bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors Influencing Hypoglycemia in Type 2 Diabetes Mellitus Outpatients with State Health Insurance at Regional General Hospitals in Jakarta, Indonesia
Authors: Veryanti Putu Rika , Sauriasari Rani , Sartika Ratu Ayu Dewi , Elya Berna 
Published: January 2024

Background:
Hypoglycemia is an acute episode that can lead to death in patients
with diabetes mellitus (DM). This condition is preventable with patient education, and
identifying factors influencing their occurrence is essential to creating effective and efficient
education. It also leads to prevention and control by re-organizing the service system and
diabetes policies. This study aimed to determine factors contributing to hypoglycemic episodes
in type 2 DM outpatients covered by the state-provided Jaminan Kesehatan Nasional (JKN)
health insurance.

Methods:
The study used a cross-sectional design and collected data from five regional general
hospitals in Jakarta, Indonesia. The outpatients were sampled consecutively from two hospitals
in September–November 2021, one in January–March 2022, and two others in April–June 2023.
Interviews produced primary data related to experienced hypoglycemic episodes, and medical
records provided secondary data on patients' clinical characteristics and treatments. Binary
logistic regression analysis was employed to process the contributing factors statistically.

Results:
From 501 patients who met the inclusion and exclusion criteria, it was found that the
prevalence of hypoglycemia was 53.3%. Factors that significantly increased hypoglycemic risk
(p < 0.05) were high HbA1C levels (OR 1.9; 95% CI 1.2–2.9), comorbidities (OR 1.6; 95% CI
1.1–2.4), insulin/sulfonylurea therapy (OR 2; 95% CI 1–4), non-smoking habit (OR 2.2; 95% CI
1.3–3.6) and physically active lifestyle (OR 1.8; 95% CI 1.2–2.6).

Conclusion:
The prevalence of hypoglycemia in type 2 diabetes mellitus (DM) outpatients with
the state-provided health insurance Jaminan Kesehatan Nasional (JKN) at general hospitals in
Jakarta is high. The diabetes self-management education (DSME) services provided by health
professionals for these outpatients must be further improved.
Impaired Awareness of Hypoglycemia and its Risk Factors among Diabetic
Patients in Jazan, Saudi Arabia: A Cross-Sectional Study
Authors: Oraibi Omar , Alameer Abdulelah , Dalak Mohammed , Alsharif Sawsan , Hakami Shatha A. , Sumayli Mohammed , Shami Ayman , Mohrag Mostafa , Madkhali Mohammed A. , Madkhali Mohammed Ali , Alhazmi Luai , Darraj Majid 
Published: January 2024

Background:
Impaired awareness of hypoglycemia (IAH) is related to a three- to sixfold
increase in the risk of severe hypoglycemia in adults with type 1 diabetes mellitus (T1D).
This study aimed to assess the prevalence of IAH and its risk factors and determine the frequency
of hypoglycemic symptoms.

Objective:
This study aimed to assess the prevalence of IAH and its risk factors and determine
the frequency of hypoglycemic symptoms.

Methodology:
A cross-sectional study was conducted among T1D patients attending Jazan Endocrine
and Diabetes Center in Jazan province, Saudi Arabia. A total of 151 patients participated,
using the interview-based Clarke questionnaire, a validated eight-item questionnaire to evaluate
IAH. Scoring four or more answers as reduced awareness categorizes the participant as having
IAH.

Results:
The prevalence of IAH was 25.2% among the T1D patients. IAH was significantly associated
with body mass index (BMI; p = 0.034), occupation (p = 0.014), and blood glucose
monitoring methods (p = 0.027). Shaking and sweating were the most commonly reported
symptoms of hypoglycemia. A BMI of <25 kg/m2 was higher linked to hunger and speech difficulty
compared to a BMI of ≥25 kg/m2 (p < 0.05). Changing the insulin injection site was associated
with confusion, odd behavior, and speech difficulty (p < 0.05). Monitoring blood glucose
four times daily was associated with sweating, odd behavior, and incoordination (p = 0.024)
compared to monitoring less than four times daily (p < 0.05). A hemoglobin A1c (HbA1c) reading
of ≥7 was linked to odd behavior compared to an HbA1c reading of <7 (p = 0.032). Patients
committed to insulin injections were more likely to experience palpitations than non-committed
patients (p = 0.038). Each one-unit increase in age, monitoring blood glucose, and income was
associated with a decrease in the odds of IAH (OR of Age = 0.89, 95% CI: 0.83-0.95) (OR of
income = 0.10, 95% CI: 0.01-0.55). Moreover, individuals with a Body Mass Index (BMI)
greater than or equal to 25 (OR = 2.99, 95% CI: 1.13-8.25), employed individuals (OR = 18.2,
95% CI: 3.75-105), and diabetes duration of more than ten years (OR = 3.96, 95% CI: 1.31-
13.2) exhibited an increase in the higher risk of IAH.

Conclusion:
IAH was prevalent among T1D patients attending Jazan Endocrine and Diabetes
Center. The main associated factors included BMI, blood glucose monitoring method, and occupation.
Future research should investigate the underlying causes of the observed associations and
explore strategies to enhance the awareness of hypoglycemia.
Causal Relationships of Chronic Constipation and Irritable Bowel Syndrome with Digestive Tract Cancers: A Mendelian Randomization Study
Authors: Fan Rencai , Zhang Jiaqi , Shen Jiaofeng , Mao Chenkai , Li Shicheng , Zhuang Zhixiang 
Published: January 2024

Background:
Chronic constipation and irritable bowel syndrome (IBS) manifest as
prevalent gastrointestinal disorders, while digestive tract cancers (DTCs) present formidable
challenges to global well-being. However, extant observational studies proffer uncertain insights
into potential causal relationships of constipation and IBS with susceptibility to DTCs.

Methods:
We executed Mendelian randomization (MR) analysis to establish causal connections
between these conditions and seven distinct categories of DTCs, including colorectal carcinoma
(CRC), hepatocellular cancer (HCC), esophageal malignancy (ESCA), pancreatic adenocarcinoma
(PAAD), biliary tract carcinoma (BTCs), gastric carcinoma (GC), and small intestine neoplasm
(SIC). Leveraging instrumental variables (IVs) obtained from GWAS data of the FinnGen
database, we employed a range of analytical methodologies, including inverse-variance
weighting multiplicative random effects (IVW_MRE), inverse-variance weighting fixed effects
(IVW_FE), maximum likelihood (ML), weighted median (WM), MR‒Egger regression, and the
MR-PRESSO test.

Results:
We observed a substantial linkage between genetically predicted constipation and increased
vulnerability to PAAD (OR = 2.29, 95% CI: 1.422-3.69, P = 0.001) via the IVW method.
Following the removal of outlier SNPs through MR-PRESSO, genetically predicted IBS
was affiliated with an increased risk of CRC (OR = 1.17, 95% CI: 1-1.37, P = 0.05). Nonetheless,
decisive causal correlations of constipation or IBS with other DTCs remain elusive.

Conclusion:
In summary, genetically predicted constipation was associated with an augmented
PAAD risk, and IBS was associated with an increased CRC susceptibility within European cohorts,
in agreement with some observational studies. Nevertheless, the causal associations of
constipation and IBS with other DTCs remain inconclusive.
Pharmacotherapy in SAH: Clinical Trial Lessons
Authors: Apostolakis Sotirios , Stavrinou Pantelis 
Published: January 2024

:
Subarachnoid Haemorrhage (SAH) is a medical emergency with potentially devastating
outcomes. It is without doubt that over the past decades, there has been a radical change in the approach
towards patients with SAH, both in terms of the surgical as well as of the pharmacological
treatments offered. The present review aims to outline the principal data regarding the best practice
in the pharmacotherapy of SAH, as well as to sum up the emerging evidence from the latest clinical
trials. To date, nimodipine is the only evidence-based treatment of vasospasm. However, extensive
research is currently underway to identify novel substances with magnesium sulphate, cilostazol,
clazosentan and fasudil, demonstrating promising results. Antifibrinolytic therapy could help reduce
mortality, and anticoagulants, in spite of their associated hazards, could actually reduce the incidence
of delayed cerebral ischemia. The effectiveness of triple-H therapy has been challenged, yet
evidence on the optimal regimen is still pending. Statins may benefit some patients by reducing the
incidence of vasospasm and delayed ischemic events. As several clinical trials are underway, it is
expected that in the years to come, more therapeutic options will be added to the attending physician’s
armamentarium.
How Different Are the Influences of Mediterranean and Japanese Diets on the Gut Microbiome?
Authors: Moriki Dafni , Koumpagioti Despoina , Francino Maria Pilar , Rufián-Henares José Ángel , Kalogiannis Michalis , Priftis Kostas N. , Douros Konstantinos 
Published: January 2024

:
The gut microbiome is a complex ecosystem, mainly composed of bacteria, that performs
essential functions for the host. Its composition is determined by many factors; however,
diet has emerged as a key regulator. Both the Mediterranean (MD) and Japanese (JD) diets have
been associated with significant health benefits and are therefore considered healthy dietary patterns.
Both are plant-based diets and although they have much in common, they also have important
differences mainly related to total calorie intake and the consumption of specific foods
and beverages. Thus, it has been hypothesized that they exert their beneficial properties through
different nutrients and bioactive compounds that interact with gut microbes and induce specific
changes on gut metabolic pathways. In this review, we present current data on the effects of the
MD and JD on the gut microbiome. Furthermore, we aim to examine whether there are differences
or shared effects on the gut microbiome of people who adhere to these dietary patterns.
Transient Central Diabetes Insipidus (Arginine Vasopressin Deficiency) Following SARS-CoV-2 Vaccination: A Case Report and Literature Review
Authors: Mazzeo Pierluigi , Ceccato Filippo , Manara Renzo , Mazzon Cinzia , Barbot Mattia 
Published: January 2024

Introduction:
Since December 2019, severe acute respiratory syndrome coronavirus
2 (SARS-CoV-2) has affected millions of people, causing the COVID-19 global pandemic. The
use of novel technologies led to the development of different types of SARS-CoV-2 vaccines
that have reduced severe disease courses and related deaths. Besides the positive impact of vaccination
on the pandemic, local and systemic side effects have been reported; they are usually
mild to moderate, although also serious adverse events have been described.

Case Presentation:
A 21-year-old female was referred to our hospital for the recent onset of
severe polyuria and polydipsia, with the need for about 8 liters of daily water intake. The symptoms
developed seven days after the administration of the second dose of the mRNA-based
(Pfizer-BioNTech® BNT162b2) SARS-CoV-2 vaccine. In the suspicion of central diabetes insipidus
(DI) development, she started treatment with desmopressin (Minirin® tablets) 60 mg/day
with an improvement of symptoms and thirst. A thickening of the pituitary stalk was observed
at the pituitary MRI with loss of the posterior pituitary bright spot on T1 weighted images. To
confirm the diagnosis of central DI, both the water deprivation test and arginine stimulated copeptin
test were performed; whilst the former gave no clear-cut indication of DI, the latter
showed a reduced copeptin peak after arginine infusion consistent with the diagnosis of partial
central DI. Furthermore, the development of symptoms right after the second dose of the vaccine
strengthened the hypothesis that DI was related to the vaccination itself. After our evaluation,
there was a progressive reduction of desmopressin dose to a complete discontinuation with
the maintenance of a normal hydroelectrolytic balance. Clinical and biochemical follow-up was
performed by repeating a pituitary MRI and a second arginine-stimulated copeptin test 15
months after the diagnosis. This time, copeptin levels reached a significantly higher peak after
arginine stimulation that completely excluded central DI and at pituitary MRI, the thickening of
the pituitary stalk previously described was no longer visible.

Conclusion:
Neurohypophysitis can have an abrupt onset independently of the etiology.
Central DI is a rather exceptional event after SARS-CoV-2 vaccination but should be recalled
in case of sudden polyuria and polydipsia. DI is indeed reported even after SARS-CoV-2
infection, thus, this report should not discourage the use of mRNA-based vaccines.
Furthermore, our case demonstrates that full recovery of posterior pituitary function is possible
after immunization with anti-Covid-19 BNT162b2 vaccine. Further studies are needed to
clarify the possible mechanism relating to SARS-CoV-2 vaccination and this rare adverse
event.
Predicting Factors of Worse Prognosis in COVID-19: Results from a
Cross-sectional Study on 52 Inpatients Admitted to the Internal Medicine
Department
Authors: Lisco Giuseppe , Solimando Antonio Giovanni , Stragapede Assunta , De Tullio Anna , Laraspata Cristiana , Laudadio Carola , Giagulli Vito Angelo , Prete Marcella , Jirillo Emilio , Saracino Annalisa , Racanelli Vito , Triggiani Vincenzo 
Published: January 2024

Background:
The initial phases of the COVID-19 pandemic posed a real need for
clinicians to identify patients at risk of poor prognosis as soon as possible after hospital admission.

Aims:
The study aimed to assess the role of baseline anamnestic information, clinical parameters,
instrumental examination, and serum biomarkers in predicting adverse outcomes of
COVID-19 in a hospital setting of Internal Medicine.

Methods:
Fifty-two inpatients consecutively admitted to the Unit of Internal Medicine “Baccelli,”
Azienda Ospedaliero – Universitaria Policlinico of Bari (February 1 - May 31, 2021) due
to confirmed COVID-19 were grouped into two categories based on the specific outcome:
good prognosis (n=44), patients discharged at home after the acute phase of the infection; poor
prognosis, a composite outcome of deaths and intensive care requirements (n=8). Data were
extracted from medical records of patients who provided written informed consent to participate.

Results:
The two study groups had similar demographic, anthropometric, clinical, and radiological
characteristics. Higher interleukin 6 (IL-6) levels and leucocyte count, and lower free triiodothyronine
(fT3) levels were found in patients with poor than those with good prognosis. Higher
IL-6 levels and leucocyte count, lower fT3 concentration, and pre-existing hypercholesterolemia
were independent risk factors of poor outcomes in our study population. A predicting risk
score, built by assigning one point if fT3 < 2 pg/mL, IL-6 >25 pg/mL, and leucocyte count
>7,000 n/mm3, revealed that patients totalizing at least 2 points by applying the predicting score
had a considerably higher risk of poor prognosis than those scoring <2 points (OR 24.35 (1.32;
448), p = 0.03). The weight of pre-existing hypercholesterolemia did not change the risk estimation.

Conclusion:
Four specific baseline variables, one anamnestic (pre-existing hypercholesterolemia)
and three laboratory parameters (leucocyte count, IL-6, and fT3), were significantly associated
with poor prognosis as independent risk factors. To prevent adverse outcomes, the updated
4-point score could be useful in identifying at-risk patients, highlighting the need for specific
trials to estimate the safety and efficacy of targeted treatments.
Herbal Medicinal Nanoformulations for Psoriasis Treatment: Current State of Knowledge and Future Directions
Authors: Sharma Himanshu , Gupta Neha , Garg Nitika , Dhankhar Sanchit , Chauhan Samrat , Beniwal Suresh , Saini Deepak 
Published: January 2024

Background:Psoriasis is a persistent immune system disorder that influences the skin, leading to red, flaky patches that can be painful and irritated.Objective:Traditional treatments for psoriasis, such as topical creams and oral medications, may be effective but also have potential side effects. Herbal remedies have been used for centuries to treat skin conditions, and advancements in nanotechnology have led to the development of herbal nanoformulations that offer several advantages over traditional herbal remedies, such as efficacy, safety, and targeted delivery.Methods:The studies and reviews published under the title were looked up in several databases (including PubMed, Elsevier, and Google Scholar).Results:Several herbal nanoformulations, including those containing curcumin, aloe vera, and neem, have been shown to exhibit anti-inflammatory and immunomodulatory impacts, which will be useful within the treatment of psoriasis. However, more study is required to decide the efficacy and safety of these details, as well as the optimal dosing, duration of treatment, and potential side effects.Conclusion:Overall, herbal nanoformulations represent a promising area of research for the treatment of psoriasis, and may offer a safe and effective alternative or adjunct therapy to conventional treatments. This review article summarizes the present state of information for the herbal nanoformulations role in the treatment of psoriasis and their future perspectives.
Antimicrobial Stewardship: Smart Approach to Combat Antibiotic
Resistance
Authors: Dikkatwar Manoj S. , Chand Sharad , Varghese Treesa P. , Shandily Shrishti , Biswas Jeetu , Roy Supriya , Vaghasiya Jitendra , Singh Rakesh K. 
Published: January 2024

Abstract:
Antimicrobial resistance (AMR) is a major public health concern worldwide. It raises morbidity and mortality and is connected with substantial/significant economic costs. Effective prevention and treatment of an increasing number of diseases caused by pathogens that can no longer be treated with conventional drugs are threatened by antimicrobial re-sistance. AMS programme helps to encourage the appropriate use of antimicrobials. The rise and spread of antibiotic resistance and strategies to combat it are the main topics of this review. Antimicrobial stewardship programme is a healthcare strategy that optimizes the use of anti-biotics and promotes the appropriate use of antimicrobials through the adoption of evidence-based interventions. AMS programme helps to encourage the right use of antimicrobials. This coordinated approach enhances patient outcomes, reduces microbial resistance, and slows the spread of diseases brought on by multidrug-resistant organisms. The growth of antibiotic re-sistance and the strategies for battling it have been the main topics of this review.
Phytochemicals in the Treatment of Tuberculosis: A Review
Authors: Paliwal Deepika , Sharma Neeraj , Sil Debiyan , Maude Hafsat 
Published: January 2024

Abstract:
One of the most common infectious diseases in the world is tuberculosis (TB), which
is spread via the bacteria Mycobacterium tuberculosis. Many people throughout the world have
stopped using anti-TB medications because of concerns related to multidrug resistance and their
effects on the liver. To treat M. tuberculosis and combat antimycobacterial resistance, it is vital
to find new medications with distinctive structures and rare modes of action. Many scientists
have discussed the usefulness of plants in the treatment of tuberculosis caused by phytochemical
exposure. A large number of chemical structures are present in naturally occurring compounds,
which exhibit a wide range of in vitro efficacy against M. tuberculosis. To investigate possible
adjuvants for tuberculosis chemotherapy, the current study has provided a mini-review on phytochemicals
evaluated for their antimycobacterial properties during the last few decades.
Ink Analysis for Forensic Investigations: An Integrated Approach Incorporating Physico-chemical Techniques and Image Processing
Authors: Kesarwani Sonali , Saran Vaibhav , Mishra Munish , Tripathy Divya Bajpai , Kumar Suneet 
Published: January 2024

Background:
Criminal actions using falsified papers are on the rise. Any
changes to the document's content are usually made with ballpoint and gel pens. All
changes made to a document using a pen necessitate ink analysis. Thus, a quick and
accurate ink analysis process must be created to cope with the challenges associated
with counterfeiting.

Aim:
This study aims to analyze several brands of ballpoint and gel pen inks using
physicochemical and computational techniques and provide a database of the results.

Methods:
A total of 24 pen samples from various brands were colour-tested first, followed
by an optical test using ImageJ software. The composition of each ink sample
was distinguished using the non-destructive method ATR-FTIR, followed by a destructive
technique TLC. Lastly, a computational technique algorithm was applied for
rapid and desirable results.

Results:
The results distinguished each brand based on RGB measures and mean values.
The differentiation of each sample using ATR-FTIR spectroscopy was challenging
due to similar structural characteristics. However, TLC (destructive) was used
with several solvent systems. Ballpoint pen inks separated well in all solvent systems,
with the greatest results achieved in solvent systems 2 and solvent system 4. The TLC
spots were identical, but when evaluated digitally using MATLAB, substantial
changes were visible, which were utilized to differentiate similar colour inks from
various brands.

Conclusion:
The chemical approaches, in conjunction with the computational techniques,
offered a rapid and sophisticated method that allowed for better distinction of
the inks and provided more accuracy in substantially less time than typical methods
employed in forensic laboratories.
ОСОБЛИВОСТІ ПЕРЕБІГУ НОВОЇ КОРОНАВІРУСНОЇ ХВОРОБИ-2019 У ВАГІТНИХ З ГІДРОНЕФРОЗОМ: ДОСЛІДЖЕННЯ СЕРІЇ ВИПАДКІВ
Authors: Х. М. Ільницька  , О. Я. Царук  , І. С. Головчак  , О. Г. Бойчук  , Мацькевич Вікторія , Т. Л. Ленчук  
Published: January 2024

Сечовидільна система є мішенню для вірусу SARS-CoV-2 поруч з легеневою та серцево-судинною. Враховуючи поширеність фізіологічного гідронефрозу у вагітних та поширеність COVID-19, важливим є вивчення впливу поєднання обох нозологічних форм на організм вагітної, особливо, якщо виникнення цих станів відбулось саме під час вагітності. Тому презентація серії таких випадків є доповнюючою для бази наукових досліджень, враховуючи, що організм жінки піддається впливу як гормональних і функціонально-конституційних змін самого стану вагітності, так і додатково чинників фізіологічного гідронефрозу і гострого карантинного інфекційного захворювання. Обстежено 9 вагітних, у терміні вагітності з 28 по 36 тиждень, віком від 21 до 42 років з фізіологічним гідронефрозом вагітних та COVID-19. У 3 пацієнток (33.3%) фізіологічний гідронефроз був двосторонній, а у 6 (66.7%) тільки правосторонній. Відзначалось помірне поширення порожнистої системи нирок, що відповідало І стадії гідронефрозу у 3 пацієнток (33.3%) та ІІ стадії гідронефрозу у 6 пацієнток (66.7%). У 5 (55.6%) пацієнток з пневмонією під час ультразвукового дослідження легень виявлено інфільтрацію легеневої тканини, плевральні синуси були вільні. Анемія, що ускладнює вагітність, гострий трахеобронхіт та безсимптомна бактеріурія були у 4 пацієнток (44.4%). Висновки. Пацієнткам у третьому триместрі вагітності при гострому інфекційному процесі слід проводити ретельне обстеження нирок, яке б включало лабораторні методи діагностики та сонографічний контроль. Диференційної діагностики потребує фізіологічний гідронефроз нирки вагітної, при COVID-19 для вчасного попередження розвитку, як пієлонефриту внаслідок бактеріальної ко-інфекції, так і гострого пошкодження нирок внаслідок дії вірусу SARS-CoV-2.
Ключові слова: вагітність, гідронефроз, ультразвукове дослідження, коронавірусна хвороба-19, вірус SARS-CoV-2.