bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, Morbidity Pattern and Outcome of HIV Exposed Infants admitted into The Special Care Baby Unit of Rivers State University Teaching Hospital, Nigeria
Authors: Awoala Boma
Published: January 2025

Background: HIV/AIDS remains a major cause of morbidity and mortality in the paediatric age group including the neonatal age.
Materials and Methods: A prospective study carried out from January 5th 2021 to 4th December, 2023 in the neonatal unit of the Rivers State University Teaching Hospital.
Results: Of 1412 neonates admitted, 48 were HIV exposed with prevalence rate of 3.4%, M:F ratio of 1:1.2 and mean birth weight of 2.82 ± 0.93kg. Most mothers were >30years, 31(64.6%) with secondary level of education 28(58.3%). Majority commenced antenatal care in the 1st trimester 26(54.7%) and delivered via emergency Caesarean section 24(50.0%). Most maternal HIV status was known before index pregnancy 28(58.2%) and commenced HAART 29(67.4%). Most baby’s feeding option was exclusive breast feeding (75.0%) while mixed feeding was 6.3%. Nevirapine was given to 31(64.6%) infants and nevirapine/zidovudine to 17(35.4%). The commonest morbidities were probable neonatal sepsis 27(58.7%), hypoglycaemia 13(28.3%), neonatal jaundice 9(19.6%) and perinatal asphyxia 9(19.6%). There was mortality rate of 4.2% with HIV seropositivity rate at 6-8 weeks being 10.9%. Mothers’ level of education and occupation were significantly associated with HIV seropositivity rate (P=0.041, 0.049) whereas the pattern of morbidity had no significant association with the infants seropositivity rate.
Conclusion: The prevalence of HIV exposed infants admitted was 3.4% with M:F ratio of 1:1.2. The commonest morbidities were probable neonatal sepsis, hypoglycaemia, neonatal jaundice and perinatal asphyxia. There was a mortality rate of 4.2% with high infants seropositivity rate of 10.9%. This therefore calls for an intensification of the PMTCT program.

Keywords: HIV exposed infants; Prevalence; Morbidity; Outcome
Evaluation of Longevity and Performance of Various Dental Filling Materials
Authors: Alshehri Zeinah Ali , Azouz Fatma Abdulqader , Almutairi Adnan Turki , Al-Johani Mahmoud Hamed , Alanazi Riyadh Obied , Almakrami Ali Mohammed
Published: January 2025

Dental filling materials are critical components of restorative dentistry, serving to restore function, aesthetics, and structural integrity to teeth affected by decay or trauma. The longevity and performance of these materials depend on various factors, including their composition, mechanical properties, environmental exposure, and patientspecific variables. Amalgam, once the gold standard for restorations due to its durability and self-sealing properties, has seen a decline in use due to environmental and aesthetic concerns. Composite resins have gained popularity for their superior aesthetics and versatility, though their susceptibility to wear, polymerization shrinkage, and microleakage remains a challenge. The oral environment, with its fluctuating pH, temperature changes, and enzymatic activity, places significant stress on restorative materials. These factors can lead to chemical degradation, marginal breakdown, and reduced mechanical stability over time. Advanced materials like ceramics and bioactive composites show promise in addressing these challenges, offering enhanced resistance to wear and fracture while promoting biological interactions that support oral health. Patient-specific factors such as dietary habits, oral hygiene, parafunctional activities, and systemic conditions further influence restoration outcomes. Innovations in material science, coupled with individualized treatment approaches, are essential to improving the success rates of dental restorations. By understanding the interplay of material properties, environmental stressors, and patient factors, clinicians can make informed choices to optimize restorative outcomes and enhance long-term oral health.
Prevalence and Predictors of Burnout Among Healthcare Workers of Palliative Care Department in King Fahad Medical City, Riyadh, Saudi Arabia
Authors: AlKhalifah Ahmad Khalifah , Alsalman Reem Sulaiman , AlShehery Maied Zaher
Published: January 2025

Background: The need for providing palliative care is increasing worldwide because of the progression in life expectancy accompanied by advances in medical care and having many patients with incurable and advanced diseases. This is mostly accompanied by a stressful life for health workers, as they face daily tragedy and suffering; therefore, they are at higher risk for burnout. The current study was conducted to estimate the rate and associated factors of burnout and its dimensions among healthcare workers of the Palliative Care Department in King Fahad Medical City, Riyadh, Saudi Arabia. Methodology: This observational cross-sectional study was performed at the palliative care department in King Fahad Medical City, Riyadh, Saudi Arabia, among all healthcare workers. Data was collected using a pre-designed, valid selfadministrated questionnaire. It included two main sections: sociodemographic and work-related data and Maslach burnout inventory (MBI) to assess the overall burnout and its three subscales: emotional exhaustion (EE), depersonalization (DP), and personal accomplishment (PA). Results: The prevalence of high EE was 49.3%, whereas those of high DP and low PA were 62% and 63.4%, respectively. The overall prevalence of burnout among palliative care health workers was 23.9%. Multivariate logistic regression analysis revealed that divorced/widowed participants were at a significantly higher risk of burnout compared to singles, with adjusted odds ratio (AOR) =18.92; 95% confidence interval (CI) 2.63-136.14, p=0.004. Compared to participants with short annual vacations (≤4 weeks), those with long annual vacations (>4 weeks) were at lower risk for burnout (AOR=0.27; 95% CI: 0.08-0.84), p=0.024. Conclusion: Burnout is a prevalent problem among healthcare workers working in palliative care in Riyadh, with no difference between physicians, nurses, and other workers. Decision makers should take care of the working environment of this category of healthcare, particularly their annual vacation length, and specific attention should be given to divorced/widowed workers to reduce the burden of burnout among them.
The Role of Photobiomodulation in Postoperative Recovery of Facial Procedures
Authors: Al-Thobaiti Yasser Eid , Batwa Mohammed Abdullah , Alghawi Jinan Abdullah , Aljamaan Rodina Fahad , Alkhowaiter Fawaz Abdulrahman , Alhejaili Manar Abdulaziz , Alshammari Shouq Zaid
Published: January 2025

Photobiomodulation (PBM) therapy has gained significant attention as a non-invasive modality for enhancing postoperative recovery, particularly in facial procedures. PBM utilizes light at specific wavelengths to interact with mitochondrial chromophores, promoting cellular repair, reducing inflammation, and alleviating pain. The therapy’s mechanisms involve stimulating adenosine triphosphate (ATP) production, modulating reactive oxygen species (ROS), and regulating cytokine activity, leading to improved wound healing and tissue regeneration. By enhancing angiogenesis and lymphatic drainage, PBM effectively addresses common postoperative challenges such as edema and bruising, particularly relevant for facial surgeries where cosmetic outcomes are critical. Applications of PBM extend across a spectrum of facial procedures, including cosmetic surgeries, maxillofacial reconstructions, and minimally invasive treatments such as laser resurfacing. It reduces pain by modulating nociceptive pathways and promoting the release of endogenous opioids, while its anti-inflammatory effects minimize swelling and expedite recovery. PBM also enhances scar quality by stimulating fibroblast activity and promoting balanced collagen synthesis, preventing the formation of hypertrophic scars. Comparative studies across procedures highlight PBM’s adaptability, with tailored dosages optimizing outcomes based on tissue depth and procedural complexity. Evidence supports its role in reducing recovery times, improving aesthetic results, and enhancing patient satisfaction. Despite its potential, variations in treatment protocols emphasize the need for standardized guidelines to maximize its clinical utility. PBM offers a promising adjunctive approach to postoperative care, contributing to improved outcomes across diverse facial interventions.
Advances in Craniofacial Reconstruction: The Role of Augmented Reality
Authors: Al-Thobaiti Yasser Eid , Al-jery Sultan Hamad , Alrayes Zakher Eid , Aljeaid Dania Hamoud , Alzaydan Hamad Ibrahim
Published: January 2025

Advancements in augmented reality (AR) are transforming craniofacial reconstruction by enhancing precision, improving planning, and optimizing outcomes. AR integrates three-dimensional imaging with real-time overlays, allowing surgeons to visualize and interact with patient-specific anatomy during every phase of the surgical process. Preoperative planning benefits from AR’s ability to generate dynamic simulations of procedures, enabling surgeons to anticipate challenges and refine techniques. Virtual models derived from imaging modalities such as CT and MRI are used to assess bone alignment, symmetry, and graft positioning with remarkable accuracy. Collaborative planning becomes seamless as multidisciplinary teams interact with the same virtual models, improving communication and decision-making. Intraoperatively, AR provides real-time guidance through overlays projected onto the surgical site. This technology facilitates precise osteotomies, graft placements, and soft tissue manipulation while preserving vital structures such as nerves and blood vessels. Head-mounted displays and markerless tracking systems enhance usability, enabling surgeons to maintain focus on the operative field. AR’s integration with robotic systems further improves precision, particularly in minimally invasive procedures where access to deep anatomical structures is limited. Postoperative assessment leverages AR for detailed comparisons between preoperative plans and surgical outcomes. Healing progress, such as bone remodeling and graft integration, can be tracked dynamically, offering insights into recovery. AR-based telemedicine platforms also enable remote monitoring, reducing the need for frequent in-person follow-ups while maintaining consistent care. Despite challenges related to cost and accessibility, AR’s transformative impact on craniofacial reconstruction is undeniable. Its ability to enhance visualization, streamline workflows, and improve patient outcomes highlights its potential to redefine surgical standards. As technology continues to evolve, AR is set to become an indispensable tool in advancing the precision and effectiveness of craniofacial surgery.
Indications, Clinical Success and Failure Rate of All-Ceramic Restorations
Authors: Khatib Summer Farouk , Alqahtani Abdulrahman Mesfir , Attaf Saud Saad , Alzaid Salman Youssef , Alshehri Faisal Mahmoud , Alshammari Naif Fahhad , Almakhloti Essa Ali
Published: January 2025

All-ceramic restorations have become a cornerstone in modern restorative dentistry, offering exceptional aesthetics, biocompatibility, and durability. Their ability to mimic natural enamel and their wide range of applications, from veneers to full crowns, make them an ideal choice for both anterior and posterior teeth. Advances in material science, particularly the development of lithium disilicate and zirconia ceramics, have expanded their indications to include cases requiring both aesthetic and functional performance. Critical factors such as tooth preparation design, adhesive protocols, and material-specific properties influence their clinical success. Despite their advantages, all-ceramic restorations face challenges, including material-specific failures, biomechanical stresses, and patient-related factors. Veneered zirconia restorations, for example, are prone to chipping, while improper bonding techniques can lead to debonding, secondary caries, or microleakage. Functional failures, often linked to occlusal overloading or parafunctional habits, highlight the importance of meticulous occlusal planning and appropriate case selection. Patientspecific considerations, such as oral hygiene and habits, significantly impact the longevity of restorations, emphasizing the need for regular maintenance and follow-ups. Technological advancements, including CAD/CAM systems and monolithic ceramic designs, have enhanced the precision and reliability of all-ceramic restorations, reducing complications associated with traditional fabrication methods. However, the success of these restorations continues to rely heavily on the clinician’s expertise and adherence to evidence-based practices. While innovations have addressed many limitations, continued research is essential to improve their durability and adapt them to the evolving demands of restorative dentistry. With proper case selection and attention to detail, all-ceramic restorations remain a reliable and aesthetically pleasing option for long-term dental rehabilitation.
The Ethics of Telemedicine Patient Care and Professional Responsibilities
Authors: Alsalim Suliman Ibrahim , Aljarallah Saleh Salem , Thabit Razan Khalid , Alrebh Hind Hussain , Almutairi Sarah Waslallah , Melaisi Zakaria Ibrahim
Published: January 2025

Telemedicine has significantly transformed healthcare delivery, allowing patients and providers to connect remotely and ensuring continuity of care, especially in remote and underserved areas. Despite its advantages, telemedicine introduces complex ethical challenges requiring thorough consideration. A primary concern is confidentiality and privacy, as patient data transmitted through digital platforms is vulnerable to breaches. Inconsistent security protocols across platforms and variations in regulatory oversight amplify the risk of unauthorized access to sensitive information. Providers and systems must adopt stringent safeguards, including encryption and compliance with data protection laws, to ensure patient trust. Equity in telemedicine access is another critical issue, as the digital divide disproportionately affects rural and economically disadvantaged populations. Limited internet access, lack of technological devices, and varying levels of digital literacy hinder the equitable adoption of telemedicine. Cultural and linguistic barriers further exacerbate disparities, creating additional challenges in diverse communities. Addressing these inequities requires systemic investment in infrastructure, education, and culturally tailored solutions to bridge existing gaps. The evolution of telemedicine also challenges traditional professional boundaries and responsibilities. Remote consultations demand adaptation to maintain the quality of care, including clear communication about the limitations of virtual assessments and the development of protocols for managing emergencies. Cross-border consultations further complicate ethical and legal responsibilities due to jurisdictional variations in regulations. Providers must navigate these complexities while adhering to principles of beneficence, nonmaleficence, and patient autonomy. By addressing these challenges, telemedicine can fulfill its potential to revolutionize healthcare delivery ethically and effectively.
Ethics of Organ Donation and Transplant Allocation Policies
Authors: Alnaim Malak Meshary , Alqahtani Manar Ali , Alsultan Nada Fahad , Alruwaithi Ziad Abdulmoti , Alhazmi Hatim Khalid , Alalwani Mohammed Anwar
Published: January 2025

Organ donation and transplantation have transformed modern medicine by offering life-saving solutions for patients with end-stage organ failure. Despite these advances, a significant gap persists between organ demand and availability, raising complex ethical challenges. Central to these challenges are principles of autonomy, altruism, and informed consent, which guide the decision-making process in organ donation. While presumed consent policies aim to address shortages, they have sparked debates regarding respect for individual autonomy and cultural differences. Similarly, incentivized donation programs, although promising, pose ethical dilemmas around coercion and exploitation. In transplant allocation, the balance between equity and utility remains contentious. Allocation systems strive to provide fair access while maximizing the overall benefit by prioritizing patients likely to achieve favorable outcomes. However, socioeconomic and geographic disparities often result in inequitable access to transplantation, disproportionately affecting vulnerable populations. Broader sharing policies and tailored scoring systems have been introduced to mitigate these disparities, but challenges in their implementation persist. Cultural and socioeconomic factors further influence ethical decision-making, impacting public perceptions of organ donation and the ability to provide informed consent. Cultural beliefs, language barriers, and socioeconomic inequities hinder donation rates and exacerbate disparities in access to transplantation. Educational campaigns and policy reforms that address these barriers are crucial for fostering trust and promoting equitable practices. Advancements in medical science, such as xenotransplantation and bioprinting, offer potential solutions to alleviate organ shortages but introduce additional ethical challenges. These include concerns related to safety, equitable access, and the risk of exacerbating existing disparities. A holistic approach to organ donation and allocation should incorporate ethical principles, acknowledge cultural differences, and address systemic inequalities. Such efforts are essential to ensuring that organ transplantation evolves in a manner that is both fair and sustainable.
The Role of Caregivers in Ethical Decision-Making for Palliative Care
Authors: Alrajeh Hanan Khalil , Alshammari Faisal Dubayyan , Alenazi Mansour Menwi , Alanazi Hamad Qutaysh , Alghamdi Mohammed Ahmed , Abdulmajeed Alafghani SaifAlislam
Published: January 2025

Caregivers play a pivotal role in the ethical decision-making process for patients receiving palliative care, particularly when patients can no longer articulate their preferences. This process is complex, influenced by emotional, cultural, and religious factors, especially in Muslim societies, where life is regarded as sacred and medical decisions must align with ethical and spiritual principles. Challenges arise in interpreting patient autonomy, balancing quality of life against aggressive treatments, and addressing caregiver emotions. Decisions such as Do Not Resuscitate (DNR) orders or withholding futile interventions are often fraught with moral distress, as caregivers navigate the tension between prolonging life and minimizing suffering. Empathetic and culturally sensitive communication by healthcare providers is essential to guide caregivers through these dilemmas. Transparent discussions about the implications of aggressive interventions versus palliative care can help families understand the benefits of prioritizing comfort and dignity. Collaborative approaches, such as shared decision-making frameworks, involve caregivers in care planning, ensuring their input aligns with the patient’s values and reduces decisional conflict. Facilitated family meetings and structured communication further support caregivers in making informed choices, fostering trust and easing the emotional burden. The integration of caregiver perspectives enhances palliative care outcomes by preserving the patient’s dignity and fostering meaningful family connections during the end-of-life period. Addressing cultural and spiritual considerations reinforces the importance of aligning medical care with ethical values, particularly in contexts where practices such as euthanasia are not permissible. This approach underscores the need for a balance between medical realities and the emotional and spiritual needs of both patients and caregivers. By adopting compassionate, patient-centered strategies, healthcare providers can ensure that end-of-life care reflects a holistic understanding of patient and family needs, fostering peace and dignity during life’s final moments.
Interspecies Mapping and Timing
Authors: Van Schendel Willem
Published: January 2025

This article argues for an interspecies methodology to challenge the human-derived spatial and temporal constructs that underpin most historical narratives. It also seeks to qualify the entrenched dichotomy between wildness and domestication.
To this end, I focus on the interaction between humans and “mithuns” (Bos frontalis), bulky bovines endemic in the mountain forests of the eastern Himalayas. In this large region—covering parts of India, Myanmar, Bangladesh, Bhutan, and China—numerous societies attuned their cultural sensibilities and cosmological assumptions to the same animal. This remarkable feat of cultural convergence attests to the unwitting power that a semi-wild bovine exerted over generations of humans—a fact that environmental historians can incorporate into their analyses of interspecies agency.
The significance of mithuns to humans had nothing to do with their livestock potential. They were sacred animals that humans needed to communicate with supernatural forces. The form that this communication took was ceremonial sacrifice. During the twentieth century, however, mithun–human relationships morphed into a new sacrality of place, ethnic identity, regional belonging, and political resistance. This transformation suggests the need for an “interspecies periodization” that takes human-nonhuman temporalities seriously.
As most of these societies historically did not use script, written evidence is not plentiful. Therefore, Indigenous forms of knowledge production about the environmental past—embedded in songs, stories, dances, rituals, material remains, dress, and sculptural art—are of paramount importance. These shaped human behaviour towards mithuns in the past, and they continue to do so today.
Porcine Paradox
Authors: Crannell-Ash Marissa
Published: January 2025

Review of:
Dolly Jørgensen, The Medieval Pig. Nature and Environment in the Middle Ages 9. Woodbridge: Boydell Press, 2024. xii + 117 pp. 26 b/w illus. £$19.99 (paperback).
Ghost, Dirge and the Forest Dance in Soyinka’s Metaphysical Play “A Dance of the Forests”
Authors: Pei Mengjie
Published: January 2025

A Dance of the Forests is a metaphysical play that integrates Yoruba ghost-summoning ritual, dirge, and forest dance into its textual creation. This integration transcends the opposition between the living and the dead, facilitating a reenactment of history and a critique of historical injustice. Although considered an obscure play, Soyinka’s A Dance of the Forests is rooted in Nigerian reality, conveying the author’s realistic concern of re-occurrence of historical injustice and the fate of Nigeria in post-independent days.
Water and Sediment Quality Assessment, and Effect on Arthropod Species Diversity of Jaja Creek and Adjoining Downstream Section of the Imo River, South-South, Nigeria
Authors: A. U. Akpan, , O. M. Ukpai, , C. N. Ehisianya, , I. K. Esenowo, , M. U. Effiong, , O. O. Okore, , D. E. Oboho, , I. E. Eduok, , U. B. Essien,
Published: January 2025

This study assessed the water and sediment quality and effect on the diversity of arthropod species of Jaja creek and adjoining downstream section of Imo river. Three (3) sampling sites each were marked out along the stretch of the Jaja creek and adjoining Imo river, plus control sampling site. Collections of samples, water, sediment and arthropods were carried out in the seven (7) sampling sites, observing standard procedures. The collected water and sediment samples were fixed with 1:1 nitric acid for the measurement of inorganic loads and heavy metals in the laboratory. Collections of arthropod fauna were done across the seven sampling sites and they were stored in 70% ethyl alcohol until identification and counting. Single factor pollution index (SFpi) and Nemerow’s pollution index (PN) were calculated to assess the water and sediment quality. The Nemerow’s pollution index of sulphate, nitrate, phosphate, iron, manganese, zinc, and copper revealed that the water and sediment was polluted. Fifty (50) different arthropod species were identified and grouped into three classes of Crustaceans, Insecta, and Arachnida, with nine orders and 23 families. The diversity indices and Pearson correlation results revealed that the water and sediment quality affected the arthropod species diversity. A strong conservation plan should be established for the preservation of the water bodies' and the aquatic arthropod species.
Understanding and Minimizing Perimeter Losses of Silicon-Based Monolithic Tandem Solar Cells – A Simulation Study
Authors: Fell Andreas , Bivour Martin , Hanser Mario , Schubert Martin
Published: January 2025

The vast majority of monolithic perovskite-silicon-based tandem cells to date is manufactured in R&D environments using small scale perovskite top cells (~1-4 cm²), typically placed on a larger silicon bottom cell. The high perimeter-to-area ratio leads to significant perimeter losses, which limit the maximum achievable efficiency and complicates loss analysis for further design optimization. An understanding of perimeter loss mechanisms and design rules for their minimization is therefore important for effectively progressing high efficient tandem solar cells in R&D. In this work we perform a 3D device simulation study of perimeter losses in an exemplary perovskite-silicon tandem solar cell. The impact of structuring the various laterally conducting layers, i.e. at the front and rear side as well as between the sub cells, on the perimeter efficiency loss is systematically investigated. We thereby identify the fundamental mechanisms of carrier transport into the perimeter, and clarify the impact of the silicon and perovskite absorber, the various laterally conducting layers, as well the electrical connection of the sub cells. We find that in each sub cell at least one carrier type must be hindered to be conducted into the perimeter. This is however complicated by the fact that this parasitic lateral transport can also be provided by “bordering” conductive layers connected via the tunnelling or recombination junction. Promising structuring variants and general design rules to achieve low perimeter losses with low structuring effort are then derived from the results. The losses are quantified to range from ~0.2 – 4%abs for a 1 cm2 top cell size, with the lowest values representing an unavoidable loss from the Si wafer conductance which is present also in champion cells with high structuring effort.
Advancements in Cancer Biology: Implications for Dentistry
Authors: Pandey Ashish , Tomar Gunjan , Kumari Nidhi , Ubale Pradnya , Jain Shrey
Published: January 2025

Cancer biology has undergone significant advancements, enhancing our understanding of tumor development, progression, and metastasis. These insights have profound implications for various medical fields, including dentistry. This article provides a comprehensive overview of recent developments in cancer biology, emphasizing their relevance to dental practice. We discuss the molecular mechanisms of cancer, the role of the tumor microenvironment, and the latest therapeutic strategies. Additionally, we explore the intersection of oncology and dentistry, highlighting the importance of dental care in cancer patients and the potential impact of cancer therapies on oral health.
Urgensi Insya’ dalam Meningkatkan Maharatul Kitabah
Authors: Ismail Abi , Isyanto Nur , Ikhwan Subaiki
Published: January 2025

Researchers found from several papers that the majority of students are students who are not graduates from Islamic boarding schools, so they have difficulty writing Arabic when teachers dictate the material. This difficulty is caused by the inability of students to write Arabic letters properly and correctly, which is caused by a lack of recognition of Arabic letters from the beginning, lack of practice, and low ability and willingness to learn Arabic, especially in Kitabah (writing) skills. This study aims to examine the urgency of Insya' in improving Maharatul Kitabah of PBA STAI Nurul Iman students. Data collection was carried out through observation techniques, in-depth interviews, and documentation. Data analysis uses Miles and Huberman's interactive analysis method, which includes data reduction, data presentation, and conclusion drawn. The methods applied in Insya' learning to improve Maharatul Kitabah include Thariqat Al-Ibtidaiyyah to start, Thariqat Al-Thattawwur to develop, Thariqat Al-Istiqrai to pour out the main ideas, and the Recording Method. Factors supporting Insya's urgency include: brilliant ideas, new innovations, writing discipline, and the habit of repeating (Muraja'ah). On the other hand, inhibiting factors include: laziness to look for new ideas and innovations, laziness to write, and lack of discipline in writing. The results of the study show that the urgency of Insya' is an important method to increase Maharatul Kitabah. In the Insya' method, students are taught about the rules of Arabic and how to structure sentences according to these rules. In addition, this method not only improves writing skills, but also encourages students to pour their thoughts, ideas, and innovations into writing essays in Arabic. This research still has limitations and needs further development. It is hoped that the results of this research can be a source of insight for readers in improving the quality of learning in their respective schools. Constructive criticism and suggestions from various parties are highly expected to improve this research.
Keywords: Urgency Insya, Maharatul Kitabah, PBA Students
Households’ Decision to Join an Informal Financial Sector Social Group: Evidence from Kenya
Authors: Agesa Jacqueline , Agesa Richard U.
Published: January 2025

Informal financial market social groups in sub-Saharan Africa (SSA) play a vital role in providing savings opportunities for households. Popularly known as Chamas, informal sector social groups in Kenya are of three types: merry-go-round, welfare, and savings and investment groups. Each type is distinguishable by its framework of operation. The current analysis examines demographic, religious, and geographic factors that determine household membership into each type of Chama. Consistent with past research, households with a matriarch disproportionately join Chamas. Additionally, the authors find that matriarch-centered households have significantly greater preference for merry-go-round and welfare Chamas. Households in North Nyanza, South Nyanza, and Eastern and Western regions—all regions dominated by small-scale, agricultural farming—have the greatest propensity to join merry-go-round Chamas. By contrast, households in Eastern parts of the country are more likely to join welfare Chamas while households in arid and semiarid areas of Northern and North Eastern Kenya are unlikely to join any type of Chama. These findings provide new insights into geographic factors that influence households’ utilization of different types of Chama social groups.
The Effect of Weather Shocks on Women’s Labor Supply and the Income of Women-Headed Households in Lesotho
Authors: Moshoeshoe Ramaele , Nchake Mamello A. , Tiberti Luca
Published: January 2025

This study examines the effect of weather shocks on labor supply decisions and income for rural farming households in Lesotho, disaggregated by the gender of individuals and household heads. Using the Lesotho Agricultural Survey data merged with the Standardized Precipitation Evapotranspiration Index (SPEI), the study applies multinomial logit and linear fixed effects (FE) models, along with the Heckman selection model, to analyze the effects of weather shocks on labor choices and household income. Upon controlling for time and community FE, the identification relies on the randomness of weather shocks. This article finds that women are more vulnerable than men to weather shocks, as they are likely to have more limited coping strategies. Drought increases the probability of men choosing to farm, supposedly because they are mostly engaged in relatively shock-resistant agricultural activities, but it does not affect labor supply choices for women. These findings have various policy implications: enhancing women’s access to shock-resistant agricultural practices, promoting climate-smart technologies like irrigation systems and improved seeds to reduce vulnerabilities in women-dominated sectors, and implementing short-term, shock-responsive public assistance programs to support households, especially women, during extreme weather events.
An “Abode of Discipline and Misery”: Wheelbarrow Men, Reformers, and the Penitentiary in Early National Philadelphia
Authors: Nash Jonathan
Published: January 2025

This article explores the role of the “wheelbarrow men” in the evolution of Pennsylvania’s legal system. These men, sentenced under the 1786 “wheelbarrow law” to public labor, became living symbols of the law’s failure as they publicly defied and mocked their punishment. Their acts of resistance spurred a societal and legislative shift, questioning the efficacy of public punishment and igniting debates on criminal reform. The article argues that the wheelbarrow men’s challenges to authority were instrumental in the development of the Walnut Street Prison and later, the Eastern State Penitentiary. By centering the wheelbarrow men’s actions, the article demonstrates how legal practices shifted not just through top-down legislative changes but also through the contentious interactions between law, society, and the individuals subjected to punishment. The article reshapes our understanding of early American criminal justice, highlighting the complex interplay between legal theory and the lived realities of punishment.
Pregnancy Loss Was Associated With the Increased Risk of Cardiovascular Diseases in Middle-Aged Women: Evidence From the China Health and Retirement Longitudinal Study
Authors: Yang Xiaoyan , Fan Qingling , Shen Can , Hou Ruirui , Chen Ruoling , Yin Jiaqian , Xiang Huifeng , Cao Yunxia , Peng Xiaoqing
Published: January 2025

Objectives: Significant associations between pregnancy loss and risk of future maternal cardiovascular disease (CVD) have been found in Western countries, but the association in China is still unclear. Therefore, this study aimed to investigate the associations of pregnancy loss, number of pregnancy losses, subtype of pregnancy loss (i.e. induced abortion, miscarriage and stillbirth) and age at the first pregnancy loss with CVD risk in Chinese population.
Methods: We examined data of 7,486 middle-aged women (mean age 58.1 years) from the China Health and Retirement Longitudinal Study. Pregnancy loss and CVD including coronary heart disease (CHD) and stroke were self-reported and documented in surveys.
Results: In the cohort, 1,850 (24.7%) women experienced pregnancy loss. Over 39 years follow-up, 2,055 (27.5%) women developed CVD. After adjusting covariates, pregnancy loss was associated with the risk of CVD (HR 1.73, 95% CI 1.56 to 1.92). Specifically, pregnancy loss due to induced abortion and miscarriage instead of stillbirth increased CVD (HR 2.11, 95% CI 1.82 to 2.44, and 1.47, 95% CI 1.16 to 1.72, respectively). The risk of CVD gradually increased from ≤23 years to 23–25, 26–29 and ≥30 years with HR 1.29, 95% CI 1.24 to 1.34.
Conclusion: Chinese women that have experienced pregnancy loss due to induced abortion and miscarriage had increased risk of CVD. The risk increased with the number of pregnancy losses and older age at the first pregnancy loss.
The Correlation Between Potential Antidiabetic Side Effects And Risk Factors In Type 2 Diabetes Mellitus Patients at Hospital Lamongan
Authors: Fifianti Enggar Ayu , Utami Primanitha Ria , Fatihah Anisa Zulfa
Published: January 2025

Diabetes mellitus is a metabolic disease caused by abnormalities in insulin performance and/or insulin secretion. Risk factors for side effects of drugs need to consider aspects of age, gender, and body mass index. This study aims to determine the relationship between potential side effects of antidiabetics and risk factors for type 2 diabetes mellitus. This study was conducted at Lamongan Hospital during the period January-March 2024. The study design used a cross-sectional design with data collection from patient medical records and the results of interviews filling out the naranjo questionnaire. The population in this study was 95 patients. The sample was selected using a purposive sampling technique and 89 patients met the inclusion criteria. Based on the results of the study, the most common potential side effect of antidiabetes was hypoglycemia experienced by 25 patients (28.08%) with the dominant number of hypoglycemia side effects due to the use of insulin actrapid (11.23%). The naranjo score results showed probable (89.89%) which means that the possibility of complaints in the form of hypoglycemia in patients is a side effect of antidiabetes. Hypoglycemia is characterized by a decrease in blood glucose levels <70 mg/dl (<4.0 mmol/L). Signs of hypoglycemia that appear in patients are trembling, hunger, nausea, and dizziness. Data analysis using the Spearman Rank Correlation test showed a significant relationship between the occurrence of potential side effects of Antidiabetics with age risk factors (p=0.004) and did not have a significant relationship with gender risk factors (p=0.553) and body mass index (p=0.473). The presence of age factors due to changes in physiology and body biochemistry, is closely related to increased glucose intolerance which is at risk of insulin resistance. Education of health workers, especially from Pharmacists, determines the success of therapy and prevention of drug-related problems including drug side effects.
The Relationship between Medication Possession Ratio Method and Medication Adherence of Hypertension Patients at Sugio Health Center
Authors: Zahrotul Wardah  , Irma Susanti  , Handayani Riana Prastiwi
Published: January 2025

Adherence to antihypertension drug consumption drugs is one of the determining factors in controlling blood pressure. Good adherence to therapy can gradually influence blood pressure and prevent complications. This study aims to investigate the relationship between the MPR (Medication Possession Rasio) method and medication adherence in hypertension patients. The current research used descriptive method whit a cross sectional approach. The data were collected prospectively with purposive sampling. The results of the study obtained 154 samples of hypertension patients with or without comorbidities aged ?17 years. The results obtained 134 patients (87.0%) in the adherent category, and 20 patients (13.0%) who were not adherent to redeeming prescription. The results indicated that 147 patients (95.5%) had moderate adherence, 4 patients (2.6%) had high adherence, and 3 patients (1.9%) were in the low adherence category. The results of the test of the relationship between the MPR method and adherence to taking medication can be concluded that the p value = 0.017, so there is a significant relationship between the MPR method and adherence to taking medication with the ARMS (Adherence of Reffil Medication Scale) questionnaire. Even though there is a relationship, the level of relationship is very low because at the level of medication compliance, the majority of hypertension patients are in the moderate compliance category due to the age of the patient who experiences difficulties when filling out the questionnaire and the high risk of manipulation by the patient by choosing good answers.
Development and Validation of Instrument to Measure Knowledge, Attitude, and Practice of Smoking in Students
Authors: Cholisoh Zakky , Nugraheni Annisa Vita , Irfanda Defana Rizki
Published: January 2025

Quit smoking is very important to reduce morbidity and mortality caused by smoking. The purpose of this study was to develop a new tool to measure the knowledge, attitude, and practice of smoking in students, their motivations, and opinions on smoking cessation by pharmacists. This study was conducted in two phases, instrument development and judgmental evidence. A panel of 3 experts (psychologist, pharmacist, student smoker) was used to validate the instrument through quantitative measures. Whereas 30 respondents were used to justify the reliability of the questionnaire.  The instrument consists of 5 domains and 53 questions. The 5 domains are: 1) knowledge; 2) attitude; 3) practice; 4) motivation of quitting smoking; 5) opinion on the help of pharmacist to quit smoking. The developed tool showed high content validity of individual items (I-CVI range: 0.50 to 1.00) and high overall content validity (S-CVI/UA?=?0.96; S-CVI/Ave?=?0.98), the relevance of items was good (Kappa: 1), and clear (Clarity: 2.93). The tool was deemed reliable with Cronbach alpha for each domains of knowledge, attitude, practice, motivation, and opinion were 0.76; 0.76; 0.79; 0.83; and 0.79 respectively. It can be concluded that the instrument demonstrated high item-content.
Nano vesicular topical drug delivery system: Types, structural components, preparation techniques, and characterizations
Authors: Hasan Milad Jawad , Rajab Nawal Ayash
Published: January 2025

Nano vesicles, one of several existing nanoscale drug delivery systems, offer extremely promising new ways to develop treatments for degenerative diseases, cancer, and inflammation. The primary goals in developing nanocarriers are to control particle size, surface characteristics, and drug release to achieve specific objectives. Therefore, it is crucial to accurately characterize nanocarriers to effectively regulate their intended behavior both in clinical settings and in the body. Nanocarriers are characterized by their size, structure, and charged state, which are determined by sophisticated microscopic methods such as scanning electron microscopy, transmission electron microscopy, and atomic force microscopy. Electron microscopy is used to evaluate the surface morphology and size of particles, while dynamic light scattering and photon correlation spectroscopy are used to estimate particle size and size distribution. Colloidal stability is determined by zeta potential, which is an indirect measure of surface charge, and differential scanning calorimetry is used to characterize particles and drug interactions.
Two cases of pancreatic tuberculosis in immunocompetent individuals presenting as diabetes mellitus: An overview of clinical features, diagnosis and management
Authors: Varadaraj G , Rai Avantika , Ghana Parthasarathi , Maribashetti Kiran
Published: January 2025

Mycobacterium tuberculosis (TB) disease is a major global health problem affecting 10.6 million people worldwide, and India alone contributes 28% to this burden. Pancreatic TB is considered an extremely rare entity which closely mimics pancreatic carcinoma. However, while 87% of the total globally notified TB cases are from 30 high-burden countries mostly from Asia, about 45% of pancreatic TB cases are from developed countries. This suggests that the identified cases of pancreatic TB in developing counties are just the tip of iceberg, and many cases either remain undetected or wrongly diagnosed. The majority of the patients with pancreatic TB undergo extensive evaluation and frequently undergo major abdominal surgeries since pancreatic carcinoma is often considered as the most probable diagnosis before TB. Here, 2 cases of pancreatic TB managed separately at two different centers are described. Both cases presented with significant unintentional weight loss and poor glycemic control which is an unusual presentation for pancreatic TB. Imaging showed pancreatic mass lesions, and initially pancreatic carcinoma was considered by the treating physicians. Chromogranin A in both patients and tumor markers done in one of the patients were negative. Both the patients underwent Ga-68 DOTANOC PET/CT scan, and one of the patients even showed multiple DOTANOC avid lesions. Owing to contradictory biochemical and imaging findings, biopsy of the pancreatic mass was done which clinched the diagnosis of pancreatic TB. On starting standard anti-tubercular therapy (ATT), both patients showed clinical and radiological recovery with a significant regain of glycemic control. The clinical features, appropriate investigation including imaging and tissue biopsy, and treatment options are described in the article for better understanding of the disease. This may guide clinicians in early detection of pancreatic TB with least invasive diagnostic procedures.
Africa’s public health battle with cerebral malaria: What are we up against?
Authors: Abdelmalik Abubaker , Kashbour Muataz
Published: January 2025

Malaria continues to pose a significant public health challenge in Africa, where 95% of global malaria cases and deaths occur in Sub-Saharan Africa (SSA). Cerebral malaria (CM) is a fatal type of severe malaria primarily caused by Plasmodium falciparum species and disproportionately affects children under five years. Despite ongoing control efforts, CM persists as one of the most prevalent presentations of severe malaria with surprisingly high prevalences even in regions with lower endemicity and transmission rates. This commentary presents an updated compilation of key CM-related public health challenges, including delayed presentation of cases and a lack of diagnostic tools in resource-limited African communities, leading to misdiagnosis. Further challenges include insufficient provision of anti-malarial drugs and inaccessibility in rural and remote areas, coupled with emerging resistance to the gold-standard therapy (artemisinin combination therapy). CM carries a high risk of long-term neurological complications and is seen in almost half of the survivors. These complications severely impair their daily quality of life and extend to social and financial challenges. CM survivors also suffer from the lack of appropriate health services such as continuous rehabilitation, medical care, and psychological support. Despite its burden, interventional research in CM management remains insufficient, particularly regarding short- and long-term neurological complications. Local African governments have occupied the backseat for the length of this continental health crisis. It is crucial for them to occupy a proactive role in supporting healthcare infrastructure and delivering high-quality health services. Intragovernmental collaborations and establishing a regional health network within Africa can ensure realistic and accurate surveillance data tracking. From this, strategic healthcare planning, control measures, and source allocation could be better observed and tailored to the needs of different African subpopulations.