bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care clinical practice guidelines in Sudan: A qualitative survey exploring national stakeholders’ perspectives
Authors: Abdelgadir Hiba Salah , Bajouri Sahar , Abdelgadir Hind Salah 
Published: October 2024

Abstract

Introduction:
The health system in Sudan faces several challenges, including increasing numbers of patients, shortages of health supplies, and disparities in the distribution of health services. Guidelines implementation improves patients’ outcomes and ensures efficient use of the resources in such a resource-limited country. This paper explored the practice of family medicine at primary health care centers addressing the struggles that impede guideline implementation from the national stakeholders' perspectives.
Methods:
A qualitative facility-based survey conducted in the public referral primary health care centers in Khartoum and Gezira States of Sudan. The study population was composed of practicing family medicine doctors the medical directors in the referral PHC centers. All the focused group discussions and the interviews were audio-recorded. Recordings were transcribed verbatim, and the transcriptions were anonymized. Thematic content analysis was used to analyze the data.
Results:
Local Sudanese guidelines are lacking good publication and regular updating of the recommendations. Most of the surveyed doctors reported reduction of the training programs that are regulated and funded by the ministry of health due to the political and economic situations in Sudan. Barriers to guidelines implementation include limited health insurance coverage, patients’ factors, absence of regular training programs, lack of filing and referral system. Massive deterioration in the family medicine practice at Gezira state was observed due economic and some governmental issues.
Conclusion:
Successful development, adaptation, and implementation of the CPG depends on many factors, including adequate resources, quality assurance, widespread dissemination, appropriate monitoring and auditing for quality improvement. Efforts should be directed to encourage the development of local guidelines through a rigorous approach that involves a multidisciplinary team representing various stakeholders. The government represented by National Health Insurance Fund must expand the health insurance coverage and services. Contribution of the reestablishment of the electronic filing system and the telemedicine consultation in Gezira state and expand the program in Khartoum state and whole Sudan.
Molecular characterization of virulence genes in quorum sensing system of different pathogenic strains of Pseudomonas aeruginosa from neonates with pulmonary infections using PCR as efficient technique
Authors: Chaudhry Maham , Rehman Safia , Zahid Sehar , Ali Nazish Mazhar , Ruhi Nabila , Liaqat Iram , Riaz Samreen 
Published: October 2024

Abstract

Background: The expectation from the current research study was to genetically identify the virulence genes involved in quorum sensing (QS) in different strains of Pseudomonas aeruginosa, as the QS controls production of many virulence factors.
Objective: The intention of current research study was to isolate the pathogenic strains of P. aeruginosa from sputum samples of neonates and infants and their molecular characterization.
Methods: P. aeruginosawere obtained from Microbiology Laboratory, Department of Zoology, Government College University Lahore were grown on selective media. Biochemical and molecular characterization was done. Molecular characterization was done by specific primers of quorum sensing virulent genes. Amplified genes were sequenced, and accession numbers were obtained from the NCBI site. Genes lasR, lasI, rhlR, and rhlI were identified in P. aeruginosa strains (ss5, ss6, and ss11).
Results: Current study revealed that these virulence genes are the main contributors of resistance of P. aeruginosa strains against different antibacterial agents.
Conclusion: P. aeruginosa is a Gram-negative bacterium with diverse metabolic capacity to regulate survival under many different conditions and can be highly resistant to antibiotics, facilitating its spread in diverse habitats, particularly in hospitals. These virulent genes contribute to the overall pathogenic potential of P. aeruginosa that facilitates its ability to cause disease.
WITHDRAWN: Excess Mortality in Alzheimer’s Patients on Anti-Aβ Monoclonal Antibodies
Authors: Dwivedi Alok K , Abanto Jesus , Schneider Lon S. , Herrup Karl , Schrag Matthew , Widera Eric , Mahajan Abhimanyu , Howard Robert , Espay Alberto J. 
Published: October 2024

Abstract

Introduction
It is unclear how the reported deaths of Alzheimer’s disease (AD) patients treated with the monoclonal antibodies lecanemab and aducanumab compare with background mortality rates.
Methods
Using post-marketing safety data from the Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS), we assessed whether the fatalities associated with the real-world use of these drugs exceed the expected mortality rates in both clinical trials and the general AD population for the age range of deaths in FAERS (75-84 years), with a background mortality rate of 229.3 deaths per 100,000.
Results
FAERS recorded 25 deaths with lecanemab and 27 with aducanumab. Without available data on the exact number of patients treated, we assumed a range of 2,000 to 10,000 patients. The mortality rate was higher for lecanemab (RR = 2.6; 95% CI: 1.4-3.8) and aducanumab (RR = 3.9; 95% CI: 1.4-6.5) compared to the background mortality rate and the pivotal trials for lecanemab (RR = 1.87; 95% CI: 1.1-2.6) and aducanumab (RR = 2.7; 95% CI: 1.7-3.7). This corresponds to 21 excess deaths for lecanemab and 41 excess deaths for aducanumab per 10,000 patients treated.
Conclusion
These findings suggest a 3- to 4-fold increase in mortality risk with these drugs compared to the untreated AD population and a 2- to 3-fold increase compared to the treated population of clinical trials.
Exploring uterine niche: A systemic review on secondary infertility rates, pathophysiological correlations, impact on assisted reproduction technology (ART), and the efficacy of surgical interventions.
Authors: Jayasundara DMCS , Jayawardane IA , Jayasingha TDKM , Weliange SDS 
Published: October 2024

Abstract

Background: The rising trend of cesarean sections worldwide has resulted in an increased incidence of uterine niches, a cavity formed at the cesarean scar site due to impaired tissue healing. Secondary infertility in women with uterine niches is a hot topic in obstetrics and gynecology. Therefore, the current study aims to untwist the link between secondary infertility and uterine niche, exploring the pathophysiological correlations, effects on assisted reproduction technology, and role of surgical interventions in resuming fertility.
Methodology: PubMed, Cochrane Library, Embase, and Science Direct were searched systematically. Rayyan was employed as a semi-automated tool for study selection. Full-text articles in the English language were included. Systematic reviews, meta-analyses, or book chapters were excluded. Newcastle-Ottawa Scale assessed the quality of cohort and case-control studies, while the Cochrane Risk-of-bias tool evaluated randomized controlled trials. Data synthesis followed a thematic analysis.
Results: 35 articles from 3301 studies met the inclusion criteria. Among those, 25 were cohort studies, only one was a randomized controlled trial, and the rest had different study designs. The study quality assessment revealed average to good quality. The incidence of secondary infertility in women with uterine niches ranged from 27.37% (n=95) to 75% (n=16). Decreased residual myometrial thickness, chronic inflammatory changes at the niche site, and fluid accumulation within the niche cavity were identified as leading causes of secondary infertility. The uterine niche adversely affected assisted reproductive outcomes through multiple mechanisms. Various surgical interventions, including hysteroscopy, laparoscopy, or combined surgery, showed differing efficacies in restoring fertility.
Conclusion: The study provides valuable insights regarding the association between secondary infertility and uterine niche. However, smaller sample sizes, retrospective nature of study designs, reliance on observational data, and heterogeneity of study reporting have limited the ability to arrive at solid conclusions. Therefore, we encourage well-designed prospective studies, including randomized controlled trials, to further explore this trending area.
The study protocol was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO CRD4204526319).
Integration of Traditional Medicine Services into Public Health Centers in Indonesia: A Qualitative Study
Authors: Yuniarsih Sri Mumpuni , Padmawati Retna Siwi , Madyaningrum Ema , Widhow Siwi Sri , Mahendradhata Yodi 
Published: October 2024

Abstract

Background: Many people are still using traditional medicine in various countries. This is a challenge for the government because they must effectively manage services, maintain quality, and protect patients. Integrating traditional medicine into public health centers provides safe and quality services. This study aimed to explore the perceptions and experiences of traditional medicine users and program implementers in Indonesian public health centers.
Methods: This study used an exploratory qualitative research design. Data were collected from program implementers and traditional medicine users. Data were collected through focus group discussions and in-depth interviews from March to June 2023. The study had 16 participants included 10 implementers in focus group discussions and six users in in-depth interviews. analysis with an inductive approach was employed.
Results: Three themes were identified, namely, user preferences for using traditional medicine, success factors of integration, and challenges for improvement of existing integration. Despite obstacles, many participants expressed their support for integration, particularly in terms of human resource readiness. Moreover, people tended to prefer traditional medicine services provided in public health centers over traditional healers because of individual belief, trust in the delivery services, and therapeutic effects.
Conclusion: The integration of traditional medicine services into public health centers is essential to provide easy access and preserve traditional health services that are in line with local wisdom, effective, and safe.
Magnitude and Determinants of knowledge of ovulatory period among young women in Somalia: multilevel analysis using 2020 SHDS
Authors: Ali abdirahman Omer 
Published: October 2024

Abstract

Introduction Ovulation is a key indicator of fertility and understanding its cycle is crucial for natural family planning. Despite its importance, knowledge of the ovulatory cycle (KOC) remains low among women, leading to unintended pregnancies.Methodology This study uses data from the 2020 Somalia Health and Demographic Survey (SHDS) to assess KOC among young Somali women. A multilevel binary logistic regression analysis was conducted to identify determinants of KOC.Results The prevalence of correct KOC was 21.83%. Factors positively associated with correct KOC included older age, higher education, and rural residency. Media exposure showed mixed effects on KOC.Discussion The study highlights a significant knowledge gap in Somalia, consistent with global trends. Regional factors and media content influence KOC. Interventions should target both individual and community levels, focusing on education and tailored media messages.Conclusion Enhancing KOC among young women in Somalia is vital for reducing unintended pregnancies and improving reproductive health. Addressing educational and regional disparities is essential for effective intervention strategies.
Optimizing Large Language Models: A Novel Approach Through Dynamic Token Pruning
Authors: Keith Christopher , Robinson Michael , Duncan Francis , Worthington Allan , Wilson Joseph , Harris Sofia 
Published: October 2024

Abstract

The rapid evolution of artificial intelligence technologies has necessitated the development of frameworks capable of executing increasingly complex tasks with remarkable efficiency and speed. In response to the pressing demands for heightened computational capabilities, a sophisticated strategy has been conceived that not only addresses the performance challenges inherent in state-of-the-art language models but also seeks to optimize their operational efficiency. The methodology proposed here introduces dynamic token pruning, a transformative approach that carefully evaluates and selectively retains only the most crucial tokens during the inference process, thereby significantly reducing both inference time and memory consumption without undermining the integrity of the generated output. Through rigorous empirical analysis, the proposed framework demonstrates substantial enhancements in processing speed, achieving remarkable reductions in memory usage while maintaining a stable level of model accuracy, as indicated by perplexity metrics. The findings demonstrate the dual advantages of increased operational efficiency and sustained predictive performance, illustrating the capability of dynamic token pruning to adapt to varying input complexities. This research not only highlights the potential for improved accessibility and scalability of advanced language models in real-world applications but also lays the groundwork for future explorations into more complex optimization techniques that can further refine model performance in diverse contexts. The implications of these advancements extend beyond mere efficiency gains, contributing to the broader integration of AI technologies across a multitude of sectors and applications.
The assessment of grip strength in preschool-aged children with and without unilateral cerebral palsy
Authors: Griet Dequeker , Emma Detobel , Ellen Dillen , Marie Heymans , Lize Kleeren , Els Ortibus , Lisa Mailleux 
Published: October 2024

Abstract

Aim: To investigate reliability and validity of two grip strength devices in children with and without unilateral cerebral palsy (uCP) aged 2 to 6 years.
Method: We assessed grip strength in 20 preschool-aged children with predominantly spastic uCP (mean age 4y0±1y2m) and 20 age-matched children without uCP (mean age 3y11m±1y3m) using the Martin Vigorimeter and MyoGrip to investigate test-retest reliability (intraclass correlation coefficients; ICC), known-group validity (comparative statistics) and convergent validity (correlation analyses) in a cross-sectional design.
Results: In both groups, test-retest reliability was excellent for both devices and both hands (ICC 0.91-0.97). Grip strength of the non-preferred hand was lower in children with uCP for both devices (p<0.001). Grip strength was decreased in the non-preferred compared to the preferred hand in children with uCP for both devices (p<0.001). In children without uCP, grip strength was lower in the non-preferred compared to the preferred hand only for the MyoGrip (p=0.02). The relation between both devices for both hands was good to very high (r=0.62-0.92, p<0.007).
Conclusion: Both devices can be implemented in clinical practice to assess grip strength in preschool-aged children with uCP. Only the MyoGrip detected differences between both hands in children without uCP and might be more sensitive.
Driving Change in Maternal Anaemia Management: A Contextual Evaluation of a Quality Improvement Initiative for Routine Screening and Intravenous Iron Treatment in Nigeria
Authors: Eboreime Ejemai , Onietan Damilola , Obi-Jeff Chisom , Akinajo Opeyemi , Adelabu Yusuf , Oluwole Esther O. , Balogun Mobolanle , Banke‑Thomas Aduragbemi , Afolabi Bosede B. 
Published: October 2024

Abstract

Background: Quality improvement (QI) models have been applied in healthcare systems with varying success, raising questions about their effectiveness. Despite growing evidence on effective interventions, a gap remains between proven strategies and actual practice, particularly in low- and middle-income countries (LMICs). Evaluating the efficacy of QI initiatives and understanding the contextual factors influencing their success is crucial. This study aims to investigate the roles and interrelationships of contextual factors in implementing the Diagnose-Intervene-Verify-Adjust (DIVA) approach for the Implementation Research for Intravenous Iron Use in Pregnant and postpartum Nigerian Women (IVON-IS) project, which seeks to enhance anaemia screening and treatment using intravenous ferric carboxymaltose (FCM).
Methods: We used a mixed method approach with a sequential explanatory design. Adapting the Model for Understanding Success in Quality (MUSIQ), we quantitatively compared contextual factors affecting DIVA implementation across six health facilities participating in the IVON-IS project. Multi-stakeholder Implementation Management Team (IMT) members from the health facilities implementing the IVON-IS project completed a self-administered questionnaire. Qualitative interviews were conducted via in-depth interviews with 12 IMT members using an open-ended semi-structured interview guide. Quantitative data was analysed descriptively, and qualitative interviews were analysed using a framework analysis approach.
Results: The IVON-IS implementing facilities scored between (87.6%) and (95.4%) out of 168 points on the MUSIQ scale, suggesting a reasonable likelihood of project success. All facilities demonstrated strong performance across MUSIQ domains, including external environment, QI team attributes, organizational capacity, microsystem, and QI support and capacity on the MUSIQ scale. Notably, external motivators scored lowest. Supportive leadership, strong microsystems and diversity of the QI team are contextual factors that facilitated the project. However, barriers such as the regulatory and policy environment and QI workforce were identified.
Conclusion: Based on the MUSIQ assessment, the IVON-IS project exhibited a reasonable chance of success. Our study highlights the utility of MUSIQ in designing and implementing sustainable QI initiatives. The framework's structured approach facilitated identifying and managing key drivers of quality care, resulting in lasting improvements in healthcare processes.
Fujairah Honey Chain (FHC): A Blockchain Framework for Monitoring Honey Production
Authors: Almiani Khaled , Mirza Shaher Bano , Zufferey Camille , Alyammahi Khawla M. , Lamghari Fouad 
Published: October 2024

Abstract

Honey is globally recognized for its substantial nutritional impact and therapeutic properties. In addition to its health benefits, honey is commonly used as a natural sweetener in daily life. However, because of its high market value, honey is susceptible to manipulation and counterfeiting. For instance, honey may be mixed with corn syrup or other sweeteners to increase profit margins. Counterfeit honey negatively impacts consumer health and the honey market. The manipulation of honey poses challenges to the growth of beekeeping businesses. These issues highlight the importance of designing solutions to ensure the authenticity of traded honey. Accordingly, this paper presents a blockchain-based framework to monitor the honey trade supply chain and detect counterfeit honey products. The proposed framework incorporates an oracle component that ensures the accuracy and authenticity of the collected information or images regarding honey quality and origin. Consequently, consumers can access all honey quality variables and origin information using the framework. By associating honey batches with fungible and non-fungible tokens, the proposed framework closely tracks honey products in the trade supply chain. Several experiments were conducted to analyze the economic feasibility of the proposed framework, demonstrating that the cost of performing a trade is expected to be less than $1. Additionally, the results indicate shows that the oracle component achieves an average accuracy rate of 90% in detecting falsified sensor data, compared to the variability found in traditional audits, which can fluctuate depending on differing standards and certifying bodies.
Diversity of Fusarium Species Infecting Maize Grown in Nakuru County, Kenya
Authors: Alaro Lawrence O. 
Published: October 2024

Abstract

Maize (Zea mays L.) is one of the famous food crops in Kenya. It is always contaminated by fungi, Fusarium spp. producing mycotoxins, The most common mycotoxin is Fumonisin FB1. Whose intake above 2.0 mg/kg body weight/day has a role in development of Oesophangeal cancer. No data is readily available on the genetic diversity of Fusarium species in various maize genotypes in Kenya. This study was to determine diversity of Fusarium fungi infecting maize in Nakuru County-Kenya. A Purposive sampling was used in collecting maize grains from 277 farmers. Fusarium species were isolated and confirmed using molecular techniques. DNA sequencing of Translation elongation factor 1-alpha (TEF-1) gene was done. The data was edited using vector NTI software and blasted in NCBI data base. Fusarium was identified using spore morphology on potato dextrose Agar (PDA). DNA sequence analysis revealed presence of F. temperatum, F. boothii, and F. verticillioides. The finding was to enlighten; the public, farmers, and agricultural officers on the infections of maize by specific Fusarium sp., hence the need to grow less infected maize genotypes H614, H6218 and H6210.
Attention-Based BiGRU Model for Real-time Sign Language Translation Applications
Authors: Nguyen Sam Xuan 
Published: October 2024

Sign language applications provide an important key to solving communication problems for deaf community and normal hearing people. Current research problem usually focuses on improving communication access between deaf and hearing people. In this study, we consider real-time communication context from deaf to hearing people, and thus we propose an attention-based bidirectional gated recurrent unit (A-BiGRU) model which demonstrates on trading-off among an precision performance, and computational efficiency which includes training time, testing time, and system resources on extended the American Sign Language Gloss (E-ASLG-PC12) dataset. The results shown that our proposal has a significant performance improvement in term of training time, testing time, system resources, comparing to attentionbased bidirectional long-short term memory (A-BiLSTM), and the other moderns of sequence to sequence models. Moreover, precision performance of our proposal model achieve closer to that of the complex architecture, A-BiLSTM. Thus, we believe that our proposed model is a suitable and potential candidate for real-time translation applications as well as and lower computational devices when they solve the communication problems from deaf to normal hearing people direction. Keywords– computational efficiency (CE), attention-based bidirectional gated recurrent unit (A-BiGRU), sign language translation applications (SLTA).