bluuebunny/crossref_metadata_2025 huggingface dataset:
The creativity of monuments: the case of bistable Belarusian identity
Authors: Beržiūnas Valentinas
Published: February 2025

During the last decades, Belarus has experienced a wave of monument construction, i.e., the monuments as creative practices through which certain historical, cultural and political meanings are constructed and articulated. The process confirms some scientists’ insights that the Belarusian identity is actively created today. However, the scientists who are interested in its construction on a practical level have not paid attention to the process of monument creation in Belarus as it also creates and articulates state identity. The analysis of the monument-making process has revealed that three identity narratives co-exist in Belarus: national-cultural and two political-historical ones, i.e., commonality with Russia and political independence from Russia. The potential contradiction of these political-historical narratives shows that the Belarusian identity is in a dichotomous and uncertain state. Although the spread of the political independence from Russia narrative allows us to talk about the existence of an independent national identity of Belarus (one of the most prominent manifestations was the mass protests in 2020, unpredicted by many scientists) in parallel with the existence of a strong historical-political narrative of commonality with Russia, the identity of Belarus remains in a bistable condition. For this reason, the further development of the Belarusian identity remains uncertain in the long-term perspective.
LensNet: Enhancing Real-time Microlensing Event Discovery with Recurrent Neural Networks in the Korea Microlensing Telescope Network
Authors: Viaña Javier , Hwang Kyu-Ha , de Beurs Zoë , Yee Jennifer C. , Vanderburg Andrew , Albrow Michael D. , Chung Sun-Ju , Gould Andrew , Han Cheongho , Jung Youn Kil , Ryu Yoon-Hyun , Shin In-Gu , Shvartzvald Yossi , Yang Hongjing , Zang Weicheng , Cha Sang-Mok , Kim Dong-Jin , Kim Seung-Lee , Lee Chung-Uk , Lee Dong-Joo , Lee Yongseok , Park Byeong-Gon , Pogge Richard W.
Published: February 2025

Traditional microlensing event vetting methods require highly trained human experts, and the process is both complex and time consuming. This reliance on manual inspection often leads to inefficiencies and constrains the ability to scale for widespread exoplanet detection, ultimately hindering discovery rates. To address the limits of traditional microlensing event vetting, we have developed LensNet, a machine learning pipeline specifically designed to distinguish legitimate microlensing events from false positives caused by instrumental artifacts, such as pixel bleed trails and diffraction spikes. Our system operates in conjunction with a preliminary algorithm that detects increasing trends in flux. These flagged instances are then passed to LensNet for further classification, allowing for timely alerts and follow-up observations. Tailored for the multiobservatory setup of the Korea Microlensing Telescope Network and trained on a rich data set of manually classified events, LensNet is optimized for early detection and warning of microlensing occurrences, enabling astronomers to organize follow-up observations promptly. The internal model of the pipeline employs a multibranch Recurrent Neural Network architecture that evaluates time-series flux data with contextual information, including sky background, the full width at half-maximum of the target star, flux errors, point-spread function quality flags, and air mass for each observation. We demonstrate a classification accuracy above 87.5% and anticipate further improvements as we expand our training set and continue to refine the algorithm.
Multifrequency Models of Black Hole Photon Rings from Low-luminosity Accretion Disks
Authors: Desire Tejahni , Cárdenas-Avendaño Alejandro , Chael Andrew
Published: February 2025

Images of black holes encode both astrophysical and gravitational properties. Detecting highly lensed features in images can differentiate between these two effects. We present an accretion disk emission model coupled to the Adaptive Analytical Ray Tracing (AART) code that allows a fast parameter space exploration of black hole photon ring images produced from synchrotron emission from 10 to 670 GHz. As an application, we systematically study several disk models and compute their total flux density, average radii, and optical depth. The model parameters are chosen around fiducial values calibrated to general relativistic magnetohydrodynamic (GRMHD) simulations and observations of M87*. For the parameter space studied, we characterize the transition between optically thin and thick regimes and the frequency at which the first photon ring is observable. Our results highlight the need for careful definitions of photon ring radius in the image domain, as in certain models the highly lensed photon ring is dimmer than the direct emission at certain angles. We find that at low frequencies the ring radii are set by the electron temperature, while at higher frequencies the magnetic field strength plays a more significant role, demonstrating how multifrequency analysis can also be used to infer plasma parameters. Lastly, we show how our implementation can qualitatively reproduce multifrequency black hole images from GRMHD simulations when adding time variability to our disk model through Gaussian random fields. This approach provides a new method for simulating observations from the Event Horizon Telescope and the proposed Black Hole Explorer space mission.
A Bias-free Deep Learning Approach for Automated Sunspot Segmentation
Authors: Chen Jing , Gyenge Norbert G. , Jiang Ye , Erdélyi Robertus , Liu Jiajia , Wang Yimin
Published: February 2025

Solar activities significantly influence space weather and the Earth’s environment, necessitating accurate and efficient sunspot detection. This study explores deep learning methods to automate sunspot identification in solar satellite images, keeping personal bias to a minimum. Utilizing observations of the Solar Dynamics Observatory, we leverage active-region data from the Helioseismic Magnetic Imager active-region patches to locate sunspot groups detected between 2011 and 2023. The Morphological Active Contour Without Edges technique is applied to produce pseudo-labels, which are utilized to train the U-Net deep learning architecture, combining their strengths for robust segmentation. Evaluation metrics—including precision, recall, F1-score, intersection over union, and Dice coefficient—demonstrate the superior performance of U-Net. Our approach achieves a high Pearson correlation coefficient of 0.97 when compared with the sunspot area estimation of the Space Weather Prediction Center and 0.96 in comparison with the Debrecen Photoheliographic Data. This hybrid methodology provides a powerful tool for sunspot identification, offering the improved accuracy and efficiency crucial for space-weather prediction.
Extracting the X-Ray Reverberation Response Functions from the Active Galactic Nucleus Light Curves Using an Autoencoder
Authors: Deesamutara Sanhanat , Chainakun Poemwai , Worrakitpoonpon Tirawut , Khanthasombat Kamonwan , Luangtip Wasutep , Jiang Jiachen , Pozo Nuñez Francisco , Young Andrew J.
Published: February 2025

We study the X-ray reverberation in active galactic nuclei (AGN) using the variational autoencoder (VAE), which is a machine learning algorithm widely used for signal processing and feature reconstruction. While the X-ray reverberation signatures that contain the information of the accretion disk and the X-ray-emitting corona are commonly analyzed in the Fourier domain, this work aims to extract the reverberation response functions directly from the AGN light curves. The VAE is trained using the simulated light curves that contain the primary X-rays from the lamppost corona, varying its height and the corresponding reflection X-rays from the disk. We use progressively more realistic light-curve models, such as those that include the effects of disk-propagating fluctuations and random noises, to assess the ability of the VAE to reconstruct the response profiles. Interestingly, the VAE can recognize the reverberation patterns on the light curves; hence, the coronal height can be predicted. We then deploy the VAE model on the XMM-Newton data of IRAS 13224–3809 and directly estimate, for the first time, the response functions of this source in various observations. The result reveals the corona changing its height between 3r

g
and 20r

g
, which is correlated with the source luminosity and in line with previous literature. Finally, we discuss the advantages and limitations of this method.
Galaxy–Galaxy Strong Lensing with U-Net (GGSL-UNet). I. Extracting Two-dimensional Information from Multiband Images in Ground and Space Observations
Authors: Zhong Fucheng , Luo Ruibiao , Napolitano Nicola R. , Tortora Crescenzo , Li Rui , Zhu Xincheng , Busillo Valerio , Koopmans L. V. E. , Longo Giuseppe
Published: February 2025

We present a novel deep learning method to separately extract the two-dimensional flux information of the foreground galaxy (deflector) and background system (source) of galaxy–galaxy strong-lensing events using U-Net (GGSL-UNet for short). In particular, the segmentation of the source image is found to enhance the performance of the lens modeling, especially for ground-based images. By combining mock lens foreground+background components with real sky survey noise to train GGSL-UNet, we show it can correctly model the input image noise and extract the lens signal. However, the most important result of this work is that GGSL-UNet can accurately reconstruct real ground-based lensing systems from the Kilo-degree Survey in 1 s. We also test GGSL-UNet on space-based lenses from BELLS GALLERY, and obtain comparable accuracy to standard lens-modeling tools. Finally, we calculate the magnitudes from the reconstructed deflector and source images and use these to derive photometric redshifts (photo-z), with the photo-z of the deflector well consistent with the spectroscopic ones. This first work demonstrates the great potential of the generative network for lens finding, image denoising, source segmentation, and decomposing and modeling of strong-lensing systems. For upcoming ground- and space-based surveys, GGSL-UNet can provide high-quality images as well as geometry and redshift information for precise lens modeling, in combination with classical Markov Chain Monte Carlo modeling for the best accuracy in galaxy–galaxy strong-lensing analysis.
NGDEEP: The Star Formation and Ionization Properties of Galaxies at 1.7 < z < 3.4
Authors: Shen Lu , Papovich Casey , Matharu Jasleen , Pirzkal Nor , Hu Weida , Berg Danielle A. , Bagley Micaela B. , Backhaus Bren E. , Cleri Nikko J. , Dickinson Mark , Finkelstein Steven L. , Hathi Nimish P. , Huertas-Company Marc , Hutchison Taylor A. , Giavalisco Mauro , Grogin Norman A. , Jaskot Anne E. , Jung Intae , Kartaltepe Jeyhan S. , Koekemoer Anton M. , Lotz Jennifer M. , Pérez-González Pablo G. , Rothberg Barry , Simons Raymond C. , Vanderhoof Brittany N. , Yung L. Y. Aaron
Published: February 2025

We use JWST/NIRISS slitless spectroscopy from the Next Generation Deep Extragalactic Exploratory Public (NGDEEP) Survey to investigate the physical condition of 178 star-forming galaxies at 1.7 < z < 3.4. At these redshifts, the deep NGDEEP NIRISS slitless spectroscopy covers the [O ii]λλ3726,3729, [O iii]λλ4959,5007, Hβ and Hα emission features for galaxies with stellar masses

log
(

M

*

/

M

⊙

)
≳
7

, nearly a factor of 100 lower than previous studies. We focus on the [O ii]/[O iii] (O32) ratio which is primarily sensitive to the ionization state and with a secondary dependence on the gas-phase metallicity of the interstellar medium. We find significant (≳5σ) correlations between the O32 ratio and galaxy properties as O32 increases with decreasing stellar mass, decreasing star formation rate (SFR), increasing specific SFR (sSFR ≡ SFR/M
*), and increasing equivalent width (EW) of Hα and Hβ. These trends suggest a tight connection between the ionization parameter and these galaxy properties. Galaxies at z ∼ 2–3 exhibit a higher O32 than local normal galaxies with the same stellar masses and SFRs, indicating that they have a higher ionization parameter and lower metallicity than local normal galaxies. In addition, we observe a mild evolutionary trend in the O32–EW(Hβ) relation from z ∼ 0 to z ≳ 5, where higher redshift galaxies show increased O32 and EW, with possibly higher O32 at fixed EW. We argue that both the enhanced recent star formation activity and the higher star formation surface density may contribute to the increase in O32 and the ionization parameter.
Differences in vascular endothelial growth factor expression and myocardial perfusion between before and after phase II cardiovascular rehabilitation in coronary artery disease patients after complete revascularization: a protocol study
Authors: Martha J.W. , Katamihardja A.H.S. , Nazir A. , Sylviana N. , Turbawaty D.K. , Tiksnadi B.B.
Published: February 2025

Introduction: Cardiac rehabilitation may improve health outcomes in coronary artery disease (CAD) patients, but the mechanism is still unknown. Collateralization and improvement of microvascular ﬂ ow is one of the hypotheses underlying this mechanism, however research on this is scant and inconclusive. Collateralization is affected by VEGF expression and has the effect of improving myocardial perfusion. Therefore, this study aimed to assess VEGF levels and myocardial perfusion before and after cardiac rehabilitation. Methods and Results: This study is a comparative study of patients who received cardiovascular rehabilitation treatment at Dr. Hasan Sadikin Hospital. The subjects of this study were consecutively selected from patients who received cardiovascular rehabilitation treatment at Dr. Hasan Sadikin Hospital. The primary outcome of this study is to assess the expression of VEGF A and myocardial perfusion in coronary artery disease patients who have undergone complete revascularization before and after phase II cardiac rehabilitation. Conclusion: This study will assess the beneﬁ cial effects of phase II rehabilitation in more detail as it uses proteomics parameters to determine the underlying mechanism and assesses myocardial perfusion as an outcome.
Postoperative echocardiographic assessment of patients with atrioventricular septal defect
Authors: Vassileva Z.
Published: February 2025

Atrioventricular septal defect (AVSD) is a combination of an atrial septal defect type ostium primum, an inlet ventricular septal defect, and a common atrioventricular (AV) valve. In the partial type, there is no ventricular communication, and the common AV valve is divided into two separate oriﬁ ces. Both kinds of AVSD can be corrected surgically through closure of the septal defects and AV valve plasty. The postoperative echocardiographic follow-up includes an assessment of residual septal defects, AV valve function, left ventricular outﬂ ow tract obstruction, ventricular dimensions and function, and indirect estimation of pulmonary artery pressure.
Towards the Adoption of Blockchain to Trustworthy Interoperability in Industry 4.0 Systems: A Case Study
Authors: Allian Ana Paula , Schnicke Frank , Antonino Pablo Oliveira , Kuhn Thomas , Nakagawa Elisa Yumi
Published: February 2025

The rapid evolution of Industry 4.0 has brought forth transformative changes in manufacturing, accentuating the need for seamless interoperability among heterogeneous systems. However, the geographically distributed and decentralized nature of Industry 4.0 ecosystems presents a pressing challenge: ensuring trustworthy interoperability within a complex web of entities and intermediaries. This paper delves into the pivotal role of blockchain technology in addressing this challenge, aiming to bridge the gap between theoretical promises and practical applications. By examining the feasibility and efficacy of blockchain solutions in fostering trust and enabling interoperability within Industry 4.0 environments, we confront the pressing issue of data security, integrity, and reliability. Through the lens of seven blockchain-based solutions, we navigate the intricate landscape of Industry 4.0, offering insights into the trade-offs, risks, and potentials associated with blockchain adoption. Real-world case studies and practical demonstrations underscore the urgency and relevance of our research, shedding light on pathways for industry stakeholders to navigate the complexities of interoperability. Our findings not only contribute to advancing the discourse on blockchain’s role in Industry 4.0 but also provide actionable strategies for addressing the overarching challenge of ensuring trustworthy interoperability in the digital age.
A new flea beetle genus from sub-Saharan Africa, and taxonomic remarks on the Blepharida genera group in the Afrotropical region (Chrysomelidae, Galerucinae, Alticini)
Authors: D'Alessandro Paola , Biondi Maurizio
Published: February 2025

Cladocera fulvipennis Jacoby is transferred to Afrotropicalticagen. nov., here described. The new genus belongs to the group of Afrotropical genera traditionally attributed to the Blepharida group: Blepharidina Bechyné, Calotheca Heyden, Diamphidia Gerstaecker, Polyclada Chevrolat, and Xanthophysca Fairmaire. A diagnostic key to these genera, and the list of species currently attributed to Diamphidia and Polyclada are provided based on type material and original species descriptions. Species and genera whose taxonomic position needs a revision were identified. Finally, the following synonymy is proposed: Cladocera fulvipennis Jacoby, 1895 = Blepharida favareli Achard, 1922, syn. nov.
Besedjeslovne razprave
Authors: Toporišič Jože
Published: February 2025

Izbrani in objavljeni Toporišičevi sestavki so bili tiskani od srede 60. let (1965) pa do leta 2005. Izhajali so kar v 25 naših (nekaj pa tudi v tujih) glasilih ali zbornikih in tudi zato jih je bilo treba napraviti realno dostopna vsem. Besedjeslovne razprave obsegajo šest razdelkov raziskovalnih razprav ter kazalo stvari, imen in sestavkov.
Introduction à la traduction du chapitre des Prinzipien der Wärmelehre : « La comparaison en tant que principe scientifique »
Authors: Santantonio Corto
Published: February 2025

Dans cette introduction, nous nous employons à
élucider quelques idées importantes et originales que Mach développe
dans le chapitre de ses Prinzipien der
Wärmelehre intitulé « La comparaison en tant que principe
scientifique ». Nous mettons en particulier l’accent sur les éléments
de rationalisme qu’il comporte, comme la nécessité pour le chercheur
d’avoir recours, dans les descriptions qu’il propose des faits, à la
théorie ou à la spéculation. Il n’est jamais question chez Mach d’une
simple « copie » ou « reproduction » de ceux-ci. La spontanéité libre
et créatrice de la pensée a un rôle prépondérant à jouer, et non pas
subalterne par rapport aux sens. Nous revenons également sur la
conception opératoire ou pragmatique de la conceptualité qui est celle
de Mach, et qui le rapproche de Kant plutôt que de l’empirisme anglais
classique.
La comparaison en tant que principe scientifique
Authors: Mach Ernst
Published: February 2025

Dans ces quelques pages d’une grande richesse,
étonnamment peu connues et rarement citées par les commentateurs,
Ernst Mach développe des réflexions guère compatibles avec la
présentation généralement donnée de son « positivisme». L’étude de la
comparaison, érigée ici en principe fondamental de l’activité
scientifique, fournit surtout l’occasion de réfléchir, au-delà des
seuls raisonnements analogiques, à ce que l’esprit scientifique ajoute
de lui-même, spontanément, aux faits. Mach nomme cet élément
« théorie» ou « idée théorique» et, tout en insistant sur les risques
qu’entraîne son utilisation acritique, il insiste également et surtout
sur les bénéfices que l’on peut en tirer. Il ne s’oppose aucunement à
son introduction dans les descriptions scientifiques. À vrai dire,
l’on voit mal comment l’on pourrait faire œuvre scientifique sans
théorie. Cette dernière présente une supériorité ou un avantage
incontestable, du point de vue quantitatif, sur l’observation isolée.
Elle permet d’élargir et d’enrichir le fait présentement observé de
déterminations nouvelles, celles obtenus au cours d’observations
passées, et de réaliser d’authentiques découvertes. Au-delà de leur
fonction illustrative, les analogies possèdent une puissance
heuristique. Puisque toute description fait intervenir de tels
éléments théoriques, elle est nécessairement plus qu’une « simple»
description. Même la description dite « directe» implique une forme de
transcendance, elle qui n’a rien d’un décalque ou d’une reproduction
des faits observés, mais doit plutôt être comprise comme leur
reconstruction en pensée. Cette dernière prend leur place, elle se
substitue à eux. La défense d’une position constructiviste, dans les
derniers paragraphes de ce texte, témoigne que Mach a su reconnaître
et donner toute sa valeur à l’activité propre de la pensée (sa
spontanéité), elle-même conçue sur un mode essentiellement pragmatique
ou opératoire (penser, c’est faire des choses, s’engager dans des
activités corporelles et intellectuelles) plutôt que
comparatif-abstractif. E. Mach, « Die Vergleichung als
wissenschaftliches Prinzip», dans Die Prinzipien der
Wärmelehre. Historisch-kritisch entwickelt [1896], mit einer
Einleitung herausgegeben von M. Heidelberger und W. Reiter, Berlin,
Xenomoi, 2016, p. 444–453.
Critical Language Pedagogy to Enhance Secondary Students' Creative Writing Skills in the EFL Classroom
Authors: Huertas-Abril Cristina A. , Molina Cristina García
Published: February 2025

This chapter presents an experimental study on the benefits of including creativity in the EFL classroom in Secondary Education, following the ideas of the Critical Language Pedagogy approach and using creative writing tasks to ignite students' creative thinking. This mixed-method study involved 101 participants, divided into experimental and control groups. The experiment followed three phases: an initial questionnaire was implemented to collect data on their perceptions of their creative abilities; then the experimental group completed the proposed tasks on creative writing; and finally, both groups filled in a final questionnaire on their perceptions of creativity. Differences were identified between the experimental groups and the control groups, as well as between academic levels and gender. Likewise, to complete the study even further, the three tasks implemented on creative writing were assessed according to a validated rubric.
Fuzzy Soft Sets Meets Machine Learning
Authors: Rajalakshmi D. , Revathy G. , Tamil Thendral M.
Published: February 2025

Soil quality is an important aspect in successful agriculture, impacting crop output and sustainability. Traditional soil prediction methods frequently encounter uncertainty and inadequate information. This study provides a unique way to improving soil quality prediction by combining fuzzy soft sets with machine learning algorithms. Using a complete dataset encompassing variables such as soil pH, nutrient levels (Nitrogen, Phosphorus, Potassium), temperature, humidity, and rainfall, our solution overcomes the inherent uncertainties in soil data by representing imprecise and ambiguous properties with fuzzy logic. Soft sets are used to accommodate partial data, giving a solid foundation for decision-making. Machine learning models, such as regression and classification approaches, are then trained on the improved information to forecast soil quality outcomes.
Morphological Complexity Development Across Proficiency Levels in English as a Foreign Language
Authors: Uzun Kutay
Published: February 2025

Morphological complexity is an important construct in achieving higher language proficiency levels but research addressing its progression across proficiency levels seem to be sparse. In that regard, this study aimed to address this gap by investigating how morphological complexity develops among learners of English. The corpus of the study included 5200 short, 200-300 word essays written by undergraduate learners of English. Morphological complexity of each essay was analyzed computationally and the following variables were extracted from each text: 1. Average inflectional variety 2. Inflectional type-token ratio 3. Inflectional mean complexity index 4. Average derivational variety 5. Derivational type-token ratio 6. Derivational mean complexity index All possible combinations (n = 31) of the aforementioned morphological complexity indices were tested in Ordinal Logistic Regression models. The results showed that the best-performing models could predict L2 proficiency level through morphological complexity, explaining approximately 5.50% of the variance in the data.
The relationship between the injury severity based on injury severity score and child seating position in the vehicle
Authors: Kouchakinejad-Eramsadati Leila , Zohrevandi Behzad , Bashi Shahabi Faranak , Homaie Rad Enayatollah , Hosseinpour Marieh , Khodadadi-Hassankiadeh Naema
Published: February 2025

The aim was to determine the relationship between the severity of the score and the child sitting position in the vehicle. In this retrospective cohort study, the severity score was obtained from HIS. After entering the data into STATA/SE version 14, univariate regression models were used to identify the potential confounding variables. Poisson regression estimators were applied to depict the relationship between safety devices, seating position of the child, and the severity indices. Out of 257 child occupants under 6 years, only 4.1% of the children used child seats and 7.7% used seat belts. There was a statistically significant positive relationship between ISS and middle rear seat (P = 0.026) and left rear seat (P = 0.000). A positive relationship existed between ISS and the right rear seat. Hospitalization of children sitting on the middle rear seat was longer than the others. The right rear seat was found to be the safest seat for children. The pattern of child accidents is different in the study region compared to other places. Local interventions should be implemented using evidences obtained from road traffic accidents. Thus, the governments should explore new strategies to increase the use of child seats by parents.
Cognitive, behavioral and brain lesional factors in the neurorehabilitation of stroke patients: prognostic and clinical outcomes
Authors: Piras Fabrizio , Piras Federica , Banaj Nerisa , Assogna Francesca , Langella Roberto , Caltagirone Carlo , Spalletta Gianfranco
Published: February 2025

Stroke is the second most common cause of death worldwide and the main cause of adult disability in Western Countries, with 40% of stroke survivors reporting problems in activities of daily living. functional and clinical outcomes of the rehabilitative process may vary as a function of a number of variables, and predicting the degree of recovery after stroke, although essential, can be challenging, such that patients with similar baseline impairments might show different recovery trajectories.In the present study, we explored this issue in a sample of 48 stroke patients (right hemisphere damage) admitted to the IRCCS Santa Lucia Foundation, a neurorehabilitation hospital located in Rome, Italy. Specifically, we focused on cognitive, neuropsychiatric and brain lesion measures to predict clinical outcome.Results revealed that age, baseline neuro-functional, neurocognitive and neuropsychiatric data, along with sparing of temporal pole and inferior frontal regions, mediate post-stroke recovery. Such results could provide further hints in considering the clinical variables involved in functional recovery and return to work in stroke patients.
[Occupational medicine and ergonomics for post-stroke patient return to work]
Authors: Capodaglio Edda , Imbriani Marcello
Published: February 2025

In the literature, the treatment of the topic of return to work in post-stroke patients has been influenced by a predominantly medical approach, at the expense of the integrated consideration of organizational, psychosocial and individual aspects that greatly influence the possibility of an effective return to work. Although integration policies are envisaged in European countries, there are often scarce or no concrete measures that favour the activation of people with residual disabilities, or aim at workplace adaptation. The work presented here aims to provide a concise overview, according to recent literature, of the factors that facilitate or hinder the return to work process in the post-stroke patient and of possible ergonomic interventions. Considering return to work as a multifactorial outcome, it seems necessary, for the Occupational Physician in collaboration with the other interested figures, to implement a paradigm shift in the design of return to work programs to respond more satisfactorily to the important challenges posed by a disabling disease such as stroke.
[The European Union's ‘new carcinogens directive’: the commitments ahead, the new opportunities that lie ahead (and we must not waste) in Italy]
Authors: Calisti Roberto
Published: February 2025

The new EU directive on the protection of workers from the risks related to exposure to carcinogens and mutagens at work, issued on December 2017, will be integrated inside the Member States' national laws not later than 17th January 2020. The new directive brings in force new binding occupational exposure limit values (BOELVs) for several agents, some of great importance such as hard wood dusts, a set of hexavalent chromium compounds and crystalline silica dust; for some cases, the entry into force of the new limits is delayed in time. The new directive clarifies that the limit values are established considering factors distinct from health necessities too.The Member States are bound to adopt national limit values not exceeding the corresponding EU ones, but are empowered to lower them. It is essential that the control of the actual respect of the limit values results not only from the application of theoretic previsional models, but is entrusted mainly to high quality exposure measurements and to estimates directly derived from measurements, on the base of publicly available JEMs. The specific health surveillance to be provided to any person both exposed and previously exposed to carcinogens at work should not be limited to proper oncological screening actions, but should include programs for biological monitoring of both exposures and related pre-neoplastic effects, every time any of these is possible and useful. A fair mapping of the exposures to carcinogens and mutagens at work and a systematical registration of cases of cancers attributable to occupational exposures will be placed side to side.
Comparative analysis of efficacy, safety, and cost-effectiveness of betahistine alone, caroverine alone, and caroverine plus ginkgo biloba in moderate tinnitus
Authors: Nayak Laxmipriya , Dehury Suhasini , Rautray Subhalaxmi , Sahu Lorika , Sahu Debadutta
Published: February 2025

BACKGROUND:

Tinnitus or “phantom sound” continues to be a significant health problem without a uniformly accepted treatment. Numerous pharmaceutical options have been investigated, but satisfactory results are yet to be obtained.

OBJECTIVES:

The objectives of this study were to study and compare the efficacy, safety, and cost-effectiveness of caroverine alone, caroverine combined with ginkgo biloba and betahistine alone in patients of moderate tinnitus.

MATERIALS AND METHODS:

In this prospective, observational, hospital-based study, wherein 72 patients were distributed equally across three groups – Group A received caroverine 20 mg twice daily, Group B received caroverine 20 mg combined with ginkgo biloba 120 mg twice daily, and Group C received betahistine 8 mg thrice daily for 12 weeks. Efficacy was zanalyzed assessing the changes in tinnitus handicap inventory (THI), tinnitus functional index (TFI), Visual Analog Scale (VAS) score, and pure tone audiometry values from baseline at 4, 8 and 12 weeks. The cost-effectiveness analysis was done at the end of 12 weeks zutilizing the incremental costeffectiveness ratio. The Chi-square test and one-way ANOVA were used to evaluate the statistical significance of the results.

RESULTS:

The reduction in the THI, TFI and VAS scores was maximum in Group B followed by Group A and Group C. All the drugs were well-tolerated, and the adverse effects encountered were mild and nonserious. Combination therapy of caroverine with gingkgo biloba was the most expensive.

CONCLUSION:

Caroverine and ginkgo biloba combination therapy was the most effective in reducing the handicap of moderate tinnitus.
Knowledge, perception and utilization of breast cancer screening among women visiting primary care clinics
Authors: Saeed Rabeeya , Usmani Maaha , Durrani Noureen , Javaid Hamna , Tahir Haya
Published: February 2025

ABSTRACT

Context:

Of all the cancers in the world, breast carcinoma claims to be the deadliest for women in the world. It is of key importance that early detection of breast cancer is made possible through awareness programs targeting the general population. However, this solution is fraught with obstacles. Noteworthy of these obstacles are lack of education.

Aims:

To determine knowledge, perception, and utilization of breast cancer screening among women visiting primary care centers in Karachi, Pakistan.

Settings and Design:

This cross-sectional study was conducted in community-based primary care centers at Liaquat National Hospital Karachi from September 2021 to February 2022.

Material and Methods:

The data was collected by using a semi-structured questionnaire. The questions were derived from the Cancer Awareness Measure (CAM) scale, the most frequently used and validated tool to assess awareness of cancer risk factors and screening.

Statistical Analysis:

Data were analyzed using the Statistical Package for the Social Sciences (SPSS) version 21.

Results:

A total of 386 participants were enrolled in the study. The median age of study participants was 32 (IQR=) years. Only a few had correct knowledge regarding the breast cancer screening method (n = 118, 30.6%). However, 114 (29.5%) correctly responded that after 40 years, yearly mammography screening should be conducted (n = 114, 29.5%). The majority considered performing breast self-examination important for health (n = 273, 70.7%). 187 (48.4%) women responded that they once performed a self-examination of their breasts.

Conclusion:

The study highlighted a significant gap in knowledge regarding breast cancer screening among women. There is a need to emphasize the integration of health education interventions at the primary care level keeping in mind the health literacy level of our population.
Sexual dysfunction among patients with type-2 diabetes mellitus attending diabetes clinics in primary healthcare centers in Bahrain—A cross-sectional study
Authors: Al Ubaidi Basem Abbas A. , Alawainati Mahmood , Ali Mohamed Shaikh , Alhalwaji Mohamed , Mahdi A. Rasool , Husain Hasan A. , Al Matooq Ahmed M.
Published: February 2025

ABSTRACT

Introduction:

Sexual dysfunction (SD) is a common problem among males with type-2 diabetes mellitus (T2DM) but often goes underdiagnosed and underreported. This study aimed to measure the prevalence and risk factors of SD among males with T2DM attending diabetes clinics in Bahrain.

Methods:

A cross-sectional study was conducted in ten primary health centers in Bahrain using a self-administered questionnaire. The questionnaire consisted of three parts: sociodemographic characteristics and the Sexual Assessment and Dysfunction in Diabetic Men (SAD-M) questionnaire. Descriptive and inferential analyses, including logistic regression, were performed.

Results:

A total of 313 patients with an average age of 54.3 ± 10.0 years were included. More than half of the patients had dyslipidemia (n = 220, 70.3%) and hypertension (n = 178, 56.9%). Approximately half of the participants had no morning erections (n = 161, 51.4%), and about a third had less than three sexual intercourse attempts in the last six months (n = 90, 28.8%). Of the participants, 32.6% had moderate SD, 42.5% had mild SD, and 25% had no SD. Univariate analysis showed that male patients with SD were older (P < 0.001) and had a higher body mass index (P = 0.036) compared to those without SD. In addition, unemployed patients (P < 0.001), Bahraini (P < 0.001), had diabetes for 10 years or more (P < 0.001) and had prostate and spinal diseases (P = 0.004 and P = 0.010, respectively) had higher rates of SD. Logistic regression analysis showed that older patients (P = 0.007) and patients with a diabetes duration of more than 10 years were more likely to have SD than their counterparts (OR = 14.908, P < 0.001).

Conclusion:

SD is a common problem among males with T2DM in Bahrain, especially among older patients and those with a prolonged history of diabetes. Therefore, primary care providers should consider screening for SD in male patients with T2DM.
Prevalence and concomitance of diabetic peripheral sensory neuropathy and lower limb peripheral arterial disease in type II diabetics and its correlation with obesity
Authors: Solanki Jayesh Dalpatbhai , Shah Axat Pragnesh , Lalwani Nisha , Trivedi Bansi Janakbhai , Savani Avan Ashokbhai , Sojitra Krupali Parshottambhai
Published: February 2025

ABSTRACT

Introduction:

Among type 2 diabetics (T2D), macrovascular complication lower limb Peripheral Arterial Disease (PAD) and microvascular complication Diabetic Peripheral Sensory Neuropathy (DPSN) have scarcely studied concordance and their association with obesity. Qualitative and general body fat parameters give a complete picture of obesity. We studied the association of vibration perception threshold (VPT)-based DSPN and ankle brachial pressure index (ABPI))-based PAD, and the effect of obesity on them, in T2Ds.

Methods:

A cross-sectional study was done on 152 under-treatment T2Ds. Bio-esthesiometer-based VPT from the sole of each foot and VersaDop-based ABPI from all limbs were assessed. Prevalence of DSPN (VPT ≥25) and PAD (ABPI ≤0.9) was measured and compared for concomitance. The odds ratio was used for testing association and multiple linear regressions were accomplished for predictors of VPT and ABPI taking P value < 0.05 as statistically significant.

Results:

T2Ds had a mean age of 53 years, a mean duration of 67 months, and 48% glycemic control. The prevalence of abnormal VPT and ABPI was 64% and 23%, respectively. VPT-based subgroups do not defer significantly from ABPI and vice versa. Obesity was associated with only abnormal ABPI (visceral > general). Odd’s ratio for neuropathy with vasculopathy was insignificant while VPT and ABPI had differences in significant predictors.

Conclusion:

T2Ds having 64% neuropathy and 23% vasculopathy had one-third concomitance but lack of association and different predictors for each. Vasculopathy not neuropathy was associated with obesity; visceral more than general; suggesting scope for its rectification. It suggests different progression of these complications, despite some cross-talk between them.
Childhood immunization, nutrition, and delivery care in the population of J and K, India from 2005-21: A secondary data analysis from national family health survey
Authors: Choudhary Neha , Sangra Sonika
Published: February 2025

ABSTRACT

Background:

Immunization plays a critical role in safeguarding public health by preventing the spread of infectious diseases and reducing morbidity and mortality worldwide. Immunization programs not only protect individuals from deadly childhood diseases but also contribute to community immunity, thereby reducing the overall burden of illness. This study aims to study the trend of childhood immunization, nutrition in those under 5 and delivery care in Jammu and Kashmir, from the data available at the public forum of the National Family Health Survey from the third to fifth rounds.

Materials and Methods:

The indicators of delivery care, nutrition status of children, and vaccination among children below 5 years of age were extracted from the last three rounds of NFHS conducted in 2005–2006, 2015–2016, and 2019–2021. The data obtained were analyzed, and summed up in tables and figures using Microsoft Excel.

Results:

Rise in vaccination rate, uptake of BCG, measles-containing vaccine, vitamin A (90% to 95%; 66% to 86.2%; 78% to 92%; 12.6% to 82% respectively) from NFHS-3 to NFHS-5. Vaccine uptake in a public health facility increased to 99.1% in NFHS-5. A rise in the percentage of children breastfed within 1 h after birth and exclusive breastfeeding (32% to 55.6% and 42.3% to 62%, respectively) from NFHS-3 to NFHS-5. An increase in wasting and severe wasting (from 14.8 to 19% and 4.4 to 9.7%, respectively) is observed. A rise in institutional births from 50.2% in NFHS-3 to 92.4% in NFHS-5 was reported.

Conclusion:

Our study highlights a rise in wasting among children under the age of 5 years in J and K despite an increase in vaccination uptake and institutional deliveries from NFHS-3 to NFHS-5.
Prevalence of stroke and associated risk factors among elderly patients in a primary care setting: A retrospective cohort study
Authors: Alabduljabbar Khaled , Elabd Kossay , Alsaif Abdulaziz , Basudan Loay
Published: February 2025

ABSTRACT

Background:

Stroke is a major health concern worldwide, with significant morbidity and mortality. This study aims to retrospectively analyze the prevalence and risk factors associated with stroke in a primary care setting in Riyadh, Saudi Arabia.

Methods:

A retrospective cohort study was conducted at the Family Medicine and Polyclinics, King Faisal Specialist Hospital and Research Centre in Riyadh. Data were collected from patients aged 50 years and older who visited the clinic between January 1, 2021, and December 31, 2022. Stroke diagnoses were determined using ICD-10 codes, and data on demographic variables and stroke risk factors were extracted from medical records. Statistical analyses included Chi-square or Fisher’s Exact tests, Mann–Whitney U test, and logistic regression analysis.

Results:

Out of 2034 patients, 36 (1.8%) were diagnosed with stroke, predominantly ischemic (91.7%). Significant correlations with stroke occurrence included advanced age, male gender, family history of stroke, and comorbidities such as hypertension, transient ischemic attack, ischemic heart disease, brain aneurysm, and carotid artery disease. Multivariable analysis identified older age (≥80 years, OR = 8.949, P = 0.013), male gender (OR = 5.980, P = 0.010), underweight status (OR = 50.873, P = 0.005), family history of stroke (OR = 12.603, P = 0.040), and hypertension (OR = 7.984, P = 0.009) as significant risk factors for stroke.

Conclusion:

Stroke prevalence in the sampled population was 18 per 100,000 individuals, with advanced age, male gender, and hypertension identified as significant risk factors. These findings highlight the need for targeted preventive strategies and further prospective research to establish causal relationships and improve stroke management in Saudi Arabia.
An online survey on the association between the use of alcohol-based hand sanitizer and dermatitis in the Jizan Population
Authors: EL-Mahdy Mona H. , Makeen Nada M. , Khrid Zenat A. , Modawi Khawla Mohammed , Sayegh Maram Abdullah , Hamrani Amnah Hussain , Humedi Anisah Mohammed , Juraybi Shumokh Fawaz , Someli Sharifah Abdulrahman , Darbashi Shatha Ahmed , Busayli Wafa Mohammed
Published: February 2025

ABSTRACT

Background:

Frequent use of alcohol-based hand sanitizers during the COVID-19 pandemic can cause skin irritation and dermatitis due to the removal of natural skin oils. This survey aims to assess the association between alcohol-based hand sanitizer use and dermatitis prevalence among the residents of Jizan, Saudi Arabia.

Methods:

This cross-sectional study was conducted using an online survey distributed between September and December 2021. The survey collected data on hand sanitizer usage patterns, dermatitis symptoms, and sociodemographic characteristics of 500 randomly selected Jizan residents aged ≥18 years. Associations between sanitizer use variables and dermatitis occurrence were analyzed using Chi-square and exact probability tests for instances with low frequencies.

Results:

The majority were 347 (69.4%) females, with a mean age of 23.6 ± 11.8 years. A total of 402 (80.4%) used sanitizers, increasing to 395 (79%) during the pandemic. Dermatitis symptoms were reported in 138 patients (27.6%) after sanitizer use. Using sanitizers >6 times daily was associated with 71.4% a dermatitis prevalence of 47.4% versus <3 times daily (P = 0.003). The use of 80–95% alcohol gels was linked to 68.8% dermatitis versus other products (P = 0.001). The common symptoms included skin roughness (55.4%), itching (46.5%), and redness (37.6%). Onset was immediate (23.3%) and within hours or days (28.2%).

Conclusions:

This study demonstrated a clear association between frequent or high-concentration sanitizer use and increased dermatitis prevalence among Jizan residents. Public awareness campaigns and product guidelines are needed to promote proper usage of techniques that balance hygiene and skin health. Future research should explore effective prevention strategies, such as moisturizer combinations or lower risk alternatives.
Prevalence of depression and anxiety among school going adolescents of Delhi: A cross-sectional study
Authors: Sonam  , Mahapatra Arun Kumar , Rajagopala S , Kumar Anil , Gupta Prashant Kumar , Rishabh  , Malhotra Shahzadi , Nesari Tanuja Manoj
Published: February 2025

ABSTRACT

Introduction:

According to UNICEF, among adolescents’ mental disorders, depression and anxiety account for 42.9% of cases. As per the National Mental Health Survey (NMHS) (2015-2016) of India; the Prevalence of Depressive Episodes and Recurrent Depressive Disorder and Phobic anxiety disorder among adolescents is 2.6% and 1.3%, respectively. The well-being and development of adolescents are directly related to the quality of their environment and early experiences of life. To understand the current mental health of adolescents the present study was initiated.

Methods:

A cross-sectional survey was conducted among 679 students aged 10-19 years at selected schools in South Delhi, India. Initially after the written informed consent procedure, a self-reported questionnaire was administered to collect data on socio-demographic variables and the Patient Health Questionnaire (PHQ-4). Descriptive statistics, Chi-square, univariate, and multivariate logistic regression were used to examine associations between variables under examination with anxiety and depression.

Results:

In the present survey, the mean age of study participants was 13.43 years, 386 (56.85%) participants were male. The overall prevalence of depression and anxiety among adolescents was found to be 25.92% and 13.70% respectively. The prevalence of depression was significantly higher among students who do not have sleep satisfaction (35.9% vs. 23.0%, P = 0.001) and among those who experience anxiety (58.1% vs. 20.8%, P = 0.000) than others. Similarly, the prevalence of anxiety was found significantly higher with increasing age (χ2, P = 0.001), increasing education levels (χ2, P = 0.001), sleep quality (χ2, P = 0.009), sleep satisfaction (χ2, P = 0.000), relationship status (χ2, P = 0.032) and depression status (30.7% vs. 7.8%, P = 0.000). Based on Multivariate analyses, higher education level (AOR: 1.53, 95%CI: 1.06–2.20) and anxiety (AOR: 4.88, 95%CI: 3.07–7.76) were associated with depression. Anxiety was associated with increasing age (16–19 years) (AOR: 3.35, 95%CI: 1.59–7.06) and depression (AOR: 5.18, 95%CI: 3.26–8.25).

Conclusion:

The present study suggests that the prevalence of depression and anxiety among school-going adolescents is 25.92% and 13.70%, respectively. The most common associated risk factors are increasing education level, sleep satisfaction, and anxiety and depression. The information may contribute to the development of preventive and control strategies for mental health conditions among adolescents for their welfare and well-being.