bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimising the usage of desflurane only by education and removal of the vaporisers – a before-and-after-trial
Authors: Lehmann Ferdinand , Mader Johannes , Koch Christian , Markmann Melanie , Leicht Dominik , Sander Michael
Published: February 2025

Background

By exceeding planetary environmental boundaries, multiple global crises have become imminent in the 21st century. The healthcare system is a contributor to the climate crisis, accounting for approximately 5% of greenhouse gas emissions in Western countries. In anaesthetic clinics, desflurane, a highly potent greenhouse gas and volatile anaesthetic with no compelling indications, accounts for up to two thirds of total emissions. Its use can be drastically reduced using simple measures. In the present study, we investigated whether a relevant and timely reduction in use could be achieved by dismounting desflurane vaporisers and providing information to the team without restricting its use.

Methods

The study was conducted in a German university hospital with approximately 1250 beds, over a 12-month period between 2021 and 2022, with a comparison to the corresponding periods of the previous years up to 2017. The interventions were, first, the removal of desflurane vaporisers, and second, staff education on the climate impact of volatile anaesthetics. The primary outcome variable was the reduction of hypnotic-related emissions in CO2 equivalents per anaesthetic procedure.

Results

Prospective data collection and interventions were conducted from 28 March 2021 to 27 March 2022. The amount of CO2 equivalent emissions per procedure in the form of volatile anaesthetics was reduced by 86% compared with the year before the interventions (p < 0.001). Interestingly, there was already a 52.1% reduction in the year before the procedure (p < 0.001). There were no significant changes in the use of sevoflurane or propofol. Hypnotic-related costs decreased by €14,549, whereas extubation time did not change significantly.

Conclusions

Removal of desflurane vaporisers and staff training can quickly and significantly reduce the emissions of an anaesthesia department in a large German teaching hospital. This may also reduce the costs.

Trial registration

The trial was registered with the German Clinical Trials Register, identifier DRKS00024973 on 12/04/2021.
A longitudinal study of the subjective birth experience and the relationship to mental health
Authors: Märthesheimer Sarah , Hagenbeck Carsten , Helbig Martina , Balan Percy , Fehm Tanja , Schaal Nora K.
Published: February 2025

Background

A satisfying birth experience has positive effects on the well-being of mother and child. The birth experience depends on subjective expectations and objective birth parameters, and the view of birth can also change over time. However, it is still unclear how birth anxiety and mode of birth affect the different dimensions of the birth experience in the first months after childbirth.

Methods

In this prospective longitudinal study, 307 first-time mothers, planning to give birth vaginally, were assessed for fear of childbirth at approximately 34 weeks of gestation and for obstetric information. Postpartum birth experience and psychological stress was evaluated 2 days, 6 weeks and 6 months postpartum using the validated Childbirth Experience Questionnaire which comprises the four dimensions emotional experience, participation, professional support and coping possibilities, and a visual analogue scale for a global birth judgement, supplemented by the Edinburgh postpartum depression scale and the Impact of Event Scale.

Results

The individual dimensions of the birth experience changed differently within the first six months. Mixed factorial ANOVAs identified a main effect of fear of childbirth for all four dimensions of the birth experience and the global birth judgment. Mode of birth influenced the dimension participation and the global judgement. For emotional experience, a complex interplay between fear of birth, birth mode and time was revealed. Correlation analyses showed significant associations between the birth experience and the psychological distress symptoms resulting from childbirth.

Conclusions

Prepartum fear of childbirth affects all dimensions of the subjective birth experience, even after six months. Birth mode, on the other hand, only affects the global birth judgement and participation. The stable correlations between the different dimensions of the birth experience and maternal mental health highlight the importance of the birth experience for clinical practise.

Trail registration

Registered in the German Clinical Trials Register (“DRKS”) (No. DRKS00022177) on 22 June 2020 (https://drks.de/search/en/trial/DRKS00022177).
Early versus delayed mobilisation for non-surgically treated proximal humerus fractures: a systematic review and meta-analysis of randomised trials
Authors: Challoumas Dimitris , Minhas Haroon , Bagni Stephanie , Millar Neal
Published: February 2025

Background

Proximal humerus fractures (PHFs) are among the commonest bony injuries and the majority of them can be managed non-surgically. The aim of our systematic review and meta-analysis was to compare the effectiveness and safety of early versus delayed mobilisation in conservatively treated PHFs.

Methods

A literature search was performed in Medline, EMBASE and clinicaltrials.gov in Januray 2025 aiming to identify all randomised controlled trials (RCTs) comparing early versus delayed (conventional) mobilisation as part of the non-surgical management of PHFs. Primary outcomes were patient-reported function and pain at short-term (3 months), mid-term (6 months) and long-term (12 months) follow-up, and secondary outcomes included secondary fracture displacement and total complications. Meta-analyses produced mean differences (MDs) or standardised MDs (SMDs) for continuous outcomes and odds ratios (ORs) for binary outcomes, with 95% confidence intervals (CI). Certainty of evidence was assessed using the GRADE tool. Recommendations for clinical practice were given only based on results of high or moderate certainty of evidence.

Results

Six (6) RCTs were included that compared early mobilisation (EM; within one week from injury) to delayed mobilisation (DM; after 3 or 4 weeks of immobilisation) with a total of 470 patients with PHFs. There were no differences in patient-reported function (combined or Constant score) or pain between the EM and DM groups at any follow-up time points except for a significant difference in combined function scores favouring EM [SMD 0.4 CI (0.1,0.7), P = 0.006] at 3 months follow-up. There were no significant differences in the incidence of secondary fracture displacement and total complications in the two groups [OR 3.5 CI (0.7,18.2), P > 0.05, and OR 1.2 CI (0.5,2.9), P > 0.05, respectively]. All results were based on moderate or high strength of evidence. The most significant limitations of our study were the small number of pooled studies and inability to perform subgroup analyses for specific fracture types.

Conclusions

Our meta-analysis of RCTs showed that commencement of mobilisation within one week from injury for non-surgically managed PHFs is safe and may confer short-term functional benefits compared to delayed mobilisation.
Radiotherapy resistance driven by Asparagine endopeptidase through ATR pathway modulation in breast cancer
Authors: Morillo-Huesca Macarena , G. López-Cepero Ignacio , Conesa-Bakkali Ryan , Tomé Mercedes , Watts Colin , Huertas Pablo , Moreno-Bueno Gema , Durán Raúl V. , Martínez-Fábregas Jonathan
Published: February 2025

Background

Tumor resistance represents a major challenge in the current oncology landscape. Asparagine endopeptidase (AEP) overexpression correlates with worse prognosis and reduced overall survival in most human solid tumors. However, the underlying mechanisms of the connection between AEP and reduced overall survival in cancer patients remain unclear.

Methods

High-throughput proteomics, cellular and molecular biology approaches and clinical data from breast cancer (BC) patients were used to identify novel, biologically relevant AEP targets. Immunoblotting and qPCR analyses were used to quantify protein and mRNA levels. Flow cytometry, confocal microscopy, chemical inhibitors, siRNA- and shRNA-silencing and DNA repair assays were used as functional assays. In-silico analyses using the TCGA BC dataset and immunofluorescence assays in an independent cohort of invasive ductal (ID) BC patients were used to validate the clinical relevance of our findings.

Results

Here we showed a dual role for AEP in genomic stability and radiotherapy resistance in BC patients by suppressing ATR and PPP1R10 levels. Reduced ATR and PPP1R10 levels were found in BC patients expressing high AEP levels and correlated with worst prognosis. Mechanistically, AEP suppresses ATR levels, reducing DNA damage-induced cell death, and PPP1R10 levels, promoting Chek1/P53 cell cycle checkpoint activation, allowing BC cells to efficiently repair DNA. Functional studies revealed AEP-deficiency results in genomic instability, increased DNA damage signaling, reduced Chek1/P53 activation, impaired DNA repair and cell death, with phosphatase inhibitors restoring the DNA damage response in AEP-deficient BC cells. Furthermore, AEP inhibition sensitized BC cells to the chemotherapeutic reagents cisplatin and etoposide. Immunofluorescence assays in an independent cohort of IDBC patients showed increased AEP levels in ductal cells. These analyses showed that higher AEP levels in radioresistant IDBC patients resulted in ATR nuclear eviction, revealing AEPhigh/ATRlow protein levels as an efficient predictive biomarker for the stratification of radioresistant patients.

Conclusion

The newly identified AEP/ATR/PPP1R10 axis plays a dual role in genomic stability and radiotherapy resistance in BC. Our work provides new clues to the underlying mechanisms of tumor resistance and strong evidence validating the AEP/ATR axis as a novel predictive biomarker and therapeutic target for the stratification and treatment of radioresistant BC patients.
Probing locus coeruleus functional network in healthy aging and its association with Alzheimer’s disease biomarkers using pupillometry
Authors: Wu Junjie , Toporek Aaron , Lin Qixiang , Goldstein Felicia C. , Loring David W. , Kelberman Michael A. , Weinshenker David , Levey Allan I. , Lah James J. , Qiu Deqiang
Published: February 2025

Background

Alzheimer’s disease (AD) is the leading cause of dementia, and the early detection of the disease-associated changes allows early interventions. The locus coeruleus (LC) has been reported to be the first brain region to develop tau pathology in AD. However, the functional brain network of the LC in both healthy aging and AD pathology is largely unknown due to technical difficulties associated with the small size of the LC. In this study, we used the measurement of spontaneous pupil constriction/dilation as a surrogate for LC activity to study LC brain network changes during healthy aging.

Methods

Thirty-seven healthy younger and thirty-nine healthy older adults were included from the Emory Healthy Brain Study and underwent resting-state functional MRI while simultaneously tracking pupil diameter. The measurements of pupil diameter dynamics were used as reference signals in brain connectivity analysis. The connectivity of the identified networks was then compared between younger and older participants. Correlations of the identified regions with neuropsychological assessments and cerebrospinal fluid (CSF) biomarkers were also evaluated.

Results

A brain network of 20 clusters associated with pupil diameter dynamics was identified, including the LC as well as brain regions functionally connected to the LC. The pupil diameter network was found to positively correlate with the salience network and negatively correlate with the central executive network. Functional connectivity decreased within the pupil diameter network with healthy aging. The pupil diameter connectivity was associated with memory, executive, and visuospatial functioning. CSF total tau closely correlated with pupil diameter network.

Conclusions

Pupil diameter dynamics provide valuable insights into LC-related processes. While they are not solely influenced by LC activity, spontaneous pupil constrictor/dilatory activity shows promise as a non-invasive approach to probe the LC network and warrants further studies to evaluate its value as an early biomarker of AD.
Autistic behavior is a common outcome of biallelic disruption of PDZD8 in humans and mice
Authors: Pantiru Andreea D. , Van de Sompele Stijn , Ligneul Clemence , Chatelain Camille , Barrea Christophe , Lerch Jason P. , Filippi Beatrice M. , Alkan Serpil , De Baere Elfride , Johnston Jamie , Clapcote Steven J.
Published: February 2025

Background

Intellectual developmental disorder with autism and dysmorphic facies (IDDADF) is a rare syndromic intellectual disability (ID) caused by homozygous disruption of PDZD8 (PDZ domain-containing protein 8), an integral endoplasmic reticulum (ER) protein. All four previously identified IDDADF cases exhibit autistic behavior, with autism spectrum disorder (ASD) diagnosed in three cases. To determine whether autistic behavior is a common outcome of PDZD8 disruption, we studied a third family with biallelic mutation of PDZD8 (family C) and further characterized PDZD8-deficient (Pdzd8

tm1b
) mice that exhibit stereotyped motor behavior relevant to ASD.

Methods

Homozygosity mapping, whole-exome sequencing, and cosegregation analysis were used to identify the PDZD8 variant responsible for IDDADF, including diagnoses of ASD, in consanguineous family C. To assess the in vivo effect of PDZD8 disruption on social responses and related phenotypes, behavioral, structural magnetic resonance imaging, and microscopy analyses were conducted on the Pdzd8

tm1b
mouse line. Metabolic activity was profiled using sealed metabolic cages.

Results

The discovery of a third family with IDDADF caused by biallelic disruption of PDZD8 permitted identification of a core clinical phenotype consisting of developmental delay, ID, autism, and facial dysmorphism. In addition to impairments in social recognition and social odor discrimination, Pdzd8

tm1b
mice exhibit increases in locomotor activity (dark phase only) and metabolic rate (both lights-on and dark phases), and decreased plasma triglyceride in males. In the brain, Pdzd8

tm1b
mice exhibit increased levels of accessory olfactory bulb volume, primary olfactory cortex volume, dendritic spine density, and ER stress- and mitochondrial fusion-related transcripts, as well as decreased levels of cerebellar nuclei volume and adult neurogenesis.

Limitations

The total number of known cases of PDZD8-related IDDADF remains low. Some mouse experiments in the study did not use balanced numbers of males and females. The assessment of ER stress and mitochondrial fusion markers did not extend beyond mRNA levels.

Conclusions

Our finding that the Pdzd8

tm1b
mouse model and all six known cases of IDDADF exhibit autistic behavior, with ASD diagnosed in five cases, identifies this trait as a common outcome of biallelic disruption of PDZD8 in humans and mice. Other abnormalities exhibited by Pdzd8

tm1b
mice suggest that the range of comorbidities associated with PDZD8 deficiency may be wider than presently recognized.
Integrating multi-source data for life-cycle risk assessment of bridge networks: a system digital twin framework
Authors: Geng Ziheng , Zhang Chao , Jiang Yishuo , Pugliese Dora , Cheng Minghui
Published: February 2025

Bridges are critical infrastructure assets that face a variety of stressors throughout their service life, requiring a life-cycle approach to assess their risk profile. Recent advancements in sensing and monitoring technologies provide a powerful data foundation to improve the accuracy of life-cycle risk assessment (LCRA). However, existing works that incorporate data for probabilistic risk assessment typically focus on individual bridges and rely on single-source data, limiting their scope and applicability. To this end, a system digital twin (SDT) framework based on Bayesian network (BN) is proposed to integrate multi-source data for LCRA of bridge networks. Specifically, the SDT can capture correlations and interdependencies across various scales, including within individual components (e.g., multiple failure modes), between components within a system (e.g., bridges along a route), and across interconnected systems (e.g., bridge and hydraulic systems). It integrates data from various sources including bridge inspections, traffic monitoring facilities, and water watch stations. A coastal bridge network in Miami-Dade County, FL, is used as an illustrative example to demonstrate how the SDT integrates multi-source data for risk assessment. Additionally, several future scenarios are hypothesized to showcase the applicability and flexibility of the proposed framework in supporting risk management for infrastructure systems.
The Current State of Pediatric Cardiac Anesthesiology Staffing in the United States
Authors: Deutsch Nina , Grant Stephanie , Zabala Luis , Staffa Steven J. , Lau Jennifer , Andropoulos Dean , Geiduschek Jeremy , Kurth C. Dean , Nasr Viviane G.
Published: February 2025

BACKGROUND:

The population of patients with congenital heart disease has grown, but the supply of pediatric cardiac anesthesiologists has not kept pace. The Pediatric Anesthesia Leadership Council (PALC) and the Congenital Cardiac Anesthesia Society (CCAS) formed a task force to evaluate the current state of the specialty of pediatric cardiac anesthesia, including staffing, work environment, education, compensation, and career development.

METHODS:

Five task force working groups developed survey questions that explored 5 different aspects of a pediatric cardiac anesthesiologist’s career. Surveys were completed by CCAS member faculty volunteers, division chiefs/directors of pediatric cardiac anesthesia programs, program directors of pediatric cardiac anesthesia fellowships, and fellowship graduates from the past 10 years.

RESULTS:

Survey completion rates were 77% (n = 86) for CCAS faculty, 52% (n = 58) for pediatric cardiac anesthesiology directors/division chiefs, 91% (n = 21) for pediatric cardiac anesthesiology fellowship directors, and 53% (n = 65) for 2013–2022 pediatric cardiac anesthesia fellowship graduates. Of CCAS faculty respondents, 31.4% (n = 27) are considering leaving pediatric cardiac anesthesia for a less stressful field. While most respondents reported being involved in academic activities, 34% (n = 29) do not receive nonclinical time. Only 35.3% (n = 30) of respondents receive formal mentorship and 44.7% (n = 38) of participants have been sponsored for leadership positions, research opportunities, or speaking engagements. The total number of anticipated hires in the next 5 years is 129; that number goes up to 194 in 10 years. The challenge in hiring was graded as 8/10 with 10 being the most challenging.

CONCLUSIONS:

This survey provides important data about the current state of pediatric cardiac anesthesiology and the need to address staffing and academic support. With nearly one-third of those practicing in the field considering leaving the pediatric cardiac subspecialty and with the decreasing number of fellows per year, there is a significant cause for concern for staffing, especially when the demand for practitioners in this field is increasing. In addition, even though the majority of faculty reported being involved in academic activities, many do not receive academic time for these activities and less than half receive formal mentorship or have been sponsored for leadership positions, publications, research opportunities, or speaking engagements. Further work to recruit, retain, and develop pediatric cardiac anesthesiologists is warranted.
Intellectuals, Philosophy, and Politics in Dark Times: Interview of Ágnes Heller by Waldemar Bulira
Authors: Heller Ágnes , Bulira Waldemar
Published: February 2025

This interview is the result of three long conversations with Ágnes Heller in 2014 and 2017. The subject matter of the interview concerns both biographical issues and Heller’s work itself. The story of her life begins in interwar Hungary, the specifics of which are portrayed through the prism of her father’s experiences; the interview then addresses Heller’s functioning within the communist system, with a special focus on the figure of György Lukács. Both figures are central to Heller’s life: her father instilled in her a belief in liberal values, while Lukács, after World War II, introduced her to Marxism. Her ultimate disillusionment with this doctrine, the first symptoms of which became apparent while the Budapest School still existed, resulted in a shift to a revisionist position and subsequent expulsion from communist Hungary. The themes raised in the interview document the intellectual evolution of Heller, whose political-philosophical beliefs gradually drifted toward liberal-postmodernist positions. On a broader level the topics of the conversation oscillate around the category of the intellectual, contemporary philosophy, the phenomenon of grand narratives, and the Holocaust, as well as the fragility of liberal democracy in contemporary modern society.
Unhappy End: Understanding Silence in Andreas Dresen’s Stilles Land
Authors: Kagel Martin
Published: February 2025

This article considers the role of silence in Andreas Dresen’s 1992 debut film Stilles Land (Silent Country). It initially provides background on the film’s setting, the theater of Anklam, its recent history and significance, before discussing the general role of theater in the German Democratic Republic (GDR) and the play rehearsed and performed in the film, Samuel Beckett’s Waiting for Godot. One heretofore overlooked aspect in which the film is connected to the play is through the use of silence. Dresen employs silence in ways akin to Beckett, not to pause or interrupt but as an integral part of the film’s narrative structure. In Silent Country, silence points to the absence of political progress, evokes past trauma, works as a form of resistance, and creates space for the utopian desire for a just society. In documenting these instances, Silent Country creates an archive of unspoken emotions and protests, preserving an essential part of what was the GDR. In its critique of GDR socialism, the film moreover aligns itself with the institutional function of theater in East Germany, which was to point to the regime’s shortcomings and evoke the horizon of its original political quest.
Macromolecular and cytological changes in fission yeast G0 nuclei
Authors: Tan Zhi Yang , Cai Shujun , Paithankar Saayli A. , Liu Tingsheng , Nie Xin , Shi Jian , Gan Lu
Published: February 2025

When starved of nitrogen, fission yeast Schizosaccharomyces pombe cells enter a quiescent “G0” state with smaller nuclei and transcriptional repression. The genomics of S. pombe G0 cells has been well studied, but much of its nuclear cell biology remains unknown. Here we use confocal microscopy, immunoblots, and electron cryotomography to investigate the cytological, biochemical, and ultrastructural differences between S. pombe proliferating, G1-arrested, and G0 cell nuclei, with an emphasis on the histone acetylation, RNA polymerase II fates, and macromolecular complex packing. Compared to proliferating cells, G0 cells have lower levels of histone acetylation, nuclear RNA polymerase II, and active transcription. The G0 nucleus has similar macromolecular crowding yet fewer chromatin-associated multi-megadalton globular complexes. Induced histone hyperacetylation during nitrogen starvation results in cells that have larger nuclei and therefore less compact chromatin. However, these histone-hyperacetylated cells remain transcriptionally repressed with similar nuclear crowding. Canonical nucleosomes – those that resemble the crystal structure – are rare in proliferating, G1-arrested, and G0 cells. Our study therefore shows that extreme changes in nucleus physiology are possible without extreme reorganisation at the macromolecular level.
Promotions and Productivity: The Role of Meritocracy and Pay Progression in the Public Sector
Authors: Deserranno Erika , Kastrau Philipp , León-Ciliotta Gianmarco
Published: February 2025

We study promotion incentives in the public sector. In collaboration with Sierra Leone’s Ministry of Health, we introduce exogenous variation in the meritocratic nature of promotions from health worker to supervisor positions and in health workers’ perceptions of pay progression upon promotion. Ten months later, our findings reveal that meritocracy leads to a 22 percent increase in health workers’ productivity. Greater perceived pay progression in a meritocratic system boosts productivity by 23 percent, whereas in a less meritocratic system, it decreases productivity by 27 percent. We show that this reduction is consistent with a negative morale effect. (JEL C93, H51, I11, J24, J31, M51, O15)
Modern methods of storage and packaging of garden strawberries (Fragaria × ananassa Duch.) (review)
Authors:   LLC «BELROSAKVA», Burak Leonid Ch. , Ovsyannikova Nataliya L. ,   LLC «BELROSAKVA»
Published: February 2025

Postharvest treatment of garden strawberries and the development of effective storage methods are crucial to increase the shelf life and preserve its quality until consumption. Although some reviews on certain treatment technologies have been published, we have not found studies that considered and compared common and advanced methods of storing garden strawberries. Therefore, the goal of this study is to review modern postharvest methods of strawberry storage (Fragaria × ananassa Duch). The review includes reports published in English and Russian in 2014—2024. PubMed, Scopus, Web of Science, Elibrary and Google Scholar databases were used to search by keywords. 50 scientific publications have been studied. In the first part of our study, the metabolic and biochemistry processes that underlie the ripening process of strawberries are considered, the factors that cause spoilage of strawberry berries are analyzed, and modern methods of strawberry treatment are presented. The preservation of garden strawberries using radiation, light or heat treatment can prevent the development of microorganisms and increase the resistance of berries to diseases. However, these methods can have a negative impact on the nutritional value, color and taste of berries over time. Cold storage is the most commonly used method of storing garden strawberries after harvest throughout the supply chain. In addition to cold storage, post-harvest treatment methods, including thermal, cold plasma and chemical treatments, have been carefully studied and individually applied to further increase of the strawberry shelf life. These treatments help to prevent fungal infection, activate the metabolic protection system and improve the structural integrity of strawberry berries, thereby maintaining their quality over time, especially during cold storage. In addition to treatment methods, storage in a modified atmosphere, the application of active packaging and functional coatings have been recognized as effective ways to preserve the quality of berries and effectively prevent spoilage after harvest. In addition, the combined use of two or more of these methods has proven to be the most effective for improving the shelf life of garden strawberries. The analysis of the antifungal effectiveness of modern storage methods, study of the synergy between different methods and the development of solutions based on biopolymers represent a key path for future research.
Síndrome de Ruphus
Authors: Vargas Rodríguez Ledmar Jovanny , Velasco Castro Julio Cesar , Guerrero Peña Paula Andrea , Holguín Barrera Monica Liseth , Rozo Ortiz Edwar Jassir
Published: February 2025

Introducción: en 1971, Peter Schur acuñó por primera vez el término Rhupus para describir a los pacientes que cursaban simultáneamente con lupus eritematoso sistémico (les) y artritis reumatoidea (ar). Caso clínico: mujer de 76 años quien ingresó por un cuadro de una semana de evolución de cefalea frontal de intensidad moderada asociada con epistaxis, hematemesis, astenia y adinamia. Tenía antecedentes de ar. En el examen físico estaba taquicárdica, con edema en las muñecas, nódulo reumatoide en el codo, desviación cubital en las falanges de ambas manos y deformidad en cuello cisne en las falanges de ambas manos. Los exámenes paraclínicos mostraron anemia macrocítica, trombocitopenia severa y daño renal agudo con hematuria microscópica. Ante estos hallazgos, se decidió transfundirle 6 unidades de plaquetas y hacerle estudios adicionales. Se encontraron los anticuerpos antinucleares (ana) ligeramente positivos con anti-adn positivo y complemento no consumido y anticuerpos antipéptido cíclico citrulinados (anti-ccp) positivos, por lo que cumplía criterios para una les junto a ar configurando un síndrome de Rhupus. Conclusiones: el síndrome de Rhupus es un síndrome de sobreposición raro, con una frecuencia estimada entre el 0.01 % y el 2 % de los pacientes. Los paraclínicos reportan una alta sensibilidad y suelen caracterizarse presencia de anti-cpp, ana, consumo de complemento, positividad del factor reumatoide, proteína C reactiva y anemia. El tratamiento se basa en la incorporación de medicamentos antirreumáticos modificadores de la enfermedad, suplementos de ácido fólico y el aumento de la dosis de corticoesteroides.
Healthcare Cost Prediction for Heterogeneous Patient Profiles Using Deep Learning Models with Administrative Claims Data
Authors: Morid Mohammad Amin , Sheng Olivia R. Liu
Published: February 2025

Accurate and equitable patient cost prediction is essential for informing health management policies and optimizing resource allocation, directly impacting government agencies, private insurers, and healthcare providers. This study highlights the importance of addressing disparities in prediction outcomes, particularly for high-need patients with complex chronic conditions, to ensure more effective economic and clinical decision making. By introducing a novel deep learning framework that segments administrative claims data into multiple channels, this research enhances both predictive accuracy and fairness, reducing overpayments and underpayments while mitigating bias in cost estimation. The findings underscore the potential of channel-wise modeling to support fair reimbursement structures, improve budget planning, and foster policies that better accommodate the diverse needs of patient populations. Policymakers and healthcare organizations can leverage these insights to design more efficient risk adjustment strategies, ensuring that vulnerable patients receive appropriate care without financial inefficiencies. The study provides a roadmap for integrating advanced machine learning approaches into healthcare decision making, promoting a more just and sustainable system.
A Polynomial-Time Algorithm for the Probabilistic Profitable Tour Problem on a Tree
Authors: Angelelli Enrico , Mansini Renata , Rizzi Romeo
Published: February 2025

The profitable tour problem (PTP) is a well-known NP-hard routing problem that searches for a tour visiting a subset of customers while maximizing profit measured as the difference between total revenue collected and traveling costs. PTP is known to be solvable in polynomial time when special structures of the underlying graph are considered. However, the computational complexity of the corresponding probabilistic generalizations is still an open issue in many cases. In this paper, we analyze the probabilistic PTP where customers are located on a tree and need, with a known probability, for a service provision at a predefined prize. The problem objective is to select a priori a subset of customers with whom the service has to be contractualized to maximize the expected profit. We provide a polynomial-time algorithm computing the optimal solution in [Formula: see text], where n is the number of nodes in the tree.
First morphological and genetic report of the hard tick, Amblyomma tigrinum (Acari: Ixodidae) in the Andean cat, Leopardus jacobita
Authors: Beltrán-Saavedra L. Fabián , Arteaga-Voigt Daniela A. , Poquechoque-Buezo Georgia E.
Published: February 2025

El gato andino (Leopardus jacobita Cornalia 1865) es una de las especies felinas más raras del mundo y de las más amenazadas de América, además de no conocerse la ixodofauna que parasita a estos pequeños felinos.  Aquí se describen morfológica y genéticamente ejemplares de garrapatas duras en un gato andino.  Se recolectaron 4 especímenes de garrapatas duras (2 hembras y 2 machos) de 1 gato andino de la localidad de Patacamaya en el departamento de La Paz, Bolivia.  Los ejemplares fueron identificados por sus características morfológicas y genéticas.  El ADN se extrajo utilizando 1 o 2 patas de las garrapatas con un daño mínimo a los ejemplares.  Las características morfológicas y genéticas correspondieron a Amblyomma trigrinum, con un porcentaje de identidad del 99.43 %.  Esta investigación constituye el primer reporte morfológico y genético de garrapatas duras en estado adulto de la especie A. tigrinum parasitando a un gato andino, ampliando la distribución de esta garrapata a la región biogeográfica boliviana de alta montaña y altiplano en el departamento de La Paz, y enfatiza la circulación de este parásito zoonótico en el país.
TOXICOMANIA E PSICANÁLISE: REFLEXÕES SOBRE A TOXICOMANIA A PARTIR DA ANÁLISE DA SÉRIE “DOM”
Authors: Vallinoto da Costa Carolina , Do Socorro Nunes Pereira Lima Patrícia
Published: February 2025

Resumo: O artigo aborda a toxicomania pelo viés psicanalítico. As autoras propõem uma dialética entre as clínicas clássicas e contemporâneas como uma maneira de analisar o fenômeno que vem crescendo exponencialmente, considerando a relação de gozo que o sujeito mantém com a droga e a tentativa de romper com o gozo fálico, aquilo que move a relação entre o toxicômano e o Outro (droga). Dispondo do aporte artístico para elucidar os conceitos aqui apresentados, utiliza-se a série “DOM”, dirigida por Breno Silveira, que mostra o cotidiano de um sujeito toxicômano em suas diversas vivências. Exemplifica-se, pois, que o toxicômano é aquele que evita se deparar com seus conflitos, se mantendo “calado” e indo buscar na droga um refúgio contra a angústia da falta.
Palavras-chave: Drogadição. Toxicomania. Psicanálise.
ADOLESCENTES EM USO ABUSIVO DE ÁLCOOL E OUTRAS DROGAS: SUJEITO DE LUGAR NENHUM
Authors: Pereira de Carvalho Maria de Fátima , Peixoto do Nascimento Ana Carolina
Published: February 2025

Resumo: Esta pesquisa teve como objetivo compreender como é realizada a oferta de cuidado em saúde mental para adolescentes em uso abusivo de álcool e outras drogas no CAPS AD III em Palmas – TO. Para tal, realizou-se uma pesquisa qualitativa utilizando entrevistas semiestruturadas junto aos profissionais que compõem a equipe multidisciplinar neste serviço. Para análise dos dados, optou-se pela Análise Temática de Bardin, evidenciando que a oferta de cuidado é individualizada, com ênfase no cuidado médico e psicológico. Além disso, foi constatado inexistência de um fluxo ou planejamento para atendimento da demanda dos adolescentes em uso abusivo de álcool e outras drogas. O estudo indicou também fragilidade no trabalho em rede, com centralização no CAPS AD, o que dificulta o trabalho interdisciplinar e a materialização da clínica ampliada. Por fim, a principal barreira para se trabalhar de forma intersetorial elucidada por este estudo está na heterogeneidade de campos discursivos acerca da adolescência e a dificuldade de escuta do próprio sujeito adolescente. É emergente que o CAPS, como serviço ordenador do cuidado em saúde mental, assuma seu lugar na mesa e convide os setores de cuidado para construção dessa rede intersetorial e, assim, se constitua o campo discursivo da rede e não de setores isolados.
Palavras-chave: Adolescência. Álcool e outras Drogas. Cuidado em saúde mental
How is the correlation between Halal Certification and the Growth of Indonesia's Export Economic Value?
Authors: Aini Nur , Go Riska Tezara
Published: February 2025

Indonesia, as the country with the largest Muslim population in the world, holds immense potential to lead the global halal sector. Efforts to accelerate halal certification, particularly in the food, beverage, and cosmetics industries, have yielded positive outcomes. By mid-2023, 38,480 products had obtained halal certification, driven by initiatives like the Free Halal Certification (Sehati) program and national campaigns. Halal certification not only serves as a legal requirement but also enhances product competitiveness in domestic and international markets. However, despite the projected global halal market size of USD 2.3 trillion by 2024, Indonesia's contribution remains relatively small compared to countries like Malaysia and the United Arab Emirates. This study investigates the correlation between halal certification issuance and export value, revealing a weak negative correlation, with the export value of halal products declining in 2023 due to global economic challenges. The findings underscore the importance of addressing external factors and adopting a comprehensive approach, involving both government and businesses, to enhance Indonesia's halal export performance and ensure long-term growth.
An analysis of dental hygiene research trends using semantic network: domestic and international comparisons
Authors: Kim Yun-Jeong , Kim Su-Yeon , Kim Seon-Yeong
Published: February 2025

Objectives: This study was conducted to understand the research trends in dental hygiene, domestically and internationally. Methods: The Journal of the Korean Society of Dental Hygiene (JKSDH) examined 1,689 articles, totaling 7,575 words, whereas the International Journal of Dental Hygiene (IJDH) reviewed 1,089 articles, totaling 10,194 words, employing a semantic network and CONCOR analysis. Results: Findings indicated that centrality analysis revealed that the top 10 most frequently used words in journals exhibited high scores in degree, betweenness, and closeness centralities. CONCOR analysis identified four clusters within the JKSDH; ‘oral health program’, ‘professionalism of dental hygienists’, ‘oral health assessment’ and ‘dental hygienist work environment’. The four categories of IJDH were ‘managing periodontitis’, ‘managing systemic diseases’, ‘oral health assessment’ and ‘oral health prevention initiatives’. Conclusions: Future dental hygiene research in Korea should focus on evidence-based practices that can serve as a foundation for enhancing the professionalism of dental hygienists through a unique knowledge system in the field.
Effects of initial pressure and sample and air cylinder dimensions on determination of soil air permeability
Authors: Baleeiro Anderson Fialho , Brito Alexsandro dos Santos , Cotrim Reinaldo Monteiro , Silva Luciano Mesquita
Published: February 2025

The intrinsic soil air permeability (Kair), defined as the capacity of soil pores to conduct air, is an important soil attribute, as it identifies changes in pore spaces. This study aimed to evaluate the influence of initial gauge pressure, permeameter air cylinder volume, and sample volume on the Kair measurement. Samples of an Oxisol were collected at a depth of 0–0.2 layer and stored in a pot. The experimental design was completely randomized in a 4x3x2 factorial scheme, characterized by four different initial gauge pressures (500, 1000, 1500, and 2000 Pa), three different permeameter cylinder volumes (0.008, 0.0124, and 0.031 m3), and two sample volumes (100 and 270 cm3). The assessment was performed under two soil density conditions in pots (1.334 and 1.421 Mg m?3). Kair showed no changes due to the different sample volumes, but a different behavior was observed for the two soil density conditions. Increasing the permeameter air cylinder volume promoted an increase in the Kair estimate. Kair was lower for the initial pressure evaluated with 2000 Pa.
FILOSOFIA TRANSCENDENTAL DE KANT E A GEOMETRIA NO PENSAMENTO CONTEMPORÂNEO
Authors: Da Silva Francisco Winston José
Published: February 2025

Este artigo busca apresentar uma reflexão sobre a filosofia transcendental de Kant e os fundamentos da geometria Euclidiana a partir da seguinte provocação: com o desenvolvimento da ciência contemporânea, da geometria não Euclidiana, da reviravolta linguística da Filosofia e da virada analítica da matemática no século XX, a proposta de uma Filosofia Transcendental ainda faz sentido no discurso filosófico atual? O objetivo é apresentar os fundamentos da geometria em Kant discutida por matemáticos, lógicos e filósofos do início do século XX buscando fazer uma reflexão sobre a possibilidade e validade da filosofia transcendental para o discurso do pensamento contemporâneo. A questão sobre o faktum da ciência pressupondo uma teoria do objeto como fundamento da Geometria é base de sustentação da arquitetônica kantiana e será considerada como justificativa de uma filosofia crítica transcendental. Três autores são destacados nessa proposta: Russell, Frege e Poincaré.
DESENVOLVIMENTO DA CARTOGRAFIA E DOS INSTRUMENTOS DE NAVEGAÇÃO NO CONTEXTO DAS VIAGENS DE DESCOBRIMENTO
Authors: Cardoso Paulo Thiago
Published: February 2025

O presente trabalho tem como objetivos a análise do papel dos instrumentos náuticos e da cartografia não só no incremento das artes náuticas portuguesas, no contexto das Viagens de Descobrimento, bem como no próprio processo de construção do conhecimento da realidade geográfica. Os navegadores portugueses envolvidos com a produção da literatura de viagens, preocuparam-se também em estabelecer critério para a construção do conhecimento dentro do âmbito aqui exposto, colocando questionamentos sobre a forma como os antigos trataram o conhecimento do mundo geográfico e, consequentemente, corrigi-los.
Vulnerability, sovereign masculinity and male identity politics in the manosphere
Authors: Gottzén Lucas
Published: February 2025

Critical masculinity scholars have recently suggested that men recognizing their own vulnerability, as well as the vulnerability of others, could be a tool for feminist masculinity politics. These arguments are inspired by feminist debates, particularly the work of Judith Butler, who stresses the importance of recognizing a universally shared vulnerability to counter masculinist discourses of sovereignty. Butler’s argument has been criticized for making vulnerability an ethical issue, rather than highlighting the social and material processes that render some bodies more vulnerable than others. While these feminist debates provide valuable insights, they often overlook men’s social vulnerabilities or see them as mere claims of unwarranted victimhood. This article aims to nuance discussions on vulnerability, by arguing that men’s recognition of vulnerability does not necessarily foster ethical responsiveness. To this end, the article analyzes books authored by activists from the manosphere group Men Going Their Own Way (MGTOW), demonstrating that while these authors embrace their own vulnerability, they simultaneously foster resentment, male identity politics and ideals of sovereign masculinity. Based on these findings, it is argued that feminist scholarship should seriously consider men’s experiences of social vulnerability and develop models that help men critique neoliberal politics and late capitalism, rather than merely encouraging men to recognize a shared ontological vulnerability.
Compliance and credibility: a critique of the sexual assault forensic examination from international perspectives
Authors: McMillan Lesley , Corrigan Rose , Mulla Sameena , Rees Gethin , White Deborah
Published: February 2025

The forensic medical examination is often lauded as an effective intervention to reduce case attrition by providing evidence that supports a rape or sexual assault complaint. We show that, despite nearly universal enthusiasm for such programmes, the examination also serves as an extra-legal opportunity for criminal justice and medical personnel to assess the credibility of rape and sexual assault complainants. Drawing on five case studies from three countries, we investigate the medico-legal exam as a complicated process that helps shape case outcomes often in ways unanticipated by proponents of forensic medical examinations. We argue that through co-optation of language about choice, consent, and empowerment, and despite significant variation in procedures, protocols, and legal rules, personnel involved with the medico-legal process often use it to impose formal and informal ‘tests’ for assessing complainant credibility and to dismiss or cast doubt upon some rape and sexual assault reports.
Viral suppression among patients in HIV/AIDS care at healthcare facilities in Ethiopia: Same-day antiretroviral initiation
Authors: Chachu Kidanu Hurisa , Maboe Kefiloe Adolphina
Published: February 2025

To achieve the 2030 goal of eradicating the HIV epidemic, the Joint United Nations Programme on HIV/AIDS has set 95-95-95 targets: 95% of HIV-infected individuals should know their status, 95% should initiate antiretroviral therapy (ART), and 95% should achieve virologic suppression. In Ethiopia, progress has been made, but challenges remain. This study evaluates same-day ART initiation and its effect viral suppression for patients in HIV/AIDS care in Ethiopia. A cross-sectional study design was used to analyze 332 clinical records of patients who initiated same-day ART between October 1, 2017, and October 30, 2019. A probability simple random sampling technique was used in the selection of the clinical records of patients started on ART. Data were analyzed using Statistical Package for Social Science (SPSS) version 28.0, employing both descriptive and inferential statistical analyses. The results showed that viral suppression rates at 6, 12, and 24 months were 93%, 95%, and 86%, respectively, indicating progress towards the global target of 95% by 2030. This supports the effectiveness of same-day ART initiation in achieving viral suppression. Chi-square test results indicated no significant relationship between gender and suppression status (p = 1.00), age and suppression status (p = 0.876), or WHO stage and suppression status (p = 0.404). However, significant associations were found between resident type and suppression status (p < 0.05), as well as retention in care and suppression status (p < 0.05). No significant association was observed between HIV disclosure status and suppression status (p = 0.072). The results suggest an urgent need for follow-up and monitoring of viral suppression as months on ART increase. Additionally, enhancing viral load testing coverage at 6, 12, and 24 months is crucial to ensure sustained viral suppression.