bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Logistic Regression Models, Random Drills and Support Vector Machines (SVM) for the Epidemiological Surveillance of Ten (10) Infectious Diseases in Senegal
Authors:   Department of Mathematics, Alioune Diop University, Bambey, Senegal, Ndao Abdourahmane , Dath Cheikh Amadou Bamba , Seck Cheikh Tidiane , Diop Boly
Published: February 2025

Objective: The objective of this study is to analyze data from epidemiological surveillance and take into account propagation factors to track and monitor 10 infectious diseases in Senegal which are: Covid-19, Measles, Poliomyelitis (AFP), Dengue, Meningitis, Rift Valley Fever (Rift), Crimean-Congo Hemorrhagic Fever (CCHF), Chikungunya (CHIK), West Nile virus fever (WN) and Yellow Fever (YF). Method : The methodology is based on a comparative analysis of the performances of three supervised learning methods: logistic regression, random forests and Support Vector Machines (SVM). Data visualization methods such as Multiple Correspondence Analysis (MCA) and similarity index (Cramer's v) are also used. The data analyzed covered the period from January 2018 to November 2022 and amounted to 113,847 suspected cases. Findings: The results show that the methods have almost similar performances with regard to the choice of the number of selected parameters (4 variables) but differ in terms of total classification error rates, with a rate of 2.73% lower for forests random, 3.10% for logistic regression and 3.32% for Support Vector Machines. Advanced age ([40, 60] years) is identified as a direct risk factor in relation to the frequency of distribution of confirmed cases of the 10 infectious diseases. Other indirect risk factors linked to the distribution of confirmed cases are also identified and are linked to the physical environment of health districts and climatic factors. The results highlighted the ability of the random forest method to analyze surveillance data and identify complex relationships between risk factors and the distribution of infectious diseases. This study contributes to improving infectious disease surveillance and shows the importance of integrating environmental factors, socioeconomic parameters, as well as behavioral and climatic factors into data and analyses. Novelty: The results obtained made it possible to propose an algorithm based on the HCPC method which combines the techniques of Principal Component Analysis (PCA) and those of Ascending Hierarchical Classification (CAH), with the application of the principle of paragons.

Keywords: Epidemiological data, Health surveillance, Logistic regression, Random Forests, Support Vector Machine
A Pair of Fractional Power of Generalized Hankel-Clifford Type Transformations and Their Differential Operators
Authors:   Director, MAEER’s MIT Arts, Commerce & Science College, Alandi, Pune, Maharashtra, India, Waphare Balasaheb B , Shaikh Rahilanaz Z
Published: February 2025

Objectives: This research aims to introduce a pair of fractional powers of the generalized Hankel-Clifford transforms and their associated differential operators. The study also seeks to explore these differential operators' characteristics in Zemanian type spaces. Methods: This study used a mathematical approach to establish and examine the fractional power of generalized Hankel-Clifford transformations. Apart from this we also study the behavior and properties of differential operators on Zemanian type spaces. Findings: The study reveals some properties and behaviors of the differential operators with respect to the fractional power of generalized Hankel-Clifford transforms. These results provide an understanding of how these operators work within Zemanian-type spaces. Novelty: The novelty of this research lies in introducing the fractional power of generalized Hankel-Clifford transforms and the detailed studies of their differential operators. This work extends the existing knowledge by investigating these operators on Zemanian-type spaces, which has not been extensively studied before.

Keywords: Fractional Hankel­-Clifford Transforms, Generalized Fractional Hankel­-Clifford Transforms, Differential Operators, Zemanian Type Spaces, Isomorphism
A Fuzzy Inventory Model for Imperfect Process, Obsolescence and its Greenhouse Gas Emissions under Vendor Managed Inventory – Consignment Stock (VMI-CS) Policy
Authors:   Research Scholar, PG and Research Department of Mathematics, Holy Cross College (Autonomous), Affiliated to Bharathidasan University, Tiruchirappalli, 620002, Tamil Nadu, India, Alda W S , Jeyakumari S Rexlin
Published: February 2025

Objectives: To discuss a green inventory management system with greenhouse gas emissions, obsolescence, imperfect process, and Vendor Managed Inventory – Consignment Stock (VMI – CS) policy in a fuzzy nature by employing hexagonal fuzzy numbers to tackle uncertain situations. Methods: To find the optimum solution, we use two methods such as centroid method and the graded mean integration representation method for hexagonal fuzzy numbers. We use different sets of data for Marchi et al’s model 1 and for the proposed model with obsolescence to verify the results. Here two supply chain models are proposed, where the crisp model is first discussed with total cost and optimum order quantity. As a second part, the fuzzy model is formulated with fuzzy total cost and fuzzy optimal order quantity. Findings: The results of our discussion represent that the solution obtained from fuzzy by using two methods is slightly the same as the solution found from the crisp model. But since five parameters with ambiguous nature are solved under fuzzy by considering them in the form of a hexagonal fuzzy number, uncertainty is faced here. To show the applicability of the proposed model, numerical examples are given. Novelty: Implementation of obsolescence cost and its emissions in a green inventory system and the process of considering and solving parameters under fuzzy is a unique and important feature of our study. It helps sectors to know the effects of obsolete inventory, the need to include it, and also to rectify vagueness in their specified data. Hence this study is novel in the sense it discusses the above criteria under two fuzzy techniques. 2020 Mathematics Subject Classification: 90B05

Keywords: Hexagonal fuzzy numbers, Centroid method, Graded mean integration representation method, Obsolescence cost, Greenhouse gas emissions
An Intelligent Knowledge Based System for Diagnosis and Treatment of Diabetes
Authors:   Department of Information Science, College of Computing and Informatics, Haramaya University, Dire Dawa, Ethiopia, Kere Hasan , Meshesha Million , Rashid Faizur , Singh Gavendra , Abate Jemal , Shiferaw Tilahun , Jifara Wabi , Ketema Demeshi
Published: February 2025

Background/Objectives: Diabetes poses a significant health challenge in Ethiopia due to factors such as lifestyle choices, a lack of medical professionals, and limited laboratory resources. Knowledge-based system (KBS) are increasingly being explored to assist healthcare providers in diagnosing and managing diseases, including diabetes. Rule-based and case-based reasoning are two primary approaches to developing these knowledge-based systems. The major goal of this research is to create an intelligent KBS for diabetes diagnosis and therapy utilizing data mining approaches. Methods: This study uses a design science research approach to develop a smart, knowledge-based system for diagnosing and managing diabetes, combining rule-based and case-based reasoning. Data were collected from Hiwot Fana Specialized Hospital at Haramaya University and Harari Regular Hospital, with the dataset undergoing preprocessing to address errors, noise, outliers, duplicates, missing values, and normalization. Rule-based reasoning was implemented using the Prolog programming language, while the case-based reasoning system was built with JCOLLIBIR studio using its CBR main cycle. For predictive and descriptive modeling, the J48 decision tree, PART, and JRip algorithms were evaluated for rule-based reasoning, while K-means and Farthest First were evaluated for case-based reasoning. Findings: The JRip rule induction algorithm produced superior results for the rule-based system, while the K-means clustering algorithm performed best for case-based reasoning. These outputs were used to construct the rule base and automatically generate the case base, respectively. The integrated system achieved an overall accuracy of 95.23%, with a precision of 100% and a recall of 89.7%. Additionally, 93.2% of users passed the user acceptance test, demonstrating the system's practical utility. Novelty and Applications: This study presents a novel integration of rule-based and case-based reasoning using a rule-dominant approach to create an intelligent knowledge-based system for diabetes diagnosis and management. The system has shown high accuracy and user satisfaction, making it a viable tool for aiding healthcare professionals in Ethiopia, especially in resource-limited settings.

Keywords: Rule Based Reasoning, Case Based Reasoning, Diagnosis and Treatment of Diabetes, Intelligent Knowledge-Based System
Formulation and Quality Evaluation of Spray-dried Bignay Vinegar Adjunct With Maltodextrin
Authors:   Professor, College of Teacher Education, Cagayan State University – Sanchez Mira, Cagayan, Philippines, Cacatian Shella B , Barcena Robert Julius V
Published: February 2025

Objective: The food industry widely employs the production of powdered vinegar from fruit by-products. The present investigation evaluated the percent recovery and physico-chemical properties of Bignay vinegar, mixed with varying concentrations of maltodextrin obtained through spray drying. Methods: Three formulations were prepared, with three samples per replication. Analysis of Variance (ANOVA) was employed to evaluate disparities among the means, while Least Significant Differences (LSD) were employed to determine significant mean differences at 0.01 and 0.05 significance levels. Findings: The percent recovery of the different formulations ranged from 68.7% to 80.4%. Consumer-based sensory evaluation revealed that the formulated Bignay vinegar powder exhibited significant acceptability concerning its aroma, taste, and general acceptability. The powdered vinegar, with the most acceptable formulation, had a pH of 3.27 at 20.6°C, total soluble solids of 98°, and titratable acidity as acetic acid of 3.03%. The proximate analysis demonstrated low concentrations of ash (0.26%), crude fat (less than 0.10%), and crude protein (0.75%), with negligible calories from fat (less than 0.009 kcal/g) and calories from protein (0.03 kcal/g), along with a moisture content of 7.26%. However, it exhibited high total carbohydrates (9.73%), calories from carbohydrates (3.67 kcal/g), and total calories (3.70 kcal/g). The Bignay vinegar with 30% added carrier exhibited the highest percent recovery, highly acceptable sensory quality, and typical acidity for food vinegar. Novelty: The formulated Bignay vinegar powder provides consumers with the opportunity to enjoy the taste of vinegar, even when the Bignay fruiting season is over.

Keywords: Spray-drying, Bignay vinegar, Maltodextrin, Percent Recovery, Physicochemical Properties
Preparation of SARS-CoV-2 Saliva Samples Using an ARTIC V4.1 Tiled Amplicon Approach for Sequencing on Illumina Platforms v1
Authors: Lariscy Leah , Sullivan Amanda , Dillon Katie , Lott Megan , Glenn Travis , Lipp Erin
Published: February 2025

This protocol describes how to prepare purified SARS-CoV-2 RNA from positive saliva samples for short-read sequencing. The initial targeted amplification utilizes the commercially available IDT ARTIC V4.1 tiled amplicon panel, followed by amplification with IDT custom-ordered fusion primers that follow the same amplicon scheme, allowing for further amplification of target molecules and eliminating the need for end repair and adapter ligation. Completion of this protocol should result in a clean, multiplexed DNA library pool ready for sequencing.
Preparation of SARS-CoV-2 Particles in Raw Wastewater Samples for Sequencing on Illumina Platforms Using an ARTIC V4.1 Tiled Amplicon Approach v1
Authors: Lariscy Leah , Sullivan Amanda , Dillon Katie , Lott Megan , Glenn Travis , Lipp Erin
Published: February 2025

This protocol describes how to prepare purified SARS-CoV-2 RNA from raw wastewater samples for short-read sequencing. The initial targeted amplification utilizes the commercially available IDT ARTIC V4.1 tiled amplicon panel, followed by amplification with IDT custom-ordered fusion primers that follow the same amplicon scheme, allowing for further amplification of target molecules and eliminating the need for end repair and adapter ligation. Completion of this protocol should result in a clean, multiplexed DNA library pool ready for sequencing.
Evaluation of the immunomodulatory effect of siRNA Nup98.1 и Nup205.1 during influenza infection using in vivo models
Authors: Rozhkova Lanita , Faizuloev Evgenii , Milchakov Danil , Lushnikov Ruslan , Bogdanova Ekaterina , Rozhkova Lanita , Svitich Oxana , Zverev Vitaliy
Published: February 2025

BACKGROUND: Influenza infection is one of the most pressing global health problems. The problems of the formation of viral resistance to existing drugs and the immunosuppressive effect induced by the influenza virus are currently acute. A promising solution seems to be the creation of drugs whose action is based on inhibition of the activity of cellular genes through RNA interference.
AIM: Evaluate the anti-influenza and immunomodulatory effect of small interfering RNAs directed to cellular genes in an in vivo model.
METHODS: The study used the influenza virus strain A/California/7/09 (H1N1), BALB/c mouse. Small interfering RNA was administered and animals were infected intranasally. Changes in the cytokine profile and viral activity were assessed using molecular genetic and virological methods.
RESULTS: In the lungs of mice with intranasal administration of all siRNA complexes, a decrease in the expression level of IL-1β and TNF-α was noted, but an increase in the expression of IL-1β and IL-6 in washings from the upper respiratory tract (URT) was noted. When using siRNA Nup98.1 and Nup98.1 / Nup205.1, a reliable increase in the expression of IL-10 in the lungs and URT by the third day was observed. Changes in expression were also noted in relation to TGF-β1. Reliable differences in the expression of pro- and anti-inflammatory cytokines were obtained. Based on this, the most active immunomodulatory effect of the used small interfering RNA complexes is shown in the upper respiratory tract and lungs, at the sites of their direct administration.
CONCLUSION: The study presented data that small interfering RNAs directed to one or more cellular genes in an in vivo model can reliably lead to a decrease in viral reproduction, a change in the cytokine profile, as well as an increase in the survival rate of laboratory animals.
BRITTO, Paulo Henriques. Tarde. São Paulo: Companhia das Letras, 2007.
Authors: Veras Eduardo Horta Nassif
Published: February 2025

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APRESENTAÇÃO
Authors: Trevizam Matheus , Sá Luiz Fernando Ferreira
Published: February 2025

Literatura e Filosofia / Literatura e Teoria Literária. A partir desses encontros, foi organizada em 2010 a II Jornada em homenagem a Jacques Derrida. O evento debateu leituras, apropriações, transgressões, deslocamentos, contaminações, enxertos e traduções da obra de Jacques Derrida. Embora tenha funcionado como um produtivo espaço de discussão, a II Jornada Jacques Derrida não esgotou, evidentemente, as questões geradas pelo encontro da Literatura, Filosofia e Teoria Literária com o pensamento derridiano. O evento, organizado  pelos professores Roberto Said e Luiz Fernando Ferreira Sá, produziu alguns efeitos significativos que estão em parte reunidos neste volume da revista Em Tese, a qual se dedica, parcialmente, a registrar e difundir alguns textos apresentados na referida Jornada.
Attitudes towards artificial intelligence in professional and personal life
Authors: Tsenov M. Y. , Bakracheva M. A.
Published: February 2025

Introduction. Digital competence is seen as key to employment, education, and social domains in the 21st century. At the same time, there is no universal framework for studying attitudes towards artificial intelligence (AI) and its use in professional and personal life. Aim. The aim of the present research is to outline respondents’ attitudes towards the benefits and threats of AI that may facilitate or hinder the process of intelligent AI integration into different aspects of life. Methodology and research methods. This article outlines results from a pilot study of attitudes towards AI, conducted with a sample of 125 Bulgarian students and professionals. The research design is mixed (quantitative and qualitative) and includes questionnaire, focus groups and interviews. Results and scientific novelty. The results reveal that both young people and adults base their opinions on their assessment of AI performance and find positive implications in terms of facilitating task performance, but have strong reservations concerning job security and the use of AI in the social sphere. They also suggest that AI skills need to become integrated into education. Future research directions highlighted include differentiating between educational, professional, and personal domains and self-assessing digital literacy from an evidence-based vs. state of the art perspective. Practical significance. Insights from this study focus on mindful mindset, educational settings and the redesign of educational content, particularly forms of critical engagement and use of AI.
Personal potential as an educational outcome in the context of inclusive university transformation
Authors: Fedina L. V. , Bruk Zh. Yu. , Volosnikova L. M. , Ignatjeva S. V.
Published: February 2025

Introduction. The discussion surrounding the formulation of educational outcomes for higher education programs at contemporary universities is gaining renewed significance due to the increasing diversity of student populations and the demand for equitable and affordable education. Aim. This research aims to identify the specific aspects of personal potential as a component of the structure of educational outcomes for students, particularly in the context of the inclusive university transformation. Methodology and research methods. The structure of educational outcomes in the context of higher inclusive education was developed based on a comparative analysis of D. Leontiev’s personal potential model and a universal competence framework created within the methodology for assessing supra-professional competencies by A. G. Komissarov, E. A. Stepаshkina, O. B. Soboleva, and others. The empirical study employed methods for assessing supra-professional competencies as adapted by A. G. Komissarov and E. A. Stepаshkina. The sample comprised 505 students from the University of Tyumen. The data collected were subjected to cluster and correlation analyses using IBM SPSS Statistics. Results. The analysis and interpretation of the psychological profiles obtained from students enabled the identification of personal potential as a central educational outcome within the framework of the inclusive university transformation. Universal design for learning serves as a tool that facilitates the adaptation of educational strategies to align with the unique characteristics of each student’s personal potential. Scientific novelty. The authors outline the structure of educational outcomes within the framework of an inclusive transformation of the university. In this context, the primary function is fulfilled by personal competencies (self-skills), while personal potential serves as the connecting factor among the various levels of competencies, including hard skills, soft skills, and self-skills. Practical significance. The university administration and faculty, by considering the diverse profiles of students with varying levels of personal potential, can create the most favorable and effective educational environment based on the principles of universal design.
How High School Seniors Perceive Knowledge Development Amidst Social Networks
Authors:   , Castañeda David Lee , Levine Bruce A.
Published: February 2025

This phenomenological study explored how young adult high school seniors perceived knowledge development as an interactive process with their social networks. Ten high school seniors participated in the study. The research engaged in social analytical phenomenology, which encouraged participants to contribute their own analysis to the data by having them interact with their own data, which was from an egocentric sociogram activity that they completed at the beginning of a one-on-one interview session. All ten volunteers participated in the interviews, and 8 participated in a follow-up focus group. The interviews and focus group were conducted using semi-structured interview protocols. Qualitative analysis of the data suggested that participants similarly structured their social networks and revealed three key themes: participants categorized different types of knowledge that they gained in different ways; participants saw social media as a given in their lives, but not trustworthy; and participants felt that the online environment made it easier to gain information and meet people than doing so in person. The study offers an innovative method of engaging participants in analytical research to better understand their interpretation of the evolving digital social atmosphere and suggests insights for approaching knowledge development activities for educators. Keywords: Social networks, social media, knowledge development, young adults, adolescents, high school seniors, learning.
Student Perceptions of Social Presence in Relation to Academic Success, Communications Tools, and Instructor Pedagogy in Online Master's Degree Courses
Authors:   , Condello Paul Anthony , Silverman Jason
Published: February 2025

Despite the popularity of online master's degree programs, students report feeling socially disconnected from their peers and their instructors in their online courses. This lack of social presence from their peers and instructors causes students to feel dissatisfied with their online courses, experience less academic success, and drop out at higher rates than students enrolled in degree programs that meet in person. However, research has pointed to the use of communication tools, such as video conferencing, that can improve social presence. While other research has pointed to an emphasis on the teaching pedagogy of online instructors as the answer to greater social connection. This exploratory qualitative dissertation examined the following research questions to better understand social presence in the online master's classroom: 1. In what ways do online students' understandings and experiences and working definitions of social presence differ from the commonly accepted understandings and definitions from the research? 2. How do graduate students describe and compare their online experiences with asynchronous and synchronous tools? How do these tools support or constrain students' perceptions of social presence and their overall academic success? 3.What teaching strategies do students believe enhance social presence in online learning? How does their online program build these activities and practices in their courses and how did they impact social presence and academic success? The purpose of this dissertation was to further our understandings of how online master's students perceive the instructor's role in combining synchronous and asynchronous communication tools with their teaching pedagogy to foster social presence in a technology-mediated environment, and how this sense of social presence impacts students' self-reported feelings of academic motivation and satisfaction. A total of 21 students enrolled in online master's programs participated in semi-structured interviews. An analysis of the interview data indicated that for these students, their perception of the social presence in their classes impacts their academic motivation and satisfaction with the course. Further, participants indicated that both synchronous and asynchronous communications tools shape the online social environment in different ways. Ultimately, findings suggest that students expect the instructor to play an active role in using the technological tools at their disposal in a way that fosters communication and social interaction among students. These findings can be used to help university leaders and online instructors design and deliver effective instruction that optimizes student satisfaction, enhances academic achievement, and ultimately boosts retention rates in online degree programs. Keywords: online degrees, social presence, video conferencing, online teaching strategies, online retention rates, online academic achievement
Diversifying donor populations in nonprofit arts and culture organizations
Authors:   , Gow Megan , Yau Pamela
Published: February 2025

The landscape of nonprofit arts and culture organizations in the United States is undergoing a significant transformation due to shifting demographics and evolving donor landscapes. This thesis explores the necessity of diversifying donor populations within these organizations, highlighting the historical overrepresentation of white donors and the implications of this trend amidst a rapidly diversified society. Despite the potential engagement of more varied donors, many fundraising practices have overlooked non-white individuals. The impact of COVID-19 has further exacerbated financial challenges within the sector, forcing organizations to reassess their fundraising strategies. By analyzing case studies and current literature, this study underscores the importance of cultivating inclusive practices and establishing long-term goals with diverse communities.
Comparative Analysis of the Effect Dual Spark Ignition and Single Spark Ignition on Performance and Exhaust Emissions in Bioethanol-Fueled Engines
Authors: Permanasari Avita Ayu , Wahidin Ahmad Faizal , Ismail Hasan , Komara Erwin , Puspitasari Poppy , Lorenzo Gina A.
Published: February 2025

Bioethanol is an alternative fuel that has a high octane value of around 100 to 110, making it difficult to be applied to spark ignition engines directly. So, it is necessary to make adjustments, including increasing combustion efficiency and thermal efficiency of the combustion chamber by increasing the compression ratio and adjusting the ignition system, both in single spark ignition (SSI) and dual spark ignition (DSI) types. The study aims to determine the effect of SSI and DSI applications on engine performance, specific fuel consumption (SFC), and exhaust emissions using 96% and 99% levels of bioethanol fuel. The results showed that, in general, there was an increase in power, torque, and thermal efficiency as well as a decrease in emissions and better SFC in the DSI engine compared to the SSI engine with 99% bioethanol fuel. The highest power was obtained at 6.89 HP or 5.6% higher than the SSI engine, and peak torque was obtained by 14.95 N.m at 6500 rpm on the DSI engine using 99% bioethanol. Meanwhile, the minimum SFC reduction was obtained at 13.87% lower than that of DSI. The highest thermal efficiency of the DSI engine occurs at 7000 rpm, which is 38.19% when using 96% bioethanol. NOx emission increased when using 99% bioethanol on the DSI engine by 15.58% compared to the SSI engine. CO emissions decreased by 72.51% in the DSI engine with 96% bioethanol fuel. At the same time, CO2 experienced the highest decrease of 76.92% at 5500 rpm on 99% bioethanol DSI engine.
Performance Enhancement of Dye Sensitized Solar Cell (DSSC) through TiO2/rGO Hybrid: Comprehensive Study on Synthesis and Characterization
Authors: Hatib Rustan , Anwar Khairil , Magga Ramang , Astak Muh Anjas , Widhiyanuriyawan Denny , Wardoyo Wardoyo
Published: February 2025

The TiO2 film is immersed in a graphite oxide solution, preparing it for thermal reduction, which converts the graphite oxide to reduced graphene oxide (rGO). This process produces rGO hybrid TiO2 photoanodes for dye-sensitized solar cells (DSSC). rGO in the TiO2 structure prevents electron recombination and improves overall efficiency. The main advantage of this method is its ability to prevent loss of rGO during the sintering process, which is a common problem with other methods. The study investigated heating temperatures ranging between 300˚C, 350˚C, 400˚C, 450˚C, and 500˚C to determine optimal conditions. The presence of rGO in the photoanode structure was confirmed via X-ray diffraction and Fourier transform infrared spectroscopy analysis. JV (current-voltage density) measurements of DSSC based on TiO2/rGO photoanode revealed that the highest photoelectric conversion efficiency (0.1923%) was achieved at 400˚C, much higher than other temperature variations. The findings demonstrate the effectiveness of a simple low-temperature thermal reduction process in producing graphene suitable for semiconductor applications in DSSC. The RGO produced through this method not only improves energy conversion efficiency but also outperforms traditional graphite electrodes. By optimizing the thermal reduction process and fine-tuning the heating conditions, this study advances the practical application of graphene-based materials in solar cell technology. This method overcomes the loss of rGO during sintering, ensuring its beneficial properties are retained. Overall, this study shows that low-temperature thermal reduction is an efficient technique to improve DSSC performance through the incorporation of reduced graphene oxide.
Medical Education in Mongolia: Bridging Tradition and Modernity
Authors: Lkhagvasuren Ts. , Bold Sh. , Altantsetseg Ts. , Otgonbayar D. , Bolorsaikhan O.
Published: February 2025

Background: Medical education in Mongolia has evolved significantly over the centuries, transitioning from traditional training methods rooted in the "Four Medical Tantras" to modern, integrated curricula. The introduction of integrated medical education seeks to address limitations in the traditional and Soviet-era models by emphasizing disease prevention, public health, and student-centered approaches.

Methods: This study examines the development of Mongolia’s integrated medical curriculum through a comparative analysis of traditional and Soviet-era education models. Quantitative and qualitative data were collected and analyzed using the SERVQUAL and SURE models to assess the quality of educational services over time. Data on student satisfaction, curriculum integration, and program outcomes were reviewed to identify trends and areas for improvement.

Results: The findings highlight significant advancements in Mongolia’s medical education system, including the implementation of a 21-block integrated curriculum and student-centered methodologies. However, gaps in service quality remain, as evidenced by SERVQUAL results showing discrepancies between student expectations and perceptions, particularly in assurance and empathy. Employment rates and licensing exam success rates have declined over recent years, indicating the need for further curriculum reforms and improved student preparation.

Conclusions: The integrated curriculum has brought Mongolia's medical education closer to global standards by focusing on prevention and public health. However, challenges such as quality gaps, declining employment rates, and student satisfaction necessitate continued reform. Future efforts should emphasize aligning curricula with national needs, fostering life skills, and enhancing service quality to produce well-rounded medical professionals.
Global variation in obesity of males and females is differentially associated with dietary macronutrient supply
Authors: Speakman John , Niu Chaoqun
Published: February 2025

Obesity prevalence varies widely across countries, as does the difference in prevalence between the sexes. To explore the relationship between obesity prevalence in female and male adults across different countries and country level food supply data, we used country level obesity prevalence data from the WHO, and food supply data from FAO to fit multiple regression models. In males both absolute fat and sugar energy supply were associated with obesity prevalence. However, in females only absolute sugar supply was significant. In both sexes relative fat and sugar energy supply (as a % of the overall energy) were significant predictors of obesity prevalence. Protein supply whether expressed as absolute or % of energy was unrelated to obesity prevalence in both sexes. Similarly, neither absolute nor relative carbohydrate energy supply was associated with obesity prevalence in either sex. Absolute fat and sugar energy supply were significant predictors of sex difference in obesity prevalence. These data suggest country level energy supplies of both sugar and fat play important roles in obesity prevalence globally, but to different extents in males and females.
Commentary:- Vitamin D for reduction in Covid-19 risks for south Asian and other vitamin D deficient groups?
Authors: Boucher Barbara
Published: February 2025

Over 7 million people died of COVID-19 globally in the current pandemic. Westernised countries reported increased COVID-19 illness with increased mortality rates in their South Asian and Black communities, while dark-skinned communities are more severely vitamin D deficient than others in westernised countries. Vitamin D has many proven mechanistic effects protective against infections and against the ‘acute respiratory distress syndrome’ that caused many COVID-19 deaths. This ‘commentary’, therefore, considers prospective evidence for reductions in COVID-19 risks with better vitamin D repletion; whether treating deficiency reduces COVID-19 risks, and discusses the many actions of vitamin D that could lead to such risk reductions.

Better pre-pandemic vitamin D status predicted ~50% COVID-19 risk reductions in each US state [in ~400,000 adults] and in health care staff. Governments generally resisted calls for higher vitamin D intakes [at 1000-2000 IU/day], quoting ‘lack of randomised controlled trials’, and fear of vitamin D ‘toxicity’, despite safe unsupervised population intake generally advised being ‘up to 4000 IU/day’. The UK has since recommended daily adult intakes of 400 IU/day, helpful, but too small to correct deficiency. American rules on ‘medical need’ meant banning treatment of COVID-19 with vitamin D so that the new mRNA vaccines could be used. More recently, trials treating COVID-19 illness with vitamin D3 [at 1,000,000 IU over 2 weeks] or with the vitamin D 25(OH)D metabolite, calcifediol [at ~2.0mg over 1 month] have shown significantly reduced Covid-19 severity and mortality. This information makes a cogent case for ensuring vitamin D sufficiency globally, most especially in dark skinned communities, as a cost-effective measure for reducing the risks from future COVID-19 variants and from the future health risks of newly emergent pathogenic viruses.
Healthcare messages communicated through artistic expressions during the COVID-19 pandemic - Hello (from the Inside)
Authors: Eidsaa Randi
Published: February 2025

The article explores healthcare messages communicated by artistic expressions presented in video formats during the COVID-19 pandemic. The subtitle Hello (from the Inside) refers to an Adele parody created by the American singer and comedian Chris Mann in March 2020. By altering Adele’s title, Hello (from the Other Side) and lyrics, Mann voiced the isolation anxiety felt worldwide when the coronavirus rapidly spread across the globe and the quarantine forced us to stay away from social activities.

From the very start of the pandemic, music and other art expressions emerged in digital formats as an immediate response, created by individuals and groups to comment on the circumstances and reflect uncertainty. Parallel with Corona narratives and information about the increase in COVID-19 cases, news channels distributed a range of messages through art, especially music. Art institutions, performing ensembles, and solo performers streamed events, and home-based music and dance activities emerged on social media. Healthcare organizations and institutions joined in the trend and spread COVID-19 information online. Hospital employers appeared with health messages creatively communicated through art. People’s homes, institution interiors, hospital lobbies, and surgery rooms became stages for narration, singing, and dancing. When the world seemed to have paused, we gratefully received healthcare messages from the `inside´. The present article applies an interdisciplinary analytic approach to eight selected video clips that juxtapose artistic expressions and healthcare messages. It aims to shed light on how health messages and aesthetic expressions created during the first wave of the pandemic reflect an artistic conceptualization of COVID-19 knowledge and experiences.
The Impact of Covid-19 on Higher-Age Mortality
Authors: Cairns Andrew , Blake David , Kessler Amy , Kessler Marsha
Published: February 2025

We propose a simple model for accelerated deaths that draws on the observation that many of those who died from Covid-19 were often, but not always, much less healthy than the average for their age group; further, the vast majority who died were over the age of 50. The model predicts that, in the absence of additional secondary effects, the impact on the life expectancy of survivors (the anti-selection effect) will be very small, and that the degree of impact depends on the average years of life lost by those who die from Covid-19. The philosophy underpinning the model is supported by reference to both all-cause mortality by age and all-cause mortality by socio-economic deprivation group. In combination, these support a proportionality link between Covid-19 mortality and individual frailty or death rates. The Accelerated Deaths Model is consistent with the mortality experience associated with respiratory diseases over the period 2013-15 and with past seasonal influenza epidemics.
Osteoporosis is a Risk Factor for Proximal Junctional Failure Following Long Spinal Fusion for Adult Spinal Deformity
Authors: Mohanty Sarthak , Gupta Anmol , Fogel Harold , Tobert Daniel , Hershman Stuart
Published: February 2025

Background: Bone health has emerged as a critical modifiable risk factor for complications following adult spinal deformity correction. Among these complications, mechanical issues and proximal junctional kyphosis/failure remain particularly challenging, affecting up to 61% and 44% of patients, respectively. We hypothesized that osteoporotic patients undergoing deformity correction experience higher rates of instrumentation failure and proximal junctional kyphosis/failure.

Purpose: To evaluate and compare the complication profiles of osteoporotic and non-osteoporotic patients undergoing long thoracolumbar fusion for adult spinal deformity.

Study Design: Retrospective comparative study

Patient Sample: adult spinal deformity patients who underwent long thoracolumbar spinal fusion (>7 levels) at two large academic medical centers between 2010 and 2019.

Outcome Measures: The primary outcome was all-cause revision surgery. Secondary outcomes included pseudarthrosis with or without implant failure, proximal junctional kyphosis/failure rates, infection rates, and time to complication occurrence.

Methods: This retrospective, multicenter study analyzed deformity patients undergoing long-segment instrumentation (≥7 levels) with a minimum two-year follow-up. Exclusion criteria included spinal deformity secondary to tumor, infection, trauma, or neuromuscular disorders. Preoperative osteoporosis status was determined using dual-energy X-ray absorptiometry (DXA) T-scores at the hip and femoral neck. The complication profiles of osteoporotic and non-osteoporotic deformity patients were compared using Chi-squared or Fisher’s exact tests for categorical variables and two-tailed t-tests for continuous variables.

Results: Among 399 adult spinal deformity patients, 131 (32.8%) were osteoporotic. Osteoporotic patients were significantly older than their non-osteoporotic counterparts [66.43 (SD: 8.9) vs. 63.51 (SD: 8.9), P = 0.0018]. The overall complication rate was significantly higher in osteoporotic patients compared to non-osteoporotic patients [40.5% (n = 53) vs. 28.0% (n = 75), P = 0.0122]. Incidences of PJK [35.1% (n = 46) vs. 21.6% (n = 58), P = 0.0040] and PJF [19.8% (n = 26) vs. 6.7% (n = 18), P = 0.0001] were also higher in the osteoporotic group, while rates of construct failure/pseudarthrosis [11.5% vs. 15.7%, P = 0.2578] and infection [4.6% vs. 3.7%, P = 0.6849] showed no significant differences. Time to pseudarthrosis (8.1 vs. 8.3 months, P = 0.4582), infection (4.7 vs. 1.5 months, P = 0.0773), PJF (9.3 vs. 10.1 months, P = 0.7300), and overall time to first complication (8.4 vs. 7.6 months, P = 0.5119) were similar between the groups.

Conclusions: Osteoporotic patients have increased risk of proximal junctional kyphosis and failure compared to non-osteoporotic patients, highlighting the need for preoperative osteoporosis surveillance, optimization, and postoperative monitoring to mitigate complications.
Lifestylopathy as Personalized Medicine: A Holistic Approach to Health
Authors: Alzeer Jawad
Published: February 2025

This article looks at Lifestylopathy, a holistic approach to healthcare that combines traditional healing methods with personalized medicine and recognizes the physical, emotional, psychological and spiritual dimensions of health. Unlike conventional medicine, which focuses primarily on symptom management, Lifestylopathy emphasizes identifying and addressing root causes of complex conditions by adapting interventions to individuals’ lifestyles, values, and specific health needs. The methods explored include balancing metabolic processes, such as anabolic and catabolic pathways, maintaining homeostasis, and optimizing the dynamic interplay between entropy and potential energy. The study also examines the role of neurotransmitter balance and lifestyle adjustments in enhancing mental health. By employing a synergistic approach that combines therapeutic interventions, placebo effects, and lifestyle alignment, Lifestylopathy offers a comprehensive framework for disease prevention, holistic recovery, and long-term wellness. This integrative methodology bridges modern and traditional practices, providing actionable insights into achieving sustained health and well-being.
Lupus Nephritis: Current Advances and Future Options for Screening and Treatment
Authors: Yaman Reena , Relan Krish , Shah Mandar , Srivastava Archit , Mumtaz Sehreen , Majithia Vikas
Published: February 2025

Background: Lupus nephritis is one of the most common severe organ manifestations of systemic lupus erythematosus (SLE). Despite the continuing advancement in therapy, up to 30% of patients progress to end-stage renal disease. The clinical manifestations of lupus nephritis are variable and screening all SLE patients for lupus nephritis is imperative. There has been substantial advancement in availability of biomarkers and therapeutic options. This review focuses on epidemiology, early screening, advances in the biomarkers and management of lupus nephritis.

Content: Lupus nephritis is a devastating consequence of SLE and disproportionately affects the minorities. Inter-ethnic variation in the prevalence and severity of lupus nephritis as well as tolerance and clinical response to various therapeutic regimens for LN has led to variation in screening and treatment of lupus nephritis in SLE patients. Periodic screening of lupus nephritis in patients with SLE is imperative for early detection. Urinalysis and urine protein-to-creatinine ratio are useful screening tests. Quantification can be performed by 24-h urine sample collection for protein. Renal biopsy remains the gold standard for diagnosis of lupus nephritis. Traditional serum biomarkers used to monitor lupus nephritis disease activity and flares include anti-double-stranded DNA antibodies and complement components 3 and 4. New biomarkers for lupus nephritis include anti-C1q and type 1 interferon regulatory genes, urinary monocyte chemoattractant protein 1, neutrophil gelatinase-associated lipocalin, tumor necrosis factor-like inducer of apoptosis, and vascular cell adhesion molecule 1. Therapeutic options that better lead to remission of lupus nephritis, preserve kidney function and reduce the toxicities of concomitant glucocorticoids are unmet needs in lupus nephritis. There are newly approved treatments as well as investigational drugs in the pipeline, including the newer generation calcineurin inhibitors, biologic agents and cellular therapeutic options. The choice of therapy depends on a numberof clinical considerations and should be tailored to individual patient circumstances. Molecular profiling, gene-signature fingerprints and urine proteomic panels might enhance the accuracy of patient stratification for treatment personalization in the future.

Summary: Promising advances have been made in screening and treatment of lupus nephritis. The use of traditional and alternative biomarkers has the potential to identify at risk patients and those having active flare-up but require validation in prospective studies. Renal remission rates in patients receiving standard of care therapy for induction and maintenance treatments have improved but remain low. Further research in newer therapeutic targets for lupus nephritis shows promising results.
Effects of COVID-19 Quarantine Restrictions on Training and Injury in Ballet Dancers
Authors: Moss Jacquelyn , Shah Selina , Sheng Dana , Zaslow Tracy , Wren Tishya , Edison Bianca
Published: February 2025

Background: The COVID-19 pandemic dramatically interrupted worldwide athletics, as closures and limited access to sports facilities forced athletes to adapt to new and often challenging conditions. Many lost access to essential training spaces like gyms, tracks, and fields, which disrupted their routines. For ballet dancers, who rely heavily on studio space, mirrors, and specialized flooring, the restrictions were especially difficult.

Aims: This study examined pandemic effects on dance and training participation for California youth dancers, training environments during shutdown, and incidence of injury prior to, during the pandemic, and after returning to studios.

Methods: This cross-sectional study surveyed 17 dancers (all female, median age 13.7 years), comparing data surrounding the COVID-19 pandemic (before March 2020, during quarantine from March 2020 to January 2021, and when studios reopened for classes). Questions assessed rates of dance instruction, ability to replicate studio environments, injury, and self-rated readiness. Descriptive results are presented along with comparison of activities before and during the pandemic.

Results: Prior to COVID-19, dancers trained a median of 6 hours/wk. Dance training decreased significantly to 3 hours/wk at home during quarantine (p=0.01). 76% (13/17) of dancers reported COVID-19 interrupted training; 54% (7/13) reported 1-10 weeks of interruption, and 46% (6/13) reported a longer interruption. During quarantine, most (94%, 16/17) reported taking home virtual dance classes. Nearly half (8/17, 47%) of dancers had access to some equipment needed to adequately train, while 12% (2/17) felt they did not have proper access. Dance training floor surfaces varied (47% on hardwood floors at home, 24% on carpet). No participants trained on any version of sprung flooring while at home. Many dancers used chairs (65%) or a barre (53%) to train. Upon returning to studios, 4 injuries occurred (no active injuries right before/during quarantine), 100% involving the lower extremity and 75% affecting the foot.

Conclusions: COVID-19 proved challenging to dancers, limiting the ability to train at the level they had prior to imposed public health restrictions. Alternative options were utilized to continue dancing, including using hardwood floors and furniture at home. These alternatives could have increased risk, resulting in lower extremity injuries.