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Burden And Determinants Of Diarrheal Disease Among Children Under Five In East Java, Indonesia: Findings From Ssgi 2024, Raudia Faridah Humaidy, Soraya Isfandiary Iskandar, Sophia Zahra, Sovia Salamah

Folia Medica Indonesiana

Diarrhea is one of the leading causes of morbidity among children under five in Indonesia and remains a major public health concern, particularly in the province East Java, which has the second-highest disease burden in the country. Unfortunately, evidence for provincial-level predictors of childhood diarrhea using recent national data is limited. This study aimed to estimate the burden of diarrhea among children under five and identify its associated factors to support targeted child health interventions. A cross-sectional analysis was conducted utilizing data from the 2024 Indonesian Nutrition Status Survey (SSGI). Data on children under five residing in East Java with …

Detection And Evaluation Of Biofilm-Producing Clinical Bacterial Isolates By Tcp Method In Karbala-Iraq, Huda Ali Salman Almosawey

Al-Esraa University College Journal for Medical Sciences

Background: A biofilm is a complicated, three-dimensional microbial community that forms at an interface and interacts with its surroundings. To detect the ability of bacteria to form biofilms, the Tissue Culture Plate Method (TCP) is one of the most widely accurate methods and is frequently used with clinical isolates. Objective: This study aims to determine the ability of clinical bacterial isolates to form biofilms using the TCP method and to compare biofilm production between different types of bacteria; to study the relationship between biofilm formation and antibiotic resistance, which helps in understanding the reasons for the failure of some antibiotic …

Epigenetic Regulation Of Immune Responses In Autoimmune Diseases And Cancer: Mechanisms And Therapeutic Implications, Faisal H. Al-Amier, Ammar B. Al-Asadi, Aljuboori M. Nafea, Karar M. Jaleel

Al-Esraa University College Journal for Medical Sciences

Immune tolerance balances immune responses with self-tolerance, a balance that is directive by epigenetic pathways. These mechanisms responsible for gene expression regulation and immune cell activity, and include DNA methylation, histone modifications, and non-coding RNAs. Disruption of mechanisms involved in the autoimmune disorder pathophysiology like systemic lupus erythematosus, rheumatoid arthritis, and multiple sclerosis through the induction of long term inflammation and breakdown of immune tolerance. In cancer, epigenetic changes allow immune evasion and establish an immunosuppressive tumor microenvironment. Epigenetic markers have been used for diagnosis and prognosis, and epigenetic treatments have the potential to rebalance the immune system and improve …

Socio-Demographic And Clinical Profile Of Diabetic Patients: A Cross-Sectional Study, Ali Kadhim Obyes, Suhair Mohammed Hassoon, Dhakam Mohammed Abbas

Al-Esraa University College Journal for Medical Sciences

Background: Diabetes mellitus is a growing global health crisis, disproportionately affecting low- and middle-income countries. In Iraq, prevalence is estimated at 12–15%, yet comprehensive local data on patient profiles remain scarce. Objectives: To describe the socio-demographic, clinical, nutritional, and laboratory profile of diabetic patients attending a tertiary hospital in Babylon, Iraq. Patients and Methods: A hospital-based cross-sectional study was conducted among 200 adult diabetic patients (type 1 or type 2) admitted to the endocrinology unit of Marjan Teaching Hospital from December 2025 to May 2026. Data were collected via face-to-face interviews, medical records, and laboratory reports. Descriptive statistics (frequencies, percentages, …

Waste Analysis Of Outpatient Waiting Time In The Obstetrics And Gynecology Polyclinic (Ob-Gyn) On Lean Healthcare Approach At X General Hospital Jember, Widian Almas Zatin, Dwi Prijatmoko, Firman Firman

Preventia: The Indonesian Journal of Public Health

In outpatient services, waiting time is one indicator of the quality of hospital services and can influence patient satisfaction. The research aims to analyze the waste of outpatient waiting time at the OB-GYN polyclinic of X General Hospital, Jember, using a lean healthcare approach. The case study for this research used a mixed-methods exploratory sequential design. Data were collected through observation, structured interviews, reviewing the standard operating procedures and the service flow, and distributing questionnaires to identify critical waste. The sequence of services was analyzed using Value Stream Mapping to identify value-added, non-value-added, and waste. Process Cycle Efficiency (PCE) was …

Respectful Maternity Care: A Narrative Review Of Current Evidence And Clinical Implications, Hadeel Rasheed Seger, Nada Abd Ali Mohammed, Khalid Alyodawi

Preventia: The Indonesian Journal of Public Health

Respectful Maternity Care (RMC) is key to improving quality maternity care and has also been recognized as a foundational approach to quality maternity services. The framework has been developed around respect and promotion of dignified care, confidentiality and privacy, and autonomy of a woman, along with her right to freedom from neglect, discrimination, physical and verbal abuse, during pregnancy and childbirth. Despite worldwide acknowledgment and promotion of RMC, disrespect and abuse during childbirth have been observed among women in maternity settings, especially in low- and middle-income countries. This narrative review summarizes the current evidence and clinical implications of RMC. The …

Glucose-Lowering Effects Of Epigallocatechin Gallate And Metformin In Diabetic Zebrafish Models: A Systematic Review And Meta-Analysis, Dinda Ayu Permatasari, Abdul Khairul Rizki Purba, Maftuchah Rochmanti, Rizky Alvian Adi Kurniawan, Shilvi Haliza Pratiwi

Folia Medica Indonesiana

Metformin is widely recognized as an effective glucose-lowering agent for type 2 diabetes mellitus, while epigallocatechin gallate (EGCG) has exhibited promising antidiabetic and antioxidant properties in experimental settings. This systematic review and meta-analysis aimed to assess the impact of EGCG and metformin on blood glucose concentrations in diabetic zebrafish models and to synthesize the related metabolic and mechanistic findings. The protocol was registered with PROSPERO (CRD420261461237) and the review was conducted in accordance with PRISMA 2020 guidelines. Comprehensive searches were performed in PubMed/MEDLINE, Scopus, Web of Science, and Embase for in vivo zebrafish studies published from January 2010 to August …

Crispr/Cas9-Based Genome Editing: Understanding Differences In Dna Repair Pathways, Profiles, And Outcomes, Samuel Effah, Shirley Barrera, Nahia Urturi Ortiz, Will Dampier, Michael Nonnemacher, Brian Wigdahl

Kimmel Cancer Center Faculty Papers

Over a decade of advances in Clustered Regularly Interspersed Short Palindromic Repeats (CRISPR) and CRISPR-associated protein 9 (Cas9)-based technologies have culminated in the first-ever FDA-approved CRISPR/Cas-based therapy. Aside from this approved therapy for sickle cell anemia, several CRISPR/Cas-based therapies are currently under development or testing for a range of chronic diseases, including viral diseases like human immunodeficiency virus type 1 (HIV-1) infection, genetic diseases like familial hypercholesterolemia, and cancer. The success of these therapies hinges on the effective delivery of CRISPR/Cas9 components to target regions, efficient Cas endonuclease editing, repair profiles generated, and their resulting outcomes. Here, we discuss the …

A Mathematical Model For Managing Diphtheria Outbreaks In Nigeria Via Vaccination, Enhanced Surveillance, Effective Quarantine, And Social Distancing Measures, Hycienth Ortser Orapine, Nyiutya Cephas Ine, Dekera Jacob Washachi, Ali Audu Baidu, Lubem Matthew Kwaghkor

Mathematical Modelling and Numerical Simulation with Applications

Diphtheria is a highly infectious respiratory and skin disease that poses a significant threat to global public health. In Nigeria, children and adults with low immunity remain at high risk due to recurring annual outbreaks in the last decade, with a death rate of as high as 68.8\%. This paper presents a deterministic compartmental model to evaluate the effectiveness of interventions implemented by the Nigerian government. The model's mathematical and epidemiological validity is established through proofs of non-negativity and boundedness. The basic reproduction number ($R_0$) is derived, and stability analysis confirms that the diphtheria-free equilibrium is locally and globally asymptotically …

The Pivotal Role Of Artificial Intelligence In Optimizing Pharmaceutical Formulation And Delivery, Ali Khidher Abbas, Mustafa M. Noori, Ibtihal Abdulkadhim Dakhil, Mohammed Hussain Al-Mayahy

Al-Esraa University College Journal for Medical Sciences

Artificial intelligence (AI) has emerged as a transformative technological paradigm within the pharmaceutical sciences, offering innovative and forward-looking solutions to surmount the inherent limitations associated with conventional drug development, formulation design, and therapeutic delivery systems. Traditional pharmaceutical methodologies frequently entail protracted development timelines, extensive experimental procedures, and substantial financial expenditures, particularly within the domains of formulation optimization and drug delivery design. The integration of AI-driven technologies – encompassing machine learning (ML), deep learning (DL), artificial neural networks (ANNs), and predictive analytics – has considerably accelerated pharmaceutical research by refining decision-making processes, alleviating experimental burden, and enhancing formulation efficiency. The present …

Clinical Significance Of Liver Enzyme Biomarkers In Chronic Statin Users, Muayad Khaleel Ibrahim, Saad Mahmoud Saeed

Al-Esraa University College Journal for Medical Sciences

It is possible that statins, by their dual capacity to modulate (both stimulate and suppress) immune responses, could play a role in influencing the course of autoimmune diseases. Consequently, our investigation was designed to explore how statins impact both the innate and adaptive branches of the immune system, as well as their effect on the crucial mechanism of self-tolerance. This was achieved through the comprehensive measurement of various antibody profiles, specifically including the detection and quantification of autoantibodies, such as antinuclear antibodies and Creatinine kinase, Aldolase, HMGCR antibody, Albumin and Bilirubin and Alanine transaminase, Aspartate aminotransferase, Our investigation employed a …

Extended-Phase Anticoagulation For Pediatric Venous Thromboembolism After Einstein Jr, Nathan Wilken, Jun Teruya

Faculty, Staff and Students Publications

No abstract provided.

Oncocytic Intraductal Carcinoma Of The Parotid Gland With Strn::Alk Fusion, Reham H Soliman, Chris Shi, Kevin E Fisher, Hong Yu, Fouad El-Dana, Xu Cao, Li Liang, Pei Ying, Songlin Zhang

Faculty, Staff and Students Publications

Intraductal carcinoma (IDC) of the salivary gland is an uncommon epithelial neoplasm characterized by a predominantly intraductal or intracystic proliferation rimmed by a myoepithelial cell layer. Advances in molecular profiling have revealed recurrent gene fusions in IDC, most frequently involving RET, although fusions implicating other kinase genes have also been described. Among these, ALK rearrangements are rare and remain poorly characterized. Herein, we report a case of oncocytic IDC of the parotid gland harboring a STRN::ALK fusion, further expanding the molecular landscape of this tumor. Although this fusion has been previously reported in intercalated duct IDC, to our knowledge, this …

Patterns Recognized In Ayres Sensory Integration®: A Scoping Review, Marica Botha, Janine Van Der Linde, Zoe Mailloux

Department of Occupational Therapy Faculty Papers

Background/Objectives: Associations between scores on tests of sensory integration functions demonstrated in numerous studies over six decades have contributed to the development of Ayres Sensory Integration® (ASI) theory and practice. Understanding these "patterns" aids therapists in their interpretation of assessment results, ensuring appropriate and effective intervention. This study aimed to describe and discuss published research on identified patterns related to constructs in the Ayres Sensory Integration® approach. Methods: Arksey and O'Malley's framework and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews Checklist were used. The literature review search was guided by the following …

Activities Of Daily Living Limitations In Middle-Aged And Older Adults With Joint Disorders And Osteoporosis: Indonesia Longitudinal Aging Survey 2023, Desfalina Aryani, Mufti As Siddiq As Siddiq M. Irzal, Agustina Sianipar

Jurnal Epidemiologi Kesehatan Indonesia

Population ageing is associated with an increasing prevalence of limitations in activities of daily living. Joint disorders and osteoporosis are common health problems among older adults and may begin to emerge during middle age, potentially accelerating functional decline. However, studies examining the association between these conditions and limitations in activities of daily living in Indonesia remain limited. This study aimed to analyse the association between joint disorders and osteoporosis and limitations in activities of daily living among middle-aged and older adults in Indonesia. This study employed a cross-sectional design using data from the Indonesia Longitudinal Aging Survey (ILAS) 2023. The …

Clinical Epidemiology Of Stroke In The Productive Age Population In Indonesia: A Scoping Review, Satria Akbar Putra Asmara, Ulil Albab Habibah

Jurnal Epidemiologi Kesehatan Indonesia

Data from the 2018 Indonesian Basic Health Research (Riskesdas) demonstrates a marked increase in stroke prevalence, rising from 7% in 2013 to 10% in 2018. This upward trend is accompanied by a notable epidemiological shift, with stroke no longer predominantly affecting older adults ≥65 years, but increasingly occurring among the productive-age population (15–64 years). This scoping review was conducted in February 2026 in accordance with the JBI methodological guidelines and PRISMA-ScR. Searches were conducted in Google Scholar, PubMed, Garuda, and ScienceDirect. Inclusion criteria include articles published within the last 10 years (2016–2026), articles discussing the characteristics of stroke patients in …

Clinical And Hematological Correlates Of Common Viral Respiratory Infections In Patients With Acute Illness In Iraq, Israa Habeeb Naser

Journal of Bioresource Management

Background: Acute viral respiratory infections are considered as the leading causes of illness and hospitalization worldwide. Influenza virus, Respiratory Syncytial Virus (RSV) and Adenovirus are general respiratory pathogens linked with significant clinical problems in Iraq. This study aims to estimate the prevalence of common respiratory viral infections and their clinical and hematological associations between Iraqi patients with acute-illness.

Methods: This a cross-sectional study was done on 160 patients showing acute febrile and/or respiratory-symptoms. Viral detection for Influenza virus, RSV and Adenovirus was performed using rapid-antigen and ELISA assays. Hematological tests including total leukocyte count (TLC), differential leukocyte count, hemoglobin and …

Endophytic Actinobacteria: Deciphering Therapeutic And Industrial Potential, And Prospects Of Genome Mining In Novel Products Discovery, Yusra Waheed, Rabia Shahdin, Imran Sajid

Journal of Bioresource Management

Endophytic actinobacteria are a diverse group of Gram-positive bacteria with high G+C content, which inhabit plants’ internal tissues, and represent a significant yet underexplored reservoir of bioactive secondary metabolites. In host plants, a remarkable repertoire of metabolites, including broad-spectrum antibiotics, anticancer, antiviral, antifungal, antioxidant, and immunomodulatory compounds, is synthesized by these microbial allies, carrying significant medicinal and agricultural potential. These endophytes, in contrast to their soil relatives, have developed unique biosynthetic gene clusters (BGCs) strongly influenced by plant-associated factors, leading to the production of structurally novel metabolites. In recent years, the advances in genome mining, metagenomics, and metabolomics have accelerated …

Detection Of Uropathogenic Multidrug-Resistant Escherichia Coli And Klebsiella Pneumoniae Isolates In Some Immunocompromised Patients., Alaa Abd Atia, Manal Mohammed Kadhim

Al-Qadisiyah Medical Journal

Background: Multidrug-resistant E. coli and K. pneumoniae isolates are the most common causes of acquired urinary tract infections (UTIs). Objective: Conclude the prevalence of multidrug-resistant E. coli and K. pneumoniae isolates in urine samples from immunocompromised patients with UTIs. Methods: A total of 543 urine samples were collected from patients with supposed UTIs. MacConkey, chromogenic agar, and blood culture were used to cultivate the samples. Disk diffusion on Mueller-Hinton agar was used to select cultures that were positive for testing for antibiotic susceptibility. Excel and SPSS software were used to gather and analyze the data. Results: Of …

Occupational Therapy’S Role And Impact In Cancer Prehabilitation: A Scoping Review, Abbey Rancour, Averi Haas, Emily Peckham, Kate Reimer, Kylie Mccaskill

Masters Projects

Background:

Oncology prehabilitation aims to optimize patients’ physical and psychosocial function before cancer treatment, yet the specific contributions of occupational therapy (OT) remain underexplored.

Objective:

This scoping review aims to map and synthesize the existing literature describing the role and reported benefits of OT within oncology prehabilitation programs.

Methodology:

Following Arksey and O’Malley’s (2005) scoping review framework and guided by the PRISMA-ScR checklist, three databases (PubMed, CINAHL, and Web of Science) were searched. Search terms included preoperative exercise, prehabilitation, neoplasms, and cancer. Articles were screened by two independent reviewers, and data were charted and analyzed descriptively and thematically.

Results:

A …

Chemotherapeutic Induction Of Cytosolic Single-Stranded Dna Accumulation Sensitizes Triple-Negative Breast Cancer To Immunotherapy, Yong Du, Li Yang, Hui Dai, Jianli Zhou, Zhicheng Zhou, Ruoxi Yuan, Rui Ye, Anh Thai Quynh Nguyen, Kishor Bhatia, Shiaw-Yih Lin

Faculty, Staff and Students Publications

Background: Despite the widespread adoption of chemoimmunotherapy in triple-negative breast cancer (TNBC), the mechanisms by which cytotoxic chemotherapy engages antitumor immunity remain poorly defined. Identifying tumor-intrinsic immunogenic programs that predict and enhance responsiveness to immune checkpoint blockade (ICB) is therefore of critical clinical importance.

Methods: Transcriptomic signatures of TREX1 deficiency were generated from CRISPR-engineered TNBC models and applied to multiple independent TNBC cohorts treated with chemoimmunotherapy. Cytosolic single-stranded DNA (ssDNA) accumulation was quantified using a flow cytometry-based assay to functionally screen chemotherapeutic agents. Immune activation and therapeutic efficacy were evaluated using in vitro assays, syngeneic mouse tumor models, flow cytometry, …

Letter To The Editor: Hemodynamic Role In Hepatic Encephalopathy Pathogenesis Following Transjugular Intrahepatic Portosystemic Shunt Placement, John Halphen, Yash S Dayal, Cameron Laurie, Mohadese Ahmadzade, David Wynne, Mohammad Ghasemi-Rad

Faculty, Staff and Students Publications

Hepatic encephalopathy (HE) is a common complication following transjugular intrahepatic portosystemic shunt (TIPS) placement and is thought to result from reduced hepatic detoxification of neurotoxins. However, Zhuang et al in the World Journal of Radiology demonstrate that this understanding may be incomplete through exploration of the pathophysiology from a hemodynamic perspective. They found significant changes in cerebral blood flow (CBF) and spontaneous brain activity following TIPS. Initially, CBF increased in specific areas within the first month, followed by a return to baseline at three months. These CBF changes coincided with increased spontaneous brain activity that persisted in some areas, suggesting …

Surviving Sepsis 2026: Key Updates, Amanda Rawa, Katherine Ghattas

Transformative Medicine

The 2026 update to the Surviving Sepsis Campaign guidelines introduces several important changes in the management of sepsis and septic shock, with a greater focus on tailoring treatment to individual patients. Notable updates include lower blood pressure targets for older adults with septic shock, continued support for early fluid resuscitation, the selective use of rapid diagnostic testing to guide antibiotic therapy, and increased flexibility in vasopressor selection for patients with cardiac dysfunction. These recommendations are based on emerging evidence aimed at improving patient outcomes while reducing unnecessary interventions and treatment-related complications. Overall, the updated guidelines reinforce a more personalized approach …

The Top 50 Cited Articles In Pediatric Neurology: A Bibliometric Analysis, Anas Alyazidi, Osama Muthaffar, Ahmed Bamaga, Hebah Qashqari, Abdulmalek Alhithlool, Ahmad Alanezi, Sameer Almehmadi, Mohamed Babiker, Fahad Bashiri

Neurosciences

Objectives: To identify and analyze the most influential articles within the field of pediatric neurology through a bibliometric lens. As pediatric neurology continues to expand across subspecialties, identifying landmark studies is critical for understanding clinical and research priorities. Bibliometric analysis enables the evaluation of citation trends to highlight impactful contributions that have shaped the field.

Method: A bibliometric analysis of the 50 most-cited pediatric neurology articles was conducted. Articles were assessed by citation metrics, study design, subspecialty, journal impact factor (JIF), and funding status. Correlation and regression analyses evaluated associations between variables.

Results: Citation counts ranged from 185 to 1,440 …

Investigating The Patent Foramen Ovale–Migraine Link In Southern Saudi Arabia, Al-Amir Bassiouny Mohamed, Maeed Alkathiri, Saad Mushabab Ali Alqahtani, Naif H. Ali, Saima Kashif, Saad A. Alshahrani, Mohammed S. Alqahtani, Mohamed Gaber Mahmoud Gabr, Eltohami Zydan Dafalla, Basharat Hameed Zargar, Wael Qenawi, Ali Mohammed A. Alshehri, Fatimah Asiri, Ahmed Borai

Neurosciences

Objective: Migraine is a highly disabling neurological condition, and increasing attention has focused on a possible connection with patent foramen ovale (PFO).

Methods: This single-center observational study enrolled 45 individuals from January to April 2024: 30 migraine patients with PFO (Group 1) and 15 migraine patients without PFO serving as controls (Group 2). All subjects underwent transthoracic echocardiography and completed standardized instruments including the Migraine Disability Assessment (MIDAS), Headache Impact Test (HIT-6), Migraine Symptom Severity Scale (MSSS), Allodynia Symptom Checklist (ASC-12), Visual Aura Rating Scale (VARS), and Migraine Treatment Optimization Questionnaire (mTOQ-6).

Results: The participant's mean age was 37.3 ± …

Syphilis And Hiv Co-Infection Risk Factors At Dr. Moewardi Hospital, 2018–2022: A Retrospective Study, Endra Yustin Ellistasari, Prasetyadi Mawardi, Pratiwi Prasetya Primisawitri, Stella Gracia Octarica

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Treponema pallidum, the agent causing syphilis, is transmitted through contact with infectious lesions, bodily fluids, blood transfusions, or perinatally. Human immunodeficiency virus (HIV) infection can mask the clinical manifestations of syphilis, while syphilis may exacerbate HIV progression. This study aimed to analyze risk factors associated with HIV co-infection among patients with syphilis.

Methods: This retrospective, analytical, observational study reviewed medical records from the Dermatology and Venereology outpatient clinic at Dr. Moewardi Hospital, Surakarta, Indonesia, between January 2018 and December 2022. Demographic, behavioral, and clinical variables were extracted. Univariable analysis was performed using simple binary logistic regression to …

Online Rights Defense Among Chinese Americans Against Racial Aggression In The U.S. During The Covid-19, Fangzhu Lu, Wenshan Jia

Communication Faculty Articles and Research

Purpose

This study investigates how Chinese American communities responded to heightened racial discrimination during the COVID-19 pandemic by utilizing social media platforms to safeguard their civil rights, articulate collective concerns, and mobilize resistance against racial aggression.

Methodology

Through qualitative case study analysis, the research examines the social media activities of six advocacy organizations, including three X accounts (WashTheHate, Chinese for Affirmative Action, Asian Americans Advancing Justice) and three Instagram accounts (Stop AAPI Hate, Stop Asian Hate, Advancing Justice: AAJC). The analysis focuses on the content strategies and communication mechanisms employed to counteract racial hostility.

Findings

The selected organizations used social …

Instructions To Authors, Academy Editors

Journal of the Arkansas Academy of Science

No abstract provided.

Nasal Polyp Treated With Homoeopathic Medicine Lemna Minor: An Evidence-Based Case Report, Milan Sengupta, Laijun Nahar, Gurudev Choubey, Chittaranjan Kundu

Indian Journal of Research in Homoeopathy

Introduction: In the general population, nasal polyps (NPs) linked to chronic rhinosinusitis (CRS) are common. Patients with CRS are 60–65% more likely to develop NP. Treatment for NPs resulting from chronic rhino-sinusitis continuous to be challenging. Case summary: A 31-year-old female came with a swelling in her left nostril, clinically diagnosed as a case of NP. Homoeopathic medicine Lemna minor 1M was prescribed based on the acute complaints and pathological symptoms. The swelling was completely resolved within 45 days. This case report demonstrates the usefulness of homoeopathic medicine in the management of NP.

Alopecia Totalis Treated With Constitutional Medicine Calcarea Carbonica: A Case Report, Deepak Prasher, Urvashi Diwakar

Indian Journal of Research in Homoeopathy

Introduction: Alopecia totalis is an autoimmune disease that causes hair loss anywhere in the body, but it most commonly affects the hair of the scalp. It occurs in people of all ages and affects 1–2% of the human population. The homoeopathic literature suggests that cases of alopecia totalis have been treated successfully with homoeopathic medicines. Case Summary: This case highlights the potential of the individualised homoeopathic remedy in promoting hair regrowth in alopecia totalis in a 14-yr old girl. The patient was prescribed Calcarea carbonica 200C, 2 doses on the basis of totality of symptoms and individualisation. This evidence-based case …