bluuebunny/crossref_metadata_2025 huggingface dataset:
Unveiling mental health perspectives: Insights from key stakeholders including primary healthcare providers in a tribal District of Gujarat
Authors: Nagar Shashwat , Patel Hirenkumar B. , Nagar Noopur , Gamit Gaurangi , Godara Naresh
Published: February 2025

ABSTRACT

Context:

Mental disorders impact over 25% of people worldwide, with a prevalence of 14.9% in India, higher in rural (17.1%) than urban (12.7%) areas. Effective treatment is limited, particularly in low- and middle-income countries. Integrating mental health into primary care and understanding stakeholder knowledge gaps are essential to improving services and reducing stigma.

Objectives:

This study qualitatively assessed the perspectives of primary healthcare providers and key stakeholders, such as PRI members, regarding common mental disorders in tribal and remote areas.

Materials and Methods:

Fourteen in-depth interviews were conducted with primary care physicians, private practitioners, and PRI members, following written consent for audio recording. Two talukas were randomly selected, and two PHCs from each were chosen for data collection. Content analysis was used to identify themes and codes from the interview transcripts.

Results:

Interviews revealed varied perspectives on mental health. PRI members demonstrated limited understanding, often attributing mental disorders to supernatural causes or stress, and preferred traditional healers. They recommended increased involvement of NGOs and enhanced awareness. Primary care providers highlighted the need for better training, mental health OPDs, and improved access to treatment and medications, noting shortages in government facilities.

Conclusions:

Key themes included limited mental health knowledge, reliance on faith healers, and a need for enhanced training and awareness. Recommendations include improving mental health education, establishing dedicated clinics, increasing professional availability in rural areas, and shifting community attitudes through awareness campaigns and local volunteer training. Effective implementation requires robust government support and NGO collaboration.
Evaluating the causes associated with false positive Galactomannan assay in suspected cases of respiratory fungal infections
Authors: Garg Parul , Suyal Shipra , Deepak Desh , Hembrom Sneha , Chauhan Ankit K. , Kaur Nirmalajit , Malhotra Shalini
Published: February 2025

ABSTRACT

Introduction:

The circulating GM antigen is considered an important and reliable biomarker according to the European Organization for Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSG) guidelines. However several possible causes of false-positive reactions have been reported, including intake of certain antibiotics, cross-reactivity with other fungi (e.g. Histoplasma capsulatum, Alternaria spp., Candida spp, and Fusarium spp etc), food (Carba beans and fava beans) and food supplements. In this context, the occurrence of false-positive results may lead to an unjustified invasive investigation and anti-fungal therapy.

Purpose:

The study was conducted to analyse of causal association of false positive galactomannan factors.

Material and Methods:

BAL samples from suspected respiratory tract infections were submitted for direct microscopic examination, GM detection and fungal culture.

Results:

Out of a total of 530 patients, 70 patients were in the case group (False positive GM) and 50 were in the control group (True positive). The average GMI of the case group was 2(1-4.2). and control group was 1.8(1-3.5). At a cut-off index of >1 false positive galactomannan results were observed maximum in patients who received Amoxiclav(48.5%), Piperacillin-tazobactam(33.3%), Amoxicillin(12.5%) followed by Meropenem(8.3%). The results showed a significant association(p-value <0.001) with false positive GM.. Other fungal agent colonization also had a higher GM index in the BAL sample but it is difficult to comment on association as the odds ratio was low (0.187). The odds were also lower (0.167) in dietary history to get false positive results and similarly with those on dietary supplements, but in contrast to these findings it was seen that the odd ratio was higher in patients suffering from tuberculosis(3.777) which can be attributed to increased colonization of aspergillus in TB patients.

Conclusion:

Galactomannan is the key biomarker of whether to start antifungal therapy for patients with IA and a higher mortality risk. Test results should be critically interpreted in the clinical context concerning potential causes of false-positive findings, especially with concomitant Piperacillin-tazobactam and amoxiclav use, other fungal infections and dietary history to prevent unnecessary antimycotic treatment.
Evaluation of different concentration techniques for microscopic diagnosis of protozoa and helminths in stool samples of children
Authors: Agarwal Krati , Mishra Shailja , Singh Parul , Sharma Rahul , Rukadikar Atul R , Hada Vivek , Mohanty Aroop
Published: February 2025

ABSTRACT

Introduction:

Intestinal parasitic infections (IPIs) are prevalent among children in developing countries, particularly in tropical and subtropical regions. These infections significantly impact physical and intellectual development and exacerbate nutritional deficiencies in early childhood.

Materials and Methods:

This hospital-based cross-sectional study, conducted at AIIMS, Gorakhpur, from July to December 2023, involved 110 children aged six months to five years with diarrhea. The study compared the diagnostic performance of routine wet mount examination and stool concentration techniques (Formol-Ether Acetate Concentration [FAC] and Formal-Ether Concentration [FEC]) for identifying intestinal parasites.

Result:

FAC detected parasites in 75% of cases, FEC in 62%, and wet mount in 41%. Protozoan infections were predominant, with Blastocystis hominis, Entamoeba coli, Entamoeba histolytica, and Giardia lamblia being the most common. Dual infections were better detected by concentration methods.

Conclusion:

The study highlighted the higher sensitivity of FAC over FEC and wet mount techniques. Environmental, socioeconomic, and geographical factors influenced the prevalence and distribution of IPIs. The study emphasizes the need for improved public health measures, including health education, safe water, and sanitation facilities. The formol–ether acetate concentration technique is recommended for its higher recovery rate, safety, and feasibility in rural settings, requiring minimal infrastructure.
In the collective called health, family has to be the central theme
Authors: Raina Sunil Kumar , Kumar Raman
Published: February 2025

ABSTRACT

The concepts in health and disease have undergone an almost unchangeable shift across the world from being largely community driven to purely service delivery concepts, driven as it is by the western construct regarding individuals, family and community. However, these constructs are appearing limited and unable to find sound replication across the majority low and middle income countries of the east.
The association between sociodemographic characteristics and knowledge about oral cancer in the Western Region of Saudi Arabia
Authors: Merdad Mazin , Alqutub Abdulsalam , Alharbi Abdullah F. , Nujoom Mohammed A. , Ali Kanawi Hala M. , Awadh Mohammed , Aljehani Zuhair H. , AlSharif Sarah M. , Alqutub Taher
Published: February 2025

ABSTRACT

Background:

Oral cancer (OC) is the third most common malignancy in Saudi Arabia, following leukemia and lymphoma. Early detection of this disease is impacted by knowledge of OC. This study aimed to evaluate public awareness of OC in the Western Region of Saudi Arabia and investigate how demographic background characteristics influence this knowledge.

Methods:

In this cross-sectional study, a web-based questionnaire was distributed in a random multistage pattern between September 2023 and December 2023. The questionnaire was designed to measure knowledge levels of OC. A logistic regression model was used with demographic background variables as independent variables and knowledge of OC as the dependent variable.

Results:

Of 389 participants, only half were aware of OC (52.4%). Most participants (56%) had poor knowledge of OC, 37.3% had a moderate level of knowledge, and only 6.7% had good knowledge about OC. On multivariate analysis, higher level of education [(odds ratio (OR = 1.53; 95% confidence interval (CI): 1.27–1.79; P < 0.0001)], higher salary (OR = 1.29; 95% CI: 1.08–1.49; P < 0.0001), and being a female (OR = 1.28; 95% CI: 1.09–1.46; P = 0.011), were positively associate with the general knowledge of OC.

Conclusion:

Nearly one in every two residents in the western region of Saudi Arabia has never heard of OC. Most of the participants had poor knowledge of OC. Socioeconomic factors, including income and educational level, were the most prominent factors affecting the general understanding of OC. Community-level educational programs focusing on high-risk groups could increase awareness about OC and improve public health.
Perception of medical students about family medicine in Karachi, Pakistan: Medical students’ perception about family medicine
Authors: Asad Munazza , Khan Unab I. , Arshad Anum
Published: February 2025

ABSTRACT

Objectives:

To assess the perceptions of medical students about Family Medicine (FM) as a career choice and to examine if exposure to FM in undergraduate medical curriculum is associated with a positive perception of FM.

Study Design:

Cross-sectional study.

Place and Duration:

The study was conducted in four medical universities of Karachi out of which two were public and two were private sectors. From July 2021 to January 20 22.

Methodology:

The investigator administered a structured questionnaire in person to the participants. Quantitative data was collected, and descriptive statistics were computed. Association between exposure to FM and perceptions about FM was compared using Chi-squared test. A P value of < 0.05 was considered as significant.

Results:

A total of 300 students were included; 116 (38.7%) were male. The mean age of participants was 22.8 (±1.7) years. Most (79%) of the participants had a positive perception of FM. Exposure to FM in the undergraduate curriculum (UGC) played a significant role in improving perception, and 80.6% of exposed participants were found to have positive perception. However, there was no association between participants’ preference for choosing FM as their career and exposure to FM (not exposed: 35 (31%) vs. exposed: 52 (28%); P = 0.598).

Conclusion:

Our study highlights the significant impact that exposure to Family Medicine (FM) in undergraduate medical education has on students’ perceptions of the specialty. While this exposure generally fosters a positive view of FM, it does not translate into a strong inclination to pursue FM as a career. The primary deterrent identified is the perception of low remuneration associated with the specialty, which remains a critical factor in specialty choice. Addressing these financial concerns may be key to encouraging more students to consider Family Medicine as a viable and rewarding career path.
The enigma of idiopathic pulmonary fibrosis in upper middle-aged individuals
Authors: Devalla Lokesh , Ghewade Babaji , Wagh Pankaj , Alone Vivek
Published: February 2025

ABSTRACT

IPF is a chronic lung disease that is characterized by progressive deterioration of pulmonary function associated with scarring of the lung interstitium, resulting in decreased vital capacity and lung compliance. The disease usually manifests in the sixth and seventh decades of life and incidence increases with advance in age and is more common in males.[1] Risk factors include hereditary factors, chronic viral infection, history of smoking, exposure to hazardous substances in the environment, acid reflux disease, etc. An inexplicable cough, low-grade fever, difficulty in breathing, loss of weight, and appetite are common presentations in patients with IPF. Respiratory examination shows bibasilar inspiratory crepitations. Here, we describe a unique case of ILD presented at an upper middle age of 45 years and so misdiagnosed as pulmonary tuberculosis which presented as a diagnostic and clinical challenge.
Myofascial Pain Syndrome: A Ultrasound-Guided Erector Spinae Plane Diagnostic Block Followed by Hydrodissection
Authors: Gyawali Hari Prasad , Das Gautam
Published: February 2025

Myofascial pain syndrome is a common cause of chronic pain affecting the daily activities of patients. Different modalities of treatment are being tried in those patients. Ultrasound-guided erector spinae plane (ESP) block has increasingly been used for the treatment of chronic pain. We present a case of a 65-year-old male treated with ESP diagnostic block followed by hydrodissection with 5% dextrose for myofascial pain of the trapezius.
The Power of Brain Waves: Applications of EEG in Chronic Pain Management
Authors: Thappa Priya , Arora Prateek , Kukanti Chandini , Dey Samarjit , Meshram Tanvi , Kumar Ashutosh
Published: February 2025

Chronic pain affects millions globally, profoundly impacting quality of life and posing significant challenges for healthcare providers. Traditional methods of pain assessment often fall short in capturing the full spectrum of this complex condition. The electroencephalogram (EEG) is a noninvasive tool for graphing the brain’s electrical activity. With the evolution of technology, the utility of EEG has been extended beyond the helms of neurological conditions. It offers a promising avenue for understanding and managing chronic pain. This review explores the basics of EEG, its utility in chronic pain assessment, and its potential applications in clinical practice.
Radiofrequency Ablation for Treatment of Symptomatic Bertolotti’s Syndrome II B
Authors: Yadav Rupesh Kumar , Thakur Jay Prakash , Amatya Shishir Prasad , Sherpa Tshering
Published: February 2025

Bertolotti’s syndrome is a congenital anomaly characterized by lumbosacral transitional vertebra with low back pain and radiculopathy. It has an incidence of 4%–8% in patients with low back pain. Conservative treatments such as medications and physiotherapy have limited success. Directed steroid injection, radiofrequency ablation (RFA), endoscopic resection, and surgical resection are recognized treatment methods. In this case, we used RFA on a medial branch of L3 and L4 in the L4/L5 facet joint. The patient had complete pain relief in subsequent follow-ups.
Severe Lumbar Canal Stenosis Treated with Caudal Epidural Steroid Injection
Authors: Nepal Niru , Das Gautam , Mahapatra Sunaina , Nanda Subhamay
Published: February 2025

Lumbar canal stenosis (LCS) is usually due to degenerative conditions in the older age group. Patients with LCS commonly present with low back pain, radiating leg pain, and neurogenic claudication. Treatment options for severe canal stenosis are mostly surgical but alternative treatment can be caudal epidural steroid in those individuals who refuse surgery. We present a case of 69-year-old male with a complaint of low back pain with neurogenic claudication, severe canal stenosis diagnosis was made after magnetic resonance imaging positive finding who underwent caudal epidural steroid injection. The patient came for follow-up after 2 months with much improvement in claudication and back pain. This case highlights the treatment outcome with caudal epidural steroid in severe LCS.
Advancing high-throughput anti-HCV drug screening: a novel dual-reporter HCV replicon model with real-time monitoring
Authors: Chitsombat Kanokwan , Chimnaronk Sarin , Sa-ngiamsuntorn Khanit , Chomnawang Mullika Traidej , Thirapanmethee Krit
Published: February 2025

Background and purpose:

Hepatitis C virus (HCV) infection is a global health concern due to its substantial impact on morbidity and mortality. The burden of diseases related to HCV continues to escalate, particularly as infections progress to late-stage liver conditions, resulting in hepatocellular carcinoma on a global scale. Direct-acting antivirals effectively target HCV replication; however, their unreasonable costs and adverse effects emphasize the need for accessible and efficient therapeutic alternatives with minimal side effects. The primary aim of this study was to devise an HCV replicon system featuring a dual-reporter mechanism to facilitate high-throughput screening of potential novel antiviral agents.

Experimental approach:

The full-length HCV genome (pJFH1) was used to construct an HCV replicon system. The glycoprotein regions (E1 and E2) were substituted with a red fluorescent reporter, mCherry, enabling visualization of protein synthesis within the replicon. In addition, an adjacent green fluorescent reporter, dBroccoli, was strategically introduced in proximity to the NS5B stop codon to serve as a reliable indicator of HCV replication activity by monitoring the fluorescence signals.

Findings/Results:

The findings of this study unequivocally validated the effectiveness of the novel HCV replicon system for transfecting Huh-7 cells. Furthermore, the replicon system demonstrated a concentration-dependent response to anti-HCV pharmaceutical agents including telaprevir and sofosbuvir.

Conclusion and implications:

These compelling results underscored the potential utility of the proposed HCV replicon system as an innovative model for the expeditious high-throughput screening of prospective anti-HCV agents within a short timeframe.
Levator surgery with and without tarsectomy for correction of fair-function congenital ptosis: A randomized controlled trial
Authors: Diab Mostafa M. , Taha Taha A. Ashraf , Abdelsattar Nada K.
Published: February 2025

PURPOSE:

The purpose is to compare the functional and cosmetic outcomes of levator resection with tarsoconjunctival mullerectomy (LR plus) versus modified LR (mLR) for correcting congenital ptosis with fair levator function (LF; 4–7 mm).

METHODS:

In this prospective, randomized, controlled, double-blinded trial, 34 children (aged 6–12 years old) with unilateral congenital ptosis and fair LF were randomized to LR plus (n = 16) or mLR group B (n = 18). Margin-reflex distance 1 (MRD1), LF, lagophthalmos, corneal staining (Miyata grading), eyelid crease, contour, and eyelash angle were assessed postoperatively at 1, 3, 6, and 12 months. Outcomes were graded by an independent observer.

RESULTS:

Both groups demonstrated significant postoperative MRD1 improvements. In the LR plus group, MRD1 increased from 0.56 ± 1.09 mm to 3.44 ± 1.15 mm (P < 0.001), and while in the mLR group, it improved from 0.89 ± 1.18 mm to 4.06 ± 0.94 mm (P < 0.001), with no significant intergroup difference. The mLR group showed significantly greater LF improvement at all-time points (P < 0.001), with a 12-month LF of 11.28 ± 2.16 mm versus 7.38 ± 2.09 mm in the LR plus group. The mLR group had less lagophthalmos, corneal staining (early follow-up), and better eyelid contour at 3, 6, and 12 months. Eyelash ptosis was more frequently observed in the LR plus group. Complications occurred in 3 (18.8%) patients in the LR plus (including exposure keratopathy, recurrence, and suture-related corneal abrasion) and in 1 (5.6%) patient in the mLR group (overcorrection).

CONCLUSION:

Both LR plus and mLR are effective for the correction of congenital ptosis with fair LF. However, mLR yielded in greater LF improvement, less postoperative lagophthalmos and corneal complications, and better eyelid contour. Therefore, mLR may be the preferred surgical technique for this condition.
On greedy approximation in complex Banach spaces
Authors: Gasnikov Alexander Vladimirovich , Temlyakov Vladimir Nikolaevich
Published: February 2025

The general theory of greedy approximation with respect to arbitrary dictionaries is well developed in the case of real Banach spaces. Recently some results proved for the Weak Chebyshev Greedy Algorithm (WCGA) in the case of real Banach spaces were extended to the case of complex Banach spaces. In this paper we extend some of the results known in the real case for greedy algorithms other than the WCGA to the case of complex Banach spaces.
Bibliography: 25 titles.
Accelerated Stochastic ExtraGradient: Mixing Hessian and gradient similarity to reduce communication in distributed and federated learning
Authors: Bylinkin Dmitry , Degtyarev Kirill , Beznosikov Aleksandr Nikolaevich
Published: February 2025

Modern realities and trends in learning require more and more generalization ability of models, which leads to an increase in both models and training sample size. It is already difficult to solve such tasks in a single device mode. This is the reason why distributed and federated learning approaches are becoming more popular every day. Distributed computing involves communication between devices, which requires solving two key problems: efficiency and privacy. One of the most well-known approaches to combat communication costs is to exploit the similarity of local data. Both Hessian similarity and homogeneous gradients have been studied in the literature, but separately. In this paper we combine both of these assumptions in analyzing a new method that incorporates the ideas of using data similarity and clients sampling. Moreover, to address privacy concerns, we apply the technique of additional noise and analyze its impact on the convergence of the proposed method. The theory is confirmed by training on real datasets.
Bibliography: 45 titles.
Strategies for discovering novel hepatocellular carcinoma biomarkers
Authors: Wu Shi-Tao , Zhu Li , Feng Xiao-Ling , Wang Hao-Yu , Li Fang
Published: February 2025

Liver cancer, particularly hepatocellular carcinoma (HCC), remains a significant global health challenge due to its high mortality rate and late-stage diagnosis. The discovery of reliable biomarkers is crucial for improving early detection and patient outcomes. This review provides a comprehensive overview of current and emerging biomarkers for HCC, including alpha-fetoprotein, des-gamma-carboxy prothrombin, glypican-3, Golgi protein 73, osteopontin, and microRNAs. Despite advancements, the diagnostic limitations of existing biomarkers underscore the urgent need for novel markers that can detect HCC in its early stages. The review emphasizes the importance of integrating multi-omics approaches, combining genomics, proteomics, and metabolomics, to develop more robust biomarker panels. Such integrative methods have the potential to capture the complex molecular landscape of HCC, offering insights into disease mechanisms and identifying targets for personalized therapies. The significance of large-scale validation studies, collaboration between research institutions and clinical settings, and consideration of regulatory pathways for clinical implementation is also discussed. In conclusion, while substantial progress has been made in biomarker discovery, continued research and innovation are essential to address the remaining challenges. The successful translation of these discoveries into clinical practice will require rigorous validation, standardization of protocols, and cross-disciplinary collaboration. By advancing the development and application of novel biomarkers, we can improve the early detection and management of HCC, ultimately enhancing patient survival and quality of life.
Immunological landscape of hepatic alveolar echinococcosis: A bibliometric analysis
Authors: Tulading Aliya , Wu Jing , Zhang Yun-Fei , Mamuti Alimujiang , Azhati Yilizhati , Lv Chun-Hui , Tuersunmaimaiti Abudusalamu , Tuxun Tuerhongjiang
Published: February 2025

BACKGROUND

Hepatic alveolar echinococcosis (HAE) is a chronic parasitic disease caused by the larval stage of Echinococcus multilocularis . Although significant research has been conducted on the pathogenesis and immunological aspects of HAE, comprehensive bibliometric analyses in this area are still lacking. This study sought to fill this gap by systematically analyzing the immunological literature on HAE using bibliometric methods.

AIM

To identify research trends, key contributors, and emerging developments and offer insights to guide future research in this field.

METHODS

Research articles on HAE published between 1983 and 2023 were retrieved from the Web of Science Core Collection database. A total of 319 articles were selected for bibliometric analysis, which was conducted using the CiteSpace and VOSviewer software. The analysis focused on key variables such as publication volume, authors, journals, countries, references, and keywords.

RESULTS

The analysis revealed a significant increase in research on HAE over the past four decades, particularly after 1995. China and Switzerland emerged as the leading countries in terms of publication volume, with Bruno Gottstein and Vuitton DA identified as the most influential authors in this field. Key research areas include the interaction between the pathogen and the host immune system, as well as advances in disease diagnosis and treatment strategies. The keyword co-occurrence analysis highlighted the primary themes and identified emerging trends within the research landscape.

CONCLUSION

This study provides a comprehensive framework for understanding HAE immunology and highlights research hotspots, future directions, key contributors, and the importance of international cooperation.
Early plasmapheresis in type 2 benign recurrent intrahepatic cholestasis: A case report and review of literature
Authors: Heyerick Lander , Dhondt Annemieke , Van Vlierberghe Hans , Verhelst Xavier , Raevens Sarah , Geerts Anja
Published: February 2025

BACKGROUND

Benign recurrent intrahepatic cholestasis (BRIC) is a rare autosomal recessive liver disease, causing episodic cholestasis with intense pruritus. This case report highlights the effectiveness of early plasmapheresis as a therapeutic option for BRIC type 2, offering rapid symptom relief and early termination of cholestatic episodes. It contributes to the limited evidence supporting plasmapheresis as a treatment for BRIC flares resistant to conventional therapies.

CASE SUMMARY

A 43-year-old male with BRIC type 2 presented with fatigue, jaundice, and severe pruritus, triggered by a recent mild severe acute respiratory syndrome coronavirus 2 infection. Laboratory results confirmed cholestasis with elevated bilirubin and alkaline phosphatase. First-line pharmacological treatments, including cholestyramine and rifampicin, failed. Endoscopic nasobiliary drainage was ineffective, prompting initiation of plasmapheresis. This intervention rapidly relieved pruritus, with complete biochemical normalisation after 11 sessions. Two years later, a similar episode occurred, and early reinitiation of plasmapheresis led to symptom resolution within two sessions and biochemical recovery within two weeks. The patient tolerated the procedure well, with no adverse effects observed. Follow-up showed no signs of cholestasis recurrence.

CONCLUSION

Plasmapheresis is a safe and effective option for therapy-refractory BRIC type 2, particularly when initiated early in cholestasis.
Thyroid hormone, immunoglobin and complements for predicting hepatocellular carcinoma development in patients with hepatitis B virus-related liver cirrhosis
Authors: Tong Xue-Cheng , Liu Kai , Huang Ze-Yu , Zhang Xiu-Jun , Xue Yuan
Published: February 2025

BACKGROUND

Hepatocellular carcinoma (HCC) surveillance is crucial for patients with compensated cirrhosis (CC) and decompensated cirrhosis (DC). Increasing evidence has revealed a connection between thyroid hormone (TH) and HCC, although this relationship remains contentious. Complements and immunoglobulin (Ig), which serve as surrogates of cirrhosis-associated immune dysfunction, are associated with the severity and outcomes of liver cirrhosis (LC). To date, there is a lack of evidence supporting the recommendation of TH, Ig, and complement tests in patients at high risk of HCC.

AIM

To assess the predictive value of TH, Ig, and complements for HCC development.

METHODS

Data from 142 patients, comprising 72 patients with CC and 70 patients with DC, were analysed as a training set. Among them, 100 patients who underwent complement and Ig tests were considered for internal validation. Logistic regression was employed to identify independent risk factors for HCC development.

RESULTS

The median follow-up duration was 32 (24-37 months) months. The incidence of HCC was significantly higher in the DC group (16/70, 22.9%) compared to the CC group (3/72, 4.2%) (χ ² = 10.698, P < 0.01). Patients with DC exhibited lower total tetraiodothyronine (TT4), total triiodothyronine (TT3), free triiodothyronine, complement C3, and C4 (all P < 0.01), and higher IgA and IgG (both P < 0.01). In both CC and DC patients, TT3 and TT4 positively correlated with alanine transaminase (ALT), aspartate transaminase (AST), and gamma-glutamyl transpeptidase (GGT). IgG positively correlated with IgM, IgA, ALT, and AST, while it negatively correlated with C3 and C4. Multivariable analysis indicated that age, DC status, and GGT were independent risk factors for HCC development.

CONCLUSION

The predictive value of TH, Ig, and complements for HCC development is suboptimal. Age, DC, and GGT emerge as more significant factors during HCC surveillance in hepatitis B virus-related LC.
Quantifying Hydroplaning Risk: Insights from Water Film Thickness
Measurements on Maryland Highways
Authors: Vilsan Alexandru , Sandu Corina , Anghelache Gabriel
Published: February 2025

Wet pavement conditions during rainfall present significant challenges to traffic
safety by reducing tire–road friction and increasing the risk of hydroplaning.
During high-intensity rain events, the roadway pavement tends to accumulate
water, forming a film that can have serious implications for vehicle control. As
the longitudinal speed of the vehicle increases, a water wedge forms in front of
the tire, leading to partial loss of contact with the road. At critical
hydroplaning speed, a complete water layer forms between the tire and the road.
Although less common, dynamic hydroplaning poses severe risks when
high-intensity rainfall coincides with high vehicle traveling speed, leading to
a complete loss of control over vehicle steering capabilities. This study
advances hydroplaning research by integrating real-world data from the Road
Weather Information System (RWIS) with an existing hydroplaning model. This
approach provides more accurate hydroplaning risk assessments, emphasizing the
importance of adapting predictive models to real-world conditions. Measurements
of water film thickness from two Maryland locations over a year showed values of
the water film heights up to 1.9 mm, with significant hydroplaning risk for
vehicles with worn tires traveling at highway speeds. Using models such as
Gengenbach and Gallaway, the study computes critical hydroplaning speeds,
highlighting the importance of tire tread depth, inflation pressure, and
pavement texture. Results indicate that the critical hydroplaning speed varies
significantly based on these factors, emphasizing the need for safe driving
practices during heavy rainfall. The findings underscore also the importance of
developing new hydroplaning models in the context of future autonomous vehicles
that needs robust algorithms for operating in wet conditions.
Surgical systems’ capacity in Africa—Where do we go from here?
Authors: Chalwe Mumba , Kigera James
Published: February 2025

No abstract.
The Kenya surgical capacity study: An audit of surgical equipment/infrastructure in Level 4 public hospitals
Authors: Chaker Sara , Henry Jaymie Ang , Hung Ya-Ching , Saad Mariam , Slater Elizabeth , Madiraju SriGita Krishna , Waiguru Estella , Mwai Patrick , Jani Pankaj , Lan Kevin , Nthumba Peter
Published: February 2025

Background: Access to surgical equipment is critical to providing safe and equitable operative care. This is the first nationwide study to provide data on the availability of surgical equipment in Kenya. Methods: This cross-sectional study collected data from May to July 2018 on the availability of non-pharmaceutical equipment, patient care, intra-operative, and anesthesia supplies in level 4 hospitals. Information regarding infrastructure such as the number of functional operating rooms, sterilization capacity, and sources of water and electricity was also collected. Results: The availability of intra-operative and anesthesia equipment was 44.5% and 47%, respectively. Nearly 60% of facilities had general patient care supplies. Over 80% of the facilities had running water in maternity wards (83.1%). Sterilization equipment was present in about half of the facilities (range: 42.6–68.3%). Additionally, 79.1% had a generator as a backup source of electricity. Only 35% of facilities always had an X-ray on-site, and 52.6% of the facilities obtained blood from the national or a regional center. Conclusion: This study provides data on the availability of surgical equipment and infrastructure in level 4 hospitals in Kenya. Availability of radiology services and blood supply was lower than that in other sub-Saharan African countries, highlighting the need for improved surgical care resources in these community-based facilities.
Perioperative management of a patient with hereditary angioedema and intestinal obstruction secondary to an ileal tumor: A case report
Authors: Gatheru Antony Peter , Barasa Anne Kasyoka , Mwangi Isaac Karogo , Ngare Stanley , Kiptoon Dan , Walong Edwin Oloo
Published: February 2025

Hereditary angioedema (HAE) is a rare genetic disorder resulting from deficiency or dysfunction of the C1-esterase inhibitor (C1-INH, C1-inhibitor) protein. It manifests with recurrent cutaneous and submucosal edema involving the extremities, abdomen, and/or larynx. Abdominal edema mimics other acute abdominal conditions including intestinal obstruction, potentially prompting unnecessary surgery if misdiagnosed. Prompt treatment with C1-INH typically alleviates abdominal angioedema symptoms within 24 hours, while untreated cases resolve within 2–5 days. Persistence of abdominal symptoms warrants further evaluation for other etiologies of acute abdomen. Surgical procedures with tracheal intubation can induce life-threatening upper airway edema in HAE patients. We describe the successful management of a 41-year-old female with HAE presenting with features of intestinal obstruction, which only partially resolved with the administration of C1-INH and conservative bowel decompressive management. Imaging revealed a small bowel tumor necessitating surgical intervention. Pre-operative prophylactic C1-INH was administered, followed by open laparotomy under general anesthesia with endotracheal intubation. Although C1-INH concentrates are the principal treatment for abdominal HAE attacks, other causes of acute abdomen should be considered, particularly in cases of persistent symptoms, to guide appropriate management. This case highlights the importance of multidisciplinary collaboration and careful perioperative planning to optimize outcomes for HAE patients requiring surgery.
Khat Chewing Practices and Treatment Discontinuation among People with Serious Mental Illness at Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
Authors: Habte Fikreselam , Kassaw Chalelgn
Published: February 2025

Comorbid substance use in individuals with serious mental illness (SMI) is considered a risk factor for treatment discontinuation. There  are limited studies on the association of khat (Catha edulis F) chewing, a common practice in Ethiopia and Eastern Africa, with treatment  discontinuation. The objective of this study was to assess the influence of khat chewing on treatment discontinuation among people with  serious mental illness at Amanuel Mental Specialized Hospital, Addis ababa, Ethiopia. Cross sectional study was undertaken. Data was  collected using semi structured questionnaire and data abstraction format from patient’s medical record. A total of 805 with 405 khat  chewer and 400 non-chewer individuals with SMI were involved in the study. The data was analysed using SPSS V-23; binary logistic  regression was used and p value less than 0.05 in multivariate analysis was considered significant. The prevalence of treatment discontinuation was 34.3% without significant difference between khat chewer and non-chewer individuals (p = 0.445). Treatment  discontinuation was significantly associated with relapse and suicide ideation. The odds of treatment discontinuation was 2.3 times  higher in relapsing individuals compared to the nonrelapsing individuals with serious mental illness, AOR (95% CI) of 2.3 (1.6 - 3.5). The  odd of treatment discontinuation was 1.7 times higher in individuals with suicidal ideation compared to those who don not have suicide  ideation, AOR (95% CI) of 1.7 (1.2 -2.5). In conclusion one third of patients with SMI had treatment discontinuation. Relapse and suicide  ideation, which were associated with treatment discontinuation, increases hospitalization and associated treatment burden in individuals  with SMI. There should be mechanism to closely follow patients at community level to detect and manage treatment discontinuation as  early as possible.
Validity and Reliability of the Amharic CDLQI for Evaluating Quality of Life in Ethiopian Atopic Dermatitis Patients
Authors: Aynalem Minychel Wale , Ali Eskinder Eshetu , Fentie Atalay Mulu , Berha Alemseged Beyene
Published: February 2025

Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease that substantially impacts healthrelated quality of life (HRQoL) in people of all ages. However, its impact is substantially high in children. The Cardiff Child Dermatology Life Quality Index (CDLQI) is one of  the most well-known dermatologyspecific instruments to measure HRQoL of children suffering from skin diseases. The tool has been translated into 44 languages in 28 countries to measure the effects of more than 14 skin conditions, including AD. However, the Amharic  version of CDLQI tool has not yet been validated. Thus, the objective of this study was to validate the Amharic version of the CDLQI tool  for AD patients in Ethiopia. A facility-based cross-sectional study was conducted. A total of 200 children (5 - 16 years) with confirmed AD  were interviewed. Bartlett’s (BS) test of sphericity and the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy were used to  ascertain the appropriateness of the data for factor analysis. Pearson correlation matrix, confirmatory factor analysis (CFA) and  Cronbach’s alpha test were performed to assess convergent validity, construct validity and internal consistency of the tool, respectively.  The Minimum Discrepancy Function divided by Degrees of Freedom (CMIN/DF) was 4.7 indicating a reasonable fit of the model. The comparative fit index (CFI) was 0.935 indicating good fit of the model. Cronbach’s alpha coefficient was 0.87 showing a good internal  consistency between the 10 items in the tool. Inter-item correlation coefficients ranged from 0.15 and 0.715. The overall finding  demonstrated that the Amharic version of CDLQI tool was a reliable and valid tool to assess the quality of life for children diagnosed with  AD in Ethiopia. Further cultural validation and feasibility studies are recommended among patients with other conditions.
Defects optimization of green part Ti-6Al-4V with palm stearin binder using response surface methodology
Authors: Saedon J.B , Mohamad Nor N. H. , Shawal S. , Arifin A. , Mifzal M. A. , Ahmad S.
Published: February 2025

Metal Injection Moulding (MIM) is an effective near-net-shape process for producing small, intricate parts in high volumes. Many optimizations of the MIM process parameter have been published without using any of the statistical based Design of Experiment (DOE) methodology and ends with unsatisfactory results in a wide range of experimental settings. This paper focuses on analysing the optimization of injection moulding process parameters for titanium alloy Ti-6Al-4V green parts using response surface methodology (RSM) to determine significant parameters. The feedstock is prepared by mixing Ti-6Al-4V powder with palm stearin (PS) and polyethylene (PE) binders in three different powder loadings: 63 vol%, 65 vol%, and 67 vol%. RSM is then used to create a Design of Experiment (DOE) to optimize parameters, including A: injection pressure, B: injection temperature, C: powder loading, D: mould temperature, and E: holding pressure. Analysis of variance (ANOVA) was performed to identify the significant parameters influencing defects in Ti-6Al-4V green parts. The study successfully identified the optimal conditions for producing Ti-6Al-4V components using PS and PE binders: A: 443.139 bars, B: 142.11 ºC, C: 65.38 vol.%, D: 44.694 ºC, and E: 629.561 bar. Scanning electron microscopy (SEM) from optimised of green part shows that the primary backbone polymer PE holds the green part and generates wetting for the feedstock and will ease moulding and shaping while the secondary backbone PS will act as a soft polymer that can provide the moisture to the feedstock.
Surface properties and characterisation of cobalt- nickel-iron alloy coating on mild steel for engineering applications
Authors: Zabri M. Z. , Masdek N. R. N. , Mardziah C. M. , Ahmad N. M.
Published: February 2025

Corrosion prevention, enhancement of mechanical properties and aesthetic improvement are key motivators for the use of protective coatings in engineering applications. This study investigates the surface characteristics of electrodeposited Cobalt-Nickel-Iron (CoNiFe) nanoparticle coatings on mild steel substrates to assess cobalt alloy potential for improved performance and durability. Through the usage of electrodeposition method, coatings were applied at varying deposition times (15, 30, and 45 minutes), with electrolyte temperatures maintained at constant 50 ± 3 °C and current levels set at 1.0, 1.5, and 3.0 A respectively. Key properties evaluated include surface roughness, hardness, coating thickness, and breaking energy. Results showed that coating thickness ranged from 14.23 μm to 40.80 μm, with the thickest coating recorded at 45 minutes’ deposition time. Hardness value also increased at longer deposition durations, with the highest achieved value of 503.12 HV at 45 minutes’ deposition time. Surface roughness ranged from 1.4210 μm (30 minutes, 1.0 A) to 8.1085 μm (45 minutes, 3.0 A), indicating significant influence of deposition conditions. Additionally, the coating had a maximum breaking energy of 74 Joules at high-temperature quenching conditions (30 minutes). These findings suggest that CoNiFe coatings applied via controlled electrodeposition process can significantly improve the mechanical resilience and lifespan of mild steel, offering promising applications for advanced engineering environments.
Numerical solutions of fractional conformable derivative using a generalized Kudryashov method
Authors: Oduselu-Hassan Oladayo Emmanuel , Ojada David Oluwatomi
Published: February 2025

This paper addresses the numerical solutions of fractional differential equations (FDEs) using the Generalized Kudryashov Method (GKM) in the context of the conformable fractional derivative. Fractional calculus, particularly the conformable derivative, provides a versatile framework for modeling systems exhibiting memory and hereditary properties commonly found in complex physical phenomena. Traditional integer-order derivatives lack the capability to accurately represent such dynamics, which fractional derivatives effectively handle. The conformable derivative, a recent addition to fractional calculus, retains many advantageous properties of integer-order differentiation, such as the chain rule, while extending to non-integer orders. The Generalized Kudryashov Method, initially developed for solving nonlinear ordinary differential equations, is adapted here to address nonlinear FDEs involving conformable derivatives. By employing a traveling wave transformation, the study converts fractional partial differential equations into ordinary differential equations, facilitating the application of GKM. Through this approach, the study derives numerical solutions, demonstrating the method’s ability to capture complex dynamics in nonlinear fractional systems. The results indicate that GKM, in conjunction with the conformable derivative, offers a robust tool for accurately approximating solutions of FDEs, with potential applications across fields such as fluid mechanics, quantum mechanics, and anomalous diffusion.
Definition of tourism itineraries in a Brazilian conservation unit using artificial intelligence
Authors: Araújo Júnior Carlos Alberto , Leite Helio Garcia , Mendes João Batista
Published: February 2025

The Pandeiros River Environmental Protection Area is an important Brazilian conservation unit used for ecotourism. However, there is a lack of research guiding decision-making regarding tourist movements. The objective of this study is to evaluate the use of a simplified version of the clonal selection metaheuristic for optimizing tourist itineraries. Thirty-one tourist sites were considered, with routes starting from three origins. A mathematical model based on the vehicle routing problem is proposed. This problem was solved using the branch and bound, clonal selection, and simulated annealing algorithms, and the proposed simplification for the clonal selection metaheuristic. Random solutions were evaluated to simulate tourist behaviour. Random solutions yield the worst results. The proposed simplification produced better results for itineraries starting from two origins. It provided an average reduction of 42% in the total distance of tourist itineraries and a 17% reduction in the use of available road networks.
Multi-material topology optimization of structural load-bearing capacity using limit analysis
Authors: Mourad Leyla , Bleyer Jeremy , Mesnil Romain , Nseir Joanna , Sab Karam , Raphael Wassim
Published: February 2025

We extend the problem of finding an optimal structure with maximum load-bearing capacity to the case of multiple materials. We first consider a reinforcement optimization case where the structure consists of a fixed background matrix material with given strength properties and optimize the reinforcement topology within this material. We discuss the use of various isotropic and anisotropic strength criteria to model the reinforcing phase, including reinforcements with discrete orientations. In a second time, we investigate a bi-material formulation where we optimize the topology of two material phases simultaneously. Various choices for the material strength conditions are proposed and we apply this formulation to the optimization of pure tensile and compressive phases of a single material. In all cases, two optimization variants are proposed using concepts of convex optimization and limit analysis theory, namely maximizing the load-bearing capacity under a fixed volume constraint or minimizing the volume under a fixed loading. Both problems are convex and a penalization procedure is proposed. The underlying problems can be solved using conic programming solvers. Illustrative applications demonstrate the versatility of the proposed formulation, including the influence of the selected strength criteria, the possibility to obtain structures with members of fixed orientation or structures with different importance granted to tensile and compressive regions. Finally, we also draw a parallel with the generation of strut-and-tie models for the analysis of reinforced concrete structures.
A função terapêutica fonoaudiológica nas patologias progressivas infantis
Authors: STRUMIELLO LISIANE FLORES DE OLIVEIRA
Published: February 2025

O presente trabalho tem por objetivo estudar a função terapêutica fonoaudiológica noatendimento a crianças portadoras de patologias progressivas. Para tanto, foramrealizadas entrevistas com fonoaudiólogos atuantes na área. A proposta de clínica aquiassumida baseia-se na teoria do desenvolvimento humano de D. W. Winnicott, o qualconsidera, em seus princípios, que a presença do outro é essencial na constituição do serde uma pessoa. O resultado da análise pretende contribuir para a construção de umametodologia própria da clínica fonoaudiológica que esteja comprometida com opaciente. Ressaltou-se, pois, a importância da cena clínica, incluindo o espaçoterapêutico, e atribuindo-lhe a possibilidade de construção de um espaço potencial. Esteestudo conclui que a experiência clínica e a fundamentação teórica consistente doterapeuta são essenciais na clínica Fonoaudiológica aqui proposta.