bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chilblains after galcanezumab for chronic migraine prevention: A case report
Authors: Gunasekera Lakshini , Ray Jason C 
Published: February 2025

Background Calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs) are effective migraine prophylactics but real-world safety data is still emerging. This is the first case of chilblains associated with galcanezumab. Case A 50-year-old female commenced galcanezumab for migraine prophylaxis. She tolerated the loading dose well. Ten days after her second dose, she developed multiple skin lesions, fluctuating distal cyanosis and polyarthralgia in both hands. Rheumatologists confirmed a diagnosis of chilblains temporally related to the CGRP mAb. Galcanezumab was subsequently ceased with full clinical recovery. There was no clinical or serological evidence of an underlying autoimmune condition. Conclusion This case demonstrates a previously unreported reaction temporally associated with galcanezumab. We hypothesise herein a mechanism of biological plausibility for this reaction based on the drug's mechanism of action. Vigilance is required in monitoring for potential adverse events. Further research is required into risk factors for such presentations.
Usability of a cross-system housing stability program for juvenile courts: A multimethod study of probation counselor perspectives
Authors: Bishop Asia S. , Walker Sarah C. , Baumgarten Ella B. , Vick Kristin , Dean Taquesha 
Published: February 2025

Background Youth in contact with the juvenile legal system experience disproportionate rates of homelessness. While system contact is a critical intervening point, juvenile courts do not typically offer housing services. One solution is to refer youth to evidence-based, community-based services to meet housing-related needs, but a myriad of individual and organizational factors often impede court staff from making such referrals. Housing Stability for Youth in Courts (HSYNC) is a novel, cross-system service linkage model for court-involved youth facing housing instability. HSYNC was developed using codesign as a strategy to improve usability and incorporated evidence on juvenile court linkage strategies effective at increasing service referrals and improving outcomes. Method The current study utilized a multimethod approach to evaluate the usability of HSYNC from the perspective of juvenile probation counselors (JPCs) as one group of end-users. As part of the pilot implementation study, survey ( N = 15) and semi-structured interview ( N = 20) data were obtained from JPCs from four juvenile courts in one northwestern state. Results Survey results indicated good usability for HSYNC (mean implementation strategy usability scale score of 80). Themes from the interviews complemented survey findings, pointing to HSYNC as a value-added program that integrated well with existing probation practices. The housing navigator's approach was highlighted as a strong facilitator of program usability. Themes also provided greater insight into implementation barriers (i.e., individual and contextual factors) and areas for improvement (e.g., eligibility screening process). Conclusions Drivers of program usability and implications for program improvement to address identified implementation challenges to ensure the HSYNC model is effective and sustainable long-term are discussed.
Developing low-carbon sustainable building material by adding micro steel fiber with recycled aggregate concrete
Authors: Rajprasad J. , Sudarsan J. S. , Prasanth M. Jeeva , Nithiyanantham S. 
Published: February 2025

Abstract
Concrete is the most tremendous and widespread building material in the world. Building materials have become expensive and scarce. There is a tremendous need for substitute materials made from industrial waste in this desolate area. In concrete, ensuring the most expedient utilization of recycled aggregate (RA) from demolished structures can aid in the preservation of the natural surroundings, environment, and dumping space. The natural aggregate is eliminated with RA by (25, 50, 75, and 100%) volumes were carried out in 7, 14, and 28 days. Due to drying shrinkage, fresh concrete develops structural fissures, resulting in structural failure. Adding micro steel fiber is one of the most efficient strategies for improving the concrete’s characteristics like tensile strength, compressive strength, and flexural strength. In addition to this, a comparison is made between conventional concrete and RA concrete furthermore contains micro steel fiber enhancing the enforcement that leads to unreeling concrete. The outcomes of micro steel fiber onto RA concrete are assessed, and the conflicts among natural and RA attributes are addressed and discussed in detail.
Inside the Intergovernmental Panel on Climate Change, with Hans-Otto Pörtner
Authors: Knight Kathryn 
Published: February 2025

ABSTRACT
Hans-Otto Pörtner is a leading animal physiologist based at the University of Bremen and the Alfred Wegener Institute, Helmholtz Centre for Polar and Marine Research, Germany, who first published in Journal of Experimental Biology in 1986. Since then, he has specialised in the physiology of marine vertebrates and invertebrates, with an interest in the impact of hypoxia and temperature on survival, developing the concept of oxygen- and capacity-limited thermal tolerance. It was Pörtner's work on the impact of rising CO2 levels on marine organisms that brought him to the attention of the Intergovernmental Panel on Climate Change (IPCC) when governments were considering storing CO2 in the deep oceans. Contributing to the IPCC Special Report on Carbon Dioxide Capture and Storage in 2005, Pörtner was part of the team that led to the prohibition of CO2 dumping in the oceans in 2007. This resulted in Pörtner being invited to contribute to the planning process for the IPCC's Fifth Assessment Main Report, approved by the IPCC in 2014, which stated that human CO2 emissions are ‘extremely likely’ to be the dominant cause of global warming and its impacts. In 2015, Pörtner was voted co-chair of the IPCC Working Group II, assessing the planet's vulnerability to climate change, culminating in the Sixth Assessment Synthesis Report released in 2023. Pörtner is co-presenting the Climate and Biodiversity Plenary Lecture on 25 March 2025 at the Biologists @ 100 conference, hosted by The Company of Biologists. Here, he reflects on his career, his contribution to the IPCC and how to minimise our impact on the planet.
Steps initiated for sustainability of faculty mentorship program at Aga Khan University Medical College: A mixed method study
Authors: Rehman Rehana , Khan Fauzia , Ali Tazeen Saeed , Ali Rahila 
Published: February 2025

Objective: To investigate and address challenges in faculty mentorship for sustainability of Faculty Mentorship Program (FMP) at Aga Khan University Medical College (AKU-MC).
Methods: This is a mixed method study conducted from June 2021 to December 2023 at AKU-MC. It comprises of the exploration of qualitative insights into the challenges faced by mentors, mentees, and administrators, also incorporating quantitative measures of success to evaluate the sustainability of the program over time. Data was retrieved from four Focus group discussions (FGD) with mentors and mentees, eight in depth interviews with the administrators of FMP and leadership. Challenges of faculty mentorship were further identified by a panel discussion and briefing sessions with faculty members of different departments at AKU-MC. Challenges identified by three data sets were presented to the FMP committee, discussed in forum meetings and recommendations were proposed for the sustainability of the program.
Results: During the interviews, mentors revealed ‘Limited Training and ‘Lack of Recognition’ as key challenges whereas mentees mentioned deficient skills in planning developmental goals. Administrators mentioned the need to enhance the visibility of the program as well as to update the resources. Panel discussion highlighted the need for recognition of mentors and providing them with protected time. Departmental meetings endorsed the need for sequential training of both mentors and mentees. To address these challenges educational grand rounds, international conferences and webinar were conducted to enhance the visibility of the program. Mentors were acknowledged by appreciation emails and tokens of appreciation. A series of workshops to enhance mentoring skills were planned and executed.
Conclusion: The FMP at AKU-MC has devised a stepwise strategy to address challenges in faculty mentorship. This approach emphasizes collaboration with departments and the active involvement of leadership. By incorporating rewards, recognition, and a series of workshops, the program aims to foster a strong mentorship culture within the university. These efforts align with the objective of investigating and resolving mentorship challenges to ensure the sustainability of the Faculty Mentorship Program at AKU-MC.
doi: https://doi.org/10.12669/pjms.41.3.10856
How to cite this: Rehman R, Khan F, Ali TS, Ali R. Steps initiated for sustainability of faculty mentorship program at Aga Khan University Medical College: A mixed method study. Pak J Med Sci. 2025;41(3):798-803. doi: https://doi.org/10.12669/pjms.41.3.10856
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Correlation of risk factors for ischemic stroke with uric acid/creatinine ratio and cerebral vascular hemodynamic index (CVHI) in physical examination population
Authors: Bai Xue , Wang Hui , Li Jiangzhe , Xu Jinjin , Cai Pan 
Published: February 2025

Objective: To investigate the risk of ischemic stroke, uric acid/creatinine ratio, cerebral vascular hemodynamic index (CVHI) and risk factors of stroke in physical examination population.
Methods: This was a retrospective study. Four hundred cases undergoing physical examination at physical examination center in Baoding No.1 Central Hospital from January 2023 to December 2023 were selected as subjects, and their general data were collected. They were divided into low ratio group, medium ratio group and high ratio group depending on the uric acid/creatinine ratio, and were classified as high-risk group, medium-risk group and low-risk group as per CVHI, the general data of all subjects were compared and analyzed.
Results: Multifactorial Logistic regression analysis was performed after assignment of stroke risk factors as dependent variables yielding that advanced age, smoking, alcohol abuse, hypertension, diabetes mellitus, BMI, hyperlipidemia, and hyperuricemia were risk factors for ischemic stroke(P<0.05). Those with high uric acid/creatinine ratio were markedly higher than those with medium and low ratio in the proportion of alcohol abuse, hypertension, diabetes mellitus, and hyperlipidemia, with statistically significant differences (P<0.05). Obesity, advanced age, smoking, hypertension, diabetes mellitus, and hyperlipidemia were obviously higher in the high-risk group for stroke than in the medium- and low-risk groups, with statistically significant differences (P<0.05).
Conclusion: Risk factors for ischemic stroke predispose to older age groups, and are linked to underlying medical conditions, especially in those with high uric acid/creatinine ratios and those at high risk of stroke. The SUA/Cr ratio is negatively correlated with the CVHI score.
doi: https://doi.org/10.12669/pjms.41.3.9912
How to cite this: Bai X, Wang H, Li J, Xu J, Cai P. Correlation of risk factors for ischemic stroke with uric acid/creatinine ratio and cerebral vascular hemodynamic index (CVHI) in physical examination population. Pak J Med Sci. 2025;41(3):804-809. doi: https://doi.org/10.12669/pjms.41.3.9912
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Syphilis seroprevalence and risk factors among first-time blood donors in Brazil: A comprehensive repeated cross-sectional analysis spanning a decade
Authors: Cortez Andre Lazzeri , Avelino-Silva Vivian I. , Labella Henriques Barbara , Vernal Sebastian , de Almeida-Neto Cesar , Rolim Belisário André , Loureiro Paula , Maximo Claudia de Alvarenga , de Oliveira Garcia Mateos Sheila , Mayaud Philippe , Cerdeira Sabino Ester 
Published: February 2025

Background
Syphilis remains a global health challenge, with rising incidence rates worldwide Prevalence surveys conducted in Brazil over extended periods of time are scarce. This study examines the secular trends and risk factors for syphilis seroprevalence among first-time blood donors in Brazil.

Methods
A retrospective analysis was conducted as part of a multicenter, repeated cross-sectional survey of blood donors from four major Brazilian blood centers, covering the period from 2007 to 2020. First-time donors who had undergone valid treponemal screening tests were included in the final dataset. Demographic characteristics and serological results were analyzed to identify risk factors for syphilis seroprevalence using multivariate Poisson models. An interaction term between age group and donation year was added to the final model. Model comparisons were performed using Likelihood Ratio Tests (LRT) and Akaike Information Criterion (AIC).

Results
1,424,850 donations from first-time donors were included during the study period. The overall syphilis seroprevalence was 2.19%, with significant heterogeneity across centers. Risk factors for increased seroprevalence included male gender, older age, lower education level, and self-reported black or mixed skin color. Notably, an increasing trend in syphilis seroprevalence was observed among younger donors and those born after 1990. Interaction analyses revealed significant effects between visit period and key demographic variables (age group, gender, education, and ethnicity), with the interaction between age group and donation year indicating higher seroprevalence among younger age groups in recent years.

Conclusion
The study highlights a high syphilis seroprevalence among first-time blood donors in Brazil, which has significant implications for blood safety and public health. The increasing trend among younger donors suggests a shift towards newer infections, warranting continued surveillance in this demographic.
Post-exercise differential response of central and brachial blood pressure in patients with coronary artery disease: A randomized crossover trial
Authors: Marôco João Luís , Angarten Vitor , Pinto Rita , Santos Vanessa , Fernhall Bo , Santa-Clara Helena , Melo Xavier 
Published: February 2025

The post-exercise hypotension response is controversial among patients with coronary artery disease (CAD). Factors behind this disparity may include post-exercise differential effects on central and brachial blood pressure (BP), exercise intensity and inter-individual variability. Thus, we investigate group and individual central and brachial BP responses 5, 15 and 30-min after combined exercise of different intensities in participants with and without CAD. Seventeen participants with stable CAD and eighteen aged-matched controls (52–81 years) completed an acute bout of high and moderate-intensity combined exercise. Brachial and central systolic (cSBP) pressures were assessed via oscillometry and carotid tonometry, respectively. Central pulse wave velocity was also measured. Group mean changes were examined with linear mixed models, and bSBP and cSBP post-exercise individual responsiveness quantified via the region of practical equivalence and highest density interval, a Bayesian decision rule. Regardless of exercise intensity, cSBP was persistently increased during recovery in participants with CAD (difference 30 –baseline (d30-bas) = 10, 95% CI: 4 to 17 mmHg, p = 0.001) but reduced in controls (d30-bas = -13, 95% CI: -19 to -7 mmHg, p = 0.003). bSBP was unchanged in both groups (CAD: d30-bas = 1, 95% CI: -3 to 6 mmHg, p = 0.995, control: d30-bas = -4, 95% CI: -2 to 8 mmHg, p = 0.999). Most participants with CAD exhibited sustained elevations in cSBP (n = 10), while most controls were post-exercise hypertensive responders (n = 11) with changes >|5| mmHg. We found differential post-exercise effects on central and brachial BP independent from combined exercise intensity but not clinical population.
Clinical trials.gov registration ID: NCT06617117
Does integration matter? an international cross-sectional study on the relationship between perceived public health and primary care integration and COVID-19 vaccination rates
Authors: Sodhi Sumeet , Chamali Rifka , Praveen Devarsetty , Sharma Manushi , Garcia Dieguez Marcelo , Mash Robert , Goodyear-Smith Felicity , Ponka David 
Published: February 2025

Background
Immunisation against COVID-19 is crucial for controlling the pandemic, yet global challenges persist in vaccine coverage and equitable distribution. A well-integrated primary health care approach can enhance vaccination programmes.

Aim
To explore the relationship between perceived PC (primary care)-PH (public health) integration, as well as other vaccination program implementation factors, and national COVID-19 vaccination coverage.

Design and setting
A convenience sample of self-identified primary care professionals completed an online survey on COVID-19 vaccination programme implementation and their perceptions of PC-PH integration.

Methods
Countries with ≥5 responses were included in the data analysis. COVID-19 vaccination implementation approach and perceived PC-PH integration against COVID-19 vaccination coverage was investigated using bivariate and subgroup analyses, Spearman correlation, and linear regression.

Results
A total of 394 responses from 32 countries were analysed. Participants included primary care providers, academics, and researchers. The median national COVID-19 vaccination coverage was 28.41% at time of study. Perceived barriers included patient hesitancy and vaccine supply shortages, while facilitators included vaccine product choices, equity, and community engagement. The study revealed a positive relationship between perceptions of PC-PH integration and national vaccination coverage in upper-middle and lower-middle income countries.

Conclusion
Perceived PC-PH integration increased with decreasing economic quartiles and this perception was linked to actual national vaccination coverage. Integration may be especially important for countries with lesser vaccine supply. High-income countries may benefit from increased collaboration between PC and PH to enhance vaccination efficiency. The findings contribute to understanding the role of PC-PH integration in vaccination programmes in different settings.
Ghana’s National Health Insurance enrollment: Does the intersection of educational and residential status matter?
Authors: Antabe Roger , Anfaara Florence W. , Sano Yujiro , Amoak Daniel 
Published: February 2025

Background
Since its inception in 2003, Ghana’s Health Insurance Scheme (NHIS) has received considerable scholarly attention on the determinants of enrollment. While most of these studies highlight the role of some socioeconomic and geographical factors, no study has explored the intersection of educational attainment and residence on NHIS enrollment. We aim to contribute to the literature and health policy in Ghana by examining the intersection of educational attainment and rural-urban residence on NHIS enrollment among women and men.

Methods
We used nationally representative data from the 2022 Ghana Demographic and Health Survey (GDHS). Using STATA 17, we applied multivariable logistic regression to our analytical sample comprising women (n = 14997) and men (n = 7040).

Results
Overall, we found that more women (90%) than men (73%) enrolled on the NHIS. Adjusting for a range of control variables, we found that women and men with secondary (OR: 1.61, 95% CI: 1.28–2.02; OR: 1.45, 95% CI: 1.16–1.82) and higher education (OR: 1.81, 95% CI: 1.24–2.64; OR: 2.85, 95% CI: 2.03–3.99) were more likely to have enrolled into the NHIS compared to those with no formal education. This difference was particularly heightened among women and men with no education. Rural women (96%) and men (90%) with higher education had higher enrollment rates compared to their urban counterparts.

Conclusion
We recommend revising the NHIS equity and pro-poor policy to include vulnerability at the intersection of low educational attainment and rural residence.
Prognostic consequence of hyperglycemia points in oral glucose intolerance test for the course and outcomes of pregnancy in women with gestational diabetes mellitus
Authors: Bunak I. V. , Sviridova M. I. , Startseva N. M. , Hamoeva Yu. A. 
Published: February 2025

BACKGROUND: The level of glycemia at different points of the glucose tolerance test measure different phases of insulin secretion, accordingly the groups of pregnant women with GDM diagnosed at different points of the test have differences.AIM: to evaluate the impact of oral glucose tolerance test results for frequency of insulin treatment, incidence of preeclampsia and pregnancy outcomes in women with GDM.MATERIALS AND METHODS: Retrospective analysis of 200 maternal medical cards and hospital cards of birth in women with GDM for the period 2021–2022. The patients were divided into two groups according the results of OGTT: 1st group — 102 pregnant women with fasting hyperglycemia, 2nd group — 98 pregnant women with hyperglycemia in 1 and 2 hours after glucose intake. Differences in age, body weight, BMI, weight gain during pregnancy, therapy of GDM were studied, and the incidence of preeclampsia and pregnancy outcomes were assessed in both groups.RESULTS: women of the 1st group had significantly higher weight and initial BMI. Pregnant women of both groups with a BMI over 25 kg/m2 more often required insulin treatment. The incidence of preeclampsia, newborn weight and the incidence of macrosomia were higher in 1st group.CONCLUSION: Fasting hyperglycemia in OGTT is associated with overweight and obesity, and these women are more likely to require insulin therapy. Women with GDM diagnosed by fasting hyperglycemia are at grate risk of developing preeclampsia and macrosomia.