bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Audio-Visual Teaching Learning Materials in Facilitating of Health Education in Early Childhood Development Centers, Pokhara, Nepal
Authors: Pant Indira , Sharma Laxmi Kanta , Sharma Mohan Kumar 
Published: December 2024

Early Childhood Development (ECD); is a crucial period for nurturing the physical, cognitive, social, emotional, and linguistic growth of children aged three to eight. The study aims to assess the factors influencing the use of audio-visual teaching and learning materials in facilitating health education in the ECD centersin Pokhara, Nepal. The research utilized a quantitative, cross-sectional research design. Data were collected using face-to-face interviews with 486 respondents from 33 selected ECD centers. The participants were randomly selected using proportionate sampling from each selected ECD center. The descriptive analysis employed for univariate and bivariate analyses using Statistical Package of Social Science (SPSS) 25 version. Variables such as school type, facilitator qualification, management of learning materials, availability of potable water and sanitation facilities, learning corner condition, and classroom decoration were significantly associated with using audio-visual aids, p<0.001. Additionally, school building,, classroom conditions, and proper sitting arrangement were also found to be significant with audio-visual aids, p<0.01. Association was further observed between the use of other materials and audio-visual aids, p<0.05. The study highlights that enhancing infrastructure, providing adequate learning tools, and improving facilitator training are essential for optimizing health education through audio-visual aids. This improvement contributes to a more engaging and effective learning environment, fostering holistic child development and aligning with national educational policies and global educational goals.
Steatotic liver disease arising in an asymptomatic 20-year-old man with panhypopituitarism and elevated transaminases
Authors: Wiebe Nicole , Stueck Ashley , McLeod Magnus 
Published: December 2024

Background: Steatotic liver disease (SLD) may be caused by cardiometabolic risk factors, drugs/toxins, viral hepatitis, genetic diseases, malnutrition, or panhypopituitarism. SLD can advance to steatohepatitis with resulting lipid accumulation, inflammation, and hepatocellular damage. SLD is associated with pituitary dysfunction, in particular growth hormone deficiency, as insulin resistance leads to lipid buildup and oxidative stress. Growth hormone replacement may improve liver steatosis and fibrosis in patients with hypopituitarism. Case: We report a case of a 20-year-old man who was referred to Hepatology with abnormal liver enzymes. He had panhypopituitarism from a resected pituitary mass, for which he was treated with levothyroxine, hydrocortisone, growth hormone, and testosterone. He presented with elevated liver enzymes, normal liver function, obesity, dyslipidemia, and had no extrahepatic manifestations of chronic liver disease. Work-up for secondary causes of liver disease, including infectious, autoimmune, drug-induced, and genetic causes, were negative. An abdominal ultrasound revealed moderate hepatic steatosis with mild hepatomegaly and splenomegaly. His liver enzymes remained elevated, and his biochemical liver function remained normal despite withdrawal of hepatotoxic medications. Liver biopsy showed grade II/III steatohepatitis with stage III-IV fibrosis. The biopsy results suggested that panhypopituitarism, with growth hormone deficiency and related metabolic dysfunction, caused his liver disease. Conclusions: This is a unique case of an aggressive form of SLD due to panhypopituitarism, and treating growth hormone deficiency with hormone replacement did not improve liver enzymes or liver damage. Physicians should recognize SLD as a serious complication of panhypopituitarism and resulting growth hormone deficiency and follow patients closely given the risk of disease progression.
The use of variable D-dimer thresholds for the improved diagnosis of pulmonary embolism in the inpatient population: A retrospective cohort study
Authors: Gerstein Lindsey , Zhong You Jia , Bendayan Solomon , Eintracht Shaun , Koolian Maral , Schwartz Blair 
Published: December 2024

Introduction: Diagnosis of pulmonary embolism (PE) among inpatients can be challenging, with the use of variable D-dimer thresholds validated only in outpatients. We sought to determine the negative predictive value (NPV) of such thresholds in inpatients for PE diagnosis. Methods: We performed a retrospective cohort study of inpatients with a D-dimer measured within 72 hours of a computed tomography pulmonary angiography (CTPA) or ventilation perfusion scan (VQ) for suspected PE at a tertiary care center in Montreal, Canada, between January 2012 and December 2019. D-dimers were assessed using the 500 μg FEU/L and age-adjusted thresholds and clinical pretest probability of PE using the Wells score and the PEGeD algorithm. The primary outcome of PE incidence was reported, and the negative predictive values of various D-dimer based approaches were determined. Using institutional and provincial cost information, we explored the cost-effectiveness of a D-dimer-based approach. Results: Our cohort included 290 patients, 68% female with a median age of 72 (52, 84) years old. Thirty-six patients were found to have a PE, for an incidence of 12%. Fourteen (5%) patients had a D-dimer value <500 μg FEU/L, yielding a NPV of 100%, 95% CI (76.8% to 100%). Twenty-seven (9%) inpatients had a negative age-adjusted D-dimer, yielding a NPV of 100%, 95% CI (87.2% to 100%). Discussion: This exploratory study suggests that D-dimer testing may have a role in inpatients to improve appropriate diagnostic testing and cost-effectiveness. The use of variable D-dimer thresholds in the inpatient population for PE diagnosis is an important area for further research.
The Existence of Women’s Representation in the House of Representatives in 2019-2024
Authors: Sapitri Imelda , Alkadafi Muammar , Rizal Yose 
Published: December 2024

Indonesia as a democratic country must involve the participation of all components of society in determining the direction and policies of the country. The female voter population of 96,572,045 is greater than the male voter population of 96,294,209. The author conducted normative legal research on the existence of women's representation in DPR. As for the research results, the urgency for gender equality is: 1. Women's freedom from the patriarchal system; 2. Women can determine their future direction and goals; 3. Women as Role Models; d. Women are able to compete. The presence of women parliament can successfully change the culture from a masculine to a more female-friendly one. Regulations on women's candidacy arestated in Article 246 of the Election Law and Article 3 of PKPU No. 20 of 2018. Currently, women's representation in the DPR is 20.87%. Women's representation has succeeded in accommodating women's rights in the form of Law No. 12 of 2022 concerning Crime of Sexual Violence. An obstacle to increasing women's representation is that political parties still tend to place the serial number positions of female legislative candidates at the bottom of the serial number. With this, political parties must also consider the potential of female legislative candidates to get the leading number
Cortical reorganization associated lower extremity motor recovery	as evidenced by functional MRI and diffusion tensor tractography in a stroke	patient
Authors: Jang Sung Ho , You Sung H. , Kwon Yong-Hyun , Hallett Mark , Lee Mi Young , Ahn Mi Young 
Published: December 2024

Purpose: Recovery mechanisms supporting upper extremity motor recovery following stroke are well established, but cortical mechanism associated with lower extremity motor recovery is unknown. The aim of this study was to assess cortical reorganization associated with lower extremity motor recovery in a hemiparetic patient. Methods: Six control subjects and a 17 year-old woman with left intracerebral hemorrhage due to an arterio-venous malformation rupture were evaluated. The motor function of the paretic (left) hip and knee had recovered slowly to the extent of her being able to overcome gravity for 10 months after the onset of stroke. However, her paretic upper extremity showed no significant motor recovery. Blood oxygenation level dependent (BOLD) functional MRI at 1.5 Tesla was used to determine the acutual location of cortical activation in the predefined regions of interest. Concurrently, Diffusion Tensor Imaging (DTI) in combination with a novel 3D-fiber reconstruction algorithm was utilized to investigate the pattern of the corticospinal pathway connectivity between the areas of the motor stream. All subjects' body parts were secured in the scanner and performed a sequential knee flexion-extension with a predetermined angle of 0–60° at 0.5 Hz. Results: Controls showed anticipated activation in the contralateral sensorimotor cortex (SM1) and the descending corticospinal fibers stemming from motor cortex. In contrast to control normal subjects, the stroke patient showed fMRI activation only in the unaffected (right) primary SM1 during either paretic or nonparetic knee movements. DTT fiber tracing data showed that the corticospinal tract fibers were found only in the unaffected hemisphere but not in the affected hemisphere.
Tindak Pidana Pengancaman Oleh Debt Collektor Terhadap Debitur Yang Wanprestasi Ditinjau Dari Undang-Undang Nomor 1 Tahun 2024 Tentang Perubahan Kedua Atas Undang-Undang Nomor 11 Tahun 2008 Tentang Informasi Transaksi Elektronik
Authors: Nurhayati  
Published: December 2024

Peningkatan Penggunaan Teknologi Seiring dengan perkembangan teknologi informasi dan komunikasi (TIK), semakin banyak debt collector yang memanfaatkan berbagai media elektronik seperti telepon, pesan teks, email, dan media sosial untuk menghubungi nasabah yang memiliki tunggakan. Hal ini membuat debt collector memiliki akses lebih luas dan lebih mudah dalam melancarkan ancaman kepada nasabah yang berhutang. Penggunaan ancaman dan tekanan psikologis oleh debt collector dapat mengakibatkan dampak emosional yang signifikan pada nasabah yang berhutang. Ancaman ini dapat berupa ancaman fisik, pencemaran nama baik, atau bahkan penyebaran informasi palsu. Kurangnya Perlindungan Konsumen Meskipun terdapat beberapa regulasi yang mengatur perlindungan konsumen, pelaksanaannya masih belum maksimal. Beberapa nasabah mungkin merasa sulit untuk melaporkan tindakan debt collector yang melanggar hukum karena takut balasan ancaman lebih lanjut
ANALISIS PRAKTIK JUAL RUGI (PREDATORY PRICING) TERHADAP PRAKTIK PROMO OLEH GRAB DITINJAU DARI ASPEK HUKUM PERSAINGAN USAHA
Authors: Ismar Ismar , Akib Ma’ruf , Umar Wahyudi 
Published: December 2024

ABSTRAK: Praktik jual rugi atau predatory pricing merupakan strategi yang sering digunakan dalam persaingan bisnis, terutama di industri e-commerce dan layanan transportasi online seperti Grab. Penelitian ini bertujuan untuk menganalisis praktik kerugian penjualan yang diterapkan oleh Grab dalam konteks hukum persaingan usaha di Indonesia. Dari sisi hukum, praktik ini dapat mengakibatkan distorsi pasar dan merugikan pelaku usaha lainnya, terutama di industri konvensional. Penelitian ini menggunakan pendekatan yuridis normatif, mengenai Undang-Undang Nomor 5 Tahun 1999 tentang Larangan Praktik Monopoli dan Persaingan Usaha Tidak Sehat, yang melarang praktik yang dapat menghambat persaingan sehat. Dalam konteks digital, Grab dan perusahaan sejenis sering memberikan diskon besar-besaran untuk menarik pelanggan, yang dapat dianggap sebagai praktik sell-loss. Penelitian menunjukkan bahwa strategi ini tidak hanya merugikan pesaing tetapi juga dapat menciptakan ketergantungan konsumen pada harga rendah, berpotensi menghilangkan pemain kecil dari pasar. Oleh karena itu, penting bagi Komisi Pengawas Persaingan Usaha (KPPU) untuk melakukan pengawasan ketat terhadap praktik-praktik tersebut agar tetap sesuai dengan peraturan yang ada dan menjaga iklim persaingan yang sehat. Lebih lanjut, penelitian ini juga menyoroti tantangan yang dihadapi KPPU dalam mengawasi praktik penjualan kerugian di era digital, di mana transaksi e-commerce meningkat dan kompleksitas pasar meningkat. KPPU perlu memperkuat kapasitas dan metodologi pengawasannya untuk dapat mendeteksi dan menindak praktik berbahaya. Dengan demikian, analisis ini diharapkan dapat memberikan wawasan yang lebih dalam tentang dampak praktik sell-loss terhadap persaingan bisnis dan perlunya penegakan hukum yang lebih efektif di Indonesia
Clinicopathological profile of dengue fever among children admitted in Medical College for Women & Hospital, Dhaka, Bangladesh
Authors: Alam Mohammad Mahbubul , Khatoon Nushura , Sultana Razia , Hoque Saidul , Karim Enamul , Kumar Ghosh Susanta 
Published: December 2024

Background: Dengue is not always manifested by its typical clinical features, its presentation may be atypical which may create confusion among physicians while making a diagnosis. The clinical profile that was seen in earlier epidemics has changed over time and various atypical features are found in day to day clinical practice. The trends in simple hematological and biochemical parameters are of utmost importance to evaluate the severity of the disease. Aim:This study was carried out to evaluate the clinico-pathological profile of dengue fever in children.Materials and Method: This cross-sectional study was conducted in the department of Paediatrics, of Medical College for Women and Hospital, Uttara, Dhaka, from August to October 2023 following ethical clearance of the protocol. A total of 250 children aged 0-18 years attended in the study center with fever with positive NSI (nonstructural protein 1) antigen or positive IgM (Immunoglobulin M) antibody of dengue were included after getting informed written consent from their legal guardians. Data were collected by using a structured questionnaire. Collected data were analyzed by the SPSS 26.Result: The mean±SD of age of the respondents was 7.12±4.26 year with male predominance (54.8%). All respondents had fever, wherein majority had low grade fever (67.2%). More than half of the respondents (52.4%) had vomiting. Oral thrush (42.8%), abdominal pain (34%), congestion of the eye (28.4%), runny nose (22.4%), cough (16%), headache (15.6%), rash (14.8%), lack of appetite (14%) and loose stool (13.6%) were the other common clinical features. Pleural effusion (15.6%) in Chest X-ray and respiratory distress (28.8%) and ascites (17.6%) were other common findings. Hepatomegaly, ascites, respiratory distress, pleural effusion and edematous gallbladder were significantly more in severe dengue than non-severe dengue fever. Besides, decreased Hb% (hemoglobin %), increased HCT (hematocrit) level, SGPT (Serum Glutamic Pyruvic Transaminase) >56U/L and SGOT (Serum Glutamic Oxalo-Acetic Transaminase) >45U/L were significantly higher in severe dengue fever than non-severe dengue.Conclusion: Dengue in children presented with diverse symptoms and severity. However, further multicenter study is recommended to verify the present findings.
J Med Coll Women Hosp.2024; 20(2): 44-55
Neonatal body composition, salivary feeding gene expression, and feeding outcomes in infants of diabetic mothers
Authors: Azuma Dara , Penner Yvette , Kaneko-Tarui Tomoko , Mahmoud Taysir , Breeze Janis L. , Rodday Angie , O’Tierney-Ginn Perrie , Maron Jill L. 
Published: December 2024

IntroductionInfants of diabetic mothers (IDMs) may exhibit decreased oral intake, requiring nasogastric feedings and prolonged hospitalization. The objective of this study was to explore whether saliva serves as an informative biofluid for detecting expression of hunger signaling and energy homeostasis modulator genes and to perform exploratory analyses examining expression profiles, body composition, and feeding outcomes in late preterm and term IDMs and infants born to mothers with normoglycemia during pregnancy.MethodsIn this prospective cohort pilot study, infants born at ≥ 35 weeks’ gestation to mothers with gestational or type II diabetes (IDM cohort) and normoglycemic mothers (control cohort) were recruited. The presence of known hunger signaling genes: 5’AMP-activated protein kinase (PRKAA2) and neuropeptide Y2 receptor (NPY2R); adipokines: leptin (LEP) and adiponectin (ADIPOQ); and energy homeostasis regulators: ghrelin (GHRL) and proopiomelanocortin (POMC) in neonatal saliva was determined with RT-qPCR and compared between cohorts. Body composition was assessed via skinfold measurements and compared between cohorts. Feeding outcomes were recorded. Exploratory analyses were performed examining associations between infant body composition, energy homeostasis and hunger signaling gene expression.ResultsTwenty-three infants in the IDM cohort and 22 infants in the control cohort were recruited. LEP and ADIPOQ were not reliably detected in neonatal saliva in either cohort. PRKAA2, GHRL and NPY2R were less likely to be detected in the IDM cohort, whereas POMC was more likely to be detected in the IDM cohort. Infants in the IDM cohort had greater adiposity compared to infants in the normoglycemia cohort. Only 3 IDMs had documented poor feeding; no infant in the control group struggled to feed. In exploring associations between hunger signaling gene expression with energy homeostasis gene expression and body composition, the odds of detecting salivary NPY2R expression decreased as fat mass increased, and the odds of detecting PRKAA2 expression increased in the presence of GHRL expression.DiscussionNon-invasive assessment of hunger signaling and energy homeostasis gene expression is possible through neonatal salivary analysis. This pilot study lays the foundation for a larger scale study to further investigate the link between in utero exposure to diabetes with body composition and regulation of appetite.
Prognostic potential of inflammatory markers in chronic kidney disease patients combined with acute myocardial infarction
Authors: Dang Peizhu , Li Bohan , Li Yongxin 
Published: December 2024

BackgroundInflammation significantly impacts chronic kidney disease (CKD) and acute myocardial infarction (AMI). This study investigates the prognostic value of inflammatory markers in predicting outcomes for CKD patients with AMI.MethodsWe enrolled patients diagnosed with CKD concomitant with AMI, choosing five inflammatory markers related to both diseases. Patients were categorized into elevated inflammatory markers group and control group based on inflammatory markers cut-off values for predicting in-hospital major adverse cardiac and cerebrovascular events (MACCE). Using univariate and multivariate logistic regression, we identified inflammation-related risk factors for MACCE. We adjusted covariates stepwise to explore the relationship between independent risk factors and adverse outcomes. We also evaluated the predictive value of these markers for MACCE by receiver operating characteristic (ROC) curves.ResultsIn the multivariate logistic regression analysis, higher levels of neutrophil-to-lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) significantly increased risk of MACCE (all P &lt; 0.05). After adjusting above two indicators, NLR was independently associated with in-hospital MACCE in CKD patients with AMI (OR = 10.764, 95% CI: 1.887–61.406, P = 0.007). Furthermore, compared to other inflammatory markers, NLR had the highest predictive value for MACCE in patients with AMI and CKD [Area Under the Curve (AUC): 0.748, 95% Confidence Interval (CI): 0.634–0.861, P &lt; 0.001].ConclusionIn CKD patients combined with AMI, elevated levels of inflammation markers could increase the risk of MACCE. NLR may provide superior predictive value compared to other markers.
Body mass index mediates the association between plasma lipid concentrations and the prevalence of obstructive sleep apnea among US adults: a cross-sectional study
Authors: Hu Xiao , Xu Jing , Gu Yang 
Published: December 2024

BackgroundThe association between obstructive sleep apnea (OSA) and plasma lipid concentrations is not consistent. This study aimed to investigate the association of plasma lipid concentrations with the prevalence of OSA among US adults, with an additional examination of the mediating effect of body mass index (BMI).MethodsThis cross-sectional study included 8,086 individuals who participated in the National Health and Nutrition Examination Survey (NHANES), conducted from 2005 to 2008 and 2015–2018. Multivariable logistic regression analysis was conducted to compute the odds ratios (ORs) and 95% confidence intervals (CIs) for the association between plasma lipid concentrations and the prevalence of OSA. Additionally, subgroup analysis was used to explore the potential interactions. Generalized additive models (GAM) were constructed to evaluate the nonlinear relationships between lipid concentrations and OSA. Furthermore, mediation analysis was performed to assess the potential mediating role of BMI.ResultsIn the fully adjusted model, when comparing the lowest quartile, the ORs for the prevalence of OSA among participants in the highest quartile were 1.367 (95% CI, 1.107–1.688) for triglyceride and 1.212 (95% CI, 1.004–1.462) for low-density lipoprotein cholesterol (LDL-C). However, total cholesterol (TC) and high-density lipoprotein cholesterol (HDL-C) were not associated with OSA. Notably, the relationship between triglyceride and OSA differed in the subgroups of gender, race, and body mass index (BMI) (P for interaction &lt;0.05). Furthermore, we discovered an inverted U-shaped association between triglyceride and OSA (inflection point: 0.813 mmol/L). Causal mediation analysis revealed that BMI significantly mediated the relationship between triglyceride and the prevalence of OSA.ConclusionsThis study revealed that an elevated level of triglyceride increased the prevalence of OSA, and this effect was potentially mediated through BMI. Lowering triglyceride concentration may help to reduce the prevalence of OSA.