bluuebunny/crossref_metadata_2025 huggingface dataset:
Presumed gabapentin-induced myoclonus in two cats
Authors: Buckley Caroline , Griffin Croix , Anderson Heather , Moore Sarah A
Published: November 2024

Case series summary

This case report describes the history and presentation of two cats with presumed gabapentin-induced myoclonus. Although this phenomenon is well documented in people, there are no previous reports in cats. Both cats in the current report had International Renal Interest Society (IRIS) stage 2 chronic kidney disease, a history of seizures (one generalized, one focal), and received gabapentin before veterinary hospital visits to alleviate anxiety (doses in the range of 11.8–16.4 mg/kg). While in the hospital, both cats were noted to have intermittent short jerks of the head that were different from the seizure activity previously noted by their owners at home. These cases appear to be the first published reports of this potential adverse effect of gabapentin in cats and risk factors in the present cases mirror those described in people.

Relevance and novel information

Clinicians should be aware of the potential for this phenomenon in cats receiving recommended doses of gabapentin, and future studies should focus on the role of chronic kidney disease and other neurologic conditions as risk factors for development of this condition.
Public Servants’ Accountability Pressure When Facing the Pandemic: The Moderating Role of Accountability Awareness
Authors: Ye Yong , Lin Yulan , Zhang Xiaojun , Liu Yifen , Han Ziqiang
Published: November 2024

Public servants have faced substantial accountability pressure during the public emergency. It was evident during the pandemic. However, the factors that influence accountability pressure remain to be examined. In this study, we attempt to demonstrate that the Robbins pressure theory provides a useful conceptual framework on how factors affect accountability pressure, and a regression method using primary survey data was applied to investigate how external pressure, the public servants’ capacity, accountability awareness, and communication between superiors and subordinates influence accountability pressure in the fact of a pandemic emergency. The findings show that external pressure had a positive impact on accountability pressure, the public servants’ capacity and communication between superiors and subordinates had a negative impact on accountability pressure, and accountability awareness played a negative moderating role in the effect of external pressure on accountability pressure. This study contributes toward the limited research base, and offers the suggestion that accountability pressure would be alleviated through optimized training and learning.
The Contribution of Family Businessesto Economic Growth: A Bibliometric Review
Authors: Nyabakora Wakara Ibrahimu
Published: November 2024

The aim of this study is to review the body of literature on the contribution of family businesses to economic growth. The Scopus database was used to conduct the bibliometric analysis of the topic under discussion. The sample procedure was completed using PRISMA. VOSviewer software was used to go through 598 publications. This way, the network’s growth, the most active contributing agents, the intellectual structure’s background, the most popular topic, and the research gap for further study were all exposed. We noticed that the Scopus database began to include publications of family business research in 1998. The terms “family businesses,”“entrepreneurship,” sustainable development, and “economic growth” have been used often. The density map displays recent themes such as family businesses, entrepreneurship, sustainable development, and economic growth. Also, it was found that the Sustainability (Switzerland) journal had the most articles overall. However, the Journal of Financial Economics was the top source, receiving more citations overall. Furthermore, the five top-ranked contributing nations in family businesses are the USA, the UK, China, Spain, and Italy. Therefore, research gaps have been presented. Researchers will learn from the findings regarding the implications for the past, present, and future. There are several restrictions on this study pertinent to the bibliometric methods’ shortcomings. One of the limitations was that the synonyms used in the search query were not exhaustive, so it excluded other documents that could be used in this research.
Influences on Student Outcomes at Small Thai Private Universities
Authors: Scott Timothy , Guan Wenyu
Published: November 2024

This research rigorously examines the determinants shaping undergraduate student outcomes within two small private Thai universities, specifically Asia-Pacific International University and Krirk University. The emphasis on small private universities is deliberate, given their heightened vulnerability to institutional instability. This susceptibility primarily stems from their intrinsic characteristics: limited enrollment capacities, significant dependence on sustained student persistence, and tuition revenue for operational continuity. Utilizing a quantitative approach, the study surveyed 371 students and analyzed the data using a mediated structural equation model (SEM). This model delineates relationships between key independent variables—academic integration, instruction, emotional distress, institutional support, satisfaction, and social integration—and student outcomes, namely student persistence, voluntary withdrawal, and institutional transfer. Academic integration directly affected satisfaction (β = .214) and indirectly influenced persistence (β = .138). Emotional distress significantly affected institutional transfer (β = .454) and voluntary withdrawal (β = .51). Furthermore, a substantial relationship was observed between instruction and academic integration, with a β value of .849. These findings offer invaluable insights into the multifaceted dynamics potentially influencing student experiences and decisions in the context of small private Thai universities. Institutions seeking improved retention rates should note the importance of balancing academic and social elements in an integrated environment.
Clinical Response to Osimertinib in a Non-Small-Cell Lung Cancer Patient With EGFR L833V/H835L Mutations: A Case Report
Authors: Al-Nusair Jowan , Bodiwala Reesha , Nwanwene Kemnasom , Abdallah Mahmoud , Alshal Mohamed , Pacioles Toni
Published: November 2024

Lung cancer, a leading cause of cancer mortality, often involves epidermal growth factor receptor (EGFR) mutations, common in 17% of Caucasian and 40% of Asian non-small-cell lung cancer (NSCLC) patients. While the exon 19 deletion and L858R mutation are prevalent, rare variants like L833V/H835L are less understood. This case reports a 75-year-old female with NSCLC harboring L833V/H835L mutations. Initial imaging showed a right upper lobe mass and nodularity in the left upper lobe. Biopsy confirmed adenocarcinoma, and genomic analysis identified EGFR L833V/H835L mutations. Based on these findings, the patient was treated with osimertinib 160 mg daily, reduced to 80 mg due to side effects. After 3 months, positron emission tomography (PET) scans revealed significant tumor reduction, and brain metastasis remained stable. This case demonstrates the efficacy of osimertinib for rare EGFR mutations, aligning with literature suggesting its potential for managing such variants. Although large-scale trials are impractical due to the rarity of these mutations, this report adds valuable evidence supporting osimertinib’s use, highlighting the need for comprehensive genomic profiling in NSCLC.
Chandelier retroillumination-assisted cataract surgery in two cases of congenital aniridia with severe aniridia-associated keratopathy: case series
Authors: Hu Joseph , Hu Chao-Chien
Published: November 2024

Congenital aniridia is a rare genetic eye disorder often associated with PAX6 gene mutations, leading to complex ocular manifestations, including aniridia-associated keratopathy (AAK) and cataracts. The surgical management of cataracts in these patients is particularly challenging due to severe corneal opacities, which obscure key surgical steps such as capsulorhexis and phacoemulsification. This report presents two cases of congenital aniridia with severe AAK, in which chandelier retroillumination-assisted cataract surgery was employed. This technique, typically used in vitreous surgery, provided enhanced visualization of the lens through posterior segment illumination, facilitating successful cataract extraction and intraocular lens implantation. Both patients showed significant postoperative improvement in visual acuity. These cases demonstrate the feasibility and effectiveness of chandelier retroillumination-assisted cataract surgery in patients with congenital aniridia complicated by severe corneal opacity.
Cortical Vision Impairment (CVI)-informed assessment and treatment of challenging behavior in a child with SCN2A-related disorder
Authors: Thomas Benjamin R. , Ludwig Natasha N. , Pelletier Danielle , Bauer Melanie , Hommer Rebecca , Smith-Hicks Constance , O’Connor Julia T.
Published: November 2024

This report presents results of parent-implemented behavioral treatments for a child with cortical visual impairment (CVI), intellectual disability (ID), epilepsy, and autism spectrum disorder (ASD) associated with a pathogenic variant in the SCN2A gene (i.e., SCN2A-Related Disorder). Treatment evaluations were informed by combined results of functional behavior assessment (FBA) and functional vision assessment (FVA) which yielded CVI-related accommodations. The treatment of escape-maintained challenging behavior involved the evaluation of behavioral prompting strategies in accordance with CVI-related accommodations, extinction (EXT), and differential reinforcement modifications. The treatment for behavior problems maintained by access to food (tangible-edible) included functional communication training (FCT), EXT, and schedule thinning with schedule-correlated visual signals. Overall, integrating child-specific CVI-related accommodations was essential for developing effective behavioral interventions for this child. FVAs are accessible and practical for uptake by behavior analysts in vision-informed assessment and treatment of challenging behavior.
Adolescents’ involvement in mental health treatment and service design: a systematic review
Authors: Viksveen Petter , Cardenas Nicole Elizabeth , Berg Siv Hilde , Salamonsen Anita , Game Julia Rose , Bjønness Stig
Published: November 2024

Background

Adolescents’ involvement in their mental healthcare is considered a fundamental human right. However, there is a lack of consensus regarding the extent and nature of user involvement and limited research on user involvement in adolescent mental healthcare has previously been identified. Given the evolving focus on this area, this study explores the experiences with, the effectiveness of, and safety issues related to adolescents’ user involvement in mental healthcare.

Method

We conducted a systematic review, updating our original review with current research evidence relating to adolescents’ involvement in mental healthcare at individual and organizational levels. Searches across six databases, screening of reference lists, and suggestions from experts within the field helped to identify 5,527 records, of which 251 full text articles were screened. Established guidelines were used for data extraction, critical appraisal, and reporting of results.

Results

Collectively, the literature searches resulted in 36 eligible studies, of which 28 provided qualitative data and eight provided quantitative data. The quantitative studies identified the importance of personal help and online tools to support adolescents’ involvement in their mental healthcare. A few qualitative studies suggested shared decision-making is associated with improved self-reported mental health and treatment satisfaction. No studies focused on safety issues. A thematic synthesis of qualitative studies yielded four themes at the individual level and two themes at the organizational level. The findings highlight the growing recognition of adolescents' right to be involved and their capacity to take part in decision-making, emphasizing shared decision-making, two-way communication, and trust as key components of a collaborative relationship fundamental to user involvement. Further facilitators for user involvement at both individual and organizational levels are described.

Conclusion

The significance of user involvement in adolescent mental healthcare is underscored by a sense of increased empowerment and services tailored to meet adolescents’ needs. The evidence gathered from qualitative studies suggests involving adolescents in their treatment contributed to greater motivation for treatment, higher attendance rates, and treatment continuation. User involvement should emphasize adolescents’ preferences and a collaborative relationship that incorporates shared decision-making. Further implications for future practice and research are discussed.
Physical activity and mental health: a systematic review and best-evidence synthesis of mediation and moderation studies
Authors: White Rhiannon L. , Vella Stewart , Biddle Stuart , Sutcliffe Jordan , Guagliano Justin M. , Uddin Riaz , Burgin Alice , Apostolopoulos Maria , Nguyen Tatiana , Young Carmen , Taylor Nicole , Lilley Samantha , Teychenne Megan
Published: November 2024

Background

While evidence consistently demonstrates that physical activity is beneficial to mental health, it remains relatively unknown how physical activity benefits mental health, and which factors influence the effect of physical activity on mental health. This understanding could vastly increase our capacity to design, recommend, and prescribe physical activity in more optimal ways. The purpose of this study was to systematically review and synthesise evidence of all mediators and moderators of the relationship between physical activity and mental health.

Methods

Systematic searches of four databases (i.e., Scopus, PsycINFO, PubMed, and SPORTDiscus) identified 11,633 initial studies. Empirical studies that quantitatively assessed physical activity, or conducted a physical activity intervention, measured a mental health outcome, and tested one or more mediator or moderator of the relationship between physical activity and mental health were included. A total of 247 met the inclusion criteria; 173 studies examined mediation and 82 examined moderation.

Results

Results of the best-evidence synthesis revealed strong evidence for 12 mediators including affect, mental health and wellbeing, self-esteem, self-efficacy, physical self-worth, body image satisfaction, resilience, social support, social connection, physical health, pain, and fatigue. Moderate evidence was identified for a further 15 mediators and eight moderators.

Conclusions

Findings should inform the design of future physical activity interventions to ensure optimal effects on mental health related outcomes. Additionally, if health professionals were to take these mediators and moderators into consideration when prescribing or recommending physical activity, physical activity would likely have a greater impact on population mental health.
Right ventricular volume overload reboots cardiomyocyte proliferation via immune responses
Authors: Zhou Chunxia , Hu Yuqing , Dong Zhuoya , Wang Zheng , Zheng Sixie , Li Debao , Xiao Yingying , Chen Dian , Chen Hao , Sun Sijuan , Ye Lincai , Zhang Haibo
Published: November 2024

Background

Right ventricular volume overload (RVVO) is one of the most important hemodynamic characteristics in children with congenital heart disease (CHD) and heart failure, and cardiomyocyte (CM) proliferation is one of the most vital factors for improving cardiac performance. However, whether and how RVVO reboots CM proliferation remains elusive.

Methods and results

We first created a neonatal RVVO mouse model via abdominal aorta and inferior vena cava-fistula microsurgery at postnatal day 7 (P7), the edge of CM proliferation window. We subsequently performed bulk RNA-seq, single cell RNA-seq/flow cytometry, and immunofluorescence staining on the right ventricles (RV) of RVVO mice at P14/P21, defined as prepubertal stage, revealing that RVVO temporarily reboots prepubertal CM proliferation via immune responses.

Conclusions

In considering the importance of RVVO and CM proliferation, this study may bring an opportunity to create a novel paradigm to treat pediatric CHDs or heart failure.

Graphical Abstract
Population genomics of a thermophilic cyanobacterium revealed divergence at subspecies level and possible adaptation genes
Authors: Chang Hsin-Ying , Yen Hsi-Ching , Chu Hsiu-An , Kuo Chih-Horng
Published: November 2024

Background

Cyanobacteria are diverse phototrophic microbes with ecological importance and potential for biotechnology applications. One species of thermophilic cyanobacteria, Thermosynechococcus taiwanensis, has been studied for biomass pyrolysis, estrogen degradation, and the production of bioethanol, monosaccharide, and phycocyanin. To better understand the diversity and evolution of this species, we sampled across different regions in Taiwan for strain isolation and genomic analysis.

Results

A total of 27 novel strains were isolated from nine of the 12 hot springs sampled and subjected to whole genome sequencing. Including strains studied previously, our genomic analyses encompassed 32 strains from 11 hot springs. Genome sizes among these strains ranged from 2.64 to 2.70 Mb, with an average of 2.66 Mb. Annotation revealed between 2465 and 2576 protein-coding genes per genome, averaging 2537 genes. Core-genome phylogeny, gene flow estimates, and overall gene content divergence consistently supported the within-species divergence into two major populations. While isolation by distance partially explained the within-population divergence, the factors driving divergence between populations remain unclear. Nevertheless, this species likely has a closed pan-genome comprising approximately 3030 genes, with our sampling providing sufficient coverage of its genomic diversity. To investigate the divergence and potential adaptations, we identified genomic regions with significantly lower nucleotide diversity, indicating loci that may have undergone selective sweeps within each population. We identified 149 and 289 genes within these regions in populations A and B, respectively. Only 16 genes were common to both populations, suggesting that selective sweeps primarily targeted different genes in the two populations. Key genes related to functions such as photosynthesis, motility, and ion transport were highlighted.

Conclusions

This work provides a population genomics perspective on a hot spring cyanobacterial species in Taiwan. Beyond advancing our understanding of microbial genomics and evolution, the strains collected and genome sequences generated in this work provide valuable materials for future development and utilization of biological resources.
TbpB-based oral mucosal vaccine provides heterologous protection against Glässer’s disease caused by different serovars of Spanish field isolates of Glaesserella parasuis
Authors: González-Fernández Alba , Mencía-Ares Oscar , García-Iglesias María José , Petrocchi-Rilo Máximo , Miguélez-Pérez Rubén , Perelló-Jiménez Alberto , Herencia-Lagunar Elena , Acebes-Fernández Vanessa , Gutiérrez-Martín César B. , Martínez-Martínez Sonia
Published: November 2024

Background

Glaesserella parasuis (G. parasuis) is the primary agent of Glässer’s disease, significantly affecting nursery and early fattening piglets. Current prophylactic measures, mainly serovar-specific bacterins administered to sows, are limited by maternal immunity, which can interfere with active immunization in piglets. Subunit vaccines containing G. parasuis-specific antigenic molecules show promise but are not yet commercially available. Transferrin-binding proteins (Tbp), which enable G. parasuis to acquire iron in low-iron environments like mucosal surfaces, have been proposed as potential vaccine antigens. The mucosal administration of a TbpB-based subunit vaccine could provide a promising solution to overcome the limitations posed by maternal immunity, offering an effective approach to control the disease in weaning piglets. This study, conducted in two phases, primarily evaluates (days 0–45) the immunogenicity of a two-dose oral mucosal TbpB-based subunit vaccine (TbpBY167A) administered to colostrum-deprived piglets, and subsequently (days 45–52), its heterologous protection by challenging these piglets with four G. parasuis clinical isolates from different TbpB clusters (I, III) and serovars (SV1, SV4, SV5, SV7) recovered from Spanish pig farms.

Results

The oral mucosal administration of the two-dose TbpB-based vaccine induced a robust humoral immune response in immunized colostrum-deprived piglets, significantly increasing IgA and IgM concentration 15 days after the second dose (p < 0.01). Upon challenge with four G. parasuis clinical isolates, the vaccine demonstrated heterologous protection, markedly improving survival rates (OR: 8.45; CI 95%: 4.97–14.36) and significantly reducing clinical signs and lesions, regardless of the TbpB cluster and serovar. The vaccine reduced G. parasuis colonization in the respiratory tract (p < 0.0001) and G. parasuis systemic target tissues, like tarsus and carpus joints, liver, and brain (p < 0.05). Immunohistochemical analysis showed a lower macrophage count in different lung locations of immunized piglets (p < 0.0001).

Conclusions

This study demonstrates that oral mucosal administration of the TbpBY167A subunit vaccine in piglets provides effective heterologous protection against diverse virulent European G. parasuis field isolates, significantly reducing bacterial colonization and dissemination. This vaccine offers a promising alternative to traditional bacterins, overcoming limitations due to maternal immunity, and represents a strong candidate for universal vaccination against Glässer’s disease.
An unusual case of primary pulmonary synovial sarcoma
Authors: Dole Sachinkumar , Barthwal M. S.
Published: November 2024

Background

An extremely rare intrathoracic tumour that typically affects young adults is primary pulmonary synovial sarcoma. It manifests as a big intrathoracic mass without involvement of the bone or mediastinal region. Tumour biopsy, immunostaining and histologic analysis can assist in determining the kind of tumour.

Case presentation

We present a case of a 25-year-old male with complaints of breathlessness and chest pain for a month. On radiological imaging, he was found to have mass in upper and middle zones of right hemithorax. For confirmation of diagnosis, the patient underwent ultrasound-guided biopsy of the lesion and histopathologhical examination (HPE) of the lesion. The histopathological features were suggestive of a rare type of lung malignancy. For further diagnosis regarding type of malignancy, immunohistochemical staining of the lesion was done with the help of with specific immunological markers, which confirmed the diagnosis of monophasic pulmonary sarcoma. On PET (positron emission tomography) CT (computed tomography) scan, there were no features suggestive of distant metastasis especially in extremities which confirmed the diagnosis of primary pulmonary synovial sarcoma. Patient was started on chemotherapy regimen of ifosfamide and doxorubicin after oncologist’s opinion but was lost to follow up after 3rd cycle of chemotherapy.

Conclusions

Primary pulmonary synovial sarcoma is an extremely uncommon tumour in young adults as lung metastases from other sources mainly extremities are more common. Diagnosis of such rare tumour requires histopathological examination along with immunohistochemical staining of the lung lesions. A multimodal strategy of treatment involving resection, chemotherapy and radiation is used for the treatment of such tumours.
Empagliflozin-induced Myopathy
Authors: Khan Sana , Broce Ashley
Published: November 2024

Sodium/glucose co-transporter 2 (SGLT2) inhibitors are a frequently used medication for patients with type 2 diabetes, congestive heart failure (CHF), and chronic kidney disease. We present a 47-year-old patient with past medical history of type 2 diabetes and CHF who was initiated on empagliflozin and subsequently developed muscle pain and weakness. Evaluation of patient and laboratory testing confirmed drug-induced myopathy with elevated creatinine kinase (CK). Symptoms of myopathy and elevated CK resolved after holding empagliflozin. There are no current adverse effects listed with SGLT2 inhibitors including myopathy or rhabdomyolysis with the exception of other case studies. Physicians should be aware of this rare but serious side effect when initiating SGLT2 inhibitors.
O Canto da SereIA: inovação ou ilusão tecnológica?
Authors: Campagnolli Juliana Narj ara Libório , Carvalho Lilian Linhares de , Athayde Caroline Cunha de Oliveira , Farias Frank Douglas Cruz de
Published: November 2024

Bem-vindo a Atrasolândia, uma cidade conhecida pela sua burocracia infinita e pela insatisfação popular com os serviços públicos lentos e ineficientes. Na última eleição municipal, a candidata Tramita Rápido venceu o pleito com base em discurso inovador norteado pelo compromisso de implementação de uma ferramenta de inteligência artificial: “O Canto da SereIA”. A candidata promete que, com tal ferramenta, revolucionará a eficiência dos serviços públicos. A oposição resiste à ideia, em especial o vereador Burocratismo Engessado, que acredita que haverá redução de postos de trabalho de servidores e exclusão da parcela da população sem acesso a tecnologias. Tramita precisa gerenciar esse processo inovador e garantir que a IA seja implementada de forma eficaz e os benefícios prometidos se concretizem. Este caso de ensino explora conflitos entre inovação e tradição, eficiência e empregabilidade, por meio da análise de conceitos como burocracia weberiana, novo gerencialismo e hollow state.
Petrobras: um caso sobre as respostas estratégicas da empresa em 2020 decorrentes da COVID-19 e os seus efeitos nas demonstrações financeiras da empresa
Authors: Ribeiro Alessandro Maurício Januário , Borré Vitor Santos
Published: November 2024

Este caso de ensino apresenta as respostas estratégicas da Diretoria Executiva da Petrobras durante o 1º ano da pandemia de COVID-19. O objetivo é provocar a reflexão analítica sobre as estratégias adotadas pela empresa em 2020 para o enfrentamento de diversos desafios, especialmente as variáveis não controladas pela empresa, como o valor do Brent e do câmbio. A Petrobras, fundada em 1953 como uma sociedade de economia mista para atuar em toda a cadeia do petróleo no Brasil, é a maior empresa de óleo e gás do país e uma das maiores empresas da indústria no mundo. A Petrobras enfrentou um ambiente extremamente desafiador devido à pandemia de COVID-19 e às oscilações significativas nos mercados de petróleo e câmbio. A estratégia adotada pela empresa em resposta a esse cenário abrangeu várias medidas financeiras e operacionais para proteger seu patrimônio e garantir a continuidade de seus negócios. Dessa forma, este caso de ensino indica a importância das demonstrações financeiras para informar às partes interessadas da companhia, em especial acionistas e investidores, as ações estratégicas que foram adotadas em 2020 em resposta aos impactos da pandemia de COVID-19.
Navigating heavy industry digital transformation: key factors for successful implementation
Authors: Picchi Junior Roberto
Published: November 2024

This article focuses on digital transformation in heavy industries and aims to identify the major factors contributing to its successful implementation. Based on reviews of case studies across various industries, the research highlights examples of digital transformation in practice, identifying common success factors and barriers specific to heavy industries. These factors include a series of challenges and considerations that organizations should navigate for favorable results. A rigorous analysis reveals, three key factors: operational challenges, planning, and organizational culture. The conclusions emphasize the importance of addressing these factors and recommend the use of competence centers as an organizational tool to remover overcome barriers to success. The article serves as a valuable resource for organizations preparing for digital transformation in heavy industries.
Petrobras: um caso sobre as respostas estratégicas da empresa em 2020 decorrentes da COVID-19 e os seus efeitos nas demonstrações financeiras da empresa
Authors: Ribeiro Alessandro Maurício Januário , Borré Vitor Santos
Published: November 2024

Informamos que as notas de ensino dos casos possuem acesso restrito e são exclusivas para docentes e instrutores vinculados à uma instituição acadêmica. Saiba mais.
Desenvolvimento e avaliação da usabilidade e aceitabilidade do aplicativo simplic – simplificando a insuficiência cardíaca
Authors: Brasil Barroso Filho Haroldo , Barbosa Ferreira da Silva Igor , Alexandre Lima Rocha Hermano , Da Silva de Oliveira Borges Tarsila Alice , Tomé de Sousa Rebeca , Borges Gleydson
Published: November 2024

Introdução: A insuficiência cardíaca (IC) é uma doença com elevada prevalência, e morbi-mortalidade, levando a muitas internações devidos à sua descompensação. Devido à necessidade de melhorar o manejo da IC, foi criado um aplicativo acessível e de uso prático para médicos, contendo informações e dados científicos sobre o tema, segundo as diretrizes brasileiras vigentes. Objetivos: Desenvolver e avaliar a usabilidade e aceitabilidade de um aplicativo para manejo terapêutico da IC, SIMPLIC – Simplificando a Insuficiência Cardíaca. Métodos: Desenvolveu-se um aplicativo nas plataformas iOs® e Android®, contendo manejo diagnóstico e terapêutico da IC. Para avaliar a usabilidade e a aceitabilidade, este foi utilizado por cinco grupos de profissionais da saúde, totalizando sessenta profissionais. Foram utilizados os instrumentos System Usability Score (SUS) e do Technology Acceptance Model (TAM). Foi realizada análise estatística descritiva e de teste de hipóteses com o software SPSS v23, IBM. Resultados: Foi desenvolvido o aplicativo SIMPLIC, baseado na Diretriz Brasileira de IC Aguda e Crônica, de 2018, atualizada em 2021, com informações sobre definição, manejo diagnóstico e terapêutico. A avaliação da usabilidade e aceitabilidade do aplicativo demonstraram resultados muito satisfatórios (SUS = x̄ = 75,2, (IC 95% 74,2 – 76,2), TAM x̄ = 90,6, (IC 95% 88,9 – 92,2)), sem diferenças estatísticas em relação aos cinco grupos de profissionais que testaram o programa. Conclusões: O  SIMPLIC oferece acesso a informações sobre o manejo diagnóstico e terapêutico da IC e mostrou excelente usabilidade e aceitabilidade, o que sugere o potencial benefício do seu uso nos diversos serviços de saúde.
Dermatoscopia Gamificada: Um Aplicativo para Triagem de Lesões Cutâneas.
Authors: Martins Presta Paola , Lyvia Rarunna Muniz Moreira Mara , Pereira de Oliveira Alex , Roberto Neves Solon Francisco , Autran Coelho Peixoto Raquel
Published: November 2024

O treinamento prático em dermatoscopia é limitado pela escassez de pacientes com lesões malignas disponíveis para ensino. Para abordar essa limitação, este estudo desenvolveu e avaliou um aplicativo gamificado voltado ao treinamento de pós-graduandos em dermatologia para triagem de lesões cutâneas malignas. Utilizou-se uma metodologia de pesquisa-ação, quantitativa, em duas etapas: desenvolvimento do aplicativo e avaliação de sua usabilidade entre estudantes de dermatologia. O aplicativo foi projetado com imagens de lesões reais, aplicando a Regra dos 3 Pontos para triagem de malignidade, e testado por alunos em fase avançada da especialização. A avaliação, feita por um questionário de usabilidade (SUS) ao término do uso mostrou uma média de pontuação de 84, evidenciando aceitação positiva. Os participantes relataram melhorias nas habilidades de diagnóstico, destacando o valor do feedback imediato e da prática repetitiva sem necessidade de pacientes reais. O desenvolvimento envolveu especialistas em saúde e tecnologia, e o aplicativo foi construído em Java, com versões para Android e iOS, estruturado em 5 fases progressivas para aprofundamento do conhecimento. Conclui-se que o aplicativo gamificado oferece uma ferramenta eficaz para a formação prática em dermatoscopia, permitindo um treinamento seguro e controlado.
Testes on-line em cursos da área da saúde: opinião dos estudantes e perspectivas sobre desempenho e segurança" teve como objetivo avaliar a opinião, adaptação e desempenho dos estudantes de graduação da área da saúde em Testes online.
Authors: Braga Diana , De Melo Veras Daniele , Barbosa Duque Taciana , Cristina Batista Melo Monica , Hipolito da Silva Bruno
Published: November 2024

Introdução: O uso da tecnologia nos processos de educação, ensino, e especialmente na avaliação, se apresenta como um desafio para instituições de ensino e de conteúdo ainda escasso na literatura. Objetivo: avaliar a opinião, adaptação e desempenho dos estudantes de graduação da área da saúde em Testes online. Método: avaliação de intervenção educacional, sobre avaliação na modalidade online/remota, com estudantes da área da saúde. Aplicado formulário estruturado em escala de Likert sobre a opinião dos estudantes com os testes online e analisados os escores médios por curso comparando com os escores nos testes impressos. Para a análise foi utilizado o pacote estatístico R. O critério de consenso foi o Ranking Médio (RM) acima de 3,0. A consistência do formulário foi avaliada pelo alfa de Cronbach. Para a comparação dos desempenhos foi utilizado o teste -T para amostras independentes. Resultados: Os estudantes mostraram-se bem adaptados, concordando que fatores estressores podem interferir em seus desempenhos. Foram analisados 1520 testes online e 2067 testes impressos, não sendo identificado um padrão único entre os cursos sobre o impacto nas médias gerais, comparando as duas modalidades de testes. Conclusão: Aspectos da avaliação on-line como adaptação, desempenho, e fraudes são discutidos neste estudo, visando contribuir com o uso da tecnologia aprimorando a avaliação.
Elaboração e validação de um treinamento híbrido simulado em parto pélvico e distócia de ombro
Authors: SILVA FELIPE , Carvalho Pinto de Melo Brena , Marques Andreto Luciana , Hipólito da Silva Bruno , Gomes de Matos Bezerra Patrícia
Published: November 2024

Introdução: O ensino híbrido combina atividades online, como a educação a distância (EaD), e presenciais, como a simulação, tem surgido como uma estratégia promissora na educação continuada de profissionais de saúde. Objetivo: Elaborar e validar o conteúdo e a aparência de um curso híbrido de parto vaginal pélvico e distócia de ombro para médicos residentes de ginecologia/obstetrícia (GO). Método: Estudo observacional de construção e validação de curso híbrido baseado no modelo de quatro componentes do desenho instrucional (4C/ID), apresentando um módulo teórico em EaD e um módulo presencial de simulação. Após aprovação do Comitê de Ética, foi conduzido no Centro de Simulação da Faculdade Pernambucana de Saúde (CSim-FPS) entre junho de 2023 e setembro de 2024. O curso teve seu conteúdo e aparência validados por um grupo de experts das áreas de EaD e simulação, através do índice de validação de conteúdo (IVC) ≥ 0,80 e o teste binomial (p≥ 0,05). Resultados: Oito experts foram incluídos, três experts em EaD e seis experts em simulação em GO. O IVC para o conteúdo e para a aparência foram respectivamente 1,0 e 0,88 validando o curso. O teste binomial teve resultados semelhantes. Conclusão: O produto do estudo foi um curso híbrido para o manejo da distocia de ombro e parto pélvico validado por experts de EaD e GO. Tais achados reforçam a relevância dos cursos híbridos - combinação de EaD e simulação – como estratégia promissora para a educação continuada, em áreas que exigem aprendizagem complexa, como a obstetrícia.
Ensino com simulação realística: Uma revisão integrativa.
Authors: Moraes Rola Junior Cristiano Walter , Almeida Livia , Macedo Silva Francisco Theogenes , Castelo Branco Fortaleza Simone , Otavio Ferreira Da Costa Grijalva
Published: November 2024

A simulação no ensino médico tem se tornado uma ferramenta essencial para a formação de profissionais competentes e preparados para enfrentar os desafios da prática clínica. A utilização de simulações de baixa, média e alta fidelidade permite que os estudantes desenvolvam habilidades práticas em um ambiente controlado, promovendo a autoconfiança e a satisfação no aprendizado. Este texto revisa a literatura recente sobre o uso da simulação na educação médica, abordando suas modalidades, aplicabilidades, benefícios, limitações e potencialidades.
Η μαγεία στα αγιολογικά κείμενα της μέσης βυζαντινής περιόδου (Η'-ΙΒ' αι.)
Authors: Γοργολίτσα Γεωργία
Published: November 2024

Αντικείμενο της παρούσας διατριβής είναι η απεικόνιση της μορφής του μάγου ως λογοτεχνικού προσώπου και ως παράγοντα της αφήγησης στα αγιολογικά κείμενα της μέσης βυζαντινής περιόδου. Στον βυζαντινό κόσμο η άσκηση της μαγείας αποτελούσε διαδεδομένο φαινόμενο στην καθημερινή ζωή και αποτυπωνόταν επίσης στη λογοτεχνική παραγωγή. Στους Βίους των αγίων περιέχονται αξιομνημόνευτες εικόνες για τη φυσιογνωμία, τις μεθόδους και την κοινωνική παρουσία των φορέων της μαγείας στο Βυζάντιο. Στην παρούσα διατριβή εξετάζονται δέκα Βίοι αγίων από τη μέση βυζαντινή περίοδο, στους οποίους φορείς της μαγείας συμμετέχουν ενεργά στην πλοκή ως δρώντα πρόσωπα. Πρόκειται για τους Βίους των αγίων Ιωαννικίου, Λέοντος Κατάνης, Θωμαΐδος Λέσβου, Ανδρέα του Σαλού, Βασιλείου του Νέου, Βαρλαάμ και Ιωάσαφ, Ειρήνης Χρυσοβαλάντου, Μαρίας της Νέας, Νίκωνος του Μετανοείτε και Λαζάρου του Γαλησιώτου. Σε αυτά τα κείμενα η άσκηση της μαγείας συνιστά σημαντικό αφηγηματικό μοτίβο. Οι μάγοι και οι μάγισσες σκιαγραφούνται με ζωηρό τρόπο και συνιστούν ενδιαφέροντα δείγματα προσωπογραφικής τέχνης. Οι συγγραφείς των Βίων ακολουθούν ένα σύστημα κοινών κανόνων και συγγραφικών συμβάσεων για τη σύνθεση των επεισοδίων μαγείας, τη διάπλαση της φυσιογνωμίας του μάγου, τη σκηνοθεσία της δράσης και τις άλλες παραμέτρους της αφήγησης. Καταρτίζεται έτσι λεπτομερής και συνθετική τυπολογία των επεισοδίων μαγείας με βάση πέντε κεντρικά αφηγηματικά κριτήρια: τα πρόσωπα που εμπλέκονται στη δράση (ο λειτουργός της μαγείας, ο πελάτης ή εντολοδότης του, ο βοηθός ή οι αρωγοί του, το θύμα που γίνεται στόχος της μαγικής ενέργειάς του), το σκηνικό όπου τοποθετούνται η μαγική ενέργεια και οι επιπτώσεις της (αστικές συνοικίες, αγροτική ύπαιθρος, μοναστήρι), τα μέσα και οι μέθοδοι που μεταχειρίζεται ο φορέας της μαγείας (φίλτρα, κατάδεσμοι, ξόρκια, επίκληση δαιμονικών δυνάμεων), ο σκοπός της μαγικής διαδικασίας (πρόκληση ερωτικού πόθου, ασθένειας, παραφροσύνης ή κοινωνικού χάους), και τέλος ο τρόπος αντιμετώπισης του μάγου και εξουδετέρωσης των ενεργειών του (κατά κανόνα με τη βοήθεια της Θείας δύναμης). Την εκτενέστερη απεικόνιση μάγου στη βυζαντινή αγιολογική γραμματεία προσφέρει ο Βίος του Αγίου Λέοντος Κατάνης, ο οποίος συγγενεύει με το είδος των «διηγήσεων μαγείας», δηλαδή τα κείμενα που έχουν ως κεντρικό θέμα την αφήγηση της δράσης και των κατορθωμάτων ενός μάγου. Πολλά μαγικά και υπερφυσικά μοτίβα από την παράδοση των διηγήσεων μαγείας μεταπλάθονται στον Βίο του Αγίου Λέοντος. Διερευνώνται από αυτήν την άποψη τα εξής μοτίβα: η εισδοχή του μάγου στον κόσμο της μαγείας, η δημιουργία οφθαλμαπάτης ή οπτασίας για να εξαπατηθούν τα θύματα του μάγου, η προσωρινή μετατροπή ευτελών υλικών σε χρυσό, η υπερφυσική δημιουργία ερωτικής επιθυμίας, ο μαγικός χειρισμός του στοιχείου της φωτιάς, η υπερφυσική μεταφορά από τον έναν τόπο σε άλλον, το ζωντάνεμα άψυχων αντικειμένων ή σχεδίων, η πρόκληση θεομηνιών και καταστροφών, και τέλος η υπερφυσική εξαφάνιση μέσω πτήσης στον αέρα.
Κατακερματισμένο QRS σύμπλεγμα και καρδιακή βηματοδότηση
Authors: Δεσποτόπουλος Στέφανος
Published: November 2024

Ιστορικό: Η μελέτη σχεδιάστηκε για να διερευνήσει την επίδραση του καρδιακού ρυθμού και του τρόπου βηματοδότησης στον κατακερματισμό του QRS (f-QRS). Επιπλέον, αξιολογήθηκε η χρησιμότητα του f-QRS στη διάκριση ασθενών με μειωμένη λειτουργία εξώθησης της αριστερής κοιλίας (EF) και κοιλιακή ταχυκαρδία (VT) σε σχέση με ασθενείς φυσιολογικό EF. Μέθοδοι: Τριακόσιοι έξι λήπτες, με διπλοεστιακό βηματοδότη, με εγγενές στενό ή ευρύ σύμπλεγμα QRS και διατηρημένη κολποκοιλιακή αγωγιμότητα ομαδοποιήθηκαν σε φυσιολογικό-EF ή μειωμένο-EF VT. Αναλύσαμε το ενδογενές στενό f-QRS και το ευρύ f-QRS καθώς και το f-QRS υπό κοιλιακή βηματοδότηση ακολουθώντας διαφορετικές καρδιακές συχνότητες (ενδογενές, 100 bpm) και τρόπους βηματοδότησης. Αποτελέσματα: Στην αρχική κατάσταση, συνολικά, οι ασθενείς με μειωμένη EF VT (35+/- 9%), σε σύγκριση με εκείνους με φυσιολογικό EF, εμφάνιζαν περισσότερο f-QRS (56% έναντι 27%, P < 0,001) και f-QRS υπό κοιλιακή βηματοδότηση (62% έναντι 16%, P < 0,0001). Η κοιλιακή βηματοδότηση αναδείκνυε τόσο στην αρχική όσο και σε υψηλότερη καρδιακή συχνότητα, συχνότερα f-QRS σε ασθενείς με μειωμένη EF VT σε σχέση με φυσιολογικό EF (P < .001). Η ανίχνευση του f-QRS υπό κοιλιακή βηματοδότηση βελτίωσε σημαντικά τη συνολική ειδικότητα (84%) και τη θετική προγνωστική αξία (91%) στην ταυτοποίηση ασθενών με μειωμένο VT EF. Συμπεράσματα: Η αυξημένη καρδιακή συχνότητα ή/και η κοιλιακή βηματοδότηση αποκαλύπτει τον κατακερματισμό του QRS. Η ανίχνευση του κοιλιακά βηματοδοτούμενου f-QRS προσθέτει αξία στη μη επεμβατική ταυτοποίηση ασθενών με μειωμένο EF VT.
Η επιχειρησιακή πρακτική της οργανωμένης απομάκρυνσης πολιτών (evacuation) για την προστασία της ανθρώπινης ζωής από τις δασικές πυρκαγιές στις περιοχές διεπαφής δασών και οικισμών wildland urban interface (WUI)
Authors: Ζικέλογλου Ιωάννης
Published: November 2024

Η Ελλάδα είναι μια χώρα της Νοτιοανατολικής Ευρώπης που βρίσκεται στη Μεσόγειο. Κάθε χρόνο αντιμετωπίζει καταστροφικές και περιστασιακά θανατηφόρες δασικές πυρκαγιές. Στο πλαίσιο διαχείρισης των επιπτώσεων των δασικών πυρκαγιών και ιδιαίτερα για την προστασία του κοινού σε περιοχές διεπαφής μεταξύ δάσους-άστυ Wildland Urban Interface (WUI), εφαρμόζεται στην Ελλάδα το μέτρο της οργανωμένης προληπτικής απομάκρυνσης πολιτών (ΟΑΠ). Η πρακτική της οργανωμένης απομάκρυνσης του πλήθους χρησιμοποιείτε από το 2018 σχεδόν σε κάθε δασική πυρκαγιά που απειλεί κατοικημένες περιοχές και έχει αποδειχθεί ιδιαίτερα αποτελεσματική στην προστασία της ανθρώπινης ζωής, καθώς έχει συμβάλει σημαντικά στη μείωση των ανθρώπινων απωλειών. Παρόλο που η τακτική αυτή έχει λάβει διεθνή αναγνώριση για την προστασία της ανθρώπινης ζωής, υπάρχουν έρευνες οι οποίες έχουν αποδείξει ότι δεν είναι η μοναδική επιλογή καθώς η φύση και η δυναμική των δασικών πυρκαγιών απαιτούν την ύπαρξη εναλλακτικών. Η παρούσα έρευνα έχει ως σκοπό την διερεύνηση όλων των παραγόντων που επηρεάζουν την οργάνωση και εκτέλεση της απόφασης για ΟΑΠ όπως επίσης και την εξέταση άλλων βιώσιμων λύσεων. Για την ικανοποίηση του παραπάνω σκοπού αλλά και των επιμέρους ερευνητικών στόχων πραγματοποιήθηκε πανελλαδική έρευνα στους Δήμους που έλαβαν την απόφαση της ΟΑΠ σε δασικές πυρκαγιές που εκδηλώθηκαν εντός των αντιπυρικών περιόδων των ετών 2021-2022, ώστε να αντληθούν στοιχεία σχετικά με τη μεθοδολογία σχεδιασμού, οργάνωσης και εκτέλεσης αυτής της πρακτικής. Επιπρόσθετα, διεξήχθη έρευνα για τη δασική πυρκαγιά της ΒΑ Αττικής το 2021 (Βαρυμπόμπη) στην οποία καταγράφηκε και αξιολογήθηκε η οργάνωση σε επίπεδο ιδιοκτησίας και η συμπεριφορά των κατοίκων σε σχέση με την πυρκαγιά και την προληπτική απομάκρυνση. Τα ευρήματα της έρευνας επιβεβαιώνουν ότι η ΟΑΠ είναι μια εξαιρετική επιλογή κατά τη διάρκεια δασικής πυρκαγιάς. Ωστόσο δεν είναι η μοναδική και δεν μπορεί να εφαρμοστεί με ασφάλεια σε όλες τις περιπτώσεις. Για το λόγο αυτό απαιτείται η εκπόνηση μεμονωμένων και απόλυτα εξειδικευμένων σχεδίων για κάθε μια ευάλωτη περιοχή που θα περιλαμβάνουν εφικτές λύσεις για κάθε περίσταση. Επιπλέον, αποδεικνύεται ότι η ασφαλής και αποδοτική εφαρμογή του μέτρου της προληπτικής απομάκρυνσης πολιτών απαιτεί την άρτια συνεργασία όλων των εμπλεκόμενων φορέων και υπηρεσιών σε κάθε μία από τις φάσεις του κύκλου της καταστροφής. Εν κατακλείδι, η ενεργητική συμμετοχή της τοπικής κοινότητας διαδραματίζει καθοριστικό ρόλο στην έκβαση κάθε θεσμοθετημένης προσπάθειας που έχει ως σκοπό την αντιμετώπιση των επιπτώσεων ενός καταστροφικού γεγονότος. Τα αποτελέσματα της έρευνας δύναται να χρησιμοποιηθούν για τη βελτίωση του σχεδιασμού εκκένωσης και την προστασία του κοινού από τις δασικές πυρκαγιές.
Cultural heritage as a field for EU’s action in external relations: the evolution of strategy and the Ukrainian check
Authors: Jurkiewicz-Eckert Dorota
Published: November 2024

The European Union’s systemic engagement in the field of cultural heritage in the external relations is a relatively new and still emerging area. This is a complex action field that requires the Union to find systemic solutions that will enable it to act effectively and make full use of cultural heritage as an instrument of its foreign policy. The process of conceptualising and adopting political decisions in order to introduce the protection, preservation and promotion of cultural heritage as a field of EU action in external relations lasted from 2016 to 2022. Influenced by internal and external factors, the concept on EU Approach to Cultural Heritage in External Action evolved. A few months before the outbreak of full-scale war in Ukraine in 2022, the Council of the European Union adopted Conclusions on EU Approach to Cultural Heritage in Conflicts and Crises. The war in Ukraine and Russia's destruction and threat to Ukrainian tangible and intangible cultural heritage has become a significant test of the EU's capabilities in this field. The text is divided into two parts. The first is an analysis of the process of integrating cultural heritage into the EU's strategy in external relations, while the second attempts to answer the question of how the EU has activated the mechanisms and instruments adopted to protect Ukraine's endangered cultural heritage in the face of Russia's systemic destructive measures.
The genome sequence of the harlequin ladybird, Harmonia axyridis (Pallas, 1773)
Authors: Boyes Douglas , Crowley Liam M. ,   University of Oxford and Wytham Woods Genome Acquisition Lab,   Darwin Tree of Life Barcoding collective,   Wellcome Sanger Institute Tree of Life programme,   Wellcome Sanger Institute Scientific Operations: DNA Pipelines collective,   Tree of Life Core Informatics collective,   Darwin Tree of Life Consortium
Published: November 2024

We present a genome assembly from an individual female Harmonia axyridis (the harlequin ladybird; Arthropoda; Insecta; Coleoptera; Coccinellidae). The genome sequence is 426 megabases in span. The majority (99.98%) of the assembly is scaffolded into 8 chromosomal pseudomolecules, with the X sex chromosome assembled.
Rate of convergence of Fourier–Legendre series of functions of the class (n^α)BV^p [−1, 1]
Authors: Bera Rameshbhai , Ghodadra Bhikha
Published: November 2024

In this paper, the rate of convergence of the Fourier–Legendre series of functions of the class (nα)BVp[−1, 1] and in particular, the class BVp[−1, 1], are estimated. The result obtained is a similar to a result of Bojani´c and Vuilleumier for the Fourier–Legendre series of functions of bounded variation, and is applicable to wider class.
A note on modified third-order Jacobsthal quaternions and their properties
Authors: Morales Gamaliel
Published: November 2024

Modified third-order Jacobsthal quaternion sequence is defined in this study. Some properties involving this sequence, including the Binet-style formula and the generating function are presented.