bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to Mental Health Service Utilization Among Patients Attending Tertiary Health Institution in Sokoto State, Nigeria
Authors: Abubakar Ahmad , Magaji Bello Arkilla , Bakare Abdulfatai Tomori , Yakubu Anas Ibrahim , Umar Mukhtar , Illo Nuratu Muhammad , Yusuf Sajjad Muhammad 
Published: September 2024

AbstractBackground:Globally, the barriers to accessing mental health services remain a public health challenge. These are more pronounced in low- and middle-income countries, where patients are at greater risk for not getting the required mental health services.Aim:To determine the barriers to mental health service utilization in two tertiary health facilities in Sokoto State, Nigeria.Subjects and Methods:A cross-sectional study was conducted among 52 psychiatric outpatients and 99 patients’ relatives using the multistage sampling technique. A semistructured interviewer-administered questionnaire was used to obtain the data. The outcome variables are physical, cultural, and financial barriers to mental health service utilization. Data were analyzed using IBM Statistical Package for Social Sciences version 25.0 for Windows, and a test of association between the variables was done using the chi-square test.Result:A total of 151 respondents were interviewed, with a mean age and standard deviation of 37.92 ± 12.62 years, while the modal age was 41 years. Overall, 95 (62.9%) of the respondents were male and 107 (70.9%) were married. In total, 120 (39.7%) were literate and 94 (60.3%) were self-employed whose average income was N50,766:67 per month. Ninety-nine (65.6%) of the participants have no community support, 116 (76.8%) have limited access to mental health services, and 122 (80.8%) have financial constraints in procuring drugs. Cultural and financial barriers were the significant barriers to mental health service utilization (χ2= 0.672,P= 0.001).Conclusion and Recommendation:There exist significant cultural and financial barriers to utilizing mental health services in Sokoto State, Nigeria. Therefore, we recommend more advocacy, public enlightenment, and increasing family and community support for patients with mental disorders.
Critical Delays in Neurosurgical Referral for Sellar Region Tumors: Unveiling the Consequences of Misdiagnosis and the Path to Timely Intervention
Authors: Ogolo Donald E. , Ndukuba Kelechi O. , Ajare Enyereibe C. , Akin-Dosumu Akin , Nnama Sunday , Ndubuisi Chika A. , Mezue Wilfred C. , Ohaegbulam Samuel C. 
Published: September 2024

Abstract

Background:
Sellar region tumors pose significant diagnostic challenges, with delays in neurosurgical referral, leading to irreversible complications such as visual loss. This study explores the causes and consequences of these delays, emphasizing misdiagnosis and systemic healthcare inefficiencies.

Objective:
To quantify delays in neurosurgical referral for sellar region tumors, identify contributing factors, and assess the impact on patient outcomes.

Subjects and Methods:
A retrospective analysis was conducted on patients referred to a tertiary neurosurgical center over 3 years, focusing on demographics, initial symptoms, time to referral, and outcomes.

Results:
The findings indicate substantial delays, with many patients waiting over a year from symptom onset to neurosurgical consultation. The majority were initially seen by non-neurosurgical specialists and often misdiagnosed with ophthalmologic conditions. Contributing factors included lack of provider awareness, socioeconomic barriers, and limited diagnostic resources. These delays correlated with worse outcomes, notably increased irreversible visual impairment, and advanced tumor stages at intervention.

Conclusions:
This study highlights the critical need for improved healthcare provider training, standardized referral protocols, and greater accessibility to diagnostic services. Addressing these issues is essential in reducing delays and improving outcomes for patients with sellar region tumors. Further research into innovative solutions, such as telemedicine and public health campaigns, is warranted to address the barriers identified in this study.
Phenobarbital as an adjunctive agent for sedation in pediatric intensive care unit patients: A single-center, retrospective study from Colorado
Authors: Welter Kelli Jo , DeVine Mackenzie N. , Gordon Sharon E. , Demasellis Gina 
Published: September 2024

Abstract

Background:
Pediatric patients require pharmacological management of pain and agitation associated with mechanical ventilation. Pain and agitation may be refractory to opioids and alpha-2 agonists, prompting the use of adjunctive analgesics and sedatives with alternative mechanisms. The purpose of this study was to describe the use of phenobarbital as an adjunctive agent for refractory agitation in critically ill, mechanically ventilated pediatric patients.

Subjects and Methods:
This was a single-center, retrospective chart review at a pediatric intensive care unit (PICU) at a pediatric academic medical center in America between 2016 and 2021. Children aged 2 months to 18 years old were admitted to the PICU were mechanically ventilated and received phenobarbital for adjunct sedation. Sixty-three patients had phenobarbital dosing data evaluated, and the 38 patients who were not receiving continuous neuromuscular blockade were included in the primary and secondary outcome analysis of time within the goal sedation score. Descriptive statistics was used to assess baseline characteristics and the primary outcome. Wilcoxon signed-rank tests were used to evaluate secondary outcomes.

Results:
Patients spent significantly more time within the goal sedation score range after phenobarbital compared to before phenobarbital. The median number of rescue sedative boluses, morphine equivalents (MEs), and benzodiazepine equivalents (BZDE) significantly decreased 2 days after the first phenobarbital dose compared to the 2 days before the first phenobarbital dose.

Conclusions:
The use of phenobarbital as an adjunct sedative was associated with a statistically significant increase in time spent in the goal sedation score range and decrease in ME, BZDE, and concomitant sedative boluses.
Effectiveness of a structured handover tool (I-PASS + C) in patients transferred out from pediatric intensive care unit to ward: A single-center, prospective observational study from Western India
Authors: Upadhyay Vaibhava , Kumar Amit , Tandon Krutika Rahul , Nimbalkar Somashekhar M. , Kadiyawala Saalim M. 
Published: September 2024

AbstractBackground:Handover is a process of communication between physicians and, thus, integral to medical practice. Communication failures commonly cause preventable medical errors and adverse events. This study was done to evaluate the effectiveness of a structured handover tool.Subjects and Methods:It is a prospective observational study conducted in pediatric intensive care unit (PICU) of tertiary care hospital of Western India. The errors were noticed in the handover process of patients who were transferred from the PICU to the pediatric ward. A modified handover tool I-PASS + C was implemented as an intervention. The outcome was measured in the form of changes in the number of errors postintervention.Results:The handovers enrolled in the control group were 46 (28.04%) and 40 (24.39%) in the intervention group. Patient’s age ranged from 3 months to 205 months. “Not mentioning information regarding counseling and parent’s response/behavior” and “no cross check by hearing back from the receiver” were the most commonly noticed errors in 40 (86.9%) and 31 (67.4%) patients, respectively, which reduced significantly in the intervention group. Other commonly noticed errors during the stay in the ward were “got phone call from ward to take further information” in 16 (34.78%) patients, followed by “medical errors reported in ward” in 8 (17.4%) patients, which also reduced significantly in the intervention group.Conclusions:A structured handover tool reduces the errors of the handover process as well as adverse events, after transferring the patient from the PICU to the ward.
Severe hypertriglyceridemia in an adolescent female with diabetic ketoacidosis: A case report
Authors: Kulkarni Noopur N. , Sarangi Bhakti U. , Walimbe Ajay A. 
Published: September 2024

Abstract
Severe hypertriglyceridemia (SHT) is a rare metabolic complication of diabetic ketoacidosis (DKA) and may complicate the course by leading to acute pancreatitis. While intravenous insulin typically treats the dyslipidemia in these cases, the role of lipid-lowering agents to prevent adverse outcomes in patients not responding to insulin warrants further investigation. We report the case of an adolescent girl who presented to us with DKA and SHT (8639 mg/dL), requiring intravenous insulin as well as fibrates. She did not develop any complications that could be attributed to diabetic lipemia; investigations revealed no sequelae of hyperlipidemia or evidence of familial dyslipidemia.
Utility of renal replacement therapy in poisoning and drug overdosage
Authors: Bhowmick Rohit , Kandasamy Sasidaran 
Published: September 2024

AbstractToxic and prescribed drug ingestions are a significant cause of pediatric morbidity and mortality. Management of the poisoned patient begins with a thorough evaluation, identification of the agent(s) involved, and assessment of severity and symptoms. Therapy consists of the provision of supportive care, prevention of poison absorption, use of antidotes, and, when appropriate, the use of renal replacement therapy (RRT) to enhance the elimination of the poison. Among several elimination techniques, extracorporeal treatment such as RRT can be lifesaving as it rapidly removes the toxin independent of the patient’s indigenous clearance. Hemodialysis remains the most commonly used RRT for toxin removal, and the role of continuous RRT and therapeutic plasma exchange is emerging. To properly utilize the RRT, the clinician should understand the chemical properties of the toxins and the underlying mechanism of clearance by the concerned RRT technique. Although pediatric literature is mainly limited to case reports, timely initiation of RRT helps manage children with poisoning and drug overdose.
Delayed treatment of diabetic foot ulcer in patients with type 2 diabetes and its prediction model
Authors: Chen Hui , Xi Ying 
Published: September 2024

BACKGROUND
Diabetic foot (DF) is a serious complication of type 2 diabetes. This study aimed to investigate the factors associated with DF occurrence and the role of delayed medical care in a cohort of patients with type 2 diabetes.
AIM
To reveal the impact of delayed medical treatment on the development of DF in patients with type 2 diabetes and to establish a predictive model for DF.
METHODS
In this retrospective cohort study, 292 patients with type 2 diabetes who underwent examination at our hospital from January 2023 to December 2023 were selected and divided into the DF group (n = 82, DF) and nondiabetic foot group (n = 210, NDF). Differential and correlation analyses of demographic indicators, laboratory parameters, and delayed medical treatment were conducted for the two groups. Logistic regression was applied to determine influencing factors. Receiver operating characteristic (ROC) analysis was performed, and indicators with good predictive value were selected to establish a combined predictive model.
RESULTS
The DF group had significantly higher body mass index (BMI) (P < 0.001), disease duration (P = 0.012), plasma glucose levels (P < 0.001), and HbA1c (P < 0.001) than the NDF group. The NDF group had significantly higher Acute Thrombosis and Myocardial Infarction Health Service System (ATMHSS) scores (P < 0.001) and a significantly lower delayed medical treatment rate (72.38% vs 13.41%, P < 0.001). BMI, duration of diabetes, plasma glucose levels, HbA1c, diabetic peripheral neuropathy, and nephropathy were all positively correlated with DF occurrence. ATMHSS scores were negatively correlated with delayed time to seek medical treatment. The logistic regression model revealed that BMI, duration of diabetes, plasma glucose levels, HbA1c, presence of diabetic peripheral neuropathy and nephropathy, ATMHSS scores, and delayed time to seek medical treatment were influencing factors for DF. ROC analysis indicated that plasma glucose levels, HbA1c, and delayed medical treatment had good predictive value with an area under the curve of 0.933 for the combined predictive model.
CONCLUSION
Delayed medical treatment significantly affects the probability of DF occurrence in patients with diabetes. Plasma glucose levels, HbA1c levels, and the combined predictive model of delayed medical treatment demonstrate good predictive value.
Identification of immune feature genes and intercellular profiles in diabetic cardiomyopathy
Authors: Zheng Ze-Qun , Cai Di-Hui , Song Yong-Fei 
Published: September 2024

BACKGROUND
Diabetic cardiomyopathy (DCM) is a multifaceted cardiovascular disorder in which immune dysregulation plays a pivotal role. The immunological molecular mechanisms underlying DCM are poorly understood.
AIM
To examine the immunological molecular mechanisms of DCM and construct diagnostic and prognostic models of DCM based on immune feature genes (IFGs).
METHODS
Weighted gene co-expression network analysis along with machine learning methods were employed to pinpoint IFGs within bulk RNA sequencing (RNA-seq) datasets. Single-sample gene set enrichment analysis (ssGSEA) facilitated the analysis of immune cell infiltration. Diagnostic and prognostic models for these IFGs were developed and assessed in a validation cohort. Gene expression in the DCM cell model was confirmed through real time-quantitative polymerase chain reaction and western blotting techniques. Additionally, single-cell RNA-seq data provided deeper insights into cellular profiles and interactions.
RESULTS
The overlap between 69 differentially expressed genes in the DCM-associated module and 2483 immune genes yielded 7 differentially expressed immune-related genes. Four IFGs showed good diagnostic and prognostic values in the validation cohort: Proenkephalin (Penk) and retinol binding protein 7 (Rbp7), which were highly expressed, and glucagon receptor and inhibin subunit alpha, which were expressed at low levels in DCM patients (all area under the curves > 0.9). SsGSEA revealed that IFG-related immune cell infiltration primarily involved type 2 T helper cells. High expression of Penk (P < 0.0001) and Rbp7 (P = 0.001) was detected in cardiomyocytes and interstitial cells and further confirmed in a DCM cell model in vitro . Intercellular events and communication analysis revealed abnormal cellular phenotype transformation and signaling communication in DCM, especially between mesenchymal cells and macrophages.
CONCLUSION
The present study identified Penk and Rbp7 as potential DCM biomarkers, and aberrant mesenchymal-immune cell phenotype communication may be an important aspect of DCM pathogenesis.
Combining GLP-1 receptor agonists and SGLT-2 inhibitors for cardiovascular disease prevention in type 2 diabetes: A systematic review with multiple network meta-regressions
Authors: Zhu Jing-Jing , Wilding John P H , Gu Xiao-Song 
Published: September 2024

BACKGROUND
Glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter-2 inhibitors (SGLT-2I) are associated with significant cardiovascular benefit in type 2 diabetes (T2D). However, GLP-1RA or SGLT-2I alone may not improve some cardiovascular outcomes in patients with prior cardiovascular co-morbidities.
AIM
To explore whether combining GLP-1RA and SGLT-2I can achieve additional benefit in preventing cardiovascular diseases in T2D.
METHODS
The systematic review was conducted according to PRISMA recommendations. The protocol was registered on PROSPERO (ID: 42022385007). A total of 107049 participants from eligible cardiovascular outcomes trials of GLP-1RA and SGLT-2I were included in network meta-regressions to estimate cardiovascular benefit of the combination treatment. Effect modification of prior myocardial infarction (MI) and heart failure (HF) was also explored to provide clinical insight as to when the combination treatment should be considered.
RESULTS
The estimated hazard ratios (HR)GLP-1RA/SGLT-2I vs Placebo (0.75-0.98) and HRCombination vs GLP-1RA/SGLT-2I (0.26-0.86) for primary and secondary cardiovascular outcomes suggested that the combination treatment may achieve additional cardiovascular benefit compared with GLP-1RA or SGLT-2I alone. In patients with prior MI or HF, the mono-therapies may not improve the overall cardiovascular outcomes, as the estimated HRMI+/HF+ (0.57-1.52) suggested that GLP-1RA or SGLT-2I alone may be associated with lower risks of hospitalization for HF but not cardiovascular death.
CONCLUSION
Considering its greater cardiovascular benefit in T2D, the combination treatment of GLP-1RA and SGLT-2I might be prioritized in patients with prior MI or HF, where the monotherapies may not provide sufficient cardiovascular protection.
The Relationship Between Cognitive Control Capacity and Language Dominance Among Malay Bilinguals
Authors: Ramly Bazrina , Ngee Thai Yap , Jalaluddin Ilyana , Basri Hamidon 
Published: September 2024

A growing number of research has suggested that bilingualism could be related to enhanced cognitive control functions (Bellegarda & Macizo, 2021), because of frequent interference suppression of the first language when a bilingual speaker chooses to speak in the second language and vice versa. Nevertheless, the relationship was not shown in some studies, which raises various questions regarding previous findings. Hence, more studies are done to explore other facets of bilingual speaker’s experience that could modulate the cognitive control functions. Accordingly, the bilingualism threshold is examined to investigate the bilingual benefits. It is suggested that bilingual benefits are not just about knowing two languages, but more so into the usage of the languages possessed. Hence, some studies claimed that balanced language dominance would have better cognitive control capacity. This is a result of the continuous practice of suppressing one language over the targeted language. Therefore, there is a need to look at how language dominance could be related to cognitive control capacity as language dominance may impact the frequency of switching as well as activation of the two languages. This study reports the findings of the relationship between cognitive control capacity and language dominance of Malay bilinguals. The participants of this study were 69 balanced bilinguals and 74 Malay-dominant bilinguals. The Bilingual Language Profile was adopted to measure the language dominance of the participants of this study. Cognitive control capacity of the participants was measured with the Stroop Task. Through a Pearson-correlation analysis, it was found that there is a significant relationship between language dominance and cognitive control capacity. Thus, the findings of this research as in line with previous literatures where language dominance of a bilingual is related to enhanced cognitive control functions.
OS CASOS DE CONDENAÇÃO DO BRASIL NA CORTE INTERAMERICANA DE DIREITOS HUMANOS – OEA : FATORES, PADRÕES DE VIOLAÇÃO E IMPACTOS NAS POLÍTICAS PÚBLICAS BRASILEIRAS
Authors: Magera Conceição Bruno 
Published: September 2024

Este livro tem como objetivo lançar luz sobre as histórias que estão por trás de casos de condenações internacionais sofridas pelo Brasil decorrentes de falhas na implementação e garantia de direitos fundamentais, oferecendo uma análise acessível e detalhada dos padrões de violações de direitos humanos no Brasil e os impactos gerados nas políticas públicas. Mais do que um simples estudo jurídico, este trabalho busca conectar o leitor às realidades vividas por pessoas reais, cujas vidas foram irreversivelmente transformadas por um sistema de justiça que falhou em protegê-las.
Enhancing Predictive Analytics for Students' Performance in Moodle: Insight from an Empirical Study
Authors: Duch Dynil , May Madeth , George Sébastien 
Published: September 2024

This paper explores the application of learning analytics in predicting students' performance (SP) within Moodle, a widely used Learning Management System (LMS). The study focuses on measurable academic progress and outcomes, aiming to assist educators in early identification and resolution of issues to boost student productivity and success. Our approach began with a literature review to identify predictive attributes for student performance. We then collected and analyzed data from a year-long study involving 160 students at the Cambodia Academy of Digital Technology (CADT). The dataset included attendance, interaction logs, quiz submissions, task completions, assignments, time spent on courses, and outcome scores. We utilized these data points to train and evaluate various classifiers, identifying the Random Forest classifier as the most effective. A predictive algorithm was developed using the coefficients from this classifier, tailored for practical application in educational settings. Our analysis confirmed significant correlations between the identified attributes and prediction accuracy, enhancing the algorithm's efficacy. A follow-up survey with the same participants one year later provided further validation, affirming the predictive indicators' effectiveness in improving academic performance. This comprehensive approach demonstrates the robustness of our findings and underscores the potential of predictive analytics in enhancing educational outcomes.

Received: 6 July 2024 | Revised: 3 September 2024 | Accepted: 20 September 2024

Conflicts of Interest
The authors declare that they have no conflicts of interest to this work.

Data Availability Statement
Data available on request from the corresponding author upon reasonable request.

Author Contribution Statement
Dynil Duch: Conceptualization, Methodology, Software, Investigation, Data Curation, Writing - original draft, Writing - Review & Editing, Project administration. Madeth May: Conceptualization, Methodology, Validation, Formal analysis, Writing - Review & Editing, Supervision, Funding acquisition, Project administration. Sébastien George: Validation, Writing - Review & Editing, Supervision, Project administration.
Struggles for Hindu Sacred Space in the Netherlands
Authors: Swamy Priya 
Published: September 2024

This book asks us to consider what is absent, rather than what is present, when studying religions. Priya Swamy argues that absent religious spaces are in themselves abstract locations that painfully memorialize feelings of shame, oppression and marginalization. She shows that these ‘traumas of absence’ – the complex, entwined and emotional responses to absent spaces – can be articulated through mob violence and destruction, but also anticolonial struggles or human rights issues.
This study focusses on the absence of temples across the global Hindu diaspora, taking the tumultuous narrative of the Devi Dhaam community in Amsterdam Southeast as a central location to detail the over thirty-year struggle to build a Hindu temple in a neighbourhood of vibrant mosques and churches. In 2010, their makeshift space was pulled away from them, provoking tears among elderly devotees, rage among board members and devastation in the wider community. Leaving their goddess with no place to live, some devotees feared for the dangerous repercussions that would follow from uprooting a divine presence from its home.
By exploring the ways in which the trauma of absent religious spaces has become a formative aspect of localized but also globalized Hindu identity, this book rethinks the way that empty lots, piles of rubble and abandoned buildings around the world are themselves powerful monuments to the trauma of absent temple spaces that mobilize campaigns for Hindu spaces.