bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring the effects of extreme events on cereal cropping systems in the Ganga River basin, Haryana
Authors: Dubey Swatantra Kumar , Veettil Prakashan Chellattan , Patil Vikram , Deb Proloy , Kumar Virender
Published: November 2024

Recent studies have highlighted the profound impact of global warming on climate patterns worldwide, but few have specifically addressed its consequences for crop yields. This study aims to bridge that gap by examining the trends of extreme events and their effects on agriculture in adjacent Ganga River Basin Haryana districts from 1981 to 2020, focusing on the Expert Team on Climate Change Detection, Monitoring and Indices. The study area experienced increasing mean maximum and minimum temperatures, raising drought concerns, especially in Sonipat and Panipat districts. Drought indices showed prolonged events in these areas, contrasting with shifting wet-dry patterns in Yamuna Nagar and fluctuating conditions in Karnal. An analysis from 1998 to 2020 revealed intricate relationships between climate factors and rice, wheat, and pearl millet production, with rising temperatures significantly impacting crop yields. Notably, both mean maximum and minimum temperatures have increased, with a significant daytime and nighttime warming trend. Extreme maximum temperature and diurnal temperature range indices were found to negatively impact crop yields, whereas precipitation extremes demonstrated positive correlations with yield outcomes. Collaborative efforts between policymakers and farmers to integrate climate-resilient practices and continuous monitoring are crucial for ensuring food security and sustainable farming amidst climate variability.
Fluoride and nitrogen contamination and potential health risks in the groundwater of a typical agricultural region
Authors: Yang Junzhu , Wang Jiangxia , Xu Han , Xu Zibo , Zhang Yun , Chen Jie
Published: November 2024

Fluoride and nitrogen contamination is a global concern and has been a serious problem in agricultural areas. This study aims to identify the source of fluoride and nitrogen in the groundwater and assess groundwater quality and human health risks in the Guanzhong Plain, northwest China. The results showed that the concentrations were 0.15–4.74 mg/L for F−, 0.02–89.89 mg/L for NO3−-N, and BDL-2.40 mg/L for NH4+-N in groundwater. Distinct area-dependent distributions of fluoride and nitrogen were observed in the study region. Higher F− and NO3−-N concentrations in groundwater were detected in the northern part, and higher NH4+-N levels were observed in the southern part. Water–rock interaction and agricultural activities were the controlling factors for fluoride and nitrogen distribution in groundwater. About 80% of samples are considered to have good water quality with WQI < 100. Exposure to fluoride and nitrogen through drinking should require more attention. The total non-carcinogenic risks through oral ingestion of groundwater were 0.22–3.19 for adults and 0.51–7.44 for children, respectively. The order of pollutants in the groundwater in terms of their hazard to residents was F− > NH4+-N > NO3−-N > NO2−-N. The findings of this study could provide more insights into groundwater management.
Exigências térmicas para a colheita e conservação pós-colheita de uvas apirênicas cultivadas no Vale do Submédio do Rio São Francisco
Authors:   , Santos Ana Elisa Oliveira dos
Published: November 2024

Este trabalho teve como objetivo caracterizar o comportamento fenológico, a exigência térmica e a evolução da maturação das uvas apirênicas 'BRS Morena', 'BRS Clara' e 'BRS Linda'; bem como aprimorar as técnicas de conservação pós-colheita, nas condições do Vale do Submédio do Rio São Francisco. Foram conduzidos três experimentos em Petrolina, PE, na safra de 2010. O Experimento I teve com objetivo caracterizar o comportamento fenológico, a exigência térmica e as características físicas e físico-químicas, no ponto de colheita. Para tanto, foram caracterizados os períodos fenológicos, desde a poda até o início das fases de brotação, floração, frutificação, maturação e colheita, além dos requerimentos térmicos para cada fase, expressos em graus-dia. No ponto de colheita, foram determinados, também, a massa dos cachos, o diâmetro das bagas, a firmeza da polpa, o teor de sólidos solúveis (SS), a acidez titulável (AT) e o pH. Em função dos resultados obtidos durante o período estudado, os ciclos das videiras entre a poda e a colheita foram de 95 dias e 1.449 GD, para 'BRS Morena'; 97 dias e 1.497 GD, para 'BRS Clara'; e 103 dias e 1.592 GD, para 'BRS Linda'. De maneira geral, as uvas dos cultivares 'BRS Morena' e 'BRS Clara' apresentaram características físicas e físico-químicas com potencial de comercialização para os mercados, nacional e internacional, desde que, práticas de manejo sejam utilizadas, no sentido de melhorar algumas características físicas desses cultivares. O Experimento II, por sua vez, objetivou acompanhar a evolução semanal da maturação. Após a mudança de cor das bagas, foram realizadas avaliações físicas e físico-químicas, com destaque para massa dos cachos, diâmetro e comprimento das bagas, firmeza da polpa, SS, AT, pH e antocianinas da casca. Esta, realizada apenas para BRS Morena . A evolução da maturação das uvas 'BRS Morena', 'BRS Clara' e 'BRS Linda' caracterizou-se por aumentos significativos de massa dos cachos, diâmetro e comprimento das bagas, teor de SS, pH e antocianinas, e por decréscimos da acidez e firmeza da polpa, podendo ser realizada a sua colheita a partir de 95 dias, para cultivar 'BRS Morena'; 97 dias, para 'BRS Clara'; e 103 dias, para 'BRS Linda'. No Experimento III estudou-se a influência de embalagens associadas à refrigeração na pós-colheita. Neste experimento, os cachos foram embalados em recipientes PET, sacolinhas e bolsas contentoras plásticas e acondicionados em caixas de papelão, sendo, em seguida, armazenados sob refrigeração a 0±1 ºC e 83±3% de U.R., por 0, 15, 25 e 35 dias. Para cada período de armazenamento, os cachos foram avaliados quanto a: perda de massa, qualidade do engaço, firmeza da polpa, SS e AT. Nas condições específicas desse experimento, recomenda-se o uso das embalagens plásticas, recipiente de PET e sacolinha plástica, associados às bolsas contentoras, para a conservação pós-colheita das uvas 'BRS Morena', 'BRS Clara' e 'BRS Linda'
Fontes de informação alternativas
Authors: Costa Júlia Raquel Farias da , Albuquerque Daniela Eugênia Moura de , Araújo da Silveira Murilo Artur
Published: November 2024

Este artigo investiga como as práticas de tradição oral de griôs da Região Nordeste do Brasil podem ser utilizadas como fontes de informação. Trata-se de uma pesquisa exploratória baseada em técnicas bibliográficas e documentais, que utilizou a entrevista semi-estruturada como instrumento de coleta de dados. A análise dos dados ocorreu por meio da análise pragmática da linguagem. Com as entrevistas, identificamos a tradição oral como uma fonte de informação que, tida como objeto de estudo, requer uma abordagem decolonial. Observou-se uma variedade de práticas de tradições orais dos entrevistados que são fontes de informação, a saber: as contações de histórias, as brincadeiras, a dança, a musicalidade e as artes marciais. Conclui-se que as práticas de tradição oral Griô podem ser utilizadas como fontes de informação em que a história e cultura local de uma comunidade são a gênese informacional, a partir das interações entre as pessoas.
Application of UPLC-MS/MS to Study Cellular Pharmacokinetics of Seven Active Components of Cnidii Fructus Extracts
Authors: Bai Yu , Ouyang Huizi , Liu Yang , Zuo Fanjiao , Li Caixia , Zhou Shuting , Chang Yanxu , He Jun
Published: November 2024

Background:

Cnidii Fructus (CF) is a herbal medicine with pharmacological activities such as antitumor,
antiviral, antiallergic, antipruritic effects, and so on.

Objective:

In this study, an ultra-high performance liquid chromatography/tandem mass spectrometry (UPLC-
MS/MS) method was prepared and verified to measure the concentrations of seven analytes (bergapten, xanthotoxol,
xanthotoxin, imperatorin, osthole, isopimpinellin, isoimperatorin) in HepG2 cells.

Methods:

The separation of seven analytes was performed on an ACQUITY UPLC® BEH C18 column
(2.1×100 mm, 1.7 μm) with a gradient mobile phase system of 0.1% formic acid/water and acetonitrile.

Results:

The CV of analytes was within 7.77%, and the bias was in the range of -5.43%-3.84%. The matrix effects
of analytes ranged from 92.95% to 104.58%, and the extraction recoveries ranged from 76.45% to
104.69%. The relative standard deviation of stability results was less than 8.21%, indicating that seven analytes
were stable.

Conclusion:

The method was successfully applied to the determination of the content of seven analytes of CF
extracts by UPLC-MS/MS, and the results will provide a reference for the cellular pharmacokinetics of CF.
Design and Comparative Characterization of Water Level IDE Sensors at Resonant Frequencies
Authors: Ranjan Prem , Chowdhury Atanu
Published: November 2024

Background:

This paper reports the design and characterization of three Interdigital
electrode (IDE) water-level sensors at resonant frequencies. The geometries of the proposed IDE
sensors are comb type, circular type, and Archimedean spiral type. These IDE sensors have been
fabricated by the printed circuit board technology. The sensor’s performance has been evaluated
on both tap and distilled water.

Methods:

The multiple resonant frequencies are investigated for the frequency span of 40 Hz to
110 MHz using a 4294A impedance analyzer. The peak of the projected admittance graph appeared
at the first resonant frequency. This first resonant frequency is chosen here for the characterization
of the proposed sensors.

Results:

The study asses that the variations in resonant frequency are caused by both the sensor's
geometry and the water under test. The resonant frequency subtly states that sensors can be presented
as lumped element equivalent series RLC circuits. In this work, an attempt has been made to
show that the change in capacitance plays a pivotal role in estimating the resonant frequency. It is
found that the sensor’s sensitivity decreases with water elevation and always be negative.

Conclusion:

The circular and Archimedean spiral sensors have comparable sensitivity performance,
while the comb IDE sensor is found to be the most sensitive. The IDE sensor features the
highest sensitivity at 1 cm of water elevation. The circular and spiral IDE sensor more closely follows
the reference resonant frequency fr α 1/(√C) when compared with the comb IDE sensor.
Real-Time Energy Management Method for Data Center Considering Shiftable Workload and Renewable Energy
Authors: Li Feng , Zhang Yinya , Xi Jianghui , Liu Yize , Yan Mingyu
Published: November 2024

Aim:

This study aimed to improve the electricity economy of data centers.

Background:

Data centers have been rapidly developed over the last decade to balance increasing
computing workloads. Such a rapid development has been found to result in a significant increase
in higher electricity expenses for data centers.

Objective:

The objective of this study was to improve the operation efficiency of a data center by
developing a data center energy management model considering shiftable data workloads, energy
storage, and renewable energy.

Method:

First, a data center workload model has been established to describe its temporal shifting
characteristics. Then, a data center power consumption model has been developed to describe
the energy usage of IT equipment and cooling systems. Finally, the energy management model
for the data center has been developed to reduce the electrical energy costs of the data center.

Results:

Case studies have been performed on a trial system to illustrate the validity of the proposed
model, which has been found to meet the requirements.

Conclusion:

Rationally re-scheduling the delay-tolerant workloads and making full use of energy
storage can enhance the flexibility of the power system and reduce electricity costs by 19.06%.
State of the Field: Digital Legal History. A (Western) methodological overview.
Authors: Romein Christel Annemieke
Published: November 2024

This article presents a comprehensive analysis of the methodological advancements in Digital Legal History (DLH), focusing on pivotal processes such as digitisation, datafication, and the evolution of ontologies. It demonstrates how digitising legal sources preserves extensive archives while datafication transforms them into structured, machine-readable formats, facilitating more sophisticated analysis. The article provides a detailed discussion of the role of ontologies in linking legal data across platforms. It outlines how the enhancement of cross-disciplinary research through interoperability is being facilitated. Furthermore, the integration of large language models (LLMs) is investigated, illustrating their capacity for automating processes such as text analysis and the summarisation of legal texts. However, challenges associated with potential bias and accuracy are also addressed. The article provides insight into how these digital methodologies are reshaping the study of legal history, facilitating new research possibilities, interdisciplinary collaborations and broader access to legal materials.
mHealth-Augmented Care for Reducing Depression Symptom Severity Among Patients With Chronic Pain: Exploratory, Retrospective Cohort Study
Authors: Holley Dan , Brooks Amanda , Hartz Matthew , Rao Sudhir , Zaubler Thomas
Published: November 2024

Background

Depression and chronic pain are commonly comorbid, mutually reinforcing, and debilitating. Emerging approaches to mobile behavioral health care (mHealth) promise to improve outcomes for patients with comorbid depression and chronic pain by integrating with existing care models to bolster support and continuity between clinical visits; however, the evidence base supporting the use of mHealth to augment care for this patient population is limited.

Objective

To develop an evidence base that sets the stage for future research, we aimed to explore the associations between changes in depression severity and various integrated care models, with and without mHealth augmentation, among patients with comorbid depression and nonmalignant chronic pain.

Methods

Our team leveraged retrospective, real-world data from 3837 patients with comorbid depression and nonmalignant chronic pain who received integrated behavioral health care (IBH) at a subspecialty pain clinic. We analyzed one IBH-only, non-mHealth cohort (n=2765), an mHealth-augmented cohort (n=844), and a collaborative care (CoCM)+mHealth cohort (n=136), which were supported by the NeuroFlow mHealth platform, and a pre-CoCM mHealth cohort (n=92), which was supported by the mHealth platform for 3 months prior to beginning the chronic pain treatment. We evaluated changes in depression severity between treatment cohorts via longitudinal analyses of both clinician- and mHealth-administered Patient Health Questionnaire-9 (PHQ-9) assessments.

Results

mHealth-augmented integrated care led to significantly greater proportions of patients reaching clinical benchmarks for reduction (725/844, 86% vs 2112/2765, 76%), response (689/844, 82% vs 2027/2765, 73%), and remission (629/844, 75% vs 1919/2765, 69%) compared with integrated care alone. Furthermore, hierarchical regression modeling revealed that patients who received mHealth-augmented psychiatric CoCM experienced the greatest sustained reductions in on-average depression severity compared with other cohorts, irrespective of clinical benchmarks. In addition, patients who engaged with an mHealth platform before entering CoCM experienced a 7.2% reduction in average depression severity before starting CoCM treatment.

Conclusions

Our findings suggest that mHealth platforms have the potential to improve treatment outcomes for patients with comorbid chronic pain and depression by providing remote measurement–based care, tailored interventions, and improved continuity between appointments. Moreover, our study set the stage for further research, including randomized controlled trials to evaluate causal relationships between mHealth engagement and treatment outcomes in integrated care settings.
The Effect of Interventions Based on the Information-Motivation-Behavioral Skills Model on the Human Papillomavirus Vaccination Rate Among 11-13-Year-Old Girls in Central and Western China: Protocol for a Randomized Controlled Trial
Authors: Jing Shu , Wu Yijin , Dai Zhenwei , Tang Shenglan , Su Xiaoyou , Qiao Youlin
Published: November 2024

Background

Persistent infection of high-risk human papillomavirus (HPV) can lead to cervical intraepithelial neoplasia, cervical cancer, and even death. HPV vaccination for girls aged 9-14 years can effectively prevent the occurrence of cervical cancer. Some Chinese provinces and cities have launched free HPV vaccination programs for school-age girls; however, due to the lack of supportive government policies, the high price and supply shortage of HPV vaccines, and vaccine hesitancy, some parents refuse to vaccinate their daughters.

Objective

This protocol reports the design of a randomized controlled trial (RCT) aiming to explore the efficacy of a digital HPV vaccination education intervention based on the information-motivation-behavioral skills (IMB) model in improving the HPV vaccination rate among 11-13-year-old girls in central and western China.

Methods

A multicenter intervention study based on an online applet will be conducted in December 2024, and about 750 eligible parents of 11-13-year-old girls will be assigned in a 1:1 ratio to an intervention group receiving 7-day digital HPV vaccination education based on the IMB model or a control group using non-HPV publicity materials. Free HPV vaccination pilot projects will be carried out among this population by our research team in central and western China (some parents might refuse to vaccinate their daughters). All participants will be asked to complete online questionnaires at baseline; postintervention; and 1 week, 1 month, and 3 months after the intervention.

Results

The primary outcome of this study will be receipt of the first HPV vaccination within 3 months. Data will be analyzed based on an intention-to-treat approach, and Stata 16.0 will be used for statistical analysis.

Conclusions

This study aims to improve the HPV vaccination rate among 11-13-year-old girls and will examine the impact of a digital HPV vaccination education intervention based on the IMB model. The findings of this study may offer promising intervention measures for HPV vaccine hesitancy in low-health-resource areas in the future.

Trial Registration

Chinese Clinical Trial Registry, ChiCTR2300067402; https://tinyurl.com/v5zt4hc9

International Registered Report Identifier (IRRID)

PRR1-10.2196/58873
Patient Profile and Cost Savings of Long-Term Care in a Spanish Hospital: Retrospective Observational Study
Authors: Mira José Joaquín , García-Torres Daniel , Bonell-Guerrero María del Mar , Cáceres-Sevilla Ana Isabel , Ramirez-Sanz Martina , Martínez-Lleo Rosa , Carratalá Concepción
Published: November 2024

Background

Long-term care hospitals have been considered an efficient response to the health care needs of an increasingly aging population. These centers are expected to contribute to better hospital bed management and more personalized care for patients needing continuous care. The evaluation of their outcomes is necessary after a sufficient period to assess their impact. Hospitals for Acute and Chronic Long-Term Extended Stay (HACLES) emerged in Spain in the late 20th century as a response to the aging population and the increase in chronic diseases.

Objective

This study aimed to analyze the profile of patients treated in a HACLES, particularly analyzing gender differences, and evaluate the cost savings associated with using these centers.

Methods

A retrospective study was conducted based on data from patients 65 years old or older admitted to a HACLES between 2022 and 2023. Gender, age, household cohabitation data, diagnosis and comorbidity, daily medication intake, and degree of dependency were obtained to describe the profile of patients who attended the HACLES. Data coded in SIA-Abucasis (version 37.00.03; Consellería Sanitat, Generalitat Valenciana; a digital medical record system used in the Valencian region) were reviewed, and descriptive statistics and comparison tests were used. The direct cost savings of HACLES admissions were calculated by comparing the daily cost of a general hospital bed with that of a HACLES bed.

Results

Data from 123 patients with a mean age of 77 years were analyzed. Most (n=81, 65.9%) had a cohabiting family member as their primary caregiver. Palliative care was the most frequent reason for admission (n=75, 61%). The mortality rate (odds ratio [OR] 61.8, 95% CI 53.2-70.5) was similar between men and women (OR 54.1, 95% CI 47.8-71.5 vs OR 59.7, 95% CI 42.2-66.0; P=.23). The cognitive assessment, using the Pfeiffer scale, improved at discharge (mean 3.2, SD 3.2 vs mean 2.5, SD 3.1; P=.003). The length of stay was significantly larger for patients who returned home compared with patients discharged to other facilities (mean 89.8, SD 58.2 versus mean 33.1, SD 43.1 days; P<.001). The direct cost savings were estimated at US $42,614,846 per 1000 admissions.

Conclusions

Patients typically treated in HACLES are older, with a high level of cognitive impairment and physical dependency, and a significant proportion are in palliative care, highlighting the importance of adapting care to the individual needs of the admitted patients. The HACLES model contributes to the sustainability of the public health system.
Mitigating Cognitive Biases in Clinical Decision-Making Through Multi-Agent Conversations Using Large Language Models: Simulation Study (Preprint)
Authors: Ke Yuhe , Yang Rui , Lie Sui An , Lim Taylor Xin Yi , Ning Yilin , Li Irene , Abdullah Hairil Rizal , Ting Daniel Shu Wei , Liu Nan
Published: November 2024

BACKGROUND

Cognitive biases in clinical decision-making significantly contribute to errors in diagnosis and suboptimal patient outcomes. Addressing these biases presents a formidable challenge in the medical field.

OBJECTIVE

This study aimed to explore the role of large language models (LLMs) in mitigating these biases through the use of the multi-agent framework. We simulate the clinical decision-making processes through multi-agent conversation and evaluate its efficacy in improving diagnostic accuracy compared with humans.

METHODS

A total of 16 published and unpublished case reports where cognitive biases have resulted in misdiagnoses were identified from the literature. In the multi-agent framework, we leveraged GPT-4 (OpenAI) to facilitate interactions among different simulated agents to replicate clinical team dynamics. Each agent was assigned a distinct role: (1) making the final diagnosis after considering the discussions, (2) acting as a devil’s advocate to correct confirmation and anchoring biases, (3) serving as a field expert in the required medical subspecialty, (4) facilitating discussions to mitigate premature closure bias, and (5) recording and summarizing findings. We tested varying combinations of these agents within the framework to determine which configuration yielded the highest rate of correct final diagnoses. Each scenario was repeated 5 times for consistency. The accuracy of the initial diagnoses and the final differential diagnoses were evaluated, and comparisons with human-generated answers were made using the Fisher exact test.

RESULTS

A total of 240 responses were evaluated (3 different multi-agent frameworks). The initial diagnosis had an accuracy of 0% (0/80). However, following multi-agent discussions, the accuracy for the top 2 differential diagnoses increased to 76% (61/80) for the best-performing multi-agent framework (Framework 4-C). This was significantly higher compared with the accuracy achieved by human evaluators (odds ratio 3.49; P=.002).

CONCLUSIONS

The multi-agent framework demonstrated an ability to re-evaluate and correct misconceptions, even in scenarios with misleading initial investigations. In addition, the LLM-driven, multi-agent conversation framework shows promise in enhancing diagnostic accuracy in diagnostically challenging medical scenarios.
Patient Profile and Cost Savings of Long-Term Care in a Spanish Hospital: Retrospective Observational Study (Preprint)
Authors: Mira José Joaquín , García-Torres Daniel , Bonell-Guerrero María del Mar , Cáceres-Sevilla Ana Isabel , Ramirez-Sanz Martina , Martínez-Lleo Rosa , Carratalá Concepción
Published: November 2024

BACKGROUND

Long-term care hospitals have been considered an efficient response to the health care needs of an increasingly aging population. These centers are expected to contribute to better hospital bed management and more personalized care for patients needing continuous care. The evaluation of their outcomes is necessary after a sufficient period to assess their impact. Hospitals for Acute and Chronic Long-Term Extended Stay (HACLES) emerged in Spain in the late 20th century as a response to the aging population and the increase in chronic diseases.

OBJECTIVE

This study aimed to analyze the profile of patients treated in a HACLES, particularly analyzing gender differences, and evaluate the cost savings associated with using these centers.

METHODS

A retrospective study was conducted based on data from patients 65 years old or older admitted to a HACLES between 2022 and 2023. Gender, age, household cohabitation data, diagnosis and comorbidity, daily medication intake, and degree of dependency were obtained to describe the profile of patients who attended the HACLES. Data coded in SIA-Abucasis (version 37.00.03; Consellería Sanitat, Generalitat Valenciana; a digital medical record system used in the Valencian region) were reviewed, and descriptive statistics and comparison tests were used. The direct cost savings of HACLES admissions were calculated by comparing the daily cost of a general hospital bed with that of a HACLES bed.

RESULTS

Data from 123 patients with a mean age of 77 years were analyzed. Most (n=81, 65.9%) had a cohabiting family member as their primary caregiver. Palliative care was the most frequent reason for admission (n=75, 61%). The mortality rate (odds ratio [OR] 61.8, 95% CI 53.2-70.5) was similar between men and women (OR 54.1, 95% CI 47.8-71.5 vs OR 59.7, 95% CI 42.2-66.0; P=.23). The cognitive assessment, using the Pfeiffer scale, improved at discharge (mean 3.2, SD 3.2 vs mean 2.5, SD 3.1; P=.003). The length of stay was significantly larger for patients who returned home compared with patients discharged to other facilities (mean 89.8, SD 58.2 versus mean 33.1, SD 43.1 days; P<.001). The direct cost savings were estimated at US $42,614,846 per 1000 admissions.

CONCLUSIONS

Patients typically treated in HACLES are older, with a high level of cognitive impairment and physical dependency, and a significant proportion are in palliative care, highlighting the importance of adapting care to the individual needs of the admitted patients. The HACLES model contributes to the sustainability of the public health system.
A Platform Technology for XR Biofeedback Training under Operant Conditioning for Functional Limb Weakness (Preprint)
Authors: Dutta Anirban
Published: November 2024

BACKGROUND

Functional Neurological Disorder (FND) is a complex condition causing significant, debilitating symptoms comparable in impact to epilepsy and multiple sclerosis. FND encompasses various types, including functional seizures, movement disorders, persistent perceptual postural dizziness, and cognitive disorders, each arising from an interplay of neurological and psychiatric mechanisms. However, only half of UK health boards have established treatment agreements for FND, highlighting substantial gaps in care. Advancements in understanding FND pathophysiology, such as abnormal sensorimotor processing, have led to the development of neurotechnologies, including extended reality (XR) biofeedback, which may support rehabilitation for functional limb weakness through haptic and visuo-motor tasks.

OBJECTIVE

This study aimed to evaluate the usability of an early-stage XR biofeedback platform designed for FND rehabilitation. The platform combines bottom-up haptic feedback with top-down visuo-motor tasks.

METHODS

Three patient representatives with lived experience of FND and three healthcare workers participated in a mixed-methods study. Initially a Delphi survey was completed to share insights on XR technology requirements and therapeutic needs, followed by usability testing during a workshop. System Usability Scale (SUS) scores were collected for tasks including position feedback control, relaxation, and force feedback control. Qualitative data from freeform feedback were analyzed using thematic coding in NVivo.

RESULTS

Qualitative analysis revealed themes around XR experience, technology relevance, and design needs. Many participants had recreational XR experience but limited familiarity with haptic feedback, valuing features such as customization, real-time feedback, and ease of use. Concerns were raised about accessibility and affordability. Usability scores were high for position feedback control and hypnotic relaxation tasks, with SUS scores above 85, indicating positive user satisfaction. However, force feedback control yielded more variable results, with some users, particularly those with functional dystonia, finding it challenging.

CONCLUSIONS

The XR platform demonstrated strong usability for position feedback control and hypnotic relaxation, though mixed responses to force feedback suggest the need for adaptation to diverse user needs. Improvements in comfort, immersion, personalization, and affordability are essential to maximize the platform's effectiveness and accessibility in FND care. The study underscores the potential of neurotechnological interventions in FND rehabilitation, while highlighting areas for design enhancement to support inclusivity and address the complex needs of FND patients.
Risk of Major Adverse Cardiovascular Events in Home Dialysis Compared With In-Center Hemodialysis
Authors: Bitar Wisam , Helve Jaakko , Haapio Mikko , Rauta Virpi , Honkanen Eero , Finne Patrik
Published: November 2024

Key Points

We observed a comparable cumulative incidence of major adverse cardiovascular event (MACE) in in-center hemodialysis (IC-HD) and continuous ambulatory peritoneal dialysis (PD) patients, which was higher than in automated PD and home hemodialysis patients.

After adjustment for confounders, there was no difference in risk of MACE between patients on home dialysis modalities and IC-HD.

Compared with IC-HD, PD was associated with lower risk of MACE among female patients and higher risk among male patients.

Background

Among dialysis patients, cardiovascular events are the leading cause of death. Little is known about how the frequency and type of cardiovascular events differ between various dialysis modalities. We compared risk of major adverse cardiovascular events (MACEs) in patients who started continuous ambulatory peritoneal dialysis (CAPD), automated peritoneal dialysis (APD), and home hemodialysis with in-center hemodialysis (IC-HD) patients.

Methods

We included 968 patients who entered dialysis in the Helsinki-Uusimaa health care district in Finland from 2004 to 2017, of whom 162 were on CAPD, 229 on APD, 145 on home hemodialysis, and 432 on IC-HD at day 90 from the start of dialysis. MACE was defined as acute myocardial infarction, stroke, or death due to cardiovascular disease. The cumulative incidence of the first MACE was calculated. Cox regression was used to compare risk of MACE between dialysis modalities with adjustment for potential confounding factors.

Results

Of all 968 patients, 195 (20%) experienced a MACE during the entire follow-up and 62 (6%) during the first year of follow-up. The cumulative incidence of first MACE was similar in IC-HD and CAPD patients and higher than that in APD and home hemodialysis patients. After adjustment for possible confounders, the hazard ratio (HR) of MACE was 1.22 (95% confidence intervals [CIs], 0.73 to 2.05) for CAPD, 0.86 (95% CI, 0.47 to 1.57) for APD and 0.67 (95% CI, 0.30 to 1.50) for home hemodialysis compared with IC-HD. Unexpectedly, compared with IC-HD, peritoneal dialysis associated with lower risk of MACE among female patients (HR, 0.37; 95% CI, 0.14 to 0.99) and higher risk among male patients (HR, 1.80; 95% CI, 1.11 to 2.92).

Conclusions

In this cohort, the risk of MACE was comparable across in-center and home dialysis modalities. However, the result differed between male patients and female patients, which requires further research.
The Impact of Dietary Patterns, Medications, and Physical Activity on Type 2 Diabetes: An In-depth Analysis Using NHANES 2017-2018 Data
Authors: Zhang Heng
Published: November 2024

Type 2 Diabetes (T2D) is a significant global health concern with rising incidence, driven largely by modifiable lifestyle factors such as diet, physical activity, and medication adherence. Using data from the NHANES 2017-2018 cohort, this study analyzes the combined effects of these factors on T2D risk. Principal Component Analysis (PCA) was employed to identify key dietary patterns, which were assessed along with physical activity and medication adherence via logistic regression. A diet rich in fruits and vegetables was associated with a 40% reduction in T2D risk (Adjusted OR: 0.60; 95% CI: 0.39-0.92), particularly in women over 50. In contrast, diets high in sugary and processed foods increased the risk, especially in individuals with a BMI above 30 kg/m². These findings emphasize the need for tailored dietary and lifestyle interventions, specifically targeting high-risk groups such as older adults and individuals with higher BMI, to mitigate T2D risk.
Using Fuzzy AI Delphi Method for dispatching ERP executives of banks
Authors: Hsieh Sung-Yi , Ling Hsiao-Chi , Chao Chiao
Published: November 2024

Enterprise resource planning is an integrated system of real-time information. With the trend of internationalization, most banks hope to use ERP systems to eliminate the shortcomings of bank operation processes, such as the waste of repeated manpower, duplication of information or delays in transmission, etc., and reduce efficiency. Improve to the highest level and minimize waste. With the openness of Taiwan’s government financial policy, the banks here are becoming more liberalized and internationalized. Taiwan is becoming a competitive financial market since more new commercial banks have been set up in Taiwan. So, it is important for a bank to dispatch good executives to overseas branch. In this paper, we analyze what kinds of characteristics and traits a bank's manager in overseas branch should have by using Fuzzy Delphi Method. The purposes of the research are 1) to analyze what kinds of characteristics and traits a bank's manager in overseas branch should have, 2) to compare the difference of manager in overseas branch in Japan and HongKong by using Wilcoxon rank sum test, 3) to set up the dispatch criteria with the AI and fuzzy Delphi method. Through the examination of FDM, a fuzzy referent model framework for the bank’s dispatch in overseas branch is built. It is anticipated that the fuzzy framework will provide a more objective means for the dispatch of appropriate personnel for overseas branches.
Prevalencia y seguimiento de cáncer cervicouterino (2018-2022): Registro Institucional de Cáncer
Authors: Capire-Castañeda Ana M. , Vázquez-Vega Salvador , Martínez-Salazar Martha , Valdespino-Vázquez Rómulo , Juárez-González Karina , Castillo-Pérez Juan J.
Published: November 2024

Objetivo: determinar la prevalencia de lesiones premalignas y malignas del cérvix, así como realizar el seguimiento del cáncer cervicouterino utilizando los datos del Registro Institucional de Cáncer. Métodos: estudio transversaldescriptivo. Se realizó un análisis de datos secundarios utilizando la metodología crisp-dm, con información proveniente de los módulos de citología, colposcopia, patología y diagnóstico definitivo, correspondientes a los años 2018-2022. Se incluyeron mujeres de 25 a 95 años de todas las delegaciones del Instituto Mexicano del Seguro Social. Resultados: de un total de 3,581,098 registros del módulo de Citología, 97.5% (3,492,835) presentó resultados negativos a lesiones pero con datos de inflamación; 2.5% (88,263) fue sospechoso, predominando lesiones de bajo grado con 56.4% (49,819). En el seguimiento de los 88,263 casos sospechosos, en colposcopia se registraron 53,099 casos, en los que la lesión premaligna fue la más frecuente (48.3%, 25,673). En anatomía patológica hubo 17,616 registros, destacando las lesiones de bajo grado (54.5%, 9,596). En el módulo de diagnóstico definitivo se registraron 1,437 casos, siendo también la lesión de bajo grado la más común (46.6%, 669). En el seguimiento, la prevalencia de cáncer cervicouterino fue de 2.3% en citología, 1.3% en colposcopia, 3.6% en patología y 13.4% en diagnóstico definitivo. La mayor proporción de registros provino de la región central del país y las mujeres entre 35 y 54 años fueron las más estudiadas, independientemente del módulo. Conclusión: los datos del Registro Institucional de Cáncer relacionados al cérvix uterino mostraron que las lesiones de bajo grado son predominantes en la población mexicana, principalmente en mujeres de 35-54 años.
Enfermedad de hígado graso no alcohólico en adultos con diabetes tipo 2 en atención primaria
Authors: Hernández-Navarrete Miguel A. , Vega-García Sandra , Millán-Hernández Manuel
Published: November 2024

Objetivo: determinar la frecuencia de la enfermedad de hígado graso no alcohólico (ehgna) en adultos con diabetes mellitus tipo 2 (dm2). Métodos: estudio transversal analítico, realizado en la Unidad de Medicina Familiar No. 7 del Instituto Mexicano del Seguro Social, Ciudad de México, México. Se incluyeron a 311 pacientes con diagnóstico confirmado de dm2 obtenidos mediante muestreo no probabilístico, de noviembre 2022 a enero 2024. Se aplicó un cuestionario para el cálculo de índice de esteatosis hepática para el diagnóstico de ehgna. Con los datos obtenidos se realizó estadística descriptiva (porcentajes y medianas) e inferencial (χ2, Fisher, prueba de Spearman). Resultados: mediana de edad de 61 años (rango intercuartil ric 12), mujeres 163 (68.8%), índice de masa corporal (imc) con una mediana de 29.6 (ric 5.71), predominio de sobrepeso 112 (47.3%), índice de esteatosis hepática mediana 42.18 (ric 7.56), con comorbilidades 170 (71.7%), ehgna en 237 (76.2%) e índice ast/alt mediana 0.94 (ric 0.40). Existió asociación estadísticamente significativa entre ehgna y el imc (p< 0.001) con correlación Spearman 0.769. Existió asociación estadísticamente significativa entre ehgna y el índice ast/alt (p< 0.001) con correlación Spearman -0.390. Conclusión: la ehgna en adultos con dm2 se encontró en un 76.2%, en esta población la relación con el imc y el índice ast/alt fue estadísticamente significativa, con una correlación fuerte con el primero y débil con el segundo.
Depresión en pacientes con diabetes tipo 1 en una unidad de medicina familiar
Authors: Araiza-Montoya Isairis , González-Rodríguez Argelia , Sánchez-Almazán Patricia , Garibay-López Leticia
Published: November 2024

Objetivo: estimar la prevalencia de depresión en los pacientes que viven con diabetes tipo 1 de la Unidad de Medicina Familiar No. 9, Ciudad de México. Métodos: estudio transversal, descriptivo en una muestra de participantes obtenida de forma no probabilística en pacientes con Diabetes tipo 1. Se aplicó el cuestionario de autoevaluación Zung para depresión y otro de características sociodemográficas. Se analizaron medidas de tendencia central para variables numéricas y proporciones para cualitativas. Resultados: de 151 participantes, el grupo de edad prevalente fue de 54 a 59 años. Al analizar a los pacientes por la escala de Zung, 75% se reportó clínicamente normal, depresión leve en 19%, depresión moderada en 5% y depresión severa en 1%. A escala global, la prevalencia de algún tipo de depresión, de leve a severa, en la población de estudio fue de 25%. Conclusión: la prevalencia global de depresión en pacientes con diabetes tipo 1 fue de 25%. Estos resultados contrastan con lo reportado en la literatura (37%). La menor prevalencia encontrada sugiere posibles diferencias en el contexto estudiado
Estado nutricional y funcionalidad en el adulto mayor de la unidad de medicina familiar No. 7
Authors: González-Sánchez Enrique , Meza-Torres Elena , Rivero-García Elizabeth , Millán- Hernández Manuel
Published: November 2024

Objetivo: determinar el estado nutricional y la funcionalidad de los adultos mayores en una unidad de medicina familiar, en la Ciudad de México, México. Método: estudio transversal descriptivo, realizado en adultos mayores de 60 años de la Unidad de Medicina Familiar No. 7 del Instituto Mexicano del Seguro Social, de marzo 2022 a enero 2024, el cálculo de tamaño de muestra fue de 403 adultos, se realizó muestreo consecutivo, se utilizó una hoja de recolección y escalas (Índice de Barthel, Mini Nutricional Assesment, sarcf). Resultados: la mediana de edad fue de 68 años (ric: 11), con 63.5% de mujeres y 36.5% de hombres. El peso medio fue de 65.6 kg (ric: 14.1) y la estatura mediana de 152 cm (ric: 14), 0.7% de los participantes presentaba dependencia en la actividad física y 37.7% mostró debilidad en la fuerza de presión. Además, 3.5% tenía una alta probabilidad de sarcopenia según el índice sarc-f, mientras que el índice de Barthel indicó que 0.5% tenía dependencia moderada; 43.4% de los participantes presentaba sobrepeso y 29.3% obesidad grado I. Un 47.4% tenía un porcentaje muy elevado de grasa corporal y 56.3% mostró un bajo porcentaje de músculo esquelético. Además, 54.6% tenía un nivel alto de grasa visceral. El perímetro de pantorrilla indicó riesgo de desnutrición en 5.7% de los casos, mientras que 70.2% presentó un perímetro de cintura asociado con riesgo de enfermedad cardiovascular y metabólica. Según la evaluación nutricional (Mini Nutritional Assessment), 1.7% estuvo desnutrido y 47.4% presentó más de dos comorbilidades, siendo las más frecuentes la hipertensión arterial (54.8%) y la diabetes mellitus (43.7%). Conclusión: la nutrición y funcionalidad es afectada por el envejecimiento.
Calidad de vida en pacientes con diabetes tipo 2 en una unidad de medicina familiar
Authors: Guerrero-Jiménez Saúl , Martínez-Peña José Luis , Madrigal-Morán Rosa
Published: November 2024

Objetivo: evaluar la calidad de vida de los pacientes con diagnóstico de diabetes mellitus tipo 2 de la Unidad de Medicina Familiar (umf) No. 162. Métodos: se realizó un estudio transversal descriptivo en la población diagnosticada con diabetes mellitus tipo 2 atendida en la umf referida, durante el periodo enero y agosto de 2023. Se calculó un tamaño de muestra de 142 participantes usando la fórmula para una proporción con poblaciones finitas. Se aplicó el cuestionario eq5d3l, con el fin de evaluar su calidad de vida relacionada con la salud. Resultados: la calidad de vida de los pacientes encuestados fue aceptable y tuvo una tendencia a la mejor salud posible. En las dimensiones evaluadas en el cuestionario eq5d3l, existió prevalencia de pacientes sin alteraciones en el estado de salud, sin predominio de sexo. La mitad de esta población estaba en el grupo etario de 60 a 69 años. En las dimensiones como la movilidad, el cuidado personal y las actividades cotidianas, la mayoría de la población estudiada presentó un alto grado de funcionalidad, siendo autosuficiente y capaz de realizar acciones de manera independiente. Esto se reflejó positivamente en su calidad de vida, con 25.4% de los participantes que reportó no tener problemas en estas áreas. Además, la escala analógica utilizada para medir la calidad de vida arrojó una media de 80.6 puntos. Conclusión: más de 50% de los participantes reportó una calidad de vida favorable.
Calidad de vida y apoyo familiar en el paciente con cáncer de próstata
Authors: Jiménez-Montes Jaime U. , López-Delgado Mariana , Sánchez-Almazán Patricia , Garibay-López Leticia
Published: November 2024

Objetivo: evaluar la calidad de vida y el apoyo familiar en pacientes con cáncer de próstata en la unidad de medicina familiar (umf) No. 9. Métodos: se realizó un estudio, transversal analítico. En una muestra de 138 pacientes diagnosticados con cáncer de próstata en el periodo de noviembre 2023 a marzo 2024 de la umf No. 9. Se utilizó un muestreo probabilístico aleatorio simple. Los instrumentos aplicados fueron cavipres-30 para calidad de vida (alfa de Crombach 0.87) y mos para apoyo familiar (alfa de Crombach 0.97). Las variables de estudio fueron calidad de vida y apoyo familiar. Para el análisis estadístico se utilizó la prueba χ2 de Pearson considerando una p<0.05. Resultados: el rango de edad más frecuente fue de 70-79 años. Al describir los componentes del apoyo familiar y asociarlos con el nivel de calidad de vida, se encontró que los pacientes con apoyo emocional alto presentaban una buena calidad de vida en 35.5%, p<0.001. El apoyo material medio estuvo asociado a una calidad de vida regular en 56.3%, p<0.001. El apoyo social medio se asoció con una calidad de vida regular en 47.1%, p<0.001 y el apoyo afectivo medio con una calidad de vida regular en 42%, p<0.001. Conclusión: 100% (138) de los participantes percibió un apoyo familiar adecuado según el instrumento mos, pero este no se asoció con una calidad de vida buena o muy buena. Esto sugiere que el apoyo familiar no es el único factor que influye en la percepción de calidad de vida.
Conocimiento sobre infecciones por virus del papiloma humano en mujeres de 20 a 25 años
Authors: Torres-Bonilla Gabriela , Alvarado-Gutiérrez Teresa , Vega-Blancas Juan L.
Published: November 2024

Objetivo: estimar el nivel de conocimiento de las infecciones por virus del papiloma humano en mujeres de 20 a 25 años. Métodos: estudio transversal descriptivo realizado en mujeres de 20 a 25 años afiliadas a la Unidad de Medicina Familiar No. 31 del Instituto Mexicano del Seguro Social, de junio 2022 a junio 2023. Cálculo de muestra de 322 mujeres por fórmula para poblaciones infinitas, muestreo no probabilístico por casos consecutivos. Se utilizó el instrumento conocimiento acerca del virus del papiloma humano (alfa de Cronbach de 0.78). Para el análisis estadístico se empleó estadística descriptiva y prueba R de Spearman para analizar la relación de las variables. Resultados: la edad con mayor frecuencia fue de 25 años con 23%, el nivel de escolaridad que predominó fue bachillerato con 40.7% y el nivel de conocimiento con mayor prevalencia fue medio con 54.4%. No se encontró una relación significativa entre el nivel de conocimiento con la edad ni con la escolaridad. Conclusión: el nivel de conocimiento encontrado fue medio, por lo que se deben mejorar los conocimientos a través de intervenciones para evitar el desarrollo de cáncer cervicouterino.