bluuebunny/crossref_metadata_2025_split huggingface dataset:
Favorable safety profile of moderate hypofractionated over normofractionated radiotherapy in breast cancer patients: a multicentric prospective real-life data farming analysis
Authors: Issoufaly Irfane , Petit Claire , Guihard Sébastien , Eugène Rémi , Jung Loic , Clavier Jean Baptiste , Servagi Vernat Stéphanie , Bellefqih Sara , Verret Benjamin , Bonnet Naïma , Deutsch Éric , Rivera Sofia 
Published: April 2022

Abstract
Background
Moderately hypofractionated whole-breast radiotherapy (HFRT) has proven to be as safe and efficient as normofractionated radiotherapy (NFRT) in randomized trials resulting in major changes in clinical practice. Toxicity rates observed in selected clinical trial patients may differ from those observed in unselected patients with possible comorbidities and frailty in real-life. This study aimed to examine the influence of HFRT versus NFRT on acute toxicity and identify risks factors of dermatitis in real-life patients.

Materials and methods
Prospective data from breast cancer patients, treated with locoregional radiotherapy were collected between November 2015 and February 2020 in 3 comprehensive cancer centers. Through a systematic data-farming strategy, acute toxicity evaluation forms (CTCAEv4.0) were prospectively completed and extracted electronically. The results from each center were then anonymously merged into a single database for analysis. A Chi-2 test was used to compare HFRT and NFRT. Furthermore, risk factors of dermatitis were identified in a sub-study (622 patients) by multivariate logistic regression analysis.

Results
In total, 3518 T0-4 N0-3 mostly M0 (85.8%) breast cancer patients with a median age of 60.7 (24–96 years old) were analyzed. Acute grade 2–3 dermatitis, grade 1–3 breast oedema, and grade 1–2 hyperpigmentation were less frequent with HFRT versus NFRT: respectively 8.9% versus 35.1% (Chi-2 = 373.7; p < 0.001), 29.0% versus 37.0% (Chi-2 = 23.1; p < 0.001) and 27.0% versus 55.8% (Chi-2 = 279.2; p < 0.001). Fewer patients experienced pain with HFRT versus NFRT: 33.4% versus 53.7% respectively (Chi-2 = 137.1; p < 0.001). Factors such as high BMI (OR = 2.30 [95% CI, 1.28–4.26], p < 0.01), large breast size (OR = 1.88 [95% CI, 1.07–3.28], p < 0.01) and lumpectomy over mastectomy (OR = 0.52 [95% CI, 0.27–0.97], p < 0.05) were associated with greater risk factors of grade 2–3 dermatitis in multivariate analysis regardless of NFRT or HFRT.

Conclusion
The results of this study suggests that breast HFRT may be a better option even for patients with a high BMI or large breast size. Acute toxicity was low to mild, and lower with HFRT compared to NFRT. Results from real-life data were robust, and support the use of HFRT beyond randomized study populations. Long-term real-life data awaits further investigation.
A resource-oriented intervention addressing balance in everyday activities and quality of life in people with advanced cancer: protocol for a feasibility study
Authors: Pilegaard Marc Sampedro , Timm Helle , Birkemose Heidi Klit , Dupont Sandra Bakkegaard , Joergensen Dorthe Soested , la Cour Karen 
Published: April 2022

Abstract
Background
People with advanced cancer need to balance their resources and energy in order to experience enjoyment and quality of life in the time they have left. A resource-oriented intervention is developed targeting these aspects. The present protocol presents a feasibility study of this resource-oriented intervention in people with advanced cancer.

Methods
A feasibility study with a repeated-measurement design without a control group will be conducted at the research clinic of REHPA, the Danish Knowledge Center for Rehabilitation and Palliative Care. Data will be gathered at baseline, during and after a 5-day residential stay, after 6 weeks, during a 2-day follow-up stay and after 12 weeks. In total, 20–25 home-living adults (≥ 18 years) with advanced cancer reporting needs in everyday life will be recruited. The intervention consists of workshops and engagement in physical and creative everyday activities provided by a multidisciplinary team.
Outcome measures are quality of life, physical function and fatigue, which will be assessed using the European Organisation for Research and Treatment of Cancer Quality-of-Life Questionnaire Core-30. Balance in everyday activities will be assessed using the Occupational Balance Questionnaire.
Feasibility data will also be collected regarding (1) fidelity, (2) adherence, (3) dose and (4) reach and mechanisms of impact. For exploration of mechanism of impact, participant observations and focus group interviews will be used.

Discussion
This study presents a new approach in rehabilitation and palliative care aimed at supporting people with advanced cancer; instead of identification of problems, the present resource-oriented palliative rehabilitation intervention will target people’s resources, enhancing balance in everyday activities and underpinning enjoyment and quality of life. The results from the feasibility study can inform ways in which to support the everyday life of people with advanced cancer and thus have potential to improve their quality of life. The long-term perspectives are to evaluate the intervention in terms of effect, process and cost-effectiveness. This will provide evidence to adjust the content of rehabilitation and palliative care for this group of people.

Trial registration
NCT04772690
Name of the registry: Balance, Activity and Quality of Life (BAL)
Date of registry: February 26, 2021
Factors influencing utilization of physiotherapy services by patients and people living with disability at Busia County Referral Hospital in Kenya
Authors: Eyinda Johnstone Milimo , Myezwa Hellen , Sekome Kganetso 
Published: April 2022

Abstract
Background
Physiotherapy, a component of primary health care, could be a remedy for physical challenges permeating widely in the world community due to non-communicable diseases trauma and infections.

Objectives
To establish the level of knowledge about physiotherapy and the association between level of knowledge and demographic profile among people living with disabilities and physiotherapy patients and how it influences utilization of physiotherapy services in Busia, Kenya.

Method
This was a descriptive cross-sectional quantitative study. One hundred fifty-eight participants were involved. Physiotherapy patients and people living with disabilities male and female above 18 years were purposively selected, and they completed self-administered questionnaires between August and November 2019. Data was cleaned, organized, and scientifically analyzed.

Results
Most of patients and PWD (67%) attended treatment sessions once a week only as there is inadequacy to meet their needs of treatment and it is difficult for them (87.42%) to recommend physiotherapy to others for they had lower level of knowledge of the importance of physiotherapy. The main challenge for patients and PWD to attend physiotherapy was lack of money (55.71%) and distance to hospital (63.3%).

Conclusion
Lower utilization of physiotherapy services in Busia County could be due to inadequate knowledge about physiotherapy, lack of finances to pay for physiotherapy, attitude of the health care providers towards physiotherapy, and inadequate infrastructure. There is a need to create awareness about physiotherapy and integrate physiotherapy service at all levels of practice of the components of primary health care in order for Busia community to benefit.
Implementation of Electronic Psychosocial Screening Among Caregivers in Pediatric Oncology
Authors: Manikowski Alison , Williamson Lewis Rebecca , Bennett Tonya , Miller Heather , Mertens Ann , Wasilewski-Masker Karen , Escoffery Cam , Gilleland Marchak Jordan 
Published: April 2022

PURPOSE: This study aimed to evaluate the reach and implementation of an electronic psychosocial screening program among caregivers of pediatric oncology patients, as well as characterize caregiver distress. METHODS: Participants (N = 2,013) included caregivers of patients age 0-17.99 years presenting across 9,280 outpatient oncology visits (median = 2; range = 1-52) from September 2018 to June 2019. At check-ins, caregivers electronically completed the pediatric distress thermometer via a patient-facing electronic health record (EHR) application. Caregiver distress ratings ≥ 8 triggered electronic alerts to medical teams to refer for social work support at point of care. Patient clinical and demographic differences in reach and fidelity were evaluated using univariate chi-square and t-tests. Caregivers reporting high distress were compared with caregivers without reports of high distress using univariate and multivariable logistic regression. RESULTS: The e-screening program was able to reach a caregiver for nearly all children seen during the study period, with 95.5% (1,923/2,013) of patients having a caregiver-completed pediatric distress thermometer. On screeners where caregivers reported high distress, medical teams made appropriate referrals to social work 95.5% (471/493) of the time. Overall, 16.9% (325/1,923) of caregivers ever indicated high distress (score ≥ 8), with caregivers of newly diagnosed (odds ratio = 3.16; 95% CI, 2.12 to 4.71) and on-therapy (odds ratio = 2.81; 95% CI, 2.11 to 3.76) patients being more likely to report high distress, compared with those who were off-treatment for the entire study. CONCLUSION: Leveraging EHR technology to provide evidence-based psychosocial screening can aid in successfully reaching a significant proportion of caregivers of pediatric oncology patients to identify and respond to ongoing psychosocial distress.
Common Variant in ALDH2 Modifies the Risk of Breast Cancer Among Carriers of the p.K3326* Variant in BRCA2
Authors: Kluźniak Wojciech , Szymiczek Agata , Rodrigue Amelie , Wokołorczyk Dominika , Rusak Bogna , Stempa Klaudia , Huzarski Tomasz , Gronwald Jacek , Lubiński Jan , Zamani Neda , Zhang Shiyu , Masson Jean-Yves , Narod Steven A. ,   Polish Hereditary Breast Cancer Consortium, Cybulski Cezary , Akbari Mohammad R. 
Published: April 2022

PURPOSE The BRCA2 p.K3326* variant is considered a low-penetrance variant for breast cancer. Aldehydes that accumulate in cells under insufficient aldehyde oxidation were most recently shown to trigger carcinogenesis by promoting depletion of BRCA2 protein. Allele T of the common variant rs10744777 in the ALDH2 gene was associated with reduced expression of aldehyde dehydrogenase, the main enzyme in aldehyde oxidation. We hypothesized that this allele could modify breast cancer risk in women with the BRCA2 p.K3326* low-penetrance variant through reduced function of ALDH2, increased accumulation of cellular aldehydes, and depletion of BRCA2 protein. MATERIALS AND METHODS We genotyped 11,873 Polish women diagnosed with breast cancer and 7,615 ethnically matched controls for these two variants. Next, we extended our analysis of rs10744777 to 231 carriers of pathogenic BRCA2 mutations. RESULTS BRCA2 p.K3326* variant was associated with significant increase in breast cancer risk only in those who were homozygous for the T allele of the ALDH2 rs10744777 variant (odds ratio = 1.72; 95% CI, 1.19 to 2.48; P = .003). The BRCA2 p.K3326* variant did not increase the risk of breast cancer among those who were heterozygous or homozygous for the C allele of the ALDH2 rs10744777 variant (odds ratio = 1.05; 95% CI, 0.73 to 1.51; P = .81). In the carriers of high-risk BRCA2 mutations, the TT genotype of rs10744777 conferred a modest (18%) and not significant increase in breast cancer risk. CONCLUSION Our results suggest that BRCA2 p.K3326* variant, which is low-penetrance by itself, confers increased breast cancer risk on the background of the TT genotype of the ALDH2 rs10744777 variant in the Polish population.
Anesthetic Practice Trends and Perceptions Toward Postoperative Delirium: A Mixed-Methods Analysis
Authors: Ragheb Jacqueline , Norcott Alexandra E. , Iskander Mina , Brooks Joseph , McKinney Amy , Mentz Graciela , Vlisides Phillip E. 
Published: April 2022

BACKGROUND:
Delirium is the most common postoperative complication in older adults, though anesthesiologist awareness of delirium prevention guidelines—and associated practice trends—remains unknown.

METHODS:
This was a convergent mixed-methods study, which simultaneously analyzed quantitative and qualitative data to determine delirium guideline awareness among anesthesiologists and practice patterns based on guideline recommendations. Quantitative data were abstracted from the Multicenter Perioperative Outcomes Group database for noncardiac surgery patients (2009–2020) aged 65 years and older. Linear trends were reported for select guideline-based delirium prevention recommendations via regression modeling. Anesthesiologists (n = 40) from a major academic center without a structured delirium reduction program on hospital wards were then surveyed regarding knowledge and practices with respect to postoperative delirium. For qualitative data, 3 focus groups were held to further discuss guideline awareness and identify challenges with delirium prevention.

RESULTS:
Quantitative results demonstrated a significant decline in the proportion of cases with midazolam between 2009 and 2020, with the largest decrease observed with urologic surgeries (−3.9%/y; 95% confidence interval [CI], −4.2 to −3.6; P < .001). Use of regional anesthesia increased over this period, particularly with gynecologic surgeries (+2.3%/y; 95% CI, 1.2–3.4; P = .001). Anesthesiologist survey results revealed variable guideline awareness, as 21 of 39 (54%) respondents reported being aware of guidelines for anesthetic management of older adults. Importantly, unawareness of delirium management guidelines was the most frequently cited challenge (17 of 37, 46%) when caring for older adults. Finally, focus group participants were largely unaware of postoperative delirium guidelines. However, participants conveyed key barriers to delirium identification and prevention, including the unclear pathophysiology, nonmodifiable risk factors, and system-based hospital challenges. Participants also expressed a desire for decision-support systems, integrated within the perioperative workflow, that provide evidence-based recommendations for reducing delirium risk.

CONCLUSIONS:
Perioperative practice trends are indicative of an improving environment for postoperative delirium. However, delirium guideline awareness remains variable among anesthesiologists, and key barriers continue to exist for identifying and preventing postoperative delirium.
Determinants of patient behavioural loyalty on primary health centres: Evidence from a cross-sectional study in Indonesia
Authors: Mardaleta Mardaleta , Lubis Abdul Rahman , Diantimala Yossi , Fahlevi Heru 
Published: April 2022

Background: Patients’ loyalty to visit and use the services provided by the primary health centers (PHCs) is an important requirement of a patient referral system in many countries. The aim of this study was to examine the influence of internal service factors (service provider, service process, and service environment) on service quality and behavioural loyalty of patients in Indonesian PHCs (Puskesmas). Methods: A cross-sectional study was conducted in 14 districts in Aceh Province, Indonesia between September and December 2020. Data were collected in 102 PHCs that were selected randomly from 137 PHCs that have an Inpatient Unit in the province. The demographic data, three components of internal service factors (service provider, service process, and service environment), the service quality and behavioural loyalty were assessed using a validated questionnaire. Hypothesis testing was conducted by using the structural equation model (SEM). Results: Our data suggested that two elements of internal service factors (service provider and service environment) had a positive and significant influence on service quality of the PHCs with p<0.001 and p=0.021, respectively. Service quality had a positive and significant influence of behavioural loyalty of patients to the PHCs (p=0.003). Service quality however did not serve as an intervening variable between internal service factors (service provider, service process, and service environment) and behavioural loyalty of patients, with p=0.091, p=0.230 and p=0.260, respectively. Conclusions: Service provider and service environment are two main factors that influence the service quality and the service quality directly influence the behavioural loyalty on PHC users. Therefore, to increase the patients’ loyalty to use the PHC services, the quality of the services should be improved by levelling up the quality of providers and both physical and social environments in the PHCs.
Analysis on short-term outcomes of patients with thoracic trauma at dr. Zainoel Abidin General Hospital in Banda Aceh
Authors: Habibie Yopie Afriandi , Anisa Widya , Nurkhalis Nurkhalis , Azharuddin Azharuddin , Ridwan Muhammad 
Published: April 2022

Background: Thoracic trauma is defined as a trauma that hits the chest wall directly or indirectly, either as a result of blunt or penetrating trauma. Thoracic trauma can occurred in any age or genders, and become a life-threatening if the treatment isn’t immediate and appropriate. Methods: This research was an observational study with a cohort retrospective design using secondary data in the form of thoracic trauma patients at The Zainoel Abidin General Hospital, Banda Aceh, Indonesia in the period January 2019- December 2020. The statistical analysis used were chi square for bivariate and multivariate analysis, spesifically logistic regression analysis was conducted to know which risk factor influences the most. Result: There were 141 medical records used in this study, thoracic trauma was more common in men compared to women. The age group of 46-55 is the age group with the highest percentage of thoracic trauma patients, road traffic are the leading cause of thoracic trauma where the most common diagnosis is rib fractures. Significant factors that associated with the short outcome of thoracic trauma are thoracic trauma diagnosis (p=0,00), management of thoracic trauma (p=0,00), ventilator (p=0,04), duration of ventilator (p=0.01), sepsis (p=0,00), qSOFA score (p=0,00) and injury severity score (p=0,00). Conclusions: Motorbike accidents contributed to a considerable number of traumatic chest injuries in this study. Diagnosis, management of trauma, days of ventilation, qSOFA score, injury severity score, and development of sepsis were associated with the short-term outcome among thoracic trauma patients. Injury severity score seems to be the most influential variable in this study, the lower the better it is. Road safety intervention is urgently needed to control the underlying problems in this study.
PEMBELAJARAN CREATIVE PROBLEM SOLVING: PENGARUHNYA TERHADAP HASIL BELAJAR MATEMATIKA DI ERA COVID-19
Authors: Feriansyah Feriansyah , Ifriyanti Syofnidah , Suherman Suherman 
Published: April 2022

Penelitian ini dilatarbelakangi oleh permasalahan terkait diketahui bahwa masaih banyak peserta didik yang mendapatkan nilai di bawahÂ kriteria ketuntasan minimal (KKM) dalam masa PANDEMI COVID-19. Hal itu juga dibuktikan dengan rendahnya kemampuan siswa dalam melakukan pemecahan masalah matematika yang telah diuji cobakan pada awal prapenelitian. Berdasarkan hal tersebut salah satu model pembelajaran yang dapat digunakan untuk mengasah kreatifitas siswa dalam menyelesaikan persoalan matematikaÂ adalah Creative Problem Solving. Tujuan dari penelitian ini untuk mengetahui pengaruh model pembelajaran Creative Problem Solving terhadap hasil belajar matematika. Penelitian ini merupakan penelitian kuantitatif. Desain yang digunakan Quasi Eksperimen.Teknik analisis dat menggunakan soal Tes Essay dengan materi FPB dan KPK. Analisis data menggunakan uji homogenitas dan normalitas, serta uji hipotesis menggunakan uj-t.Â Hasil penelitian menunjukkan bahwa thitung>ttabel = 2,595 > 2,158 atauÂ sig (2-tailed) sebesar 0,000 < 0,05. Hal iniberarti terdapat pengaruh model pembelajaran creative problem solving terhadap hasil belajar Matematika
PENGEMBANGAN MEDIA FUN THINKERS DALAM MELATIH KETERAMPILAN MENULIS KARANGAN SISWA KELAS V SEKOLAH DASAR
Authors: Sukma Hanum Hanifa , Amalia Nur Rizky 
Published: April 2022

Penelitian ini bertujuan untuk dapat membuat keterampilan menulis karangan narasi peserta didik menjadi lebih baik. Media Fun Thinkers harus diuji kelayakannya dengan melakukan uji coba validasi oleh tiga dosen ahli, yaitu ahli media, ahli materi, dan ahli pembelajaran. Penelitian ini merupakan penelitian Research and Development (RnD) dengan menggunakan model pengembangan Analys, Design, Development, Implementation, Evaluation (ADDIE). Teknik dalam penelitian ini adalah observasi dan angket. Teknik analisis data menggunakan analisis data kualitatif untuk mengolah data berdasarkan komentar atau saran dari para ahli serta analisis data kuantitatif untuk mengetahui kualitas produk. Hasil yang didapatkan pada penelitian dari hasil uji coba validasi yaitu ahli media 100 dengan kriteria â€œBaik Sekaliâ€, ahli materi 80 dengan kriteria â€œBaik Sekali, dan ahli pembelajaran 80 dengan kriteria â€œBaik Sekaliâ€. Hasil uji coba validasi ahli tersebut menunjukkan bahwa media Fun Thinkers layak untuk digunakan dalam proses pembelajaran khususnya pada keterampilan menulis karangan narasi peserta didik kelas V Sekolah Dasar. Â Â
Penilaian Autentik Berbasis HOTS Terintegrasi Karakter
Authors: Ngazizah Nur , Rahmawati Rahmawati , Suprayitno Suprayitno , Hastono Widi 
Published: April 2022

Kurikulum 2013 merupakan kurikulum dengan penilaian autentik yang menyeluruh. Penerapannya juga dituntut untuk menggunakan keterampilan berpikir tingkat tinggi serta karakter peserta didik. Permasalahan yang muncul yaitu di SD belum mengadakan penilaian untuk mengukur kemampuan tersebut. Oleh sebab itu, dilakukan pengembangan dengan tujuan: 1.) mengembangkan instrumen penilaian autentik berbasis HOTS yang terintegrasi karakter yang layak digunakan, 2.) kelayakan instrumen penilaian,. Model penelitian yang digunakan yaitu dengan model penelitian 4-D (Define, Design, Development, dan Dessiminate). Pengumpulan data diperoleh menggunakan angket, wawancara, dan observasi. Teknik analisis data yang digunakanÂ yaitu analisis uji validitas, reliabilitas, Berdasarkan penelitian dapat disimpulkan: 1.) Dihasilkan instrumen penilaian autentik berbasis HOTS terintegrasi karakter, 2.) Hasil validasi data secara keseluruhan mendapatÂ nilai 3,61 dengan kategori sangat layak serta mendapatkkan nilai 95,3 % pada uji reliabilitas dalam Pesentage Agreement sangat reliable.