bluuebunny/crossref_metadata_2025_split huggingface dataset:
Go beyond the limits of Genetic Algorithm in daily covariate selection practice
Authors: Ronchi Davide , Tosca Elena Maria , Bartolucci Roberta Bartolucci , Magni Paolo 
Published: February 2023

Abstract
Covariate identification is an important step in the development of a population pharmacokinetic/pharmacodynamic (PK/PD) model. Among the different available approaches, the stepwise covariate model (SCM) is the most used. However, SCM is based on a local search and on the assumption of independent covariate effects. Moreover, it is manly designed to test few covariate-parameter relationships, often chosen ad hoc or based on prior knowledge. The application of genetic algorithms (GA) for covariate selection has been proposed as a possible solution to overcome these limitations. However, their actual use during model building is limited by the extremely high computational costs and convergence issues, both related to the number of models being tested. In this paper, we proposed a new genetic algorithm for covariate selection to address these challenges. The GA was first developed on a simulated case study; then, its performances were evaluated on a real-world problem related to Remifentanil. The implemented GA showed good results both in terms of correctness of the selected model and fitness optimization, and it was able to outperform the SCM in both scenarios. Furthermore, the heuristics introduced to overcome the limitations affecting currently available GA approaches allowed to reduce convergence times, obtain replicable results, and limit the number of selected covariates.
Spatial pattern and influential factors for early marriage: Evidence from Bangladesh Demographic Health Survey Data 2017-18
Authors: Billah Md Arif , Khan Md. Mostaured Ali , Hanifi Syed Manzoor Ahmed , Islam M Mofizul , Khan Md. Nuruzzaman 
Published: February 2023

Abstract
Background
Early marriage is highly prevalent in Bangladesh. It is linked with a range of adverse outcomes, including maternal and child mortality. However, research on regional variations and factors associated with early marriage is scarce in Bangladesh. This study aimed to explore the geographical variations and predictors of early marriage in Bangladesh.
Methods
Data of women aged 20–24 in the 2017-18 Bangladesh Demographic and Health Survey were analysed. The occurrence of early marriage was the outcome variable. Explanatory variables were several individual-, household- and community-level factors. Geographical hot spots and cold spots of early marriage were first determined using Global Moran’s I statistic. Multilevel mixed-effect Poisson regression was used to determine the association of early marriage with individual-, household-, and community-level factors.
Results
Almost 59% of women aged 20–24 reported they were married before reached18. The hotspots of early marriage were mainly concentrated in Rajshahi, Rangpur and Barishal, and the cold spots were in Sylhet and Chattogram divisions. The prevalence of early marriage was lower among higher educated (adjusted prevalence ratio (aPR): 0.45; 95% CI: 0.40, 0.52), and non-Muslim women (aPR: 0.89; 95% CI: 0.79, 0.99) than their counterparts. Higher community-level poverty was significantly associated with early marriage (aPR, 1.16; 95% CI: 1.04, 1.29).
Conclusion
Early marriage is highly prevalent in Bangladesh. Promoting girls’ education, awareness-building programs about the adverse effects of early marriage and proper application of the child marriage restraint act, particularly in disadvantaged communities are recommended.
High Performance and Area Efficient Multi-Operand Binary Tree Adder
Authors: S SUTHAGAR 
Published: February 2023

Abstract

The building blocks of many digital systems like digital signal processors, microprocessors are the arithmetic units. Adders are the most important component in arithmetic processing unit. In recent times the multi operand adder (MOA) are used widely in signal and image processing applications because of its low power consumption, and it also reduces the partial sum and propagated carries. In this work multi operand binary tree adder is designed using EXOR-MUX based full adder. The proposed BTA gives an enhanced performance than the existing adder architecture which is designed based on AOI/OAI logic. The existing system takes more logic size because the OAI logic is implemented as the inverse of AOI logic. The functionality of the binary tree adder is verified using VERILOG HDL and synthesized using MODEL SIM 6.5 and XILINX ISE 14.7. The performance of the proposed binary tree adder is increased 44% with respect to area and 32% with respect to delay. Taking everything into account, the proposed BTAs outdo the existing BTAs.
Knowledge of nurses on neonatal sepsis: a tertiary teaching hospital-based study
Authors: Qazi Mahvish , Mohammed Syed Muneeb , Saqib Najmus , Daraz Zahoor Hussain , Kumar Niraj 
Published: January 2023

Neonatal sepsis is a significant cause of morbidity and mortality in hospitalized newborns and premature infants. Therefore, knowledge of essential newborn Care (ENC) is important for a newborn's survival, growth and development.
The aim of this study was to assess the knowledge of nurses regarding essential newborn care in our Special Care Neonatal Unit (SCNU).
Methods: A descriptive cross-sectional study was conducted between 1st September 2021 and 30th November 2021 among the nurses working in SNCU of Government Medical College and Hospital (GMC), Doda, Jammu and Kashmir, India. Data were was collected using a pre-tested questionnaire by purposive sample. Collected data were checked, and coding was done and analyzed using SPSS 20 software.
Results: 72.0 % of nurses were of the age group of 21–30 years. The majority (74 %) were females, 78 % had completed B Sc Nursing, and 66 % had experience of 2 to 4 years. Most of the nurses had good knowledge about ENC, about basic equipment’s used in SNCU, and about advanced equipment’s or procedures had less knowledge. All nurses answered bacteria correctly as a causative organism of neonatal sepsis.
Conclusions: Most of the nurses working in the SCNU of GMC Doda had good knowledge regarding ENC. The knowledge appeared irrespective of their age, gender, religion, educational status, working place and special courses/training in neonatology.
Prediction of one-year adverse clinical outcomes by macrophage migration inhibitory factor in stemi patients
Authors: Vyshnevska Iryna , Storozhenko Tatyana , Kopytsya Mykola , Bila Natalia 
Published: January 2023

Biomarkers have taken one of the first places as diagnostic and prognostic tools in ST-segment elevation myocardial infarction (STEMI) and are consequently widely used as predictors of short-term and long-term prognosis. One of the promising biomarkers for early cardiovascular outcomes prediction is the pro-inflammatory cytokine macrophage migration inhibitory factor (MIF).
The aim of the study was to elucidate a plausible predictive value of the MIF levels for one-year clinical outcomes in STEMI patients who underwent primary percutaneous coronary intervention (PCI).
Materials and methods. 134 STEMI patients were enrolled in the study after receiving voluntary informed consent. All patients underwent conventional investigations, and additionally, the MIF levels were determined at baseline, directly before and after PCI. During 1-year follow-up, 37 % of patients reached the endpoint, which was composite and included all-cause mortality, non-fatal myocardial infarction, non-fatal stroke, hospitalization for unstable angina, heart failure decompensation, and urgent revascularization.
Results. We have found that pre-PCI MIF levels > 3934 pg/mL (AUC=0.7; 95 % CI 0.578 to 0.753; Youden index=0.31; p=0.008) might be an independent predictor of composite endpoints with sensitivity 54 % and specificity 82 %. A positive correlation between MIF and inflammatory biomarkers was revealed (WBC count r=0.33, p=0.0001; CRP r=0.19, p=0.032). Adverse outcomes associated with higher pre- and post-PCI MIF levels (OR 1.0, 95 % CI 1.0001–1.0008; p=0.013 and OR 1.0, 95 % CI 1.0001–1.0009; p=0.019) and CRP that determined during the first week after the event (OR 1.0, 95 % CI 1.005–1.2, p=0.03). Kaplan-Meier analysis has shown a substantially lower long-term survival rate in patients with a MIF level > 3493 pg/ml compared to a MIF level ≤ 3493 pg/ml (Log rank=0.00025).
Conclusions. The MIF levels exceeding 3934 ng/ml were associated with a higher risk of one-year adverse clinical outcomes in STEMI patients who underwent primary PCI.
Prevention of gastrointestinal diseases in piglets at weaning using probiotics Bacillus coagylans and Bacillus megaterium
Authors: Bakun Yuliia 
Published: January 2023

The aim of the study is to determine the preventive effect of the use of probiotics Bacillus coagulans and Bacillus megaterium in case of gastrointestinal diseases in piglets and as a potential strategy to reduce the misuse of antibiotics in monogastric animals by adding probiotics to the diet of pregnant sows and piglets in the period before and after weaning.
Materials and methods. Three research groups were formed to study the preventive effect of probiotics of the genus Bacillus coagulans and Bacillus megaterium. The piglets of the first experimental group received probiotics at the rate of 0.4 kg per 1 ton of feed in the periods before and after weaning, and that is, the moment of the entire study, the second experimental group received probiotics in the period after weaning, before that they received milk from the sow. The third group was the control group, which received only milk from the sow, and fodder during the weaning period. The effectiveness of the prevention result was determined by the absence/presence of clinical signs of morbidity and % survival of animals during the study period.
The results. It was established that the preservation of livestock in the 1st experimental group was 90 %, and in the 2nd group – 70 %, and control – 50 %.
Conclusions. Research results show that probiotics of the genus Bacillus coagulans and Bacillus megaterium, the components of which provide a wide spectrum of antimicrobial activity, are a reliable preventive measure for gastrointestinal diseases in piglets.
Surgical treatment of acute complicated duodenal ulcer
Authors: Bilyachenko Maxim , Kurbanov Anton , Povch Oleg 
Published: January 2023

The aim. To analyze treatment approaches and tactics and improve acutely complicated duodenal ulcers (DU) treatment results.
Materials and methods. The results of the analysis of the surgical treatment of acutely complicated duodenal ulcers (a combination of 3 and/or 4 combined complications) are presented for 2 periods: the 1st (2000–2014) years (group A) – 47 patients, the 2nd (2015–2021) years (group B) – 34 patients.
Results. 81 (100 %) patients were operated on for acutely complicated duodenal ulcers, of which 68 (84.3 %) patients had a combination of three complications, and 13 (15.7 %) had four complications. Out of 81 patients, 72 had bleeding complications, which is 89.3 %. Complications of ulcer perforation – in 36 patients, 44.7 % of all other complications.
Based on the obtained analysis data, there is a steady trend towards an increase in the share of organ-sparing operations (OSO) by 1.6 times (from 50.9 % to 81.4 %), a decrease in the number of gastric resections (GR) by 2.9 times (from 14.9 % to 4.9 %) and palliative operations (PO) by 3.2 times (from 15.8 % to 4.9 %) with a relatively stable number of performed organ-preserving operations (OPO): in group A – 17 (24 .6 %) interventions, in group B – 4 (21.1 %).
Conclusions. The use of modern measures of endoscopic hemostasis made it possible to adequately prepare and operate on patients in the delayed period, and their share from the first period to the second increased by 2.9 times.
The number of patients who underwent emergency surgery with ulcer perforation and bleeding as combined complications decreased in the second period compared to the first by 2.5 times, which is associated with the widespread use of modern proton pump inhibitors (PPIs) in the conservative treatment of DU.
The number of complications and mortality of this cohort of patients also significantly decreased due to the use of endoscopic hemostasis methods, making it possible to stabilize and prepare patients on the operating table.
According to the analysis results, it became known that the chosen active-individualized tactics and the use of developed algorithms for choosing the type of surgical intervention made it possible to achieve a stable level of postoperative mortality at 8.1 %.
Relationship between maternal abo blood group and rh typing with maternal and perinatal outcome
Authors: Devi Arukonda Niranjani , Pathri Manjula , Tammala Sruthi 
Published: January 2023

The ABO blood group type has been considered an independent risk factor in pregnancy-related complications leading to significant morbidity and mortality in pregnant mothers and neonates.
Aim: To study the relationship between maternal ABO blood group and Rh typing with maternal and perinatal outcomes.
Materials and methods: Prospective Observational study was carried out for 24 months from November among 1000 pregnant women attending outpatient for ABO blood group and Rh typing with maternal and perinatal outcome.
Results: Among 1000 subjects, 43.5 % belonged to blood group O, followed by 30 % in blood group B. 20.7 % had blood group A, and 5.8 % had AB blood group. In the present study, 95.4 % had Rh+ve, and 4.6 % had Rh-ve typing. The incidence of preterm labour was high at 6.3 % in the O+ve blood group, followed by 1.8 % in the AB +ve, 0.6 % in the A+ve and 0.3 % in the B+ve blood group. A statistically significant association was found between blood grouping and preeclampsia with high incidence among the A+ve blood group. A statistically significant association was found between blood grouping and imminent eclampsia with high incidence among the AB+ve blood group. There was a statistically significant association found between blood grouping and intrauterine death.
Conclusion: The findings in the present study will help clinicians to identify the patients at risk of developing adverse pregnancy outcomes like preeclampsia and imminent eclampsia; hence, the timely intervention will help to improve maternal and perinatal outcome and also helps to reduce the complications of preeclampsia and imminent eclampsia.
Cross-sectional study to evaluate various cardiovascular manifestations in pregnant women with preeclampsia using 2d echocardiogram
Authors: Devi Lakshmi , Banerjee Preet , Durga D. V. K. , Sahu Pooja 
Published: January 2023

Preeclampsia is one of the most frequent complications found in pregnancy. Preeclampsia was initially thought to cause poor long-term cardiovascular outcomes, but recent studies have shown its effect to be more early and severe.
Aims: To reduce the morbidity and mortality for all patients with hypertension in pregnancy through any cardiovascular problem that is directly caused by hypertension in pregnancy
Methods: it is a cross-sectional and observational study of pregnant women with preeclampsia in the reproductive age group (15–44 years) diagnosed with preeclampsia in the antenatal ward/HDU/MICU at Niloufer hospital were evaluated with 2d echo on diagnosis and a follow up 2d echo after delivery was done and changes in 2d echo were noted, patients with prior changes in 2d echo have been excluded from the study. About 113 preeclamptic patients were studied and further classified as non-severe and severe preeclampsia, and their results were compared.
Results: This study shows significant cardiovascular dynamics changes in subjects with preeclampsia (both severe and non-severe) which can be studied by 2 D echo. Non-severe preeclampsia was associated with more normal birth weight. This was found statistically significant in our study. IUD and early neonatal death were more associated with severe preeclampsia when compared to non-severe preeclampsia, which was found statistically significant.
Conclusions: Early identification of preeclamptic patients at higher risk of developing cardiovascular complications later in life by undergoing timely echocardiography.
دور البنك المركزي العراقي في تعزيز الشمول المالي في العراق
Authors: Ahmad Muhsin Ibrahim 
Published: January 2023

يعد الشمول المالي من المواضيع التي نالت إهتمام البنوك المركزية والمؤسسات المالية في جميع بلدان العالم، من خلال العمل على إعداد وتنفيذ إستراتيجيات خاصة لهذا الغرض. وفي هذا الأطار فقد وضع البنك المركزي العراقي ضمن إسترايجيته للسنوات (2016-2020) توجهات كثيرة يأتي في مقدمتها توسيع وتطوير الشمول المالي، كونه يساهم في تحقيق الأستقرار والتنمية الأقتصاية من خلال توفير خدمات مالية ومصرفية لمختلف الفئات والأسهام في جهود محاربة الفقر وتحسين مستوى المعيشة للمواطنين عن طريق توفير التمويل بتكاليف معقولة وتوسيع نطاق المستفيدين من الخدمات والمنتجات المالية، بالآضافة الى رفع مساهمة المصارف والشركات المالية في تمويل الأستثمارات وبالتالي المساهمة في عملية التنمية الأقتصادية.
يهدف البحث الى التعرف على واقع الشمول المالي في العراق، عن طريق تحليل أهم مؤشراته، ودراسة مدى مساهمة كل من المصارف والشركات المالية غير المصرفية في تحقيق الشمول المالي، بالأضافة الى دراسة مدى مساهمة إستراتجية البنك المركزي في رفع مؤشر الشمول المالي من خلال مبادرات تمويل المشاريع الأستثمارية.
Domains, Feasibility, Effectiveness, Cost, and Acceptability of Telehealth in Aging Care: Scoping Review of Systematic Reviews
Authors: Zhang Yichi , Leuk Jessie Siew-Pin , Teo Wei-Peng 
Published: January 2023

Background
Aging is becoming a major global challenge. Compared with younger adults, the older population has greater health needs but faces inadequate access to appropriate, affordable, and high-quality health care. Telehealth can remove geographic and time boundaries, as well as enabling socially isolated and physically homebound people to access a wider range of care options. The impacts of different telehealth interventions in terms of their effectiveness, cost, and acceptability in aging care are still unclear.

Objective
This scoping review of systematic reviews aimed to provide an overview of the domains of telehealth implemented in aging care; synthesize evidence of telehealth’s feasibility, effectiveness, cost benefits, and acceptability in the context of aging care; identify gaps in the literature; and determine the priorities for future research.

Methods
Guided by the methodological framework of the Joanna Briggs Institute, we reviewed systematic reviews concerning all types of telehealth interventions involving direct communication between older users and health care providers. In total, 5 major electronic databases, PubMed, Embase (Ovid), Cochrane Library, CINAHL, and PsycINFO (EBSCO), were searched on September 16, 2021, and an updated search was performed on April 28, 2022, across the same databases as well as the first 10 pages of the Google search.

Results
A total of 29 systematic reviews, including 1 post hoc subanalysis of a previously published large Cochrane systematic review with meta-analysis, were included. Telehealth has been adopted in various domains in aging care, such as cardiovascular diseases, mental health, cognitive impairment, prefrailty and frailty, chronic diseases, and oral health, and it seems to be a promising, feasible, effective, cost-effective, and acceptable alternative to usual care in selected domains. However, it should be noted that the generalizability of the results might be limited, and further studies with larger sample sizes, more rigorous designs, adequate reporting, and more consistently defined outcomes and methodologies are needed. The factors affecting telehealth use among older adults have been categorized into individual, interpersonal, technological, system, and policy levels, which could help direct collaborative efforts toward improving the security, accessibility, and affordability of telehealth as well as better prepare the older population for digital inclusion.

Conclusions
Although telehealth remains in its infancy and there is a lack of high-quality studies to rigorously prove the feasibility, effectiveness, cost benefit, and acceptability of telehealth, mounting evidence has indicated that it could play a promising complementary role in the care of the aging population.
Implementation Science Perspectives on Implementing Telemedicine Interventions for Hypertension or Diabetes Management: Scoping Review
Authors: Khalid Ayisha , Dong Quanfang , Chuluunbaatar Enkhzaya , Haldane Victoria , Durrani Hammad , Wei Xiaolin 
Published: January 2023

Background
Hypertension and diabetes are becoming increasingly prevalent worldwide. Telemedicine is an accessible and cost-effective means of supporting hypertension and diabetes management, especially as the COVID-19 pandemic has accelerated the adoption of technological solutions for care. However, to date, no review has examined the contextual factors that influence the implementation of telemedicine interventions for hypertension or diabetes worldwide.

Objective
We adopted a comprehensive implementation research perspective to synthesize the barriers to and facilitators of implementing telemedicine interventions for the management of hypertension, diabetes, or both.

Methods
We performed a scoping review involving searches in Ovid MEDLINE, Embase, CINAHL, Cochrane Library, Web of Science, and Google Scholar to identify studies published in English from 2017 to 2022 describing barriers and facilitators related to the implementation of telemedicine interventions for hypertension and diabetes management. The coding and synthesis of barriers and facilitators were guided by the Consolidated Framework for Implementation Research.

Results
Of the 17,687 records identified, 35 (0.2%) studies were included in our scoping review. We found that facilitators of and barriers to implementation were dispersed across the constructs of the Consolidated Framework for Implementation Research. Barriers related to cost, patient needs and resources (eg, lack of consideration of language needs, culture, and rural residency), and personal attributes of patients (eg, demographics and priorities) were the most common. Facilitators related to the design and packaging of the intervention (eg, user-friendliness), patient needs and resources (eg, personalized information that leveraged existing strengths), implementation climate (eg, intervention embedded into existing infrastructure), knowledge of and beliefs about the intervention (eg, convenience of telemedicine), and other personal attributes (eg, technical literacy) were the most common.

Conclusions
Our findings suggest that the successful implementation of telemedicine interventions for hypertension and diabetes requires comprehensive efforts at the planning, execution, engagement, and reflection and evaluation stages of intervention implementation to address challenges at the individual, interpersonal, organizational, and environmental levels.