bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multicenter Randomized Trial of Intermittently Scanned Continuous Glucose Monitoring Versus Self-Monitoring of Blood Glucose in Individuals With Type 2 Diabetes and Recent-Onset Acute Myocardial Infarction: Results of the LIBERATES Trial
Authors: Ajjan Ramzi A. , Heller Simon R. , Everett Colin C. , Vargas-Palacios Armando , Higham Ruchi , Sharples Linda , Gorog Diana A. , Rogers Alice , Reynolds Catherine , Fernandez Catherine , Rodrigues Pedro , Sathyapalan Thozhukat , Storey Robert F. , Stocken Deborah D. 
Published: December 2022

OBJECTIVE
To analyze the impact of modern glucose-monitoring strategies on glycemic and patient-related outcomes in individuals with type 2 diabetes (T2D) and recent myocardial infarction (MI) and assess cost effectiveness.

RESEARCH DESIGN AND METHODS
LIBERATES was a multicenter two-arm randomized trial comparing self-monitoring of blood glucose (SMBG) with intermittently scanned continuous glucose monitoring (isCGM), also known as flash CGM, in individuals with T2D and recent MI, treated with insulin and/or a sulphonylurea before hospital admission. The primary outcome measure was time in range (TIR) (glucose 3.9–10 mmol/L/day) on days 76–90 post-randomization. Secondary and exploratory outcomes included time in hypoglycemia, hemoglobin A1c (HbA1c), clinical outcome, quality of life (QOL), and cost effectiveness.

RESULTS
Of 141 participants randomly assigned (median age 63 years; interquartile range 53, 70), 73% of whom were men, isCGM was associated with increased TIR by 17 min/day (95% credible interval −105 to +153 min/day), with 59% probability of benefit. Users of isCGM showed lower hypoglycemic exposure (&lt;3.9 mmol/L) at days 76–90 (−80 min/day; 95% CI −118, −43), also evident at days 16–30 (−28 min/day; 95% CI −92, 2). Compared with baseline, HbA1c showed similar reductions of 7 mmol/mol at 3 months in both study arms. Combined glycemic emergencies and mortality occurred in four isCGM and seven SMBG study participants. QOL measures marginally favored isCGM, and the intervention proved to be cost effective.

CONCLUSIONS
Compared with SMBG, isCGM in T2D individuals with MI marginally increases TIR and significantly reduces hypoglycemic exposure while equally improving HbA1c, explaining its cost effectiveness. Studies are required to understand whether these glycemic differences translate into longer-term clinical benefit.
Associations of Mid- and Late-Life Severe Hypoglycemic Episodes With Incident Dementia Among Patients With Type 2 Diabetes: A Population-Based Cohort Study
Authors: Alkabbani Wajd , Maxwell Colleen J. , Marrie Ruth Ann , Tyas Suzanne L. , Lega Iliana C. , Gamble John-Michael 
Published: December 2022

OBJECTIVE
Severe hypoglycemia is associated with an increased risk of dementia. We examined if the association is consistently present in mid- and late-life hypoglycemia.

RESEARCH DESIGN AND METHODS
Using health care data from Population Data BC, we created a base cohort of patients age ≥40 years with incident type 2 diabetes. Exposure was the first occurrence of severe hypoglycemia (hospitalization or physician visit). We assessed exposure versus no exposure in mid- (age 45–64 years) and late-life (age 65–84 years) cohorts. Index date was the later of the 45th birthday (midlife cohort), 65th birthday (late-life cohort), or diabetes diagnosis. Those with hypoglycemia or dementia before the index date were excluded. Patients were followed from index date until dementia diagnosis, death, emigration, or 31 December 2018. Exposure was modeled as time dependent. We adjusted for confounding using propensity score weighting. Dementia risk was estimated using cause-specific hazards models with death as a competing risk.

RESULTS
Of 221,683 patients in the midlife cohort, 1,793 experienced their first severe hypoglycemic event. Over a median of 9.14 years, 3,117 dementia outcomes occurred (32 among exposed). Of 223,940 patients in the late-life cohort, 2,466 experienced their first severe hypoglycemic event. Over a median of 6.7 years, 15,997 dementia outcomes occurred (158 among exposed). The rate of dementia was higher for those with (vs. without) hypoglycemia in both the mid- (hazard ratio 2.85; 95% CI 1.72–4.72) and late-life (2.38; 1.83–3.11) cohorts.

CONCLUSIONS
Both mid- and late-life hypoglycemia were associated with approximately double the risk of dementia, indicating the need for prevention throughout the life course of those with diabetes.
Ultra-Processed Food Consumption and Increased Risk of Metabolic Syndrome in Adults: The ELSA-Brasil
Authors: Canhada Scheine Leite , Vigo Álvaro , Luft Vivian Cristine , Levy Renata Bertazzi , Alvim Matos Sheila Maria , del Carmen Molina Maria , Giatti Luana , Barreto Sandhi , Duncan Bruce Bartholow , Schmidt Maria Inês 
Published: December 2022

OBJECTIVETo investigate the association between ultra-processed food (UPF) consumption and the incidence of metabolic syndrome (MetS).RESEARCH DESIGN AND METHODSFrom 2008 to 2010, we enrolled 15,105 adults, aged 35–74 years, who were employees from six public education and research institutions to assemble the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We used a food frequency questionnaire to assess UPF consumption (measured in grams per day) at baseline. We then assessed the outcomes of those returning to visits between 2012 and 2014 and between 2017 and 2019. We defined incident MetS by the presence of at least three of the following five abnormalities: high fasting glucose level, high triglyceride level, low HDL cholesterol level, high blood pressure, and abdominal obesity, after excluding those meeting such criteria at baseline. We also excluded those who had missing data or an implausible energy intake, leaving 8,065 participants in the study.RESULTSThe median age was 49 years, 59% of participants were women, and the median consumption of UPFs was 366 g/day. After 8 years, there were 2,508 new cases of MetS. In robust Poisson regression, adjusting for sociodemographics, behavioral factors, and energy intake, we found a 7% (relative risk [RR] 1.07; 95% CI 1.05–1.08) higher risk of incident MetS for an increase of 150 g/day in UPF consumption. Similarly, those in the fourth quartile (compared with the first quartile) had a 33% increased risk (RR 1.33; 95% CI 1.20–1.47). Further adjustment for BMI attenuated these associations (for 150 g/day increases in UPF consumption and for the fourth quartile compared to the first one, respectively, RR = 1.04, 95% CI 1.02–1.06; RR = 1.19, 95% CI 1.07–1.32).CONCLUSIONSGreater consumption of UPFs is associated with an increased risk of MetS. These findings have important implications for diabetes and cardiovascular disease prevention and management.
Urine Leucine-Rich α-2 Glycoprotein 1 (LRG1) Predicts the Risk of Progression to End-Stage Kidney Disease in Patients With Type 2 Diabetes
Authors: Liu Jian-Jun , Liu Sylvia , Wang Jiexun , Pek Sharon L.T. , Lee Janus , Gurung Resham L. , Ang Keven , Shao Yi Ming , Tavintharan Subramaniam , Tang Wern Ee , Sum Chee Fang , Lim Su Chi 
Published: December 2022

OBJECTIVE
Leucine-rich α-2 glycoprotein 1 (LRG1) was recently identified as an amplifier of transforming growth factor-β (TGF-β)–induced kidney fibrosis in animal models. We aimed to study whether urine LRG1 is associated with risk of progression to end-stage kidney disease (ESKD) in individuals with type 2 diabetes.

RESEARCH DESIGN AND METHODS
A total of 1,837 participants with type 2 diabetes and estimated glomerular filtration rate (eGFR) &gt;30 mL/min/1.73 m2 were recruited from a regional hospital and a primary care facility. Association of urine LRG1 with risk of ESKD (progression to sustained eGFR &lt;15 mL/min/1.73 m2, dialysis, or death resulting from renal causes) was assessed by survival analyses.

RESULTS
During a median follow-up of 8.6 (interquartile range 5.8–9.6) years, 134 incident ESKD events were identified. Compared with those in the lowest tertile, participants with baseline urine LRG1 in the highest tertile had a 1.91-fold (95% CI 1.04–3.50) increased risk of progression to ESKD, after adjustment for cardiorenal risk factors, including eGFR and albuminuria. As a continuous variable, 1 SD increment in urine LRG1 was associated with a 1.53-fold (95% CI 1.19–1.98) adjusted risk of ESKD. Of note, the association of urine LRG1 with ESKD was independent of plasma LRG1. Moreover, urine LRG1 was associated with rapid kidney function decline and progression to macroalbuminuria, two common pathways leading to ESKD.

CONCLUSIONS
Urine LRG1, a TGF-β signaling modulator, predicts risk of progression to ESKD independently of clinical risk factors in patients with type 2 diabetes, suggesting that it may be a novel factor involved in the pathophysiological pathway leading to kidney disease progression.
Ultra-processed Foods Consumption and Increased Risk of Metabolic Syndrome in Adults – the ELSA-Brasil
Authors: Canhada Scheine Leite , Vigo Álvaro , Luft Vivian Cristine , Levy Renata Bertazzi , Matos Sheila Maria Alvim , Molina Maria del Carmen , Giatti Luana , Barreto Sandhi , Bartholow Duncan Bruce , Schmidt Maria Ines 
Published: December 2022

<p> </p>
<p>Objective: To investigate the association between ultra-processed food (UPF) consumption and the incidence of metabolic syndrome.</p>
<p>Research Design and Methods: From 2008 to 2010, we enrolled 15105 adults, aged 35-74 years, employees from six public education/research institutions to assemble the Longitudinal Study of Adult Health (ELSA-Brasil). We used a food frequency questionnaire to assess UPF consumption (grams/day) at baseline. We then assessed the outcomes of those returning to visits between 2012-2014 and 2017-2019. We defined incident metabolic syndrome by the presence of at least three of the five abnormalities – high fasting glucose, high triglycerides, low HDL cholesterol, high blood pressure, and abdominal obesity, after excluding those meeting such criteria at baseline. We excluded additionally those who had missing data or an implausible energy intake, leaving 8065 participants.</p>
<p>Results: The median age was 49, 59% were women, and the median consumption of UPFs was 366 g/day. After eight years, there were 2508 new cases of metabolic syndrome. In robust Poisson regression, adjusting for socio-demographics, behavioral factors, and energy intake, we found a 7% (RR=1.07, 95%CI 1.05-1.08) higher risk of incident metabolic syndrome for an increase of 150 g/day in UPF consumption. Similarly, those in the 4th quartile (compared to the 1st quartile) had a 33% increased risk (RR=1.33; 95%CI 1.20-1.47). Further adjustment for BMI attenuated these associations (respectively, RR=1.04; 95%CI 1.02-1.06; RR=1.19, 95%CI 1.07-1.32).</p>
<p>Conclusions: Greater consumption of UPFs is associated with an increased risk of metabolic syndrome. These findings have important implications for diabetes and cardiovascular disease prevention and management.</p>
EFEKTIVITAS PEMBELAJARAN JARAK JAUH DALAM PEMBELAJARAN PJOK BERBASIS DARING UNTUK PESERTA DIDIK KELAS X DI SMA NEGERI 1 BANGLI TAHUN PELAJARAN 2021/2022
Authors: Eka Kurnia Wiratama I Gede , Suwiwa I Gede , Dartini Ni Putu Dwi Sucita 
Published: December 2022

Penelitian ini bertujuan untuk mengetahui efektivitas pembelajaran jarak jauh dalam pembelajaran PJOK berbasis daring untuk peserta didik kelas X di SMA Negeri 1 Bangli tahun pelajaran 2021/2022. Pendekatan yang pergunakan pada penelitan ini adalah pendekatan deskriptif dengan jenis penelitian kualitatif fenomenologi.Populasi penelitian ini adalah peserta didik kelas X SMA N 1 Bangli dengan jumlah keseluruhan 281 orang. Teknik pengambilan sampel penelitian ini menggunakan tabel Isaac dan Michael dengan tarap kesalahan 5% sehingga jumlah sampel dalam penelitian ini sebanyak 155 orang peserta didik kelas X, serta 1 orang Guru PJOK kelas X di SMA Negeri 1 Bangli. Adapun teknik pengumpulan data yang akan dipakai dalam penelitian ini adalah observasi, wawancara, angket kuisioner dan dokumentasi. Hasil penelitian menunjukkan bahwa pembelajaran jarak jauh dalam pembelajaran PJOK berbasis daring di SMA Negeri 1 Bangli dinyatakan kurang efektif, disebabkan beberapa alasan yaitu: (1) pembelajaran daring mempersulit proses pembelajaran yang dilakukan oleh peserta didik, (2) pembelajaran tatap muka lebih menyenangkan dari pembelajaran daring, (3) adanya kendala seperti terbatasnya jaringan internet, kuota belajar, dan kadang-kadang aplikasi susah untuk diakses. (4) tujuan pembelajaran yang kurang tercapai. Jadi dapat disimpulkan bahwa pembelajaran jarak jauh dalam pembelajaran PJOK secara daring kurang efektif terlaksana dalam pembelajaran PJOK di SMA Negeri 1 Bangli.
The Logics of Invited and Uninvited Material Participation
Authors: Weiner Kate , Flis Henwood  , Jacob Andrews  , Catherine Will  , Ros Williams  
Published: December 2022

This paper addresses debates concerning the ‘participatory turn’ in healthcare. It focuses on the case of blood pressure self-monitoring, understanding this as a form of patient participation at the level of individual care. Drawing and expanding on the work of Marres and Wynne and their notions of material participation and of uninvited engagement, we examine how patients’ home blood pressure self-monitoring is incorporated into clinical care, how the materials of blood pressure self-monitoring mediate participation and how we might characterise the practices of participation found within everyday clinical care. Our analysis makes new conceptual links, suggesting that, in this context, invited participation appears to align with participation made easy, while uninvited participation involves more invested, more engaged participation. We offer two further developments of these concepts. First, we trouble characterisations of invited and uninvited participation as distinct and separate, observing movement between these. Second, through applying the logics of material participation in a new context, everyday clinical practice, we suggest that the logic of participation made easy might be extended beyond lay people, to apply to professionals as well. Our analysis illustrates how materials are mobilised to facilitate invited and uninvited participation within the context of the on-going asymmetries in doctor patient relationships.
HUBUNGAN POLA MAKAN DENGAN KEJADIAN GASTRITIS PADA PASIEN DI PUSKESMAS BADEGAN KABUPATEN PONOROGO
Authors: Nurrohmah Laily Ayu , Nurhidayat Saiful , Munawaroh Siti , Muftiana Elmie , Verawati Metti 
Published: December 2022

Kejadian gastritis saat ini sedang meningkat, dan pola makan masyarakat yang buruk menjadi salah satu faktor penyebabnya. Banyak orang yang sering melewatkan sarapan juga sering minum kopi dan lebih menyukai makanan cepat saji seperti junk food, dan makanan pedas. Tujuan dari penelitian ini adalah untuk mengetahui keterkaitan antara pola makan dan kejadian gastritis pada pasien di Puskesmas Badegan Kabupaten Ponorogo. Penelitian ini bersifat kuantitatif dan meliputi analisis korelasi, metodologi cross-sectional, dan quota sampling dengan jumlah sampel 35 responden. Dengan menggunakan perhitungan Fisher's Exact untuk meneliti hubungan antara pola makan dengan kejadian gastritis di Puskesmas Badegan Kabupaten Ponorogo. Hasil penelitian menunjukkan bahwa 23 responden (65,7%) memiliki pola makan baik dan 11 responden (31,4%) dari 35 responden menderita gastritis. Hasil perhitungan Fisher Exact dengan alpha 0,05 didapatkan hasil p-value 0,002. Maka Ho ditolak dan H1 diterima. Dapat ditarik kesimpulan bahwa ada hubungan pola makan dengan kejadian gastritis pada pasien di Puskesmas Badegan Kabupaten Ponorogo. Untuk mencegah gastritis, peneliti menyarankan pasien di Puskesmas Badegan untuk memperhatikan, menerapkan dan meningkatkan asupan makanan yang sehat dan gizi seimbang.
HUBUNGAN PENDAMPINGAN SUAMI TERHADAP TINGKAT KECEMASAN IBU SELAMA PROSES PERSALINAN NORMAL KALA I DI RUMAH SAKIT UMUM MUHAMMADIYAH PONOROGO
Authors: Oktavia Sari , Ernawati Hery , Dwirahayu Yayuk 
Published: December 2022

Abstrak“Kecemasan yang dialami oleh ibu bersalin semakin lama akan semakin meningkat seiring dengan semakin seringnya kontraksi muncul sehingga kehadiran suami sangat dianjurkan untuk mendampingi ibu selama persalinan karena pengeluaran energi yang banyak ibu membutuhkan perhatian dan kasih sayang, dengan mengusap keringat memberi makanan, minuman, dan semangat selama proses persalinan membuat ibu menjadi lebih senang dan bersemangat sehingga proses persalinan dapat berjalan dengan lancar dan singkat.” “Tujuan penelitian ini untuk mengetahui hubungan pendampingan suami terhadap tingkat kecemasan ibu selama proses persalinan normal kala 1 di Rumah Sakit Umum Muhammadiyah Ponorogo.”Metode yang digunakan dalam penelitian ini adalah penelitian korelasi. Instrumen penelitian ini menggunakan kuesioner likert pada perilaku pendampingan suami dan kecemasan menggunakan kuesioner HARS. Pengambilan sampel dilakukan dengan teknik consequtif sampling selama 30 hari mulai tanggal 11 April sampai 11 Mei 2022 sampel berjumlah 34 responden. Penelitian ini menggunakan uji statistik Chi Square dengan nilai p value 0,05.Hasil Penelitian menunjukkan perhitungan Chi-Square dengan menggunakan SPSS didapatkan hasil p value 0,009 dengan df 2 yang berarti lebih kecil dari sebesar 0,05 yang berarti ada hubungan pendampingan suami terhadap tingkat kecemasan ibu selama proses persalinan normal kala I di Rumah Sakit Umum Muhammadiyah Ponorogo. Hasil penelitian ini diharapkan dapat digunakan bahan masukkan untuk pemangku kebijakan Rumah Sakit agar memberikan sosialisasi kepada suami ibu hamil bagaimana mendampingi ibu hamil yang baik selama proses persalinan kala I sehingga dapat membantu kelancaran proses persalinan. Kata Kunci : Persalinan normal, Kecemasan, Pendampingan Suami
HUBUNGAN PERILAKU PERSONAL HYGIENE SAAT MENSTRUASI DENGAN KEJADIAN PRURITUS VULVAE PADA REMAJA PUTRI DI MTS NEGERI 1 MADIUN
Authors: Laily Heny Mahirotul , Dwirahayu Yayuk , Purwaningroom Dian Laila 
Published: December 2022

AbstrakPendahuluan: Vulvae merupakan area sensitif dan mudah terinfeksi saat menstruasi karena kuman dapat dengan mudah masuk dan menyebabkan penyakit pada saluran reproduksi. Salah satu gangguan remaja saat menstruasi adalah gatal-gatal di sekitar vulva yang disebut pruritus vulvae. Tujuan Penelitian: untuk menganalisis hubungan perilaku personal hygiene saat menstruasi dengan kejadian pruritus vulva pada remaja putri. Metode Penelitian: Jenis penelitian ini menggunakan kuantitatif analitik dengan desain cross sectional. Populasi seluruh siswa kelas VII MTS Negeri 1 Madiun adalah 141 siswa dan sampel sebanyak 42 responden, dengan menggunakan teknik simple random sampling. Instrumen dalam penelitian ini menggunakan kuesioner, pengolahan data editing, coding, scoring dan tabulating, dalam analisis menggunakan uji statistik Chi-Square dengan α 0,05. Hasil Penelitian : Hasil dalam penelitian ini adalah sebagian besar responden memiliki perilaku personal hygiene menstruasi yang negatif sebanyak 22 remaja (52,4%) dan setengahnya sebanyak 20 responden (47,6%) berperilaku positif, serta sebagian besar 22 responden (52,4%) mengalami kejadian pruritus vulvae, dan hampir setengahnya 20 responden (47,6%) tidak mengalami kejadian pruritus vulvae. Kesimpulan : Didapatkan p value (0,000) α (0,05) yang berarti H1 diterima dan H0 ditolak yang artinya ada hubungan antara perilaku personal hygine dengan kejadian pruritus vulvae di MTS Negeri 1 Madiun. Saran : Responden yang terjadi pruritus vulvae dapat mencari informasi tentang perilaku personal hygine yang benar sehingga kejadian pruritus vulvae dapat dihindari. Untuk menurunkan kejadian pruritus vulvae, responden dihimbau untuk memperhatikan kebersihan vulvae, menerapkan perilaku personal hygine yang positif terutama ketika terjadi menstruasi agar terhindar dari pruritus vulvae. Kata kunci: Perilaku Personal Hygiene, Pruritus Vulvae, Remaja Putri
Effect of diet and weight loss on the severity of psoriasis
Authors: Owczarczyk-Saczonek Agnieszka , Kasprowicz-Furmańczyk Marta , Krajewska-Włodarczyk Magdalena , Szepietowski Jacek 
Published: December 2022

AbstractPsoriasis is one of the most common chronic inflammatory skin diseases, constituting a significant health and socioeconomic problem. Despite numerous therapeutic options, the results of treatment often remain insufficient. This may be due to the lack of compliance with medical prescriptions and patients’ limited knowledge of their disease. Psoriatic patient's skin well-being is affected by many factors, including lifestyle. The course of the disease is affected by obesity, improper diet, and stimulants. Often these factors coexist. Excessive weight gain in psoriasis can be caused by a decrease in physical activity, caused by feelings of social stigma, coexistence of psoriatic arthritis, depression, and increased alcohol consumption. Several studies have confirmed that the average fat, protein, and calorie content in the diet of a patient with psoriasis are above the recommended norms. On the other hand, adhering to a low calorie, reducing diet results in a clinically significant improvement in the Psoriasis Area Severity Index (PASI) and patients’ quality of life (i.e., reduction of Dermatology Life Quality Index [DLQI]). Weight reduction caused by diet and exercise reduces the severity of skin lesions, even in people who have not achieved improvement after general treatment. Therefore, it is important to educate the patient about the nature of the disease at the very beginning of treatment. Patients with moderate to severe forms of the disease are predisposed to the development of cardiovascular diseases, obesity, diabetes, and anxiety. That is why plaque psoriasis requires a comprehensive treatment and a holistic approach to the patient.
ANALISIS FAKTOR YANG MEMPENGARUHI KINERJA UMKM DI TANGERANG SELATAN
Authors: Diana Diana , Hakim Luqman , Fahmi Muhammad 
Published: December 2022

Penelitian ini menganalisis faktor-faktor penentu kinerja UMKM di Wilayah tangerang Selatan. Tujuan dari penelitian ini adalah menganalisa sejauh mana masalah utama dan kendala yang dihadapi oleh pengusaha Mikro, Kecil dan Menengah (UMKM) di wilayah Tangerang Selatan. Tantangan terberat para pelaku UMKM saat ini adalah kemampuan dalam pengelolaan usahanya terutama di Pasca Pandemi Covid-19 saat ini. Pengumpulan data dilakukan menggunakan kuesioner, yang dikembangkan dengan Google Form, dan disebarkan melalui media sosial online. Teknik purposive dilakukan terhadap komunitas UMKM di Tangerang Selatan, dengan menyebarkan kuesioner kepada para pelaku dan komunitas UMKM sebanyak 392 responden mengirimkan dan memenuhi syarat kriteria responden. Kemudian data tersebut diuji menggunakan Structural Equation Modeling (SEM) Amos 25.0. yang menghasilkan Kompetensi Pelaku Usaha memiliki pengaruh positif dan signifikan terhadap Kreatifitas Strategi Pemasaran, Akses Permodalan memiliki pengaruh positif dan signifikan terhadap Kreatifitas Strategi Pemasaran, Kreatifitas Strategi Pemasaran memiliki pengaruh positif dan signifikan terhadap Kinerja UMKM, namun Akses Permodalan memiliki pengaruh positif namun tidak signifikan terhadap Kinerja UMKM, dan Kompetensi Pelaku Usaha memiliki pengaruh positif namun tidak signifikan terhadap Kinerja UKM. Hasil ini agar dapat sebagai rujukan pihak pemerintah dalam mendukung peningkatan kinerja para pelaku UMKM dengan memperhatikan faktor Kompetensi, Kreatifitas Pemasaran namun tidak mengabaikan faktor akses permodalan sehingga dapat turut meningkatkan pendapatan daerah.