bluuebunny/crossref_metadata_2025_split huggingface dataset:
On the role of the US in EU-Japan relations: Is trilateralism still on agenda?
Authors: Chizhevskaya M. P. 
Published: July 2022

This article is devoted to analyzing the contemporary configuration of relations inside the triad of the US, the European Union, and Japan, often addressed to as trilateral relations. The ‘three pillars’ theory, which is acknowledged to be a root of the trilateralism concept, was originally introduced by the Japanese Prime Minister Ikeda Hayato during his visit to Paris in 1962. Later, in the 1980s, it was developed by the Japanese diplomat Owada Hisashi, known for his active participation in the Hague declaration preparatory process. This concept was widely used by researchers in the 1990–2000s to explain current EU-Japan relations and their place in world politics. Indeed, it seems natural to develop cooperation between the participants of the so-called ‘triangle’, which dominated the world economically and shared common values of democracy, human rights, and free trade. Meanwhile, although the Transatlantic and Transpacific relations were highly developed due to security cooperation, the Japan-EU relations during the whole post-war period were far less advanced and thus were often called a ‘weak side’ of the triangle. Today, when the US is actively promoting new alliances in the Indo-Pacific region, engaging Australia and India, and the economic predominance of the three economies is challenged by China, addressing this triangle scheme as a working political relations model can be put in doubt.The article argues that, presently, it is difficult to interpret the triangle as a working political model, which is characterized by mutual interdependence of the three engaging actors. The author looks at the roots of this concept, analyzes the reasons why it was the Japanese side who offered such a vision of the US-EC-Japan relations, the role of the US in Japan-Western Europe relations. After considering the decisions of the D. Trump and J. Biden administrations towards their ‘junior partners’, the author concludes that inconsistent, difficult to forecast policy of the Trump administration led to the strengthening of the EU-Japan relationship, which gives reason to point to a certain extent of interdependence between the participants of the triangle. However, the Biden administration’s policy, which seems to be more consistent, but short of idealism towards its allies, has not significantly influenced the EU-Japan relations so far. Rather, it opened the way to search for new partnerships. The conclusion of a defense pact between Japan and Australia in January 2022 is a good example of this process, showing that the partners’ choice is dictated not by a necessity to develop ‘trilateral’ relations, but by pragmatic assessment of effectiveness of this or that partnership.
Antenatal Care for High Risk Pregnancy
Authors: Sungkar Ali , Surya Raymond 
Published: July 2022

<p>Despite 38% gradual fall since 2000, there was still approximately 295,000 women died during and following pregnancy and childbirth in 2017. Factors that lead to high maternal mortality include inequality access to health service, severe bleeding (mostly postpartum hemorrhage), infection, high blood pressure during pregnancy, complication from delivery, and unsafe abortion. These deaths are correlated to delay in decision to seek care, delay in reaching care, delay in receiving adequate health care. Improvement of antenatal care was the solution to this problem. Indonesia has not updated to the newest model of WHO antenatal care in 2016. Defining high-risk and updating the model can help Indonesia provides excellent care for mothers and reduce maternal deaths.</p><p>Meskipun terdapat penurunan angka kematian ibu (AKI) sebesar 38% sejak tahun 2000, 295.000 wanita meninggal peripartum pada tahun 2017. Faktor yang menyebabkan AKI di antaranya tidak meratanya akses pelayanan kesehatan, perdarahan berat, infeksi, tekanan darah tinggi selama kehamilan, komplikasi persalinan, dan aborsi tidak aman. Kematian ini terkait dengan keterlambatan keputusan untuk merujuk, keterlambatan untuk mencapai tempat rujukan, dan keterlambatan mendapatkan tatalaksana yang baik. Hingga saat ini, Indonesia belum mengikuti panduan kunjungan antenatal terbaru dari WHO tahun 2016. Mendefinisikan kehamilan risiko tinggi dan penyesuaian model kunjungan antenatal diharapkan dapat memberikan perawatan yang baik bagi ibu dan menurunkan kematian maternal.</p><p> </p>
Gunakan Insulin dengan CERMAT
Authors: Lukito Johan Indra 
Published: July 2022

<p>Insulin digunakan sebagai salah satu terapi diabetes melitus (DM). Penderita DM dan keluarganya perlu mendapat edukasi tentang penggunaan insulin. Penulis menyusun sebuah mnemonik untuk membantu pasien dan keluarganya mengingat hal-hal penting terkait penggunaan insulin. Mnemonik ini berupa slogan “Gunakan Insulin dengan CERMAT”.</p><p>Insulin is used for diabetes mellitus (DM) therapy. DM sufferers and their families need to be educated on using insulin to control their blood glucose levels. The author suggested a mnemonic to help patients and their families remember essential points related to insulin use. This mnemonic is "Use Insulin with CERMAT".</p><p> </p>
Tatalaksana Herpes Genitalis pada Kehamilan
Authors: Triana Agung , Dyah Ayu Ardelia , Zulfikar Dendy , Yustin Endra 
Published: July 2022

<p>Herpes simplex virus (HSV) adalah penyebab herpes genitalis (HG). Perubahan imunologi saat kehamilan akan meningkatkan kerentanan terhadap infeksi HSV yang merupakan penyebab morbiditas dan mortalitas ibu dan janin. Pengaruh infeksi ini pada ibu dan janin/neonatus tergantung apakah infeksi primer (inisial) atau rekuren. Penentuan episode infeksi HG penting baik untuk tatalaksana maupun edukasi pasien.</p><p>Genital herpes is caused by Herpes simplex virus (HSV). Immunologic changes in pregnancy may increase susceptibility to HSV infection as one of the major cause of morbidity and mortality for both mother and fetus. The effect to the mother and fetus/ neonate depends on whether a primary infection (initial) or a recurrent infection. Determination of an episode of genital herpes is important to provide best management and education.</p><p> </p>
Persepsi Mahasiswa Fakultas Kedokteran Universitas Tanjungpura Mengenai Konsep Profesionalisme Dokter
Authors: Purwanti Melvy , Armyanti Ita , Asroruddin Muhammad 
Published: July 2022

<p>Latar Belakang: Salah satu standar kompetensi dokter lulusan Indonesia adalah profesionalisme; usaha pembelajaran profesionalisme sangat tepat jika dimulai sejak dini. Tujuan: Mengetahui persepsi mahasiswa kedokteran Prodi Kedokteran FK UNTAN tahap akademik dan profesi tentang konsep profesionalisme dokter. Metodologi: Penelitian deskriptif kualitatif dengan pendekatan wawancara mendalam. Pemilihan sampel menggunakan metode purposive sampling. Responden berjumlah 10 orang mahasiswa. Analisis data dengan analisis tematik. Hasil: Sebanyak 7 dari total 10 responden (70%) mendefinisikan profesionalisme dokter yaitu seorang dokter yang bekerja sesuai standar profesi dokter. Mengenai persepsi atribut perilaku profesionalisme, 7 responden (70%) menyatakan bahwa dokter yang profesional harus memiliki tanggung jawab. Seluruh responden menyatakan prinsip pembelajaran profesionalisme yaitu dilatih dan diterapkan sejak mahasiswa akademik-profesi hingga menjadi dokter serta terintegrasi dengan kurikulum. Sebanyak 5 responden (50%) menyatakan peran penting profesionalisme pada pendidikan kedokteran yaitu belajar profesionalisme agar terbiasa saat menjadi dokter. Simpulan: Profesionalisme dalam kedokteran perlu diperkenalkan kepada mahasiswa sejak dini. Pendidikan profesionalisme juga harus dengan pengarahan dan bimbingan.</p><p>Background: One of the standard of competencies of Indonesian Doctor is professionalism. Professionalism is obligatory for all doctors and this competence can be acquired at early phase. Objective: This paper aims to identify the perceptions of academic and profession stage medical students in Tanjungpura University on the concept of doctor’s professionalism. Methodology: This paper was a descriptive qualitative with in-depth interview. Ten participants were selected through purposive sampling method. Data were analysed thematically. Results: Seven of 10 participants (70%) defined doctor’s professionalism as work according to the standards of doctor profession. Seven (70%) participants stated that a professional doctor must have a sense of responsibility. All participants indicated that professionalism training should begin in academic-profession level. Five respondents (50%) stated the important role of professionalism in medical education, namely learning professionalism to get used to being a doctor. Conclusion: In medical faculty, professionalism should be introduced as early as possible.</p><p> </p>
Efikasi Suplementasi Vitamin D terhadap Indeks Glikemik pada Diabetes Melitus Gestasional
Authors: Safitri Yolanda , Novita Rachma , Louisa Melva 
Published: July 2022

<p>Beberapa studi efikasi suplementasi vitamin D pada diabetes melitus gestasional hasilnya masih bertentangan. Laporan kasus berbasis bukti ini bertujuan untuk konfirmasi efikasi suplementasi vitamin D terhadap kontrol glikemik pada wanita hamil dengan diabetes melitus gestasional dan hipovitaminosis D. Pencarian artikel komprehensif melalui PubMed dan Scopus. Studi yang dipilih adalah studi dengan desain randomized controlled trial atau systematic review pada wanita hamil dengan diabetes melitus gestasional dan hipovitaminosis D membandingkan terapi standar obat anti diabetes (OAD) dengan obat terapi standar dan suplementasi vitamin D. Telaah kritis sesuai perangkat dari Center for Evidence Based Medicine (CEBM). Diperoleh 3 studi systematic review yang memenuhi kriteria eligibilitas. Dua studi menunjukkan perbedaan kadar glukosa darah puasa dan HbA1C yang bermakna secara statistik dan klinis pada kelompok yang mendapat suplementasi vitamin D dibandingkan kelompok kontrol. Satu studi hasilnya tidak bermakna.</p><p>Results of recent studies on the use of vitamin D supplementation in gestational diabetes mellitus were conflicting. This evidence-based case report aimed to confirm the efficacy of vitamin D supplementation on glycemic control in pregnant women with gestational diabetes mellitus and hypovitaminosis D. A comprehensive search for articles in PubMed and Scopus included randomized controlled trial or systematic reviews in gestational diabetes mellitus and hypovitaminosis D comparing standard anti-diabetic drug therapy (OAD) with standard therapeutic drugs and vitamin D supplementation. Critical appraisals were done using the tools from Center for Evidence Based Medicine (CEBM). Three systematic reviews met the eligibility criteria. Two studies showed statistically and clinically significant differences in fasting blood glucose and HbA1C level in vitamin D supplementation group compared to the control group, while the result of the third study was not significant.</p><p> </p>
Pattern of Blood Donation and Transfusion Transmissible Infections in a Hospital-Based Blood Transfusion Service in Lagos, Nigeria
Authors: Ogbenna A , Adewoyin S A , Famuyiwa C O , Oyewole K M , Oyedeji O A , Akanmu A S 
Published: July 2022

Background: Blood transfusion therapy remains a mainstay in the care of many tropical diseases. Blood supply in sub-Saharan Africa (SSA) including Nigeria is still a challenge in terms of perennial blood shortages and transfusion transmissible infections (TTI). This study aimed to describe blood donation patterns and compare the rates of TTIs among types of blood donors seen at LUTH.
Study method: A 6-year retrospective review of data on donor types and pattern of TTIs at LUTH transfusion service. TTI rates and odd ratios (OR) of TTI positivity amongst VNRD versus FRD were computed at 95% confidence intervals. Proportion of TTI sero-positivity was also compared between the VNRD and FRD groups.
Results: A total of 53,319 blood donors were observed over the study period, with average of 8886.5 donors per year. VNRDs accounted for 12.3% (6533/53,319), while FRDs accounted for 87.7% (46,789/53,319) of all donors. The proportion of VNRDs ranged from 5.1% to 20.8%. The overall prevalence of TTIs over the 6-year period for all donors was 1.34% for HIV, 5.79% for HBV, 2.23% for HCV and 0.88% for syphilis. Sero-positivity rates for HIV, HBV, HCV, and syphilis was statistically significantly lower among VNRD compared to FRDs.
Conclusion: There exists a lot of room for improvement in our blood donation practices to improve blood stock and transfusion safety. A more aggressive strategic effort needs to be directed towards achieving a target of 100% voluntary blood donor base through partnerships, advocacy, more financing and resource allocation, and other proven initiatives.
Keywords: Nigeria; Transfusion; Transfusion transmitted infections; blood donors.
Epidemiologic Characteristics, Clinical Features and Outcomes of COVID 19: Patients Admitted at the Asokoro District Hospital Isolation and Treatment Center, Abuja, North Central Nigeria
Authors: Onyegbutulem H C , Dogo D , Nnabuchi C V , Aghahowa M E , Alu F E , Afiomah E U , Atanda O D , Nwankwo C G , Ani-Osheku I , Olatise O O , Abolade B O , Akerele I O , Henry-Onyegbutulem P I 
Published: July 2022

Background: The COVID -19 pandemic spread rapidly across the globe, making a land-fall on the Nigerian geo-space in early 2020. Key presenting features were; fever, dry cough, fatigue, myalgia, headache, sore-throat, abdominal pain, diarrhea, dyspnoea amongst others, with a clinical spectrum ranging from mild through severe forms. Aside infection control and supportive care, there was no specific therapy until trials with Remdesivir. Studies have described limited epidemiological findings, presentations and outcomes of COVID patients in Nigeria and elsewhere, but not for the Federal Capital Territory, (FCT) specifically Abuja, the Nation's capital city and the second epicenter of the pandemic in Nigeria. The objective of this study therefore, was to describe the Clinical and demographic characteristics of the patients admitted at the Asokoro District Hospital (ADH), Abuja.
Methods: Retrospective study that used records of patients admitted, between April and September 2020. Data include; Socio-demographics, medical history, exposure, residential area, co-morbidities, symptoms, signs, treatment measures, duration of hospital stay and outcomes.
Results: 270 patients were enrolled for this study. 170(63%) males and 100(37%) females. Mean age was 40.03+13.5years. Forty-one(15.2%) had travel history while 99(36.7%) had contact with confirmed cases. Majority of the patients were married(63.33%), and had tertiary education(74.82%). Commonest symptoms were cough(43.33%), fever(36.67%), headaches(32.22%) and fatigue(31.48%). The duration of stay at the ADH ranged from 2 hours to 28 days.
Conclusion: Our patients were young, mainly of the upper class, educated people with mild to severe disease. There was one death, a case with multiple comorbid factors.
Keywords: Abuja-Nigeria; COVID patients; Socio-demographics; clinical features; outcomes.
Prevalence of Needle Stick and Sharps Injury and Hepatitis B Vaccination among Healthcare Workers in a South-East Nigerian Tertiary Hospital
Authors: Onubogu  
Published: July 2022

Background: Daily, HCWs are exposed to needle stick and sharps injury (NSSI) and associated risk of life-threatening infections.
Aim: A cross-sectional study was conducted to determine the prevalence of NSSI and HBV vaccination among 341 HCWs at NAUTH, Nnewi.
Methods: Data was collected using a self-administered. questionnaire and interview of key staff.
Results: The mean age of participants was 33.4±11.9 years while male: female ratio was 1:1.7. Prevalence of NSSI in the preceding 12 months was 25.5% with doctors (43.0% [34/79]), laboratory scientists (27.5%[14/51]) and nurses (21.8%[17/78]) leading (p=0.014). Noncompliance with standard precaution (SP) and non-display of relevant SP SOPs in prominent places were significantly associated with NSSI (p=0.001). Among those exposed to NSSI, only 33.7% (28/83) consulted a doctor, while 16.9%(14/83) took post-exposure prophylaxis. Two-third (68.8% [190/276]) of respondents correctly cited HBV/HCV as vaccine-preventable blood-borne healthcare-associated infection (HAI) while half (50.9% [161/316]) had received HBV vaccination. Profession (p=0.018), display of SOPs in prominent places (p=0.015), ability to cite HBV/HCV as vaccine-preventable blood-borne HAI (p=0.001), and compliance with SP (p<0.001) were significantly associated with HBV vaccination. Unit heads' responses implied lack of written policy on HBV vaccination, adequate training on NSSI prevention, and HBV vaccination support.
Conclusion: Among HCWs, NSSI is high but under-reported while HBV vaccination rate is unimpressive. Profession, display of relevant SOPs, and compliance with SP positively affected both NSSI occurrence and HBV vaccination while knowledge about vaccine-preventable blood-borne HAI also influence HBV vaccination status. Written policies on HBV vaccination and NSSI prevention/ management, their communication and enforcement among HCWs, adequate training/retraining, display of SOPs in prominent places, and free HBV vaccination are recommended
Authors
C U Onubogu 1, E I Nwaneli 1, C G Chigbo 2, M C Egbuniwe 3, R O Egeonu 4, S N Chukwurah 5, N P Maduekwe 6, I Onyeyili 6, C P Umobi 3, O F Emelumadu 7
Correlative Ultrasound Evaluation of Anterior Abdominal Wall Subcutaneous Tissue Thickness in Type 2 Diabetic and Non-Diabetic Adults
Authors: Adeyekun  
Published: July 2022

Background: Subcutaneous fat accumulation complicating diabetes mellitus (DM) has long been recognised, even as its clinical significance remains controversial. Ultrasound is safe and accurate in assessing soft tissue dimensions. Reports on ultrasound evaluation of anterior abdominal wall subcutaneous fat in diabetic and apparently healthy normoglycaemic subjects are scanty in the Nigerian environment.
Aims and objectives: To sonographically assess and compare the mean anterior abdominal wall subcutaneous tissue thickness (AAST) in adult diabetic subjects and apparently healthy, normoglycaemic subjects and correlate the values with age, gender, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and glycated hemoglobin (Hb1c).
Materials and methods: The AAST in 150 adult diabetic subjects and equal numbers of age, and sex matched apparently healthy individuals was assessed with a SONOACE X4 ultrasound scanner. (Medison Inc, SOUTH KOREA), using a l inear array transducer of frequency 7. 5MHz10MHz.Measurements were taken in the midline at two points; 2cm above and below the umbilicus. Anthropometric parameters such as BMI, WC, WHR, were recorded.
Results: Adult diabetic subjects had significantly higher AAST values, compared to age and BMI matched male and female apparently healthy controls respectively. (2.7±0.9cm vs 2.2 ± 0.9cm (below the umbilicus; p=0.001), and 2.1 ± 0.8cm vs 1.6 ± 0.8cm (above the umbilicus; p = 0.001). Below the umbilicus, AAST correlated positively with WHR, BM1 and disease duration among diabetic patients.
Conclusion: AAST is significantly increased in diabetic subjects compared to controls, and can be a useful guide in the management of obesity in these patients. There is correlation of AAST below the umbilicus with BMI and waist circumference.
Author
A A Adeyekun 1, J P Okojie 1, M M Abubakar 1, E E Efe-Aluta 1
Acute Leukaemias in Bauchi State, Northeastern Nigeria: Pattern of Presentations and Clinical Entities
Authors: Dachi  
Published: July 2022

Background: Acute leukaemias are very aggressive diseases that run a rapidly fatal course if not promptly diagnosed and appropriately treated. The clinical presentations range from bone marrow failure such as anaemia, neutropenia or thrombocytopenia to features of organ infiltrations such as lymphadenopathy, splenomegaly, etc, but presentations may be non-specific. Misdiagnosis is very common with delay in diagnosis and prompt treatment being the causes of high morbidity and mortality in acute leukaemias. This study aims to determine the pattern of presentation and various clinical entities of acute leukaemias in Bauchi State, North-Eastern Nigeria.
Subjects, materials and methods: This was a three year retrospective study in which records of cases of acute leukaemias diagnosed in the Haematology Department of Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH) Bauchi from the bone marrow aspiration cytology register from 1st January, 2018 to 31st December, 2020 were collected. Data on socio-demographic characteristics of the patients that include age, gender, diagnosis as well as subtypes of some of the malignancies diagnosed were also collated. The collated data were analyzed using SPSS Version 20.0. A p-value of < 0.05 was considered significant.
Results: Twenty-nine cases of acute leukaemias were diagnosed during the period under review. Majority of cases had acute lymphoblastic leukaemia (ALL) 19/29 (65.5%) while acute myeloid leukaemia (AML) was seen in 10/29 (34.5%). The mean ± SD age of the patients was 22.2±9.2 years with a range 6 months to 60 years. Males constituted 75.9% (22/29) of the cases of acute leukaemias diagnosed. The male to female ratios for AML and ALL were 2:1 and 2.6:1 respectively. The mean±SD ages for AML and ALL were 27±9.2years and 17.3±11.3 years respectively. The most common form of presentation of acute leukaemia in this study is recurrent anaemia necessitating blood transfusion while proptosis and epistaxis were the least forms of presentation.
Conclusion: Acute lymphoblastic leukaemia is the commonest form of acute leukaemias while recurrent anaemia is the commonest form of clinical presentations in our setting. Early referral of patients with clinical features suggestive of acute leukaemias is recommended.
Author
R A Dachi 1, F G Mustapha 1, M Mahdi 1, H Abbas 2
Correlates of Depression among Elderly Patients Attending the General Out-Patient Department of a Tertiary Hospital in Northwestern Nigeria
Authors: Damagum  
Published: July 2022

Background: Depression is a common mental health problem in the geriatric population associated with significant morbidity (including decreased physical, cognitive and social functioning) and mortality. Although patients differ in their presentations, certain social and demographic characteristics are common to the elderly population with depression. It is hoped that identifying these patients based on their sociodemographic characteristics will help reduce the difficulties in diagnosis.
Objective: The objective of this study is to determine the risk factors for depressive illness among elderly patients attending the GOPD of AKTH.
Methods: This cross-sectional questionnaire-based study involved 392 elderly patients systematically selected from Family Medicine Clinic attendees in Kano, Nigeria. Data collected included sociodemographic and clinical characteristics. Geriatric Depression Scale was used to screen for depression. Chi-square test and logistic regression analysis were used to determine the association between categorical variables and predictors of depression among participants, respectively.
Results: The prevalence of depression prevalence was 22.4%. Most participants were females aged 60-69 years (62.5%), Hausas (77.6%) and living with their spouses and children (77.3%). Gender, marital status, marital setting, socio-economic class, osteoarthritis and body-mass index were associated with depression. The predictors of depression were female gender (p=0.014, OR=1.401, CI=1.757- 2.591), widows/widowers (p=0.030, OR=4.533, CI= 1.186-17.317) and obesity (p=0.001, OR=5.644, CI=2.759-11.544).
Conclusion: The high prevalence of depression among this population highlights the need for screening. Females, widows/ widowers and obese geriatric patients are more likely to be depressed and should be targeted for screening in our busy outpatient setting.
Author
F Damagum 1, B A Grema 1, G C Michael 1