bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Mitochondrial Genome Arrangement of Labeorohita with Some Selected Vertebrae Species.
Authors: Bari Khandakar Arshadul , Jahan Associate Professor Hawa , Alam Professor Mohammad Shamimul , Shahjahan Professor Dr. Reza Md. , Begum Professor Dr. Rowshan Ara
Published: April 2024

The mitochondrial genome of Labeorohita serves as a microcosm for exploring genetic diversity and evolutionary relationships within vertebrates. Through comprehensive analysis of the mitochondrial genome, encompassing 37 genes including protein-coding genes (PCGs), transfer RNA (tRNA), and ribosomal RNA (rRNA), we elucidated its organization and compared it with other vertebrate taxa. Our investigation revealed a compact mitochondrial genome of approximately 16 kb, comprising 13 PCGs, 22 tRNA genes, and 2 rRNA genes, with a distinctive dispersed loop region (D-loop). Notably, the arrangement of PCGs formed three distinct clusters, shared across Labeo species, suggesting evolutionary conservation within the genus. Comparative analyses with other osteichthyes species corroborated this conservation, underscoring L. rohita‘s representative status within the class. Furthermore, comparisons with chondrichthyes, lungfish, amphibians, reptiles, birds, and mammals unveiled evolutionary trends in mitochondrial genome organization. Noteworthy findings include the unique replication origin in lungfish and amphibians, and transposition events in birds. Phylogenetic reconstructions based on mitochondrial gene sequences affirmed the close relationship between lungfish and amphibians, supporting lungfish as the closest relatives of class Amphibia. In summary, our study provides comprehensive insights into the mitochondrial genome organization of L. rohita and its implications for vertebrate evolution. The findings contribute to a deeper understanding of genetic diversity and evolutionary relationships within vertebrates, with potential applications in taxonomy, conservation, and evolutionary biology.
Çözüm Odaklı Kısa Süreli Grupla Psikolojik Danışmanın Parçalanmış Aileye Sahip Ergenlerin Kaygı ve Umutsuzluk Düzeyleri Üzerindeki Etkisi
Authors: Yıldırım Oğuzhan , Koser İlknur Ezgi , Kumcağız Hatice
Published: April 2024

Bu araştırmada çözüm odaklı kısa süreli yaklaşıma dayalı grupla psikolojik danışmanın parçalanmış aileye sahip ergenlerin kaygı ve umutsuzluk düzeyleri üzerindeki etkisini incelemek amaçlanmıştır. Araştırmada ön test - son test kontrol gruplu yarı deneysel desen kullanılmıştır. Araştırmanın deney süreci için araştırmacılar tarafından çözüm odaklı kısa süreli yaklaşıma dayalı olarak 8 oturumluk grupla psikolojik danışma programı hazırlanmıştır. Araştırmanın çalışma grubunu bir devlet ortaokulunda eğitim gören ve parçalanmış aileye sahip olan 18 ergen oluşturmaktadır. Ergenlerden 9’u deney grubuna 9’u kontrol grubuna eşleştirilerek atanmıştır. Uygulamaya başlamadan önce her iki gruba “Beck Anksiyete Ölçeği” ile “Beck Umutsuzluk Ölçeği” ön test olarak uygulanmıştır. Deney grubuna 8 haftadan oluşan grupla psikolojik danışma uygulaması yapılırken kontrol grubuna herhangi bir müdahalede bulunulmamıştır. Uygulamanın ardından her iki gruba aynı ölçekler son test olarak uygulanmıştır. Araştırma verilerinin analizinde Bağımsız Örneklemler t-testi ile İlişkili Örneklemler t-testi uygulanmıştır. Araştırmanın sonucuna göre çözüm odaklı kısa süreli yaklaşıma dayalı grupla psikolojik danışmanın parçalanmış aileye sahip ergenlerin kaygı ve umutsuzluk düzeyini azaltmada etkili olduğu görülmüştür. Alan araştırmacılarına ve okul psikolojik danışmanlarına önerilerde bulunulmuş ve araştırmanın bulguları ergenlik dönemi, aile ve okul psikolojik danışmanlığı açısından tartışılmıştır.
PENGARUH SENAM YOGA TERHADAP PENURUNAN INTENSITAS DYSMENORRHEA PADA SISWI SMA ISLAM PUJON KABUPATEN MALANG
Authors: Tarinda Nadia Eva , Alfitri Rosyidah , Ilmiah Widia Shofa
Published: April 2024

Pendahuluan: Banyak perempuan yang mengalami masalah saat menstruasi dan salah satunya adalah nyeri haid. Nyeri haid sebagai suatu kondisi yang umum dialami remaja perempuan yang sudah mendapatkan menstruasi. Dysmenorrhea bisa menyebabkan ketidaknyamanan dalam aktivitas fisik sehari-hari. Penelitian ini bertujuan menganalisis pengaruh senam yoga terhadap penurunan intensitas dysmenorrhea sebelum dan sesudah diberikan dan yang tidak diberikan senam yoga pada siswi SMA Islam Pujon Kabupaten Malang. Metode: Penelitian menggunakan quasi eksperimental dengan pendekatan pretest-posttest control group design. Populasi penelitian adalah siswi SMA Islam Pujon Kabupaten Malang dengan jumlah sampel 32 orang. Pengambilan sampel menggunakan quota sampling dengan instrumen penelitian skala nyeri Universal Pain Asessment Tool. Teknik analisis uji Wilcoxon. Hasil: Hasil penelitian menunjukkan bahwa kelompok eksperimen sebelum dilakukan senam yoga hampir setengahnya mengalami nyeri sedang 43,7% dan setelah diberi senam yoga nyeri yang dirasakan sebagian besar mengalami nyeri ringan 56,3% dan hampir setengahnya tidak nyeri 43,7%. Kelompok kontrol didapatkan hampir setengahnya mengalami nyeri sedang 43,7% dan setelahnya nyeri yang dirasakan sebagian besar mengalami nyeri ringan 75%. Hasil uji Wilcoxon didapatkan p-value 0,004 < 0,05 artinya terdapat pengaruh senam yoga terhadap penurunan intensitas dysmenorrhea pada siswi SMA Islam Pujon Kabupaten Malang. Kesimpulan: Senam yoga efektif dalam meminimalisir nyeri haid pada remaja.
Kata kunci: dysmenorrhea, remaja, senam yoga
HUBUNGAN ANTARA WAKTU LAMA PUASA DENGAN KEJADIAN MUAL MUNTAH PADA PASIEN POST OPERASI DI RSUD PIRU KABUPATEN SERAM BAGIAN BARAT
Authors: Timbu Aloysius , Zakaria Amin , Negoro Widigdo Rekso , Suryanto Suryanto
Published: April 2024

Pendahuluan: Post Operative Nausea and Vomiting (PONV) merupakan pengalaman yang tidak menyenangkan selama masa postoperasi pada 24-48 jam, yang menyusahkan bagi pasien dan dapat memperpanjang masa tinggal, serta meningkat resiko komplikasi pasca operasi. Puasa sebelum operasi diperlukan untuk meminimalkan risiko aspirasi selama prosedur anestesi. Tujuan penelitian ini adalah menganalisa hubungan antara waktu lama puasa dengan kejadiaan mual dan muntah pada pasien post operasi.  Metode: Jenis penelitian ini adalah analisa korelasi dengan desain cross-sectional. Populasi pasien di unit anestesi yang menjalani seksio sesaria dengan anestesi SAB spinal. Sampel berjumlah 64 metode konsekutif sampling periode bulan April 2023. Variable bebas waktu lama puasa  dan variable terikat kejadian mual dan muntah yang diukur menggunakan lembar observasi,  Skala data rasio dan analisa data menggunakan uji korelasi one way anova dengan data berpasangan. Hasil: Hasil uji hipotesis hubungan antara lama puasa dengan kejadian mual dan muntah pada pasien operasi sexcio caesarea dengan spinal anestesi didapatkan nilai significan 0.23 yang berarti tidak ada hubungan antara lama puasa dengan kejadian mual dan muntah pada pasien dikarenakan kejadian mjual dan muntah paska operasi dengan spinal anastesi kemungkinan disebabkan oleh faktor lain yaitu: hipotensi mengakibatkan hipoperfusi, aerophagi, pemberian obat, teknik operasi (banyak manipulasi organ usus, dan faktor-faktor lainnya. Kesimpulan: Bagi peneliti berikutnya menganalisa hubungan kejadian mual muntah pada faktor yang lain atau mengendalikan variabel perancu.
Kata kunci: Lama Puasa, Post Operative, Nausea and Vomiting
HUBUNGAN ANTARA TINGKAT NYERI DENGAN KEMAMPUAN AKTIVITAS PADA PASIEN POST OPERASI SECTIO CAESAREA DENGAN ANESTESI SPINAL
Authors: Yusuf Muhammad , Suryanto Suryanto , Umifa Kaslinda Nur , Zakaria Amin
Published: April 2024

Pendahuluan: Nyeri post operasi sectio caesarea akan menyebabkan terbatasnya mobilisasi karena intensitas nyeri. Rasa nyeri yang signifikan dapat membuat seseorang merasa sulit untuk bergerak dengan bebas dan melakukan aktivitas yang memerlukan penggunaan otot perut dan panggul. Tujuan penelitian ini yaitu menganalisa hubungan  antara tingkat nyeri  dengan  kemampuan aktivitas  pada pasien post operasi sectio caesarea dengan anestesi spinal. Metode: Jenis penelitian analisa korelasi dengan desain cross-sectional pada populasi pasien diunit recovery room 24 jam paska operasi, kuota sampling dengan 30 responden. Variable bebas yaitu tingkat nyeri dan variable terikat kemampuan melakukan aktifitas. Tingkat nyeri yang diukur menggunakan lembar observasi skala nyeri numeric rating scale,  skala data rasio. Kemampuan melakukan aktifitas diukur dengan lembar observasi yaitu kemampuan duduk, berdiri dan kemampuan berjalan. analisa data menggunakan uji korelasi pearson, menggunakan komputer bantuan aplikasi SPSS 22. Hasil: Ada hubungan antara tingkat nyeri dengan kemampuan aktifitas pasien post operasi SC dengan anestesi spinal. Hubungannya negative yaitu semakin tinggi tingkat nyeri maka kemampuan aktifitas semakin rendah. Tingkat hubungannya sangat kuat yaitu dengan  nilai -0,886. Kesimpulan: Untuk mampu melakukan aktifitas berjalan, minimal rasa nyeri sedang sehingga pasien perlu diturunkan tingkat nyerinya pada tingkat sedang dan ringan agar mampu melakukan aktifitas berjalan.
Kata Kunci : Nyeri, Kemampuan Aktivitas, Anastesi Spinal, Sectio Caesarea
Survey on the Patterns of Feeding Difficulties and Behaviors in Filipino Children with Autism Spectrum Disorder Seen in a Philippine Tertiary Hospital and the Impact of the COVID-19 Pandemic
Authors: Fernandez, MD Francesca Antonina Jiao , Quilendrino, MD Maria Isabel O. , Borlongan, MSc Martin Augustine B.
Published: April 2024

Objective. To describe patterns of feeding difficulties and behaviors of Filipino children diagnosed with Autism Spectrum Disorder (ASD).
Methods. An electronic mealtime survey was administered to caregivers of 3- to 9-year-old children diagnosed with ASD in a Philippine tertiary government hospital. Descriptive statistics and correlation analyses between feeding difficulties measured as Mealtime Survey Score, sociodemographic data, and early feeding history were performed. The impact of the COVID-19 pandemic to these was analyzed through a binomial test.
Results. All of the 115 study subjects reported at least one problematic feeding behavior, with picky eating being the most frequent (61.74%). Significantly, more feeding difficulties were observed among the children with reported early feeding difficulties during their 2nd and 3rd year of life. There were no documented statistically significant changes in feeding behaviors during the past six months of the COVID-19 pandemic.
Conclusion. There is a high prevalence of feeding difficulties and problematic feeding behavior among Filipinochildren with ASD, however no significant changes to these during the past six months of the COVID-19 pandemic were documented. Present feeding difficulties and behaviors were associated with history of early feeding difficulties, highlighting the need to include feeding difficulties in screening tools, and early training programs and interventions for children with ASD.
Intracerebral Hemorrhage in a Child with Renal Artery Stenosis and COVID-19
Authors: Filomeno, MD Paul Lawrence C. , Tiam-Lee, MD Joyce Gillian A. , Reyes, MD Bryan Nicole M. , Dorado, MD Jonah Mikka B. , Pimentel, MD Ma. Micaela Therese J. , Lukban, MD Marissa B.
Published: April 2024

Pediatric intracerebral hemorrhage is a rare condition among children. We discuss the case of a 7-year-old Filipino male with generalized tonic seizures and diagnosed to have both SARS-CoV-2 infection and hypertension secondary to renal arterial stenosis. The occurrence of intracerebral hemorrhage in children, though commonly caused by arteriovenous malformations, may be secondary to an acute hypertensive episode. In this case, the presence of COVID-19 in the patient may have been contributory to the development of spontaneous intracerebral hemorrhage due to its direct endothelial effects, as well as its dysregulatory action on the renin-angiotensin-aldosterone system.
Factores relacionados a la recurrencia después de la lesión del núcleo subtalámico para el tratamiento de la enfermedad de Parkinson
Authors: Vilela Filho Osvaldo , Silva Delson J.
Published: April 2024

La recurrencia se produjo en 3 de nuestros 54 pacientes que se sometieron a lesión del núcleo subtalámico por presentar la enfermedad de Parkinson. En un intento por determinar si existe algún elemento relacionado con la recurrencia, los pacientes fueron divididos en dos grupos: aquellos con recurrencia (n = 3) y aquellos con resultados estables (n = 51) después de un período de seguimiento de 4 a 102 meses, y se los comparó respecto a los siguientes parámetros: los parámetros de la lesión, los diámetros de la lesión, el aspecto de la lesión en la secuencia ponderada en T2 de la RMN posoperatoria temprana y el territorio del núcleo subtalámico afectado por la lesión. Los diámetros y los parámetros de la lesión fueron similares en ambos grupos. El compromiso exclusivo del territorio central del núcleo subtalámico y las lesiones con aspecto hiperintenso en la secuencia en T2 de la RMN posoperatoria temprana se presentaron sólo en los pacientes con recurrencia de la enfermedad. Los autores concluyen que estos dos hallazgos probablemente deberían ser considerados como factores de mal pronóstico en la evolución de los pacientes con enfermedad de Parkinson a quienes se realizó lesión del núcleo subtalámico.
Desde agosto de 1999 hasta octubre de 2007 hemos realizado lesión del núcleo subtalámico para el tratamiento de la enfermedad de Parkinson (EP) en 54 pacientes. La tasa de recurrencia fue del 5,6% (en 3 de 54 pacientes) dentro del primer mes posoperatorio en todos los pacientes. En este trabajo los autores intentan determinar si hay algún factor relacionado a la recurrencia.
Tech Business Analytics in Quaternary Industry Sector
Authors: Kumar Sachin , K. Krishna Prasad , Aithal P. S.
Published: April 2024

Purpose: The knowledge-based segment of the economy is referred to as the "quaternary sector," which comprises businesses like information technology, telecommunications, research and development, and other professional services. Businesses in this industry may find that technology-driven business analytics greatly aids in helping them to make data-driven decisions, optimize workflows, and enhance overall performance. Utilizing technology to analyse business analytics can significantly improve market trends, consumer behaviour, and an organization's operational performance. Through analysis of this data, companies can make more informed decisions that support expansion and competitiveness. Analytics tools assist companies in identifying inefficiencies in their processes and operations so they can make changes that reduce expenses, boost output, and ultimately boost revenue. Customer loyalty and satisfaction may rise as a result of this. Information regarding emerging technologies and their integration with data science and business analytics may support to prediction of market trends and could present companies with chances for growth and innovation. Methodology: There are particular potential and challenges for business analytics in the Quaternary industry sector because of its emphasis on knowledge-based activities, innovation, and cutting-edge technology. Here, we present a methodical strategy for using technology for analytics in this industry, allowing businesses to obtain useful information for long-term planning calculations. This approach gives businesses in the Quaternary industry sector a methodical framework for utilizing technology-driven analytics. This framework helps them obtain competitive advantages in an increasingly data-driven business environment by helping them access important insights and spur innovation. Findings/Result: The study looks at how digital business analytics have been used to control growth in the Quaternary sector from the birth of the industry to the present. Originality/Value: An explanation of how tech business analytics differs from traditional business analytics within the Quaternary industry. It also includes a general design that can be used for technical purposes, and it examines thirty recently submitted research recommendations related to Tech Business Analytics in Quaternary industries. Paper Type: Exploratory research.
How Language Gaps Constrain Generative AI Development
Authors: Ta Regina , Lee Nicol
Published: April 2024

Prompt-based generative artificial intelligence (AI) tools are quickly being deployed for a range of use cases, from writing emails and compiling legal cases to personalizing research essays in a wide range of educational, professional, and vocational disciplines. But language is not monolithic, and opportunities may be missed in developing generative AI tools for non-standard languages and dialects. Current applications often are not optimized for certain populations or communities and, in some instances, may exacerbate social and economic divisions. As noted by the Austrian linguist and philosopher Ludwig Wittgenstein, “The limits of my language mean the limits of my world.” This is especially true today, when the language we speak can change how we engage with technology, and the limits of our online vernacular can constrain the full and fair use of existing and emerging technologies.
TRANSFORMATION OF THE RUSSIAN OIL INDUSTRY IN 2022-2023
Authors: Yushkov I. V.
Published: April 2024

The article examines the state of Russia’s oil industry over the period 2022 and 2023 as geopolitical changes shifted from one year to the next. The author notes that despite the sanctions pressure, Russia has successfully managed to reorient its oil markets towards Asia. Exports to India are the most actively developing; the ease of transition was due, among other things, to the availability of ready-made business in India: new refineries were built on the coast, for which oil was purchased from the nearest markets. In 2022-2023, India became the largest market for Russian oil delivered by sea. As for supplies via oil pipelines, China remains the largest consumer. Under these conditions, Russian companies have an opportunity use the competition between the countries to their advantage by reducing the discount on their products.

The USA used to be the biggest buyer of Russian oil products until 2022, currently this role is taken by Turkiye. The state buys large volumes from Russia and then resells similar volumes to the EU countries. Despite the statements about different origin of oil products, formally the volumes of purchases and sales coincide.

A significant role in the supply of Russian resources by sea is played by the shadow fleet, which began operating after the introduction of the «price ceiling». The fleet’s tankers have been bought off the world market by various companies that are registered offshore.

There has been no reduction in production and exports due to technical problems caused by sanctions on the supply of equipment and technologies to Russia, or due to the withdrawal of Western oil service companies. Domestic structures quickly managed to establish a system of parallel imports, as well as to find alternative equipment in China.
RUSSIAN-MONGOLIAN RELATIONS: A NEW STAGE
Authors: Egorov V. G. , Belonogova A. A.
Published: April 2024

The article characterizes the current stage of Russian-Mongolian cooperation, reveals the factors and conditions that determined the new stage of bilateral interaction after 2010. The development of cooperation is conditioned by the needs of regional interaction and the need to solve the problems of internal socio-economic process of Russia and Mongolia. The authors note that the expansion of trade and economic relations with Russia is important for Mongolia for several reasons, including diversification of the public economy, prevention of unipolar orientation of foreign economic activity and the need to solve internal socio-economic problems. The article emphasizes Mongolia’s transit potential and its role in Russia-China relations.

The authors separately note that Mongolia faces economic development challenges, including low GDP and high unemployment. In this regard, the Mongolian government is implementing policies and programs aimed at economic development, employment and reducing unemployment and poverty.

The intensification of relations between the two countries in the context of Russian interests contributes to the expansion of functional geopolitical space, helps to overcome the artificial isolation constructed by the West, as well as increases the transit opportunities for Russia.
Metabolic syndrome in children and adolescents
Authors: Shim Young Suk , Lee Hae Sang , Hwang Jin Soon
Published: April 2024

Background: Metabolic syndrome is a serious condition associated with multiple diseases. The prevalence of metabolic syndrome is increasing caused by an increase in obesity rates among children and adolescents.Current Concepts: Owing to the various definitions used, there is lack of consensus regarding the diagnostic criteria for metabolic syndrome in children and adolescents. Although the exact pathogenesis remains unclear, insulin resistance and subsequent inflammation are key mechanistic contributors. Metabolic syndrome is characterized by overweight and obesity accompanied by abnormalities in glucose metabolism, dyslipidemia, and hypertension and is associated with other conditions such as fatty liver, polycystic ovary syndrome, and a pro-inflammatory state. Prevention and management of metabolic syndrome can be achieved through lifestyle modifications, behavioral interventions, pharmacotherapy, and surgical interventions.Discussion and Conclusion: Childhood and adolescent obesity serves as a risk factor for metabolic syndrome during later life. Early identification and intervention are important to prevent the progression of metabolic syndrome. Clinicians must identify at-risk children and adolescents and provide guidance for the prevention and management of metabolic syndrome.
Medical treatment of pediatric obesity
Authors: Chung Yoojin Lindsey
Published: April 2024

Background: The increasing prevalence of pediatric obesity over the past few decades has become a serious public health concern. Quarantine measures during the coronavirus disease pandemic have led to an increase in childhood obesity rates. Children with obesity are at greater risk for type 2 diabetes, hypertension, dyslipidemia, polycystic ovary syndrome, obstructive sleep apnea, and adult obesity. Lifestyle modification therapy is the firstline treatment for pediatric obesity. Pharmacotherapy is the next logical treatment option in patients in whom lifestyle modifications alone are ineffective.Current Concepts: Anti-obesity medications for pediatric obesity include metformin, orlistat, glucagon-like peptide-1 agonists, phentermine, and phentermine/topiramate combination. Metformin, a medication used for type 2 diabetes has not been approved for treatment of pediatric obesity. Orlistat, a lipase inhibitor, prevents fat absorption from the human diet. Liraglutide, a glucagon-like peptide-1 agonist, is associated with decreased gastric emptying, increased satiety, and appetite suppression. Phentermine, a norepinephrine reuptake inhibitor, is approved by the Food and Drug Administration for short-term treatment of patients aged >16 years. Phentermine/topiramate is a combination of the conventional anti-obesity medication, phentermine and an antiepileptic agent, topiramate that is commonly associated with weight loss as an adverse effect.Discussion and Conclusion: Anti-obesity treatment may serve as the next logical therapeutic option for pediatric obesity. However, sufficient lifestyle modification therapy should be attempted before considering medication, and anti-obesity medications should preferably be used in combination with lifestyle modifications. Monitoring growth and pubertal development during anti-obesity treatment is essential to ensure healthy development of children and adolescents.
Link between obesity and growth in children and adolescents
Authors: Lee Hae Sang
Published: April 2024

Background: The increasing prevalence of childhood obesity is a global problem. Childhood obesity is associated with an increased risk of several metabolic complications such as insulin resistance, impaired glucose tolerance, and type 2 diabetes mellitus (T2DM). Moreover, childhood obesity plays a significant role in growth patterns.Current Concepts: Growth during childhood and adolescence is influenced by multiple factors, including genes, hormones, and environmental aspects. Excess adiposity can influence growth velocity and final adult height owing to changes in several hormonal parameters such as insulin, leptin, and ghrelin.Discussion and Conclusion: Obese children typically exhibit a tall stature during the prepubertal and pubertal periods, which resolves later in adolescence. In addition, increased obesity in children precedes advancements in skeletal maturation and leads to earlier onset of puberty. Although potential mechanisms have been hypothesized, those underlying the putative association between childhood obesity and growth remain unclear. Further studies are required to gain insight into the mechanisms underlying the growth patterns in children and adolescents with obesity.
Diabetic ketoacidosis in type 1 diabetes mellitus in children and adolescents
Authors: Kim Minsun
Published: April 2024

Background: Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (T1DM). Although T1DM can occur in children and adults, DKA caused by T1DM is more severe in children and adolescents and metabolic changes occur more rapidly. This review discusses clinical factors associated with DKA assessed during diagnosis in children and adolescents with T1DM.Current Concepts: DKA is a severe complication that can occur in children with T1DM because of insulin deficiency, leading to high levels of catabolism with increased gluconeogenesis, glycogenolysis, lipolysis, muscle proteolysis, hyperglycemia, and osmotic diuresis. High levels of counterregulatory hormones that enhance ketogenesis have also been noted. High blood sugar levels, dehydration, and the release of ketone bodies into the circulation cause high occurrence of acidosis. DKA can lead to life-threatening complications, such as cerebral edema, which is more common in children than in adults. Other potential complications include kidney failure, respiratory distress, and cardiovascular collapse. Children with T1DM are at a higher risk of developing DKA, particularly during times of illness or stress, or when insulin doses are missed or insufficient. In addition, undiagnosed T1DM in children can lead to DKA when the body enters a state of severe insulin deficiency.Discussion and Conclusion: The risks should be detected earlier and the pathogenesis of T1DM should be understood and assessed by physicians in children and adolescents during check-ups. Furthermore, efforts to increase public awareness are required to reduce the cognitive delays associated with DKA.
Characteristics and management of juvenile type 2 diabetes mellitus
Authors: Rhie Young-Jun
Published: April 2024

Background: Over the past two decades, there have been numerous reports on the increasing incidence of type 2 diabetes mellitus (T2DM) in children and adolescents. This trend, which parallels the increase in the prevalence and degree of pediatric obesity, is causing significant concern. This review focuses on the characteristics andcurrent management strategies for juvenile patients with T2DM. Current Concepts: Juvenile T2DM differs from type 1 diabetes mellitus (T1DM) in children and T2DM in adults as it is an aggressive disease with rapidly progressive β-cell decline, high treatment failure rate, and accelerated development of complications. Current management approaches include lifestyle changes such as improved diet and increased physical activity, and pharmacological interventions such as metformin, insulin, and liraglutide.Discussion and Conclusion: Early diagnosis and prevention of T2DM in children and adolescents are essential. Furthermore, compared to adults, there is still a lack of available treatment drugs or research in children and adolescents. Therefore, long-term research on the efficacy and safety of various drug treatments for T2DM in children and adolescents is required. Additionally, as it is often asymptomatic in its early stages, significant efforts by physicians are required for the early diagnosis and prevention of T2DM.
Diagnosis and treatment of dyslipidemia in children and adolescents
Authors: Park Su Jin
Published: April 2024

Background: Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality worldwide, including in South Korea. Dyslipidemia is an independent risk factor for the development of atherosclerotic cardiovascular diseases. There is strong evidence that atherosclerosis begins early in life and that elevated lipid levels in childhood predict elevated lipid levels into adulthood.Current Concepts: A universal approach for cholesterol screening in all children is recommended. Lipid profiles should be studied for all children aged 9 to 11 years and then for those aged 17 to 21 years, as cholesterol levels may vary after puberty. The non-fasting lipid profile can be as useful in detecting severe genetic dyslipidemias as the fasting lipid profile and thus can be used as a first-line screening in children. The initial treatment for dyslipidemia in a child always begins with a 6-month trial of lifestyle modifications, such as improvements in dietary and physical activity patterns. Statins are as effective in children as in adults and can lower low-density lipoprotein cholesterol levels by up to 50%. Therefore, they are considered first-line therapy for children who meet the criteria for pharmacological therapy.Discussion and Conclusion: Statins and non-statin lipid-lowering agents can lower cholesterol levels with minimal adverse effects in children and adolescents with hypercholesterolemia. However, limited data is currently available on the long-term safety and efficacy of lipid-lowering agents in the pediatric population. Furthermore, non-statin lipid-lowering agents are used far less frequently in children. Therefore, further long-term safety and efficacy studies on lipid-lowering agents in pediatric populations and clinical trials with non-statin lipid-lowering agents are required.
Clinical features and treatment of rosacea
Authors: Shin Min Kyung
Published: April 2024

Background: Rosacea is a common facial dermatological disease characterized by central erythema and flushing. It is more common in females than males, with a prevalence of approximately 5.5% in the global population and 2.4% among all dermatological outpatients. In 2002, the National Rosacea Society Expert Committee suggested a subtype-based standardized classification system. The most common subtype of rosacea is erythematotelangiectatic rosacea (ETR), followed by papulopustular rosacea (PPR), phymatous rosacea, and ocular rosacea.Current Concepts: Rosacea is characterized by hyperactive innate and neurovascular immune reactions, which lead to altered adaptive immune reactions and hyperreactive inflammation. In 2017, the National Rosacea Society Expert Committee developed a phenotype-based classification system. The diagnostic features include persistent centrofacial erythema and phymatous changes. ETR is associated with sensitive skin and may have a debilitating psychological impact, often leading to psychological conditions such as depression and anxiety. Doxycycline and minocycline are considered the gold-standard oral treatments for rosacea. Topical ivermectin and metronidazole are commonly used to treat PPR. Low-dose isotretinoin is an alternative to avoid long-term chronic antibiotic use. Carvedilol and propranolol are off-label medications used to reduce persistent facial flushing and erythema in rosacea. Some alpha-adrenergic receptor agonists have also been approved for the treatment of persistent erythema in rosacea.Discussion and Conclusion: Rosacea exhibits multiple phenotypic manifestations. The treatment approach is individualized for each patient through the customization of multimodal treatments, including the avoidance of trigger factors and the assessment of comorbid diseases.
Profiling consumers’ online shopping and following social media influencers behaviors
Authors: Wu Ming-Yi
Published: April 2024

In order to develop effective digital marketing strategies, this study explores how demographic factors may affect consumers’ online shopping and following social media influencers behaviors.  Market segmentation theory and consumer demographics theory provide the theoretical foundation for this study.  By analyzing survey data collected from 6,034 U.S. adults with decision tree analysis, there are a number of significant findings.  First, educational level, income, and age category are the important predictors for consumers’ buying things online using a desktop or laptop computer behavior.  Second, age category, geographic location (urban, suburban, rural) are the predictors for consumers’ buying things online using a smartphone behavior.  Third, educational level, age, and geographic location are the predictors for consumers’ preferring online shopping over in-store shopping behavior.  Fourth, age category and race-ethnicity are the predictors for following social media influencers behavior.  Fifth, gender and age category are the predictors for purchasing something after seeing an influencer’s posts behavior.  Finally, age category and gender are the predictors for purchase decisions getting impacted by influencers.  The results provide valuable insights about consumer behaviors online, market segmentation, and influencer marketing strategies.
Islamic Boarding School-Based School Human Resource Management In Shaping Student Character
Authors: Bahri Syamsul
Published: April 2024

The purpose of this article is to investigate the methods of character development that can be used in extracurricular, cocurricular, and extracurricular activities in kindergarten–12 schools. This pesantren-based school has an advantage since it preserves the unique pesantren culture as an educational establishment whose primary goal is to inculcate religious principles to shape the morality of the country's youth. This study is a sort of qualitative research that is part of a descriptive research study that uses a case study methodology. The SMAN 1 WAJO is the study's location. Documentation, structured interviews, and participant observation were used to gather data. The study's findings indicate that: (1) SMAN 1 WAJO carefully planned its character development program, beginning with the creation of its vision, mission, and goals; (2) integrated character development through extracurricular, cocurricular, and intracurricular activities, including flagship programs like the English Club, Qiro 'Wal Hufadz, and the Yellow Book Study; and (3) monitored and evaluated through the following methods: (1) development of agreed-upon character value indicators; (2) compilation of assessment instruments; (3) summary of indicator achievements; (4) analysis and evaluation; and (5) follow-up.
MANEJO CLÍNICO DA DERMATITE ATÓPICA EM LACTENTES E CRIANÇAS: ATUALIZAÇÕES E RECOMENDAÇÕES
Authors: Santos Cirlene Luciana Ramalho dos , Pestana Clara Mariana Dias , Tischner Nathalia , Nava Silvia Luana Rodrigues , Paiva Kelly Cristine Lyra de , Populin Nicole Aparecida dos Santos , Conceição Damaris Rodrigues da , Assunção Iris Beatriz Pinheiro de Oliveira , Sady Louise Mota da Rocha , Saraiva Ana Flávia Fernandes
Published: April 2024

A dermatite atópica é uma doença inflamatória crônica da pele que afeta principalmente lactentes e crianças, caracterizada por prurido intenso e lesões cutâneas. Este resumo aborda as atualizações e recomendações para o manejo clínico da dermatite atópica nesse grupo populacional. As estratégias de tratamento incluem medidas gerais de cuidados com a pele, como hidratação regular e o uso de emolientes, além de evitar fatores desencadeantes, como irritantes e alérgenos. A educação do paciente e dos familiares desempenha um papel fundamental na compreensão da doença e na adesão ao tratamento. O uso de corticosteroides tópicos é a principal terapia para controlar a inflamação cutânea, sendo essencial escolher a formulação e a potência adequadas de acordo com a gravidade da doença e a idade do paciente. Alternativas terapêuticas incluem imunomoduladores tópicos, como tacrolimo e pimecrolimo, particularmente úteis em áreas sensíveis e no tratamento de exacerbações agudas. Para casos mais graves e refratários, o tratamento sistêmico pode ser necessário, incluindo corticosteroides sistêmicos, ciclosporina e agentes biológicos. No entanto, o uso dessas terapias deve ser cuidadosamente avaliado devido aos riscos associados, especialmente em lactentes e crianças, e sua prescrição deve ser individualizada. A pesquisa continua a ser realizada para desenvolver novas terapias e estratégias de manejo da dermatite atópica, com foco em tratamentos específicos para lactentes e crianças. A colaboração entre profissionais de saúde, pesquisadores e pacientes é essencial para melhorar os resultados clínicos e a qualidade de vida dos pacientes afetados por essa condição cutânea crônica.
High-resolution US methane emissions inferred from an inversion of 2019 TROPOMI satellite data: contributions from individual states, urban areas, and landfills
Authors: Nesser Hannah , Jacob Daniel J. , Maasakkers Joannes D. , Lorente Alba , Chen Zichong , Lu Xiao , Shen Lu , Qu Zhen , Sulprizio Melissa P. , Winter Margaux , Ma Shuang , Bloom A. Anthony , Worden John R. , Stavins Robert N. , Randles Cynthia A.
Published: April 2024

Abstract. We quantify 2019 annual mean methane emissions in the contiguous US (CONUS) at 0.25° × 0.3125° resolution by inverse analysis of atmospheric methane columns measured by the Tropospheric Monitoring Instrument (TROPOMI). A gridded version of the US Environmental Protection Agency (EPA) Greenhouse Gas Emissions Inventory (GHGI) serves as the basis for the prior estimate for the inversion. We optimize emissions and quantify observing system information content for an eight-member inversion ensemble through analytical minimization of a Bayesian cost function. We achieve high resolution with a reduced-rank characterization of the observing system that optimally preserves information content. Our optimal (posterior) estimate of anthropogenic emissions in CONUS is 30.9 (30.0–31.8) Tg a−1, where the values in parentheses give the spread of the ensemble. This is a 13 % increase from the 2023 GHGI estimate for CONUS in 2019. We find emissions for livestock of 10.4 (10.0–10.7) Tg a−1, for oil and gas of 10.4 (10.1–10.7) Tg a−1, for coal of 1.5 (1.2–1.9) Tg a−1, for landfills of 6.9 (6.4–7.5) Tg a−1, for wastewater of 0.6 (0.5–0.7), and for other anthropogenic sources of 1.1 (1.0–1.2) Tg a−1. The largest increase relative to the GHGI occurs for landfills (51 %), with smaller increases for oil and gas (12 %) and livestock (11 %). These three sectors are responsible for 89 % of posterior anthropogenic emissions in CONUS. The largest decrease (28 %) is for coal. We exploit the high resolution of our inversion to quantify emissions from 70 individual landfills, where we find emissions are on median 77 % larger than the values reported to the EPA's Greenhouse Gas Reporting Program (GHGRP), a key data source for the GHGI. We attribute this underestimate to overestimated recovery efficiencies at landfill gas facilities and to under-accounting of site-specific operational changes and leaks. We also quantify emissions for the 48 individual states in CONUS, which we compare to the GHGI's new state-level inventories and to independent state-produced inventories. Our posterior emissions are on average 27 % larger than the GHGI in the largest 10 methane-producing states, with the biggest upward adjustments in states with large oil and gas emissions, including Texas, New Mexico, Louisiana, and Oklahoma. We also calculate emissions for 95 geographically diverse urban areas in CONUS. Emissions for these urban areas total 6.0 (5.4–6.7) Tg a−1 and are on average 39 (27–52) % larger than a gridded version of the 2023 GHGI, which we attribute to underestimated landfill and gas distribution emissions.
Role of the Indian Ocean basin mode in driving the interdecadal variations of summer precipitation over the East Asian monsoon boundary zone
Authors: Wang Jing , Liu Yanju , Cheng Fei , Song Chengyu , Li Qiaoping , Ding Yihui , Xu Xiangde
Published: April 2024

Abstract. Based on long-term observational and reanalysis datasets from 1901 through 2014, this study investigates the characteristics and physical causes of the interdecadal variations in the summer precipitation over the East Asian monsoon boundary zone (EAMBZ), which is a peculiar domain defined from the perspective of the interplay between climatic systems (i.e., mid-latitude westerly and East Asian summer monsoon). Observational evidence reveals that, similarly to previous studies, the EAMBZ precipitation featured prominent interdecadal fluctuations, e.g., with dry summers during the periods preceding 1927, 1939–1945, 1968–1982, and 1998–2010 and wet summers during the periods of 1928–1938, 1946–1967, and 2011 onwards. Further analyses identify that, amongst the major interdecadal oceanic forcings (e.g., Atlantic multidecadal oscillation and Pacific decadal oscillation), the Indian Ocean basin mode (IOBM) is a significant oceanic forcing responsible for the interdecadal variations of the EAMBZ precipitation, playing an independent and critical modulation role. When the cold phase of the IOBM occurs, an anomalous cyclonic circulation is excited around the northeast corner of the tropical Indian Ocean, which further induces a north-low–south-high meridional seesaw pattern over the Northeast China–subtropical western Pacific (SWP) sector. Such seesaw pattern is conducive to the enhanced EAMBZ precipitation by linking favorable environments for the transportation of water vapor from the SWP and the convergence over the EAMBZ at interdecadal timescales. For this reason, a physical–empirical model for the EAMBZ precipitation is developed in terms of the IOBM cooling. Despite the fact that the extreme summer EAMBZ precipitation cannot be captured by this model, it can still well capture its interdecadal fluctuations and reflect their steady relationship. The key physical pathway connecting the IOBM cooling with the interdecadal variations of the summer EAMBZ precipitation is supported by the numerical results based on the large ensemble experiment and the Indian Ocean pacemaker experiment. Our findings may provide new insights into the understanding of the causes of the interdecadal variations in the summer EAMBZ precipitation, which may favor the long-term policy decision-making for the local hydrometeorological planning.
Stable isotope evidence for long-term stability of large-scale hydroclimate in the Neogene North American Great Plains
Authors: Manser Livia , Kukla Tyler , Rugenstein Jeremy K. C.
Published: April 2024

Abstract. The Great Plains of North America host a stark climatic gradient, separating the humid and well-watered eastern US from the semi-arid and arid western US, and this gradient shapes the region's water availability, its ecosystems, and its economies. This climatic boundary is largely set by the influence of two competing atmospheric circulation systems that meet over the Great Plains – the wintertime westerlies bring dominantly dry air that gives way to moist, southerly air transported by the Great Plains low-level jet in the warmer months. Climate model simulations suggest that, as CO2 rises, this low-level jet will strengthen, leading to greater precipitation in the spring but less in the summer and, thus, no change in mean annual precipitation. Combined with rising temperatures that will increase potential evapotranspiration, semi-arid conditions will shift eastward, with potentially large consequences for the ecosystems and inhabitants of the Great Plains. We examine how hydroclimate in the Great Plains varied in the past in response to warmer global climate by studying the paleoclimate record within the Ogallala Formation, which underlies nearly the entire Great Plains and provides a spatially resolved record of hydroclimate during the globally warmer late Miocene. We use the stable isotopes of oxygen (δ18O) as preserved in authigenic carbonates hosted within the abundant paleosol and fluvial successions that comprise the Ogallala Formation as a record of past hydroclimate. Today, and coincident with the modern aridity gradient, there is a sharp meteoric water δ18O gradient with high (−6 ‰ to 0 ‰) δ18O in the southern Great Plains and low (−12 ‰ to −18 ‰) δ18O in the northern plains. We find that the spatial pattern of reconstructed late Miocene precipitation δ18O is indistinguishable from the spatial pattern of modern meteoric water δ18O. We use a recently developed vapor transport model to demonstrate that this δ18O spatial pattern requires air mass mixing over the Great Plains between dry westerly and moist southerly air masses in the late Miocene – consistent with today. Our results suggest that the spatial extents of these two atmospheric circulation systems have been largely unchanged since the late Miocene and any strengthening of the Great Plains low-level jet in response to warming has been isotopically masked by proportional increases in westerly moisture delivery. Our results hold implications for the sensitivity of Great Plains climate to changes in global temperature and CO2 and also for our understanding of the processes that drove Ogallala Formation deposition in the late Miocene.
The Role of the Radial Vorticity Gradient in Intensification of Tropical Cyclones
Authors: Watson Samuel , Quinn Courtney
Published: April 2024

Abstract. The role of the radial vorticity gradient in tropical cyclone dynamics is explored through a low-order conceptual box model. Specifically, we look at stable-to-stable state transitions which may be linked to tropical cyclone intensification, dissipation, or eyewall replacement cycles. To this end, we identify two parameters of interest: the exponent of radial decline and sea surface temperature. We examine how variation in these parameters affect the stable states of the model and consider the behaviour of the system under time-dependent parameters. By externally forcing the exponent of radial decline and sea surface temperature we show the existence of rate-dependent behaviour in the model. These findings are brought together in a case study of Hurricane Irma (2017). The results highlight the role of the radial vorticity gradient in behaviour such as rate-induced tipping and overshoot recovery. They also show that a simple model can be used to explore relatively complex tropical cyclone dynamics.
NEWTS1.0: Numerical model of coastal Erosion by Waves and Transgressive Scarps
Authors: Palermo Rose V. , Perron J. Taylor , Soderblom Jason M. , Birch Samuel P. D. , Hayes Alexander G. , Ashton Andrew D.
Published: April 2024

Abstract. Models of rocky-coast erosion help us understand the physical phenomena that control coastal morphology and evolution, infer the processes shaping coasts in remote environments, and evaluate risk from natural hazards and future climate change. Existing models, however, are highly complex, are computationally expensive, and depend on many input parameters; this limits our ability to explore planform erosion of rocky coasts over long timescales (thousands to millions of years) and over a range of conditions. In this paper, we present a simplified cellular model of coastline evolution in closed basins through uniform erosion and wave-driven erosion. Uniform erosion is modeled as a constant rate of retreat. Wave erosion is modeled as a function of fetch, the distance over which the wind blows to generate waves, and the angle between the incident wave and the shoreline. This reduced-complexity model can be used to evaluate how a detachment-limited coastal landscape reflects climate, sea-level history, material properties, and the relative influence of different erosional processes.