bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bacterial Profile and their Antimicrobial Susceptibility Pattern in Pediatric Septicemia patients from Tertiary Care Hospital.
Authors: Rasheed Farhan , Jamil Iqra , Tehseen Tahira , Sikandar Abeera , Anwar Saba , Rafique Sajjad 
Published: September 2023

Background:
Blood stream infection is a life-threatening infection, leading to increased morbidity and mortality in pediatric population. Antimicrobial drug resistance is a major therapeutic challenge and may result in treatment failure. Thus, this study aimed to assess the bacterial profile causing septicemia and their antimicrobial resistance pattern among pediatric population.
Methods:
This reterospective study was conducted in pathology department of Hameed Latif Hospital, Lahore, over a period of two years, from 1st January 2021 to 31 December 2022. Blood samples were aseptically collected and were transferred into Bact/Alert blood culture bottle. After the detection of microbial growth by Bact/Alert 3D system, bacterial isolates were identified by standard microbiological procedures. Antimicrobial sensitivity pattern was determined by Modified Kirby-Bauer disc diffusion method on Mueller Hinton agar. Data was entered and analyzed by using Microsoft Excel 2010.
Results:
In our study, out of 1306 blood culture samples, 217(16.6%) were positive for bacterial growth. Among positive cases, Gram negative organisms were predominant isolates 181(83.4%), while Gram positive organisms were isolated in 36(16.6%) samples. Most common bacterial isolates were S. typhi (24%), A.baumanii (19%), P.aeruginosa (9%), while S.aureus and MRSA were 8% each. Highly resistant class of drugs for Gram-positive bacteria were found to be Aminopenicillin (69.1%) and Macrolides (68.6%), while Gram-negative organisms showed maximum resistance against Tetracycline (72.9%), Fluoroquinolones (62.1%) and Cephalosporins (61%).
Conclusion:
Bacterial isolates clinically suspected cases of septicemia were high. Majority of bacterial isolates showed maximum drug resistance against different classes of antibiotics. To prevent antibiotic resistance, strict regulation of antibiotic utilization and infection control programs should be implemented.
PERCEIVED FACTORS AFFECTING THE MANAGEMENT OF EPILEPTIC ATTACKS AMONG LEARNERS IN A SELECTED SCHOOL IN LIVINGSTONE – ZAMBIA
Authors: Mweemba Delphine , Mandyata Joseph , Muzata Kenneth K. 
Published: September 2023

This was a qualitative study of learners with epilepsy. This study investigated the management practices involving learners with epilepsy in one selected school. The objectives of the study were to examine the existing practices in the management of epilepsy among learners in one selected regular school and to establish the challenges teachers face in the management of epilepsy in school. A qualitative case study design was used. The sample comprised 32 participants; 7 teachers, 5 parents, 5 learners with epilepsy and 15 learners without epilepsy. Data were collected through interviews and focus group discussions. Participants were selected through use of purposive sampling technique. Analysis of data was done thematically. The study revealed that the most common management practice used by most participants was making sure that learners with epilepsy adhered to medication prescribed by doctors; and making sure that learners with epilepsy are placed in a safe positions during seizure attacks. Among other findings, parents felt they were not fully educated on how to manage the children when under attack. Further, beliefs and myths about epilepsy still had a toll on the provision of services to learners with epilepsy. The study recommends that there should be a deliberate policy to orient and train stakeholders on the management of learners with epilepsy in schools and local communities. Efforts should be made to provide basic materials and equipment to use in the management of epileptic conditions in study schools. Schools, nearby clinics and hospitals build collaboration on the management of learners with epilepsy in institutions of learning.
Los trastornos del espectro autista
Authors: Zúñiga A. Hervás , García N. Maraver , Peña M. Salgado , Santos L. Sánchez 
Published: September 2023

Presentación del caso
Motivo de consulta
La familia de Pablo acude al pediatra con su hijo, de 2 años y 11 meses, porque están preocupados por aspectos de su desarrollo.
Anamnesis
Los padres explican que el desarrollo de Pablo fue aparentemente normal hasta los 12-13 meses: miraba, reía, gateaba a los 9 meses, jugaba al escondite, etc. A partir de esa edad, los padres empezaron a preocuparse porque la mirada de su hijo disminuyó, no decía "papá" ni "mamá", se puso más serio, dejó de comer algunos alimentos sólidos, etc.
Gaya Kepemimpinan dan Kinerja Pemerintah Desa Dalam Mempengaruhi Kepuasan Masyarakat
Authors: Fathurrozaqi Nafi' 
Published: September 2023

Latar Belakang: Kepuasan masyarakat merupakan suatu penilaian emosional dari masyarakat setelah mereka menggunakan layanan yang ditawarkan oleh penyelenggara pelayanan publik, salah satunya pelayanan yang diberikan oleh pemerintah desa. Berkaitan dengan hal itu, diketahui ada beberapa faktor yang diprediksi dapat mempengaruhi tinggi-rendahnya kepuasan masyarakat, antara lain faktor gaya kepemimpin dan kinerja dari para perangkat pemerintah desa.
Tujuan: Penelitian ini bertujuan untuk menguji apakah gaya kepemimpinan kepala desa dan kinerja perangkat desa berpengaruh terhadap kepuasan layanan masyarakat.
Metode Penelitian: Penelitian ini menggunakan data primer yang diperoleh dari 98 orang responden yang merupakan masyarakat Desa Ngudikan Kecamatan Wilangan Kabupaten Nganjuk dengan menggunakan alat kuesioner. Data yang diperoleh dilakukan analisis deskriptif, asumsi klasik dan regresi linier berganda.
Hasil Penelitian: Gaya kepemimpinan kepala desa dan kinerja perangkat desa berpengaruh terhadap kepuasan layanan masyarakat baik secara parsial dan simultan.
Keaslian/Kebaruan Penelitian: Memberikan gambaran lebih luas mengenai pengaruh gaya kepemimpinan dan kinerja perangkat di sektor publik pemerintahan desa.
Estimating fiscal multipliers for North Macedonia: a structural vector error correction model
Authors: Raveni Arbresh 
Published: September 2023

The aim of this research is to evaluate the effectiveness of fiscal policy as a means of influencing output in North Macedonia. We apply a VEC model, and use quarterly data for the period 2000q1-2019q4. Our findings suggest that the possibility of fiscal policy to be used as a short-term stabilization tool was limited by the turbulent early phase of transition and several IMF arrangements; the exchange rate peg; and the scarcity of financial resources. The results of the baseline model suggest that a government spending shock is more effective as a stabilization fiscal tool in Macedonia, compared to a tax shock, although fiscal multipliers smaller than one suggest that the effectiveness of fiscal policy in boosting output is limited. The findings confirm the importance of structural characteristics, suggesing that not accounting for monetary policy reaction and debt dynamics will result in an overstatement of fiscal multipliers. In
particular, the results suggest that the “crowding out” effect of fiscal policy due to interest rate pressure is absent and that monetary policy is accommodating an expansionary fiscal policy. The results of our investigation suggest that an increase in government expenditures will induce a significant increase in taxes. Moreover, although an increase in spending/taxes will result in a short-lived increase/decrease in public debt, as a priori expected, we find a long-equilibrium relationship between government spending and taxation suggesting that debt sustainability is not an issue in the case of Macedonia.
Kelayakan Program Pengembangan Usaha Namaste 21 Handmade berbasis toko online
Authors: Juni Antari Ayu Putu 
Published: September 2023

Keberadaan Industri Kecil dan Menengah (IKM) menjadi penting dalam upaya menggerakan roda perekonomian oleh karena itu Pemerintah kota Denpasar makin gencar mendorong pertumbuhan dan pengembangan IKM. Kendati demikian Upaya tersebut juga seringkali dihambat oleh beberapa hal terlebih munculnya pandemic covid 19 membuat para pelaku IKM salah satunya usaha Namaste 21 Handmade dipaksa beralih ke digitalisasi melalui platform-platform toko online yang ada. Diperlukan analisis kelayakan yang hasilnya digunakan untuk mengambil keputusan usaha ini layak dikembangkan atau tidak. Tujuan penelitian ini adalah untuk mengetahui kelayakan pengembangan Namaste 21 Handmade berbasis toko online ditinjau dari seluruh aspek. Penelitian ini menggunakan metode penelitian Deskriptif kualitatif menggunakan teknik analisis data kualitatif untuk menganalisis Manajemen strategi dan aspek-aspek non finansial Sedangkan pengolahan data kuantitatif dilakukan untuk menganalisis aspek finansial. Hasil Penelitian ini menunjukan dalam metode QSPM dihasilkan beberapa strategi seperti: memanfaatkan toko online sebagai media promosi dan penjualan serta mempertahankan kualitas dan branding produk untuk mencapai keadaan keunggulan bersaing yang lebih baik. Disamping itu ditinjau dari Aspek Hukum berdasarkan hasil analisis mendapatkan rata-rata skor 2 dipengkategorian masuk kedalam kategori layak. Aspek pasar dan pemasaran mendapatkan rata-rata skor 4,4 dengan kategori sangat layak. Aspek manajemen dan SDM mendapatkan rata-rata skor 2,75 dengan kategori sangat layak. Aspek ekonomi dan sosial mendapatkan rata-rata skor 3,75 dengan kategori sangat layak. Aspek teknis dan teknologi mendapatkan rata-rata skor 3, dengan kategori sangat layak. Aspek keuangan mendapatkan rata-rata skor 5 dengan kategori sangat layak. Dengan demikian secara keseluruhan aspek, keberadaan Namaste 21 Handmade berbasis toko online dinyatakan layak.
Kata Kunci: Studi Kelayakan Bisnis, Toko Online, Industri Kecil Menengah
Diagnostic Accuracy of Anthropometric Markers of Obesity for Prediabetes: A Systematic Review and Meta-Analysis
Authors: Vera-Ponce Víctor Juan , Zuzunaga-Montoya Fiorella E. , Loayza-Castro Joan A. , Ramirez-Ortega Andrea P. , Torres-Malca Jenny Raquel , García-Lara Rosa A. , Iturregui Paucar Cori Raquel , Valladares-Garrido Mario J. , Cruz-Vargas Jhony A. De La 
Published: September 2023

Introduction: Prediabetes is a significant public health concern due to its high risk of progressing to diabetes. Anthropometric measures of obesity, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) have been demonstrated as key risk factors in the development of prediabetes. However, there is a lack of clarity on the diagnostic accuracy and cut-off points of these measures.
Objective: To determine the diagnostic accuracy of these anthropometric measures for their most effective use in identifying prediabetes.
Methodology: A systematic review (SR) with metanalysis of observational studies was carried out. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. For the meta-analysis, sensitivity and specificity, together with their 95% confidence intervals (CI 95%) were calculated.
Results: Among all the manuscripts chosen for review, we had four cross-sectional studies, and three were classified as cohort studies.
The forest plots showed the combined sensitivity and specificity for both cross-sectional and cohort studies. For cross-sectional studies, the values were as follows: BMI had a sensitivity of 0.63 and specificity of 0.56, WC had a sensitivity of 0.59 and specificity of 0.58, and WHtR had a sensitivity of 0.63 and specificity of 0.73. In the cohort studies, the combined sensitivity and specificity were: BMI at 0.70 and 0.45, WC at 0.68 and 0.56, and WHtR at 0.68 and 0.56, respectively. All values are provided with 95% confidence intervals.
Conclusions: This systematic review and meta-analysis evaluated the diagnostic accuracy of BMI, WC, and WHtR in identifying prediabetes. The results showed variations in sensitivity and specificity, with WHtR having the highest specificity in cross-sectional studies and BMI having improved sensitivity in cohort studies.
Development and validation of a personalized classifier to predict the prognosis and response to immunotherapy in glioma based on glycolysis and the tumor microenvironment
Authors: Fan Pengfei , Xia Jinjin , Zhou Meifeng , Zhuo Chao , He Hui 
Published: September 2023

Background
Glycolysis is closely associated with cancer progression and treatment outcomes. However, the role of glycolysis in the immune microenvironment, prognosis, and immunotherapy of glioma remains unclear.

Methods
This study investigated the role of glycolysis on prognosis and its relationship with the tumor microenvironment (TME). Subsequently, we developed and validated the glycolysis-related gene signature (GRS)-TME classifier using multiple independent cohorts. Furthermore, we also examined the prognostic value, somatic alterations, molecular characteristics, and potential benefits of immunotherapy based on GRS-TME classifier. Lastly, the effect of kinesin family member 20A (KIF20A) on the proliferation and migration of glioma cells was evaluated in vitro.

Results
Glycolysis was identified as a significant prognostic risk factor in glioma, and closely associated with an immunosuppressive microenvironment characterized by altered distribution of immune cells. Furthermore, a personalized GRS-TME classifier was developed and validated by combining the glycolysis (18 genes) and TME (seven immune cells) scores. Patients in the GRSlow/TMEhigh subgroup exhibited a more favorable prognosis compared to other subgroups. Distinct genomic alterations and signaling pathways were observed among different subgroups, which are closely associated with cell cycle, epithelial—mesenchymal transition, p53 signaling pathway, and interferon-alpha response. Additionally, we found that patients in the GRSlow/TMEhigh subgroup exhibit a higher response rate to immunotherapy, and the GRS-TME classifier can serve as a novel biomarker for predicting immunotherapy outcomes. Finally, high expression of KIF20A is associated with an unfavorable prognosis in glioma, and its knockdown can inhibit the proliferation and migration of glioma cells.

Conclusions
Our study developed a GRS-TME classifier for predicting the prognosis and potential benefits of immunotherapy in glioma patients. Additionally, we identified KIF20A as a prognostic and therapeutic biomarker for glioma.
Energy flow in men’s javelin throw and its relationship to joint load and performance
Authors: Köhler Hans-Peter , Witt Maren 
Published: September 2023

Background
Performance in javelin throwing is dependent on the release speed and therefore the energy transferred to the javelin. Little is known about the flow of mechanical energy in javelin throwing and whether there is a connection to joint loading and throwing performance. The purpose of the study was therefore to investigate (1) the energy flow within the kinetic chain of the throwing arm, (2) how it is related to performance and joint loads and (3) how joint forces and torques are used to transfer, generate and absorb mechanical energy.

Methods
The kinematics of 10 experienced javelin throwers were recorded using a 12-camera infrared system. 16 markers were placed on the athlete’s body, five on the javelin to track the movement of each segment. A segmental power analysis was carried out to calculate energy flow between upper body, upper arm, forearm and hand. Stepwise regression analysis was used to calculate the variable that best predicts release speed and joint loads.

Results
The results indicate that the higher the peak rate of energy transfer from the thorax to the humerus, the higher the release speed and the joint loads. While there were no differences between the peak rate of energy transfer in the different joints, the energy transferred differed depending on whether joint forces or torques were used. It can be further shown that higher joint torques and thus higher rotational kinetics at the shoulder are linked to higher release speeds. Thus, the movements of the upper body can be of great influence on the result in javelin throwing. Furthermore, the data show that athletes who are able to transfer more energy through the shoulder, rather than generate it, experience a smaller joint loading. An effective technique for improved energy transfer can thus help perform at the same level while lowering joint stress or have higher performance at the same joint loading.
Affected of Ameliorated Alkaline Water and Soil Amendments on Exchangeable Cation, Macro and Micronutrients in Sodic Soil under Drip Irrigation
Authors: Suresh T. , Selvamurugan M. , Baskar M. , Santhy P. , Balasubramaniam P. 
Published: September 2023

The Field experiment was carried out at Anbil Dharmalingam Agricultural College and Research Institute, Tiruchirappalli using cotton (RCH- 20) as a test crop to examine the effect of ameliorated alkali water and soil amendments on soil properties, growth, and yield of hybrid cotton in sodic soil under drip irrigation. In this experiment, Drip irrigation with gypsum treatment water and drip irrigation with spent wash treatment water were used as main-plots treatments. Soil application of gypsum @ 50 % GR (5.2 t ha-1) and one time soil application of distillery spent wash @ 5 lakh litter ha-1 were imposed as sub-plot treatments. The treatment without amendments both under main plot and sub plots were used as control. The experiment was carried out using a strip-plot design with four replications. The application of additives through irrigation water (or) soil considerably decreased the pH of post-harvest soil. The soil exchangeable Ca and Mg were found significant due to soil application of amendments only and value ranged from 8.51 to 9.35 and 5.03 to 5.20 Cmol (p+) kg -1 respectively. The soil available nutrients N, P and K were found significant, and value range from 167 to 311, 15.4 to 21.5, 158 to 928 kg ha-1 respectively. The application distillery spent wash (DSW) and gypsum slightly increased the micronutrient cations range which from 4.80 to 6.85 mg kg-1 of Fe, 8.60 to 10.43 mg kg-1 of Mn, 0.64 to 0.88 of mg kg-1 of Zn, 1.10 to 1.42 mg kg-1 of Cu. The results of the field experiment revealed that application of amended alkali water and amended soil significantly increased all the growth and yield parameters of cotton. An increase in seed cotton yield of 701 and 544 kg ha-1 was recorded due to the application of gypsum treated water and DSW treated water respectively over control. Similarly, an increase of 773 and 973 kg ha-1 of seed cotton yield was recorded due to soil application of gypsum and DSW respectively over control. While considering the interaction effect, soil application of DSW along with gypsum bed treated water found to be the best for getting higher seed cotton yield (3015 kg ha-1) when compared to other treatment combination.
National Institutes of Health Funding Gaps for Principal Investigators
Authors: Gillen Kelly M. , Markowitz Daniel M. , Long Patricia , Villegas-Estrada Adriel , Chang Eileen , Gupta Ajay 
Published: September 2023

ImportanceEarly-stage and established investigators compete for a limited supply of funds from the National Institutes of Health (NIH). Regardless of their previous funding success, many principal investigators (PIs) encounter a funding gap in which they no longer receive ongoing funding from the NIH.ObjectiveTo determine incidence rates of PI-level funding gaps, the mean funding gap length, and whether these 2 metrics are associated with previous funding success.Design, Setting, and ParticipantsThis study was conducted using data from NIH RePORTER. Historical datafiles for fiscal year (FY) 2011 to FY 2021 were aggregated to generate 2 master datafiles for this period: all NIH awards and only R01 awards. PIs with no funding in FY 2011 or FY 2021 were removed. PIs were sorted by FY 2011 total funding amounts and grouped by quarter of amount.ResultsA total of 39 944 unique researchers were awarded 220 131 NIH awards, of which 103 753 were R01 awards. For all NIH awards, there was an overall linear increase from top quarter to bottom quarter in the percentage of PIs who had at least 1 year without funding (from 27% to 75%), percentage of these gap PIs who had at least 2 consecutive years without funding (from 56% to 68%), and mean maximum consecutive years without funding for gap PIs (2.2 years to 3.1 years). For only R01 awards, there was an overall linear increase from top quarter to bottom quarter in the percentage of PIs who had at least 1 year without funding (50% to 74%), percentage of gap PIs who had at least 2 consecutive years without funding (59% to 71%), and mean maximum consecutive years without funding for gap PIs (2.4 years to 3.1 years).Conclusions and RelevanceIn this cohort study of NIH-funded investigators, PIs with higher NIH funding were less likely to experience a funding gap. Additionally, when these PIs encountered a funding gap, this period without funding was shorter; however, among all PIs, funding gaps typically lasted 2 to 3 years. These associations were found inclusive of all NIH awards and when analysis was limited to only R01 awards. These findings may be useful to PIs and academic institutions as they prepare, structure, and project research resource allocations.
Skilled Nursing Facility Changes in Ownership and Short-Stay Medicare Patient Outcomes
Authors: Prusynski Rachel A. , Humbert Andrew , Mroz Tracy M. 
Published: September 2023

ImportanceSkilled nursing facility (SNF) changes in ownership are receiving attention in the national conversation regarding health care quality and oversight. SNF ownership changes have been cited as possible ways for SNFs to obscure financial arrangements and shift funds away from patient care; however, it is unclear whether ownership changes are associated with quality outcomes, especially for short-stay patients.ObjectiveTo determine which SNF characteristics are associated with changes in ownership and whether ownership changes were associated with differences in short-stay patient outcomes.Design, Setting, and ParticipantsThis cohort study was a secondary analysis of 2016 to 2019 Medicare administrative data including SNFs in the United States with complete data. Data were analyzed from January 2016 through December 2019.ExposureSNF change in ownership.Main Outcomes and MeasuresOutcomes of interest were facility-level risk-adjusted rates of hospital readmissions, emergency department visits, and community discharge for short-stay patients after admission to an SNF. Analyses were conducted using multivariable logistic regression and controlled interrupted time series.ResultsOf 11 004 SNFs, 1459 (13.26%) changed ownership between 2016 and 2019. Compared with for-profit SNFs, nonprofit and government SNFs had lower odds of changing ownership (nonprofit: odds ratio [OR], 0.40; 95% CI, 0.32-0.49; government: OR, 0.26; 95% CI, 0.17-0.41). Chain SNFs had higher odds of changing ownership than nonchain SNFs (OR, 1.38; 95% CI, 1.21-1.59). Urban SNFs with lower occupancy rates (OR per 10–percentage-point decrease, 1.19; 95% CI, 1.14-1.25), larger Medicaid populations (OR per 10–percentage-point increase, 1.17; 95% CI, 1.13-1.22), and lower staffing ratings (OR per 1-star increase on staffing rating, 1.18; 95% CI, 1.14-1.25) had higher odds of changing ownership. Descriptively, all 3 quality outcomes were worse throughout the study in SNFs undergoing ownership change compared with controls that did not change ownership. However, results of interrupted time series models found no associations between an ownership change and hospital readmissions or community discharge rates. Ownership change was associated with a short-term increase of 0.32 (95% CI, 0.03 to 0.62) percentage points in emergency department visits.Conclusions and RelevanceIn this cohort study of 11 004 SNFs in the US between 2016 and 2019, SNF characteristics historically associated with lower quality were more likely to change ownership; however, ownership changes were only associated with short-term increases in ED visits. These results suggest that SNF ownership changes may be a symptom, not a cause, of lower quality.