bluuebunny/crossref_metadata_2025 huggingface dataset:
A Global Review of Accountable Care Organizations: Design Features and Lessons Learned
Authors: Finch Michael , Parente Stephen , Grossbach Anna , Zismer Daniel , Alluhidan Mohammed , Alfaisal Abdulrahman , Saber Rana , Alamri Adwa , Zhang Yi , Dong Di , Herbst Christopher
Published: January 2025

As health systems around the world increasingly adopt accountable care models, certain design features tied to success begin to emerge. This review draws upon lessons learned from three accountable care models: Health Maintenance Organizations, Accountable Care Organizations (ACOs), and Advanced Primary Care.

Five elements are integral to the success of accountable care models. First, continuous strengthening of organizational alignment among health providers within ACOs to achieve shared visions and goals at operational, cultural, and cognitive levels. Second, partnerships to improve the scope of clinical operations (horizontal integration of service lines) to build efficient resource interdependence and collaboration to deliver consistent high-quality care at a scale that includes a full spectrum of clinical services (primary care through long-term care). Third, availability of adequate health information management and health information technology to improve patient management, coordination, and engagement. Fourth, employing risk adjustment models that accurately estimate the cost of the highest-risk patients to ensure sustainable health financing. Finally, using performance benchmarks to incentivize high-performing groups, achieving organizational transformation.

Applying these models’ successes internationally requires leadership to understand cultural and clinical contexts, providers to commit to developing competencies, and governing bodies to address systemic impediments to providers’ ability to work together to improve patient access, experience, and outcomes, while reducing costs.
Gaussian Graphical Model Estimations in Multivariate Linear Regression: A method and applications in omics studies
Authors: Zeng Irene , Lumley Thomas
Published: January 2025

Introduction: Regression models for high-dimensional multivariate data curated from high throughput biological assays in omics, brain networks, medical imaging, and psychometric instruments contain network features. Multivariate linear regression is a standard model that fits these data as response variables and the participant characteristics as explanatory variables. More often, the number of variates of the response variables is larger than the number of observations ( ). To solve these problems, a structured covariance model is necessary to maintain the network feature of the response data, and sparsity induction will be advancing to reduce the number of unknown parameters in the large variance-covariance matrix.

Method: This study investigated an approach to solving multivariate linear regression for multivariate-normal distributed response variables using a sparsity-induced latent precision matrix. The multivariate linear regression coefficients were derived from an algorithm that estimated the precision matrix as a plug-in parameter using different Gaussian Graphical Models. The developed Bioconductor tool “sparsenetgls” based on this algorithm was applied to case studies of real omics datasets. Data simulations were also used to compare different Gaussian Graphical Models estimation methods in multivariate linear regression.

Results: The GGM multivariate linear regression (GGM-MLS) advances the multivariate regression. In the scenario when the number of observations is smaller than the number of response variates ( ), GGM-MLS tackles this challenge using sparsity induction in the covariance matrix. Analytical proof suggests that the estimation of the response variable's precision matrix and the regression coefficient of GGM-MLS are two independent processes. Simulation studies and case studies also consistently suggested that the regression coefficient estimates of GGM-MLS are similar to the estimates using linear mixed regression with only the variance terms in the covariance matrix. Furthermore, GGM-MLS method reduces the variance (standard errors) of the regression coefficients in both and scenarios.
Keywords: GGM in multivariate linear regression, network outcome responses, omics data analysis, sparsity induction in multivariate linear regression
Ongoing Remission Following Early B-Cell Recovery After Tisagenlecleucel in a Patient with Down Syndrome and B-ALL: A Case Report
Authors: Rahrig April , Woodburn Stayce , Harrison Jessica , Czader Magdalena , Hopper Audrey , Skiles Jodi
Published: January 2025

Background: Chimeric antigen receptor-T cell therapy with tisagenlecleucel has durable efficacy and manageable safety in pediatric relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL). However, evidence of its efficacy and safety in patients with Down syndrome-associated B-ALL is currently limited.

Case Report: Here, we describe a male pediatric patient with Down syndrome-associated refractory B-ALL who was infused with tisagenlecleucel twice. He was minimal residual disease-negative and had central nervous system 1 status before and after each tisagenlecleucel infusion. Adverse events of special interest following the first infusion included grade 2 cytokine release syndrome, which resolved without the need for tocilizumab, and grade 1 immune effector cell-associated neurotoxicity syndrome. Though clinically well, B-cell recovery was detected <6 months after the first tisagenlecleucel infusion. The second tisagenlecleucel infusion, followed by pembrolizumab, was administered in an unsuccessful attempt to restore B-cell aplasia. Four years after the first tisagenlecleucel infusion, the patient is disease-free with no ongoing pembrolizumab toxicity.

Conclusions: Treatment with two doses of tisagenlecleucel was relatively safe and effective in this pediatric case with Down syndrome-associated relapsed/refractory B-ALL. The results also suggest that achieving long-term B-cell aplasia may not be required for long-term remission in some cases.
Current Status of Bovine Tuberculosis in Brazil
Authors: Neto José
Published: January 2025

Bovine tuberculosis is a major zoonotic disease, and cattle are the main source of infection for humans. The disease also causes economic losses in the dairy and beef industries, primarily due to reduced milk and meat production, condemned carcasses at slaughterhouses, and, in rare cases, cattle mortality. As a result, many countries have implemented measures to control or eradicate it. Brazil is a major player in the international beef market, but bovine tuberculosis remains a significant animal health issue in search of an effective solution. This review provides data on the epidemiological situation of the disease in the country, the initiatives being implemented, and the prospects for the future. Brazil only established a rational program to combat the disease in 2001. For 90% of Brazil's cattle population, high-quality epidemiological data show that the prevalence of tuberculosis-infected herds in Brazilian states ranges from 0.16% to 9.0%, with some states exhibiting significant internal heterogeneity. The disease in Brazil is most commonly associated with high-production dairy farms. Its spread is primarily attributed to the introduction of animals without proper precautions against the disease, although specific factors may vary depending on the state. The accreditation of tuberculosis-free herds has yielded very poor results in Brazil. Currently, there are only 5,472 tuberculosis-free accredited farms in the entire country, 97% of which are in the two southern states: Santa Catarina (3,3050, and Rio Grande do Sul (1,981). The remaining 197 tuberculosis-free herds are distributed across 11 other states. Santa Catarina and Mato Grosso have recently implemented surveillance systems with the aim of eradicating the disease. It is essential that these systems achieve adequate levels of efficiency, as they will serve as a model for other Brazilian states. This situation raises concerns about the zoonotic transmission of Mycobacterium bovis in Brazil, both occupationally and among populations that consume unpasteurized dairy products. Special attention should be given to dairy products made with unpasteurized milk, which can be authorized only if the properties are accredited as free of tuberculosis and brucellosis. Otherwise, the milk must be pasteurized to ensure health guarantees for dairy consumers.
Overcoming Patient Blood Management Barriers in Low- and Medium- Income Countries: Starting Small to Stand Tall
Authors: Brito Priscelly
Published: January 2025

Although being essential in several clinical and surgical contexts, the transfusion of blood components is not considered a risk-free approach or an abundantly available resource, becoming imperative to establish judicious transfusion decisions, based not only on medical purposes, but also on economic grounds and the estimated cost of the entire chain of blood components. It was in this context that Patient Blood Management (PBM) programmes emerged, a patient-centered bundle of care, upon which decisions are taken from a multidisciplinary, systematized and evidence-based vision, optimizing treatment, prognosis and the use of resources. Notwithstanding that PBM pillars are universally applicable, regional differences require thorough scrutiny on how they can be effectively met, considering local reality, its potentials and challenges. Healthcare providers and funders, professional medical societies and scholars, each of them in their limited scale, are the main advocates for PBM implementation, by creating local-adapted, pilot guidelines and algorithms, with whatever tools and resources available, that will permit the first kickoff to set up PBM as the standard of care, personalized to the reality of each society or institution.
Appraisal of Modified Tests for Diagnosis and Treatment of Primary Aldosteronism: A Single Center Experience
Authors: G. Piaditis , G. Kaltsas , L. Papanastasiou , Ch Gravvanis , A. Gouli , N. Voulgaris , V. Tsiavos , E. Tyfoxilou , S. Vlachou , K. Vamvakidis , G Zografos , G. Chrousos , A. Markou
Published: January 2025

Introduction: Primary aldosteronism (PA), the most common endocrine cause of secondary hypertension, is generally under diagnosed using current diagnostic tests.

Objective: To present our findings, based on studies using modified diagnostic tests, on the diagnosis, prevalence and treatment of PA.

Design and Methods: We prospectively studied 992 hypertensive patients and 278 matched controls. Participants underwent conventional confirmatory tests for the diagnosis of PA modified by the addition of dexamethasone including the Fludrocortisone Dexamethasone Suppression Test (FDST), the Dexamethasone Captopril Valsartan Test (DCVT) and the Dexamethasone Saline Infusion Test (DSIT). Normal cut-offs of basal aldosterone-to-renin ratio and post-test (FDST, DCVT and DSIT) aldosterone levels and aldosterone-to-renin ratio were calculated from the control groups, who had normal adrenal imaging.

Results: Hypertensive patients had significantly higher baseline blood pressure and lower serum potassium levels compared to controls. Using the basal aldosterone-to-renin ratio as screening test, the prevalence of PA was 17.8%. After applying the modified tests to all patients, the prevalence of PA was 33.4%. Targeted treatment with Mineralocorticoid Receptor Antagonists was administered in 252 hypertensives, with bilateral PA; 188 (74.6%) of them obtained a biochemical response and normalization of blood pressure. Unilateral disease had 48 patients who underwent laparoscopic adrenalectomy obtaining a biochemical success rate was 94%.

Conclusion: Our modified methodology and the use of normotensive controls for calculation of normal cut-offs of aldosterone suppression, significantly improves the sensitivity and specificity of the existing tests on the diagnosis of PA, allowing the detection of milder forms.
Diastolic Dysfunction Unveiling Cardiac Light-Chain Amyloidosis: A Case Report
Authors: Saha Somesh , Mondal Ritwick , Deb Shramana , Sarkar Biswarup , Leon Julián
Published: January 2025

Background: Cardiac light-chain amyloidosis represents a critical component of this multi-systemic disease, significantly impacting prognosis. The extent of cardiac free light-chain deposition is the primary determinant of survival.

Case Presentation
We report the case of a 67-year-old male with a 10-year history of diabetes mellitus and arterial hypertension who presented with a two-day history of chest discomfort and difficulty lying down or sleeping, along with a two-month history of progressively worsening exertional dyspnea. On examination, the patient exhibited low blood pressure. A 12-lead electrocardiogram revealed poor R-wave progression and left ventricular hypertrophy. Further evaluation using 2D echocardiography demonstrated significant concentric left ventricular hypertrophy, a restrictive filling pattern, and mild pericardial effusion. Cardiac magnetic resonance imaging, nuclear imaging, and biopsy confirmed the diagnosis of cardiac light-chain amyloidosis.

Conclusion: Timely recognition and a high index of suspicion are essential for the early diagnosis of cardiac amyloidosis. Prompt diagnosis enables the initiation of definitive therapy, which may halt disease progression and significantly improve prognosis.
Acipimox in Type 1 Diabetes: fatty acids as a potential, but challenging, therapeutic target
Authors: Kaput Katie , Lyon Ellen , Schauer irene
Published: January 2025

Objective: To examine the effect of acute, isolated non-esterified fatty acid lowering, on insulin action, arterial stiffness and cardiac autonomic function in type I diabetes.

Methods: Randomized, double-blind, crossover trial of acipimox versus placebo in participants with and without type 1 diabetes (n=9 and 8, respectively).

Results: Participants with type 1 diabetes were more insulin resistant than controls and exhibited increased arterial stiffness (pulse wave velocity and augmentation index), autonomic dysregulation (heart rate variability), cardiac diastolic dysfunction (E:A ratio), and increased cardiac contractility (fractional shortening) with preserved cardiac output. Acipimox treatment was confounded by a pronounced early rebound effect. However, independent of acipimox, within-subject higher pretest fatty acid levels corresponded to greater insulin resistance, higher mean tachycardic heart rates at rest, and possibly increased cardiac output.

Conclusions: These findings confirm and expand upon previous observations that individuals with type 1 diabetes are more insulin resistant and exhibit cardiovascular changes consistent with increased sympathetic tone. The correlation of poor peripheral glucose utilization and cardiovascular changes with elevated fatty acid levels suggests that lowering fatty acid levels may improve insulin sensitivity and decrease sympathetic tone. In the future, a more durable or targeted method of fatty acid lowering could represent a novel cardioprotective target of intervention in people with type 1 diabetes.
COVID-19 PANDEMIC AND BLOOD AVAILABILITY IN LOW- AND MIDDLE- INCOME COUNTRIES: WHAT HAPPENED?
Authors: Sibinga Cees
Published: January 2025

Background: Of the 118.5 million blood donations collected globally in 2023, 40% of these were collected in high-income countries, home to only 16% of the global population. An increase of 10.7 million blood donations from voluntary unpaid donors, excluding paid and family and acquainted donors, has been reported from 2008 to 2018. In total, 79 countries collected over 90% of their blood supply from voluntary unpaid blood donors. However, 54 countries collected more than 50% of their blood supply from paid or family/acquainted donors.

Observation – When the COVID-19 pandemic conquered the world, the blood shortage in the less developed world unfortunately decreased. Based on samples of 1000 adult people, the pre-COVID-19 blood donation rate of 31.5 donations in high-income countries, 16.4 donations in upper- middle-income countries, 6.6 donations in lower-middle- income countries and 5.0 donations in low-income countries changed dramatically.

Response – The Asian Association of Transfusion Medicine (AATM) investigated early 2020 the blood supply situation (challenges and approaches) in 25 member states (Low-and Medium Income Countries (LMICs). The Global Transfusion Forum of the Association to Advance Blood and Biotherapies (AABB) did a survey with 31 blood collection institutions in 26 LMICs focused on characterization of the challenges experienced during the global pandemic and the adaptations and resilience, published in 2022 WHO responded immediately to the outbreak, supporting organization and governance of the blood supply.

Conclusion – Due the to the adequate action of WHO in Geneva, and the alertness of AATM, and the GTF of AABB reacting on the outbreak of the COVID-19 the pandemic turned out to be a ‘blessing in disguise’ for the future of the global blood supply illustrating prominently the existing challenges and weaknesses, and providing tools to accelerate COVID-19 risk mitigation and blood supply progress.
Monitoring and outcome prediction of sepsis by neutrophil specific biomarkers
Authors: Venge Per , Xu Shengyuan
Published: January 2025

HNL (human Neutrophil Lipocalin) is a protein secreted from the activated neutrophil granulocytes but also from epithelial cells. HNL is measured by sensitive immunoassays in most bodily fluids and exists in several variants of which the monomer and the dimer variants are the most abundant. Depending on the antibody configuration of the immunoassays we may detect different molecular variants of HNL, and which may have different cellular origins. The dimeric form of HNL is entirely neutrophil specific and other assays may preferentially detect HNL originating from epithelial cells such as the tubular cells of the kidney. In this brief review we have focused on the utility of HNL as a biomarker for antibiotics stewardship in patients with sepsis and show that the dimeric form of HNL is reduced within 24 hours as the response to successful antibiotic treatment in sepsis in contrast to the reduction of blood levels of procalcitonin and heparin-binding protein which takes 3-4 days. Another variant of HNL showed to be the most powerful predictor of outcome of these patients. We conclude that the measurements of these HNL variants should be considered for implementation in intensive care units and other settings with seriously ill infected patients.
Efficacy and Safety of Janus Kinase Inhibitors in Lupus Nephritis Patients- Clinical Trials and Case Reports
Authors: Torun Ege
Published: January 2025

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organs and systems that has a variable clinical course and prognosis among different patients. Lupus nephritis (LN) is one of the most common and severe organ manifestations of SLE which is associated with significant morbidity and mortality with up to 20% of patients progressing to end stage renal disease. Despite the improvements in therapeutic options, there is a significant proportion of refractory patients and a considerable amount of damage accrual and treatment associated morbidity even among patients that respond to the current treatment modalities. Janus kinase (JAK) inhibitors are currently successfully used in rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis patients. JAK inhibitors simultaneously block the signalling of multiple cytokines and represent a promising class of therapeutic agents for SLE which has a high immunological heterogeneity. Some animal studies demonstrated the significance of JAK/STAT pathway in the pathogenesis of LN and the possible role of JAK inhibitors in alleviating the renal inflammation in animal models of LN. This review covers the clinical data on the use of JAK inhibitors in LN patients by focusing on the clinical trials and few case reports that assess the efficacy and safety of JAK inhibitors in LN patients.
Exploring the therapeutic potentials of peroxisome proliferated receptors family (PPAR)
Authors: Jain Vikas Kumar , Tiwari Nishant , Vishwakarma Himanshu
Published: January 2025

The nuclear hormone receptor family has three distinct subtypes: PPAR-α, PPAR-β/δ, and PPAR-γ.Peroxisome proliferator activated receptor (PPARs)are genes that are activated by compounds. Triglycerides levels are reduced and the balance of energy is maintained when PPAR-α is stimulated. Fibrates are compounds that act as agonists for the PPAR, and have been used to treat dyslipidemia because of their effects on reducing triglycerides and increasing HDL-C (high density lipoprotein cholesterol). Recent research has also demonstrated that PPAR- agonist have anti-inflammatory and anti- thrombotic properties in the arterial wall. The stimulation of PPAR-β/δ increases the efficiency of the metabolism of fatty acids, it also maintains physical stamina and is considered the primary option for dealing with metabolic disorders. The activation of PPAR-γ promotes glucose metabolism and increase the sensitivity of insulin. Today, it is commonly understood that the dysregulated IGF systems is associated with the developmental and progression of various human cancers. As a result, the balance of energy and metabolic processes is primarily determined by the nuclear receptors of the PPAR family. The current state of knowledge regarding the beneficial and detrimental effects of PPAR agonists on various diseases, including dyslipidemia, diabetes, adipocyte inflammation, cancer, and obesity is the subject of this review.
Synthesis of mutual prodrug of mefenamic acid and fluroquinolones
Authors: Jain Deepak Kumar , Jain Sameeksha , Rajpoot Anjali Devi , Khare Basant , Soni Sanjana , Yadav Ruchi
Published: January 2025

A novel strategy in medicinal chemistry to increase the therapeutic efficacy and reduce the side effects of separate medications is the creation of mutual prodrugs. The production and pharmacological assessment of a mutual prodrug including the broad-spectrum antibiotic class fluoroquinolones and the nonsteroidal anti-inflammatory drug (NSAID) mefenamic acid are the main topics of this paper. The justification for this combination is its ability to reduce the gastrointestinal and other systemic side effects that are frequently linked to NSAIDs and fluoroquinolones, while also potentially enhancing anti-inflammatory and antibacterial activity in a synergistic manner. The chemical characteristics, production pathways, and modes of action of mefenamic acid and fluoroquinolones are thoroughly covered in this work. The design strategies for mutual prodrugs are further examined, emphasising the need to optimise reaction conditions and choose appropriate chemical linkers in order to produce a stable and potent prodrug. By contrasting the mutual prodrug with its parent molecules, a review of in vitro and in vivo research is conducted to assess the pharmacokinetic and pharmacodynamic advantages of this strategy. The paper also discusses the difficulties that arise during the synthesis and development of mutual prodrugs, such as problems with stability, bioavailability, and regulatory barriers. Future perspectives on the potential of mutual prodrugs in drug development are discussed in the paper's conclusion, which highlights the need for more study to get past present obstacles and fully realise the therapeutic benefits of this exciting approach.
From concept to compliance: The role of QbD in modern product development
Authors: Tamboli Firoj A. , Mane Prafull P. , Babaleshwar Rakesh B. , Mane Dnyaneshwar M. , Attar Parvej S. , Disale Pratik P. , Patil Pranoti A. , Parkhi Shweta M. , Rathod Mohan P
Published: January 2025

Pharmaceutical development is revolutionized by the Quality by Design (QbD) strategy, which replaces conventional trial-and-error procedures with a systematic, science-based approach that ensures product quality, safety, and efficacy. This article offers a comprehensive description of the key elements and instruments required to execute QbD, as specified by regulatory recommendations like ICH Q8 (R2) and ICH Q9. The construction of a Target Product Quality Profile (TPQP), which acts as a dynamic summary of the quality attributes required to achieve the intended product quality, safety, and efficacy, is the basic concept of quality-based development (QbD). Critical quality attributes, or CQAs that are, are important qualities that need to be maintained within specified limits in order to ensure the quality of the final product. These are connected to Critical Process Parameters (CPPs) and Critical Material Attributes (CMAs) via risk assessment techniques like Fault Tree Analysis (FTA) and Failure Mode Effects Analysis (FMEA). An essential component of Quality-Based Development (QbD) is Quality Risk Management (QRM), which offers a framework for evaluating and controlling risks over the course of a product's existence. To identify and reduce potential risks, a variety of tools are used, such as Hazard Analysis and Critical Control Points (HACCP), FMEA, and FTA. The foundation of Quality-Based Design (QbD) is the idea of Design Space, which is described as the multifaceted collection of variable inputs and process factors that ensures quality assurance. Another crucial element of QbD is Control Strategy, which consists of a series of planned controls based on knowledge about present products and processes. The concepts of lifecycle management and continuous improvement highlight the significance of implementing a pharmaceutical quality system at every stage of the product lifecycle in order to encourage innovation and continuous improvement while assuring regulatory compliance. The principles of Quality by Design (QbD) are applied with the use of several technologies, including Process Analysis Technologies (PAT) and Design of Experiments (DOE). These technologies allow for the real-time monitoring and management of critical process parameters, which reduce manufacturing unpredictability and increase product quality.
Formulation and evaluation of pazopanib-loaded PLGA nanoparticles for enhanced bioavailability and sustained release in cancer chemotherapy
Authors: Sapkal Sandip B. , Shrikhande V.N. , Dhongade Hemantkumar J , Mapari Mangesh A. , Gandhi Akhil N. , Laddhad Gauri R.
Published: January 2025

The objective of this study was to develop and characterize a Nano formulation of Pazopanib using poly(DL-lactide-co-glycolide) (PLGA) for improved bioavailability and reduced systemic toxicity. Pazopanib, a tyrosine kinase inhibitor used in the treatment of renal cell carcinoma and soft tissue sarcoma, exhibits limited solubility and bioavailability, restricting its clinical efficacy. We employed an oil-in-water (o/w) emulsion solvent evaporation technique to prepare Pazopanib-loaded PLGA nanoparticles. Various formulations were optimized by adjusting the drug-to-polymer ratio, yielding spherical nanoparticles with an average size of 135 nm and a low polydispersity index, as confirmed by dynamic light scattering and transmission electron microscopy. The nanoparticles demonstrated a high entrapment efficiency of 33.9 ± 2.5% and a zeta potential of -20.12 mV, indicating good colloidal stability. Fourier transform infrared spectroscopy confirmed the compatibility of Pazopanib with PLGA and other excipients. The in vitro drug release studies revealed a sustained release profile over 7 days, contrasting with the rapid release from the free drug solution. These findings suggest that the developed PLGA-based nanoparticulate system could potentially enhance the therapeutic efficacy of Pazopanib by increasing its bioavailability and ensuring controlled release, thus offering a promising approach for cancer chemotherapy.
A concise review- Development of an analytical method and validation of dutasteride
Authors: Jain Pritam S , Chaudhari Hina , Chaudhari Mayuri , Haswani NG
Published: January 2025

The synthetic 4-azasteroid dutasteride inhibits the type 1 and type 2 isoenzymes of 5-alpha-reductase in a selective and competitive manner. Men with symptomatic benign prostatic hyperplasia (BPH), which is characterized by an enlarged prostate, may use it. Orally administered dutasteride has a 60% bioavailability and is quickly absorbed.

This work focuses on the most recent developments in analytical techniques for quantifying dutasteride in various biological samples (including human plasma), as well as in commercially available dose forms and bulk. High-performance thin-layer chromatography (HPTLC), gas chromatography in conjunction with tandem mass spectrometry (GC-MS), high-performance liquid chromatography (HPLC), and UV spectroscopy will all be thoroughly examined in this review. The matrix, stationary phase, mobile phase composition, detection wavelength, RF value, retention duration, detection limit (DL), carrier gas, and flow rate are just a few of the characteristics that will be covered.
Examining the integrity of whistleblowing systems and apparatus in the context of fraud prevention
Authors: Paranoan Natalia , Padolo Amson , Patiung Naomi , Palalangan Carolus Askikarno
Published: January 2025

This study aims to analyze the impact of the whistleblowing system and personnel integrity on fraud prevention at the Inspectorate Offices in South Sulawesi Provincial and Makassar City, Indonesia. Using a quantitative research design, primary data were collected through electronic questionnaires distributed to 70 auditors in these offices. The relationship between the independent variables (whistleblowing system and personnel integrity) and the dependent variable (fraud prevention) was analyzed using multiple regression. The findings revealed that both variables positively and significantly influence fraud prevention. Specifically, the whistleblowing system enables early detection of fraudulent activities, while high personnel integrity is essential for effective fraud mitigation. These results support the hypothesis that robust whistleblowing mechanisms and strong integrity within institutions play a crucial role in preventing fraud. The study highlights the importance of fostering a culture of transparency and accountability by implementing an integrated whistleblowing system and encouraging individuals to report fraud or violations without fear of retribution. This is vital for maintaining organizational integrity and financial health. Thus, organizations should focus on establishing comprehensive strategies that enhance both whistleblowing mechanisms and personnel integrity to ensure effective fraud prevention and the promotion of ethical conduct within institutions.
Public sector security governance: A must for societal safety of Nigeria
Authors: Idiege Adie Hilary , Otu Michael Takim , Achu Ayuk Awunghe , Owan Emeka Josephat , Isomakwo Aboh Fidelis
Published: January 2025

This study aims to investigate how public sector security governance defects facilitate and aggravate insecurity in the Akpabuyo Local Government Area, Nigeria. This was achieved by the development of two research questions and goals which then evolved into two hypotheses that were put to the test in a null form. Methodologically, a cross- sectional survey research design was adopted for the study. Sources of data collection were both primary and secondary. The instruments for data collection were questionnaire and key informant guide. The findings revealed that covert security agency operations and the corrupt behavior of civil servants and politicians play a significant role in amplifying insecurity. The study concludes with practical recommendations, including establishing specialized government court for the expedited trial and punishment of individuals found guilty of sabotaging government efforts in securing its citizens with sentences ranging from 10 to 30 years of imprisonment. Additionally, it is suggested that a collaborative task force comprising personnel from the military, police, state security service (SSS), immigration and customs service be formed and trained specifically in intelligence gathering, sharing, and management. Furthermore, it is proposed that further research be conducted on this topic with a broader focus on public sector security governance.
Exploring model-as-a-service for generative ai on cloud platforms
Authors: Pitkar Harshad , Bauskar Sanjay , Parmar Devendra Singh , Saran Hemlatha Kaur
Published: January 2025

This study examines the exploration of Model-as-a-Service for generative AI on cloud platforms. Model-as-a-Service (MaaS) could revolutionize generative AI; thus, we examine its impact on sectors, implementation best practices, and future trends. Business usage of generative AI for content development, predictive modelling, and consumer engagement is flexible and scalable using Software as a Service (SaaS). We explore how MaaS lets companies access, train, and deploy complex generative models like Generative Adversarial Networks (GAN), Variational Autoencoders (VAE), and Transformers without expensive in-house AI infrastructure. Lifecycle management in MaaS simplifies model training, deployment, versioning, and continuous improvement for iterative development in dynamic business contexts. MaaS security and compliance are crucial in highly regulated areas, including healthcare, finance, and law. Encryption, network isolation, and access control protect data and models. Generative AI models handle sensitive data; hence, industry standards and data sovereignty must be followed. Ethical AI, edge computing, and low-code/no-code platforms will enable more people to use models in real time and follow responsible AI guidelines, making MaaS's future bright. Generative AI applications and real-world case studies in healthcare, banking, retail, and entertainment demonstrate how MaaS can create value and stimulate innovation. Our study finds that using MaaS for generative AI, businesses can immensely benefit and explains how developers can speed up development, improve customer experiences, and remain ahead in the ever-changing digital landscape.
Porosity and water retention characteristics of humid tropical soil at specific depths of different land use practices
Authors: Tochukwu Amanze Chikamnele , Olughu Ibe, Kalu , Ogochukwu Nwosu Comfort , Fransisca Eluagu Kelechi , Ekeoma Ukabiala Maduabuchi , Patience Okoror
Published: January 2025

Soil porosity and water retention characteristics influence permeability and water dynamics of soils. This study examines soil porosity and water retention characteristics of different land-use practices at specific depths. The split-plot experiment under Randomized Complete Block Design had land-use as the main plot factor at four levels, and depth, the sub-plot factor at five levels. Soil samples were collected at specific depths of nine randomly selected points in each land-use. Samples were analyzed in a laboratory. Data were analyzed for variance and correlation using Statistical Analysis System (SAS) and Statistical Package for the Social Sciences (SPSS) software, respectively. Results showed that treatments varied significantly (P≤5 %); oil palm plantation (OP) had the highest water content at 0 – 20 and 20 – 40 cm depths, while continuously cultivated land (CC) had the lowest water content across depths. Also, OP had the highest total porosity at 0 – 80 cm depths, while grassland (GL) had the lowest total porosity across depths. The CC had the highest macro-porosity across depths, while forest land (FL) had the lowest accordingly. Porosity decreased with increase in depth, while water retention characteristics increased with depth. There was significant (P≤5 %) negative relationship between soil porosity and water retention characteristics at the land-use practices. The order of optimum soil porosity and water retention capacity of the land-use practices was OP ˃ FL ˃ GL ˃ CC, while the strength of the relationship between porosity and water retention characteristics was greatest at the soil under CC.
Seasonal variation in nutritional value of variegated grasshopper Zonocerus variegatus in Abeokuta Ogun state Nigeria
Authors: AV Adeniyi , KO Ademolu , CI Iyeh , AA Osipitan , AB Idowu
Published: January 2025

Zonocerus variegatus is a polyphagous species capable of consuming most of the plant species in its surroundings, climatic conditions and pesticide application have been reported to affect their natural life. In our locality, little or no information is available on the seasonal variation in the nutritional value of Zonocerus variegates. This study therefore evaluated the seasonal variation in the nutritional value of Z. variegatus in Abeokuta, Ogun state, Nigeria. Adult male and female Z. variegatus were collected during dry and wet seasons using a sweep net from an uncultivated farm at the Federal University of Agriculture, Abeokuta. Proximate composition, mineral composition, antinutrients, and vitamins) were determined using standard methods. All data collected were presented as Means±S.D. and compared using the T-test at (p < 0.05). Results showed that dry-season populations of Z. variegatus had significantly (p < 0.05) higher moisture content, crude protein, and carbohydrates than wet-season counterparts. Similarly, phosphorus concentration showed significant differences (p < 0.05) in the sample population for both seasons with the wet season population having higher values than the dry season. Vitamin A had a higher value (121.38 mg/100g) in the wet season than during the dry season (13,877 μg/100 g), while Vitamins D, B2, B6, and B12 values were higher during the dry season than in the wet-season. Antinutrient concentration was higher (p < 0.05) in the wet-season population than in the dry-season population. This study has shown that the dry-season Z. variegatus population is richer in nutrients than the wet-season population.
A Rare Case of Pneumothorax Caused by Ruptured Pulmonary Hydatid Cysts Accompanied by Deep Vein Thrombosis: A Case Report
Authors: Eslamian Reza , Moslemi Sam , Sharghi Sina A , Fazeli Amir Reza
Published: January 2025

Hydatid disease is mostly found in endemic areas such as the Middle East, particularly in patients with a certain history of exposure. Signs and symptoms depend on the organ infected by the cysts. Hepatic cysts may cause abdominal pain and jaundice. Pulmonary hydatid cysts, on the other hand, usually occur in the lower lobe of the right lung and present with chest pain, cough, or shortness of breath. Rupture occurs in about one-third of patients, releasing a highly antigenic fluid, which can result in anaphylaxis when ruptured into the bronchus. Alternatively, although not common, pulmonary hydatid cyst rupture may result in pleural effusion or, rarely, pneumothorax. Our patient was a young man who presented with pneumothorax resulting from a ruptured pulmonary hydatid cyst and concurrent extensive DVT. The cysts were completely resected, and the underlying parenchyma was repaired through a posterolateral thoracotomy, while DVT was managed by anti-thrombotic therapy.
Dermatofibrosarcoma Protuberans of the Face: A Case Report
Authors: Taheri Abolfazl , Ghoroghchiyan Yaser , Mohsenzade Parisa
Published: January 2025

Background: Dermatofibrosarcoma protuberans (DFSP) is a rare locally aggressive tumor with high rate of local recurrence but low metastatic potential. Its occurrence in the head and neck is a rare finding but it is associated with increased morbidity and mortality.
Methods: A 53-year-old Iranian man referred to a complaint about an increase in the size of the subcutaneous mass on the right cheek that had been present since he was 17 years old. On clinical examination, the lesion was not painful and had no erythema. In examining the patient's CT scan without contrast, a mass-like area with soft tissue density was seen. During the surgery, the flap was lifted after a lateral rhinotomy incision. The biopsy sample was sent for frozen section, and the pathology result was a Spindle cell tumor. In immunohistochemistry (IHC), two factors, including CD34 and VIMENTIN, were positive and Dermatofibrosarcoma protuberans (DFSP) was reported.
Conclusions: The most important prognostic factor for surgery of Dermatofibrosarcoma protuberans is obtaining tumor free surgical margins. As a result, accurate diagnosis and correct management of this uncommon and locally invasive malignancy is very important, especially in head and neck surgery.
Evaluation of Brain CT Findings in Patients with Head Trauma Visiting Khatam Al-Anbia Hospital in Zahedan in 2022
Authors: Ziaei Maryam , Ei Ali Dah Mardeh , Bahmani Alireza
Published: January 2025

Background: Traumatic brain injury (TBI) remains a leading cause of mortality and long-term disability. This study aims to evaluate brain CT scan findings in patients with head trauma admitted to Khatam al-Anbia Hospital in Zahedan during 2022.
Methods: This cross-sectional, descriptive-analytical study focused on patients presenting with head trauma at Khatam al-Anbia Hospital in Zahedan throughout 2022 who underwent brain CT scans. A census-based sampling method was employed, and data were collected using a structured checklist. The analysis was conducted using SPSS software.
Results: The study included patients with a mean age of 51.78 ± 26.75 years, ranging from 1 to 99 years. Among the 100 participants, 25 (25%) were women and 75 (75%) were men. The highest incidence of TBI was observed in the 70 to 80-year age group, with 15 patients, whereas the lowest incidence was found in the 50 to 60-year and over 90-year age groups, with 6 patients each. Car accidents were identified as the leading cause of head trauma, accounting for 32 cases (32%), followed by physical altercations, which contributed to 10 cases (10%). CT scan results indicated that 10% of the scans were normal, while 90% were abnormal. Notable abnormal findings included subdural hemorrhage (6 cases), frontal bone fractures (16 cases), and cytotoxic edema (6 cases). The most frequent location and type of skull fractures were in the temporal region (8 cases, 29.6%) and linear fractures (16 cases, 59.3%), respectively. The majority of TBIs were classified as mild (54 cases), with moderate TBIs being the least common (16 cases). Additionally, significant associations were found between injury type, gender, and the nature of the trauma.
Conclusions: This study highlights that road traffic accidents are a predominant cause of traumatic brain injuries, consistent with findings from various studies. The most frequently affected age group was 70 to 80 years, with a predominance of men. Abnormal CT findings commonly included subdural hemorrhage, frontal bone fractures, and cytotoxic edema. These results indicate potential regional differences in TBI patterns and emphasize the importance of targeted diagnostic and treatment strategies. The findings underscore the need for early and precise CT imaging in managing head trauma to improve patient outcomes. Further research is essential to refine management approaches and address regional variations in TBI.
The Rate of Hernia Recurrence in Surgical Patients with Mesh Repair and Non-Mesh Repair
Authors: Movahedi Hamidreza , Nazemi Lena , Dehghani Farzad , Ghadyani Saina
Published: January 2025

Background: Hernia repair is one of the most common procedures in general surgery, which is performed by various methods. One of the consequences of hernia repair is the recurrence of hernia in the short or long term. In this study, the rate of hernia recurrence in surgical patients with mesh and non-mesh repair methods was investigated.
Methods: This prospective cohort study was conducted on 138 patients who underwent repair surgery with mesh (28 individuals) and without mesh (110 individuals) due to hernia in Hamadan Ba’ath Hospital in 2019 and 2014. The authors investigated and compared in terms of frequency of recurrence and complications. Part of the required data was obtained from the patient’s medical records and part was obtained through telephone calls. Data analysis was done with SPSS software version 26.
Results: The average age of the patients was 41.2±26.25 years, 88.4% were male and 11.6% were female. The frequency of hernia recurrence was 3.6% in total, all of which were in the non-mesh repair group. No significant difference was observed between hernia repair with and without mesh in terms of frequency of recurrence (P=0.583) and complications (P=0.964). Also, no significant relationship was observed between hernia recurrence with gender, age, smoking, employment status, and body mass index (P>0.05).
Conclusions: Hernia repair with both methods with and without meshing have a relatively favorable short-term outcome. Although meshing reduces hernia recurrence; However, there was no significant difference between the two methods of hernia repair with and without meshing in terms of recurrence and complications.
Rapid Progressive Synovial Sarcoma of Right Knee: A Rare Case Presentation
Authors: Saputra Rhyan Darma , Kusuma Dita Anggara , Baharano Zeno Aquarista
Published: January 2025

Background: Synovial sarcoma is a rare malignant soft tissue tumor that commonly emerges in the para-articular area, with the knee as the predominant location. The preferred intervention for this tumor is still currently debated
Case description: We presented a 29-year-old male with a very large mass in the right knee. The physical examination revealed impairment of the right lower extremities, particularly the knee. MRI confirmed the extent of the pathology, but the first pathology analysis was inconclusive. A wide resection was performed without prior neoadjuvant therapy. The second pathology analysis from the resected tissue confirmed the diagnosis of biphasic-type synovial sarcoma. The patient was able to walk with no assistance, had an increased range of motion, and the utmost preservation of the limb.
Conclusions: We presented a successful case of wide resection of synovial sarcoma with a promising clinical outcome. The complexity of the case leads to the need for a tailored approach that should be limited to musculoskeletal oncologists
Prevalence of post-traumatic stress disorder among Intensive Care unit survivors. A prospective study in Rasht, Iran
Authors: Sedadi Parinaz , Ashraf Ali , Pourramezani Ali , Zareh Roghaye
Published: January 2025

Background: Post-traumatic stress disorder (PTSD) is a psychological disorder resulting from a previous traumatic experience. The objective of the present study was to investigate the prevalence of PTSD and its related risk factors among Intensive Care Unit (ICU) survivors.
Methods: A total of 152 patients were followed up prospectively for one month. All included participants had Glasgow Coma Scale scores ranging from 12 to 15. PTSD was assessed using a Persian-translated version of the PTSD Checklist (PCL). Data were analyzed using SPSS 22.0 software.
Results: Among the participants, seventy-two (47.4%) men and eighty (52.6%) women with a mean age of 54.5 ± 19.19 years responded to the questionnaire. The prevalence of post-discharge PTSD was 87.5%. There was a significant correlation between PTSD mean score and clinical factors such as hospitalization reason, self and familial history of psychological disorders, and Richmond Agitation Sedation Score (RASS) (p < 0.05).
Conclusions: Our findings suggest that, despite often being ignored, post-discharge PTSD is a significant psychological issue for ICU survivors. This highlights the importance of supportive care plans for patients with a history of mental disorders and agitation. The involvement of psychotherapists is crucial to improving post-discharge quality of life.