bluuebunny/crossref_metadata_2025 huggingface dataset:
Enfrentamiento inicial de las intoxicaciones por medicamentos orales en el servicio de urgencia
Authors: Basauri Savelli Sofia , Vasquez Arancibia Valentina , Maluenda Barrientos Felipe , Lara Hernandez Barbara
Published: June 2023

Las intoxicaciones en Chile siguen siendo un motivo importante de consulta en el servicio de urgencia (SU). Tanto intoxicaciones accidentales como intencionales constituyen una fuente de morbimortalidad y gasto de recursos monetarios no solo en Chile, si no que en todo el mundo. Debido a los múltiples compuestos que pueden producir una intoxicación grave, sigue siendo un desafío para el equipo de salud su enfrentamiento y manejo oportuno. Los médicos que tratan a estos pacientes deben ser sistemáticos y ordenados en su enfrentamiento, ya que la presentación clínica es variada y depende del agente ingerido, co-ingestas, si es aguda o crónica o concomitante con otras patologías (trauma, infecciones, etc.). El manejo está dirigido a las maniobras básicas de reanimación y soporte vital, prevención de absorción del tóxico y cuando corresponda, la administración del antídoto. La evaluación y tratamiento inicial serán abordados en esta revisión, temas específicos para diferentes drogas serán discutidos de forma separada. Objetivo: entregar las nociones básicas del enfrentamiento y manejo terapéutico inicial de un paciente intoxicado desde la perspectiva de la medicina de urgencias. Método: se realizó una revisión bibliográfica de la literatura científica, presentándose la evidencia actual del manejo e intervenciones terapéuticas utilizadas actualmente de un paciente intoxicado.
As cidades novas de Joaquim Guedes
Authors: Quintanilha Rogério Penna
Published: June 2023

Este artigo pretende contribuir para a compreensão da produção de cidades novas ao longo da trajetória do urbanista brasileiro
Joaquim Guedes, identificando temas que perpassam os quatro planos desenvolvidos pelo arquiteto ao longo de 25 anos de carreira: o plano para
a nova capital federal, Brasília, projeto participante do concurso nacional realizado em 1957; o plano para Nova Marabá, realizado em 1973
para o governo federal e não executado; o plano para a cidade de Caraíba, realizado entre 1976-1982 para a Caraíba Metais, executado e
atualmente conhecido como Núcleo do Pilar, distrito de Jaguarari; e o plano para Barcarena Nova, realizado em 1980 para a Albras,
executado e conhecido atualmente como Vila dos Cabanos. Após apresentá-los, esta pesquisa investiga como os temas das unidades de
izinhança, dos meios de circulação pela cidade, do diagnóstico social, do papel da educação e da questão do crescimento e transformação
da cidade surgem em cada caso, construindo um guia importante para a leitura projetual do arquiteto.
The Limits of Confrontation: Nuclear Weapons, the 1958 Taiwan Strait Crisis, and China-U.S. Relations
Authors: Zhao Xuegong
Published: June 2023

During the 1958 Taiwan Strait crisis, the Eisenhower administration used nuclear weapons to deter Chinese shelling of the Quemoy islands. Zhao claims that the oblique nuclear threats had no effect on Beijing's decisions and operations and instead created problems for the Eisenhower administration by generating widespread opposition at home and abroad. Based on recently declassified U.S. and Chinese materials, this article examines U.S. and Chinese leaders’ perspectives on nuclear weapons during the crisis and other features of U.S.-China relations in the late 1950s.
On the Explanatory Validity of Proxies of Frequency in Heritage Language Acquisition Research
Authors: Thane Patrick
Published: June 2023

Use and activation of the heritage language (HL) are essential for its maintenance, and the frequency of individual words affects heritage speakers’ (HS) morphological knowledge. However, some studies have used participants’ ratings of frequency of words and proficiency as proxies for frequency of use and activation. Regarding lexical frequency, some studies have relied on language corpora, while others have used participants’ self-ratings. This study explores the relationships between these variables, comparing 53 Spanish HS’ frequency of HL use with their self-ratings of thirty verbs, proficiency, and age of onset of bilingualism. Self-ratings correlated weakly with frequency of use while proficiency and age of onset did not, but the rankings of verbs according to participants’ self-ratings correlated with those from three corpora. Therefore, proficiency and age of onset may not be ideal proxies for activation, but the two techniques used to measure lexical frequency show a robust relationship with each other.
Lack-of-Corruption Goes with Liberal–Egalitarian Features of Democracy
Authors: Kask Peet , Nahkur Oliver , Taagepera Rein
Published: June 2023

This study aims at ferreting out a sparse subset, among the many democracy indicators, that best predicts lack-of-corruption (LoC). Two factors enable the authors to improve on previous research. First, the Varieties of Democracy (VD) data have become available over an extended time span, involving an unprecedented number of separate indicators. Second, the authors apply previously neglected methods, such as Gaussian standardization and measures to avoid overfitting. They also reduce random error on the LoC side by using the mean of two separate indices, VD and Transparency International, that correlate with R2 = 0.81. This results in an optimal set of 11 democracy indicators that predict the mean LoC with R2 = 0.87, close to what one could ideally expect to achieve. Among the five main categories VD distinguishes, the indicators that predict lack-of-corruption are mainly part of Liberal and Egalitarian Democracy, with lesser incidence of Electoral Democracy. This leaves out Participatory, and Deliberative Democracy.
Body as Text/Text as Body: Embodied Knowledge Transmission in Sixteenth Century Morocco
Authors: Spragins Elizabeth
Published: June 2023

The stories told about the battle of Wādī al-Makhāzin (August 4, 1578) reveal a major crisis of information for all involved in the event. At the very center of that epistemological crisis were the three warring kings. Even as new leadership gradually wrested the Western Mediterranean out of chaos, there remained a nagging sense that the knowable rested on shaky footing. This article explores one way in which a Maghrebi chronicler of this event contemplates the difficulty of protecting and transmitting reliable knowledge in a broad Mediterranean context. Ultimately, he promotes a theory for the conservation and transmission of knowledge reliant upon the functional interaction of enlightened leadership and information incorporated within situated human bodies.
The Danish Rigsfællesskab
Authors: Lorenzo Villaverde José María
Published: June 2023

The Danish Realm or Rigsfællesskab is a decentralised state in which the Faroe Islands and Greenland each count with a home-rule, holding the executive and legislative power over transferred matters. The paper discusses several issues concerning this decentralised legal framework and its functioning. In spite of what is stated in the home-rule arrangements about equality between parties, there is a dominant position of Danish authorities and Danish law. ‘Danish central authorities’ (Rigsmyndigheder) do not exist strictly speaking since the Danish authorities act as authorities for both Denmark proper and the Danish Realm. The mechanism for solving conflicts of competences is also questioned as non-functional, potentially reinforcing inequality and uncertainty. A territorial limit to Greenlandic/Faroese laws is of little use when the criterion for application of the laws is personal, not territorial. Finally, it is argued that the bilateral nature of the home-rule arrangements is not suitable for a three-part decentralised state in which all involved laws are lex fori.
A First Violation of the Sharia Provision: Egypt’s SCC’s Ruling of 15 January 2006, in the Case No. 113/xxvi (Annotated and Translated)
Authors: Parolin Gianluca
Published: June 2023

In early 2006, Egypt’s Supreme Constitutional Court found a statutory provision in force at the time of the decision to be in violation of the constitutional provision declaring the principles of Islamic law the chief source of legislation (Article 2). It was the first time since the provision was originally introduced in the Constitution in 1971 and later amended in 1980. Since this ruling, the Court found another two statutory provisions to be in violation of the sharia provision in the latter’s five decades of operation, in 2013 and in 2021. In the ruling considered here, the Court confirmed its conventional construction of Article 2, but took a position on a critical and contentious device of legal reform: Can legal change be produced through procedural expedients? Ultimately, the Court had to answer another and even more fundamental question: Can the legislator deny legal effects to a religiously valid act like unilateral divorce (ṭalāq)?
Climate Change and its ‘Grotian’ Effects on a Principle of Corporate Liability in International Law
Authors: Chiussi Curzi Ludovica
Published: June 2023

As climate change hazards keep intensifying, there seems to be an increasing recognition that corporations are not immune from international obligations on the protection of human rights and the environment. The present article argues that the climate crisis might be contributing, as a ‘Grotian Moment’, to the crystallisation of an already developing principle on corporate liability for human rights and environmental violations. After a brief account of the long-lasting debate on the existence and nature of corporate obligations under international law, the relevant business and human rights (non-binding) instruments will be addressed, highlighting their limits as well as their preparatory role in the ongoing paradigm shift. The ‘Grotian’ implications of climate change will be examined through the lens of climate litigation against companies, which highlights a crucial osmosis between the relevant international standards and domestic legal systems.
Larval morphology of Belgica antarctica Jacobs, 1900 (Diptera, Chironomidae, Orthocladiinae) from central part of the maritime Antarctic and deformities found in the larvae
Authors: IHTIMANSKA MILA K. , KOVALENKO PAVLO A. , MICHAILOVA PARASKEVA V. , PARNIKOZA IVAN YU.
Published: June 2023

The larval morphology of the endemic species Belgica antarctica Jacobs, collected in January and February (2022) from six sites of Antarctica, was studied. The mouth apparatus and the parapods of one hundred seventy-six larvae were analyzed. No differences were found in the morphology of these structures between individuals of different sites. However, differences (with the exception of the length of 2nd antennal segment) were estimated in the sizes of the morphological features, as 2023 measurements were made of fifteen kinds of these structures and larval body. Deformities of mentum, mandible, antennal blade and antennal segments in percentage were established in larvae of almost all of the studied sites. The reasons for the differences and deformities are discussed.
Detailed safety profile of acalabrutinib vs ibrutinib in previously treated chronic lymphocytic leukemia in the ELEVATE-RR trial
Authors: Seymour John F. , Byrd John C. , Ghia Paolo , Kater Arnon P. , Chanan-Khan Asher , Furman Richard R. , O’Brien Susan , Brown Jennifer R. , Munir Talha , Mato Anthony , Stilgenbauer Stephan , Bajwa Naghmana , Miranda Paulo , Higgins Kara , John Ellie , de Borja Marianne , Jurczak Wojciech , Woyach Jennifer A.
Published: June 2023

ELEVATE-RR demonstrated noninferior progression-free survival and lower incidence of key adverse events (AEs) with acalabrutinib vs ibrutinib in previously treated chronic lymphocytic leukemia. We further characterize AEs of acalabrutinib and ibrutinib via post hoc analysis. Overall and exposure-adjusted incidence rate was assessed for common Bruton tyrosine kinase inhibitor–associated AEs and for selected events of clinical interest (ECIs). AE burden scores based on previously published methodology were calculated for AEs overall and selected ECIs. Safety analyses included 529 patients (acalabrutinib, n = 266; ibrutinib, n = 263). Among common AEs, incidences of any-grade diarrhea, arthralgia, urinary tract infection, back pain, muscle spasms, and dyspepsia were higher with ibrutinib, with 1.5- to 4.1-fold higher exposure-adjusted incidence rates. Incidences of headache and cough were higher with acalabrutinib, with 1.6- and 1.2-fold higher exposure-adjusted incidence rate, respectively. Among ECIs, incidences of any-grade atrial fibrillation/flutter, hypertension, and bleeding were higher with ibrutinib, as were exposure-adjusted incidence rates (2.0-, 2.8-, and 1.6-fold, respectively); incidences of cardiac events overall (the Medical Dictionary for Regulatory Activities system organ class) and infections were similar between arms. Rate of discontinuation because of AEs was lower for acalabrutinib (hazard ratio, 0.62; 95% confidence interval, 0.41-0.93). AE burden score was higher for ibrutinib vs acalabrutinib overall and for the ECIs atrial fibrillation/flutter, hypertension, and bleeding. A limitation of this analysis is its open-label study design, which may influence the reporting of more subjective AEs. Overall, event-based analyses and AE burden scores demonstrated higher AE burden overall and specifically for atrial fibrillation, hypertension, and hemorrhage with ibrutinib vs acalabrutinib. This trial was registered at www.clinicaltrials.gov as #NCT02477696.
Comparing methods for drug–gene interaction prediction on the biomedical literature knowledge graph: performance versus explainability
Authors: Aisopos Fotis , Paliouras Georgios
Published: June 2023

This paper applies different link prediction methods on a knowledge graph generated from biomedical literature, with the aim to compare their ability to identify unknown drug-gene interactions and explain their predictions. Identifying novel drug–target interactions is a crucial step in drug discovery and repurposing. One approach to this problem is to predict missing links between drug and gene nodes, in a graph that contains relevant biomedical knowledge. Such a knowledge graph can be extracted from biomedical literature, using text mining tools. In this work, we compare state-of-the-art graph embedding approaches and contextual path analysis on the interaction prediction task. The comparison reveals a trade-off between predictive accuracy and explainability of predictions. Focusing on explainability, we train a decision tree on model predictions and show how it can aid the understanding of the prediction process. We further test the methods on a drug repurposing task and validate the predicted interactions against external databases, with very encouraging results.
Effect of inactivated COVID-19 vaccine on the negative conversion of nucleic acid in asymptomatic or mild patients with COVID-19
Authors: Luo Yifeng , Zhou Qian , Huang Xinyan , Ding Yuqi , Ye Xiangrong , Ding Jie , Kuang Yukun , Liu Yihao , Peng Sui , Zhu Qingtang , Wang Haibo , Xiao Haipeng
Published: June 2023

Background

Negative conversion of nucleic acid was a key factor in deciding discharge or the end of isolation of asymptomatic or mild COVID-19 patients. We aimed to explore the effect of vaccination on the time to negative conversion after Omicron infection.

Methods

This retrospective cohort study included asymptomatic or mild patients with COVID-19 admitted to Fangcang shelter Hospital from November 10, 2022 to December 2, 2022. The relationship between vaccination status and the time to negative conversion was analyzed by multiple linear regression.

Results

A total of 2,104 asymptomatic or mild COVID-19 patients were included in the analysis, of whom 1,963 were vaccinated. The mean time to negative conversion of no vaccination, one dose, two doses, and three doses were 12.57 (5.05), 12.18 (3.46), 11.67 (4.86) and 11.22 (4.02) days, respectively (p = 0.002). Compared with no vaccination, two doses (β=-0.88, 95% CI: -1.74, -0.02, p = 0.045), and three doses (β=-1.51, 95% CI: -2.33, -0.70, p < 0.001) were both associated with shorter time to negative conversion. Comparing with two doses, booster dose was associated significantly with shorter time to negative conversion (β=-0.63, 95% CI: -1.07, -0.20, p = 0.004). Age was positively correlated with the time to negative conversion (β = 0.04, 95% CI: 0.02, 0.05, p < 0.001).

Conclusion

Vaccination with inactivated vaccine and booster dose can shorten the time to negative conversion of asymptomatic or mild COVID-19 patients. The significant prolongation of time to negative conversion with increasing age suggests the promotion of vaccination, especially booster dose, particularly in the elderly.
Preceding symptoms and temporal development of cortical superficial siderosis in cerebral amyloid angiopathy: a case report
Authors: Andersen Naja H. , Blauenfeldt Rolf A. , Mikkelsen Ronni , Simonsen Claus Z.
Published: June 2023

Background

We present a case illustrating evolution of symptoms and brain magnetic resonance imaging in cortical superficial siderosis.

Case presentation

A 74-year-old man with no prior medical history presented with transient focal neurological episodes with subtle imaging changes. There was no evidence of cortical superficial siderosis. Two weeks later, the patient was readmitted with new episodes, and had developed cortical superficial siderosis adjacent to a cerebral microbleed. Transient focal neurological episode secondary to cortical superficial siderosis was diagnosed together with probable cerebral amyloid angiopathy.

Conclusion

Clinical symptoms may precede the development of cortical superficial siderosis prior to being detectable on brain MRI. This case highlights the temporal development of cortical superficial siderosis.
Elevated levels of MMP12 sourced from macrophages are associated with poor prognosis in urothelial bladder cancer
Authors: Kerzeli Iliana K. , Kostakis Alexandros , Türker Polat , Malmström Per-Uno , Hemdan Tammer , Mezheyeuski Artur , Ward Douglas G. , Bryan Richard T. , Segersten Ulrika , Lord Martin , Mangsbo Sara M.
Published: June 2023

Background

Urothelial bladder cancer is most frequently diagnosed at the non-muscle-invasive stage (NMIBC). However, recurrences and interventions for intermediate and high-risk NMIBC patients impact the quality of life. Biomarkers for patient stratification could help to avoid unnecessary interventions whilst indicating aggressive measures when required.

Methods

In this study, immuno-oncology focused, multiplexed proximity extension assays were utilised to analyse plasma (n = 90) and urine (n = 40) samples from 90 newly-diagnosed and treatment-naïve bladder cancer patients. Public single-cell RNA-sequencing and microarray data from patient tumour tissues and murine OH-BBN-induced urothelial carcinomas were also explored to further corroborate the proteomic findings.

Results

Plasma from muscle-invasive, urothelial bladder cancer patients displayed higher levels of MMP7 (p = 0.028) and CCL23 (p = 0.03) compared to NMIBC patients, whereas urine displayed higher levels of CD27 (p = 0.044) and CD40 (p = 0.04) in the NMIBC group by two-sided Wilcoxon rank-sum tests. Random forest survival and multivariable regression analyses identified increased MMP12 plasma levels as an independent marker (p < 0.001) associated with shorter overall survival (HR = 1.8, p < 0.001, 95% CI:1.3–2.5); this finding was validated in an independent patient OLINK cohort, but could not be established using a transcriptomic microarray dataset. Single-cell transcriptomics analyses indicated tumour-infiltrating macrophages as a putative source of MMP12.

Conclusions

The measurable levels of tumour-localised, immune-cell-derived MMP12 in blood suggest MMP12 as an important biomarker that could complement histopathology-based risk stratification.

As MMP12 stems from infiltrating immune cells rather than the tumor cells themselves, analyses performed on tissue biopsy material risk a biased selection of biomarkers produced by the tumour, while ignoring the surrounding microenvironment.
Urban-rural difference in the lagged effects of PM2.5 and PM10 on COPD mortality in Chongqing, China
Authors: Gou Aiping , Tan Guanzheng , Ding Xianbin , Wang Jiangbo , Lv Xiaoyan , Gou Chunyan , Tan Qiang
Published: June 2023

Background

It is true that Chronic obstructive pulmonary disease (COPD) will increase social burden, especially in developing countries. Urban-rural differences in the lagged effects of PM2.5 and PM10 on COPD mortality remain unclear, in Chongqing, China.

Methods

In this study, a distributed lag non-linear model (DLNMs) was established to describe the urban-rural differences in the lagged effects of PM2.5, PM10 and COPD mortality in Chongqing, using 312,917 deaths between 2015 and 2020.

Results

According to the DLNMs results, COPD mortality in Chongqing increases with increasing PM2.5 and PM10 concentrations, and the relative risk (RR) of the overall 7-day cumulative effect is higher in rural areas than in urban areas. High values of RR in urban areas occurred at the beginning of exposure (Lag 0 ~ Lag 1). High values of RR in rural areas occur mainly during Lag 1 to Lag 2 and Lag 6 to Lag 7.

Conclusion

Exposure to PM2.5 and PM10 is associated with an increased risk of COPD mortality in Chongqing, China. COPD mortality in urban areas has a high risk of increase in the initial phase of PM2.5 and PM10 exposure. There is a stronger lagging effect at high concentrations of PM2.5 and PM10 exposure in rural areas, which may further exacerbate inequalities in levels of health and urbanization.
Three-dimensional comparison between the effects of mandibular advancement device and maxillomandibular advancement surgery on upper airway
Authors: Gurgel Marcela , Cevidanes Lucia , Costa Fabio , Pereira Rowdley , Cunali Paulo , Bittencourt Lia , Ruellas Antonio , Gonçalves Joao , Bianchi Jonas , Chaves Cauby
Published: June 2023

Background

The efficacy of mandibular advancement devices (MAD) and maxillomandibular advancement (MMA) in improving upper airway (UA) patency has been described as being comparable to continuous positive airway pressure (CPAP) outcomes. However, no previous study has compared MAD and MMA treatment outcomes for the upper airway enlargement. This study aimed to evaluate three-dimensionally the UA changes and mandibular rotation in patients after MAD compared to MMA.

Methods

The sample consisted of 17 patients with treated with MAD and 17 patients treated with MMA matched by weight, height, body mass index. Cone-beam computed tomography from before and after both treatments were used to measure total UA, superior/inferior oropharynx volume and surface area; and mandibular rotation.

Results

Both groups showed a significant increase in the superior oropharynx volume after the treatments (p = 0.003) and the MMA group showed greater increase (p = 0.010). No statistical difference was identified in the MAD group considering the inferior volume, while the MMA group showed a significantly gain (p = 0.010) and greater volume (p = 0.024). Both groups showed anterior mandibular displacement. However, the mandibular rotation were statistically different between the groups (p < 0.001). While the MAD group showed a clockwise rotation pattern (-3.97 ± 1.07 and − 4.08 ± 1.30), the MMA group demonstrated a counterclockwise (2.40 ± 3.43 and 3.41 ± 2.79). In the MAD group, the mandibular linear anterior displacement was correlated with superior [p = 0.002 (r=-0.697)] and inferior [p = 0.004 (r = 0.658)] oropharynx volume, suggesting that greater amounts of mandibular advancement are correlated to a decrease in the superior oropharynx and an increase in the inferior oropharynx. In the MMA group, the superior oropharynx volume was correlated to mandibular anteroposterior [p = 0.029 (r=-0.530)] and vertical displacement [p = 0.047 (r = 0.488)], indicating greater amounts of mandibular advancement may lead to a lowest gain in the superior oropharynx volume, while a great mandibular superior displacement is correlated with improvements in this region.

Conclusions

The MAD therapy led to a clockwise mandibular rotation, increasing the dimensions of the superior oropharynx; while a counterclockwise rotation with greater increases in all UA regions were showed in the MMA treatment.
Combined oral antibiotics and intrauterine perfusion can improve in vitro fertilization and embryo transfer pregnancy outcomes in patients with chronic endometritis and repeated embryo implantation failure
Authors: Ma Nana , Li Jiaxu , Zhang Junlei , Jin Yufu , Wang Jiawei , Qin Weili , Hang Fu , Qin Aiping
Published: June 2023

Background

The aim of this retrospective study was to investigate whether oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone) are beneficial for patients with repeated implantation failure (RIF) and chronic endometritis (CE) to improve clinical pregnancy outcomes.

Methods

Patients with RIF and CE were diagnosed using hysteroscopy and histology together. A total of 42 patients were enrolled in the study. All patients received oral antibiotics (doxycycline combined with metronidazole) and 22 patients underwent intrauterine perfusion (gentamicin combined with dexamethasone) immediately after the end of oral antibiotic therapy. Pregnancy outcomes were evaluated during the first in vitro fertilization (IVF) and embryo transfer (ET) cycle.

Results

For the first D3 ET after treatment with oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone), higher embryo implantation rate (30.95% vs. 26.67%, P = 0.0308), clinical pregnancy rate (30% vs. 50%, P < 0.001), live birth rate (33.33% vs. 45.45%, P < 0.0001). No fetal malformations or ectopic pregnancies were observed.

Conclusion

We report oral antibiotics (doxycycline and metronidazole) combined with intrauterine perfusion (gentamicin and dexamethasone) as a novel treatment for CE to improve the outcomes of successful pregnancy compared with those of oral antibiotics alone.
Importance of clinical parameters for cultivation of critical care thinking by online teaching of critical care medicine
Authors: Pan Pan , Zheng Min , Luo Hongbo , Liu Jinbang , Li Lina , Su Longxiang
Published: June 2023

Background

The teaching of critical care medicine is a very important task, especially during the COVID-19 pandemic. The understanding of critical care parameters is the foundation and core, which is conducive to the formation of clinical thinking. This study is to evaluate the training effect of teaching of critical care parameters based on an online platform, and explore the teaching methods of critical care medicine that can help to cultivate trainees’ clinical thinking and practical ability.

Methods

Questionnaires were released before and after the training through the official new media platform “Yisheng” application (APP) of China Medical Tribune involving 1109 participants. The trainees who filled in the questionnaire in APP and received training were randomly selected as the investigated population. Statistical description and analysis were carried out using SPSS 20.0 and Excel 2020.

Results

The trainees were mainly attending physicians in tertiary hospitals and above. Among all critical care parameters, trainees paid more attention to critical hemodynamics, respiratory mechanics, severity of illness scoring systems, critical ultrasound, and critical hemofiltration. The degree of satisfaction with the courses was high, especially the course of critical hemodynamics was scored the highest. The trainees believed that the course contents were of great help to clinical work. However, no significant difference was found in the trainees’ understanding or cognition of the connotation of the parameters before and after the training.

Conclusion

Teaching of critical care parameters based on an online platform is conducive to improving and consolidating the clinical care ability of trainees. However, it is still necessary to strengthen the cultivation of clinical thinking in critical care. In the future, the integration of theory with practice must be strengthened in clinical practice, ultimately achieving the homogeneous diagnosis and treatment of patients with critical illness.
A comprehensive medical Spanish curriculum model: the Vida Medical Spanish Curriculum
Authors: Chang Kyle E. , Lewis Jennifer , Lopez Vera Alexandra
Published: June 2023

Introduction

Racial and language disparities in the United States healthcare system have long undermined the quality of care provided to minority patients. With the projected growth of the Hispanic population, there is an urgent need for medical schools to integrate high-quality medical Spanish and cultural competency content. We propose a comprehensive medical Spanish curriculum aligned with the preclinical curriculum as a solution to these issues. The primary goal of this study is to demonstrate the effectiveness of a clinically focused, culturally competent medical Spanish program and advocate for its widespread adoption in medical institutions nationwide.

Methods

The study utilized the Kirkpatrick Model to evaluate the success of the medical Spanish curriculum. A total of 111 medical students voluntarily enrolled in the medical Spanish course. Out of these students, 47 completed the final evaluation, which included a Spanish Objective Structured Clinical Examination and a 40-question Multiple-Choice Exam assessing the integration of Spanish language skills and cultural competency. Both assessment methods took place in clinical skills facilities. Descriptive statistics summarized exam results, and two-tailed t-tests compared mean exam scores between students of different proficiency levels.

Results and discussion

Students achieved a mean score of over 80% on all components of the Spanish Objective Structured Clinical Examination and the Multiple-Choice Exam. Survey data suggest that students felt able to communicate in Spanish with patients after completing the course series. The study also provides a model for a medical Spanish curriculum that applies expert-recommended best practices to meet the needs of Hispanic patient populations.

Limitations and conclusions

Students who sat for the OSCE and MCE were self-selected. Baseline data on student perceptions and Spanish competency are not sufficient for making comparisons.
The effect of physical activity level on the severity of diastolic dysfunction
Authors: Ashraf Ali , Rimaz Siamak , Seddighinejad Abbas , karimi Amin , Hassanzadeh-Rad Afagh , Gholipour Mahboobeh , Motiei Mahsa , Yazdanipour Mohammad Ali , Rimaz Sheida
Published: June 2023

Background

Diastolic dysfunction (DD) is a risk factor for cardiovascular events in patients undergoing non-cardiac surgeries. Investigators aimed to assess the effect of physical activity level on the diastolic function of the left ventricle (LV) in patients attending the preoperative visit.

Methods

This analytic cross-sectional study was conducted on 228 patients referred to Poursina hospital from November 2021 to March 2022. To define the physical activity level, we used the short form of the International Physical Activity Questionnaire (IPAQ). We categorized patients into inactive, minimally active, and health-enhancing physical activity groups. We also divided participants into three groups based on their daily sitting time. Also, echocardiographic parameters were calculated. The diastolic function of LV was evaluated, and its grading was defined from mild (grade1) to severe (grade 3).

Results

Results showed that patients with DD had significantly higher age and lower levels of education (P < 0.001 and P = 0.005, respectively). After assessing echocardiographic parameters, we found that E/e’, TR Velocity, left atrial volume index, and pulmonary artery pressure had a statistically significant inverse relationship with physical activity level (P < 0.001 for all). Comparing physical activity level of subgroups showed that in HEPA (health-enhancing physical activity), the chance of developing grade 2 or 3 DD was reduced by 97% compared to the inactive group (OR = 0.03, P < 0.001). Still, there was no significant difference between the inactive and minimally active groups (P = 0.223).

Conclusions

This study showed an inverse relationship between physical activity level and DD of the LV in a sample of 228 individuals attending the Anesthesia Clinic, independent of potentially confounding variables.Therefore, due to lower rate of DD in patients who are physically active, we can expect lower occurrence rate of cardiovascular events during surgery.
Overcoming acquired resistance to cancer immune checkpoint therapy: potential strategies based on molecular mechanisms
Authors: Wang Bin , Han Yin , Zhang Yuyu , Zhao Qin , Wang Huanhuan , Wei Jinlong , Meng Lingbin , Xin Ying , Jiang Xin
Published: June 2023

Immune checkpoint inhibitors (ICIs) targeting CTLA-4 and PD-1/PD-L1 to boost tumor-specific T lymphocyte immunity have opened up new avenues for the treatment of various histological types of malignancies, with the possibility of durable responses and improved survival. However, the development of acquired resistance to ICI therapy over time after an initial response remains a major obstacle in cancer therapeutics. The potential mechanisms of acquired resistance to ICI therapy are still ambiguous. In this review, we focused on the current understanding of the mechanisms of acquired resistance to ICIs, including the lack of neoantigens and effective antigen presentation, mutations of IFN‐γ/JAK signaling, and activation of alternate inhibitory immune checkpoints, immunosuppressive tumor microenvironment, epigenetic modification, and dysbiosis of the gut microbiome. Further, based on these mechanisms, potential therapeutic strategies to reverse the resistance to ICIs, which could provide clinical benefits to cancer patients, are also briefly discussed.
Intimate partner violence against women during pregnancy: a systematic review and meta-analysis protocol for producing global and regional estimates
Authors: Schrubbe Leah , García-Moreno Claudia , Sardinha Lynnmarie , Stöckl Heidi
Published: June 2023

Background

Intimate partner violence is a devastating human rights violation and public health problem with high prevalence rates globally. Intimate partner violence during pregnancy is associated with devastating maternal, perinatal, and neonatal health effects. We present the protocol for a systematic review and meta-analysis to estimate the global lifetime prevalence of intimate partner violence during pregnancy.

Methods

This review aims to systematically synthesize the evidence on the global prevalence of violence against women by intimate partners during pregnancy using available population-based data. A comprehensive search of MEDLINE, EMBASE, Global Health, PsychInfo, and Web of Science databases will be conducted to identify all relevant articles. Manual searches will be conducted in Demographic and Health Survey (DHS) data reports and websites of national statistics and/or other offices. DHS data analysis will also be conducted. Based on inclusion and exclusion criteria, titles and abstracts will be screened for eligibility. Then, full-text articles will be assessed for eligibility. The following data will be extracted from included articles: study characteristics, population characteristics (e.g., ever-partnered, currently partnered, or any women, and age range), violence characteristics (e.g., type of violence, and perpetrator), estimate type (e.g., intimate partner violence during any pregnancy or during last pregnancy), subpopulation type (e.g., by age, marital status, urban/rural), prevalence estimate, and key quality indicators. A hierarchical Bayesian meta-regression framework will be used. This multilevel modelling approach will use survey-specific, country-specific, and region-specific random effects to pool observations. This modelling technique will be used to estimate global and regional prevalence.

Discussion

This systematic review and meta-analysis will provide estimates on the global and regional prevalence of intimate partner violence during pregnancy and contribute to monitoring progress towards Sustainable Development Goal (SDG) Target 5.2 on eliminating violence against women and to SDG Targets 3.1 and 3.2 on reducing maternal mortality and neonatal mortality.

Given the significant health impacts of intimate partner violence during pregnancy, potential for intervention, and urgency to address violence and improve health, this review will provide critical evidence to governments, non-governmental organizations, and policymakers on the magnitude of violence during pregnancy. It will also inform effective policies and programs to prevent and respond to intimate partner violence during pregnancy.

Systematic review registration

PROSPERO ID CRD42022332592.
Comparing self-reported health interview survey and pharmacy billing data in determining the prevalence of diabetes, hypertension, and hypercholesterolemia in Belgium
Authors: Vasquez Maria Salve , Mertens Elly , Berete Finaba , Van der Heyden Johan , Peñalvo José L. , Vandevijvere Stefanie
Published: June 2023

Background

Administrative and health surveys are used in monitoring key health indicators in a population. This study investigated the agreement between self-reported disease status from the Belgian Health Interview Survey (BHIS) and pharmaceutical insurance claims extracted from the Belgian Compulsory Health Insurance (BCHI) in ascertaining the prevalence of diabetes, hypertension, and hypercholesterolemia.

Methods

Linkage was made between the BHIS 2018 and the BCHI 2018, from which chronic condition was ascertained using the Anatomical Therapeutic Chemical (ATC) classification and defined daily dose. The data sources were compared using estimates of disease prevalence and various measures of agreement and validity. Multivariable logistic regression was performed for each chronic condition to identify the factors associated to the agreement between the two data sources.

Results

The prevalence estimates computed from the BCHI and the self-reported disease definition in BHIS, respectively, are 5.8% and 5.9% diabetes cases, 24.6% and 17.6% hypertension cases, and 16.2% and 18.1% of hypercholesterolemia cases. The overall agreement and kappa coefficient between the BCHI and the self-reported disease status is highest for diabetes and is equivalent to 97.6% and 0.80, respectively. The disagreement between the two data sources in ascertaining diabetes is associated with multimorbidity and older age categories.

Conclusion

This study demonstrated the capability of pharmacy billing data in ascertaining and monitoring diabetes in the Belgian population. More studies are needed to assess the applicability of pharmacy claims in ascertaining other chronic conditions and to evaluate the performance of other administrative data such as hospital records containing diagnostic codes.
Characterization of the circulating transcriptome expression profile and identification of novel miRNA biomarkers in hypertrophic cardiomyopathy
Authors: Guo Lanyan , Cai Yue , Wang Bo , Zhang Fuyang , Zhao Hang , Liu Liwen , Tao Ling
Published: June 2023

Background

Hypertrophic cardiomyopathy (HCM), one of the most common genetic cardiovascular diseases, but cannot be explained by single genetic factors. Circulating microRNAs (miRNAs) are stable and highly conserved. Inflammation and immune response participate in HCM pathophysiology, but whether the miRNA profile changes correspondingly in human peripheral blood mononuclear cells (PBMCs) with HCM is unclear. Herein, we aimed to investigate the circulating non-coding RNA (ncRNA) expression profile in PBMCs and identify potential miRNAs for HCM biomarkers.

Methods

A Custom CeRNA Human Gene Expression Microarray was used to identify differentially expressed (DE) mRNAs, miRNAs, and ncRNAs (including circRNA and lncRNA) in HCM PBMCs. Weighted correlation network analysis (WGCNA) was used to identify HCM-related miRNA and mRNA modules. The mRNAs and miRNAs from the key modules were used to construct a co-expression network. Three separate machine learning algorithms (random forest, support vector machine, and logistic regression) were applied to identify potential biomarkers based on miRNAs from the HCM co-expression network. Gene Expression Omnibus (GEO) database (GSE188324) and experimental samples were used for further verification. Gene set enrichment analysis (GSEA) and competing endogenous RNA (ceRNA) network was used to determine the potential functions of the selected miRNAs in HCM.

Results

We identified 1194 DE-mRNAs, 232 DE-miRNAs and 7696 DE-ncRNAs in HCM samples compared with normal controls from the microarray data sets. WGCNA identified key miRNA modules and mRNA modules evidently associated with HCM. We constructed a miRNA‒mRNA co-expression network based on these modules. A total of three hub miRNAs (miR-924, miR-98 and miR-1) were identified by random forest, and the areas under the receiver operator characteristic curves of miR-924, miR-98 and miR-1 were 0.829, 0.866, and 0.866, respectively.

Conclusions

We elucidated the transcriptome expression profile in PBMCs and identified three hub miRNAs (miR-924, miR-98 and miR-1) as potential biomarkers for HCM detection.
Venetoclax-based therapy for relapsed or refractory acute myeloid leukemia: latest updates from the 2022 ASH annual meeting
Authors: Gong Xubo , Zhang Yi , He Xin , Moloudizargari Milad , Yu Teng , Wang Lin , Liu Weiwei , Jin Lan , Xu Huiying , Xu Yang , Tao Zhihua , Qian Wenbin
Published: June 2023

Venetoclax (VEN), the first selective Bcl-2 inhibitor, has shown efficacy and safety both as monotherapy and in combination with other agents in the treatment of newly diagnosed acute myeloid leukemia (AML), while its role in relapsed or refractory (R/R) disease is not well defined. Here, we reviewed the latest advances of VEN-based therapy for R/R AML from the 2022 American Society of Hematology (ASH) Annual Meeting, including some novel and encouraging regimes, such as VCA, VAH, and HAM regimes, etc. Further research is still needed to fully understand the optimal use of these agents in R/R AML treatment.
Availability and cost–benefit analysis of a fault tolerant series–parallel system with human-robotic operators
Authors: Sanusi Abdullahi , Yusuf Ibrahim
Published: June 2023

Without excellent system uptime and profit margins, many manufacturing systems will not be able to continue operating. Strong business performance of manufacturing companies is facilitated by system availability and profit generation. Most manufacturing systems are set up in series–parallel, parallel-series, or hybrid configurations. In this present study, we analyze a series–parallel system composed of two subsystems with the following specifications: subsystem A consists of two similar units/components that are operated by Human, whereas subsystem B is made up of two similar units/components that are operated by Robot. We have also introduced fault tolerance factor in this work, so that the failure of each unit in each subsystem, common cause failure as well as failure due to human error and robot, will be accompanied by this fault tolerance factor. Our key goals are to examine how fault tolerance will increase the model’s availability and profitability and to identify optimum maintenance plan. In order to meet these key goals, certain expressions for reliability metrics have been developed and validated through numerical examples. Tables and graphs are used to illustrate the results and form conclusions from them.
Changes on economic freedom in 11 post-socialist countries of Central-Eastern and South-Eastern Europe in 1996–2022
Authors: Lach Bartłomiej , Malaga Krzysztof
Published: June 2023

Motivation: One of the most important dimensions of socio-economic development in democratic countries with market economies remains economic freedom. In this context, it is worth assessing the evolution of economic freedom in 11 countries of Central and Eastern Europe and South-Eastern Europe: Bulgaria, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Latvia, Poland, Romania, Slovenia, Slovakia during the period of institutional transformations in 1996–2022.Aim: The aim of the article is to present the results on correlation, s-convergence and s-divergence, as well as a multidimensional comparative analysis in the field of economic freedom. In order to conduct comparative analyzes, the economic freedom indexes published by The Heritage Foundation in Washington and Wall Street Journal will be used. They measure 12 quantitative and qualitative aspects grouped around the four pillars of economic freedom: Rule of Law — property rights, government integrity, judicial effectiveness; Government Size — government spending, tax burden, fiscal health; Efficiency regulators — business freedom, labour freedom, monetary freedom; Open Markets — trade freedom, investment freedom, financial freedom.Results: The obtained results allow us to assess the generally positive changes in economic freedom in its 12 partial and 1 general aspects in relation to each country separately, as well as in relation to the group of countries that joined the European Union after 2003. They are a significant supplement to the knowledge about creating economic freedom in 11 post-socialist countries in the years 1996–2022.
Intraday trading patterns in Bitcoin: does the war in Ukraine matter?
Authors: Miłobędzki Paweł
Published: June 2023

Motivation: So far, nothing has been known about the impact of the war in Ukraine on the dynamics of cryptocurrency markets, in particular on the intraday trading patterns in Bitcoin, nowadays the largest market capitalization and trading volume cryptocurrency.Aim: Use the data from the period January–April 2022 exhibiting over 1.5 million trades at Bitstamp, one out of four largest in trading volume Bitcoin markets, to identify and compare the day of the week and the hour of the day effects in the rate of return, bid-ask spread and trading volume at times preceding and following the war outbreak.Results: The analysis based on the regression including dummy variables showed that the bid-ask spread and trading volume exhibited both the day of the week and the hour of the day effects. The same applied to the rate of return — but only incidentally. The effects differed in the magnitude across the peace and war periods being mostly smaller in the latter one due to increased risk faced by market participants who, as reflected in the number of trades and trading volume, lowered their activity. Since Bitcoin at Bitstamp is traded 24 hours a day and 7 days a week and incoming information is continuously impounded into its prices, the intraday trading patterns are different from those at the mature and emerging stock markets. The wider spreads and larger trading volumes were found present close to open of the major stock markets (NYSE, NASDAQ, London, Frankfurt, Tokyo).
Motives and expectations of platform workers in Poland
Authors: Tusińska Magdalena
Published: June 2023

Motivation: Nowadays in economic literature the increasing popularity of the concept of platform work and gig economy can be observed. Nevertheless, this growth is not accompanied by a sufficient amount of empirical research into this new phenomenon, especially referring to the Polish labour market. Therefore, such studies on this issue are fundamental.Aim: The first aim of the article was to identify the main motives why some people in Poland started rendering services as platform workers. The second one was to assess to what extent the expectations of platform workers in Poland have been met.Results: Based on the analysis of the current world literature and using the method of the diagnostic survey, it was verified which circumstances and features of platform work were crucial to workers in Poland and what reasons led to expectations not being met. It turned out, that income, flexibility and independence are crucial motives. A concern for majority of respondents was low and unstable incomes. Many workers were also disappointed with the apparent flexibility. In general, the expectations of platform workers in Poland seem to be met to a significant extent, which may contribute to the growing acceptance of this form of work and its popularity.