bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved Clinical Outcomes with Appropriate Meropenem De-escalation in Patients with Febrile Neutropenia
Authors: Luu Tyler , Fan Austin , Shaw Reid , Dalal Hina , Adams Jenna , Santarossa Maressa , Reid Gail , Tsai Stephanie , Clark Nina M. , Albarillo Fritzie S. 
Published: December 2024

Introduction:
Antibiotic stewardship is a critical aspect of managing cancer patients with febrile neutropenia (FN) to limit the development of drug-resistant organisms and minimize adverse drug effects. Thus, it has been recommended that patients with FN receiving empiric antibiotics should be re-evaluated for safe antibiotic de-escalation.

Methods:
Subjects treated with meropenem for febrile neutropenia who met Loyola University Medical Center’s (LUMC) criteria for de-escalation were stratified based on whether meropenem was de-escalated, and 30-day all-cause mortality for both groups was assessed.

Results:
181 patients met criteria for meropenem de-escalation. Sixty patients (31.3%) were ade-escalated (MDE), and 121 subjects were not (NDE). The 30-day all-cause mortality was 8.3% (n = 5/60 subjects) in the MDE group and 2.4% (n = 3/121) in the NDE group but was not statistically significant (P=0.1). Median hospital length of stay was 13 days in the MDE group versus 20 days in the NDE group (P = 0.049). CDI rate was also lower in the de-escalated group. In addition, consultations by infectious diseases physicians were more common in the de-escalation group. Logistic regression model demonstrated positive culture (OR 4.78, P = 0.03), including positive blood culture (OR 8.05, P = 0.003), and GVHD (OR 19.44, P = 0.029), and were associated with high rates of appropriate de-escalation. Immunosuppression (OR 0.22, P = 0.004) was associated with lower rates of appropriate de-escalation.

Conclusion:
Appropriate meropenem de-escalation in FN patients is safe and can result in improved clinical outcomes.
Hypersensitive Pneumonitis Masquerading as Acute Severe Asthma
Authors: Babu Sarath Balaji , Sohanraj Chetan Kumar , Chellakutti Thangaraj 
Published: December 2024

Abstract
Hypersensitive pneumonitis (HP) is an uncommon cause of interstitial lung diseases in children and is often misdiagnosed as a case of asthma and treated with inhaled corticosteroids. Prompt identification of exposure in children can reduce unnecessary investigations and step-up therapy. Early identification of HP can bring better outcomes in children. We present the case of an 8-year-old boy with a recent onset of poorly controlled asthma, who presented with cyanosis, and was found to have been exposed to pigeons; his serum specific protein level for pigeon exposure was positive with lymphocytic broncho-alveolar lavage and computed tomography of the chest, consistent with HP, and on administration of oral steroids recovered completely.
Behavioral Insomnia of Childhood and Sleep Coaching for Children: A Narrative Review
Authors: Ghosh Gautam 
Published: December 2024

Abstract
Childhood insomnia is a sleep disorder that makes it hard for children to fall asleep, stay asleep, or sleep long enough. Behavioral insomnia during childhood (BIC; more commonly known as bedtime problems and night waking) commonly occurs in young children (<5 years). If left untreated, bedtime problems and night waking can result in impairments in behavior, emotion regulation, and academic performance, yet it has been shown that pediatricians do not adequately address sleep in routine child wellness visits and under-diagnose sleep issues. Pediatricians receive little formal training in medical school or in residency regarding sleep medicine. An understanding of the physiology of sleep is critical to a pediatrician’s ability to effectively and confidently counsel patients about sleep. Treatments for bedtime problems and night waking have been found to be efficacious and durable. This article begins with a review of the diagnostic criteria and clinical presentation of BIC. This is followed by a brief review of application of operant theory to behavioral interventions for BIC and a detailed discussion of application of these treatments for bedtime problems and night waking in young children.
Role of Cystatin C for Early Detection of Acute Kidney Injury in Children
Authors: Luna Sharmin Akter , Bushra Farhana , Sultana Jakia , Sultana Nadira , Mamun Abdullah-Al , Huque Syed Saimul , Jesmin Tahmina , Begum Afroza , Roy Ranjit Ranjan 
Published: December 2024

Abstract

Background:
Acute kidney injury (AKI) has been associated with high morbidity and mortality in children, including neonates. Early diagnosis would be of great value for treatment and prevention.

Objective:
The goal of this study was to assess the role of cystatin C to detect AKI early in children who were at risk.

Materials and Methods:
This prospective analytical study was conducted at Department of Paediatric Nephrology and performed on critically and non-critically ill patients admitted in the Department of General Paediatrics and Allied, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study period ranged from May 2018 to July 2019. Patients aged 4 days–17 years were included, who were at risk for AKI. The risk was considered when patients presented with symptoms of hypovolemia, shock, sepsis, and used nephrotoxic agents. Anthropometry was measured in all patients with the standard method. Then, blood samples were collected to assess creatinine at 0, 48, and 72 h for the contrast group and on the fifth day instead of 72 hr for the non-contrast group, to assess cystatin C at 0 and 48 h. For diagnosis of AKI, Kidney Disease Improving Global Outcomes criteria were used for all patients.

Results:
A total of 52 patients at risk of AKI were enrolled in this study, among which 42 were in the older age group and 10 were neonates. Twenty patients (38%) developed AKI. The mean age of the older age group was 11.3 ± 3.7 years with male preponderance, and mean age in neonates was 10.8 ± 5.4 days with female preponderance. The major risk factor for AKI was nephrotoxic drugs, followed by hypovolemia in the older age group. In neonates, the primary risk factor for AKI was hypovolemia, followed by sepsis and asphyxia. Cystatin C level increased in serum 1–2 days before creatinine in patients with AKI. Only 6 (30%) patients with AKI were detected by creatinine levels within 48 h and all AKI patients by cystatin C within 48 h. The ability of serum cystatin C to predict AKI at 48 h was analyzed, which revealed the area under the curve (AUC) was 0.93 with 95% confidence interval (CI) = 0.864–0.995. Using a cut-off value of 1.35 mg/L for cystatin C, the sensitivity and specificity were 95% and 84% (95% CI = 0.779–0.997 and 0.737–0.873), respectively. The positive predictive value and negative predictive value, accuracy, positive likelihood ratio, and negative likelihood ratio were 79%, 96%, 88.7%, 6.08, and 0.06, respectively. The association between age, gender, height, weight, body mass index, and risk factors and cystatin C was explored, revealing no effects on cystatin C.

Conclusion:
Serum cystatin C is an effective and early marker for detection of AKI in children at risk.
Acute Kidney Injury in a Child Due to Wasp Stings: A Case Report
Authors: Chowdhury Md. Murad , Akhter Shammi , Biswas Susmita , Quader Mohammed Maruful , Kayes Mohammad Imrul 
Published: December 2024

Abstract
Following a wasp sting, a child may present with multisystem involvements, such as anaphylactic shock, acute renal failure, and acute liver failure. Multiple toxins in wasp venom, including melitin, apamin, phospholipase A2, hyaluronidase, and chemotactic peptides, are responsible for various systemic involvements. Here, we report a 10-year-old boy who developed swelling of the whole body, anuria for 18 h, and respiratory distress after 40 h following multiple wasp stings. Initially, the patient was managed with one session of peritoneal dialysis, and subsequently, the patient switched to intermittent hemodialysis. After four sessions of intermittent hemodialysis, urine output was established. After a total of eight sessions of intermittent hemodialysis, the patient was discharged from the hospital with regular follow-up advice. The management of wasp sting should be started as early as possible, and when progressive renal failure ensues, intensive dialysis support results in good renal recovery with the return of renal function to normal in the majority of the survivors.
Radioactivity concentration of natural and anthropogenic radionuclides in the soil of Banswara region, Rajasthan and associated radiation index parameters
Authors: Gill Rajpal , Meena Balram , Tiwari Shailesh Nath , Saradhi I. V. , Kumar A. Vinod 
Published: December 2024

Abstract
Activity concentrations of gamma-emitting naturally occurring radionuclides (NORM’s) of 226Ra, 232Th, and 40K along with anthropogenic radionuclides of 137Cs in soil samples collected around the new upcoming nuclear power plant site at Banswara district, of Rajasthan, India were estimated. The mean radioactivity concentrations of 226Ra, 232Th, 40K, and 137Cs in surface soil samples of Banswara region were 17.6, 36.4, 309.7, and 1.4 Bq.kg−1, respectively. The mean activity of 226Ra, 232Th, and 40K is lower when compared to the world average values. Average radium equivalent activity (Raeq), absorbed gamma dose rates in air (DR), and annual effective dose (AED) for the soil of the study area are calculated as 94.0 Bq.kg−1, 43.0 nGy.h−1, and 0.26 mSv.y−1, respectively. Estimated AED to the general public is 0.24 mSv.y−1, which is comparable to the global values due to terrestrial radiation. These radiological index parameters were compared with internationally approved values and the recommended safety limits. The study and analysis of collected soil samples from the Banswara region of Rajasthan indicate that the soil of this area does not pose any significant radiological health hazard to the people residing in adjacent areas. Multivariate Statistical analysis of Pearson correlation and analysis of variance (ANOVA) has been carried out. The result of ANOVA test indicated that there is no remarkable difference in the total variance of radioactivity of NORMs with respect to distance and it also indicated that the soil of the area belongs to a similar lithologic origin. The Pearson correlation of 226Ra with 232Th (r = 0.53) and 40K (r = 0.68) showed a fairly positive correlation, suggesting that their content in soil samples were mostly influenced and controlled by sources of similar origin. Spatial distribution maps using the kriging interpolation algorithm have been generated for the 30 km × 30 km area.
An observational study on digital addiction among school-going children of adolescent age group
Authors: Kolli Katyayani , Pasupula Sai Kiran , Kiran Vaddadi Venkat , Nair Vishnu Gopinadhan , Sandra BR , Jyothi Neeli Uma 
Published: December 2024

Background:
Behavioral addiction is a form of addiction that involves a compulsion to engage in a rewarding nonsubstance-related behavior called a natural reward, despite any adverse consequences to the person’s physical, mental, social, or financial well-being. Increased new gadget development, as well as remote teaching for children via apps, software, and recreational environments, have resulted in increased time spent with digital media at the expense of regular functioning. Its impact is more among school-going children and adolescents. The main objective of the study is to study the prevalence of digital addiction among school-going children.

Methodology:
This observational study comprised 289 school students from one school. The age range of subjects ranged between 12 and 16 years. A pretested and prevalidated questionnaire for addiction was done. Digital Addiction Scale for Children (DASC) is a simple self-report that comprises 25 questions based on the emerging clinical criteria used to diagnose addictive behavioral disorders.

Results:
The current study comprised 289 school students from one school. The age range of subjects ranged between 12 and 16 years with gender distribution of 134 males and 156 females, respectively. The total mean DASC score among females and males is 49.14 and 47.85, respectively.

Conclusion:
The prevalence of digital addiction is on alarming rise among school-going children. Awareness and effective treatment strategies need to be created for the well-being of future generation.
Food Calorie Scale Equipped with Daily Calorie Needs Analysis
Authors: Abidin Muhammad Sainal , Kasih Ridia Utami , Sutiari Desak Ketut 
Published: December 2024

In carrying out their activities, humans need various kinds of nutritional intake. The nutrients contained in a meal will form calories which are a source of energy needed to carry out activities. The remaining calories that are not converted into energy will be stored in the body as fat. Therefore, it is important to know the amount of intake consumed by a person according to the number of calories needed each day. Each type of food contains a different number of calories that are affected by their content and amount. In general, there have been many references that explain the number of calories contained in a food, but with the variety of types of food consumed, the process of calculating the total number of calories consumed is complicated. With this tool, the process of analyzing daily calorie needs can be done easily. The tool is made using a microcontroller to carry out the process of analyzing and processing data automatically and structured based on the program that has been entered. Food weight measurement uses a load cell with a 4x4 keypad as an interface so that the process of entering data becomes easier. There are 15 types of foods that have been included in the program to be able to calculate their calorie content. The caloric value of food can be calculated based on the measured weight of the type of food weighed. From the measurement results, the difference between the measurement of the weight of the equipment and the manufacturer's scale of 0.6 gr with a value of R2 = 0.998 was obtained which indicates good accuracy.
Vulnerability Evaluation for Student Enrollment at SMKS Pandawa Bali Global Abiansemal
Authors: Indrianto Indrianto , Edwar Edwar 
Published: December 2024

The development of information technology has driven the adoption of digital student enrollment systems by various educational institutions, including SMKS Pandawa Bali Global Abiansemal. The school employs the CodeIgniter 3 framework with standard configurations to enhance efficiency, transparency, and accessibility in the student admission process. However, this technological progress also introduces significant security risks, such as potential data breaches, system integrity disruptions, and damage to the school's reputation. This study aims to evaluate the security vulnerabilities of SMKS Pandawa Bali Global’s online registration system through risk analysis and penetration testing. The research methodology involves a literature review, identification of vulnerabilities, risk assessment, and formulation of recommendations. The findings reveal several critical vulnerabilities, including risks of SQL injection attacks, Cross-Site Scripting (XSS), and insecure session management. To address these issues, the study recommends implementing security measures such as deploying a Web Application Firewall (WAF), enabling multi-factor authentication, conducting regular security testing, and providing security training for staff. By adopting these measures, the school can enhance the security and stability of its enrollment system, ensuring a smoother, safer, and more reliable student registration process in the future.
Analysis of Locus of Control and Self Efficacy on Satisfaction Employee Work and its Impact on Performance Achievement Levels
Authors: Safitri Wahyu , Zulher Zulher , Basem Zamhir 
Published: December 2024

The Kampar Regency Ministry of Religion Office has the main task of carrying out functions in formulating and establishing vision, mission and technical policies in the field of religious life services and guidance to the community in Kampar Regency as well as providing services, guidance and guidance in the field of Hajj and Umrah. Therefore, employees with optimal performance are very necessary. Many factors influence employee performance, including job satisfaction, locus of control and self-efficacy. This research was conducted at the Ministry of Religion of Kampar Regency which is located on Jalan DI Panjaitan, Bangkinang District. The aim of this research is to find out and analyze the influence of locus of control on employee job satisfaction, the influence of self-efficacy on employee job satisfaction, direct influence of locus of control on employee performance, the direct influence of self-efficacy on employee performance, the influence of job satisfaction on employee performance, the indirect influence of locus of control on employee performance through job satisfaction and , the direct influence of self-efficacy on employee performance through job satisfaction; This research uses primary data and secondary data obtained by distributing questionnaires, observations, interviews and research files. The population in this study were all employees at the Ministry of Religion office in Kampar Regency, totaling 48 people and all of them were used as samples. Data analysis was carried out using the Structural Equation Modeling (SEM) analysis tool and hypothesis testing was carried out at an alpha of 5%. The results of this study concluded that locus of control was proven to have no significant effect on job satisfaction, self-efficacy has been proven to have a significant effect on employee job satisfaction, locus of control has been proven to have a direct and significant effect on employee performance, self-efficacy is proven to have a direct and significant effect on employee performance, job satisfaction has a significant effect on employee performance, locus of control is indirectly proven to have no significant effect on employee performance through job satisfaction and self efficacy is indirectly proven to have a significant effect on employee performance through job satisfaction at the Kampar Regency Ministry of Religion Office.
Epiphytic Orchids in the Flora of Ecuador: a Review of Their Richness, Abundance, Ethnobotanical Importance, and Conservation Strategies in the Context of the Sustainable Development Goals SDGs
Authors: Herrera-Morales Greys , Colcha-Ortiz Alfredo , Colcha-Ortiz Raquel , Cadena-Oleas Byron , Ati-Cutiupala Guicela , Silva-Peñafiel Geovanny , Tenorio-Taipe Karina , Veloz-Cherrez Diego , Ruiz-Salgado Myrian , Mazón-Fierro Guido 
Published: December 2024

Objective: The objective of this study is to describe the current status of the Orchidaceae family with respect to its conservation in the Canton Lago Agrio. Determine the richness and abundance of orchids in the Canton Lago Agrio. 2. Determine the ethnobotanical importance of the orchids of the Canton Lago Agrio. 3. To establish conservation strategies for the most representative orchids of the Lago Agrio Canton.

Method: The methodology adopted for the research included field trips through direct and random observation, the use of taxonomic identification guides, an exhaustive bibliographic search in high impact databases such as Scopus and Web of Science, and the application of expert judgment.

Results and Discussion: The results revealed the richness and abundance of orchids within the Lago Agrio canton. 42 species and 497 individuals, each of them with epiphytic habit. The importance of this taxonomic group lies in economic factors, such as, commercialization of specimens, use in medicine and gastronomic taste. Its main conservation strategies are environmental education and the implementation of informative posters in educational centers and natural spaces, such as natural parks.

Research Implications: The results of this study have implications for orchid planning and conservation in Lago Agrio Canton. The research underscores the need for a multidisciplinary approach to taxonomic conceptualization and conservation, as well as the importance of considering the landscape as a central element in the development of sustainable tourism products and experiences.

Originality/Value: This study contributes to the literature by providing a comprehensive and up-to-date review of the relationship between the natural landscape and orchid conservation status, bringing together knowledge from various disciplines.
Advances and Challenges in Public Health and the SDGs: a Critical Review of Emerging Trends
Authors: Paucar Gladys Vilma Ccosi , Paucar Erwin William Ccosi , Paucar Hilda Zenaida Ccosi , Paucar Dina Ruth Ccosi , Sotelo Cristian Gumercindo Medina 
Published: December 2024

Objective: To critically analyze the advances and challenges in the field of public health and the SDGs, identifying emerging trends and their impact on health promotion, disease prevention, and health systems management.

Theoretical Framework: The COVID-19 pandemic revealed both limitations and areas for improvement in health systems, highlighting the need for agile responses to complex problems. The reappearance of infectious diseases such as dengue and Guillain-Barré syndrome underlines the urgency of strengthening epidemiological surveillance and health response capacity.

Method: The methodology adopted consisted of a comprehensive review of the scientific and technical literature published between 2020 and 2024. Databases such as Scopus, PubMed, and Scielo were consulted, using key terms related to public health, climate change, digitalization, and mental health.

Results and Discussion: Among the main results, the progress towards the digitalization of health stands out, including telemedicine and artificial intelligence, as elements that have improved the quality of care. However, challenges related to access in vulnerable areas persist.
Research Implications: Despite momentous advances in public health, such as the integration of digital technologies and prevention policies, significant challenges persist that require urgent attention to ensure healthy lives for all (SDG:3).

Originality/Value: This study provides a critical review of trends in public health, highlighting its originality in assessing the impact of digitalization and preventive policies, and its value in proposing sustainable strategies for future challenges.