of all pregnancies and are associated with substantial psychological morbidity. However, their relationship with cardiometabolic risk factors is not well known. Therefore, in this study we aimed to estimate the burden of cardiovascular risk factors including diabetes mellitus (type 1 or 2) and hypertension in women with miscarriage compared to women without a record of miscarriage.

Methods
A population-based retrospective cohort study was conducted using IVQIA Medical Research Data UK (IMRD-UK) between January 1995 and May 2016, an anonymised electronic health records database that is representative of the UK population. A total of 86,509, 16–50-year-old women with a record of miscarriage (exposed group) were matched by age, smoking status, and body mass index to 329,865 women without a record of miscarriage (unexposed group). Patients with pre-existing hypertension and diabetes were excluded. Adjusted incidence rate ratios (aIRR) and 95% confidence intervals (95% CI) for diabetes and hypertension were estimated using multivariable Poisson regression models offsetting for person-years follow-up.

Results
The mean age at cohort entry was 31 years and median follow up was 4.6 (IQR 1.7–9.4) years. During the study period, a total of 792 (IR 1.44 per 1000 years) and 2525 (IR 1.26 per 1000 years) patients developed diabetes in the exposed and unexposed groups, respectively. For hypertension, 1995 (IR 3.73 per 1000 years) and 1605 (IR 3.39 per 1000 years) new diagnoses were recorded in the exposed and unexposed groups, respectively. Compared to unexposed individuals, women with a record miscarriage were more likely to develop diabetes (aIRR = 1.25, 95% CI: 1.15–1.36; p<0.001) and hypertension (aIRR = 1.07, 95% CI: 1.02–1.12; p = 0.005).

Conclusions
Women diagnosed with miscarriage were at increased risk of developing diabetes mellitus and hypertension. Women with history of miscarriage may benefit from periodic monitoring of their cardiometabolic health.
Confidence and knowledge in emergency management among medical students across Colombia: A role for the WHO basic emergency care course
Authors: Moretti Katelyn , Aluisio Adam R. , Gallo Marin Benjamin , Chen Chuan-Jay Jeffrey , González Marqués Catalina , Beaudoin Francesca L. , Clark Melissa , Patiño Andrés , Carranza Heidy , Duarte Andres , Moreno Atilio , Aguiar Leonar G. , Arbelaez Christian 
Published: January 2022

IntroductionGlobally, medical students have demonstrated knowledge gaps in emergency care and acute stabilization. In Colombia, new graduates provide care for vulnerable populations. The World Health Organization (WHO) Basic Emergency Care (BEC) course trains frontline providers with limited resources in the management of acute illness and injury. While this course may serve medical students as adjunct to current curriculum, its utility in this learner group has not been investigated. This study performs a baseline assessment of knowledge and confidence in emergency management taught in the BEC amongst medical students in Colombia.MethodsA validated, cross-sectional survey assessing knowledge and confidence of emergency care congruent with BEC content was electronically administered to graduating medical students across Colombia. Knowledge was evaluated via 15 multiple choice questions and confidence via 13 questions using 100 mm visual analog scales. Mean knowledge and confidence scores were compared across demographics, geography and prior training using Chi-Squared or one-way ANOVA analyses.ResultsData were gathered from 468 graduating medical students at 36 institutions. The mean knowledge score was 59.9% ± 23% (95% CI 57.8–62.0%); the mean confidence score was 59.6 mm ±16.7 mm (95% CI 58.1–61.2). Increasing knowledge and confidence scores were associated with prior completion of emergency management training courses (p<0.0001).ConclusionKnowledge and confidence levels of emergency care management for graduating medical students across Colombia demonstrated room for additional, specialized training. Higher scores were seen in groups that had completed emergency care courses. Implementation of the BEC as an adjunct to current curriculum may serve a valuable addition.
Timely Colonoscopy After Positive Fecal Immunochemical Tests in the Veterans Health Administration: A Qualitative Assessment of Current Practice and Perceived Barriers
Authors: Mog Ashley C. , Liang Peter S. , Donovan Lucas M. , Sayre George G. , Shaukat Aasma , May Folasade P. , Glorioso Thomas J. , Jorgenson Michelle A. , Wood Gordon Blake , Mueller Candice , Dominitz Jason A. 
Published: January 2022

INTRODUCTION:
The Veterans Health Administration introduced a clinical reminder system in 2018 to help address process gaps in colorectal cancer screening, including the diagnostic evaluation of positive fecal immunochemical test (FIT) results. We conducted a qualitative study to explore the differences between facilities who performed in the top vs bottom decile for follow-up colonoscopy.

METHODS:
Seventeen semistructured interviews with gastroenterology (GI) providers and staff were conducted at 9 high-performing and 8 low-performing sites.

RESULTS:
We identified 2 domains, current practices and perceived barriers, and most findings were described by both high- and low-performing sites. Findings exclusive to 1 group mainly pertained to current practices, especially arranging colonoscopy for FIT-positive patients. We observed only 1 difference in the perceived barriers domain, which pertained to primary care providers.

DISCUSSION:
These results suggest that what primarily distinguishes high- and low-performing sites is not a difference in barriers but rather in the GI clinical care process. Developing and disseminating patient education materials about the importance of diagnostic colonoscopy, eliminating in-person precolonoscopy visits when clinically appropriate, and involving GI in missed colonoscopy appointments and outside referrals should all be considered to increase follow-up colonoscopy rates. Our study illustrates the challenges of performing a timely colonoscopy after a positive FIT result and provides insights on improving the clinical care process for patients who are at substantially increased risk for colorectal cancer.
Functional Brain Changes Due to Chronic Abdominal Pain in Inflammatory Bowel Disease: A Case-Control Magnetic Resonance Imaging Study
Authors: Prüß Magdalena S. , Bayer Arian , Bayer Kian-Elias , Schumann Michael , Atreya Raja , Mekle Ralf , Fiebach Jochen B. , Siegmund Britta , Neeb Lars 
Published: January 2022

INTRODUCTION:
Various chronic pain conditions go along with functional and structural brain changes. This study aimed to investigate functional and structural brain changes by magnetic resonance imaging (MRI) in inflammatory bowel disease (IBD) patients with chronic abdominal pain.

METHODS:
Sixty-four subjects were included in the final analysis (32 IBD patients with chronic abdominal pain; 32 age-matched and sex-matched controls). All patients suffered from chronic abdominal pain, defined as a score of ≥3/10 on the visual analog scale for at least 3 months in the past 6 months. Besides structural MRI, resting state functional MRI was used to compare functional connectivity of 10 networks between groups.

RESULTS:
Patients with IBD showed no structural brain alterations but a significantly increased resting state functional connectivity of the secondary somatosensory cortex within the salience network.

DISCUSSION:
Because the secondary somatosensory cortex saves sensory stimuli and compares novel information with latter experiences, these functions may be maladaptive in IBD patients with abdominal pain.
Arahan Pengembangan Hutan Rakyat untuk Penanganan Lahan Kritis di Kabupaten Sukabumi, Provinsi Jawa Barat
Authors: Sirait Dharma Agustinus , Widiatmaka Widiatmaka , Rusdiana Omo 
Published: January 2022

Community forest plants can be an alternative fulfillment of raw material for the timber industry. While Sukabumi Regency is region with the largest area in West Java Province, so it the potential for development of community forest plants. This study wants to find the availability of land for development community forest plants, analyzing the suitability of community forest plantations, and formulating direction for development community forest plants in Sukabumi Regency. The study was conducted in Sukabumi Regency, which began in February-August 2019. The data used is the weight of each criteria for suitability of community forest plants from experts, data Land Map Units from BBSDLP, land use maps, RTRW maps, forest area maps, and land licensing. The method used is spatial analysis for determining available land, Analytical Hierarchy Process (AHP) for determining criteria weights, Multi Criteria Evaluation (MCE) for analyzing land suitability, and spatial analysis for determining development priority directions. The results showed that availability land for development of community forest plants in Sukabumi Regency was 57,786 hectares. The available land area in Sukabumi Regency which is classified as suitable (S1, S2, S3) i.e 57%. The development of community forest plants is directed at priority 1, which is an 83%.
Hubungan antara Persepsi terhadap Kualitas dan Pemanfaatan Ruang Terbuka Hijau dengan Kesejahteraan Psikologis Anak
Authors: Rasyida Afinnisa 
Published: January 2022

Gresik Regency has been trying to implement a green open space policy in the form of a child-friendly park. It is very substantial for Gresik Regency to have a park that can be both as outdoor space for children and also air pollution filter. This study aims to identify the relationship between perceptions of the quality and utilization of green open space with child psychological well-being. Data was collected using Perception of the Quality and Utilization of Green Open Space scale and Strength and Difficulties Questionnaire that obtained from parent’s assessment. The results suggested that there was a relationship between the perception of the quality and utilization of green open space with the child’s psychological well-being in the dimension of strength, specifically in developing prosocial behavior. However, there was no relationship in the dimension of difficulties. The results also obtained that the perception of the quality and utilization of green space in Gresik was good. Even so, the community still perceived the lack of park safety factors. They also infrequently visit the park. These results can be used as an evaluation for the Local Regional Government to improve the safety and comfort factor of the park.
Can Competitive Digital Games Support Real-Time Music Creation?
Authors: Studley Thomas , Drummond Jon , Scott Nathan , Nesbitt Keith 
Published: January 2022

This article presents practice-based research exploring the interplay of real-time music creation and competitive gameplay. Musically creative video games, apps, and sound art are first surveyed to highlight their characteristic avoidance of competitive game elements. The relationship between play, games, and musical activity is then examined with reference to theoretical perspectives from ludomusicology and game studies, revealing a series of mechanical and aesthetic design tensions emerging between competitive gameplay and music creation. Two original music games are presented to explore this interplay across contrasting design approaches: EvoMusic engenders an abstract competitive dialogue between the player and system for authorial control, while Idea presents a more explicit ludic framework with goals, progression, danger, and victory. The games are evaluated in a comparative user study to capture the player experience of composing within competitive game settings.
Participant responses revealed conflicting expectations for ludic and compositional experiences. Idea was the preferred game, yet its strong ludic elements distracted from or disincentivized music creation; EvoMusic offered more focused music creation yet also a weaker gameplay experience for lacking these same competitive elements. This relationship reflects the theoretical design tensions suggested by ludomusical scholarship. Further, a majority of participants characterized EvoMusic as being simultaneously competitive and creatively stimulating. The implication is that competitive games can support music creation for certain players, though it remains challenging to satisfy expectations for both within any one system. Design recommendations are drawn from these insights, and the potential for future research into creative music games is discussed.
A (Silent) Game of Words
Authors: Freitas Joana 
Published: January 2022

When Jeremy Soule, composer for some of the most well-known video game franchises in the world such as Guild Wars and The Elder Scrolls, was accused of sexual misconduct by women in the gaming industry in 2019, the internet hosted reactions from several fronts. From questioning the victims’ credibility to taking a neutral position while waiting for further development, gamers and fans made use of digital platforms to express either concern, astonishment, or doubt; these reactions point to the significant symbolic capital that Soule possesses in the context of video game music.
The Elder Scrolls franchise, and in particular Skyrim, is highly recognized for its soundtracks, and this franchise has given rise to the largest mods community to date. In previous research, I examined this mods community in order to consider music and sound in relation to immersion and modification in Elder Scrolls games. Since the data collected in that earlier research was limited to a time span until 2017, the recent developments concerning composer Jeremy Soule weren’t addressed in that earlier setting. However, these allegations were part of a larger phenomenon of awareness and public exposure of negative and abusive practices in several labor contexts in the video game industry, shedding some light on a much-needed discussion about sexism and mistreatment toward women and nonbinary professionals in these fields and raising some pertinent questions concerning users’ feedback and engagement.
This article aims to discuss the possible impacts these accusations had on the relationship between Soule’s music and users in the mods community, including users’ overviews of their own personal affective engagement with the games, thus verifying the deep connection between music, interactivity, authorship and gamer identity.
Efektivitas Pelatihan Keuangan Dalam Meningkatkan Akuntabilitas dan Transparansi Pelaporan Keuangan Dana Desa
Authors: Hasanah Nurul , Yanto Heri 
Published: January 2022

The purpose of this study was to determine the effectiveness of financial training in improving financial reporting of village funds in Alian District. The population of this study was 16 Alian Districts and the sampling technique was saturated samples. This study uses a qualitative approach. Methods of collecting data using observation, interviews and documentation. Data analysis techniques used descriptive analysis by collecting data, reducing data, and then presented to draw conclusions. The results of the study showed (1) Financial training carried out by the village apparatus of the Alian District was effective. The form of accountability that is carried out is by making financial reporting in accordance with the financial regulations determined by the government by attaching evidence and documentation of the activities that have been carried out. In addition, openness to the community has been carried out by the Alian District government through village development planning meetings, (2) Constraints faced in increasing accountability and transparency in financial reporting of village funds in Alian District are internal constraints, namely the age of village officials and education. Besides internal, there are external factors caused by government policies that often change. The conclusions of this study are the effectiveness of financial training in increasing the accountability and transparency of financial reporting of village funds in Alian District is quite good, but still needs hard work from the government by providing local village assistance, especially for villages whose village equipment is lacking in education and experience.
Analysis of Korean Middle School Students’ Scientific Interpretation Differences With or Without Arrows in the Energy Pyramid
Authors: Kim D. 
Published: January 2022

This study analyzed differences in Korean middle school students’ scientific interpretation of the energy pyramid diagram, which is a central concept of ecosystem learning, based on whether or not arrows were presented in the chart. Two classes that did not show statistically significant differences in school science academic achievement were selected. One class was shown the energy pyramid diagram with arrows, and the other without. A quasi-experimental design was adopted for quantitative research. The study found that the group interpreting the energy pyramid with arrows had a statistically significant scientific interpretation than the group interpreting the energy pyramid without arrows. In other words, arrows aided understanding of the concepts of size, biomass, and energy transfer of biological elements in the energy pyramid. In addition, the arrows aided understanding of the meaning of each piece of a pie chart, as the amount of biomass or energy being transferred to the next level of nutrition as pieces of a pie chart. Thus, it was concluded that the arrows in the energy pyramid were efficient visual elements in conveying the flow of matter and energy between living creatures. Based on the results, this study recommends that science textbooks should use arrows for more efficient understanding of scientific phenomena throughout textbooks beyond only the “ecosystem” topic.
Standardizing Opioid Prescribing in a Pediatric Hospital: A Quality Improvement Effort
Authors: Donado Carolina , Solodiuk Jean C. , Mahan Susan T. , Difazio Rachel L. , Heeney Matthew M. , Starmer Amy J. , Cravero Joseph P , Berde Charles B. , Greco Christine D. 
Published: January 2022

BACKGROUND
Opioids are indicated for moderate-to-severe pain caused by trauma, ischemia, surgery, cancer and sickle cell disease, and vaso-occlusive episodes (SCD-VOC). There is only limited evidence regarding the appropriate number of doses to prescribe for specific indications. Therefore, we developed and implemented an opioid prescribing algorithm with dosing guidelines for specific procedures and conditions. We aimed to reach and sustain 90% compliance within 1 year of implementation.

METHODS
We conducted this quality improvement effort at a pediatric academic quaternary care institution. In 2018, a multidisciplinary team identified the need for a standard approach to opioid prescribing. The algorithm guides prescribers to evaluate the medical history, physical examination, red flags, pain type, and to initiate opioid-sparing interventions before prescribing opioids. Opioid prescriptions written between January 2015 and September 2020 were included. Examples from 2 hospital departments will be highlighted. Control charts for compliance with guidelines and variability in the doses prescribed are presented for selected procedures and conditions.

RESULTS
Over 5 years, 83 037 opioid prescriptions in 53 804 unique patients were entered electronically. The encounters with ≥1 opioid prescription decreased from 48% to 25% between 2015 and 2019. Compliance with the specific guidelines increased to ∼85% for periacetabular osteotomies and SCD-VOC and close to 100% for anterior-cruciate ligament surgery. In all 3 procedures and conditions, variability in the number of doses prescribed decreased significantly.

CONCLUSION
We developed an algorithm, guidelines, and a process for improvement. The number of opioid prescriptions and variability in opioid prescribing decreased. Future evaluation of specific initiatives within departments is needed.
Ventetid på OP i kritisk diskursivt perspektiv
Authors: Jensen Lisbeth Dons , Frederiksen Jesper 
Published: January 2022

Akut indlagte patienter risikerer at vente længe på operation. Plejepersonalet finder det ikke optimalt, men accepterer det som et fast vilkår. I denne artikel undersøger vi med en socialkonstruktivistisk tilgang, med hvilke diskurser sundhedsfagligt personale italesætter akut indlagte operationspatienters ventetid, og hvilke konsekvenser det kan have for ventetiden. Det empiriske materiale er indsamlet i seks interviews med sundhedspersonale på operationsafdelingen, som er udført og analyseret med Norman Faircloughs model for kritisk diskursanalyse. En diskursorden om akutte patienters præoperative ventetid viser fire diskurser: en politisk/økonomisk diskurs, en biomedicinsk diskurs, en demokratisk diskurs og en humanistisk diskurs. Diskurserne reproducerer en social praksis, hvor en humanistisk diskurs dog åbner for potentiel social forandring. Diskurserne afspejler og konstituerer et sundhedsvæsen i udvikling mellem patientcentrering og standardisering. Tilsvarende diskurser ses i andre undersøgelser af sundhedsvæsenet. Fundene bidrager med en kritisk opmærksomhed for sundhedsfagligt personale på ventetid, og sproget omkring temaet. Dermed kan kritisk opmærksomhed bidrage til social forandring af praksis omkring ventetid. Det er imidlertid vigtigt at huske på at social forandring gennem kritisk opmærksomhed, ikke alene er et spørgsmål om sprog, men også er knyttet til magt relationer, der er båret af strukturelle og organisatoriske forhold.
ANALISIS KETIDAKPASTIAN PENGUKURAN KEKUATAN TARIK DAN ELONGASI SPESIMEN SS304 BERBENTUK RING
Authors: Ismarwanti Sri , Setiawan Jan , Ajiriyanto Maman Kartaman , Sigit Rohmad 
Published: January 2022

ANALISIS KETIDAKPASTIAN PENGUKURAN KEKUATAN TARIK DAN ELONGASI SPESIMEN SS304 BERBENTUK RING. Ketidakpastian adalah tolok ukur dari kehandalan suatu pengukuran. Salah satu pendekatan analisa ketidakpastian yang banyak digunakan adalah dengan menggunakan Guide to the expression of uncertainty in measurement (GUM). Langkah-langkah untuk menganalisa ketidakpastian dari suatu pengukuran telah dijelaskan secara rinci oleh pendekatan GUM. Analisa ketidakpastian dilakukan pada pengujian tarik untuk mengetahui ketertelusuran data yang diperoleh. Pengujian tarik menghasilkan data berupa kekuatan tarik dan elongasi dari material uji. Kekuatan tarik adalah besaran yang melibatkan besaran gaya dan panjang. Elongasi adalah penambahan panjang saat dilakukan penarikan. Kekuatan tarik pada sampel berbentuk ring akan dipengaruhi oleh luas penampang pada kedua belah sisi ring ketika diberikan tegangan tarik. Sehingga untuk menentukan ketidakpastian pengujian tarik akan memerlukan analisa terhadap penyumbang ketidakpastian. Makalah ini memberikan penjelasan bagaimana cara untuk menganalisa ketidakpastian pengukuran kekuatan tarik dan elongasi pada sampel berbentuk ring. Selain itu juga akan diperoleh nilai ketidakpastian pengukuran kekuatan tarik dan elongasi SS304 berbentuk ring. Dari pengujian yang dilakukan dapat diketahui bahwa kekuatan tarik ring SS304 rata-rata adalah 631,070 ± 26,976 Nmm-2 dengan ketidakpastian diperluas sebesar 50,451 Nmm-2 pada tingkat kepercayaan 95%. Selain itu pada tingkat kepercayaan yang sama diperoleh hasil elongasi ring SS304 rata-rata 18,681% ± 2,425% dengan ketidakpastian diperluas sebesar 2,867%. Keberulangan data atau repeatability menjadi penyumbang terbesar terhadap ketidakpastian pengukuran kekuatan tarik dan elongasi ring SS304.Kata kunci: Ketidakpastian, GUM, kekuatan tarik, elongasi, ring SS304.