bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Health Record Protection Beyond the Health Insurance Portability and Accountability Act: Mixed Methods Study
Authors: Subramanian Hemang , Sengupta Arijit , Xu Yilin 
Published: September 2024

Background
The security and privacy of health care information are crucial for maintaining the societal value of health care as a public good. However, governance over electronic health care data has proven inefficient, despite robust enforcement efforts. Both federal (HIPAA [Health Insurance Portability and Accountability Act]) and state regulations, along with the ombudsman rule, have not effectively reduced the frequency or impact of data breaches in the US health care system. While legal frameworks have bolstered data security, recent years have seen a concerning increase in breach incidents. This paper investigates common breach types and proposes best practices derived from the data as potential solutions.

Objective
The primary aim of this study is to analyze health care and hospital breach data, comparing it against HIPAA compliance levels across states (spatial analysis) and the impact of the Omnibus Rule over time (temporal analysis). The goal is to establish guidelines for best practices in handling sensitive information within hospitals and clinical environments.

Methods
The study used data from the Department of Health and Human Services on reported breaches, assessing the severity and impact of each breach type. We then analyzed secondary data to examine whether HIPAA’s storage and retention rule amendments have influenced security and privacy incidents across all 50 states. Finally, we conducted a qualitative analysis of textual data from vulnerability and breach reports to identify actionable best practices for health care settings.

Results
Our findings indicate that hacking or IT incidents have the most significant impact on the number of individuals affected, highlighting this as a primary breach category. The overall difference-in-differences trend reveals no significant reduction in breach rates (P=.50), despite state-level regulations exceeding HIPAA requirements and the introduction of the ombudsman rule. This persistence in breach trends implies that even strengthened protections and additional guidelines have not effectively curbed the rising number of affected individuals. Through qualitative analysis, we identified 15 unique values and associated best practices from industry standards.

Conclusions
Combining quantitative and qualitative insights, we propose the “SecureSphere framework” to enhance data security in health care institutions. This framework presents key security values structured in concentric circles: core values at the center and peripheral values around them. The core values include employee management, policy, procedures, and IT management. Peripheral values encompass the remaining security attributes that support these core elements. This structured approach provides a comprehensive security strategy for protecting patient health information and is designed to help health care organizations develop sustainable practices for data security.
Use of SNOMED CT in Large Language Models: Scoping Review
Authors: Chang Eunsuk , Sung Sumi 
Published: September 2024

Background
Large language models (LLMs) have substantially advanced natural language processing (NLP) capabilities but often struggle with knowledge-driven tasks in specialized domains such as biomedicine. Integrating biomedical knowledge sources such as SNOMED CT into LLMs may enhance their performance on biomedical tasks. However, the methodologies and effectiveness of incorporating SNOMED CT into LLMs have not been systematically reviewed.

Objective
This scoping review aims to examine how SNOMED CT is integrated into LLMs, focusing on (1) the types and components of LLMs being integrated with SNOMED CT, (2) which contents of SNOMED CT are being integrated, and (3) whether this integration improves LLM performance on NLP tasks.

Methods
Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we searched ACM Digital Library, ACL Anthology, IEEE Xplore, PubMed, and Embase for relevant studies published from 2018 to 2023. Studies were included if they incorporated SNOMED CT into LLM pipelines for natural language understanding or generation tasks. Data on LLM types, SNOMED CT integration methods, end tasks, and performance metrics were extracted and synthesized.

Results
The review included 37 studies. Bidirectional Encoder Representations from Transformers and its biomedical variants were the most commonly used LLMs. Three main approaches for integrating SNOMED CT were identified: (1) incorporating SNOMED CT into LLM inputs (28/37, 76%), primarily using concept descriptions to expand training corpora; (2) integrating SNOMED CT into additional fusion modules (5/37, 14%); and (3) using SNOMED CT as an external knowledge retriever during inference (5/37, 14%). The most frequent end task was medical concept normalization (15/37, 41%), followed by entity extraction or typing and classification. While most studies (17/19, 89%) reported performance improvements after SNOMED CT integration, only a small fraction (19/37, 51%) provided direct comparisons. The reported gains varied widely across different metrics and tasks, ranging from 0.87% to 131.66%. However, some studies showed either no improvement or a decline in certain performance metrics.

Conclusions
This review demonstrates diverse approaches for integrating SNOMED CT into LLMs, with a focus on using concept descriptions to enhance biomedical language understanding and generation. While the results suggest potential benefits of SNOMED CT integration, the lack of standardized evaluation methods and comprehensive performance reporting hinders definitive conclusions about its effectiveness. Future research should prioritize consistent reporting of performance comparisons and explore more sophisticated methods for incorporating SNOMED CT’s relational structure into LLMs. In addition, the biomedical NLP community should develop standardized evaluation frameworks to better assess the impact of ontology integration on LLM performance.
Cooking Temperature and Hold Time Affect Beef Brisket Textural Properties and Cooking Yield
Authors: Kerth Chris R. , Wall Kayley R. , Grayson-Holter Adria 
Published: September 2024

The objective of this study was to determine whether holding beef briskets after smoking would improve textural properties and cooking yield compared to those that were not held at the endpoint temperature. We hypothesized that cooking and holding briskets at lower endpoint temperatures would maintain textural properties and improve yield compared to cooking to a higher endpoint temperature. To test this hypothesis, USDA Choice beef briskets (n = 96; 2 lots x 6/batch x 4 temperatures x 2 hold times) were selected from 2 separate lots at a commercial processing plant. Briskets (both muscles were left connected in each brisket) were cooked in batches of 6, and each batch was randomly assigned an internal endpoint temperature of 75, 80, 85, or 90°C and hold time of 0 or 3 h at each internal temperature, respectively. A flop test was conducted to test the flexibility of the cooked brisket at each temperature/hold time combination. Endpoint temperature and hold time affected brisket tenderness differently between the superficial pectoral (flat) and deep pectoral (point) muscles (P &lt; 0.05). Compared to 90°C with a 3 h hold, briskets cooked to 85°C with a 3 h hold achieved enhanced yield (56.0% vs. 59.3%, respectively; P &lt; 0.05) without sacrificing desirable objective tenderness attributes. Briskets cooked to 75°C with a 0 h hold had the least (P &lt; 0.05) collagen solubility in both the flat and point (12.88% and 9.81%, respectively). The greatest (P &lt; 0.05) collagen solubility was observed in the flat of briskets cooked to 85°C with 3 h hold or 90°C and either 0 or 3 h hold. Extending the end of the briskets off the edge of a tabletop determined brisket doneness by having an angle of less than 45° between the horizontal table surface and the brisket extended off the table (P &lt; 0.05). Cooking and holding briskets at lower endpoint temperatures improved yield while maintaining positive textural properties.
Rehabilitation of a Cracked Tooth: A Case Report
Authors: Mathew Kshema , Rao H Murali , Prasad B S Keshava 
Published: September 2024

A cracked tooth is a tooth in which there exists a partial or complete fracture of a stress plane. The prevalence of cracked teeth is relatively more in patients over 40 years of age. The incidence of cracks or incomplete tooth fracture with vital pulps is 9.7%. The average biting loads in humans range from 45.7kg/mm2 (males) to 36.4kg/mm2 (females) and the force ratio between molars, premolars, and incisors is 4:2:1 respectively.
A tooth stress plane results from occlusal forces that are commonly imposed on that tooth. This may cause an instance of higher energy to occur within the stress plane during masticatory cycle. The functional prognosis and periodontal treatment requirements of a cracked or incompletely fractured tooth depend on the location and amount of tooth structure intersected along with involvement in the stress plane.
This case report highlights the diagnosis and management of a cracked maxillary first molar and identifies the prognostic indicators, which are largely dependent on the extent of the fracture within the tooth structure.
Keywords: Crack tooth; Orthodontic banding; Ribbond; Bite test; Transillumination
CT-Assisted Management with Biodentine Obturation and Aesthetic Rehabilitation of a Geminated Maxillary Central Incisor with Mid-Root Fracture: A Rare Case Report
Authors: Mittal Neelam , Aggarwal Harshitaa , Kharat Shubham , Sharma Shelly , Thangamuthu Thivyashankari , Ayubi Aiyman , Samad Silviya 
Published: September 2024

Gemination, a rare aberration in tooth development, results from the incomplete division of one tooth germ into two. In this case report, a true geminated permanent maxillary central incisor tooth with a horizontal mid-root fracture is successfully treated by non-surgical endodontic treatment. To elucidate the intricate root canal anatomy of this rare geminated incisor, we employed computed tomography imaging technology, enhancing our understanding of this complex case. Utilizing biodentine for obturation proved pivotal, as its capacity to accelerate reparative dentin formation facilitated prompt healing, particularly beneficial in fracture cases. This was followed by aesthetic rehabilitation to achieve a pleasing mesio-distal dimension for both the central incisors using a zirconia-reinforced porcelain crowns.
Keywords: Computed Tomography (CT), Gemination, Horizontal root fracture, Biodentine Obturation
Exploring the Efficacy of Natural Biomaterials in Endodontics
Authors: THOMAS ELIZABETH , Rao H Murali , Prasad B S Keshava , Suman C 
Published: September 2024

Endodontic therapy aims for thorough disinfection and three-dimensional filling of the root canal system, a goal often challenged by the complexity of root canal morphology. Traditional chemical irrigants and intracanal medicaments, such as sodium hypochlorite (NaOCl) and calcium hydroxide (CaOH2), are effective but can be cytotoxic and cause detrimental effects on periapical tissues and radicular dentin. Increasing antibiotic resistance and the adverse effects of synthetic agents have spurred interest in natural phytochemicals as alternatives. These phytochemicals exhibit promising antimicrobial, anti-inflammatory, and chelating properties, making them viable candidates for root canal irrigation, intracanal medicaments, and smear layer removal. The agents reviewed include Terminalia chebula [Triphala], Camellia sinensis [Green Tea] , Curcuma longa [Turmeric], Glycyrrhiza glabra [Liquorice], Propolis, Melaleuca alternifolia [Tea Tree Oil], Azadirachta indica [Neem] etc. These biomaterials have been studied in various combinations and against a variety of common intraoral bacteria like Enterococcus Faecalis. However, most of the conducted researches are in-vitro studies such as agar diffusion test. Despite their potential, there is a need for further comprehensive clinical and experimental studies to fully evaluate their biocompatibility, safety, and effectiveness compared to conventional treatments. This review aims to underscores the necessity of rigorous research and standardization protocols to confidently employ herbal extracts in endodontic practice.
Keywords: Endodntic irrigants, Herbal irrigants, Intracanal medicaments, antibacterial, Glycyrrhiza glabra, Azadirachta indica, Aloe vera
Pregnancy Related Medication Prescription Patterns
Authors: Amaravadi Divya , Guptha Sravya , Tadikonda Rama Rao 
Published: September 2024

Introduction: Drug use during pregnancy presents significant challenges due to altered pharmacokinetics and pharmacodynamics, with potential adverse effects on the fetus. The USFDA (United States Food and Drug Administration) categorizes drugs from A to X based on their safety in pregnancy, guiding appropriate drug use. Hence, this research aimed to assess rationality in prescription pattern and to identify commonly prescribed medications in pregnant women.
Methodology: A pilot prospective observational study was conducted for three months at Gandhi Hospital, Secunderabad. Women of any gestational age willing to participate voluntarily were included in study while non-pregnancy cases and cases with incomplete data were excluded. Data collection focused on demographics, medical history, and prescribed medications. Prescription pattern was analyzed using WHO (World Health Organization) core prescribing indicators and USFDA pregnancy drug-risk categories.
Results: Study highlighted the prevalence of anemia in 50% of pregnant women making it a possible factor for complications like premature birth and low birth weight if untreated. Majority of prescribed medications belong to Category B. Among 70 prescriptions, average number of drugs per prescription was 5.857 which was excess. Supplemental drug use accounted for 40.97% of the 410 prescription drugs, 168 drugs, and 242 drugs (59.024%) of the non-supplemental drugs prescribed.
Conclusion: Study emphasizes importance of supplemental drug use which was found to be deficient in the prescriptions. It is necessary for the well-being of mother and growth of fetus. Findings provide healthcare professionals with insights into current prescribing practices, aiming to enhance rational drug use in pregnancy.
Keywords: Pregnancy; USFDA drug risk category; prescription pattern.
Assessment of Helicobacter pylori Infection and Associated Risk Factors in Asymptomatic Patients Attending Muhoza Health Center
Authors: ALAIN PRUDENCE ISHIMWE , Jean de Dieu TUYISHIME , Consolee UWAMAHORO , Godefroid NZEYIMANA , Hiberte MIGABO 
Published: September 2024

Background: H. pylori, is a bacterial pathogen that colonizes the gastric mucous lining and the epithelial tissue of the stomach. Helicobacter pylori strains infections can lead to several diseases such as duodenal ulcers, gastric ulcers, adenocarcinoma of the distal stomach, mucosa-associated lymphoid tissue (MALT) lymphoma, diabetes mellitus, cardiovascular disease and autoimmune diseases. The objectives of this study were to assess the prevalence of H. pylori infection and risk factors associated with H. pylori in asymptomatic participants attending Muhoza health center
Methodology: A cross-sectional study was conducted from 13th September to 13th October. Stool samples from 60 eligible participants were collected in sterile containers and they were immunoserologicaly analysed. Rapid tests were used to detect H. pylori antigens. A liquid in the testing kit was mixed with a small portion of the stool. The mixture was poured to the sample hole on the rapid test which displayed results. Data regarding risk factors were collected using questionnaires and were analyzed statistically using SPSS 20.
Results: The prevalence of H. pylori infection was 37%. Females were more affected than males, with 25% and 12% respectively. Age, education, source of water and household population were significantly associated with Helicobacter pylori with p-values < 0.05. The study was limited since it was one health center based, hence not having large representative population.
Conclusion: Education of the population about prevention of the infection, supply clean, treated water for home usage and drinking, are recommended to the local government authorities in Musanze. Screening for H. pylori infection, good adherence on antibiotics against H. pylori, hand washing, and proper household settings to reduce crowding issue are recommended. Further researches are recommended for more conclusive results.
Keywords: H. pylori infection, risk factors, stomach, asymptomatic.
Policy Analysis for Anemia and Pregnant Women Care Eleviation Program Through Prospective Bride’s Preparation
Authors: Cahyati Peni , Pertiwi Sinar , Mardiah Siti Saadah , Gantini Dede , Rismawan Wawan 
Published: September 2024

Background: The percentage of pregnant women experiencing anemia in Indonesia has increased 37.1% compared to 2018 Riskesdas. The incidence of stunting is also influenced by the anemia and nutritional status of the mother during pregnancy. The implementation of 1000HPK has been widely implemented in all districts and cities throughout Indonesia but there are still obstacles in policy integration and cross-sector coordination caused by a lack of understanding of the program so that priority placement is not determined. Aim: to obtain policy recommendations for improving programs to prevent and alleviate anemia and Chronic Energy Deficiency (CED) for pregnant women through the process of prospective bride’s preparation. Research method: The method used Action research with 3 stages. The sample are key persons of 1000 HPK program which are Public Health Office, BKKBN, Midwifery and Nursing Health Providers, and Regional Ministry of Religion (Kemenag and KUA). 24 people participate in FGD and 5 people for the In-depth Interview which was carried out at a place agreed upon by the respondents. Results: of the research provide recommendations for the need for collaboration between schools and universities for health education, schools and community health centers in providing blood supplement tablets, the need for an SOP for administration flow and procurement flow for Fe tablets as well as evaluation and monitoring. Modifying Fe tablets to make them popular with teenagers, creating health check formats for use, utilizing research and community service results and utilizing digital-based communications. Conclusion: achieving the goals of the anemia policy program requires cooperation and collaboration between various stakeholders.
Keywords: Policy, Anemia, CED, Pregnant Women, Prospective Brides
The Multifaceted Therapeutic Profile of Madecassoside: A Scholarly Review
Authors: Sivasankaran Shanmugam Manoharan , Pethanasamy Manoharan , Surya Saravanan , Harish Krishnan , Sakthisankaran Shanmugam Manoharan , Kowsalya Raju 
Published: September 2024

Medicinal plants are indispensable in both modern and traditional healthcare, offering a diverse array of bioactive compounds with therapeutic properties, including anti-inflammatory, antimicrobial, and anticancer effects. They provide accessible and affordable treatment options and play a crucial role in drug discovery, enhancing holistic health and promoting biodiversity conservation. Ongoing scientific research continues to validate and expand their applications in contemporary medicine, underscoring their enduring significance. Centella asiatica, a medicinal plant known for its therapeutic properties in traditional medicine and increasingly recognized in modern pharmacology for various health benefits. Madecassoside, stands out as a phytoactive constituent of Centella asiatica, renowned for its wide-ranging pharmacological properties, encompassing anti-inflammatory, antioxidant, wound-healing, and skin-protective effects. The present review illuminates madecassoside's pharmacological properties and its mechanistic roles, as documented by various researchers.
Keywords: Madecassoside, Centella asiatica, anti-inflammatory, antioxidant, wound-healing
Management of Knee Osteoarthritis with integrative approach using Regimenal therapy (Massage and Medicated Steam Fomentation) and Pharmacotherapy (Habb-e -Muqil): A Case Study
Authors: Parveen Shaik Adeena , Mir Uzair Yousf , Abbasi Safia , Nayab Mohd , Azeez Abdul , Ansari Abdul Nasir 
Published: September 2024

Osteoarthritis (OA) is the most common progressive musculoskeletal disorder, that is characterized by pathological changes in cartilage, bone, synovium, ligament, muscle, and periarticular fat, leading to joint dysfunction, pain, stiffness, functional limitation, and loss of day to day life activities. It affects an estimated more than 240 million people worldwide. It can involve almost any joint but typically affects the hands, knees, hips, and feet. In India, 28.7% of adults ≥ 40 years of age and 45.5% of adults ≥ 60 years of age have KOA. The annual incidence rate of KOA in India is 2.4%. The management of KOA involves a comprehensive approach, including non pharmacological management, pharmacological management, and surgical management. In Unani medicine, KOA comes within the domain of a broader term, “Waja-ul-Mafasil”, which refers to joint pain. It occurs due to quantitative and qualitative derangement of Akhlat (humors) and derangement of optimal temperament (Mizaj). We present the case of a 48 year old male patient, who was presented to the OPD of Regimenal therapies at National Institute of Unani Medicine, Bengaluru. Patient complains of bilateral knee pain, stiffness, limited mobility and difficulty in daily activities since 3 years. Pain exaggerates on walking for more than 50 minutes and standing continuously for more than 30 minutes. The patient was assessed and examined clinically prior to intervention and was diagnosed with bilateral KOA, which was further accentuated by radiological investigations. The patient received treatment for 6 weeks. The patient was assessed using multiple assessment parameters at baseline, 3rd and 6th week. The patient reported improvement in both subjective and objective parameters. The study found that massage therapy and steam fomentation along with pharmacotherapy can be an effective approach in treatment for KOA, however it merits further research.
Keywords: Osteoarthritis, joint pain, bilateral knee pain, stiffness, limited mobility
Management of Hand Eczema with Unani Medicine: A Case Study
Authors: Wani Khalid Rahim , Shah Nadeem Ahmad , Ashraf Aaqib , Wani Nasir Nazir 
Published: September 2024

Background: Eczema, is a common chronic skin condition that can lead to recurrent infections and poor quality of life if left untreated. This paper presents the case of a 30-year-old male patient, who came to the outpatient department (OPD) of the Kashmir Tibbia College Hospital and Research Centre, Shilvath, Bandipora, Kashmir, India. Clinical presentation: His chief complaints were lesions on the palm of his left hand for one year. The patient also complains that his skin is black and thickened with severe itching on the affected area. Diagnosis: The patient was diagnosed clinically with hand eczema resembling Nar-e-Farsi in the Unani system of medicine. Interventions: For 30 days, Marham Kafoor was topically applied twice a day at a dose of 8-10 gm. Outcome: The patient was assessed before, the 15th day and 30th day of treatment based on the EASI, POEM, and VAS. Results: After the intervention, significant improvement was observed in all scales from baseline to 30th day. EASI changes from 18 (moderate) to 5 (mild), POEM changes from 19 (severe) to 7(mild), and VAS from 8 (severe) to 1 (mild). Conclusion: Marham Kafoor has been proven beneficial in treating hand eczema and enhancing patients' quality of life
Keywords: Eczema; Marham Kafoor; Unani Medicine