bluuebunny/crossref_metadata_2025_split huggingface dataset:
Practice of antimicrobial stewardship in a government hospital of India and its impact on extended point prevalence of antibiotic usage
Authors: kumar Shweta , Tadepalli karuna , Joshi Rajnish , Shrivastava Manisha , Malik Rajesh , Saxena Pradeep , Saigal Saurabh , Jhaj Ratinder , khadanga Sagar 
Published: February 2021

Background:
Antimicrobial resistance (AMR) is a global concern requiring immediate attention. Among many proven measures of decreasing AMR, practice of antimicrobial stewardship is the lowest hanging which can be adapted with negligible financial implications.

Methods:
This is a case record based extended cross-sectional type of observational operation research study conducted at an institute of national importance established by Government of India. Point prevalence of antibiotic usage among the patients admitted in the hospital, on four different days in four different quarters of a year was done to study the impact of antimicrobial stewardship program (AMSP).

Results:
A cumulative 711 patients were exposed on antibiotics among 1396 study participants. There was a significant decrease in antibiotic consumption across the 1st and 4th quarter. The average antibiotic usage was 50.9% (61.75, 60%, 48.4%, and 39% respectively in the 1st to 4th quarter). Among the total number of patients, intravenous antibiotic usage was 47.9% (60.71%, 58.4%, 44.9%, and 34.2% respectively in 1st to 4th quarter). Among the newly admitted patients, the consumption of antibiotic usage decreased from 45.9% to 25.7%. Among the intravenous antibiotics, the top 10 consumed antibiotics were 3rd generation cephalosporin (39.8%), aminoglycoside (14.8%), amoxicillin/amoxy-clav (12.5%), piperacillin-tazobactum (8.5%), carbapenams (6.6%), cefuroxime (6.4%), quinolones (4.3%), vancomycin/linezolid (4.1%), colistin (0.8%), and others (0.8%).

Conclusion:
Government run hospitals can run low budget antimicrobial stewardship program with sustainable impact on antibiotic consumption. For a successful AMSP, it requires change in attitude, commitment, and administrative support rather than a huge financial support.
Role of platelet count and mean platelet volume and red cell distribution width in the prediction of preeclampsia in early pregnancy
Authors: Sachan Rekha , Patel Munna Lal , Vandana  , Sachan Pushplata , Shyam Radhey 
Published: February 2021

Introduction:
Mean platelet volume (MPV), platelet count (PC), and red cell distribution width (RDW) are various blood indices that play important role in preeclampsia. This study aimed to evaluate the role of MPV, RDW, and PC for the prediction of preeclampsia in the early second trimester of pregnancy and to observe its correlation with disease severity.

Material and Methods:
A prospective case-control study was conducted for 1 year in the Department of Obstetrics and Gynecology. A total of 543 healthy pregnant women were recruited, after obtaining informed consent and ethical clearance and followed till 6 weeks postpartum, 43 were lost to follow-up. Out of 500 women, nonsevere preeclampsia (NSPE) occurred in 16 women and severe preeclampsia (SPE) in 34 women. Around 51 healthy normotensive pregnant women were recruited after systematic randomization from the same cohort, who had not developed the disease, served as controls. NSPE and SPE were defined as per ACOG 2013b guideline. MPV, RDW, and PC were measured two times by the Siemens Advia analyzer; the first samples were withdrawn at the time of enrolment and the next sample was taken after the development of the disease, and both samples were analyzed.

Results:
MPV was increased with the severity of preeclampsia, diagnostic accuracy was 69.4%, at a cutoff value of ≥9.05 fl and MPV discriminated controls and NSPE with 50.0% sensitivity and 82.4% specificity. To discriminate between controls and SPE, diagnostic accuracy was 74.6% at a cutoff value of ≥9.05 fl, with a sensitivity of 50%. For control versus SPE, MPCs at the cutoff value of ≥2.085 lac/mm3 had sensitivity 52.9% and specificity 66.7%, and diagnostic accuracy 61.2%. For RDW NSPE, at a cutoff value of ≥11.5%, it discriminated against controls and NSPE with 85.3% sensitivity and 49.0% specificity.

Conclusion:
NSPE, MPV, RDW, and PCs had good discriminatory value with the severity of the disease.
Attitude of parents towards seasonal influenza vaccination for children in Saudi Arabia
Authors: Hamadah Reem E. , Hussain Aneela N. , Alsoghayer Najd A. , Alkhenizan Zeyad A. , Alajlan Haya A. , Alkhenizan Abdullah H. 
Published: February 2021

Introduction:
The aim of this study is to assess attitudes, beliefs, and behavior towards seasonal influenza vaccination for children among parents in Saudi Arabia and to correlate parental demographic characteristics with hesitancy.

Methodology:
This is a cross-sectional study conducted in the Family Medicine clinics linked to a tertiary referral hospital in Riyadh. Inclusion criteria were: being a parent, having a child aged six months to 14 years whom is following at that hospital, and living in Saudi Arabia. The Parent Attitudes about Childhood Vaccines (PACV) survey was used for data collection. Demographic questions were added.

Results:
The number of participants was 388. Out of these, 298 (76.8%) parents were not hesitant for their child to get vaccinated. Whereas 90 (23.2%) parents were hesitant. Parental gender and age were the only demographic factors found to have a statistically significant impact on their hesitant behavior. For the influenza season of 2018–2019, 148 (38.14%) children received the influenza vaccine. The most common reason for not receiving it was the belief that the vaccine is not necessary. While 25 (27.78%) of the 90 parents who were hesitant allowed their child to get vaccinated, 123 (41.28%) of the 298 parents who were not hesitant allowed their child to get vaccinated, creating a statistically significant difference (p = 0.0255).

Conclusion:
Despite the overall positive attitude and low hesitancy, the vaccine uptake was low. Improving access, education about the importance of the vaccine, advocacy from doctors, and correction of misconceptions about it will facilitate an increase in the uptake.
knowledge, attitude, and practice regarding diabetic foot care among Saudi and non-Saudi diabetic patients in Alkharj
Authors: Shamim Muhammad , Alhakbani Mohammed Saad A. , Alqahtani Meshari Saeed B. , Alharthi Omar Saud Obeid , Alhaqbani Yazeed Jaber Naji 
Published: February 2021

Context:
There is a high prevalence of diabetes mellitus in Saudi Arabia. Also, the diabetic foot complication rate is alarmingly high with many patients ending in amputation.

Aims:
To assess the knowledge, attitude, and practices regarding diabetic foot care among Saudi and non-Saudi diabetic patients in Alkharj.

Settings and Design:
It is a cross-sectional study conducted from May 22nd, 2019 to April 1st, 2020 at Diabetic clinic, Military Hospital in Alkharj.

Methods and Materials:
Non-randomized, non-probability convenience sampling technique was used to collect data from 224 patients by using a validated and confidential questionnaire in either face-to-face interviews or as an electronic survey. All adult patients over 18 years of age of both sexes having type 1 and 2 diabetes mellitus were included. The patients who were unable to provide the requested information were excluded.

Statistical Analysis:
The data were analyzed using SPSS version 24.

Results:
The mean age of patients was 49.37 years with 58.5% male and 41.5% female patients. About 58% of patients had diabetes for more than 10 years. More than half of the patients reported some foot problems, while 9.4% have had active or healed ulcerations. The mean scores for knowledge, attitude, and practice were 8.576, 4, and 13, respectively, all statistically significant.

Conclusions:
Our study population has sufficient knowledge about diabetes and its foot complication, and they also had a positive attitude towards its management. However, they were lagging in the practices required for diabetic foot management.
Factors associated with survival in adult people living with HIV/AIDS (PLHAs) in Mumbai, India (2004-2019)
Authors: Acharya Shrikala , Palkar Amol , keskar Padmaja , Setia Maninder Singh 
Published: February 2021

Background:
knowledge of factors that affect survival in People living with HIV/AIDS (PLHAs) on anti-retroviral therapy (ART) will help us develop and implement interventions to improve the clinical outcomes and survival in these individuals. The aim of this study was to estimate the survival in PLHAs on ART in the government ART programme in Mumbai, and the factors associated with survival in these individuals.

Methods:
It is a retrospective survival analysis of 28,345 adult PLHAs from 18 government ART centres in Mumbai (registration period 2004–2019). We estimated the mortality rates and their 95% confidence intervals [CIs], plotted the kaplan Meier Survival curves, estimated incidence rate ratios (IRR) and hazard ratios (HR). There were done for the whole cohort and according to various demographic and clinical characteristics.

Results:
The mortality in PLHAs on ART was 9.04 per 1000 person years. The HR was significantly for those aged 50 years and more at the time of registration (HR: 3.01, 95% CI: 2.37, 3.83; P < 0.001), in those with baseline CD4 count of less than 200 higher hazard (HR: 1.83, 95% CI: 1.47, 2.27; P < 0.001), those with an adherence of 80–95% (HR; 5.58, 95% CI: 4.61, 6.75; P < 0.001) and adherence of <80% (HR: 9.37, 95% CI: 7.74, 11.33; P < 0.001). Furthermore, the hazard was significantly higher in those with TB compared those without TB (HR: 3.28, 95% CI: 2.87, 3.75; P < 0.001). Time from diagnosis (per month increase) to initiation of ART was not significantly associated with mortality.

Conclusions:
Increasing awareness about HIV testing and early detection of HIV in those who have high-risk behaviours, prompt diagnosis and management of TB among those infected, and developing and implementing strategies (such as enhanced counselling, telephone-based applications, messages, or reminders) to ensure ART adherence of more than 95% in those on ART will potentially help improve survival in PLHAs in India.
Prevalence of overweight and obesity and their associated factors among health sciences college students, Saudi Arabia
Authors: Makkawy Eyad , Alrakha Almaali M. , Al-Mubarak Amena F. , Alotaibi Hanouf T. , Alotaibi Nour T. , Alasmari Aeshah A. , Altamimi Tahani 
Published: February 2021

Context:
The healthcare sciences college students have a lifestyle with low physical activity and disordered eating habits, which exposes them to a higher risk of obesity. Health science college students were the target group of particular interest in this study as they are future physicians. If they are overweight or obese, they will carry the wrong impression to the general population.

Aim:
To assess the prevalence of overweight and obesity among healthcare science college students at private university in Saudi Arabia. Also, it assesses the relationship between the sociodemographic characteristics and risk of overweight and obesity in this population.

Methods:
A cross-sectional study was conducted among healthcare science college students. A validated, structured, closed-ended questionnaire was self-administered through the Monkey survey. All data were analyzed using SPSS.

Results:
401 students participated, in which 33.4% were male and 66.6% were female students; and the mean age was 22 years. The study showed that 23.7% of participants were overweight, and 11% were obese. The prevalence of obesity was higher among males. Family history of obesity and fatigue were risk factors for obesity.

Conclusion:
The healthcare Science College students showed a high prevalence of obesity and overweight. This is strengthening the need to encourage a healthy lifestyle, healthy food habits, and physical activities to avoid obesity-related complications.
Comparison of demographic profile, risk factors, and in-hospital outcome in young and old patients with acute coronary syndrome
Authors: Bush Nikhil , Sharma Yash Paul , Prasad krishna , kumar Pankaj , Mehrotra Saurabh 
Published: February 2021

Background:
Coronary artery disease (CAD) is witnessing a demographic transition with increasing prevalence in younger individuals. Data is scarce comparing various characteristics of acute coronary syndrome (ACS) between young and old patients in an Indian setting. Hence, we evaluated the epidemiological, demographic, risk factor, and outcome profile of young and old ACS patients in Indian setting.

Methods:
This was a prospective observational study, which enrolled 50 consecutive ACS patients each into two groups: younger (≤45 years) and elderly (>45 years), respectively. Comparison of clinical presentation, electrocardiography, echocardiographic findings, conventional, nonconventional risk factors, and in-hospital outcomes including duration of hospital stay and major adverse cardiac events (MACE) were made between the two groups. Multivariate regression analysis of risk factors as determinants of MACE adjusting for other confounding factors was also performed.

Results:
Fifty patients in each group were compared. Mean age in the younger and elderly group was 36 ± 4.69 and 61.58 ± 10.69 years, respectively. Male sex, smoking, family history of CAD, hyperhomocysteinemia, and obesity were observed more in the younger population. While dyslipidemia, low physical activity, diabetes mellitus, and history of previous ACS was more in the older population. Single-vessel disease was more common in younger patients while multivessel involvement was more common in elderly patients. Older patients had longer hospital stays and more in-hospital MACE including deaths. By multivariate analysis, shock was found to be an independent predictor of MACE in both groups.

Conclusion:
Younger ACS patients have a different risk profile and better in-hospital outcomes compared to older patients.
Clinical features, presentation and hormonal parameters in patients with pubertal gynecomastia
Authors: Acharya Shrikrishna V. 
Published: February 2021

Objective:
Gynecomastia is benign enlargement of breast in male. It is postulated that its development is primarily due to a mismatch in ratio of oestrogen and androgen at breast tissue. The aim of this study was to highlight the clinical features, presentation and hormonal parameters at the time of consultation.

Methods:
All adolescent patients who attended endocrinology department with the complaint of breast enlargement were taken into study. We analysed their thyroid function test, oestrogen, testosterone, prolactin, alpha-fetoprotein, follicle-stimulating hormone, luteinizing hormone, beta HCG (human chorionic gonadotropin) and liver function. Clinical features and anthropometry were recorded.

Results:
Out of 50 patients enrolled, 34 (68%) had bilateral gynaecomastia while 16 patients (32%) had unilateral disease. Mastalgia was seen in 44 patients (88%). Psychological disturbance in the form of depression was seen in 60% of adolescent boys with gynecomastia. Tanner stage B had positive correlation with oestrogen to testosterone (E2/TTE) ratio (r = 0.47; P = 0.034). All other hormonal parameters were normal.

Conclusion:
Mastalgia was one of the presenting complaints in majority of patients and many had bilateral enlargement. Altered oestrogen to testosterone ratio is altered in majority of patients thus may be reason for pubertal gynecomastia.
knowledge, attitude, and barriers of seasonal influenza vaccination among pregnant women visiting primary healthcare centers in Al-Ahsa, Saudi Arabia. 2019/2020
Authors: Albattat Huda Saleh , Alahmed Alzahra Abdulaziz , Alkadi Fatimah Ahmed , Aldrees Ola Saleh 
Published: February 2021

Background:
The seasonal influenza vaccine is beneficial for both the pregnant women and their infants. It is considered as primary prevention for pregnant women and it decreases the serious outcomes when infection does occur. The present study was conducted to evaluate the knowledge, attitude, and barriers linked to uptake of seasonal influenza vaccine among pregnant women visiting primary healthcare centers (PHCs) in Al-Ahsa region of Saudi Arabia.

Methods:
A cross-sectional study done in Al-Ahsa with a target population of 410 Saudi pregnant women who attend antenatal care (ANC) clinics in PHCs in Al-Ahsa. The selection of participants was made by using multistage random sampling. A self-administered questionnaire was used as an instrument for data collection.

Results:
Two-thirds of the participants (66.1%) stated that they were not offered the flu vaccine by any doctor. Sixty percent of the participants (60.6%) show lack of knowledge regarding flu vaccine during pregnancy. One hundred and fifty-four of the participants (61.1%) have negative attitude toward the flu vaccine uptake during pregnancy. Concern regarding the side effects of the vaccine was the most mentioned barrier (80.9%).

Conclusions:
The uptake rate of influenza vaccine among pregnant women visiting Al-Ahsa PHCs is considerably low. In order to improve the uptake, we recommend increasing awareness among physicians working in PHCs of the importance of vaccination, enhancing the knowledge of women in childbearing age about influenza and its vaccine, and emphasizing the need to provide the influenza vaccine as part of routine ANC.
knowledge, attitude, and practice study regarding cholera among the people in Jazan city, kSA
Authors: Ali Eman Merghani , Mohamed Moawiya Badawi , Tawhari Mosa 
Published: February 2021

Background:
Cholera is a contagious infection that can be fatal; in spite of this, it can be easily prevented by sticking to proper hygienic measures as well as administering cholera vaccine. However, prevention of cholera is highly dependent on the knowledge and attitude of the general population toward the symptoms and preventive measures of cholera, which is unclear in medical literature.

Objective:
This survey analysis aims to explore the level of knowledge as well as attitude and practice of people in Jazan, Saudi Arbaia toward cholera infections.

Design and Setting:
A self-administered structured questionnaire was distributed via online link to individuals living in Jazan region in Saudi Arabia. The survey included questions on knowledge about cholera symptoms, etiology, and prevention as well as attitude and practices of the responders on this type of infection in addition to sociodemographic data. Data analysis was done through SPSS program version 24.

Results:
400 participants responded to this questionnaire. The mean score for knowledge section was 1.86 ± 0.990, for practice section was 5.07 ± 1.353, and for attitude section was 6.14 ± 2.346, all of them were below average rating. There was statistically significant difference (P-value = 0.003) between different educational levels, with a positive correlation between educational level and level of knowledge about cholera. There was a statistically significant difference (P-value = 0.034) between different genders. Females showed a significantly improved practice towards cholera infection.

Conclusion:
The level of knowledge of the public in Saudi Arabia is poor. Also, the attitudes and practices of people in Jazan area, Saudi Arabia is considered unsatisfactory. Further studies in other regions of Saudi Arabia are highly recommended.
On webs in quantum type C
Authors: Rose David E. V. , Tatham Logan C. 
Published: February 2021

AbstractWe study webs in quantum type C, focusing on the rank three case. We define a linear pivotal category
$\textbf {Web}(\mathfrak {sp}_{6})$
diagrammatically by generators and relations, and conjecture that it is equivalent to the category

$\textbf {FundRep}(U_q(\mathfrak {sp}_{6}))$
of quantum

$\mathfrak {sp}_{6}$
representations generated by the fundamental representations, for generic values of the parameter q. We prove a number of results in support of this conjecture, most notably that there is a full, essentially surjective functor

$\textbf {Web}(\mathfrak {sp}_{6}) \rightarrow \textbf {FundRep}(U_q(\mathfrak {sp}_{6}))$
, that all

$\textrm {Hom}$
-spaces in

$\textbf {Web}(\mathfrak {sp}_{6})$
are finite-dimensional, and that the endomorphism algebra of the monoidal unit in

$\textbf {Web}(\mathfrak {sp}_{6})$
is one-dimensional. The latter corresponds to the statement that all closed webs can be evaluated to scalars using local relations; as such, we obtain a new approach to the quantum

$\mathfrak {sp}_{6}$
link invariants, akin to the Kauffman bracket description of the Jones polynomial.
DESAIN DAPUR UMUM PORTABLE UNTUK PENANGGULANGAN BENCANA ALAM
Authors: Hidayanto Andi Farid , Rulia Anna 
Published: February 2021

Indonesia is a disaster-prone areas. To meet the logistical needs of the victim and the officer needed a common kitchen. Common kitchen that is generally in the form of tents, buildings used as shelters, or modified car. Common kitchen there is an emergency nature, improvise, and how far from the disaster site. These problems need to design a common kitchen for natural disaster management, which can meet the needs, the officer and the victim. In designing methods Pahl and Beitz with steps Planning and explanation of the task, design concept, design forms, and design details. Collecting data using methods Individual Questionnaire and Focus Group Discussion the results obtained attributes required in the design. Results of the research is a common kitchen design for a natural disaster are portable, easily assembled and disassembled, can be set up in various locations condition, easy to operate, able to accommodate facilities and needs. Common kitchen design produced in the form oflarge-scale three-dimensional model, a blueprint for the technical specifications, and the protoype.
Indonesia merupakan daerah rawan bencana. Untuk memenuhi kebutuhan logistik korban dan petugas diperlukan dapur umum. Dapur umum yang ada umumnya berupa tenda peleton, bangunan yang dijadikan posko, atau mobil yang dimodifikasi. Dapur umum yang ada sifatnya darurat, seadanya dan lokasinya jauh dari lokasi bencana. Dari masalah tersebut perlu desain dapur umum untuk penanggulangan bencana alam, yang bisa memenuhi kebutuhan, baik petugas maupun korban. Dalam mendesain menggunakan metode Pahl dan Beitz dengan langkah-langkah Perencanaan dan penjelasan tugas, Perancangan konsep, Perancangan bentuk, dan Perancangan detail. Pengumpulan data menggunakan metode Individual Questionnaire dan Focus Group Discussion yang hasilnya didapatkan atribut yang diperlukan dalam desain. Hasil dari penelitian berupa desain dapur umum untuk penanggulangan bencana alam yang portable, mudah dirakit dan dibongkar, bisa didirikan di lokasi yang beraneka kondisi, mudah dioperasikan, mampu menampung fasilitas dan kebutuhan. Desain dapur umum yang dihasilkan dalam bentuk model tiga dimensi berskala, blue print spesifikasi teknis, dan protoype.