Documentation Center of Cambodia

The type of AI used to design video game enemies greatly affects the gameplay experience of speed, difficulty, and enjoyment. In most cases, the majority of developers who create 2D platforming games will choose to implement a simple but efficient AI design over an advanced AI model that learns based on experience. One of these simpler AI models that is frequently utilized by 2D platforming game developers is the Finite State Machine (FSM) model. The FSM model creates an organization of the enemy's actions into a limited number of well-defined behaviours, while also indicating how these behaviours relate to one another. We look at how AI uses the FSM method in the 2D platform game "Kirby: Nightmare in Dreamland," which first came out on the Game Boy Advance. The analysis of FSM models enemy AI behaviors and how those behaviors change and when they do so affects how hard the game is. Simulated experiments were conducted on how state time is spread out and how to make things harder by changing the attack cooldown. The results show that FSM-based AI is easy to control, doesn't need a lot of processing power, and has behavior that can be predicted. This makes it a good choice for platform games that are easy to get into. The results show that FSMs are still important in AI research and game design today.

This research examines the macroeconomic determinants of inflation in Cambodia with an ARDL cointegration analysis. The results demonstrate a long-run negative association between inflation and exchange rates, tax revenue, and broad money. In the short run, growth in tax revenues dampens inflation, while money supply growth boosts it. Looking at the results, we can infer that expansionary fiscal policy (in particular, tax effort) and prudent monetary policy can control Cambodia’s currency and inflation. Policymakers should take into account the system of relationships among these macroeconomic variables to design such policies, which can cause price stability and long-term growth in the economy.

Objectives: This study utilized artificial intelligence (AI)-based radiomics analysis of computed tomography (CT) images using a modified U-Net for lung nodule segmentation and convolutional neural network based on VGG-16 to predict lymphovascular invasion (LVI) in stage 0-I lung adenocarcinoma. Additionally, the study investigated whether combining radiomics data with serum microRNA (miR)-30d level as a potential biomarker could enhance predictive performance. Methods: A total of 1265 patients who underwent complete resection between 2008 and 2018 were included. AI-based CT analysis was performed, and logistic regression was applied to predict LVI using 35 imaging features. A risk score (RS) generated from 840 patients in the derivation cohort was used to identify a high-risk group, with validation performed using 425 patients. Additionally, 47 cases with extracellular vesicle (EV)-derived miR-30d level data were analyzed to evaluate the value of the integrated approach. Results: Among all the patients, 467 patients (36.9%) were LVI-positive, and LVI was independently associated with poorer overall survival. The receiver operating characteristic curve for LVI based on the RS yielded an area under the curve of 0.899. For LVI prediction, the sensitivity, specificity, and accuracy were 84.8%, 83.7%, and 83.9%, respectively, in the derivation group, and 82.3%, 79.4%, and 80.5%, respectively, in the validation group. The integrated approach with miR-30d enhanced the predictability of LVI, achieving a sensitivity of 93.3%, specificity of 70.5%, and accuracy of 85.1%. Conclusions: AI-based radiomics demonstrated high effectiveness for predicting LVI, with RSs showing broad clinical applications. The addition of EV-derived miR-30d modestly improved predictability.

Available data on the demand for orthotic services is limited, especially in low- and middle-income countries, yet the development and delivery of services relies on this information. In this study, routinely collected digital patient records are used to provide insights into orthotic service users from three Cambodian physical rehabilitation centres. Analysis of the digital patient records from 1998–2019 investigated trends by sex, clinic, reason for orthosis use, orthotic type, and age. The analysis showed that the characteristics of service users and the provision of orthotics have changed over time. The predominant reason for orthosis use prior to 2006 was polio, whereas in 2019 it was cerebral palsy. Ankle Foot Orthoses (AFOs) are the most common type of orthosis provided; however, key differences have been found between type of orthosis and age which suggests older individuals have different experiences of physical rehabilitation compared to younger age groups. Longitudinal trends indicate a substantial reduction in orthotics appointments which may be associated with change in service delivery and changing service user characteristics. The study has illustrated the insights which can be derived from digital patient records into the demand for orthotics services over two decades and demonstrates the need for targeted resources and planning for the provision of services.

Swelling disease is a poorly understood clinical syndrome of South African Angora goats that is characterised by acute-onset diffuse oedema. Adrenocorticotropic hormone-stimulated aldosterone secretion has been proposed as a possible aetiology of swelling disease, but this hypothesis has not been tested. To investigate aldosterone secretion in swelling disease by reanalysing data collected during a 2015 clinical investigation of the syndrome in which serum aldosterone and cortisol levels were measured along with standard clinical laboratory variables in affected and unaffected animals. Goats affected with swelling disease, and unaffected herd-mates, were sampled for measurement of haematology variables, serum protein variables, and serum sodium, aldosterone, and cortisol. Results for affected and unaffected goats were compared using the Mann-Whitney U test, and the association between variables was investigated using Spearman's rank-order correlation analysis. Goats affected with swelling disease had significantly higher white blood cell counts (WBC) and serum aldosterone than unaffected animals, and significantly lower total serum protein (TSP), albumin, globulin, and albumin/globulin ratios. For all animals (n = 60), serum protein variables showed a significant and strong positive correlation with one another, and a negative correlation with serum aldosterone and WBC. Swelling disease of South African Angora goats is characterised by panhypoproteinaemia, a low A/G ratio, leukocytosis, and hyperaldosteronaemia. Causal relationships between variables could not be determined, however, the detection of hyperaldosteronaemia provides novel insight into the possible pathophysiological mechanisms of this syndrome.

Dear Editor, The publication on “Correlation of pelvic ultrasonography with pubertal development in girls”() is interesting. The purpose of this study was to investigate the association between pelvic ultrasound pictures and pubertal development in girls, as well as to assess the efficacy of various factors in predicting puberty, particularly the use of uterine Doppler values, […]

Mental health disorders are major public health challenges, particularly in low- and middle-income countries such as Cambodia, where chronic shortages in mental health services and human resources exist. These issues are compounded for marginalized groups such as persons with physical disabilities due to their being at a higher risk of psychological distress and PTSD symptoms. The development of effective and accessible mental health systems in Cambodia will require evidence-based culturally appropriate mental health interventions. There are insufficient good-quality studies which have been completed to draw firm conclusions about the effectiveness of culturally appropriate mental health interventions in Cambodia. The aim of this study was to evaluate the effectiveness of a task shifted multi-component mental health intervention (named 'Friendship groups') at reducing psychological distress and PTSD, worry, rumination and increasing mindfulness among cohort of prosthetic and orthotic (P&O) service users. From March 2023 to June 2024 data (N = 465) were collected as part of a mental health screening programme for P&O service users across Cambodia. Participants experiencing mild to moderate psychological distress were screened and invited to participate in this study. Due to ethical considerations a non-randomised controlled trial design with repeated measures (pre-post intervention) was conducted to evaluate the effects of Friendship groups (N = 33) against a non-active control condition (N = 39). When compared to the control condition the Friendship groups were found to have a moderate to large effect on psychological distress, and a small to moderate effect on rumination. The Friendship group participants experienced reduced PTSD symptoms, worry and improved mindfulness post group but these changes were not significant when compared to the control condition. The results from this study evidence the acceptability and effectiveness of Friendship groups at reducing psychological distress. Our results also provide clear guidance that if Friendship groups are implemented across P&O services in Cambodia, P&O service users are likely to experience reduced psychological distress. These findings also add to the growing literature supporting the need for culturally adapted task shifted mental health interventions in low- and middle-income countries, where access to specialised care remains limited.

ABSTRACTObjectivesThe majority of people globally who have undergone limb amputations are living in low- and middle-income countries. For those with lower-limb amputations, ambulatory mobility with a prosthesis is considered a key factor for achieving independent living; however, little is known of determinants of mobility for prosthesis users in low- to middle-income countries. In this study, we sought to assess levels of self-reported mobility in Cambodian prosthesis users and to identify determinants associated with their ambulant mobility.DesignCross-sectional survey.SettingThree secondary care centres located in urban and rural Cambodia.ParticipantsAdults receiving prosthetic services for a major lower-limb amputation.Primary and secondary outcome measurementsThe Khmer version of the LCI-5 and the mobility dimension of the EuroQol five-dimensional five levels (EQ-5D-5L) were used as dependent variables, while personal, physical, psychological and social determinants served as independent variables. Associations were assessed using hierarchical and ordinal regression analyses.Results347 participants completed the survey. Determinants that were negatively associated with mobility outcomes were as follows: being female, having an amputation due to dysvascular complications, using an above-knee prosthesis and reporting higher levels of psychological distress. Social determinants did not appear to have any major association with mobility outcomes.ConclusionsFindings highlight the multidimensional nature of mobility and suggest that future interventions may benefit from targeting female prosthesis users and those with diabetes or vascular disease. Mental health interventions addressing symptoms of anxiety and depression may also contribute to improved mobility outcomes. Social determinants explored in the study were not associated with significant changes in mobility scores. This may be due to high overall levels of mobility, a relatively homogenous group or failure to identify context-specific variables that impact on mobility outcomes.