bluuebunny/crossref_metadata_2025 huggingface dataset:
Business Optimization of Quantitative Analytics for Trade-off between Cost and System Availability in Cloud Logistics
Authors: Chiang Yi-Ju , Lee Dung-Lun , Shih Cheng-Min , Lai Chun-Ming , Jiang Fuu-Cheng
Published: December 2024

Cost item is one of the main issues that will drive the design of logistics on cloud computing (CC), especially of those devoted to provide services in a long-term and steady manner. The high availability of cloud platform has emerged to an essential requirement for CC business. To keep the service level agreement committed to cloud customers, the CC platform should adopt necessary cloud logistic approach to backup breakdown servers. Aiming at searching for a feasible architecture with optimal running cost, two control parameters of standbys and repairmen in the cloud logistics has been considered to maintain regulated service quality for the cloud enterprise. Based on the queuing theory, quantitative exploration with MRP (Machine Repair Problem) model has been adopted and conducted for optimal methodology. The proposed cloud logistic framework has been designed in systematic profile. Comprehensive mathematical materials have been elaborated in details between cost pattern and system availability. Relevant numerical experiments have been conducted to verify the feasibility for trade-off between cost and availability as well. On engineering application, the proposed approach indeed provides a feasibly cost-effective decision-making support to adapt cloud-based logistics.
WITHDRAWN: Integrative transcriptomic and proteomic analysis reveals that SERPING1 inhibits neuronal proliferation via the CaMKII-CREB-BDNF pathway in schizophrenia
Authors: Li Xing , Ti Wang , Li Wang , Wei Biao
Published: December 2024

BACKGROUND
Schizophrenia (SZ), a chronic and widespread brain disorder, presents with complex etiology and pathogenesis that remain inadequately understood. Despite the absence of a universally recognized endophenotype, peripheral blood mononuclear cells (PBMCs) serve as a robust model for investigating intracellular alterations linked to SZ.
AIM
To preliminarily investigate potential pathogenic mechanisms and identify novel biomarkers for SZ.
METHODS
PBMCs from SZ patients were subjected to integrative transcriptomic and proteomic analyses to uncover differentially expressed genes (DEGs) and differentially expressed proteins while mapping putative disease-associated signaling pathways. Key findings were validated using western blot (WB) and real-time fluorescence quantitative PCR (RT-qPCR). RNAi-lentivirus was employed to transfect rat hippocampal CA1 neurons in vitro, with subsequent verification of target gene expression via RT-qPCR. The levels of neuronal conduction proteins, including caMKII, CREB, and BDNF, were assessed through WB. Apoptosis was quantified by flow cytometry, while cell proliferation and viability were evaluated using the Cell Counting Kit-8 assay.
RESULTS
The integration of transcriptomic and proteomic analyses identified 6079 co-expressed genes, among which 25 DEGs were significantly altered between the SZ group and healthy controls. Notably, HP, LTF, and SERPING1 exhibited marked upregulation. KEGG pathway enrichment analysis implicated neuroactive ligand-receptor interaction pathways in disease pathogenesis. Clinical sample validation demonstrated elevated protein and mRNA levels of HP, LTF, and SERPING1 in the SZ group compared to controls. WB analysis of all clinical samples further corroborated the significant upregulation of SERPING1. In hippocampal CA1 neurons transfected with lentivirus, reduced SERPING1 expression was accompanied by increased levels of CaMKII, CREB, and BDNF, enhanced cell viability, and reduced apoptosis.
CONCLUSION
SERPING1 may suppress neural cell proliferation in SZ patients via modulation of the CaMKII-CREB-BDNF signaling pathway.
Vocación, identidad y trabajo en la enfermería: el equilibrio entre los bienes internos de la profesión y las demandas del entorno de la práctica
Authors: Pereira-Sánchez Miriam
Published: December 2024

La enfermería, como profesión vocacional, se define por un profundo compromiso hacia el bienestar de los pacientes, impulsado por principios éticos y humanos. Sin embargo, en los actuales entornos sanitarios, las demandas organizacionales pueden entrar en conflicto con los valores internos que guían la profesión, como la atención centrada en la persona y la construcción de relaciones auténticas con los pacientes. Esta tensión entre la vocación profesional y las condiciones del entorno de la práctica puede generar una desconexión que afecta tanto al bienestar de las enfermeras como a la calidad de la atención que proporcionan. Factores como la falta de tiempo, la sobrecarga de trabajo y la elevada “ratio” enfermera-paciente, dificultan que las enfermeras ejerzan plenamente su vocación, lo que contribuye al aumento del malestar moral y el agotamiento. Un equilibrio adecuado entre los bienes internos de la profesión y las demandas del entorno de la práctica que valore la vocación de los profesionales y favorezca la autonomía, la colaboración interdisciplinaria y una cultura de cuidado puede mitigar el agotamiento y promover el compromiso de las enfermeras. Para ello es esencial que las organizaciones de salud adapten sus estructuras organizacionales a las características de la identidad profesional de las enfermeras, garantizando que puedan cumplir con sus fines internos.
Differences in gaze in the figure form of
Authors:   Dong Nam Eo-Mun-Hak-Hoi, Yang HyeSeung
Published: December 2024

This study analyzed the difference in social position and perspective on the love between Yi Saeng and Cho Ok through an analysis of the character shape of the 19th-century affectionate novel . In addition, the narrative development of their meeting and breakup was divided into two, and the social gaze on Cho-ok was discussed through conversation with Gisaeng. In a conversation with a gisaeng, the two gisaengs value highly for “the work of a beautiful woman making a scholar who failed to hold a government post as a friend,” and are said to be not to be treated as low-class women. Cho-ok's behavior was foolish, but it is worth living high in terms of damaging others or not following profits and wealth. However, Cho-ok's value is high because her behavior is suitable for internalization of the Confucian order. Based on her high Confucian knowledge, she longed for her recognized relationship and life. Trust in a man who did not follow profits and wealth even though she was a poor subordinate woman also falls under the ethics that women should protect in the system of Confucianism. Here, the fact that Cho-ok is a married woman is not a big concern in the ethics of the male perspective of the aristocrat. It can be said that Cho-ok's husband's role and value in the work are too reduced because she is a subordinate woman.
This phenomenon reflects the urban culture of late Joseon, where desires were increasingly embraced, and romantic relationships became prominent themes across cultural domains. Despite the varied expressions of interest in the love and desires of men and women, texts like Yeolnyeojeon (Biographies of Exemplary Women) were still read by lower-class women, illustrating the tension between traditional norms and cultural shifts.
The portrayal of “a beautiful woman associating with an incompetent yangban (aristocrat)” highlights a duality: it affirms societal norms regarding fidelity and validates men's desires while also presenting an image of women aligned with Confucian ethics, emphasizing loyalty and chastity. The fact that Confucian texts like Yeolnyeojeon continued to be influential among lower-class women reveals the persistence of traditional moral standards amidst societal changes.
While Yeolnyeojeon emphasized Confucian virtues of loyalty and chastity as exemplary standards for women, late Joseon literature also depicted scenarios like “a beautiful woman engaging with an incapable yangban,” positively portraying men's desires. Such narratives recognized, to some extent, women's agency and emotions while simultaneously framing idealized female roles within the boundaries of Confucian ethics.
Ultimately, the urban culture of late Joseon embodied a complex and paradoxical interplay between Confucian values and emerging popular desires. This duality, along with diverse perspectives, permeated the literature and culture of the time, reflecting the multifaceted nature of the society.
Critical success factors for implementing a smart IoT-based decision framework in the water industry
Authors: Narang Dheeraj , Madaan Jitender , Chandra Ram
Published: December 2024

The decentralized nature of information and the widespread use of mobile devices for accessing content make the water sector an excellent platform for using the Internet of Things (IoT) paradigm to streamline procedures, benchmark standards, and create a sustainable environment. Smart devices play an essential role in deploying digital solutions through IoT. They help connect the physical world with the digital universe and are regarded as fundamental entities within a network-integrated through IoT. The study provides a better understanding to assess the critical success factors (CSFs) for smart device implementation in the water sector. The factors are obtained from the literature and shortlisted with the help of experts using the Delphi method. Kappa statistics are used to further validate the experts' consensus. The significant factors identified were leadership, usability, cost of implementation, technology awareness, data privacy, interoperability and community partnership. Mental modeler software has been used to construct a fuzzy logic cognitive mapping of CSFs to represent causal reasoning in diagraphs. Scenario analysis was conducted for each CSF. The study provides recommendations for policymakers to develop precise strategies for integrating IoT in the water industry.
INTERAÇÕES MEDICAMENTOSAS ENTRE VARFARINA E ANTIBIÓTICOS: REVISÃO INTEGRATIVA
Authors: Bersagui Cristina Cardoso , Pavanello Larissa , Müller Karina Cogo
Published: December 2024

Introdução: A administração de varfarina com antibióticos é desafiador devido ao aumento do risco de episódios hemorrágicos. Objetivos: Frente a isto, este estudo objetivou investigar as interações medicamentosas mais frequentes entre a varfarina e antibióticos. Metodologia: Foram realizadas buscas nas bases de dados PubMed, Biblioteca Virtual em Saúde (BVS) e Scientific Eletronic Library Online (Scielo) com os termos MeSH warfarin, drug interactions e antibacterial agents. Foram considerados artigos publicados em inglês e português, sem restrição de data. As interações medicamentosas foram classificadas de acordo com o drugs.com. Resultados: Um total de 19 artigos foram incluídos. Foram identificadas 85 interações medicamentosas sendo as mais prevalentes entre varfarina e antibióticos β-lactâmicos (50%) e quinolonas e fluoroquinolonas (33%). Em relação a classificação, 41% interações medicamentosas foram importantes e 53% moderadas. Não foram encontradas interações medicamentosas entre a varfarina e dois antibióticos (2%, diritromicina e cefonicida) no drugs.com, apesar dos estudos confirmarem a interação medicamentosa. Além do uso de antibióticos, sabe-se que os níveis de coagulação durante o uso de varfarina pode ser influenciado por fatores como adesão do paciente ao tratamento, dieta, presença de infecções e uso de diversos medicamentos. Dessa forma, a compreensão sobre a influência dos antibióticos no metabolismo da varfarina é comprometida. Conclusão: Portanto, para assegurar que a terapia anticoagulante e antibiótica seja eficaz e segura para os pacientes, é crucial desenvolver estratégias de supervisão e acompanhamento. Adicionalmente, é fundamental realizar estudos adicionais para aprofundar o entendimento da interferência dos antibióticos na via metabólica da varfarina.  
Palavras-chave: Varfarina; Interações medicamentosas, Antibióticos.
PERFIL EPIDEMIOLÓGICO DA SÍFILIS ADQUIRIDA EM UM MUNICÍPIO DO INTERIOR DO ESTADO DE RONDÔNIA
Authors: Guédes Rebeca Pereira , Eller Willian Todescatto , Paciencia Gabriel de Paula
Published: December 2024

Introdução: A sífilis é uma das doenças sexualmente transmissíveis mais comuns no mundo. Embora seja curável, há um aumento preocupante no número de casos dessa patologia em território nacional. Em Rondônia, a falta de pesquisas locais, aliada ao crescimento dos casos, justifica a necessidade deste estudo, que visa analisar a prevalência, características da população afetada e fatores de transmissão para contribuir na redução dos riscos associados. Objetivo: Delimitou-se como objetivo estabelecer o perfil epidemiológico da sífilis adquirida em um município do interior do estado de Rondônia, Vilhena. Metodologia: O método de pesquisa baseou-se em um estudo observacional, transversal, descritivo e retrospectivo, com abordagem quantitativa, desenvolvido a partir de dados obtidos dos registros de notificação através do banco de dados do Sistema de Informação de Agravos de Notificação (SINAN). Resultados: Ao todo, dos 643 casos notificados de 2018 a 2022, a maioria foi do sexo masculino, entre 20 a 29 anos, com escolaridade ignorada ou não preenchida e auto declarado pardo. Conclusões: Dessa forma, devido ao aumento do número de casos de sífilis em Vilhena, conclui-se a necessidade de ações de prevenção e rastreio da doença, principalmente em populações consideradas vulneráveis.
 
Keywords: Epidemiology. Treponemal Infections. Sexually Transmitted Diseases. Public Health. Treponema pallidum.
RETRATAMENTO DE FACETAS DIRETAS: RELATO DE CASO
Authors: Paulo Jonathas José de , Durão Márcia de Almeida , Ribeiro Laura Letícia Guerra , Silva Bruna Estefany Ferreira da
Published: December 2024

Introdução: A busca por um padrão estético imposto pela sociedade, e a insatisfação
com cor e forma dos elementos dentários, tem levado a um aumento da procura por
tratamentos estéticos. Com o avanço das técnicas e materiais restauradores, as resinas
compostas tem possibilitado mínimos desgastes e maior preservação a estrutura dentária, ademais a sua capacidade de mimetizar as características dos dentes naturais. Objetivo: Relatar por meio de um caso clínico a necessidade e a importância do retratamento de facetas diretas insatisfatórias restabelecendo a estética e função à
paciente, fundamentada no planejamento digital. Descrição do caso: Paciente do sexo feminino, 45 anos de idade buscou tratamento na Clínica Escola de Odontologia Uninassau por estar insatisfeita com as facetas de seus dentes anteriores superiores. Após fazer a análise clínica, radiográfica, fotográfica e do modelo 3D obtido após o escaneamento intraoral, foi definido e aprovado o planejamento. Iniciando com clareamento de consultório, após quinze dias, foi realizado a seleção das cores das resinas Vittra APS (FGM, Joinvile, Brasil), e visto a necessidade de utilizar a resina opacificadora, para mascarar o substrato escurecido. No relato em questão foi confeccionada uma guia palatina partir do modelo com enceramento digital para a construção da concha palatina. Conclusões: Conclui-se que o retratamento de facetas em resinas compostas é indicado para desarmonias no sorriso, devido à cor e forma, e o mesmo têm-se mostrado bastante eficiente para reestabelecer a função, saúde e estética, e consequentemente contribuir de forma positiva para a melhora da autoestima da paciente. Também é possível perceber que o planejamento digital possibilita a obtenção de excelentes resultados, bem como uma maior previsibilidade e praticidade para a realização de casos clínicos.
Palavras-Chave: Resina Composta; Facetas Dentárias; Estética Dental; Reabilitação.
PREVALÊNCIA DE FAMÍLIAS EM RISCO MÁXIMO E IMPACTOS NAS VISITAS DOMICILIARES EM CAICÓ-RIO GRANDE DO NORTE
Authors: Moura Inara da Silva de , Bonfada Diego , Rolim Ana Carine Arruda , Ribeiro Rafael Bezerra
Published: December 2024

Objetivo: Analisar a prevalência de famílias com risco máximo de vulnerabilidade através da aplicação da Escala de Risco Familiar de Coelho e Savassi e seus impactos nas visitas domiciliares realizadas pela equipe da Unidade Básica de Saúde da Família situada no município de Caicó-RN. Metodologia: Estudo descritivo, transversal, com abordagem quantitativa. A pesquisa envolveu 90 famílias adscritas pela Unidade de Saúde no período de junho a setembro de 2023. Após o processo de estratificação e sorteio aleatório houve a aplicação do Instrumento de coleta de dados Sociodemográficos e de saúde e aplicação da Escala de Risco Familiar. Os dados foram tabulados e processados no software IBM SPSS® Statistics 26.  Resultados: Encontrou-se alto percentual de famílias em risco máximo de vulnerabilidade familiar e este fator se associou com a presença da necessidade de atendimento familiar, deficiência física, idoso acima de 70 anos, diabetes mellitus, analfabetismo, uso de drogas na família, comorbidade, hipertensão arterial, desemprego, deficiência mental e reduzida visitas domiciliares por profissionais de ensino superior.  Conclusões: O estudo possibilitou, através da aplicação da Escala de Risco Familiar, verificar que há impactos na redução das visitas domiciliares realizadas por profissionais de ensino superior quando se tem uma área com prevalência de vulnerabilidade familiar. Permitiu, ainda, analisar quais sentinelas ou fatores de risco prevaleciam no grupo das famílias em risco máximo de vulnerabilidade.
COMPARATIVE ANALYSIS OF THE EPIDEMIOLOGICAL PROFILE OF SYPHILIS BETWEEN TWO MUNICIPALITIES IN SANTA CATARINA, STATE ENTIRE AND BRAZIL FROM 2014 TO 2022
Authors: Medero Rosemeri Inês Dams , Pellis Emilyn Marcilio , Lopes Catarina , Hotz Francinara
Published: December 2024

Introdução: A sífilis é uma Infecção Sexualmente Transmissível (IST) que afeta tanto homens como mulheres. Ao longo dos anos tem havido um aumento no número de casos no Brasil. Objetivo: descrever o perfil epidemiológico de sífilis de 2014 a 2022 em Jaraguá do Sul e Joinville, Santa Catarina. Metodologia: A coleta de dados foi feita através das bases de dados DATASUS no Sistema de Informação de Agravos de Notificação.  Resultados: A sífilis adquirida apresentou a maior incidência na população com uma tendência de queda de 2019 a 2021, sugerindo uma possível subnotificação devido à pandemia e mostrou que a maioria dos casos de sífilis adquirida ocorreu na faixa etária entre 20 e 39 anos, com ensino médio completo. No Brasil a prevalência da doença ocorreu na população parda e preta e em Santa Catarina na população de etnia branca. O sexo masculino foi responsável pela maioria dos casos. A população com baixa escolaridade apresentou maior prevalência de sífilis. Mulheres com baixa escolaridade apresentaram maior prevalência de sífilis durante a gravidez, com idade inferior a 39 anos, e com ensino fundamental e médio, com sífilis primária e latente. A maioria dos casos de sífilis congênita no Brasil e em SC não houve tratamento para o companheiro, mas realizou pré-natal. Conclusões: Tanto no Brasil como em Santa Catarina a sífilis permanece como um grave problema de saúde pública. Com esse estudo espera-se contribuir para melhor entendimento da epidemiologia de sífilis, especialmente no estado de Santa Catarina.
Palavras-Chave:  Sífilis. Infecções por Treponema; Infecções Sexualmente Transmissíveis; Treponema Pallidum.
Comportamento hidromêcanico de misturas de solos areno argilosos com fibras de polipropileno
Authors: Merville Ana Kelly Fernandes , Soares Anderson Borghetti
Published: December 2024

O uso de fibras de polipropileno como reforço de solos é aplicável quando o solo em seu estado natural não possui as propriedades geotécnicas necessárias para suportar as solicitações previstas em campo. As fibras podem trazer melhorias como o aumento da resistência ao cisalhamento e diminuição da compressibilidade do solo. Com relação à permeabilidade ocorre aumento no solo adicionado com fibras, esse efeito pode não representar um ponto negativo, desde que a permeabilidade da mistura seja adequada à aplicação em campo. Este trabalho tem como objetivo estudar o comportamento hidromecânico de um solo areno-argiloso, utilizado como material de cobertura de aterro sanitário do Estado do Ceará, com inserção de fibras de polipropileno, em diferentes teores e comprimentos de fibra e verificar a influência nos parâmetros geotécnicos do solo cobertura. Como parte da pesquisa, foram realizados ensaios laboratoriais de caracterização geotécnica e mineralógica. Foram utilizadas fibras de polipropileno de 6 e 12 mm de comprimento, nos teores gravimétricos de 0 a 1,25%. Os resultados indicaram ganhos de resistência com a adição de fibras até certo teor. A permeabilidade aumentou progressivamente com o aumento do teor de fibras, mas o compósito ainda pode ser utilizado como camada impermeabilizante na cobertura de aterros.
Cícero e o tratamento do corpo
Authors: Teixeira Matheus Roberto Breda
Published: December 2024

O objetivo deste trabalho é analisar a proposta de tratamento dado ao corpo presente na obra Discussões Tusculanas de Marco Túlio Cícero. Nessa obra, o autor organiza diversos elementos da cultura ocidental, a fim de apresentar uma sabedoria genuinamente latina, diferenciando-a dos gregos. Cícero direciona seus escritos aos acadêmicos Romanos, esse período também enfatiza Roma e seu o papel como transmissora da cultura grega. Ademais, são feitas menções a respeito da morte, do mal e da dor, e as perturbações que o homem encontra ao viver e se relacionar, além de considerar que essas circunstâncias não são capazes de abalar o sábio. Para a análise da obra que, em certo sentido, apresenta os tratamentos concebidos ao corpo do homem naquela época foi utilizada a história social. Nesse sentido, o ponto de partida foi o contexto no qual Marco Túlio Cícero esteve inserido, depois se abordou a respeito do tratamento do corpo tendo em vista o desenvolvimento da filosofia, ao analisar as Discussões Tusculanas, especialmente, o livro IV. Desse modo, compreende-se sobre o momento de transformações sociais na qual o Ocidente estava passando. Além disso, Cícero apresenta a ideia de que é preciso se preocupar tanto com o corpo quanto com o espírito para que essa formação do homem o faça superar as perturbações e enfermidades (do espírito e do corpo) que os acometem, e, assim, viver da melhor maneira possível.
Um Ebó para descarregar Foucault da Colonialidade
Authors: Santos Wheber Mendes dos
Published: December 2024

Este texto analisa a obra de Michel Foucault, especialmente suas teses sobre biopoder e racismo de Estado, destacando uma lacuna crítica na sua análise: a omissão do impacto do colonialismo europeu. Apesar das contribuições significativas de Foucault para a compreensão das dinâmicas de poder e controle social, suas genealogias, centradas na Europa, negligenciam o papel do colonialismo na formação das práticas de vigilância e controle.A crítica de Stoler (2020) é central, apontando que a análise de Foucault, ao focar excessivamente nos corpos brancos europeus, desconsidera a influência do Oriente e das colônias, resultando em uma narrativa eurocêntrica. Stoler argumenta que essa limitação reduz a capacidade da obra de Foucault de capturar as dinâmicas raciais e coloniais que moldaram o biopoder.
As manifestações de ginástica no contexto paranaense
Authors: Matias Fernanda do Nascimento , Silva Marcelo Moraes e , Moro Vera Luiza
Published: December 2024

O presente artigo analisou as diferentes formas de educação do corpo existente entre as manifestações de ginástica que circularam na imprensa paranaense, no período compreendido entre os anos de 1854 e 1920. A delimitação temporal inicial se deu pelo fato de que foi neste ano que foi possível localizar a primeira notícia referente à ginástica em um jornal paranaense, especificamente relacionada à manifestação circense. Já o ano de 1920 se torna a delimitação final devido à diminuição das notícias relativas à ginástica circense, associativa e militar e ao aumento das notícias relacionadas à ginástica escolar, em função das reformas empreendidas na instrução pública pelo governo do Estado do Paraná. A pesquisa baseou-se em fontes jornalísticas, encontradas nos seguintes periódicos paranaenses: Dezenove de Dezembro, A República e o Diário da Tarde. A título de conclusão o artigo aponta que as diferentes manifestações de ginástica acionaram retóricas relativas aos processos de educação do corpo que apresentam objetivos diversos.
Comparing the effectiveness of different extenders for preserving rooster semen
Authors: Paulo Ferreira Rufino João , Lorena Monteiro da Silva Marcia , Alberto de Lima Chave Francisco , Antonio de Freitas Mendonça Marco , Lima da Silva Junior Joel , de Queiroz da Costa Neto Pedro
Published: December 2024

The present study aimed to evaluate the effectiveness of experimental extenders based on coconut oil (COC) and copaiba oil (COP) compared to extenders based on whole powdered milk (WPM) and powdered egg (PWE) in preserving rooster semen for up to 15 minutes at room temperature. The experimental design employed a factorial layout (4x4), encompassing four different extenders (extenders based on COC, COP, WPM or PWE), each applied across four distinct timeframes after semen collection (1, 5, 10, and 15 minutes). All evaluated variables displayed a significant impact (p<0.05). This investigation revealed that the extender containing COC led to a noteworthy reduction in the pH of the sperm samples, approximately 1.31 in semen pH, resulting in a more acidic environment, while COP caused a reduction of 0.25 in semen pH. This alteration created an unfavorable condition for the sperm, which inherently favors a more alkaline pH setting, subsequently compromising their quality. In contrast, extenders based on WPM and PWE yielded superior results in sperm quality and viability at room temperature, providing lower reductions (less than 0.25) in pH and, consequently, a better environment for the sperm. Conclusively, extenders based on WPM and PWE exhibited superior capability in preserving rooster sperm at room temperature for up to 15 minutes when compared to extenders formulated with COP or COC. These extenders demonstrated remarkable outcomes in terms of sperm quality and viability.
Metabolic profile and adipokines in cardio-reno metabolic syndrome stages 1 and 2 in young people
Authors: Martynov S. A. , Chulkov V. S. , Gavrilova E. S. , Ektova N. A. , Chulkov Vl. S.
Published: December 2024

Objective: to compare metabolic parameters and adipokine levels in cardiorenal metabolic syndrome (CRMS) stages 1 and 2 in young individuals aged 25–44 years.

Materials and methods: a cross-sectional study based on a prospective cohort study included 120 people aged 25–44 years: group 1 (controls) — young individuals without cardiometabolic risk factors, stage 0 (n=40), group 2 — young individuals with CMS stage 1 (n=40), group 3 — young individuals with CMS stage 2 (n=40).

Results: the most significant differences in the groups with stage 1 and 2 CRMS were observed for HOMA-IR index, glycosylated hemoglobin, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, triglycerides, and uric acid in comparison with the control group. The most common cardiometabolic risk factors in the group with stage 2 CRMS were overweight/obesity, hyperlipidemia, hyperglycemia, arterial hypertension, hyperuricemia, and a burdened heredity for cardiovascular diseases. The serum concentration of leptin was highest in women with stage 1 and 2 CRMS, whereas the serum concentration of adiponectin was lower in all individuals with stage 1 and 2 CRMS than in the control group, with no gender differences.

Conclusion: modern approaches to the stages of CRMS contribute to the integration of cardiovascular diseases and metabolic disorders as components of a single pathophysiological process. They also allow a comprehensive and quantitative assessment of the likelihood of cardiovascular disease and type 2 diabetes mellitus. Measuring serum cytokine levels can serve as an effective tool for assessing overall cardiometabolic risk and predicting the development of cardiovascular diseases and type 2 diabetes mellitus.
Machine Learning Driven by Magnetic Resonance Imaging for the Classification of Alzheimer Disease Progression: Systematic Review and Meta-Analysis
Authors: Battineni Gopi , Chintalapudi Nalini , Amenta Francesco
Published: December 2024

Background

To diagnose Alzheimer disease (AD), individuals are classified according to the severity of their cognitive impairment. There are currently no specific causes or conditions for this disease.

Objective

The purpose of this systematic review and meta-analysis was to assess AD prevalence across different stages using machine learning (ML) approaches comprehensively.

Methods

The selection of papers was conducted in 3 phases, as per PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 guidelines: identification, screening, and final inclusion. The final analysis included 24 papers that met the criteria. The selection of ML approaches for AD diagnosis was rigorously based on their relevance to the investigation. The prevalence of patients with AD at 2, 3, 4, and 6 stages was illustrated through the use of forest plots.

Results

The prevalence rate for both cognitively normal (CN) and AD across 6 studies was 49.28% (95% CI 46.12%-52.45%; P=.32). The prevalence estimate for the 3 stages of cognitive impairment (CN, mild cognitive impairment, and AD) is 29.75% (95% CI 25.11%-34.84%, P<.001). Among 5 studies with 14,839 participants, the analysis of 4 stages (nondemented, moderately demented, mildly demented, and AD) found an overall prevalence of 13.13% (95% CI 3.75%-36.66%; P<.001). In addition, 4 studies involving 3819 participants estimated the prevalence of 6 stages (CN, significant memory concern, early mild cognitive impairment, mild cognitive impairment, late mild cognitive impairment, and AD), yielding a prevalence of 23.75% (95% CI 12.22%-41.12%; P<.001).

Conclusions

The significant heterogeneity observed across studies reveals that demographic and setting characteristics are responsible for the impact on AD prevalence estimates. This study shows how ML approaches can be used to describe AD prevalence across different stages, which provides valuable insights for future research.
Reassessing AI in Medicine: Exploring the Capabilities of AI in Academic Abstract Synthesis (Preprint)
Authors: Wang Zijian , Zhou Chunyang
Published: December 2024

UNSTRUCTURED
Authors’ Reply: Reassessing AI in Medicine: Exploring the Capabilities of AI in Academic Abstract Synthesis (Preprint)
Authors: Hsu Tien-Wei , Liang Chih-Sung
Published: December 2024

UNSTRUCTURED
Autonomous Sensory Meridian Response (ASMR) Videos Are Popular Among Young Adults but Likely Not Effective as a Stress-Relief Treatment Option (Preprint)
Authors: Lee Hyeeun , Youk Sungbin , Lee Yoon Esther , Malik Musa , Weber René
Published: December 2024

BACKGROUND

The potential of using online media content as an efficient and affordable alternative to mental health care depends on the ability to identify and select content that offers therapeutic benefits. Autonomous Sensory Meridian Response (ASMR) videos, known for inducing a tingling sensation through repetitive behaviors and enhanced audio features, have gained attention largely due to self-reported evidence suggesting their effectiveness in reducing stress.

OBJECTIVE

This study aimed to assess physiological evidence from the central nervous system (CNS) using functional magnetic resonance imaging to validate the stress-relief effects of ASMR videos within an uninterrupted, naturalistic paradigm.

METHODS

This study investigated the neurological responses of 72 young adults to popular ASMR videos, focusing on established CNS indicators of stress, and examines how neural synchrony in response to these videos varies with stress levels.

RESULTS

Despite the use of an advanced analytic pipeline suitable for naturalistic paradigms—incorporating inter-subject correlation (ISC) and inter-subject representational similarity analysis (IS-RSA)—this study found no substantial neurological evidence to support ASMR's stress-relief effects across carefully selected video stimuli. Among the 16 stress-related regions of interest, significant neural synchrony was observed solely in the left insula (Brodmann area 13) with ISC = 0.013, p < .05, after false-discovery rate correction. Furthermore, the degree of neural synchronization was not moderated by individuals’ stress levels.

CONCLUSIONS

Despite ensuring ecological validity and utilizing a state-of-the-art analytic pipeline suited for naturalistic paradigms, this study did not provide neurological evidence supporting the stress-relief effects of ASMR videos. Consequently, these results challenge the therapeutic claims made by researchers and media outlets regarding ASMR's effectiveness as a stress-relief tool.
Evaluation of Large Language Models in Medical Record Error Detection: A Comparative Analysis (Preprint)
Authors: Wang Ben , Deng Yiwen , Jiang Haiyue
Published: December 2024

BACKGROUND

Medical records are essential for accurate diagnosis and treatment, but high workloads often lead to errors, which can compromise patient safety and increase legal risks. Traditional error detection algorithms are limited to basic spelling issues and lack the capability to identify complex, knowledge-based errors.

OBJECTIVE

This study evaluates whether advanced large language models(LLMs) in artificial intelligence can effectively detect and correct such complex errors in medical records.

METHODS

This cross-sectional study utilized 50 simulated medical records, each containing various types of errors. Four LLMs (GPT-4o, Doubao-3-Haiku, Doubao-Lite-4k, Gemini-1.5-Flash) were tested with standardized prompts, and two physicians independently screened and evaluated the performance of different LLMs in error detection. A statistical analysis was performed to evaluate the detection rates of each error type, as well as the time and financial resources expended by each group.

RESULTS

GPT-4's overall detection rate for medical record errors is 61.30%.The detection rate of GPT-4o group was approximately the same as that of physician1 group and physician2 group, with no statistically significant difference (p=0.103; p=0.199).In terms of detection rates for different error types, GPT-4o achieved a 58.00% detection rate for diagnostic errors, 52.00% for spelling errors, and 74.00% for inconsistencies, comparable to the performance of the attending physicians. However, GPT-4o consumed significantly fewer resources in terms of time and cost, amounting to only 1% of the cost incurred by human physicians.

CONCLUSIONS

GPT-4o's performance in detecting errors in medical records is comparable to that of attending physicians, with a clear cost advantage in resource consumption. It holds promise for reducing physicians' workload and minimizing medical risks.

CLINICALTRIAL

No research registration is required for this study
Effect of Implementing Preventive Nursing Measures on Tracheoesophageal Fistula among Patients Undergoing Mechanical Ventilation (Preprint)
Authors: Al-Metyazidy Heba
Published: December 2024

BACKGROUND

Abstract: Tracheoesophageal fistula represents a serious and often life-threatening complication in mechanically ventilated patients, characterized by an abnormal connection between the trachea and esophagus. Proper caring of patients on mechanical ventilation to minimize rate of TOF as, monitoring respiratory status and placement of endotracheal or tracheostomy tube, continuous monitoring for endotracheal and tracheostomy cuff pressure.

OBJECTIVE

The aim of the study was to evaluate the effect of implementing preventive nursing measures on Tracheoesophageal fistula among patients’ undergoing mechanical ventilation

METHODS

Methods: A total of 60 mechanically ventilated patients were randomly allocated into two equal groups of 30 each. Data were collected using two tools; tool I for assessing mechanically ventilated patients and tool II for clinical evaluation of TOF.

RESULTS

Results: Post-intervention, it was observed that the incidence of TOF was significantly lower in the study group (10.0%) compared to the control group (60.0%). This indicates a substantial reduction in TOF incidence due to the preventive nursing measures implemented.

CONCLUSIONS

Conclusion: The study demonstrates that preventive nursing measures are effective significantly in reducing the incidence of TOF among mechanically ventilated patients. These findings underscore the importance of implementing targeted nursing interventions to enhance patient safety and reduce complications associated with mechanical ventilation.

CLINICALTRIAL

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Empowered Patients in the Age of Artificial Intelligence (Preprint)
Authors: Cotliar Dustin , Schoening Mary Beth
Published: December 2024

UNSTRUCTURED

This paper examines how artificial intelligence (AI) tools can empower patients to better understand and engage with their healthcare information, using a detailed case study of a patient-caregiver experience navigating a complex neurological diagnosis.

Through analysis of real-world implementation, we identify three key areas where AI demonstrates particular value: medical document interpretation, treatment research, and healthcare system navigation. The paper provides practical frameworks for utilizing AI tools in each domain, with specific emphasis on prompt engineering and verification protocols. We present evidence that proper AI implementation can compress the timeline between receiving medical information and taking informed action, while enhancing rather than replacing the patient-provider relationship.

Our findings indicate that AI-assisted preparation leads to more productive medical consultations by enabling patients to arrive with well-researched questions and better understanding of their conditions. The paper concludes with practical recommendations for leveraging AI tools effectively while preserving the essential human elements of healthcare delivery, ultimately demonstrating how AI can transform the patient experience from passive confusion to active engagement.
Exploring Nonresponse to Botulinum Toxin in Aesthetics: A Review of Key Trigger Factors and Effective Management Strategies (Preprint)
Authors: Kroumpouzos- George , Silikovich Fernando
Published: December 2024

BACKGROUND

Nonresponse to botulinum toxin (BoNT) type A (BoNT-A) has been reported in medical and aesthetic applications. Secondary nonresponse (SNR) occurs when BoNT-A is initially successful before failure commences at a later point. Most reported cases involve SNR in aesthetics. Several aspects of this complication remain elusive or controversial.

OBJECTIVE

We aimed to address unanswered questions regarding the prevalence and etiology of SNR. Additionally, we investigated the immunogenicity of BoNT-A formulations, mainly focusing on the development of neutralizing antibodies (NAbs) that hinder the toxin’s pharmacologic effects. Furthermore, we sought to examine the management strategies for SNR.

METHODS

PubMed and Google Scholar databases were searched from inception for articles on nonresponse to BoNT-A therapy. Articles were evaluated regarding their contribution to the field. Expert opinions and panel recommendations regarding management and data gaps were also included in the review.

RESULTS

There are limited data on SNR prevalence in aesthetic applications compared to therapeutic uses. Trigger factors of SNR relate to the handling of BoNT-A, incorrect injection practices, and impurities present in the formulation, such as clostridial complexing proteins that may increase immunogenicity. Other contributing factors include infection, patient characteristics, and treatment parameters that encompass an increased frequency of BoNT-A injections (i.e., <3 months apart), higher cumulative dosages, elevated treatment dosage, and booster injections (re-treatment within 3 weeks of the initial injection). NAbs developed with first-generation formulations, like onabotulinumtoxinA and abobotulinumtoxinA, that contain clostridial proteins, but not with second-generation BoNT-As like incobotulinumtoxinA and daxibotulinumtoxinA that lack such proteins. For patients who developed SNR after using first-generation BoNT-A for aesthetic purposes, switching to incoBoNT-A therapy did not result in the development of immune responses. Switching to a protein-free BoNT-A formulation, such as incobotulinumtoxinA, once SNR develops has been advocated. To effectively manage SNR, it is crucial to minimize the identified trigger factors.

CONCLUSIONS

Nonresponse to BoNT-A is gaining importance in aesthetic treatments. When choosing a BoNT-A formulation, considering the potential for immunogenicity is essential. Preventing SNR is crucial, given the lack of solid data on effective treatments.
Long-term usage of the gamified breathing training Breeze and its effect on momentary relaxation in people with cancer: A cohort study (Preprint)
Authors: Bischof Anja Yvonne , Budig Tobias , Schläpfer Sonja , Lukic Yanick Xavier , Schneider Fabian , Santhanam Prabhakaran , Barth Jürgen , Witt Claudia M. , Kowatsch Tobias
Published: December 2024

BACKGROUND

People with cancer often experience stress. Digital health interventions (DHIs) can help individuals increase momentary relaxation. Breeze is a gamified breathing training that can be embedded into DHIs. Its effectiveness in controlled cross-sectional studies was shown. However, adherence to Breeze and its effect on momentary relaxation in longitudinal interventional studies has yet to be investigated.

OBJECTIVE

This work aims to assess the use of Breeze and its effect on momentary relaxation in people with cancer.

METHODS

Breeze was one of seven relaxation techniques included in the CanRelax 2.0 app, designed specifically for individuals diagnosed with cancer. Participants could select any of the seven techniques to promote momentary relaxation. The intervention was designed to last 10 weeks. However, participants were allowed to use the CanRelax 2.0 app after that period. Participants were adults diagnosed with cancer in the last five years recruited across Switzerland, Germany, and Austria. Momentary relaxation was measured pre- and post-exercise using an 11-point visual analog scale, while Breeze was assessed through objective usage metrics. Statistical analyses included linear mixed-effects models and effect size calculations.

RESULTS

Out of 352 participants, 118 (33.5%) used Breeze at least once. The 118 participants engaged in 754 breathing sessions with Breeze. Momentary relaxation was assessed and calculated for 249 (33.0%) Breeze sessions. The use of Breeze remained stable even after the formal intervention period. Participants also followed the pre-defined breathing rates of Breeze. On average, a small effect on momentary relaxation was observed for 2-minute breathing sessions (d = .20), while a large effect (d = .74) resulted from breathing sessions >=4 minutes.

CONCLUSIONS

This study shows the potential of Breeze to reduce acute stress in individuals with a chronic condition, such as cancer. By combining gamification with evidence-based breathing techniques, Breeze fosters sustained user engagement and momentary relaxation. Future research aims to assess the impact of Breeze on other populations and chronic conditions.

CLINICALTRIAL

German Clinical Trials Register DRKS00027546; registered on 23 February 2022
Continuous Rural High School Educational Outreach and Lasting Impact on Healthcare Career Attitudes: A Pilot Study (Preprint)
Authors: Bolen Rebecca , Flesch Meagan , Dennis Jerrica , Shouse Logan , Payton Mark , Ross David
Published: December 2024

BACKGROUND

Rural communities often face significant challenges in attracting and retaining healthcare professionals. By encouraging students from these communities to consider healthcare careers, we increase the likelihood that they will return to their hometowns to practice medicine, improving access. A previous study conducted in 2020 analyzed the effects of a single educational workshop at a rural high school in New Hampshire. The results suggested that students had a better understanding of the medical field.

OBJECTIVE

This study aims to analyze how continuous educational outreach initiatives affect rural high school students’ attitudes toward a healthcare career. By providing recurrent questionnaires alongside a presentation series, we can analyze if our impact is being met.

METHODS

Data collection took place at a rural high school over four sessions and spaced approximately one month apart. During each session, a 20-minute presentation was given on various healthcare topics. Presentations outlined frequently seen conditions, medical personnel involved in the care of those conditions, daily roles, education path of each of those medical personnel, and clinical case presentations. Immediately before and after each presentation, participants completed a voluntary survey assessing their interest in healthcare through Likert Scale questions.

RESULTS

Likert scale questions from before and after the presentation series indicated a significant increase in interest in a career in healthcare and the likelihood of going into a career in healthcare (p <0.0329, p <0.0437).

CONCLUSIONS

This data shows that through continuous educational outreach, we have increased interest and heightened likelihood of pursuing a healthcare career. This supports future endeavors to bring healthcare series to rural high schools, ultimately in efforts to increase the rural healthcare workforce in the future.
Generational Conflict and Identity Negotiation in Jhumpa Lahiri’s The Namesake
Authors: Alzuhairi Ali
Published: December 2024

This paper explores the generational conflict within Jhumpa Lahiri’s The Namesake (2003), focusing on the complexities of identity formation in the context of immigrant families. The novel intricately depicts the tension between Ashoke and Ashima, first-generation Bengali immigrants, and their son Gogol, a second-generation American caught between two worlds. Through a comparative lens, this study examines how generational conflict in The Namesake serves as a metaphor for the broader struggles of assimilation, cultural preservation, and personal identity within diasporic communities. By analyzing the significance of Gogol’s name and its evolving role throughout the narrative, this paper argues that Lahiri uses generational conflict as a powerful tool to address the challenges of belonging and self-definition faced by immigrants and their children. Drawing from postcolonial theory and diaspora studies, the paper also engages with existing scholarship on immigrant literature, offering new insights into how Lahiri’s portrayal of family dynamics speaks to the ongoing negotiations of cultural identity in a globalized world. Ultimately, this study reflects on how the generational divide in The Namesake not only shapes individual identity but also offers a broader commentary on the immigrant experience, suggesting that reconciliation between cultures is not simply an act of coexistence, but a continuous process of negotiation and transformation.
La teoría pura del derecho no es una teoría del derecho
Authors: Cofré-Lagos Juan Omar
Published: December 2024

Se sostiene que la Teoría pura del derecho de Kelsen no es una teoría del derecho, sino una epistemología jurídica que pretende legislar (en el sentido kantiano) sobre las condiciones lógicas y semánticas que debe reunir una verdadera ciencia jurídica o ciencia del derecho. Se trata de un intento de Kelsen de hacer de la jurisprudencia una ciencia estricta. Influyen notablemente en esta pretensión kelseniana las ideas centrales del Círculo de Viena que él conoció, primero, como Profesor de la Facultad de Derecho de la Universidad de Viena y, después de dejar esa ciudad, como académico de otras universidades europeas y norteamericanas.