bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Business Capabilities Through Digital Transformation, Upscaling, and Upskilling in the Era of Industry 5.0
Authors: Subburayan Baranidharan
Published: April 2024

This literature review aims to understand the recent developments in the field of upscaling and upskilling in the digital transformation of business, from an Industry 5.0 prospective. It used a comprehensive search of relevant peer-reviewed journal articles, industry reports, and online sources to gather the relevant data. The findings indicate that upscaling is essential for industry 5.0, and that businesses should invest in upskilling and upscaling programs to meet the changing demands of the digital economy. This literature review provides a comprehensive analysis of the current state of upscaling and upskilling in the digital transformation of business and provides insights into the future direction of this field. It also highlights the importance of collaboration between businesses, governments, and educational institutions to ensure that the workforce is prepared for the future of work.
Getting More Out of Software Prototypes
Authors: Sánchez-Villarin Alejandro , Santos Alejandro E. , Gonzalez-Enriquez José E. , Gutierrez Javier J. , Sanchez-Gomez Nicolas E. , Koch Nora E. , Escalona Maria Jose
Published: April 2024

Prototyping is a requirement technique frequently used for communication between customers and developers. Software prototypes help to understand users' expectations, but they are often seen as disposable artifacts because it is not easy to manage the transfer of knowledge from prototypes to software models or code. This chapter studies whether suitable solutions already exist for exploiting the knowledge acquired during the building of prototypes in the early phases of the lifecycle. The objective is addressed by means of a systematic literature review of approaches offering solutions for transforming software prototypes into analysis models. We propose a characterization schema for comparing them and describing the current state-of-the-art. The results reveal a need for more automated solutions that are more economical in terms of time and effort for transforming prototypes into models and thereby ensuring traceability between requirements and design artifacts.
The Role of Internet of Things (IoT) in Disaster Management
Authors: Ozen Cagla , Yolcu İremnaz
Published: April 2024

The purpose of this book chapter is to delve into the role of the internet of things (IoT) in disaster management. Specifically, this chapter will address the following research questions and subjects: How can IoT be utilized in early warning systems for natural disasters? How does big data analytics contribute to disaster management when combined with IoT? Furthermore, a review of literature on the analysis of case studies involving IoT-based disaster management approaches will also be discussed.
Revolutionizing Patient Care
Authors: Rajendran Rajaprabakaran , Subramanian Yavana Rani
Published: April 2024

Virtual reality (VR) technology has been gradually gaining traction in the healthcare industry and has the potential to significantly transform the way that patients receive medical care. VR technology delivers an immersive experience that may improve diagnosis, treatment, and overall patient outcomes by enabling patients and medical professionals to visualise and interact with medical data more effectively and intuitively. VR can help patients gain a better understanding of their medical diagnoses and treatments. Better health results may result from this and an improvement in the way care is delivered generally. In conclusion, VR technology creates an exceptional opportunity for medical practitioners to transform the way they treat patients. The field of digital health is an emerging discipline that integrates technology and healthcare to boost overall care, save costs, and improve patient outcomes.
Integration of Biomedical Engineering in Augmented Reality and Virtual Reality Applications
Authors: Rubi Jaya , Vijayalakshmi A. , Venkatesan Shivani
Published: April 2024

This book chapter delves into the profound synergy between Biomedical Engineering and the burgeoning realm of augmented reality (AR) and virtual reality (VR) applications. Through a meticulous examination of state-of-the-art advancements and a forward-looking analysis of future prospects, this chapter endeavors to offer a comprehensive resource for a diverse audience, including dedicated researchers, seasoned healthcare practitioners, discerning educators, and aspiring students. The integration of these technologies has the potential to revolutionize medical training, patient education, surgical planning, and therapy delivery, ushering in an era of more personalized and effective healthcare solutions. This chapter serves as a guiding beacon in navigating this transformative landscape, ensuring that the adoption of AR/VR technologies is not only innovative but also ethically grounded and attuned to the highest standards of patient care.
Navigating the Legal and Ethical Framework for Generative AI
Authors: Ghose Anuttama , Ali S. M. Aamir , Deshmukh Sachin
Published: April 2024

Generative AI systems have given incredible ability to independently produce a wide variety of content types, including textual, visual, and more. Complex issues with copyright protection and intellectual property rights have arisen as a result of this change. With a focus on fostering responsible global governance, this research delves into the complex legal and ethical considerations underlying Generative AI. The goal of this chapter is to take a look at the complicated legal issues that come up because of Generative AI's ability to generate material on its own. This chapter analyzes the current legal documents, legislation, and international treaties, focusing on ethical concerns. Ultimately, the authors want to have a positive impact on efforts to build responsible and efficient international frameworks for regulating Generative AI. This study provides an exhaustive case for the implementation of legal frameworks that can efficiently tackle the intricate legal and ethical quandaries posed by Generative AI, while simultaneously encouraging the progress of innovation and creativity.
Serverless Computing
Authors: Worah Nidhi Niraj , Patil Megharani
Published: April 2024

This chapter serves as a comprehensive initiation into serverless computing, a revolutionary paradigm in cloud computing. It begins by elucidating the foundational concepts, breaking down its architecture that simplifies development through modular functions triggered by specific events. The narrative unfolds, highlighting the myriad benefits, such as enhanced efficiency, seamless scalability, and liberating developers from intricate server management. A comparative analysis with traditional cloud computing underscores serverless computing's unique attributes. However, the chapter maintains balance by addressing challenges like cold start latency, execution duration limits, and potential vendor lock-in. The exploration concludes by showcasing real-world applications in domains like real-time data processing, backend APIs, batch processing, image and video processing, and chatbots. Offering a nuanced understanding of serverless computing, this chapter stands as an invaluable resource for readers exploring its advantages, challenges, and diverse applications.
“I felt like a freak when I would go to the doctor”: Investigating healthcare experiences across the lifespan among older LGBT and transgender/gender diverse adults
Authors: Diamant-Wilson Roni , Ray-Novak Meagan , Gillani Braveheart , Prince Dana M. , Mintz Laura J. , Moore Scott Emory
Published: April 2024

In the past several decades, the United States has enacted civil rights legislation protecting lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations from discrimination, including enacting proactive healthcare laws such as the Affordable Care Act. However, given today’s divisive politics, LGBTQ people’s access to appropriate and respectful health care is precarious. This study explored the disconnections from and connections to health care and the respective health effects among two self-identified groups: i) older LGBT adults and ii) transgender and gender-diverse (TG/GD) adults. Using a life course perspective, qualitative data from 17 older LGBT and TG/GD participants were analyzed. Thematic and content analyses indicated that despite progress made, discrimination and prejudice in obtaining health care persist, particularly among TG/GD people of color. The results highlight the ongoing challenges LGBTQ populations face as they risk being denied care by healthcare providers and disconnected from the healthcare system.
Kaposi’s Varicelliform Eruption in a Patient with Darier’s Disease: A Rare Case Report
Authors: Trishala Shirahatti , Bangaru H
Published: April 2024

Darier's disease is a rare autosomal dominant disorder, characterized clinically by the appearance of multiple, pruritic, discrete, and scaly papules affecting seborrheic areas coupled with palmar pits, nail changes, and mucosal involvement. Histologically, the lesions show supra-basal clefts with acantholytic and dyskeratotic cells. Kaposi's varicelliform eruption (KVE) is the dissemination of the herpes simplex virus in the setting of preexisting skin disease, presenting with disseminated vesico-pustules. Darier's disease presenting as KVE is a rare occurrence. If misdiagnosed or left untreated can increase the rate of mortality. Here, we report the case of a 25-year-old male patient who presented with multiple vesicles and crusted lesions over the face, neck, chest, and upper back. After thorough cutaneous examination, he was found to have multiple hyperkeratotic, dirty-warty papules over seborrheic areas, present since childhood. With detailed clinical and laboratory evaluation, we arrived at the diagnosis of KVE with underlying Darier disease.
Cutaneous Vascular Anomalies: A Cross-Sectional Study in a Tertiary Care Hospital
Authors: Somashekhar Sachin , Loganathan Eswari , Ramesh Heera
Published: April 2024

Background:

Vascular anomalies are a group of disorders that are divided into two categories: tumors and malformations. Given the vast diversity of clinical presentations with overlapping signs and symptoms, diagnosis can be difficult.

Objective:

We conducted a cross-sectional study to evaluate the common cutaneous vascular anomalies encountered in our outpatient department.

Materials and Methods:

A total of 28 patients suspected to be having cutaneous vascular anomalies were screened and subjected to biopsy. The diagnosis was based on clinicopathological correlation.

Results:

In our study, pyogenic granuloma was the most common vascular anomaly seen in 25% of patients; majority of these patients gave a history of trauma and spontaneous bleeding. It was followed by angiokeratoma (17.8%), infantile hemangioma, port-wine stain, and verrucous hemangioma which was seen in 10.7% of patients. Other common vascular anomalies included are glomus tumor and tufted angioma.

Conclusion:

Vascular anomalies comprise a spectrum of diseases, diagnosis of which is often challenging. Accurate diagnosis is critical to generate a management plan for the patient. Our study highlights the varied clinical spectrum of vascular tumors that we come across in clinical practice and it will increase familiarity of the various clinical presentations, thereby enabling clinicians to better identify and manage these challenging entities.
Solitary Pancreatic Metastasis from an Ovarian Carcinoma: A Diagnostic Perplexity
Authors: Agarwal Arti , Sharma Sonam
Published: April 2024

Ovarian cancer presenting as an isolated pancreatic metastasis after years of treatment is extremely rare. Most such patients are easily misdiagnosed as a case of primary pancreatic cancer. We herein describe a unique case of posttreatment high-grade serous papillary ovarian carcinoma metastasizing to the pancreas that mimicked primary pancreatic cancer and caused a diagnostic dilemma. The approach to such a case, pathogenesis, differential diagnosis, management, and a brief literature review is also presented.
Application of Noise Reduction Earplugs in Patients undergoing Total Knee Arthroplasty: A Retrospective Study
Authors: Wen Xi , Yang Huaixia , Wang Juan
Published: April 2024

Background: Patients undergoing total knee arthroplasty (TKA) need to tolerate the effects of noise. Materials and Methods: This study retrospectively analyzed the clinical data of 167 TKA patients at The Affiliated Hospital of Southwest Medical University from April 2019 to April 2021. A total of 154 patients who met inclusion criteria were divided into the conventional noise reduction management group (CMG) and the noise reduction earplug group (EPG), following different management schemes. The CMG received routine noise reduction management after surgery, while the EPG used noise reduction earplugs based on the CMG. The clinical indexes of the two groups were compared. Results: In this study, 79 patients were included in the CMG, and 75 patients were included in the EPG. The results showed that the Pittsburgh Sleep Quality Index (PSQI) scores of both groups 2 weeks after surgery were significantly lower than those before management (Z
EPG = 5.995, Z
CMG = 4.109, all P < 0.001), and the EPG exhibited a significantly lower PSQI score than the CMG (Z = −2.442, P < 0.05). Two weeks after surgery, the EPG had significantly lower levels of systolic blood pressure (Z
SBP = −4.303) and diastolic blood pressure (Z
DBP = −3.115), as well as lower scores on the Hospital Anxiety and Depression Scale-Anxiety (HADS-A; Z
HADS-A = −7.140) and Hospital Anxiety and Depression Scale-Depression (HADS-D; Z
HADS-D = −4.545) compared to the CMG (all P < 0.05). In addition, no significant correlation existed between the duration of wearing earplugs and the HADS-A and HADS-D scores (r = −0.201, r = −0.002, P > 0.05). Conclusion: Noise reduction earplugs can improve sleep quality and regulate negative emotions of patients undergoing TKA treatment through a complex mechanism involving noise, which is beneficial to the prognosis of the disease.
Distributions of zeros and masses of entire and
subharmonic functions with restrictions on their growth along the strip
Authors: Khabibullin Bulat Nurmievich
Published: April 2024

Let $\mathrm Z$ and $\mathrm W$ be distributions of points on the complex
plane $\mathbb C$. The following problem dates back to
F. Carlson, T. Carleman, L. Schwartz, A. F. Leont'ev, B. Ya. Levin,
J.-P. Kahane, and others. For which $\mathrm Z$ and $\mathrm W$,
for an entire function $g\neq 0$ of exponential type which vanishes on $\mathrm W$, there
exists an entire function $f\neq 0$ of exponential type
that vanishes on $\mathrm Z$ and is such that $|f|\leqslant |g|$ on the imaginary axis?
The classical Malliavin-Rubel theorem of the early 1960s completely
solves this problem for "positive" $\mathrm Z$ and $\mathrm W$ (which lie only
on the positive semiaxis). Several generalizations of this criterion were
established by the author of the present paper in the late 1980s for "complex"
$\mathrm Z \subset \mathbb C$ and $\mathrm W\subset \mathbb C$ separated
by angles from the imaginary axis, with some advances in the 2020s.
In this paper, we solve more involved problems in a more general subharmonic
framework for distributions of masses on $\mathbb C$. All the previously
mentioned results can be obtained from the main results of this paper
in a much stronger form (even for the initial formulation for distributions
of points $\mathrm Z$ and $\mathrm W$ and entire functions $f$ and $g$
of exponential type).
Some results of the present paper are closely related
to the famous Beurling-Malliavin theorems on the radius of completeness and a multiplier.
Identification and Antibiotic Resistance Edwardsiella tarda from Clown Knifefish (Chitala chitala) in the Mekong Delta, Vietnam
Authors: Dung Tu Thanh , Thi Quach Van Cao , Trung Nguyen Bao
Published: April 2024

This investigation is intended to isolate, identify, and assess the pathogenicity of Edwardsiella tarda, which originated from diseased clown knifefish. A total of 43 isolates were obtained from infected fish samples in Hau Giang and Dong Thap provinces of the Mekong Delta, Vietnam. Two isolates of DT37 and HG41 were identified as E. tarda by morphological, biochemical, and 16S rRNA gene sequencing. Experimental challenge studies revealed that isolate DT37 leads to 83.33% at a 108 CFU/ml concentration after 60 hours. Meanwhile, in isolate HG41, mortality reached 100% within 48 hours post-injection at the highest concentration of 108 CFU/ml. The challenged clown knifefish exhibited gross signs of abnormal swimming, skin ulcerations, and petechial hemorrhages in the body. Internally, ascites with hemoperitoneum, light-colored nodules on the liver, hemorrhagic kidneys, and splenomegaly were also recorded. The LD50 of two isolates, DT37 and HG41, was 4.89 × 105 and 4.07 × 105 CFU/ml, respectively. The antibiogram result showed that most of the isolates were highly susceptible to ampicillin (65%), enrofloxacin (85%), florfenicol (100%), flumequine (90%), cefotaxime (80%), and trimethoprim and sulfamethoxazole (70%). However, the bacterial isolates were highly resistant to doxycycline (75%) and streptomycin (100%).
Successful Primer Picking and Pooling for the Design of Multiplex PCR Primers Specific to Pork, Beef, Chicken, and Rat DNA
Authors: Kusumawaty Diah , Faridah Nurul , Fibriani Azzania , Priyandoko Didik , Dzikrina Hanina , Puspitasari Diah , Tallei Trina Ekawati , Aryani Any
Published: April 2024

DNA markers and Multiplex-PCR have emerged as methods for species detection in processed meat products. The primary objective of this study is to design multiplex primer sequences for pork, rat, beef, and chicken, generating distinguishable amplicons through agarose gel electrophoresis for halal detection in processed meat products. Primer design involved utilizing mitochondrial genomic data and the NCBI-Primer BLAST site to obtain specific pork and beef primer sequences. In silico simulations, including single and multiplex-PCR, were conducted using Primer Pooler. In vitro validation encompassed Single-PCR and Multiplex-PCR annealing temperature optimization, using samples of chicken, beef, pork, and rat as well as processed meat products like meatballs, sausages, and nuggets. In vitro validation demonstrated that the halal marker gene's multiplex primer efficiently amplified the target sequence, specifically at the optimal annealing temperature of 58°C. Amplicons from beef (1,217 bp), pork (860 bp), rat (622 bp), and chicken (272 bp) primers could be distinguished on a 1.5% agarose gel. The study's results can aid in cost-effective and rapid halal testing and authentication of processed meat products, offering advantages over PCR with a single primer.
Enhancing Kojic Acid Production in Aspergillus oryzae: Leveraging Crude Cellulase from Achatina fulica for Strain Improvement via Protoplasting and UV Mutagenesis
Authors: Putri Mulia Ocha , Larosa Febri LS , Septiarini Tri Hastuti , Rahmasari Ratika , Suryadi Herman
Published: April 2024

This study aims to prove the ability of crude cellulase enzymes from snails for protoplasting Aspergillus oryzae cells and its application for strain improvement with UV mutagenesis. Snail enzyme was obtained from Achatina fulica by dissolving its digestion track and fractionating it with ammonium sulfate. The activity of fractions was measured Spectrophotometrically and used for cell protoplasting for 2 hours, then irradiated with UV for 10, 15, and 20 minutes, respectively, with 5 cm in the distance. Screening of mutants is carried out with 1% FeCl3, and the potential mutant strain was tested for kojic acid production in an aerobic state and determined by Spectrophotometry at 268 nm. The cellulase activity in crude snail enzyme was 11.5807 U/ml and increased to 16.3984 U/ml after fractionation. The best protoplast formation was obtained with a 60% fraction, which showed transparent performance under the microscope. The UV mutagenesis of protoplasts showed that the highest number of potential mutants was obtained from UV treatment for 15 minutes (41.67%). The potential mutants look dark brown (DBC), such as strain 10H3, and produced higher kojic acid concentration than the parent strain. In conclusion, UV mutagenesis of Aspergillus oryzae through protoplasting by crude cellulase of snail enzyme was effective and improved kojic acid concentration.
Editor’s choice: Infections, non-communicable diseases, and reproductive health issues in a world beset by conflict and climate change
Authors: K Tumwine James
Published: April 2024

NIL
High resolution chest computed tomography findings in patients with clinically suspected COVID-19 pneumonia in Uganda: a cross-sectional study
Authors: Rita Nassanga , Aloysius Gonzaga Mubuuke , Randhawa Mangun , Max Crescent Tumusiime , Erem Geoffrey , Valeria Nabbosa , Francis Olweny , Faith Ameda , Sam Bugeza
Published: April 2024

Background: The alarming spread of the COVID-19 pandemic has led to a shortage of RT-PCR kits in Uganda necessitating the use of high-resolution chest Computed Tomography to guide patient management and treatment.Main Objective: To describe the chest HRCT findings in patients with clinically suspected COVID-19 pneumonia and to compare its diagnostic accuracy to RT-PCR. .Methods: In this cross-sectional study, chest HRCT findings of 384 patients and available RT-PCR laboratory results were reviewed and recorded in the data collection form.Results: The commonest chest HRCT findings were bilateral ground glass opacities (78.2%). Out of the 31.7% patients that took the PCR test only 26.9% tested positive. 16 out of 17 patients who tested negative, were classified under CORADS 5.The sensitivity of chest HRCT was 90.4%, 95% CI (82.6-95.5), positive predictive value of 84.2%, 95% CI (75.6-90.7), and accuracy of 77.5%, 95% CI (71.5-87.1).Conclusions: HRCT was found superior to RT-PCR in diagnosing COVID-19. A patient with positive HRCT findings should be treated as COVID 19 when RT-PCR is inaccessible or results are negative. A patient with negative HRCT requires complimentary RT-PCR and possibly follow up CT scans if symptoms persist before treating for COVID 19.
Bolstering the willingness to uptake covid-19 vaccination through multidisciplinary health communication intervention: a cue for reaching herd immunity in Nigeria
Authors: Ndidi C Ibenyenwa , Ogechi K Onyekwere , Ndubuisi F Ugwu , Adijat B Adams , Philip I Ajewole , Veronica I Makinde , Blessing N Onyekachi , Anselm U Anibueze , J K Opele , Onyemaechi F Nwogu
Published: April 2024

Background: The prevailing unwillingness to accept COVID-19 vaccination among the eligible population has been a serious setback in Nigeria’s bid to reach herd immunity against the pandemic.Objective: We assessed the impact of a multidisciplinary health communication intervention (MHCI) on willingness to accept COVID-19 vaccination among eligible unvaccinated community dwellers (EUCD) in Nsukka Urban, Enugu State, Nigeria.Methods: Through a quasi-experiment that adopted a pre-test, post-test, non-control group design, we studied a total of 85 eligibleunvaccinated adults. A researcher-designed "Willingness to Accept COVID-19 Vaccination Questionnaire" was the instrument used for data collection. The data gathered was analysed by means of Statistical Package for Social Sciences (SPSS) version 23.0. Specifically, descriptive and inferential statistics were used to test the formulated research questions and the hypothesis at 0.05 level of significance.Results: We found that the mean scores of willingness to accept COVID-19 vaccination increased significantly after the treatment.There was no significant interaction effect of gender, level of education, and age on the mean of willingness to accept COVID-19 vaccination scores of EUCD after MHCI.Conclusion: The study established that MHCI is impactful in bolstering the willingness to accept COVID-19 vaccination. The Nigerian government should adopt and implement this intervention in schools, communities, and other institutions in order to attain herd immunity in Nigeria.
Patients’ perceived quality of the care provided during the management of HIV/AIDS in a tertiary care setting in Nigeria
Authors: Unyime Israel Eshiet , Chikosolu Njoku , Chidinma Wogu
Published: April 2024

Background: The provision of patient-centred care by clinicians is believed to improve patient satisfaction with care as well as the outcome of treatment.Objective: To assess the quality of personalized care provided to people living with HIV/AIDS in a typical Nigerian health care setting and its association with patients’ knowledge and attitude towards HIV/AIDS and patients’ knowledge and attitude towards antiretroviral therapy.Methods: The study was a cross sectional study carried out in the HIV/AIDS clinic of the University of Uyo Teaching Hospital, Nigeria. Data on the demographic and clinical details of the patients were obtained from patients’ case notes using a suitably designed, pre-piloted data collection instrument. Furthermore, data on the quality of patient-centred care, patients’ knowledge and attitude towards HIV/AIDS, and patients’ knowledge and attitude towards antiretroviral therapy was obtained using ‘Patient Assessment of Quality of Individualized care for Chronic Illness Scale’, ‘Patient knowledge and attitude towards HIV/AIDS questionnaire; and ‘Patient knowledge and attitude towards antiretroviral therapy questionnaire’, respectively.Quantitative data were analysed using Statistical Program and Service Solutions (SPSS) version 25.0 computer package. Descriptivestatistics were used to summarize data, while inferential statistics were used where applicable with statistical significance set at p<0.05.Results: The overall mean patients’ satisfaction with individualized care score was 3.54 (SD = ±0.86; Max. = 5). The mean scores of the patients’ knowledge and attitude towards HIV/AIDS were 6.80 (SD = ± 1.079; Max. = 8) and 5.5 (SD = ± 0.924; Max. = 7) respectively, while the mean scores of the patients’ knowledge and attitude toward antiretroviral therapy were 5.7 (SD = ± 1.103; Max. = 10) and 4.2 (SD = ± 0.874; Max. = 6). Multivariate linear regression revealed that the quality of patient centred care was a predictor of knowledge and attitude towards antiretroviral therapy (B=0.511; CI = 95%, p = 0.024).Conclusion: The quality of patient-centred care provided to persons living with HIV/AIDS in the facility is satisfactory. Patients perceived quality of care appear to be a predictor of knowledge and attitude towards antiretroviral therapy.
Platelet indices in children with type 1 diabetes mellitus: a simple glucoregulation monitoring tool
Authors: Dejan Dobrijević , Jelena Antić , Goran Rakić , Ljiljana Andrijević
Published: April 2024

Introduction: Long-term hyperglycemia can lead to changes in the function and morphology of platelets.Objective: This study aimed to test the potential glucoregulation monitoring properties of platelet indices, mean platelet volume (MPV) and platelet distribution width (PDW), in children with type 1 diabetes mellitus (T1DM).Methods: The study included 453 patients below the age of 18 with T1DM treated at the Institute for Child and Youth Health Care of Vojvodina. Children were divided into two groups, according to their glucoregulation quality, i.e., glycated hemoglobin (HbA1c) levels. Descriptive and inferential statistical analyses were performed.Results: MPV and PDW were found to be important in predicting poor glucoregulation, both in independent and conjoint analysis. Proposed cut-off values for MPV and PDW in the glucose control monitoring of children with T1DM were 7.6 fL and 14.4%, respectively.Conclusion: Our study showed that MPV and PDW have monitoring properties in terms of glucose control in children with T1DM. Additionally, our study emphasizes the importance of selecting the most convenient control group in order to avoid misleading conclusions.
Maxillofacial trauma and cerebrospinal fluid leak: a retrospective clinical study
Authors: Charles E Anyanechi , Birch D Saheeb
Published: April 2024

Objectives: To determine the prevalence of maxillofacial fractures associated with persistent CSF leak, and to assess its bearing on clinical outcomes of consecutive patients managed at our centre.Methods: This was a retrospective cross-sectional study. The medical records of patients over 11-year period were analysed for age, gender, etiology of injuries, duration between injury and presentation to the hospital, types of facial fracture and their treatments, treatment done to control CSF leak, and complication(s). Descriptive and bivariate statistics were computed.Results: Overall, 1473 patients were evaluated, 66 (4.5%) presented with craniofacial injuries associated with persistent CSF leak after 5 days of non-surgical treatment. Males (92.5%, P= 0.0000) and those in the 21 to 30 years age group (59.1 %, P= 0.01) were predominant. The most common (68.2%) type of fracture combination was Le Fort I, II and III, NOE, zygomatic complex and mandible. The commonest clinical presentation of CSF leak was rhinorrhea only, in 66.7% of patients (P= 0.001).Conclusions: This study shows that the prevalence of maxillofacial fractures associated with persistent CSF leak was low, which was 4.5% of patients that presented with persistent CSF leak and 84.9% of the cases resolved after treatment of the various maxillofacial fractures.
Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes and its acceptability in a multicultural setting. A narrative review
Authors: Grace Muzanyi , Muhammad Ntale , Robert Salata , Moses Joloba , Jackson Mukonzo , David K Mafigiri , Paul Mubiri , Godfrey Bbosa
Published: April 2024

Background: Accumulation of chemicals including drugs in hair has been used in forensic investigations. Studies have reported isoniazid drug levels in the hair of TB patients.Objective: To review literature for evidence on isoniazid hair drug levels as a tool to monitor adherence, exposure, and TB treatment outcomes and the acceptability of using human hair for medical testing.Methods: We reviewed literature through Pubmed, Embase, Medline, google scholar, and google grey literature. The search terms focused on isoniazid/TB hair drug levels, adherence, treatment outcomes, and acceptability of using hair for medical testing. We kept refining our search terms at each step of our search.Results: The initial search yielded 186859 articles, which dropped to 88 after removing duplicates and irrelevant articles and eventually to 14 on further refining our search terms. On full review,2 out of 14 and 1 out of 14 articles touched the area of Isoniazid hair drug levels; adherence, exposure, TB treatment outcomes, and acceptability respectively. Further scrutiny showed that none of the articles had addressed our research question.Conclusion: Literature on Isoniazid hair drug levels among TB patients as a tool to monitor adherence, exposure, and TB treatment outcomes, and its acceptability is limited and more research is needed.
Risk factors for infertility and barriers to treatment in Tanzania: a survey and medical records study
Authors: Emily A Groene , Cyrialis Mutabuzi , Dickson Chinunje , Ester Shango , Mkhoi L Mkhoi , Susan M Mason , Shalini Kulasingam , Charles R Majinge
Published: April 2024

Background: The burden of infertility is serious for women in high-fertility countries.Objectives: We sought to identify demographic, behavioral/environmental, and reproductive risk factors for various infertility factors (i.e., ovarian, tubal, uterine/cervical, male/other) among women seeking infertility treatment in central Tanzania; to determine the association between pelvic inflammatory disease (PID) and tubal factor infertility (TFI); and to identify barriers to infertility treatment by women’s home regional zone.Methods: We conducted a cross-sectional survey of women seeking infertility treatment in Dodoma, Tanzania from January-March 2020. We surveyed 168 participants aged 18-49 years and reviewed their medical records to confirm infertility status and potential risk factors. We estimated prevalence ratios for factors associated with infertility using logistic regression. Treatment barriers were compared by women’s regional zone to see if barriers varied geographically.Results: The median age of participants was 32 years (range: 18-48). Infertility factors did not vary greatly by patient demographics, behavioral/environmental, or reproductive risk factors. Approximately 31.48% of women had PID diagnoses. Those with PID had 1.94 (95% CI: 1.30, 2.90) times the prevalence of TFI diagnosis as those with other infertility factors, after adjusting for age, pesticide use, alcohol use, age at sexual debut, prior obstetric events, and family history of infertility. Logistical barriers to treatment, such as time and cost, were more frequently reported than emotional, stigma, or other barriers, regardless of regional zone.Conclusions: PID was strongly associated with TFI after adjustment for confounders. Infertility treatment access due to cost remains a challenge in Tanzania.
The reliability and validity of the isixhosa version of the euroqol toddler and infant populations (EQ-TIPS) health related quality of life instrument
Authors: Janine Verstraete , Razia Amien
Published: April 2024

Background: Considering the high burden of disease in young children measurement of Health-Related Quality of Life is needed to evaluate the burden of morbidity. This study aims to report on the validity and reliability of the isiXhosa EuroQol Toddler and Infant Populations (EQ-TIPS) measure for South Africa.Methods: A sample of 181 caregivers of children 0-36 months were recruited from a hospital in-patient (inpt) and outpatient (outpt) facility and crèches. The EQ-TIPS, Ages and Stages Questionnaire (ASQ), Faces, Leg, Activity, Cry, Consolability (FLACC) and dietary information were administered at baseline. EQ-TIPS was administered one week later in crèche children for test-retest reliability.Results: Known groups showed significant differences for pain (X2=37.21, p<0.001), and EQ-TIPS level sum score (KWH=25.9, p<0.001) between health groups. The Visual Analogue Scale was unable to discriminate general health between groups (KW-H=3.92, p=0.141). Concurrent validity was weak to moderate and significant for all dimensions hypothesised to correlate. There was significant fair to moderate test-retest reliability for EQ-TIPS dimensions of movement, play, pain and eating.Conclusion: The isiXhosa EQ-TIPS is valid and reliable for very young children in South Africa and we suggest that it be included in the assessment of children with health conditions within this context.
Clinical characteristics and variables associated with COVID-19 morbidity and mortality in Luanda, Angola, in the first year of the pandemic
Authors: Margarete LT Arrais , Welwitschia A F Dias , Maura P A Silva , Luquenia E S Neto , Naiol M F Pedro , Sónia F. I Jungo , Avelina R. C Miguel , Elsa M. V Fortes-Gabriel , Cruz S Sebastião , Jorge M. R Gama , Miguel D Brito
Published: April 2024

Background: The impact of SARS-CoV-2 infection in Africa is still unclear. In comparison to Europe and North America, morbidity and death rates are lower. Several factors have been proposed, including geographical variation in virus impact, environmental factors, differences in age distribution, and the impact of infectious diseases such as malaria, HIV infection and tuberculosis.Objectives: We investigated the clinical characteristics and putative determinants linked with COVID-19 in Angolan patients.Methods: Cross-sectional study undertaken at Military Hospital, Luanda, from March 2020 to March 2021. The survey collected sociodemographic and clinical information.Results: The sample included 1,683 patients aged ≥18 years, 64% men, with mean age of 46.3 years. SARS-CoV-2 was positive in 39% of the cases with RT-PCR. Patients ≥46 years with a level of education of ≥12 years had a considerably higher likelihood of testing positive. About 58% of positive patients had at least one comorbidity, of which hypertension and Diabetes were associated with SARS-CoV-2 infection. HIV and pulmonary TB were putative protective factors. About 14% of positive patients died. Most deaths occurred in patients ≥46 years, with less education and unemployed. Working as a healthcare practitioner was linked to a protective effect. Malignant diseases were the most common comorbidities associated with death.Conclusions: We identified putative factors related to SARS-CoV-2 infection and mortality. HIV and TB were protective and not associated with mortality. Further study with a broader scope should be conducted to explain the main features related to COVID-19 mortality in Angola.
Effects of SNPs on TNF-α and IL-10 cytokine expression in TB and HIV patients in the Capricorn district, Limpopo Province, South Africa
Authors: A Manabile Mosebo , C Maguga-Phasha Tibello , E Makgatho Marema
Published: April 2024

Background: The impact of Tuberculosis (TB) places an immense burden on the health care system. Infection with HumanImmunodeficiency Virus (HIV) is a significant risk factor in the development and progression of TB disease. Single NucleotidePolymorphisms (SNPs) in the promoter region of Interleukin-10 (IL-10) and Tumour Necrotic Factor-Alpha (TNF-α) may playa major role in the disease mechanism and understanding these mechanisms might prove to be a useful diagnostic tool in evaluatingthe immune regulation and progression of the disease.

Objective: This study aimed to determine the relationship between cytokine levels and gene variants of Interleukin-10 and TumourNecrotic Factor Alpha in TB and HIV-infected participants.

Methods: Cytokine levels were determined by ELISA, and SNPs were determined by MassArray®.

Results: The levels of TNF-α were higher in the TB group than the HIV (p < 0.001) and TB-HIV (p = 0.011) groups, but similar to the TNF-α levels in the control group. In the HIV group, IL-10 levels were higher than those of the TB (p < 0.001) and control groups (p = 0.039), whereas there was no difference between the IL-10 levels in the HIV and the TB-HIV infection groups. The ratio was determined and there were no differences between the four infection groups. In this study, no associations were detected between the circulating plasma levels of TNF-α and IL-10 and their genotypes.

Conclusion: Our data showed that the gene variants were not associated with circulating plasma levels of TNF-α and IL-10 in our study population. A pro-inflammatory environment was found in the TB and TB-HIV groups, which is suggesting of bacterial clearance, while an anti-inflammatory environment was found in the HIV group, which suggests the suppression ofviral replication.

Keywords: Tuberculosis; Human immunodeficiency virus; interleukin-10.
Haematological parameter among drug resistant tuberculosis patients in Ibadan
Authors: Daniel Adewole Pelumi , Deborah Ogundipe Tosin , Samuel Alabi Olumuyiwa , Nuhu Abdulrazak
Published: April 2024

Background: Haematological abnormalities are common among tuberculosis patients but there is dearth of information on their value as prognostic markers in multidrug resistant tuberculosis patients. This study examined the association between complete blood count variables and drug resistant tuberculosis.

Materials and methods: Nighty (90) consenting adults comprising 30 Drug Resistant Tuberculosis patients (DR-TB), 30 Drug susceptible tuberculosis patients (DS-TB) and 30 healthy participants were recruited in this study. Ethical approval was obtained from Oyo State Ministry of Health Institutional Review Board while patients’ demographic data were collected using structured questionnaire. Five milliliters (5mL) of blood samples were collected in EDTA bottle. Haematological parameters were analysed using impedance technique and Mindary-BG5380 5-part automated system.

Result: The mean hemoglobin levels were significantly lower in DR-TB patients (11.70 ± 2.73 g/dL) than in DS-TB patients (8.33 ± 9.56 fL), with a mean difference of -3.37 ± 12.29 g/dL. The mean MCH and MCHC levels were also slightly lower in DR-TB patients (26.17 ± 3.44 pg and 30.41 ± 1.92 g/dL, respectively), but the differences were not statistically significant. The WBC count was similar in both groups (8.20 ± 3.80 × 10^9 /L and 8.45 ± 3.63 × 10^9 /L, respectively).

Conclusion: The mean hemoglobin levels were significantly lower in DR-TB patients than in DS-TB patients which may be due to the increased inflammation associated with DR-TB. The WBC count was similar in both groups, suggesting that the immune system is responding similarly to the infection in both DR-TB and DS-TB patients.Recommendation: In the meantime, healthcare providers should be aware of these potential differences and use them to inform their diagnosis and treatment of patients with tuberculosis.

Keywords: Haematological parameters; drug resistant tuberculosis; Ibadan.
Preconception and contraceptive care for women living with HIV/AIDS attending antiretroviral treatment clinics in Lagos State, Nigeria
Authors: Oyibo Samuel , Oghenewoke Atariata , O Balogun Mary , Maurice-Joel Ugbe Ugbe
Published: April 2024

Background: Women living with HIV/AIDS possess fertility desires similar to their uninfected counterparts, and with advances in health therapies, these women can realistically have and raise uninfected children. Preconception care (PC) is a specialized form of intervention aimed at the prevention, identification, treatment, and management of biomedical, behavioural, and social conditions that militate against safe motherhood and the delivery of healthy offspring.

Objective: The study aimed to assess preconception and contraceptive care among women living with HIV and attending Antiretroviral Therapy Clinics in Alimosho, Lagos State, Nigeria.

Methods: This was a descriptive facility-based cross-sectional study of 383 women of reproductive age living with HIV/AIDS and attending ART clinics in the study area. Probability sampling methods were used in the selection procedures. Data were analyzed using descriptive statistics, Chi-square test, and univariate logistic regression at a 5% level of significance. Stratified and simple random sampling were used in the selection process.

Results: Only 37.4% of respondents received optimal PC services. Being 20-29 years old [OR =1.716 (95% CI: 1.664, 1.769), p = 0.020], being 30-39 years [OR =1.514 (95% CI: 0.598, 3.831), p = 0.005], tertiary education [OR =8.43. (95% CI: 1.41, 18.5), p = 0.020], and being single [OR =2.00 (95% CI: 1.928-2.072), p = 0.002] were significantly related to the utilization of contraceptives.

Conclusion: There is a need to provide structure and guidelines for optimal streamlined PC and contraceptive services for women living with HIV/AIDS.

Keywords: Preconception care; contraceptive care; HIV/AIDS; women.
Clinicopathological study of otomycosis in a tertiary hospital in South-west Nigeria
Authors: A Sogebi Olusola , A Oyewole Emmanuel , A Osinupebi Olubunmi
Published: April 2024

Background: Otomycosis is common in environments with hot, humid weather, and it may be challenging to manage.

Objectives: To profile common clinical presentations, the pathogenic fungi, the treatment modalities with responses, and exploreclinical factors associated with having positive fungal culture in Otomycosis.

Methods: Retrospective review of patients with Otomycosis. Demographic and clinical parameters, otoscopic findings andmycological study results were recorded. The treatment modalities used and treatment response were summarized. Comparativestatistical analyses of associated factors to positive fungal culture were performed with Chi square test, and Student’s t-test, usingSPSS version 22.0

Results: Total of 71 patients with M: F=1:1.8, mean age 38.5±19.8 years. Average duration of symptoms was 5.4 ±4.6 weeks;common presenting complaint was itchy ear (33.8%). Majority of patients (85.9%) had unilateral ear involvement, 50.0% appliedototopic medications before presentation, 8.5% had multiple co-morbidities. 20 patients had positive fungal culture results; commonfungal isolate was Aspergillus niger 9 (45.0%).Clinical factors associated with positive culture of fungus were age, non-previous use of ototopic drugs, and presence ofco-morbidity. The most common treatment was local ear debridement and use of topical antifungal creams. Majority (91.5%)of the patients responded with resolution of fungal infection. Complications rate was 8.4%.

Conclusions: Otomycosis commonly present with itchy ears, the pathogenic fungi commonly being Aspergillus species. Thefactors associated with positive fungal culture were age, non-usage of ototopic agents and presence of co-morbidity. Treatmentmodality used was local debridement and topical antifungal agents, which produced favourable response in most patients.

Keywords: Otomycosis; mycology; presentations; treatment; complications; associations.
Legislative Power over Mineral Resources in the Ethiopian Federation: Legal and Practical Challenges
Authors: Yared Hailemariam
Published: April 2024

The assignment of legislative power over mineral resources is a highly contentious issue in federal constitutional design. This article aims to shed light on this issue by examining the assignment and exercise of legislative powers over mineral resources in the Ethiopian Federation. A qualitative research approach was used which included analysis of laws, examining documents and in-depth interviews. The legal framework, policy documents, and decisions of government officials relating to legislative authority over mineral resources were scrutinized. Furthermore, interviews were conducted with key stakeholders involved in the matter to gain an understanding of the actual challenges and difficulties associated with the exercise of this power. An integrated data analysis approach is used. According to the analysis, the Constitution of the Federal Democratic Republic of Ethiopia lacks clarity regarding legislative power over mineral resources. The study also reveals significant gaps in the institutional and legal frameworks governing the exercise of legislative power over mineral resources. These gaps have also resulted in the development of a legal framework that contradicts the principles laid out in the Constitution. The findings highlight the need to address the legal and practical challenges within the Ethiopian Federation.
Integer weighted goal programming model for a multi-product company: a case study in the Nigerian food industry
Authors: Okoroafor P. I. , Iwuji A. C.
Published: April 2024

Production planning is a complicated task that requires cooperation among multiple functional units in any organization. The management of production companies have several goals or target which they intend to achieve for their company. Henceforth, this research work presents a weighted Goal programming model for the production problem of a Nigerian food manufacturing company. The goals of the work include minimization of the underachievement of the profit goal, minimization of the underachievement of production target of the breads (burger, sardine, banana, hot dog roll, coconut, mixed fruit) and minimization of the overachievement of the machine production time. The data was collected from the production and sales department of the case company. The data included the quantity of each raw material (flour, sugar, salt, milk, nutmeg, water, butter, yeast, preserver, improver) used in producing one unit of each bread type (burger, sardine, banana, hot dog roll, coconut, mixed fruit), profit per unit of bread, time used in producing 1 unit of bread, quantity target of 1 unit of bread. The goals of this work are 8 goals which include profit goal, machine time goal, production goal of burger bread, sardine bread, banana bread, hot dog roll bread, coconut bread, mixed fruit bread. From the results obtained using LINGO optimization software, 6 goals out of 8 target goals were achieved. The achieved goals include production goal of burger, sardine, banana, hot dog roll, coconut, mixed fruit bread while the goals not achieved includes machine time goal and profit goal.