bluuebunny/crossref_metadata_2025 huggingface dataset:
Call for Decision Support for Electrocardiographic Alarm Administration Among Neonatal Intensive Care Unit Staff: Multicenter, Cross-Sectional Survey
Authors: Tang Xiaoli , Yang Xiaochen , Yuan Jiajun , Yang Jie , Jin Qian , Zhang Hanting , Zhao Liebin , Guo Weiwei
Published: November 2024

Background

Previous studies have shown that electrocardiographic (ECG) alarms have high sensitivity and low specificity, have underreported adverse events, and may cause neonatal intensive care unit (NICU) staff fatigue or alarm ignoring. Moreover, prolonged noise stimuli in hospitalized neonates can disrupt neonatal development.

Objective

The aim of the study is to conduct a nationwide, multicenter, large-sample cross-sectional survey to identify current practices and investigate the decision-making requirements of health care providers regarding ECG alarms.

Methods

We conducted a nationwide, cross-sectional survey of NICU staff working in grade III level A hospitals in 27 Chinese provinces to investigate current clinical practices, perceptions, decision-making processes, and decision-support requirements for clinical ECG alarms. A comparative analysis was conducted on the results using the chi-square, Kruskal-Wallis, or Mann-Whitney U tests.

Results

In total, 1019 respondents participated in this study. NICU staff reported experiencing a significant number of nuisance alarms and negative perceptions as well as practices regarding ECG alarms. Compared to nurses, physicians had more negative perceptions. Individuals with higher education levels and job titles had more negative perceptions of alarm systems than those with lower education levels and job titles. The mean difficulty score for decision-making about ECG alarms was 2.96 (SD 0.27) of 5. A total of 62.32% (n=635) respondents reported difficulty in resetting or modifying alarm parameters. Intelligent module–assisted decision support systems were perceived as the most popular form of decision support.

Conclusions

This study highlights the negative perceptions and strong decision-making requirements of NICU staff related to ECG alarm handling. Health care policy makers must draw attention to the decision-making requirements and provide adequate decision support in different forms.
Adapting the Technology Acceptance Model to Examine the Use of Information Communication Technologies and Loneliness Among Low-Income, Older Asian Americans: Cross-Sectional Survey Analysis
Authors: DeLange Martinez Pauline , Tancredi Daniel , Pavel Misha , Garcia Lorena , Young Heather M
Published: November 2024

Background

Loneliness is a significant issue among older Asian Americans, exacerbated by the COVID-19 pandemic. Older age, lower income, limited education, and immigrant status heighten loneliness risk. Information communication technologies (ICTs) have been associated with decreased loneliness among older adults. However, older Asian Americans are less likely to use ICTs, particularly if they are immigrants, have limited English proficiency, or are low income. The Technology Acceptance Model posits that perceived usefulness (PU), and perceived ease of use (PEOU) are key factors in predicting technology use.

Objective

This study aimed to examine associations between PU, PEOU, ICT use, and loneliness among low-income, older Asian Americans.

Methods

Cross-sectional survey data were gathered from predominately older Asian Americans in affordable senior housing (N=401). Using exploratory factor analysis and Horn parallel analysis, we examined 12 survey items to identify factors accounting for variance in ICT use. We deployed structural equation modeling to explore relationships among the latent factors and loneliness, adjusting for demographic and cognitive factors.

Results

Exploratory factor analysis and Horn parallel analysis revealed 3 factors that accounted for 56.48% (6.78/12) total variance. PEOU combined items from validated subscales of tech anxiety and comfort, accounting for a 28.44% (3.41/12) variance. ICT use combined years of technological experience, computer, tablet, and smartphone use frequency, accounting for 15.59% (1.87/12) variance. PU combined 2 items assessing the usefulness of technology for social connection and learning and accounted for a 12.44% (1.49/12) variance. The 3-factor structural equation modeling revealed reasonable fit indexes (χ2133=345.132; P<.001, chi-square minimum (CMIN)/df = 2595, comparative fit index (CFI)=0.93, Tucker-Lewis Index (TLI)=0.88). PEOU was positively associated with PU (β=.15; P=.01); PEOU and PU were positive predictors of ICT use (PEOU β=.26, P<.001; PU β=.18, P=.01); and ICT use was negatively associated with loneliness (β=–.28, P<.001). Demographic and health covariates also significantly influenced PU, PEOU, ICT use, and loneliness. English proficiency and education positively predicted PEOU (r=0.25, P<.001; r=0.26, P<.001) and ICT use (β=1.66, P=.03; β=.21, P<.001), while subjective cognitive decline and Asian ethnicity were positively associated with loneliness (β=.31, P<.001; β=.25, P<.001).

Conclusions

This study suggests that targeted interventions enhancing PU or PEOU could increase ICT acceptance and reduce loneliness among low-income Asian Americans. Findings also underscore the importance of considering limited English proficiency and subjective cognitive decline when designing interventions and in future research.
Baseline Smartphone App Survey Return in the Electronic Framingham Heart Study Offspring and Omni 1 Study: eCohort Study
Authors: Rong Jian , Pathiravasan Chathurangi H , Zhang Yuankai , Faro Jamie M , Wang Xuzhi , Schramm Eric , Borrelli Belinda , Benjamin Emelia J , Liu Chunyu , Murabito Joanne M
Published: November 2024

Background

Smartphone apps can be used to monitor chronic conditions and offer opportunities for self-assessment conveniently at home. However, few digital studies include older adults.

Objective

We aim to describe a new electronic cohort of older adults embedded in the Framingham Heart Study including baseline smartphone survey return rates and survey completion rates by smartphone type (iPhone [Apple Inc] and Android [Google LLC] users). We also aim to report survey results for selected baseline surveys and participant experience with this study’s app.

Methods

Framingham Heart Study Offspring and Omni (multiethnic cohort) participants who owned a smartphone were invited to download this study’s app that contained a range of survey types to report on different aspects of health including self-reported measures from the Patient-Reported Outcomes Measurement Information System (PROMIS). iPhone users also completed 4 tasks including 2 cognitive and 2 physical function testing tasks. Baseline survey return and completion rates were calculated for 12 surveys and compared between iPhone and Android users. We calculated standardized scores for the PROMIS surveys. The Mobile App Rating Scale (MARS) was deployed 30 days after enrollment to obtain participant feedback on app functionality and aesthetics.

Results

We enrolled 611 smartphone users (average age 73.6, SD 6.3 y; n=346, 56.6% women; n=88, 14.4% Omni participants; 478, 78.2% iPhone users) and 596 (97.5%) returned at least 1 baseline survey. iPhone users had higher app survey return rates than Android users for each survey (range 85.5% to 98.3% vs 73.8% to 95.2%, respectively), but survey completion rates did not differ in the 2 smartphone groups. The return rate for the 4 iPhone tasks ranged from 80.9% (380/470) for the gait task to 88.9% (418/470) for the Trail Making Test task. The Electronic Framingham Heart Study participants had better standardized t scores in 6 of 7 PROMIS surveys compared to the general population mean (t score=50) including higher cognitive function (n=55.6) and lower fatigue (n=45.5). Among 469 participants who returned the MARS survey, app functionality and aesthetics was rated high (total MARS score=8.6 on a 1‐10 scale).

Conclusions

We effectively engaged community-dwelling older adults to use a smartphone app designed to collect health information relevant to older adults. High app survey return rates and very high app survey completion rates were observed along with high participant rating of this study’s app.
A Reminder App to Optimize Bladder Filling during a Course of Radiotherapy for Prostate Cancer: Protocol of the Prospective REFILL-PAC Trial (Preprint)
Authors: Rades Dirk , Küter Jan-Dirk , von Staden Michael , Al-Salool Ahmed , Janssen Stefan , Timke Carmen , Duma Marciana Nona , Bartscht Tobias , Vestergård Madsen Christine , Kristiansen Charlotte , Cremers Florian
Published: November 2024

BACKGROUND

Many patients with non-metastatic prostate cancer receive radiotherapy, which may be associated with acute cystitis, particularly if the volume of the urinary bladder is small. Three studies showed bladder volumes <200 ml or <180 ml to be associated with increased urinary toxicity. Therefore, it appears important to achieve bladder volumes >200 ml at as many radiation fractions as possible. Several studies investigated drinking protocols, where patients were asked to drink a certain amount of water prior to radiotherapy sessions. This may require considerable discipline from the mainly elderly patients. Adherence to a drinking protocol may be facilitated by a mobile application (app) that reminds the patients prior to each radiation session to drink water. Our present study investigates the effect of such an app on the filling status of the bladder in prostate cancer patients receiving external beam radiotherapy alone (EBRT).

OBJECTIVE

The main goal of this study is to evaluate the impact of an app, which reminds patients irradiated for prostate cancer to drink 300 ml of water prior to each radiotherapy session, on the number of fractions with bladder volumes <200 ml during the radiotherapy course.

METHODS

This phase 2 study is ongoing and requires recruitment of 28 patients treated with EBRT alone for non-metastatic prostate cancer. Radiotherapy will be administered using normo-fractionation with 70-80 Gy in 35-40 fractions of 2.0 Gy, preferably with volumetric-modulated arc therapy (VMAT). Treatment volumes include the prostate with or without the seminal vesicles. A newly developed app will remind the patients to drink 300 ml of water 45 minutes prior to each fraction of radiotherapy. At the end of the radiotherapy course, patients will be asked to complete a questionnaire regarding their satisfaction with the app. In case of a dissatisfaction rate >40%, the app will be considered not useful. Patients will also be asked about the impact of the app on the general use of health technology. In addition, the phase 2 cohort will be matched and compared to a historical control group not supported by an app. The control group is considered appropriate for the comparison, since all patients were treated very recently (in 2022 or 2023) with EBRT alone.

RESULTS

This trial is the first study that evaluates the impact of a reminder app on the number of radiotherapy fractions with bladder volumes <200 ml in patients irradiated for localized prostate cancer.

CONCLUSIONS

This study will help identify the potential benefit of a reminder app on the bladder filling status of prostate cancer patients during a course of radiotherapy.

CLINICALTRIAL

Clinicaltrials.gov NCT06653751; https://clinicaltrials.gov/show/NCT06653751
Integrated Model of Cancer Control for Early Detection and Treatment in Adolescents and Young Adults Living with HIV in Zambia: Protocol for a Cluster-Randomized Control Trial (Preprint)
Authors: Batabyal Sanjana , Zirali Praveen , Hoover Sonja , Mungoni Ronald , Chelwa Nachela , Mulenga Drosin , Lusaka Mildred , Nyblade Laura , Jones Madeline , Mwaba Catherine K , Mbizvo Michael , Subramanian Sujha
Published: November 2024

UNSTRUCTURED

Background: Zambia has one of the highest rates of prevalence of HIV among adolescents and young adults living with HIV (AYAHIV) in sub-Saharan Africa, who, as of 2023, represent half of all new HIV cases annually. Compared to their peers who are HIV negative, AYAHIV are at an increased risk of developing cancer. The most frequently diagnosed cancers among AYAHIV in Zambia are cervical cancer (CC), Kaposi Sarcoma (KS), and non-Hodgkin’s Lymphoma (NHL). Premature cancer mortality among AYAHIV is driven by late-stage presentation and poor treatment adherence. The objective of this proposed research is to develop and test an integrated model of cancer control for AYAHIV that can be delivered as an embedded component in existing HIV treatment programs in primary care facilities and linked with specialist treatment in cancer centers.
Methods: We propose a cluster randomized control trial to compare the AYAHIV Role-based Responsibilities for Oncology-focused Workforce (ARROW) program with a one-time education campaign. The ARROW Program consists of interventions at three levels. At the individual level, peer counselors will educate AYAHIV through one-on-one and group education sessions, provide emotional support, and offer care coordination and linkages with the clinical team. At the provider level, collaborative education and training among HIV and oncology workforce will be facilitated. At the health system level, the ARROW Healthcare Collaborative will bring together administrators and policy makers to address system-level barriers. The study will recruit 3,600 AYAHIV across 18 HIV treatment facilities in Lusaka, Zambia between the ages of 15 and 39, who have been on ART for at least 6 months, and are not pregnant in its early detection cohort and 500 AYAHIV who have been diagnosed with CC, KS, or NHL in its cancer treatment cohort. We will also conduct economic evaluations to assess the cost-effectiveness of the ARROW program.
Discussion: The ARROW cohort recruitment has begun, and results pertaining to the 12-month endpoints will be available in early 2026. The ARROW program, if shown to be successful, will offer a model for improved linkages and integration between HIV and cancer services to improve cancer prevention, early diagnosis and treatment. Furthermore, ARROW can provide a framework for implementing expanded services, such as survivorship care, for AYAHIV.
The Role of Low-Carb Ketogenic Diets in Managing Diabetes

Abstract:
The ketogenic diet, characterized by high fat, moderate protein, and very low carbohydrate intake, has gained attention as a potential strategy for managing diabetes. This dietary approach shifts the body's metabolism from glucose to ketone bodies, promoting a state of ketosis. By reducing carbohydrate consumption, the ketogenic diet may help stabilize blood glucose levels and improve insulin sensitivity, which are crucial for diabetes control. Emerging evidence suggests that this diet can lead to significant improvements in glycemic control, weight management, and lipid profiles in individuals with type 2 diabetes. Additionally, reduced insulin requirements and better (Preprint)
Authors: Mental Abbasi
Published: November 2024

UNSTRUCTURED

Abstract:
The ketogenic diet, characterized by high fat, moderate protein, and very low carbohydrate intake, has gained attention as a potential strategy for managing diabetes. This dietary approach shifts the body's metabolism from glucose to ketone bodies, promoting a state of ketosis. By reducing carbohydrate consumption, the ketogenic diet may help stabilize blood glucose levels and improve insulin sensitivity, which are crucial for diabetes control. Emerging evidence suggests that this diet can lead to significant improvements in glycemic control, weight management, and lipid profiles in individuals with type 2 diabetes. Additionally, reduced insulin requirements and better glycemic stability have been reported in some cases. However, the impact on type 1 diabetes remains controversial, as the diet may pose risks such as hypoglycemia or ketoacidosis if not carefully managed. The mechanisms underlying these benefits include decreased insulin resistance, lower hepatic glucose output, and enhanced fat oxidation. Despite promising outcomes, the long-term sustainability and safety of ketogenic diets remain subjects of debate. Adherence to the diet can be challenging, and potential side effects, such as nutrient deficiencies, should be considered. Furthermore, individual variability in response to dietary changes emphasizes the need for personalized nutritional plans. Future research is essential to fully understand the implications of ketogenic diets in diabetes care and to establish comprehensive guidelines for safe and effective implementation. Clinicians and patients must work collaboratively to assess whether this approach is suitable, weighing the potential advantages against risks and lifestyle factors. This review highlights the potential of ketogenic diets as a tool for diabetes management, while calling for caution and further investigation to ensure optimal patient outcomes.
The Role of Medical Culture in the Adoption of Mobile Application Interventions in Physical Therapy: A Cross-Sectional Study. (Preprint)
Authors: Alahmari Khalid A. , Reddy Ravi Shanakr
Published: November 2024

BACKGROUND

Medical culture significantly influences the adoption of technology in healthcare, including mobile health applications, which have the potential to enhance patient care in physical therapy settings. Understanding the role of medical culture and other factors such as app usability and workplace setting in shaping the adoption and perceived effectiveness of mobile applications is essential for promoting their integration into clinical practice.

OBJECTIVE

The study aimed to assess how medical culture influences healthcare professionals' adoption of mobile applications in clinical settings, particularly in physical therapy interventions, and to examine the relationship between the perceived effectiveness of mobile applications and cultural attitudes toward technology in healthcare teams.

METHODS

This cross-sectional study was conducted between April 2023 and March 2024 at a tertiary care hospital specializing in rehabilitation and physical therapy. A total of 456 healthcare professionals, including physical therapists and rehabilitation specialists, were surveyed. Medical culture was measured using a composite scale, while mobile app usage and perceived effectiveness were assessed through structured questionnaires.

RESULTS

Medical culture was strongly associated with mobile app adoption (r = 0.54, p = 0.014), and multiple linear regression analysis showed that medical culture significantly predicted app usage (β = 0.45, p = 0.002). App usability, in terms of ease of use (β = 0.37, p = 0.008) and patient engagement features (β = 0.28, p = 0.021), also contributed to the perceived effectiveness of mobile applications. Hospitals showed higher adoption and perceived effectiveness compared to private practices and rehabilitation centers. Years of experience (β = 0.32, p = 0.014) and app usage frequency (β = 0.45, p = 0.010) were additional significant predictors.

CONCLUSIONS

his study highlights the critical role of medical culture in promoting the adoption and perceived effectiveness of mobile applications in physical therapy. Positive cultural attitudes toward technology, combined with user-friendly app designs, can enhance the integration of mobile health tools in clinical settings. These findings underscore the importance of fostering an innovative medical culture and supporting the development of usable, patient-centered applications to optimize patient care.

CLINICALTRIAL

Not Applicable
"Guangzhou-Shenzhen" Urban Linkage and Cooperation Study
Authors: Yang Yuqi , An Mingming
Published: November 2024

As important cities in the Guangdong-Hong Kong-Macao Greater Bay Area, the development of Shenzhen and Guangzhou is of great significance for achieving resource complementarity and promoting industrial synergy in the region. Based on data from 2002 to 2022, this paper uses the Euclidean distance measurement algorithm to calculate the gravitational strength between the two cities, and assesses their competitive and complementary relationships through the geographical affinity strength. Combining these relationships, this paper analyzes the directions in which the two cities can achieve complementary development in the future three industries, and proposes suggestions for optimizing their industrial structures and improving government policies.
DEVELOPMENT OF NOVEL SINGLE HPLC METHOD FOR SIMULTANEOUS SEPARATION OF MULTIPLE IMPURITIES IN DEXAMETHASONE DRUG PRODUCT
Authors: SHAH JIGESH H. , MEHTA TUSHAR , MUKHARYA AMIT , CHOWDHURY ANIRBAN ROY , PATEL AJAY , MEVADA SANJAY , THAKER B. T. , AMETA RAKSHIT
Published: November 2024

Objective: A simple, reliable, and rapid HPLC method has been established for the detection of Dexamethasone (DEX) and its related impurities. The proposed method has been validated for specificity, linearity, system suitability, accuracy, precision, robustness, LOD, and LOQ as per International Council for Harmonisation (ICH) guidelines. All parameters were found to be within the accepted limits, affirming the method's reliability.
Methods: Analysis was conducted using HPLC on X-Bridge C18 column (250 mm×4.6 mm id, 3.5 µm) with a mobile phase-A comprising buffer and acetonitrile (90:10, v/v), mobile phase-B comprising buffer and acetonitrile (25:75, v/v) and a flow rate of 0.8 ml/min by following gradient elution. The detection was performed with a UV detector set at 240 nm. The method has been employed to investigate DEX and DEX-related impurities. These studies were conducted in tablet formulations of DEX.
Results: The Retention Time (tR) of DEX was about 41.589 min, and all parameters met acceptable limit values. The response exhibited linearity over a concentration range of 0.162 to 3.052 µg/ml (R2= 0.9999). The percentage of DEX recovered from the pharmaceutical tablet dosage form ranged from 96.3 % to 100.4 %. Sensitivity levels for the developed method were indicated by LOD and LOQ values of 0.081–0.162 µg/ml. The proposed method was validated according to ICH guideline.
Conclusion: Hence, a simple, reliable, accurate, and precise HPLC method was developed, proving suitable for the separation of DEX and DEX-related impurities in commercial formulations.
OPTIMIZING DRUG DOSING IN CRITICALLY ILL PATIENTS WITH AUGMENTED RENAL CLEARANCE: A COMPREHENSIVE REVIEW AND META-ANALYSIS
Authors: CHACHAR MIHIR , LOKHANDE TALLINI , KUMBHAR ANJALI , CHAVAN ROHINI , SHINDE DHANRAJ
Published: November 2024

Renal clearance plays a pivotal role in eliminating most administered drugs, particularly antibiotics, which is crucial for achieving therapeutic goals by maintaining plasma concentrations within the therapeutic window. Various pre-existing conditions such as renal replacement therapies, kidney or liver impairment, and enhanced excretory organ function can disrupt drug concentrations, leading to treatment failure. Augmented Renal Clearance (ARC) exacerbates this by causing rapid drug elimination, notably in critically ill patients. Consequently, careful monitoring and adjustment of drug dosages tailored to individual patient conditions and comorbidities are imperative to prevent sub-therapeutic outcomes or treatment failures. Our review highlights the necessity of dosage modifications informed by current research to optimize therapeutic outcomes in such cases. We provide a comprehensive table detailing effective antibiotics and their adjustments for ARC.
VARIATIONS IN VOLATILE OIL CONSTITUENTS OF ECHINOPS SPECIES GROWING IN THE MIDDLE EAST AND THE MEDITERRANEAN REGIONS: MINI REVIEW
Authors: MAJID GHINA ABDUL , HIJAZI MOHAMAD ALI , LAKANY ABDALLA EL , ELA MAHA ABOUL
Published: November 2024

The genus Echinops of the family Asteraceae has commonly been a subject of interest because its members have various chemical constituents and crucial pharmacological activities of great medicinal importance over the last decade (2010-2023). Therefore, this genus has attracted serious research in pharmacognosy and herbal medicine. Detailed studies revealed that Echinops species contain numerous bioactive compounds, such as sesquiterpene lactones, essential oils, flavonoids, and polyacetylenic aliphatic acids, largely in plant parts that are important for therapeutic use. These bioactive constituents have been associated with a wide diversity of pharmacological activities such as anti-inflammatory, antimicrobial, and cytotoxic underlined while proceeding to show some antioxidant activity and even hepatoprotective action of the genus, hence encouraging the further development of novel therapeutic agents. Most of these activities have been studied both in vitro and in vivo to establish their underlying effects. This will help us evaluate pharmacological properties attributed to the genus Echinops and pave the way for future studies to validate traditional uses and optimize extraction methods and their clinical applications. This work highlighted the position of Echinops species in Mediterranean areas, especially essential oils as a source of bioactive compounds useful in the well-being of humans and its variation concerning several factors. It has reaffirmed the place of natural products in drug discovery and development.
VOLATILE ANTIDIABETIC PROPERTIES OF PIPER NIGRUM L. ETHANOL EXTRACT (ORIGINAL AND PLANT STEM CELL): NETWORK PHARMACOLOGY STUDY AND ANTIOXIDANT ACTIVITY
Authors: FITHRIA RISHA FILLAH , HUDA MUHAMMAD BADRUL , MOHAMED FARAHIDAH , LINGYU SU
Published: November 2024

Objective: This study aims to identify and compare the active chemical components in the ethanol extracts of Piper nigrum L. (black pepper) plant and its callus and to investigate their potential roles in treating diabetes mellitus through Protein-Protein Interaction (PPI) analysis.
Methods: Ethanol extracts were prepared from both the original black pepper plant and its callus. Chemical analysis identified key active substances, including piperine and β-D-Glucopyranoside, using Retention Times (RT). PPI investigations were conducted to determine the interactions involved in diabetes management. The antioxidant capacities of the extracts were assessed using IC50 values, and the biological processes and molecular functions related to diabetes treatment were evaluated.
Results: Both the original plant and callus extracts contained active substances such as piperine (37.715%, RT: 28.1967) and β-D-Glucopyranoside (54.272%, RT: 16.5768). The primary biological processes identified were the P450 epoxygenase pathway and glycogen production. Additionally, the organic acid metabolic process and nucleosome core were implicated in the management of diabetes mellitus by the extracts. The main molecular functions predicted were p53 binding and cyclin. The antioxidant capacities of the extracts were moderate for the callus extract (IC50: 129.92±0.83) and poor for the original plant extract (IC50: 156.69±1.36).
Conclusion: The study reveals that the ethanol extracts from the black pepper callus and the original plant possess distinct chemical profiles and mechanisms in treating diabetes mellitus. The callus extract demonstrates a more favorable antioxidant capacity compared to the original plant extract. Both extracts engage in similar biological processes but exhibit differences in their chemical composition and potential therapeutic pathways for diabetes management.
UNDERSTANDING THE BENEFITS OF STEVIA REBAUDIANA BERTONI FOR DIABETES: A COMPREHENSIVE REVIEW
Authors: DHARANI B. , A SUBA , SEBASTIAN STEPHY
Published: November 2024

Diabetes Mellitus (DM) is a complicated metabolic condition defined by long-term elevated blood glucose levels. This chronic hyperglycemia induces metabolic dysfunctions that cause structural and functional disruptions in the vasculature, leading to macrovascular and microvascular complications. Stevia rebaudiana Bertoni, commonly known as Stevia, is a perennial shrub that contains various bioactive constituents responsible for its sweetness and several other activities. Many studies on Stevia have shown that it possesses various beneficial effects on health, including being zero-calorie, anti-obesity, anti-diabetic, anti-hypertensive, antioxidant, antimicrobial and anti-tumor. Several studies have found that neither gastric juice nor digestive enzymes decompose stevioside. The presence of bioactive phenolic and flavonoid compounds supports Stevia's medicinal properties and its potential use in both the food/nutraceutical and pharmaceutical industries. A significant antioxidant capacity of Stevia has been identified recently. It can also help limit essential nutrient supply to tumor cells. Research on Stevia's effects on the human body has largely found no negative side effects. The growing body of evidence underscores Stevia's potential role in managing various health conditions, particularly for diabetic patients, due to its minimal impact on blood sugar levels. However, to fully harness its benefits and meet the increasing global demand, further scientific research is essential to optimize its cultivation, enhance its chemical constituents and ensure its safety. Overall, Stevia stands out as a promising natural sweetener with significant health benefits for diabetic patients. In this review article, we explore different aspects of Stevia and its beneficial effects on diabetic patients.
PREBIOTIC EFFICACY OF DEFATTED FENUGREEK SEED FLAKES (FENUFLAKESTM): A SHORT-TERM COLONIC SIMULATION STUDY
Authors: THAKURDESAI PRASAD , DESHPANDE PALLAVI , NIMSE SAVITA , BHASKARAN SUNIL , KARVE MADHURA , RAJE DHANANJAY
Published: November 2024

Objective: To investigate the prebiotic effects of defatted fenugreek seed flakes (Fenuflakes™) using a 48-hour colonic simulation model.
Methods: Fecal samples from three healthy adult human donors were exposed to treatment conditions of blank (medium control), Fenuflakes, or inulin (fiber control). The effects on microbial fermentation (pH and gas production), metabolite production [Short Chain Fatty Acid (SCFAs), Branched-Chain Fatty Acid (BCFA), ammonium and lactate production], and microbial community composition were evaluated at 0, 6, 24, and 48 h.
Results: In comparison to inulin, Fenuflakes demonstrated a significant reduction in gas production. Both inulin and Fenuflakes significantly increased beneficial SCFAs, but no significant change was observed in BCFA. Ammonium production increased upon Fenuflakes treatment due to a residual protein fraction reaching the colon, in contrast to inulin, which is in a protein-depleted state. The lactate levels significantly increased for Fenuflakes and inulin. The presence of Fenuflakes and inulin resulted in favorable fermentation by the colonic gut microbiota, indicating an increase in species enrichment and alpha diversity in the microbial community composition.
Conclusion: Fenuflakes exhibit prebiotic potential by increasing SCFA and promoting the enrichment of several beneficial colonic bacteria while maintaining normal colonic pH and producing less gas than inulin.
IS ONLINE SEARCH FOR MEDICATION INFORMATION WILL BECOME A NEW DIMENSION FOR NONCOMPLIANCE
Authors: P. GIRISH , CHOWDARY CHALIKI SUNIL , SANDEEP  , CHANDRASEKHAR BODDU V. S.
Published: November 2024

Objective: The aim of the present study was to investigate the effect of online medication information on adherence and beliefs with chronic illness.
Methods: The study was carried out at a tertiary-care teaching hospital. A questionnaire was used to assess beliefs on the online information, stopped the medication without consultation, missed dose based on information on online, trust on information provided by the health care provider, type and frequency of the online search information on medications and finally, adhere to the medication regimen.
Results: A total of 95 participants were interviewed and 60 participants were showed interest to participate in the study. Chronic illness conditions among them were mostly hypertension, diabetes milletus followed by asthma and COPD, renal failure, inflammation and convulsions. Seeking online health information 30% daily, 33% weekly, monthly 10%, rarely 16% never 10%. The information mostly searched around 40% of treatment options, 35% of medication information and flowed by disease symptoms, dietary advises and physical exercises. Belief on online information was 66.7% positively and 33.3 negatively. Trust on healthcare provider about medication information the complete trust 60%, somewhat trust 38.30%, not trust was 1.6%. Only 15% subjects felt difficulty to adhere to medication regimen.
Conclusion: Despite of participants searching for online health information, still they have strong belief on prescription and medication adherence.
Algunos aspectos de la arqueología prehistórica de Uruguay
Authors: Taddei Antonio
Published: November 2024

Antecedentes de la arqueología en UruguayEl territorio uruguayo constituyó hasta poco tiempo una zona arqueológicamente desconocida. Sólo el esfuerzo particular de aficionados con cierta labor metódica llenó, en pequeña parte, el desinterés oficial por hurgar sus raíces prehistóricas. Esa temática, preferida en la enseñanza media y superior de Uruguay, fue cumplida, con todas las limitaciones emanadas de actuar sin apoyo económico y plena de sacrificios de toda índole, por el Centro de Estudios Arqueológicos de Montevideo, institución privada que nucleó aficionados dispersos pero con clara vocación e interés. La creación posterior por ley del Departamento de Antropología en el seno de nuestra Facultad de Humanidades y Ciencias en el año 1974 cumple con una necesidad largo tiempo anhelada. Desde entonces se trabaja con paso seguro, en un avance conceptual y metodológico que, sin duda, aportará datos más concretos en la reconstrucción del pasado prehistórico de Uruguay.
Sistemas de asentamiento y movilidad durante el Arcaico.
Authors: Rodríguez M. Fernanda
Published: November 2024

Plant macroremains recovered in Archaic levels (10000-3000 years BP) or the archaeological sites Quebrada Seca 3 and Cueva Salamanca. situated in the Hoyada of Antofagasta de la Sierra, province of Catamarca (Southern Argentine Puna). The starting point for the study of the archaeobotanical records was a survey of the current flora of the surroundings. The comparative anatomical and morphological analysis of the current and archaeological plants allowed the determination of the latter and the identification of species that do not develope in the arca or this study. The results indicated the presence of artefacts that had been mad with no local species.  From this, the mobility and the probable existence of socioeconomic interactions during the Archaic period in the Argentine Puna were analized.
Una contribución a la determinación taxonómica de la familia Camelidae en sitios formativos del Loa Medio.
Authors: Cartajena Fasting María Isabel , Concha Ismael
Published: November 2024

This study makes a contribution to the methodological discussion about taxonomic determination of camelids. Results about differentiation between wild and domestic species, using mixed archacological records with a high degree of morphological similarity especially in units with low diagnosis power, are presented . The taxonomic determination was performed in two steps. Firstly, contrasting morphological indicators, secondly using osteometric methods. We found the presence Lama Guanicoe, Lama Glama, Vicugna Vicugna and probably Lama Pacos. The archaeofaunistical remains belong from the formative sites Topaler and Chiu-Chiu 273 (Middle Loa) and were placed as offering in both cemeteries.
Interacción y Paisaje social en La Aguada.
Authors: Kusch M. Florencia , Gordillo Inés
Published: November 2024

The aim of the paper is to undertake the study of the La Aguada phenomenon focussing of the different types or interaction which articulate the inter and intra-regional spaces. For this purpose we adopt a concept of space starting from the notion of social space, presenting the archaeologycal register and its significant variants through time.
Indicios caravaneros en contextos funerarios de la Puna argentina.
Authors: Pérez de Micou Cecilia
Published: November 2024

The Doncellas collection deposited on the Etnographic Museum (Buenos Aires) and the Pucará Museum (Tilcara. Jujuy) since the forties becomes from the homonymous site placed in the Department of Cochinoca, Province of Jujuy, in the argentine Puna.Their artifacts(weaves, basketry, carved wood, lities, ceramics, cordages and pumpkin recipients) were entirety exhumated from burials of the kind chulpa, dated from 1200 AD to the hispanic ocupation.
In this paper, it is presented the cordages analysis (bridles and ropes) of plants raw materials which study, asociated to other evidencies or the same collection, allow to think about the relationship between this burials and the caravanian activity which sustained the products interchange in the andine altiplano.
El Pukara de Volcán en el sur de la Quebrada de Humahuaca ¿un eje articulador de las relaciones entre las Yungas y las tierras altas? (Provincia de Jujuy, Argentina).
Authors: Cremonte María Beatríz , Garay de Fumagalli Mercedes
Published: November 2024

Pukara of Volcan situated in the border of the Prepuna ecological zone is a large and high settlement probably the political head of a southern chiefdom developed during the Desarrollos Regionales and Inka periods (from aproximately XIII to XVI Century). A fundamental property of this Humalmaca valley portion is its proximity to the Western Yunga in the upper basin of the Corral de Piedra river, where 23 sites surveyed covered a lapse since 800 AD to 1.440 AD at least. Excavation records show interaction signs between Pukara of Volcan and Yunga sites, but also with settlements such as Tastil and Morohuasi in Toro Valley (Puna Salteña southern border). According to the data obtained at the moment, we postulate that interactions were related to the highlands societies interest in the access to the Yunga resources, favored by the routes which link Toro and Humahuaca Valleys.
Tramando redes:
Authors: Scattolin María Cristina , Lazzari Marisa
Published: November 2024

Exchange has always been a central issue among South Andean archaeologists. Usually, explanations have been centred in stylistic similarity or complementary resources. In this paper we attempt to demonstrate that the use of different classes or evidence will render a more insightful understanding of exchange relationships of material objects as part of a wider set of social interaction strategies that structure and reproduce societies. Therefore, obsidian sourcing analysis from sites on the western side or the Aconquija (Catamarca, Argentina) and other areas can be usetl to reinterpreting interaction and discuss the principies normally assumed as structuring exchange relationships.
Casabindo: Las sociedades de período tardío y su vinculación con las áreas aledañas.
Authors: Abeck María Ester , Ruíz María Susana
Published: November 2024

This paper characterizes casabindo as an archaeological group belonging to the Periodo Tardío (1000-1430) in the puna de Jujuy. A review is made of the resources of this part of the puna, very similar to the territory occupied by the casabindo and cochinoca of the Colonial Period. Exogenous archeological materials recovered in Casabindo are analyzed and the relationships with neighbouring societies are discussed.
Las interacciones prehispánicas a través del estilo: el caso de la iconografía santamariana.
Authors: Tarrago Myriam , González Luis , Nastri Javier
Published: November 2024

In the present work there are explored interactions among south-andean societies in late prehispanic times through the study of the distribution of Santamaría style.After revising advances of the investigation in course in the valley of Yocavil, in the Catamarca province (Argentina), it is discussed the conceptual framework employed, standing out the importance of the iconography in the development of the complex societies of the area.It is compilated thc whole range of discoveries or santamarian iconographical elements and motifs along a vast territory, being analyzed the different forms that adopt this manifestations according to variable row materials and expression means. Different hypothesis are also formulated to give bill of the presence of santamarian motifs and configurations outside of the valleys valliserrano of the Argentinean northwest, standing out the necessity to carry out specific studies that allow to generate more precise patterns of distribution of findings.
Cuminaldehyde in Combination with Ciprofloxacin Shows Antibiofilm Activity against Clinical Strains of Pseudomonas aeruginosa: A Study to Explore the Underlying Mechanism
Authors: Malik Moumita , Das Sharmistha , Paul Payel , Chakraborty Poulomi , Das Awantika , Roy Ritwik , Sarkar Sarita , Tribedi Prosun
Published: November 2024

Pseudomonas aeruginosa poses a serious threat in healthcare settings. This bacterium can develop resistance to many antibiotics, rendering even last-resort treatments ineffective. Additionally, it forms protective biofilms that shield it from the immune system, making infection treatment challenging. This study investigated the susceptibility of five clinically isolated strains of the test bacteria to a combination of ciprofloxacin and cuminaldehyde. Cuminaldehyde (a natural phytochemical) and ciprofloxacin (an antibiotic) were separately found to show antimicrobial effect against test organism. However, the combination of selected compounds showed an additive effect in their microbial growth inhibitory activity. The mentioned compounds at their sub-MIC doses subjected to test whether they could show any extent of biofilm inhibition or disintegration property against the clinical strains of P. aeruginosa. The chosen concentrations of the compounds demonstrated significant antibiofilm activity against all the tested clinical strains. Additionally, it was observed that the compounds not only accumulated reactive oxygen species (ROS) but also enhanced the cell membrane permeability of the clinical strains. These findings suggest that the combination of ciprofloxacin and cuminaldehyde could explore new directions in fighting P. aeruginosa-linked infections.
Evaluating the Impact of Precipitation, Temperature, and Topological Factors on Flood Severity in Myanmar: A Data-Driven Analysis
Authors: Potdar Kabir
Published: November 2024

Abstract: This study really takes a look at the perplexing connection between precipitation, temperature, and the effect of floods in Myanmar, zeroing in on how these natural elements impact the quantity of individual people impacted by flood catastrophes. Through an itemized investigation of climate information and flood influence reports from different districts, we find that high precipitation levels don't be guaranteed to correspond with expanded flood harm. A few locales experience serious flooding in spite of having lower precipitation, showing that variables past precipitation, for example, geography and soil conditions, assume a huge part in flood weakness. This exploration features the requirement for complete appraisals of these ecological variables in regions encountering destroying floods, implying that districts with lower precipitation yet critical flood effects ought to go through careful topological assessments to all the more likely illuminate flood risk the executives techniques.
PROCESSO SAÚDE-DOENÇA MENTAL NA CONCEPÇÃO DE GRADUANDOS EM PSICOLOGIA
Authors: Pinho Paula Hayasi , Santos Natalia Oliveira , Cortes Helena Moraes
Published: November 2024

The objective was to understand, based on the narratives of students from an undergraduate psychology course, the social representation regarding the mental health and illness process. This is narrative research carried out at a public university in Bahia. Data collection took place online, using an electronic form made available in 2021, for data analysis dialectical hermeneutics was used. 34 students participated in the study. The results were presented in two empirical categories: biomedical model in the mental health and illness process and social determinants model in the mental health and illness process. The students narrated their social representation about the mental health and illness process, both from a perspective that favors the biomedical model and based on the psychosocial care model. Considering the analysis carried out, there is an urgent need for undergraduate courses in Psychology and other courses in the health field to review their curricula in order to meet the precepts of the Brazilian Psychiatric Reform, making use of mandatory and optional components with active methodologies of teaching-learning that address the topic, thus aiming to resolve stigmatized conceptions in the field of mental health and prepare professionals who base their work on the precepts of psychosocial care.
Situational diagnosis of basic sanitation planning in the upper west region of Rio Grande do Norte
Authors: Leite Francisco Fernando Pinheiro , Alves Larissa da Silva Ferreira , Costa Franklin Roberto da , Barbosa Jane Roberta de Assis
Published: November 2024

This article examines the development and implementation of Municipal Basic Sanitation Plans (PMSB) in the Upper West Region of the Brazilian Northeastern state of Rio Grande do Norte. The investigation reveals that, despite the legal requirement for PMSB, many municipalities encounter significant challenges, including a dearth of trained personnel and financial resources, insufficient public engagement, and the absence of a unified information system for basic sanitation policy. Moreover, the lack of budget provisions for executing the actions outlined in the plans was identified as a critical issue. The article concludes that it is essential to fortify planning processes, ensure public participation, furnish the requisite technical and financial capacity, integrate basic sanitation actions into municipal budgetary frameworks, and address the political disarticulation of small municipalities.
Diagnóstico situacional do planejamento em saneamento básico no Alto Oeste Potiguar
Authors: Leite Francisco Fernando Pinheiro , Alves Larissa da Silva Ferreira , Costa Franklin Roberto da , Barbosa Jane Roberta de Assis
Published: November 2024

Este artigo analisa o processo de elaboração e de implementação dos Planos Municipais de Saneamento Básico (PMSB) no Alto Oeste Potiguar. A pesquisa mostra que, apesar de a legislação exigir a elaboração dos PMSB, muitos municípios enfrentam desafios significativos, incluindo a escassez de pessoal capacitado e de recursos financeiros, além da falta de envolvimento da sociedade e da inexistência de um sistema de informações unificado sobre a política de saneamento básico. Adicionalmente, a falta de previsão orçamentária para execução das ações traçadas nos planos foi um fator crítico identificado. O artigo conclui que é necessário fortalecer os processos de planejamento, garantir a participação social, assim como a capacidade técnica e financeira necessária, e integrar as ações de saneamento básico nos instrumentos orçamentários municipais, além de buscar combater a desarticulação política dos pequenos municípios.