bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cultural Competency Training in Medical Education: Adopting a Multipronged Approach to Overcome Challenges
Authors: Shrivastava Saurabh RamBihariLal , Bobhate Prateek Sudhakar , Mendhe Harshal Gajanan , Tiwade Yugeshwari R 
Published: March 2024

Abstract
The domain of cultural competency in medical education deals with the varied cultural backgrounds and specific needs of different patients who are accessing health-care delivery services. The training in cultural competency imparted to medical students augments their knowledge and makes them aware of the presence and role of cultural, ethnic, and socioeconomic diversity in heterogeneous population groups. It is quite essential that training of medical students to become culturally competent must be conducted across all professional years of training in a longitudinal manner. Even though there are multiple benefits of training medical students in the domain of cultural competency, once we plan and implement such training, there can be multiple challenges. In conclusion, as medical education continues to evolve to meet the health-related needs of diverse population groups, cultural competency has to be acknowledged as one of the foundational pillars in empowering future cohorts of health-care professionals to deliver inclusive and culturally sensitive patient-centered medical care. The need of the hour is to identify the potential challenges in its successful implementation and then adopt a multipronged approach to effectively respond to them.
Invasive fungal disease in children with viral pneumonia in pediatric intensive care unit in a tertiary care center from Eastern India
Authors: Saha Sayantika , Chowdhury Pooja , Meur Saumen , Dutta Monideepa 
Published: March 2024

Background:
Invasive fungal disease is common in immunocompromised children, although rare in children suffering from viral pneumonia. Recently, it was our observation that a large number of children who were otherwise normal were suffering from invasive fungal disease along with viral pneumonia. The aim of our study is to determine the epidemiological and clinical profile of fungal infection in children suffering from viral pneumonia.

Subjects and Methods:
It was a retrospective study of medical records of children between January 2023 and March 2023 from pediatric intensive care unit (PICU) tertiary care hospital from Eastern India. Children with suspected fungal disease as per inclusion criteria were included in the study. A total of 27 patients were enrolled in this study. The serum galactomannan and beta-D-glucan (BDG) were measured. Clinical profile and outcome were compared between children with and without invasive fungal disease.

Results:
Out of 27 subjects, 16 (59%) had invasive fungal disease. All had adenovirus pneumonia. Seven (4.44%) had acute respiratory distress syndrome while four (25%) had shock and multiple organ dysfunction syndrome each. The duration of mechanical ventilation (P = 0.01), duration of PICU stay (P = 0.02), and duration of hospital stay (P = 0.004) were significantly higher in children with invasive fungal disease. These children had significantly higher rates of complications (P = 0.001) and higher mortality (P = 0.04).

Conclusions:
The serum galactomannan and BDG can diagnose invasive fungal disease in patients of viral pneumonia with persistent symptoms for more than 2 weeks. The invasive fungal disease is associated with higher morbidity and mortality in these children.
Artificial Intelligence in Early Diagnosis of Preeclampsia
Authors: Bülez A , Hansu K , Çağan ES , Şahin AR , Dokumacı HÖ 
Published: March 2024

Background:
Every day, 810 women die of preventable causes related to pregnancy and childbirth worldwide, and preeclampsia is among the top three causes of maternal deaths.

Aim:
To develop a diagnostic system with artificial intelligence for the early diagnosis of preeclampsia.

Methods:
This retrospective study included pregnant women who were screened for the inclusion criteria on the hospital’s database, and the sample consisted of the data of 1158 pregnant women diagnosed with preeclampsia and 9194 pregnant women who were not diagnosed with preeclampsia at Kahramanmaras Necip Fazıl City Hospital Gynecology and Pediatrics Additional Service Building, Kahramanmaras/Turkey. The statistical analysis was performed using the Statistical Package for social sciences (SPSS) version 22 for windows. Artificial intelligence models were created using Python, scikit-learn, and TensorFlow.

Results:
The model achieved 73.7% sensitivity (95% confidence interval (CI): 70.2%–77.1%) and 92.7% specificity (95% CI: 91.7%–93.6%) on the test set. Furthermore, the model had 90.6% accuracy (95% CI: 90.1% - 91.1%) and an area under the curve (AUC) value of 0.832 (95% CI: 0.818-0.846). The significant parameters in predicting preeclampsia in the model were hemoglobin (HGB), age, aspartate transaminase level (AST), alanine transferase level (ALT), and the blood group.

Conclusion:
Artificial intelligence is effective in the prediction and diagnosis of preeclampsia.
Nonalcoholic Fatty Liver Disease and Associated Risk Factors in Obese Nigerians: A Cross-Sectional Study
Authors: Onyia CP , Asogwa P , Adiri W , Obienu O , Ijoma UN , Nwokediuko SC , Okeke EN 
Published: March 2024

Background:
Nonalcoholic fatty liver disease (NAFLD) is now adjudged the most common liver disease in the world, contributing to the rising incidence of hepatocellular carcinoma worldwide. However, the true prevalence of nonalcoholic fatty liver disease among obese individuals and its contribution to the burden of liver disease in Nigeria is unknown.

Aim:
To determine the prevalence of nonalcoholic fatty liver disease and associated risk factors in obese subjects.

Methods:
This was a cross-sectional analytical study of 280 obese subjects and 280 nonobese age and sex-matched controls seen at our health facility. Data collection was done using an interviewer-administered questionnaire and anthropometric parameters were obtained. Fasting blood samples were collected for blood glucose, lipid profile, and liver biochemistry. Abdominal ultrasound was used to screen for NAFLD. The results were subjected to relevant statistical analysis using SPSS version 20.

Results:
A higher prevalence of NAFLD was found in obese subjects, compared with nonobese controls (36.4% versus 0.4% P < 0.001). The degree of obesity, transaminases, total cholesterol, diastolic hypertension, fasting blood glucose, and waist circumference was significantly associated with a higher prevalence of NAFLD. However, using multivariate logistic regression analysis, diabetes mellitus and hypertension were significant associations for NAFLD. Individuals with NAFLD had a significantly higher prevalence of metabolic syndrome 65.9%, compared with 34.1% in obese individuals without NAFLD (P < 0.001).

Conclusion:
The prevalence of NAFLD in obese subjects was significant. NAFLD in obese subjects was associated with degree of obesity, hyperlipidemia, hypertension, and diabetes mellitus.
Are the GLIM Criteria Guiding in the Course of Hematological Malignancies?
Authors: Yilmaz F , Aras MR , Ozturk HBA , Sahin HN , Gunes AK , Albayrak M 
Published: March 2024

Background:
Different degrees of malnutrition are seen in patients with hematological malignancies. None of the approaches used to determine malnutrition risk have general acceptance. The use of the GLIM criteria developed by the Global Leadership Initiative on Malnutrition has promising results.

Materials and Methods:
A total of 67 patients with leukemia, lymphoma, and multiple myeloma were included in the study. NRS-2002 (Nutritional Risk Screening—2002) was used to screen the nutritional status of the patients, and malnutrition was diagnosed and graded using the GLIM criteria in patients who were found to be at risk of malnutrition in this test. The parameters followed in the groups with and without malnutrition were compared. The Kolmogorov–Smirnov, Mann–Whitney U, and Chi-square test were used for statistical analysis.

Results:
Patients were analyzed by dividing them into two groups as those with and without malnutrition. The presence of infection, duration of fever, antibiotic, and antifungal use were significantly higher in malnourished than in nonmalnourished patients. Platelet counts and sodium levels were significantly lower in the malnourished arm.

Conclusion:
Early nutritional support can increase the immunological status of patients with malignant disorders as well as their tolerability to treatment. Minimizing the risk of malnutrition and providing timely calorie and vitamin support are factors that may directly affect febrile neutropenia, duration of fever, and antifungal use, which will consequently lead to a decrease in the length of hospitalization.
Diagnostic and Prognostic Value of Pentraxin 3, Interleukin-6, CRP, and Procalcitonin Levels in Patients with Sepsis and Septic Shock
Authors: Palalıoğlu B , Erdoğan S , Atay G , Tugrul HC , Özer ÖF 
Published: March 2024

Introduction and Purpose:
In this prospective study, we aim to evaluate the effects of antibiotherapy on pentraxin-3 (PTX3), C-reactive protein (CRP), and interleukin-6 (IL-6) levels in patients with sepsis and septic shock.

Materials and Methods:
In our study, CRP, procalcitonin, IL-6, and PTX3 levels at initial and 48 hours of the antibiotherapy of patients who were admitted to the pediatric intensive care unit (PICU) with the diagnosis of sepsis and septic shock between June 2020 and March 2021 were compared. Patients were compared with the age-appropriate case-control group formed from the patients who received pre-operative routines to investigate the diagnostic value.

Results:
CRP, IL-6, and PTX3 levels of the patients were significantly higher compared to controls (P < 0.05). After the 48th hour of treatment compared to initial CRP, lactate and PCT levels were significantly lower (P < 0.05). The IL-6 and PCT levels were significantly higher in patients with mortality than in surviving patients. Surviving patients showed a significant decrease in CRP level at the 48th hour. IL-6 levels of patients with septic shock were significantly higher than those with sepsis (P = 0.010; P < 0.05). In the diagnosis of septic shock, the area under curve was 0.785 for IL-6 and the standard deviation was 0.09 (P = 0.002, cut-off value, >32 pg/mL, 88.9% sensitivity, 65.6% specifity).

Conclusion:
The results of this study indicated that IL-6 level is an appropriate biomarker with high specificity in the diagnosis of sepsis and septic shock and in evaluating the response to treatment and determining the prognosis.
Vitamin D Attenuates Cardiac Hypertrophy in Rats through mRNA Regulation of Interleukin-6 and Its Receptor
Authors: Nikkholgh Ahad , Tavakoli Fatemeh , Alborzi Nasrin , Araste Fatemeh 
Published: March 2024

Abstract

Context:
Interleukin-6 (IL-6), a pro-inflammatory cytokine, plays an important role in the pathogenesis of myocardial hypertrophy. By integrating its membrane receptor complex (gp80), IL-6 activates the signal guidance components (gp130) and activates the hypertrophic signaling pathways. There is some evidence that 1,25 dihydroxyvitamin D exerts antihypertrophic effects, but the cellular and molecular mechanisms are not fully understood. The aim of this study was to evaluate the effect of calcitriol on the level of IL-6 and its receptor components in hypertrophied rat heart.

Subjects and Methods:
Male rats were divided into control, hypertrophy, Vitamin D + hypertrophy, and propylene glycol + hypertrophy groups. The groups receiving Vitamin D and propylene glycol were treated 2 weeks before induction of hypertrophy and 2 weeks after hypertrophy. Myocardial hypertrophy was induced by abdominal aortic stenosis. Mean arterial blood pressure was measured by cannulation of the left carotid artery, and expression of genes was determined by reverse transcription-polymerase chain reaction.

Results:
Blood pressure and heart-to-body weight ratio increased in hypertrophic groups compared to the control group (P < 0.01), but Vitamin D administration decreased these parameters (P < 0.05). Abdominal aortic stenosis increased IL-6 expression levels (P < 0.001) and Vitamin-D decreased IL-6 mRNA levels (P < 0.01). The expression of gp80 in the hypertrophic group increased compared to the control group (P < 0.05), but Vitamin D did not affect the expression of receptor subunits genes.

Conclusions:
The data from this study suggest a possible mechanism for the antihypertrophic effects of Vitamin D through the regulation of inflammatory responses during hypertrophy. Thus, Vitamin D can reduce IL-6 expression levels, thereby reducing hypertrophy.
Current Status of La Crosse Virus in North America and Potential for Future Spread
Authors: Goldman Taylor , Hamer Davidson H. 
Published: March 2024

ABSTRACT.
La Crosse virus (LACV) is an arthropod-borne RNA virus with substantial potential for future spread in North America. La Crosse virus is responsible for La Crosse encephalitis, a leading cause of arboviral encephalitis in children in the United States. Primarily transmitted by Aedes triseriatus (Eastern treehole) mosquitos and amplified by small mammal hosts, LACV has caused infections throughout the upper Midwest and, more recently, the mid-Atlantic and southeastern United States. Notably, in recent years, infections have also been identified increasingly in the Appalachian region. Anthropogenic and environmental factors have likely contributed to recent LACV spread, including the introduction of invasive vector species (especially Ae. albopictus), biotic interactions between and among vector and host species, land-use change, habitat disturbance, increased human travel and transport, and rising global temperatures. Prevention and control strategies, such as increased surveillance of vector and host populations, increased awareness among populations at risk for infection, and increased awareness among physicians are needed to limit future spread. Continued climate change with increases in global temperatures and erratic weather patterns may result in the expansion of competent mosquito vector species and thus could facilitate the geographic spread of LACV.
Demographic Characteristics and Low Iron Status Markers Are Associated with Hemoglobin Levels and Anemia among Children Living at High Elevation in Cusco, Peru
Authors: Caravedo Maria A. , Morales Maria Luisa , Tanabe Melinda , Lopez Martha , White A. Clinton , Cabada Miguel M. 
Published: March 2024

ABSTRACT.
Anemia is a complex condition associated with diet, chronic infections, and blood loss. Children living at high altitudes have higher absolute hemoglobin levels due to hypoxemia. However, they are exposed to repeated infections and dietary limitations. We conducted a cross-sectional study to identify factors affecting the hemoglobin concentration in children living in high-altitude rural communities in the Anta province of Peru. All children 3–16 years of age attending public schools were invited to participate. We enrolled children 3–16 years old in schools and visited their homes to collect demographic, socioeconomic, medical history, and anthropometric data. Children provided blood and stool samples for complete blood counts, iron status markers, and helminth infection testing. Among the 2,000 children enrolled, the mean age was 9.9 (±3.4) years, 1,004 (50.2%) were female, and the median residence altitude was 3,398 (interquartile range 3,35–3,497) meters. The mean hemoglobin level was 15 (±1.15) mg/dL; 320 (16%) had anemia as defined by WHO. Children with anemia were more likely to have lower serum iron levels (odds ratio [OR] 2.8 [95% CI 2.2–3.6], P <0.001) and serum transferrin saturation (OR 2.8 [95% CI 2–3.9], P <0.001). Younger age (OR 0.85 [95% CI 0.82–0.89], P <0.001), stunting (OR 0.68 [95% CI 0.59–0.79], P <0.001), education of the mother (OR 0.94 [95% CI 0.91–0.98], P <0.005), and low eosinophils (OR 0.49 [95% CI 0.26–0.9], P = 0.022) were associated with anemia. Helminth infections were not associated with anemia. Anemia among children at high altitude is multifactorial, but iron deficiency is a contributing factor. Further studies are needed to evaluate iron status and anemia in children living at high altitudes.
First Report of Chagas Disease Vector Species Triatoma sanguisuga (Hemiptera: Reduviidae) Infected with Trypanosoma cruzi in Delaware
Authors: Peterson Jennifer K. , Hoyos Juliana , Bartlett Charles R. , Gottdenker Nicole L. , Kunkel Brian , Murphy Carrie , Alvarado Antonio 
Published: March 2024

ABSTRACT.
In July and October 2023, two live triatomine bugs were found inside a home in New Castle County, Delaware. The bugs were identified as Triatoma sanguisuga, the most widespread triatomine bug species in the United States. Triatoma sanguisuga is a competent vector of Trypanosoma cruzi, the causative agent of Chagas disease. The two specimens were tested via real-time PCR (qPCR) for infection with T. cruzi, and one of the specimens was positive. Despite T. sanguisuga being endemic to the area, attainment of accurate species identification and T. cruzi testing of the bugs required multiple calls to federal, state, private, and academic institutions over several months. This constitutes the first report of T. sanguisuga infected with T. cruzi in Delaware. In addition, this is the first published report of T. sanguisuga in New Castle County, the northernmost and most densely populated county in Delaware. New Castle County still conforms to the described geographic range of T. sanguisuga, which spans from Texas to the East Coast of the United States. The T. cruzi infection prevalence of the species has not been studied in the northeastern United States, but collections in southern states have found prevalences as high as 60%. The Delaware homeowner’s lengthy pursuit of accurate information about the vector highlights the need for more research on this important disease vector in Delaware.
PENEGAKAN HUKUM DALAM TINDAK PIDANA DALAM TRANSAKSI JUAL BELI ONLINE
Authors: Dendi Pajriansyah  , Kris Moresikani  , Mei Nadhila  , Redo Patoni  , Zuhdyen Elva Haza  
Published: March 2024

AbstrakTindak pidana penipuan saat ini semakin berkembang mengikuti perkembangan zaman dan kemajuan teknologi. Aturan hukum dibuat untuk mengantisipasi hal tersebut namun aturan yang ada rupanya tidak membuat tindak pidana tersebut semakin berkurang tetapi mengalami peningkatan. Penelitian ini bertujuan untuk: pertama, mengetahui penegakan hukum terhadap tindak pidana penipuan berbasis e-commerce; dan kedua, mengetahui faktor-faktor penghambat dalam penegakan hukum pidana terhadap tindak pidana penipuan berbasis e-commerce. Hasil penelitian menggambarkan bahwa tindak pidana penipuan berbasis e-commerce pada prinisipnya sama dengan penipuan dengan cara konvensional namun yang menjadi perbedaan terletak pada alat bukti atau sarana perbuatannya yakni menggunakan sistem elektronik (komputer, internet, perangkat telekomunikasi). Oleh karenanya penegakan hukum mengenai tindak pidana penipuan ini seyogyanya masih dapat diakomodir oleh KUHP melalui pasal 378, dan untuk memperkuat dasar hukum maka dapat diakomodir juga melalui Pasal 28 ayat (1) Undang-Undang Nomor 19 Tahun 2016 tentang Informasi dan Transaksi Elektronik. Sebagai Undang-Undang yang bersifat khusus (Lex Spesialis Derogat Lex Generale), UU ITE paling tidak dapat menjadi pedoman dan landasan hukum bagi anggota masyarakat dalam beraktivitas di dunia siber.
Kata Kunci : Penegakan Hukum, Transaksi, Jual Beli, Online
AbstractCriminal acts of fraud are currently growing following the times and advances in technology. Legal regulations are made to anticipate this, but the existing regulations do not seem to reduce these crimes but have increased. This study aims to: first, determine law enforcement against criminal acts of fraud based on e-commerce; and second, knowing the inhibiting factors in enforcing criminal law against criminal acts of e-commerce based fraud. The results of the study illustrate that the crime of fraud based on e-commerce is in principle the same as fraud in the conventional way, but the difference lies in the evidence or means of action, namely using electronic systems (computers, internet, telecommunication devices). Therefore law enforcement regarding this crime of fraud should still be accommodated by the Criminal Code through article 378, and to strengthen the legal basis it can also be accommodated through Article 28 paragraph (1) of Law Number 19 of 2016 concerning Information and Electronic Transactions. As a special law (Lex Specialist Derogat Lex Generale), the ITE Law can at least become a guideline and legal basis for members of the public in their activities in cyberspace.
Keywords: Law Enforcement, Transactions, Buying and Selling, Online
PERLINDUNGAN KONSUMEN BAGI PENUNDAAN (DELAY) DALAM PENERBANGAN
Authors: Rahayu Dwi , Akhir Dendy Djumadil , Umbara Tri Oktiadi , Hasnan Amri Destriani , Utami Rezi Niti , Jauhari Jauhari 
Published: March 2024

AbstrakPelanggaran hak konsumen dan perlindungan hukum pengguna jasa penerbangan dalam kasus delay. Metode penelitian normatif dengan menggunakan pendekatan perundang-undangan. Bentuk perlindungan hukum bagi penumpang pengguna jasa transportasi udara, serta upaya hukum bagi penumpang yang dirugikan oleh perusahaan transportasi udara. yaitu antara lain: Undang-Undang Nomor 15 Tahun 1992 tentang Penerbangan dan Peraturan Menteri Perhubungan Nomor 89 Tahun 2015 tentang Penanganan Keterlambatan Penerbangan. Peraturan tersebut menentukan upaya hukum yang dapat ditempuh oleh penumpang yang mengalami kerugian.
Kata Kunci: Perlindungan, Konsumen dan Jasa Penerbangan.
KONSEP HUKUM PROGRESIF DALAM PEMERINTAHAN DAERAH
Authors: Candra Andi , Kinaria Afriani  , Jauhari Jauhari 
Published: March 2024

Abstrak
Hukum progresif adalah hukum yang hidup dan berkembang, yang didukung peran aktif baik masyarakat maupun aparatur pemerintahan yang tidak hanya mampu mendengarkan suara hati rakyat tetapi juga aparatur pemerintahan yang berani dan menjalankan hukum dan pemerintahan tidak hanya dengan logikanya akan tetapi juga dengan menggunakan kecerdasan spiritualnya. Dari adanya suatu konsep hukum progresif diharapkan terwujud suatu pemerintahan daerah yang didukung dengan aparatur pemerintahannya yang mampu dan mau mendengarkan suara hati rakyatnya. Dengan penerapan hukum progresif dalam pemerintahan di daerah sebagai suatu gagasan diharapkan mampu mendukung pelaksanaan otonomi daerah sehingga tercapai kebahagiaan, keamanan, ketertiban, serta kesejahteraan bagi masyarakat.
Kata Kunci : Hukum Progresif, Pemerintah, Otonomi Daerah
Abstract
Progressive law is a law that lives and develops, which is supported by the active role of both the community and government officials who are not only able to listen to the voices of the people's hearts but also government officials who are brave and run the law and government not only with logic but also by using their spiritual intelligence. From the existence of a progressive legal concept, it is hoped that a regional government will be supported by government officials who are able and willing to listen to the voices of the people's hearts. With the application of progressive law in regional government as an idea, it is hoped that it will be able to support the implementation of regional autonomy so that happiness, security, order and welfare for the community are achieved.
Keywords: Progressive Law, Government, Regional Autonomy