bluuebunny/crossref_metadata_2025 huggingface dataset:
Depenalization of Drug Abuse Criminal Act as a Humanist Criminal Law Policy
Authors: R.B. Muhammad Zainal Abidin
Published: December 2024

The purpose of this research is to analyze and evaluate ratio legis of criminal sanctions against perpetrators of narcotics abuse and policy reformulation of humanist sanction arrangements against narcotics abusers in the future. This research is a legal research that uses statutory and conceptual approaches. The results of study; (1) ratio legis of providing criminal sanctions against narcotics abusers as referred to in Act Number 35 Year 2009 concerning Narcotics is that the formers of the Act still adhere to the retrebutive paradigm. The target of rehabilitation is only limited to victims of drug abuse, not drug abusers; (2) the policy reformulation of sanctions against drug abusers in the future is no longer using criminal law means. The means used are non-penal means that remove criminal sanctions and replace them with rehabilitation measures.
Experiences and challenges in the development of carbon footprinting in megacities - taking Shanghai as an example
Authors: Liu Hanbin , Niu Yirui
Published: December 2024

Using Shanghai as a case study, this article discusses the practices and methods of carbon footprint measurement in megacities, analyzing its evolution and significance in supporting densely populated megacities worldwide to achieve carbon neutrality. The study emphasizes thorough greenhouse gas emission accounting in high-density urban areas characterized by intensive economic activity and population concentration. Globally, nations, including China, are enhancing carbon management strategies by introducing new standards under the regulatory guidance of organizations such as the National Development and Reform Commission. However, notable obstacles remain, including the lack of a centralized database, insufficient product-specific approaches to managing emissions, and the absence of standardized certification systems for labeling products based on their environmental impact. To address these challenges, Shanghai is promoting a low-carbon transition across industries and encouraging the city's green development by fostering a collaborative industrial framework. This includes the CN100 program, which mobilizes leading companies to reduce the carbon footprint of supply chains and industrial processes.
State and High Technologies
Authors: Chemezov S.
Published: December 2024

The article is devoted to analysis of foreign countries policies in the sphere of interaction with the producers of double purpose products. It is concluded that in order to succeed in resolving the urgent task of putting the Russian industries on the path of innovative development we need systemic and complex approach. Its basic component relates to the government’s multifaceted economic and political supports of a broad spectrum of high technology industries.
On Endogenous Factors of Russia’s Identity Fragmentation
Authors: Gadzhiev K.
Published: December 2024

After the breakdown of the USSR the formerly single territory of the multi-century empire was torn into a number of fragments, not only through the line of states’ borders but also including ethnic, national, regional, confessional and other dimensions. Russia itself faced the challenge of “Balkanization”. The issue of intra- national tolerance became highly acute. The reason is that counteraction to radical nationalism turned to stay in the heart of struggle for state’s integrity. To preserve such integrity is currently the key problem. Only with successful resolution of this problem can open favorable prospects for Russian statehood.
Library and «Electronic Revolution»
Authors: Rashkovsky E.
Published: December 2024

The author aims to understand the unique and indispensable status of library in the era of electronic revolution, to comprehend at least some of most determining features of this era, namely the characteristics of its technological, cultural and mental peculiarity. There is a need to develop – at least in general and preliminary terms – the philosophy of a modern library that takes into account the most important technological, cultural and mental dimensions of the modern world, including Russia.
Rachel Carson’s enduring call: a 60-year echo for harmony with nature
Authors: Ünver Olcay , Orman Gavrielle , Hristovski Kiril
Published: December 2024

Sixty years after Rachel Carson’s Silent Spring exposed some harmful effects of pesticides on species and ecosystems, this article examines the enduring relevance of her call for a more sustainable approach to agriculture. We explore pest management through three examples where significant improvements have been achieved. While the ongoing use of pesticides is far from the international goal of minimizing their impact, a beacon of hope emerges in the growing movement toward ecosystem-based solutions supported by science and international organizations. This article delves into the core principles of integrated pest management (IPM) and biopesticides, offering alternatives to traditional chemical insecticides. We showcase success stories from the citrus and apple industries, demonstrating significant reductions in synthetic pesticide use through the implementation of these methods. Additionally, the article explores Push–Pull technology, a powerful example from Kenya where habitat management effectively controls pests without harming the environment. By examining these advancements, we emphasize the progress made toward achieving better ecological balance in agricultural practices. This review aims to provide support for more sustainable agricultural practices, highlighting a few win–win relationships between farmers and nature.
Faktor Pendukung dan Penghambat Proses Pemberdayaan Perempuan melalui Budidaya Jahe dan Lengkuas (Studi Kasus CSR PT. Combiphar)
Authors: Sulistyaningrum Dian , Sugihardjo Sugihardjo , Ihsaniyati Hanifah
Published: December 2024

The women’s empowerment program through ginger and galangal cultivation was initiated by Corporate Social Responsibility (CSR) of Combiphar Inc. This program aims to improve the welfare and capacity of women farmers. Initially, this program was welcomed enthusiastically by members of the target women’s farmer groups (KWT), but there was a decline in KWT member participation in the second planting period. This research aims to determine the supporting and inhibiting factors in the process of empowering KWT Karya Makmur II in ginger and galangal cultivation carried out by CSR of Combiphar Inc. This research uses a descriptive qualitative analysis method with a case study approach. In this research, the informants involved included members of KWT Karya Makmur II, the Persada Yogyakarta Foundation as Combiphar’s partner, the Agriculture and Food Service, Field Agricultural Extension Officers (PPL), as well as the local community. Data collection techniques were carried out using in-depth interviews, observation and documentation as well as using Miles and Huberman’s interactive analysis. The research results show that leadership, cooperation, policy and technology are supporting factors in the empowerment process of KWT Karya Makmur II in ginger and galangal cultivation. Meanwhile, inhibiting factors include dependency, commitment, organizational management, and marketing. Research findings reveal that the success of empowerment programs depends not only on technical factors but also on social and institutional factors. This provides important recommendations for further CSR program development, namely the need for a holistic approach that takes into account socio-economic aspects and institutional capacity in community empowerment efforts.
Concepciones del alma, el cuerpo y el intelecto en Ibn Hazm de Córdoba
Authors: Quintana Pablo
Published: December 2024

Este artículo presenta un análisis de los argumentos que Ibn Ḥazm de Córdoba expone, principalmente en su Kitāb al-Fiṣal, con el fin de refutar un conjunto de ideas atribuidas a los “Antiguos” relativas a la naturaleza y las facultades del alma, y su relación con el cuerpo y el intelecto. Su tratamiento del alma no es sistemático ni sus consideraciones son expuestas mediante referencias directas a la tradición filosófica griega o a los falāsifa como fundamento de su doctrina. De modo que nos enfocaremos en la identificación de los principios filosóficos que fundamentan tanto los argumentos que Ibn Ḥazm pretende refutar como su propia doctrina acerca del alma.
Epistemología de la imagen y el espejo en la contemplación según Ricardo de San Víctor
Authors: Zegers-Correa María José
Published: December 2024

Los escritos sobre la contemplación y la Trinidad en Ricardo de San Víctor ponen de relieve la importancia que tienen las ideas de imagen y de reflejo especular en su pensamiento. Para el victorino, la belleza invisible se hace reconocible en la belleza de lo visible, principalmente en el hombre, creado a imagen y semejanza de Dios. Eso explica la relevancia que otorga al conocimiento propio en el camino de la contemplación: en la medida en que el hombre profundiza en el conocimiento de sí puede descubrir, como en un espejo, la imagen de Dios. Siguiendo cuanto dice Ricardo en el Liber exceptionum, en el Beniamin minor, en el Beniamin maior y en el De quatuor gradibus violentae caritatis, se presentará el papel de la imagen y el espejo como claves interpretativas de sus enseñanzas sobre el ascenso contemplativo hacia la Trinidad.
Presencias escépticas del Medievo a la Modernidad: la influencia de Agustín de Hipona en el anti-escepticismo pascaliano
Authors: Raga Rosaleny Vicente
Published: December 2024

Muchos interpretes han tratado de establecer el carácter pirrónico o académico del escepticismo que Pascal expone y critica explícitamente en referencia al autor de los Ensayos, Michel de Montaigne, e implícitamente en relación con el Descartes de las primeras Meditaciones metafísicas, indagando en las fuentes clásicas del autor francés.
Pero en estas lecturas se ha dejado de lado el origen de la caracterización polémica del escepticismo en las obras de Pascal, que no es otro que Agustín de Hipona, en su diálogo Contra los académicos, y en algunos otros textos. Así pues, ilustrar los rasgos principales de la respuesta al escepticismo académico de Agustín nos permitirá tener una mejor comprensión del papel que juega la actitud escéptica en Pascal, las transformaciones que en su obra padecen los modelos clásicos al pasar por el pensamiento medieval, y aquello que de innovador tiene su propuesta.
Prevalencia del HLTV-1: una revisión sistemática de revisiones sistemáticas
Authors:   , Calderon Palacios Renzo Andre , Carcelen Peñaloza Andre Martin , Valeriani Pelaez Aldo Gabriel
Published: December 2024

Introducción: Los reportes de la prevalencia de HLTV-1 durante los últimos años en diferentes regiones del mundo son escasa, y las revisiones sistemáticas que han estudiado esta problemática también han demostrado no ser muy abundantes. Objetivos: Determinar la prevalencia de infección por HLTV-1 en la población general registrada en las revisiones sistemáticas y metaanálisis sobre el tema. Metodología: El presente diseño de la investigación es una revisión de revisiones, conocida también, como “Umbrella Review” que analizó la prevalencia del virus linfotrópico humano de células T tipo 1 (HLTV-1) en la población general. Las bases de datos donde se obtuvo la información para esta investigación fueron las siguientes: MEDLINE (Pubmed), Scopus, WoS, Embase, y Google Scholar. No se realizaron restricciones de tiempo, ni restricciones de lenguaje. Resultados: Hlela 2009 reporto que Japón fue el lugar con mayor prevalencia de 36.4% (IC 95% 29.9 – 42.8); África tuvo una prevalencia entre 8.5% (IC 95% 6.99 – 10.1) y 1.05% (IC 95% 0.63 – 1.47). Ngoma 2019 encontró en la población de África Subsahariana con una prevalencia general de 3.19% (IC 95% 2.36 – 4.12). Eusebio-Ponce 2019 encontró que en los diferentes países de América Latina reportando una prevalencia de 6.4% en Brasil, 2.8% en Colombia, 2.5% en Perú, 0.5% en Honduras, 2% en República Dominicana, 4.2% en Haití y 6.1% en Jamaica. Conclusión: La prevalencia de HLTV-1 en la población general es difícil de determinar con la información disponible actualmente.
Identidad universitaria y su relación con la Identidad profesional en estudiantes de medicina humana de la Universidad Científica del Sur
Authors:   , Bravo Hilario Cristina Abigail , Chavez Serpa Kenyo Gerardo , Chumpitaz Cuya Angie Fiorella
Published: December 2024

Introducción: La educación médica en la actualidad desempeña un papel crucial en la formación de profesionales médicos, no solo proporcionando conocimientos científicos y habilidades clínicas, sino también desarrollando importantes competencias como el pensamiento crítico, una comunicación asertiva y las decisiones éticas gracias a una formación más completa que busca generar un impacto positivo en los estudiantes, contribuyendo a la construcción y consolidación de su identidad profesional e identidad universitaria. Objetivo: Identificar la asociación entre la identidad universitaria y la identidad profesional en estudiantes de medicina humana de la Universidad Científica del Sur. Métodos: Se hizo un estudio correlacional, analítico y de corte transversal, el cual se analizó a partir una base de datos de un estudio previo sobre la identidad universitaria en 562 alumnos matriculados en Medicina Humana de la Universidad Científica del Sur durante el 2021, Se midieron a través de escalas la identidad profesional y universitaria, junto con otras variables sociodemográficas, posterior a ello se efectuó el análisis descriptivo. En el análisis bivariado, se aplicaron pruebas como Chi cuadrado y Mann-Whitney, centrándose en la variable identidad profesional con un valor estadísticamente significativo de P≤0.05. Se construyó modelo de regresión de Poisson (IC: 95%) incorporando variables significativas del análisis bivariado. Resultados: Se encontró que la mayoría de los estudiantes (76.33%) mostraron identidad universitaria media o baja, y el 78.29% tuvo niveles medios o bajos de identidad profesional. Predominaban mujeres con edad promedio de 21.25 años. El análisis bivariado reveló asociaciones significativas entre identidad profesional y estudios previos en otra institución (32.26% con identidad alta) y con identidad universitaria (37.04% con identidad alta). No se encontraron asociaciones con edad, sexo u otros factores sociodemográficos. En el análisis de regresión de Poisson ajustado, tener identidad universitaria alta...
Optimum corrosion performance using microstructure design and additive manufacturing process control
Authors: Moazzen Parisa , Shahriari Ayda , Shamsdini SeyedAmirReza , Seraj Payam , Forooghi Foroozan , Aghayar Yahya , Shakerin Sajad , Purdy Mackenzie Remington , Mohammadi Mohsen
Published: December 2024

Compatibility of traditional metallic alloys, particularly 316L stainless steel, with additive manufacturing (AM) processes, is essential for industrial applications. This involves manipulating process parameters to design microstructural features at various length scales, which enables the achievement of desired physical, mechanical, and chemical properties, leading to high-performance components with tailored functionalities. In this study, a hierarchical design approach, from the morphology of melt pools to subgrains, was employed, resulting in laser powder bed fusion (LPBF) 316L parts with subgrain sizes ranging from approximately 400 nm to 900 nm, confined within grains of about 40 µm to 60 µm. Findings indicated that variations in process parameters, specifically different scan strategies with a constant energy input of 60.9 J/m3, led to the production of high-density components with the smallest grains/subgrains in the continuous scan strategy. Additionally, using a combination of computational frameworks and experimental observations, we developed equations to elucidate the intrinsic relationship between energy density and grain size for LPBF-316L within the context of two optimal scanning strategies. Furthermore, the correlation between these designed microstructural features and corrosion behavior, focusing on the electrochemical properties of the components, was explored by manipulating key process parameters in LPBF. The results revealed a possible Hall–Petch relationship between corrosion rate and grain size, indicating that the microstructural features in the form of grains/subgrains influence the electrochemical behavior, resulting in a lower corrosion rate in samples with the smallest grains/subgrains.
Factors Influencing Whether Doctors Intend to Stay Working In Primary Health Care After Completing Residency in Family and Community Medicine in Paraíba, Brazil
Authors: Oliveira¹ José Danúzio Leite , Luna² Fernanda Darliane Tavares , Machado¹ Ana Paula Ramos , Souza¹ Élida de Fátima Diniz , Oliveira¹ José Olivandro Duarte , Nóbrega¹ Lauradella Geraldinne Sousa , Toscano¹ Maysa Barbosa Rodrigues , Olinda¹ Ricardo Alves , Madruga¹ Renata Cardoso Rocha , Matheson David , Beltrammi¹ Daniel Gomes Monteiro , Santos¹ Silvana
Published: December 2024

Background
In the last decade, there has been a 250% increase in the number of doctors trained in Family and Community Medicine (FCM) residency programs in Brazil; however, it is estimated that there is a need to train around 50,000 specialists to work in Primary Health Care (PHC) teams, especially in more remote regions with vulnerable populations. This study investigates the factors associated with the intention of doctors linked to the ten FCM residency programs in the state of Paraíba to continue working in PHC.
Methods
This is a cross-sectional, analytical study with a quantitative approach and a census-type sample of 211 doctors, residents and preceptors. Data was obtained using an electronic questionnaire administered in the second half of 2023. Descriptive, bivariate (Chi-square and Fisher's exact) and logistic regression analyses were carried out. The grouping variable “intention to continue working in PHC” was found to be associated with sociodemographic and academic variables and intrinsic and extrinsic factors that could influence doctors' decisions.
Results
Most participants were female (61.6%), without a partner (57.3%), and without children (82%). 42 (19.9%) worked as preceptors and 169 (80.1%) as residents. 90.5% of the preceptors intended to continue in primary care, compared to 54.4% of the residents. There was an association between being married or in a stable union (p = 0.031), having children (p = 0.002), having graduated from a public institution (p = 0.017) and experience in PHC (p = 0.049) with the grouping variable. The majority of doctors make this decision during their undergraduate studies (p < 0.001), the period of experience in PHC contributes to the decision (p = 0.002), as do more stable employment relationships, such as permanent (p = 0.015), statutory (p < 0.001), the offer of a master's degree (p < 0.001).
Conclusion
The intention of doctors linked to the ten FCM residency programs in the state of Paraíba to continue working in PHC is associated with their identification with the area. The decision is made during graduation and strengthens with experience. More stable employment relationships, the offer of a master's degree in the area and the opportunity to act as a preceptor in the FCM residency program all contribute to the desire to remain in PHC throughout their professional career.
Response of grain yield and soil health to the individual application of organic manures and chemical fertilizers in the rice-rice cropping systems
Authors: Rashid Md. Mamunur , Begum Setara , Manir Mohammad Rezaul , Islam Md. Sirajul , Shalahuddin AKM , Hera Md. Hasibur Rahaman , Rahman Md. Mamunur , Rahman Md. Sentu
Published: December 2024

Fertilizer application to supply essential plant nutrients is a widely recognized approach to better rice production. Since long-term chemical fertilizer use leads to decreased soil fertility, applying organic fertilizer is irrefutable to maintain soil health. A field experiment was conducted during 2017–2019 at Bangladesh Rice Research Institute, Gazipur, aiming to evaluate the suitability of different sources of organic materials and chemical fertilizers for the Boro-Fallow-T. Aman rice cropping pattern. The experiment involved a randomized complete block design with three replications. Five treatments, with organic materials and chemical fertilizers, have been imposed. The treatments are i) BRRI recommended chemical fertilizer doses, ii) Kitchen waste @ 6 t ha− 1, iii) Cowdung bio-slurry @ 6 t ha− 1, iv) Poultry manure 6 t ha− 1, and v) control (no nutrient supply). Applying chemical fertilizer, poultry manure, kitchen waste, and cowdung bio-slurry produced the highest plant height, tiller, and panicle number per, spikelet per panicle over control in both season and year. Among organic materials, the poultry manure (6 t ha− 1) effect was statistically similar to chemical fertilizer in the case of plant height, tiller, and panicle number. Maximum grain (6.3 to 4.9 t ha− 1) and straw (6.7 to 4.9 t ha− 1) yield were observed in chemical fertilizer and poultry manure-treated plots in both season and year. Chemical fertilizer and all organic materials treated plots produced the maximum grain yield over control in both seasons and years. There was a slight increase in soil organic matter, pH, total N (%), available P, S, and exchangeable K from initial in two years. The study's overall findings indicate that the huge number of organic materials, especially poultry manure, is suitable for sustainable crop yield in a rice-rice cropping pattern.
Preoperative factors predicting outcomes in patients with suspected perihilar cholangiocarcinoma referred for curative resection— a single-center 10-year experience
Authors: Al-Saffar Hasan Ahmad , Larsen Peter Nørrgaard , Schultz Nicolai , Kristensen Thomas Skårup , Ramirez Diana Elena Renteria , Knøfler Lucas Alexander , Pommergaard Hans-Christian
Published: December 2024

Background
Perihilar cholangiocarcinoma (pCCA) is a rare malignancy requiring resection of extrahepatic bile ducts with or without hepatectomy, for radicality. Prognostic models for post-operative outcomes in pCCA are unusable in pre-operative decision-making as most are based on post-operative variables. Additionally, no pre-operative model consider futile laparotomy or benign hilar stenosis (BHS) as an outcome, despite rates of up to 30 % and 15 % respectively. We investigated pre-operative predictive factors for non-resectability, disease-free survival (DFS), and overall survival (OS), in patients referred for resection of suspected pCCA.
Method
Patients with suspected pCCA evaluated at multidisciplinary team (MDT) conference and referred for curative resection at Rigshospitalet, from 2013-2023. All were identified from the Danish Liver Cancer Group (DLGCD). Patients were evaluated, starting from date of first MDT for suspected pCCA; and starting from date of surgery if proven pCCA. Outcomes were preoperative factors related to OS, DFS and non-resectability.
Results
Ninety-three patients with suspected pCCA were considered resectable at MDT, of which
74 (79.5 %) were resected. In resected patients 65 (87.8 %) had pCCA, 2 (2.1 %) had gallbladder cancer (GBC) and 7 (7.5 %) had BHS.
Patients with futile lapartomy (n=19 [20.4%]) had higher pre-operative p-bilirubin and ECOG-performance status (ECOG-PS) score >0 compared to resected pCCA and BHS (p=0.02 and 0.01). Portal vein embolization (p<0.001, HR 2.99 [95 % CI 1.61-5.53]) and ECOG-PS >0 (p=0.003, HR 2.32 [95% CI 1.31-4.11]) had worse OS. No preoperative factors were independently associated with non-resectability or DFS.
Conclusion
ECOG-PS >0 and PVE had worse survival in patients with suspected pCCA. Patients with futile laparotomy had higher frequency of ECOG-PS >0 and elevated p-bilirubin compared to resected pCCA and BHS.
Galectin-3: a novel biomarker of glycogen storage disease type III
Authors: HOCH Lucile , Rossiaud Lucille , Miagoux Quentin , Benabides Manon , Reiss Océane , Jauze Louisa , Jarrige Margot , Hélène Polvèche , Malfatti Edoardo , Laforêt Pascal , Ronzitti Giuseppe , Nissan Xavier
Published: December 2024

Glycogen storage disease type III (GSDIII) is a rare genetic disorder leading to abnormal glycogen storage in liver and skeletal muscle. In this study, we conducted a comparative gene expression analysis of several in vitro and in vivo models identifying galectin-3 as a potential biomarker of the disease. Interestingly, we also observed a significant decrease in galectin-3 expression in mice treated with an AAV gene therapy. Finally, galectin-3 expression was studied in muscle biopsies of GSDIII patients, confirming its increase in patient tissue. Beyond the identification of this novel biomarker, our study offers a new perspective for future therapeutic developments.
Emergence of a novel reassortant H3N3 avian inﬂuenza virus with enhanced pathogenicity and transmissibility in chickens in China
Authors: Zhang Chunping , Zhao Conghui , Huang Jiacheng , Wang Yang , Jiang Bo , Zheng Hangyu , Zhuang Mingzhi , Peng Yanni , Zhang Xiaoxuan , Liu Sha , Qiang Haoxi , Wang Huanhuan , Zeng Xiancheng , Guo Guijie , Chen Ji-Long , Ma Shujie
Published: December 2024

The H3N3 avian influenza viruses (AIVs) are not as prevalent as H3N8 viruses in poultry. Yet, reassortant H3N3 viruses are occasionally detected in domestic poultry and wild birds. In this study, we isolated an H3N3 virus in chickens from a live poultry market in China. Full genomic analysis revealed that the virus had a single basic amino acid in the cleavage site of the hemagglutinin (HA) gene. Phylogenetic analysis revealed that eight genes of the H3N3 virus belong to the Eurasian lineage and the HA and NA genes were clustered with H3N2 and H11N3, respectively, while the internal genes were closely related to H3N8 and H9N2 viruses. The H3N3 virus demonstrated high and moderate stability in thermal and acid conditions, respectively, along with efficient replication capabilities in mammalian cells. Moreover, the H3N3 virus could infect and replicate in the upper and lower respiratory tract of BALB/c mice without prior adaptation, triggering hemagglutination inhibition (HI) antibody titers ranging from 80 to 160. The H3N3 virus replicated vigorously within the chicken respiratory and digestive tracts, transmitted efficiently and swiftly among chickens via direct contact, and resulted in elevated HI antibody titers in both the inoculated and contact birds. These findings indicate that the H3N3 virus might be a novel reassortant originating from viruses circulating in domestic poultry, demonstrating increased pathogenicity and transmissibility in chickens. Our findings demonstrate that H3N3 AIV may pose a potential threat to poultry industry and public health, thereby highlighting the importance of active surveillance of AIVs.
Health benefits and economical aspects on laparoscopic vs open Nissen fundoplication in children
Authors: Högberg Niclas , Danielson Johan , Westblom Amanda , Gustafson Elisabet
Published: December 2024

Background
Nissen fundoplication is one of the most common surgical procedures for gastroesophageal reflux. Current and previous research comparing laparoscopic Nissen fundoplication (LNF) versus open Nissen fundoplication (ONF) in children suggest ambiguous conclusions. The purpose of this retrospective study was to compare the outcome for children operated with LNF or ONF at our institution, and to evaluate the economic aspects.
Methods
32 consecutive patients (LNF: n = 18, ONF: n = 14) operated with Nissen fundoplication between the years 2011–2017 were included in the study. Data was collected by examination of the patient journals and preoperative, operative, postoperative, and post-discharge parameters were analyzed.
Results
Compared to ONF, the LNF group had shorter operating time (165.2 vs 216.6 min, p < 0.05), shorter overall operating room duration (315.0 vs 334.9 min, p < 0.05) and shorter postoperative hospital stay (3.8 vs 8.1 days, p < 0.05). The LNF group also required less morphine (1.2 vs 1.7 mg/kg, p < 0.05) and the total cost per case was 39% lower (261.1 vs 427.4 kSEK, p < 0.05). No difference was seen in postoperative complications and results.
Conclusion
Laparoscopic Nissen fundoplication is more beneficial for patients compared to open surgery, and at a lower cost.
Effectiveness and safety of opioid-free anaesthesia and analgesia in pain control and postoperative recovery of patients undergoing gynaecologic oncologic surgery: a retrospective cohort study
Authors: Garcia Jose Alexander Puentes , Tocancipa Daniel Rivera , Medina Eugenio , Díaz Julián Jovel , Pisso Francisco Javier Quinayas , Gil Vincent Jean Carlo García , Hernandez Fredy Leonardo Carreño
Published: December 2024

Introduction: Opioids have been essential for the anesthesiologic management of patients undergoing surgical procedures such as gynecologic oncology. However, the use of opioids brings with it hemodynamic problems, which is why opioid-free anesthesia (OFA) and multimodal postoperative analgesia techniques that restrict the excessive use of opioids are necessary.
Objective: To determine the effectiveness and safety of opioid-free anesthesia and analgesia in pain control and postoperative recovery of adult patients undergoing gynecologic oncology surgery.
Methodology: A retrospective observational cohort study was conducted by reviewing the medical records of patients at the Neiva University Hospital. Female patients who underwent gynecologic oncology surgery at the Neiva University Hospital and who received OFA, or opioid-based anesthesia (OBA) were identified. Data on pain were collected using a visual analog pain scale (VAPS), along with hemodynamic variables and adverse events at 7 different times from admission to the operating room until discharge from the hospital. A bivariate analysis was performed for the type of anesthesia, comparing frequencies of VAPS and adverse events with chi2 and mean difference for hemodynamic variables with t student. A multivariate analysis was performed with multiple logistic regression to evaluate differences in frequency of pain by VAPS based on the anesthesia regimen and other clinical variables for statistical difference times.
Results: Data were collected from 335 patients, of whom 196 (58.5%) received an OBA regimen and 139 (41.5%) an OFA regimen. A difference was identified for greater pain in OFA than in OBA (p<0.001) for the times before surgery, recovery discharge, and 24 hours after surgery. For heart rate, significant differences were only identified at admission to the operating room, 30 minutes of induction and admission to the recovery room. For respiratory rate, the differences were only significant at admission to the operating room, 30 minutes of induction. For mean arterial pressure, it was significant only in the recovery room and for oxygen saturation at admission to the operating room and discharge from recovery. As an adverse event, a higher frequency of requiring antiemetics was only identified in patients with AFO than with ABO on the fifth day of surgery. No significance was identified in multivariate analysis between OBA and OFA controlled for VAPS by other factors at 24 hours.
Conclusions: Opioids for gynecologic oncologic surgery patients have a partial impact on pain control, with poor control upon discharge to recovery areas, at 24 and 48 hours, and no clinically relevant differences in hemodynamic variables or adverse events.
Environmental Actions, Support for Policy, and Information’s provision Experimental Evidence from the US
Authors: Binelli Chiara , Loveless Matthew
Published: December 2024

We investigate the effectiveness of providing prospective versus retrospective information on local climate change to promote pro-environmental behavior and support for green policies. A randomized experiment on a representative sample of American adults finds that providing prospective local climate change information is most effective at increasing pro-environmental actions and policy support, regardless of partisanship. The impact of this information provision increases when individuals feel responsible for addressing climate change, have young children, and trust the central government. Prospective information on local climate change can thus contribute to promoting the vast support for the necessary actions to address the climate crisis.
JEL Codes: Q54; D84; C93.
Clinical and MRI Markers for Acute vs Chronic TMD Using a Machine Learning and Deep Learning Approach
Authors: Lee Yeon-Hee , Jeon Seonggwang , Auh Q-Schick , Lee Jeong- Hoon , Noh Yung-Kyun
Published: December 2024

This study aimed to identify factors that significantly contribute to the chronicity of symptoms in patients with temporomandibular disorders (TMD). Statistical, machine learning, and deep learning models were used for analysis. The study include 239 patients with TMD (161 women and 78 men; mean age 35.60 ± 17.93 years), diagnosed using Diagnostic Criteria for TMD (Axis I). Participants were categorized into: acute TMD (< 6 months) and chronic TMD (≥ 6 months) (51.05%). Significance clinical findings revealed that temporomandibular joint (TMJ) noise and bruxism were more frequently reported in patients with chronic TMD than in those with acute TMD. The visual analog scale (VAS) score, reflecting subjective pain intensity, was significantly higher in chronic TMD than in acute TMD. Additionally, patients with chronic TMD had shorter average sleep durations than their acute counterparts. STOP-Bang total scores were higher in chronic TMD (3.02 ± 2.09 vs. 2.39 ± 1.73, p = 0.012) than in acute TMD. Magnetic resonance imaging revealed structural abnormalities in patients with chronic TMD, with significantly higher rates of anterior disc displacement (ADD), TMJ osteoarthritis, and joint space narrowing. Using logistic regression—a widely recognized machine learning model—the AUROC for predicting chronic TMD was 0.7550 (95% CI]: 0.6550–0.8550). Significant predictors of chronic TMD included TMJ noise, bruxism, VAS score, sleep disturbance, STOP-Bang total score ≥ 5 (high risk of obstructive sleep apnea), ADD, and joint space narrowing. Deep learning (multilayered perceptron) improved prediction performance by 3.99% over logistic regression (79.49% vs. 75.50%, p = 0.3067). These findings may help clinicians prevent symptom chronicity and mitigate the progression to chronic TMD, ultimately improving patient care.
Correlation between diabetic retinopathy and bone mineral density and bone metabolism indexes：a case-control study
Authors: Li Ning , Dang Yalong , Qu Guodong , Huang Xiufeng , Ye Guangbin , Wang Changli , Liu Haodan , Ma Fuwei , Zhang Fangfang , Huang Kairi , Bin Xiaoyun
Published: December 2024

Objective
The objective of this research is to examine the correlation between diabetic retinopathy and bone mineral density(BMD), as well as bone metabolism indicators, through clinical research and bioinformatics analysis.
Methods
① 64 patients diagnosed with both diabetes mellitus and retinopathy constituted the observation group, whereas 91 patients with diabetes mellitus alone formed the control group. Their BMD and bone metabolism indices were then compared.② Disease genes were searched in the relevant databases for diabetic retinopathy and osteoporosis respectively.Common target genes were obtained after de-replicating the intersections. The common target genes were constructed through theSTRING database to construct PPI network maps and screen common core targets, and finally, GO and KEGG enrichment analyses were performed.
Results
The observation group exhibited lower levels of BMD, BMC, T-Score, and Z-Score than the control group(P < 0.05).and the common core targets of diabetic retinopathy and osteoporosis were INS, IL6, AKT1, TNF, etc. Their common core targets mainly act on the AGE-RAGE, lipid and atherosclerosis, HIF-1 and other specific pathways in diabetic complications to play a regulatory role in the regulation of bone metabolism and thus trigger osteoporosis.
Conclusion
The decrease in BMD and diabetic osteoporosis is probably another manifestation of diabetic microangiopathy, and the common core targets and signalling pathways involved in the two diseases can regulate both diseases and have an impact on them, suggesting that there is a close correlation between diabetic retinopathy and BMDin terms of pathology and molecular mechanisms.
Integrative Bioinformatics Analysis of m1A Genes in Periodontitis and Diabetes: Identifying Potential Diagnostic Biomarkers
Authors: Wang Kai , Qiu Liewang , Wang Aiguo , Xu Ling , Wei Jingjing
Published: December 2024

Periodontitis (PD) and type 2 diabetes mellitus (T2DM) are common chronic diseases with an established bidirectional relationship. This study investigates the expression patterns and regulatory roles of m1A-modified genes in PD and T2DM, aiming to explore potential molecular mechanisms, and evaluate their potential as diagnostic biomarkers.Transcriptomic data for PD and T2DM patients were integrated from GEO to analyze m1A-related gene expression. A diagnostic model was developed using ridge and logistic regression. Gene function enrichment, immune infiltration, and PPI analyses explored m1A regulatory mechanisms based on m1A scoring and patient clustering models. And the expression of specific genes was further validated by qRT-PCR. Differential expression of m1A-related genes was significant in PD and T2DM, with BMT2 downregulated in both and RRP8 upregulated in T2DM. RRP8 and ALKBH3 had high predictive value in the diagnostic model. Immune infiltration and PPI analyses indicated marked differences in immune cell infiltration between disease groups. Hub genes MAK16 and DDX18 were associated with T cell activity and immune infiltration, suggesting relevance to the PD-T2DM relationship. This study provides preliminary evidence supporting the potential use of m1A-modified genes as diagnostic biomarkers for both conditions. Additional research is necessary to confirm these mechanisms and explore their clinical applicability.
Prediction Models for Early Post-Discharge Falls Among Older Adults Using Machine Learning: A Prospective Cohort Study
Authors: Onishi Mai , Takeshita Yuko , Masuda Hirotada , Katsuhisa Mizuki , Saizen Yuichiro , Ikuta Kasumi , Kasamatsu Misaki , Fujii Misaki , Moriki Yuki , Koujiya Eriko , Yamakawa Miyae , Takeya Yasushi
Published: December 2024

Purpose
To construct a prediction model for early post-discharge falls among older adults in Japan using machine learning, leveraging patient information collected during hospitalization.
Methods
This prospective cohort study was conducted at an acute care hospital in Osaka, Japan. Participants were inpatients aged ≥ 65 years admitted to the geriatric ward between February 2022 and July 2023. At admission and discharge, 83 patient information items were collected from electronic medical records. The outcome, recorded within three months of discharge, was collected telephonically. Variables used in the model were selected based on statistical analyses and clinical findings, and the model was constructed using five algorithms.
Results
The analysis included 156 patients [mean age: 78.1 ± 5.8 years; women: 79 (50.6%)], 19 (12.2%) of whom had fallen within three months of discharge. Six variables were used in the model: “alanine aminotransferase (ALT),” “self-assessment of health status,” “decrease in grip strength,” “Clinical Frailty Scale ≥ 4,” “fecal incontinence,” and “urinary incontinence.” The best area under the precision-recall curve (AUPRC) and area under the receiver operating characteristic curve (AUROC) values were obtained using CatBoost (AUROC: 0.801; AUPRC: 0.392; sensitivity: 0.375; specificity: 0.964). The highest sensitivity was found for ExtraTrees (AUROC: 0.719; AUPRC: 0.331; sensitivity: 0.500: specificity: 0.964).
Conclusion
The results demonstrate the potential of using machine learning to construct a model for predicting early post-discharge falls in hospitalized older adult patients.
Evaluating women’s experiences and satisfaction with labour induction in India: a comparison of the Participant Generated Experience and Satisfaction (PaGES) Index with standard methods
Authors: Patel Avni , Howard Rachel , Faragher Brian , Durocher Jill , Winikoff Beverly , Symon Andrew , Weeks Andrew , Mundle Shuchita , Lightly Kate
Published: December 2024

Background
Although induction of labour is becoming more common worldwide, there are few studies that assess women’s satisfaction with it. The newly developed Participant Generated Experience and Satisfaction (PaGES) Index collects brief qualitative data and quantifies it, allowing detailed satisfaction data to be collected on large populations. The PaGES data has never previously been compared to other methods of assessing study participants’ satisfaction. We aimed to triangulate PaGES Index, Likert questionnaire and interview data from a large, randomised trial of labour induction to fully understand women’s priorities, experience and satisfaction and to compare the findings of the three instruments.
Methods
A convergent parallel multi-methods research design was used. Participants in the Misoprostol or Oxytocin for Labour Induction (MOLI) trial (n=520) completed the PaGES Index before and after birth, listing priorities and allocating spending points to demonstrate their relative importance. Postnatally, participants scored their satisfaction with each item. Quantitative data was collected postnatally on the acceptability of augmentation, delivery time, pain and anxiety using a Likert scale. Semi-structured interviews were also conducted, and thematic analysis was carried out using a framework approach. The data from 20 participants who had completed all three outcome measures were integrated and compared.
Results
Although common themes, such as pain, emerged from participants’ responses to the three instruments, each provided different insights. The Likert responses demonstrated overall satisfaction with the induction process but with high levels of pain and anxiety. Semi-structured interviews highlighted that safety and health of the baby was a key priority. The PaGES Index confirmed that the baby’s wellbeing was most important to women, but women also expressed a strong preference for vaginal delivery.
Conclusions
The PaGES Index, Likert questionnaire and semi-structured interview data provide varied but complimentary insights on women’s birth experiences and their satisfaction with their induction process. The outputs of the three methods align, but the PaGES index was unique in capturing both detailed qualitative and quantitative information for all study participants.
Trial registration
The MOLI study is registered in ClinicalTrials.gov (NCT03749902, Registration date: 21st Nov 2018) and Clinical Trial Registry, India (CTRI/2019/04/018827)
ESI Triage Level Assignment for Headache Patients: Comparative Analysis of ChatGPT and Gemini Performance for Supporting Care Provider Decisions and Self-triage
Authors: Samadpour Hamed , Kalhori Sharareh Rostam Niakan , Tahmasebi Masoumeh , Rakhshi Mahla , Lotfi Fatemeh
Published: December 2024

Objective
This study evaluated the performance of two advanced large language models (LLMs), ChatGPT and Gemini, in supporting triage decisions for headache patients in emergency settings via the Emergency Severity Index (ESI) from both patient self-triage and healthcare provider perspectives.
Methods
Data, including 500 records of patients presenting with headache complaints, were obtained from the MIMIC-IV-ED database. Two distinct prompt types were created: one for self-triage to assist patients in assessing their care needs on the basis of symptom descriptions and another for healthcare providers to determine ESI levels. Each model's output was compared to actual ESI levels via precision, recall, and F1 scores to measure performance.
Results
ChatGPT achieved greater accuracy at lower acuity levels (ESIs 3 and 4), accurately identifying patients who did not require urgent care. Gemini demonstrated improved performance at higher acuity levels (ESIs 1 and 2), indicating its ability to recognize critical cases effectively. Both models showed stronger performance with healthcare provider prompts than with self-triage prompts, underscoring the importance of structured input for accurate triage assessments. This variation highlights the need to refine self-triage prompts to ensure safe and precise use.
Conclusion
ChatGPT and Gemini show promise as decision-support tools for ED triage, particularly for assisting healthcare providers in prioritizing cases on the basis of acuity. However, further refinement is needed to increase accuracy in self-triage scenarios. Future studies should validate these findings across a broader dataset and explore the integration of LLMs into clinical decision support systems to strengthen triage reliability and effectiveness.
Mortality Risk Factors and Clinical Profiles of Pediatric Adenovirus Pneumonia: A Study from a Comprehensive Hospital in Northeast China
Authors: Shen Yuetong , Xu Wei , Song Wenliang
Published: December 2024

Adenovirus pneumonia (ADVP) is a significant cause of morbidity and mortality in children admitted to the Pediatric Intensive Care Unit (PICU). This study analyzes the clinical characteristics and key risk factors for mortality in children with ADVP admitted to a PICU in Northeast China. A total of 91 cases were reviewed, with a focus on clinical features, laboratory results, and radiological findings. In Northeast China, the incidence of ADVP peaked in autumn (34.1%) and winter (38.5%), with a PICU mortality rate of 22.9% in winter. The median onset age was 2.6 years, and the overall PICU mortality rate was 13.19%. Mortality was notably higher among children aged ≤ 2 years and those with a history of preterm birth. Clinical markers such as carbon dioxide retention, a low P/F ratio, hypoalbuminemia, elevated LDH levels, and pleural effusion were associated with increased mortality. Logistic regression identified age ≤ 2 years (OR: 24.542, 95% CI: 1.443 ~ 417.42), preterm birth (OR: 36.107, 95% CI: 1.444 ~ 903.032), and a P/F ratio < 300 mmHg (OR: 19.725, 95% CI: 1.539 ~ 252.808) as independent risk factors for mortality. These findings highlight the need for early risk identification and targeted interventions in high-risk pediatric groups to improve outcomes.