bluuebunny/crossref_metadata_2025_split huggingface dataset:
Polypharmacy in an Older Female: Thoughtful Deprescribing
Authors: George Sudeep Mathew , Vasu  , Kashyap Kritartha , Dhar Minakshi 
Published: November 2024

Abstract
The magnitude of polypharmacy is on the rise as the global population faces a demographic shift with a larger proportion of older people, along with a marked increase in the prevalence of multimorbidity. An 85-year-old woman with diabetes mellitus, systemic hypertension, rheumatoid arthritis, chronic depression, parkinsonism, and dementia presented with inappropriate polypharmacy, taking 32 medications. Comprehensive medication reconciliation was performed using the Discuss, Review, Use tools, Geriatric medicine approach, and Stop medication guide, assessing appropriateness based on Beers Criteria. Goals of care were established through shared decision-making, focusing on reducing her pill burden and relaxing treatment targets for blood pressure and glycated hemoglobin. The patient was ultimately prescribed 13 medications. This case highlights the importance of tailored, patient-centered approaches in managing polypharmacy and chronic conditions in older adults to improve overall health outcomes.
Frailty in Hemodialysis Patients: A Study from Two Tertiary Care Dialysis Units
Authors: Premlatha K. Sunitha , Shivani R. Namratha , Yadav P. Vaishnavi , Anandh Urmila 
Published: November 2024

Background:
Frailty is common in elderly individuals and is an important parameter predicting mortality. Multiple factors are responsible for this clinical syndrome and many are present in patients undergoing hemodialysis. Understanding the prevalence and factors associated with frailty in maintenance hemodialysis patients helps us to prognosticate and offer interventions in this vulnerable group.

Aims and Objectives: (
1) To study the prevalence of frailty in two quaternary maintenance hemodialysis units, (2) to understand factors that correlate with frailty, and (3) to look at the short-term impact of frailty on hospitalization and mortality in this cohort.

Materials and Methods:
A prospective study in two hemodialysis centers was conducted over a period of 6 months. Data on demographics, comorbid conditions, laboratory parameters, and nutritional parameters were collected. Nutritional assessment included information from 7-point subjective global assessment and Global Initiative on Malnutrition (GLIM). Data were also collected regarding the body composition analyses of these patients. Frailty was assessed by using the Fried’s classification. Data analysis was done looking at the prevalence of frailty in this cohort and factors associated with frailty. The cohort was followed up for another 6 months and survival outcome during this follow-up was recorded. Follow-up data were analyzed to look at the impact of frailty on short-term survival.

Results:
A total of 121 maintenance hemodialysis patients were included in the study. There were 44 (36%) females in the observational cohort. The mean (±standard deviation [SD]) age of the cohort was 56.59 (±13.58) years. The mean (± SD) dialysis vintage was 28.42 (±28.67) months. Sixty-eight (56.2%) patients had Type 2 diabetes mellitus and 111 (91.7%) had hypertension. Frailty (based on Fried’s classification) was seen in 107 (88.4%) patients. The incidence of frailty was distributed across all ages. There was also no significant association between frailty and nutritional parameters. Patients on thrice-weekly dialysis were found to have a higher incidence of frailty (P = 0.01). The presence of frailty did not impact short-term hospitalization and mortality.

Discussion:
There is a high incidence of frailty in hemodialysis patients across all ages. The underlying comorbidities and the repeated stress of the hemodialysis procedure make frailty prevalent in younger individuals, as was noted in our study. The incidence of frailty was more in patients on thrice-weekly dialysis. Frailty was not associated with hospitalizations and short-term mortality in our cohort.

Conclusions:
There is a high incidence of frailty across all ages in hemodialysis patients and should be assessed in all hemodialysis patients, risk factors identified, and appropriate therapeutic interventions instituted in these vulnerable patients.
Subjective Global Assessment in Patients on Maintenance Hemodialysis - A Study from Public Sector Hospital
Authors: Bachalakuri Snigdha , Yadla Manjusha , Kumar B. Vikram , Srinivas P. , Burri Sreekanth 
Published: November 2024

Introduction:
Chronic kidney disease (CKD) is a global public health concern that has a significant financial impact on health-care systems. Protein energy malnutrition (PEM) in MHD patients is associated with increased in mortality, reduced quality of life and increases morbidity, hospitalization, and mortality. According to a global meta-analysis of 65 studies from 10 geographical regions, malnutrition is highly prevalent in maintenance hemodialysis (MHD) patients. The gold standard for evaluating the nutritional state of patients with ESKD is total body nitrogen. SGA tool, MIS, mini nutritional assessment (MNA) tool, Health-Related Quality of Life Short Form 36-Index (WHO HRQOL SF 36), and subjective global nutritional assessment are some of the tools that are practical, validated, and affordable questionnaires that can be utilized in the public domain. A combination of anthropometric measurements and nutritional assessment tools is the most effective way to determine nutritional status.

Aim:
To assess the nutritional status of maintenance hemodialysis patients in a tertiary care centre using the 7 point SGA method.

Type of Study:
observational study.

Study Setting:
Tertiary care hospital in south India.

Study Population:
Patients undergoing maintenance Hemodialysis in our hospital.

Results:
Total Number of patients included in the study is 68. Mean age is 46.78years with a standard deviation of 11.181years. Male predominance was seen in the study group 72.1% to female patients 27.9%. Hypertension is the most common associated comorbidity 67.6%, followed by Diabetes mellitus 39.7%. Majority of the study group are in the Dialysis vintage group 1-2 years. Male patients have significant association with Malnutrition (P =0.006*). There is no significant correlation with kuppuswamy socio-economic class(P=0.123). There is no significant correlation between dialysis vintage and malnutrition (P=0.35). There was significant association with serum albumin(P<0.001), Body Mass Index (P<0.001), Mid Arm Circumference (P<0.001), Mid Arm Muscle Circumference (P<0.001), Skin Fold Thickness-Triceps (P<0.001).

Conclusion:
Moderate malnutrition was present in majority of patients 62%. Severe malnutrition was seen in only 0.8% patients. Statistically significant association was noted between anthropometric measurements-BMI, MAMC, MAC, Skin fold thickness and malnourishment. Serum albumin has significant association.

Limitations:
Small sample size. SGA is subjective assessment, has inter observer variations.
BUGWRIGHT2 remote inspection techniques in medium and small-sized Scandinavian ports
Authors: Pastra Aspasia , Johansson Tafsir , Francke Herbert , Dalaklis Dimitrios 
Published: November 2024

During the last few years, the utilization of Remote Inspection Techniques (RIT), including Unmanned Aerial Vehicles (UAVs) and Remote Operated Vehicles (ROVs), has gained significant momentum within the maritime sector. Today, RIT are rather extensively being exploited for ship inspection and maintenance purposes, thereby revolutionizing conventional practices and setting a new benchmark in the industry. In this context, these technologies are clearly emerging as indispensable tools in the modernisation of port operations. By effectively leveraging the capabilities of these technologies, ports can achieve remarkable strides in security, safety, efficiency, and sustainability. This paper aims to examine the extent to which small and medium-sized ports in Scandinavia are using RIT for ground-based port operations and sea navigation. To this end, it is based on findings from a focus group discussion with seventeen (17) different Port Facility Security Officers (PFSOs) in Scandinavia that draw reference to the extent of use of these technologies in ports. Recommendations for the use of RIT in ports have been, thereupon, tabled considering the need for a review of the International Ship and Port Facility Security (ISPS) Code to address the application of UAVs in managing port security.
Au cours des dernières années, l’utilisation des techniques d’inspection à distance (RIT), y compris les véhicules aériens sans pilote (UAV) et les véhicules télécommandés (ROV), a pris une ampleur considérable dans le secteur maritime. Aujourd’hui, les techniques d’inspection à distance sont largement exploitées à des fins d’inspection et de maintenance des navires,révolutionnant ainsi les pratiques conventionnelles et établissant une nouvelle référence dans l’industrie. Dans ce contexte, ces technologies apparaissent clairement comme des outils indispensables à la modernisation des opérations portuaires. En exploitant efficacement ces technologies, les ports peuvent réaliser des progrès remarquables en matière de sécurité, de sûreté, d’efficacité et de durabilité. Cet article vise à examiner dans quelle mesure les ports de petite et moyenne taille en Scandinavie utilisent les technologies de l’information et de la communication pour les opérations portuaires au sol et la navigation maritime. Pour ce faire,il s’appuie sur les conclusions d’un groupe de discussion avec dix-sept agents de sûreté des installations portuaires (PFSO) en Scandinavie qui font référence à l’étendue de l’utilisation de ces technologies dans les ports. Des recommandations pour l’utilisation des technologies de l’information et de la communication dans les ports sont ensuite présentées, compte tenu de la nécessité de réviser le Code international pour la sûreté des navires et des installations portuaires (ISPS) afin de prendre en compte l'application des drones dans la gestion de la sécurité portuaire.
Nurses’ reported training needs for advanced cell therapies: a survey on behalf of the Nurses Group of the EBMT
Authors: Kenyon Michelle , Liptrott Sarah Jayne , Kisch Annika , Mooyaart Jarl , Piepenbroek Brian , Hutt Daphna , Salcedo Isabel , Ruggeri Annalisa , Chabannon Cristian , Ellard Rose , Murray John 
Published: November 2024

Background Advanced Therapy Medicinal Products (ATMPs) for human use have advanced globally with the rapid adoption of Chimeric Antigen Receptor T-cell (CAR-T) therapies in haemato-oncology. CAR-T cell therapy and ATMPs have unique, significant acute and chronic toxicities, and appropriate patient care is crucial. Significant challenges, including the need for nurse education and training, accompany optimal patient success and benefits. Objectives This study aimed to describe nurses’ training needs in relation to ATMP management and patient care. Methods A cross-sectional online survey was performed by the European Society for Blood and Marrow Transplantation, based on a previously tested questionnaire developed in the UK. Findings 109 complete responses from 86 different centers from 24 countries were returned (1207 distributed). Over 1/3 reported experience delivering licensed ATMPs (CAR-T). High-priority training areas included a general introduction to ATMPs, toxicity management, product-specific information, and regulatory frameworks for ATMPs. A clear need for ATMP-specific training exists and is regarded as important. Training prior to implementation is key and should be supported by ongoing competency maintenance. Counseling, patient support, and long-term follow-up are identified for future training and opportunities for nurse experience sharing in this rapidly evolving field.
Formulation and Evaluation of Herbal Cough Syrup
Authors: Kodalkar Shubham Dada  , Kate Atul Shivaji  , Shendge Ajit Dada  , Dr. L. D. Hingane  
Published: November 2024

1. Cough is a common problem faced by individuals worldwide, acting as the body’s protective mechanism, classified based on various factors like signs, duration, and type of cough.
2.	Syrup is a widely used form of medication to treat cough and cold, with herbal syrup being the preferred choice due to its benefits over synthetic alternatives.
3.	Medicinal plants, especially in Asian countries, are utilized as primary healthcare agents, with ingredients showing expectorant and antitussive properties being commonly used in herbal treatments for cough.
4.	Herbal cough syrup, a liquid dosage form, is considered easier to administer than solid forms and is noted for its quicker and more effective action in curing coughs.
5.	The preparation of cough syrups involves specific methods and quantities of ingredients, with honey-based syrups evaluated for their quality based on different concentrations like 35%, 40%, and 45% w/v..
Three Modified Three-Term Conjugate Gradient Method in Non- linear Optimization
Authors: Farhan Khalaf Muord  
Published: November 2024

In this work several a Tree –Term Conjugate -Gradient (CG) – algorithms are Modified; and that satisfies the sufficient descent condition and a global convergence . primariliy, us- have derive three new methods of this type algorithms . and we compared with (HS) , (PR) and (LS). Algorithms by using (15) Well-Known test functions. And by using Wolfe and Strong Wolfe condition on every iteration. These new algorithms are used different memory less (BFGS) algorithms. Our new numerical results are proved very robust and efficient than the same classes of algorithms.
RSM and ANN Modeling Techniques to Forecast How Various Parameters will Affect the Improvement of Electronics Cooling using Radial Heat Sink.
Authors: Mangesh Dadarao Shende  
Published: November 2024

This research provides the mathematical modeling for temperature difference for natural convection using Response Surface Methodology (RSM) and Artificial Neural Network (ANN) based modelling. Length of fin (L), height of fin (H), number of fins (N) and the heat input (Q) for the Radial heat sink are the parameters selected under natural convection heat transfer. Looking at the pattern of the data, feed forward back propagation type neural network is chosen. The RSM mathematical model of temperature difference is used to compare the performance of the created ANN models. ANN Simulations proved to be successful in terms of agreement with actual values of experimentation. ANN simulations perform accurate to validate the experimental results and the results obtained from the RSM for the output under natural convection. The optimum values for the dimensional parameters namely length of fin, height of the fin, number of fins are obtained by RSM method. Also the optimum operating parameter that is heat input for minimum temperature difference is obtained.
The Alpha Star-Perfect Mapping in Topological Spaces
Authors: Abu Firas  Al –Musawi,  
Published: November 2024

Abstract: In this paper, we introduce new types of continuity mappings by using open sets in topological spaces which is called perfect mapping ( ), and also study some properties of these types. Some definitions are given. This research shows that if is ( ). Then the restriction of on the clopen set is also ( ). Next, for any mapping between two topological spaces with are disjoint clopen sets, where . This work shows that and are ( ) if and only if is ( ). Finally, we prove that if and are mappings with is ( ), then each one of and is ( ).
A Search on Integer Solutions to Ternary Non-homogeneous Nonic Diophantine Equation a α(x2+y2)-(2α-1)xy=4αz9
Authors: N.Thiruniraiselvi  
Published: November 2024

Different sets of integer solutions to the non-homogeneous Nonic Diophantine equation with three unknowns given by
α(x2+y2)-(2α-1) xy=4αz9 are presented in this paper.
MHD Non-Uniform Heat Source / Sink for Microorganism Bioconvection Flow on Casson Nanofluid Over an Exponential Stretching Sheet
Authors: Avinash B. Raut  
Published: November 2024

This study explores the numerical analysis of Casson nanofluid flow over an exponential stretching sheet, incorporating the effects of magnetic field, nonuniform heat source/sink, activation energy and motile microorganisms. The primary aim of the current study is to investigate the effects of these factors on the bioconvection dynamics within the fluid. By using a bvp4c algorithm, the governing equations that describe the nanofluid flow, taking into account of the non-Newtonian Casson fluid behaviour over an exponential stretching sheet’s velocity, temperature and concentration profiles along with the influence of activation energy on chemical reactions. Additionally, the study examines how motile microorganisms interact with the nanofluid flows, affecting the bioconvection patterns and overall fluid behaviour. The analysis provides a comprehensive understanding of the interplay between these variables and their effect on heat and mass transfer in the system. The results reveal that, for higher activation energy increases the temperature gradient and concentration fields, affecting the overall bioconvection process. The motile microorganisms impact to the bioconvection process by affecting the concentration and velocity fields. Their presence modifies the bioconvection patterns, which can either enhance or suppress the convective transport depending on their density and motility. Also, an increase in the values A∗ and B∗ leads to a enhance the fluid temperature.
An Introduction to Ternary Γ-Semirings
Authors: G. Chandrasekhar  
Published: November 2024

In this research article has to introduce the concept of ternary Γ-semirings.We first consider the congruences and ideals of ternary Γ-semirings then we construct a new ternary Γ-semiring and to be discussed formation of ideals on this ternary Γ-semiring. Also with the help of congruences induced by homomorphism of a ternary Γ-semiring.After that we will establish some of isomorphism theorems and identified the some of commutativity in the diagrams. particularly some fundamental results of ternary Γ-semiring were proved and strengthened.
Homomorphic Encryption and Secure Multi-Party Computation: Mathematical Tools for Privacy-Preserving Data Analysis in the Cloud
Authors: Mayuri Arun Gaikwad  
Published: November 2024

With more and more people using cloud computing and storing and handling data remotely, protecting the privacy and safety of private data has become very important. Homomorphic encryption and safe multi-party computing (MPC) are two new mathematics tools that offer strong ways to analyze data in the cloud while protecting privacy. When you use homomorphic encryption, you can do calculations directly on protected data, so you can process data securely without having to decode private data. This method makes sure that data stays protected while operations are being done, keeping it safe from people who shouldn't have access to it or seeing it. Cloud service providers can use homomorphic encryption to do different types of analysis on protected data, like collecting, searching, and machine learning, without revealing the private information that lies beneath. Secure multi-party computation protects privacy in situations where multiple people work together to analyze data. MPC allows for joint analysis without letting other people see individual datasets by spreading computations across multiple entities, each of which holds a piece of the data. MPC uses cryptographic protocols and methods to make sure that processes are done without revealing private inputs. This lets multiple people work together to analyze data while keeping privacy. These math tools can be used for many different types of data analysis jobs in the cloud, such as predictive modeling, machine learning, and statistical analysis. They also make it safe for different groups to share and work together on data, like businesses, academics, and people, without putting data protection at risk. There are still problems with how homomorphic encryption and safe MPC can be used in the real world and how they can be scaled up. These problems are mostly related to the amount of work that needs to be done and how efficiently it works. The main goal of ongoing study is to create improved methods and programs that will make these techniques work better and be easier to use in the real world.
A Comparative approach of Depression Detection: A state of Art
Authors: Ganesh D. Jadhav  
Published: November 2024

Depression is an unconscious state of mind; it directly affects the mental health condition of patients, so it is required to accurately detect with a certain time to prevent severe depression. Depression detection with traditional approaches includes the patient's interviews and self-reporting to doctors or psychotherapists, but this approach faces challenges like time consumption and subjectivity. Another approach is to detect depression by using some computational techniques, including ‘machine learning (ML)’, ‘deep learning’, ‘natural language processing’, and also some wearable technologies or devices. The study compares the hybrid ensemble model and the late fusion method with other classifiers that are used for depression detection based on various performance parameters, like ‘accuracy’, classification report, ‘mean squared error’, and R2 score , etc. This study also discusses some ethical terms, such as the privacy of patient data and the risk of misdiagnosis. The study highlights the multimodal approach of various modality to build an effective and personalized system for depression detection.
ЭКОТУРИЗМ КАК НАПРАВЛЕНИЕ ОБЕСПЕЧЕНИЯ УСТОЙЧИВОГО ХАРАКТЕРА ТУРИСТСКОЙ ДЕЯТЕЛЬНОСТИ
Authors: Е.Н. ЗАХАРОВА , М.З. АБЕСАЛАШВИЛИ , М.Е. ОРДЫНСКАЯ 
Published: November 2024

В статье рассмотрены вопросы, касающиеся развития экологического туризма в современных условиях и его роли в части обеспечения устойчивости регионов, в том числе Республики Адыгея. Экотуризм основан на удовлетворении потребностей туристов, туристского сектора и принимающих туристские потоки территорий с учетом текущих и потенциальных экономических, социальных и экологических последствий. Актуальность исследования объясняется тем, что в настоящее время экотуризм развивается в три раза быстрее, чем туристский сектор в целом. Проведена оценка основных доминант экотуризма в Республике Адыгея. Выработаны рекомендации, способствующие развитию туризма как направления обеспечения регионального устойчивого развития.
The paper considers issues related to the development of ecological tourism in modern conditions and its role in ensuring the sustainability of regions, including the Republic of Adygea. Ecotourism is based on meeting the needs of tourists, the tourism sector and territories receiving tourist flows, taking into account current and potential economic, social and environmental consequences. The relevance of the study is explained by the fact that ecotourism is currently developing three times faster than the tourism sector as a whole. An assessment of the main dominants of ecotourism in the Republic of Adygea was carried out. Recommendations were made to contribute the development of tourism as a direction for ensuring regional sustainable development.