bluuebunny/crossref_metadata_2025_split huggingface dataset:
A PROSCRIÇÃO DA AÇÃO REFLEXIVA DOS SUJEITOS: O experimentalismo didático no filme “A Onda”
Authors: Bezerra Leonardo Mendes 
Published: October 2024

O artigo objetivou analisar os aspectos pedagógicos do filme “A onda” como instrumento para desenvolver as capacidades perceptivas, analíticas e argumentativas dos alunos no curso de licenciatura em Letras. A investigação foi norteada pelas seguintes questões: até que ponto os docentes influenciam os comportamentos dos discentes? A argumentação é um instrumento que pode ser utilizado para a massificação e a alienação dos indivíduos? Para se chegar a uma resposta a essas indagações, busca-se observar e refletir sobre as personalidades autoritárias e massificadas/alienadas presentes no filme, além de verificar as aptidões que os docentes têm em influenciar hábitos, pensamentos e comportamentos. Metodologicamente, a pesquisa trata-se de um estudo bibliográfico, exploratório, participativo e qualitativo, com alguns levantamentos quantitativos, originários da pesquisa analítica das percepções ocorridas com estudantes do curso de Letras em uma Universidade, localizada no Sul do Maranhão. Como resultado, originaram-se três categorias de análise: 1. Do texto ao contexto e as percepções sobre o enredo do filme, 2. Posicionamento composto por elementos psicológicos e emotivos, 3. Aspectos didáticos do processo de ensino-aprendizagem. E como resultado final, destaca-se a importância de uma prática didático-pedagógica (re)planejada, (re)avaliada e re(definida), considerando os casos particulares da turma. A propósito, faz-se necessário expor que os professores não têm o direito de proporcionar ações engessadas e alienadoras nos diversos níveis de ensino.
Apresentação do Dossiê - CURRÍCULOS E IMAGENS E SONS E CHEIROS E MOVIMENTOS
Authors: Alves Nilda , Rangel dos Reis Leonardo 
Published: October 2024

O dossiê CURRÍCULOS E IMAGENS E SONS E CHEIROS E MOVIMENTOS, que agora apresentamos, tem como foco pesquisas que tratam de repertórios culturais diversos que estão sempre em diálogo em todo processo educativo, mobilizando distintos sentidos e movimentos, mas que muitas vezes se encontram invisibilizados pelos códigos característicos das linguagens dominantes. Não obstante, sempre emergem, como insistência insubordinada, nas tantas e complexas redes educativas que formamos e que nos formam, forjando acontecimentos momentâneos e/ou duradouros nos múltiplos processos curriculares desenvolvidos nos cotidianos escolares, produzindo imagens, cheiros, saberes, sabores etc. Em tempos tão duros de retirada de direitos e ataque à democracia, proclamamos o direito ao livre pensamento, e ao fazer ciência(s) comprometida(s) com as populações subalternizadas, com os historicamente excluídos, com as mulheres e homens ‘praticantespensantes’ nos/dos/com cotidianos, inventores de sonhos e movimentos, e esperanças e imagens e odores e saberes, que afirmam sua presença através da inelidível criação das multiplicidades curriculares, ou dos múltiplos currículos, fazendo Educação, em sua dimensão tanto ética quanto estética, a partir da pluralidade de linguagens, abarcando projetos participativos, criativos e de resistências.
Ischemic mitral regurgitation: To repair or replace? A single center experience
Authors: Sweeney Joseph C. , Alotaibi Amal , Porter Gene D. , Avula Divya , Trivedi Jaimin R. , Slaughter Mark S. , Ganzel Brian L. , Pahwa Siddharth V. 
Published: October 2024

Objective
Recent reports on ischemic mitral valve (MV) regurgitation surgical strategies have suggested better hemodynamic performance with MV replacement (MVR) than MV repair (MVr) with no survival difference at 2 years. We evaluated the difference between MVR and MVr outcomes in patients with ischemic MR, including hemodynamic MV performance at 1 and 2 years postoperatively.

Methods
A single center cardiac surgery database was queried for patients (aged >/ = 18 years) requiring mitral valve surgery with concomitant CABG or PCI between January 2010 and June 2018. Patients were separated into two groups: mitral valve repair using ring annuloplasty (MVr) and mitral valve replacement (MVR).

Results
A total of 111 patients (median age 66 years, 76% male) underwent an operation for ischemic mitral regurgitation during the study period. (44%) had MVr and 62 (56%) had MVR. Both groups had > 80% concomitant CABG. The MVr group had lower EF (40% vs. 55%, p < 0.01), shorter cardiopulmonary bypass time (117 vs. 164 minutes, p < .01) and shorter aortic cross-clamp time (80 vs. 116 minutes, p < .01). The in-hospital mortality (6% vs. 10%, p = 1.00) and 1-year mortality (14% vs. 18%, p = 0.17) were similar between the groups. Pre-operative left ventricular internal diameter at end-diastole was greater in the MVr group (5.6cm vs. 4.6cm, p < .01). At 1-year, more patients in the MVR group had no or trace regurgitation (29% vs. 61%, p = 0.01), however, the number of patients with moderate or greater mitral regurgitation was similar (6% vs. 12%, p = 0.69). At 2-years, the MVr and MVR groups had no difference in moderate or severe mitral regurgitation (7% vs. 13%, p = 0.68).

Conclusion
Our findings demonstrate similar early mortality and mid-term mitral valve performance, suggesting that MV repair could be a good surgical option in patients with ischemic MR requiring surgical revascularization.
Mind your pain: A single-arm feasibility study to assess a smartphone-based interoceptive attention training for patients with chronic low back pain
Authors: Mehling Wolf E. , Strigo Irina A. , Goldman Veronica , Hartogensis Wendy , Adler Shelley R. , Lotz Jeffrey , Hecht Frederick M. 
Published: October 2024

Objective
People commonly cope with chronic low back pain (cLBP) by ignoring and distraction. Can mindful interoceptive exposure to the pain sensation itself and its phenomenological components be an alternative approach?

Methods
Single-arm feasibility study in patients with cLBP using a 2-minute attention exercise guided by a smartphone app several times per day over 8 weeks. We assessed feasibility, pre/post pain, function, and psychological parameters using mixed methods: standard questionnaires, ecological momentary assessment, and exit interviews that included micro-phenomenology technique and subsequent reflexive thematic qualitative analysis.

Results
We enrolled 31 participants, mostly female, mean age 48, the majority had pain for >5 years; 29 completed. Mean pain intensity [0–10] improved from 4.8 ±1.7 to 3.1 ±1.9 (p < .0001); mean PEG scores (intensity and interference with daily life; range 0–30) improved from 13.7 ±6.2 to 8.4 ±6.6 (p < .0001); pain impact (9 items incl physical function) 22.3 ±8.7 to 19.7 ±8.1 (p = .0010). Twenty-one of 29 improved PEG score ≥30%. There were significant improvements in PCS Rumination and MAIA Not-Worrying. Participants became aware of their usual habit of avoidance and the challenge of and resistance to focusing on pain. They were surprised how pain sensations varied over time, and that pain intensity and the threat value of pain could diminish by focusing on it. They described a variety of 3D pain shapes (e.g., football, pool ball, rod, nail, brick, stars) with a range of colors, transparency, temperature, and density that for some changed with mindful attention. Most struggled to find appropriate words for sensory awareness and attention regulation and found that the threat value of their pain diminished.

Conclusions
Mindful interoceptive exposure to the sensations of their cLBP using a 2-minute attention exercise with a phone app—rather than ignoring and distracting from it—may be a beneficial intervention for cLBP.

Trial registration
ClinicalTrials.gov #NCT06186193.
Epigenetic aging differentially impacts breast cancer risk by self-reported race
Authors: Wu Yanning , Miller Megan E. , Gilmore Hannah L. , Thompson Cheryl L. , Schumacher Fredrick R. 
Published: October 2024

Background
Breast cancer (BrCa) is the most common cancer for women globally. BrCa incidence varies by age and differs between racial groups, with Black women having an earlier age of onset and higher mortality compared to White women. The underlying biological mechanisms of this disparity remain uncertain. Here, we address this knowledge gap by examining the association between overall epigenetic age acceleration and BrCa initiation as well as the mediating role of race.

Results
We measured whole-genome methylation (866,238 CpGs) using the Illumina EPIC array in blood DNA extracted from 209 women recruited from University Hospitals Cleveland Medical Center. Overall and intrinsic epigenetic age acceleration was calculated–accounting for the estimated white blood cell distribution–using the second-generation biological clock GrimAge. After quality control, 149 BrCa patients and 42 disease-free controls remained. The overall chronological mean age at BrCa diagnosis was 57.4 ± 11.4 years and nearly one-third of BrCa cases were self-reported Black women (29.5%). When comparing BrCa cases to disease-free controls, GrimAge acceleration was 2.48 years greater (p-value = 0.0056), while intrinsic epigenetic age acceleration was 1.72 years higher (p-value = 0.026) for cases compared to controls. After adjusting for known BrCa risk factors, we observed BrCa risk increased by 14% [odds ratio (OR) = 1.14; 95% CI: 1.05, 1.25] for a one-year increase in GrimAge acceleration. The stratified analysis by self-reported race revealed differing ORs for GrimAge acceleration: White women (OR = 1.17; 95% CI: 1.03, 1.36), and Black women (OR = 1.08; 95% CI: 0.96, 1.23). However, our limited sample size failed to detect a statistically significant interaction for self-reported race (p-value >0.05) when examining GrimAge acceleration with BrCa risk.

Conclusions
Our study demonstrated that epigenetic age acceleration is associated with BrCa risk, and the association suggests variation by self-reported race. Although our sample size is limited, these results highlight a potential biological mechanism for BrCa risk and identifies a novel research area of BrCa health disparities requiring further inquiry.
Substance abuse among new patients attending main government hospitals in Malaysia from 2018–2021: A comparison between before and during COVID-19 pandemic
Authors: Muhamad Nor Asiah , Chemi Norliza , Ma’amor Nur Hasnah , Rosli Izzah Athirah , Leman Fatin Norhasny , Mohamad Isa Mohd Fadzli , Johari Mohammad Zabri , Abdullah Norni , Ibrahim Nor Ashikin , Chan Huan-Keat , Abu Hassan Muhammad Radzi ,   on behalf of My Substance Abuse Study Group
Published: October 2024

Background
Substance abuse admission to health facilities following the pandemic is often met with challenges. COVID-19 is causing an insurmountable psychosocial impact on the whole of mankind. Marginalized communities, particularly those with substance use disorders (SUDs), are also likely to suffer from greater psychosocial burden.

Objectives
This study sought to evaluate substance abuse trends before and during the pandemic.

Methods
A cross-sectional study was conducted among patients attending selected government hospitals in Malaysia. Data from the year 2018 to 2021 was utilized.

Results
A total of 9,606 patients consisting of 7881 males and 1725 females were identified. Most of the patients involved with substance abuse from 2018 to 2021 were males, aged between 26 and 44 years old, Malays, high school students, singles, workers of private sectors and those residing in urban areas. The most abused substances over the four years were tobacco (61.8%), followed by amphetamine-type stimulants (ATS) (43.1%), alcohol (39.7%), cannabis (17.2%), opioids (13.0%), and kratom (8.8%). Those who worked in the private sector and were self-employed or unemployed were more associated with substance abuse during the pandemic compared to those who worked in the government sector. Those with a history of psychiatric illness were more associated with abuse of substances during the pandemic than those without the history (adjusted OR: 1.18, 95% CI 1.09–1.29, p <0.001).

Conclusions
Targeted exploration of factors affecting substance abuse in Malaysia is essential. The results of this study assist in identifying variations in substance abuse treatment characteristics for those admitted to treatment in Malaysia.
A fuzzy ontology-based case-based reasoning system for stomach dystemperament in Persian medicine
Authors: Shojaee-Mend Hassan , Ayatollahi Haleh , Abdolahadi Azam 
Published: October 2024

Background
In Persian medicine, early diagnosis and treatment of stomach dystemperament is crucial for preventing other diseases. However, traditional medicine diagnosis often involves ambiguous and less structured information making it challenging for practitioners. Integrating fuzzy ontology with case-based reasoning (CBR) systems can enhance diagnostic accuracy in this filed.

Objectives
This study aimed to develop and evaluate a fuzzy ontology-based CBR system for diagnosing and treating stomach dystemperament in Persian medicine.

Methods
This was a mixed-methods research in which a fuzzy ontology-based CBR system was developed based on the fuzzy features, utilizing trapezoidal, triangular, right shoulder and left shoulder membership functions to represent linguistic variables such as hunger level and digestion power. The research phases included identifying relevant terms, concepts, and relationships, developing the fuzzy case-base ontology using the IKARUS-Onto methodology, and subsequently designing and implementing the CBR system. The system performance was evaluated in terms of its sensitivity, specificity, accuracy, precision, and F1-score.

Results
Initially, a case-base fuzzy ontology was created. Then, the database was built up using 88 expert-validated medical records. Of these cases, 72% (63 cases) were diagnosed with phlegmatic dystemperament, 18% (16 cases) with cold-dry dystemperament, and 10% (9 cases) had no stomach dystemperament. The CBR system was developed and evaluated using sensitivity, specificity, accuracy, precision, and F1-score which were 97.5%, 87.5%, 96.6%, 98.7%, and 98.1%, respectively.

Conclusions
Our fuzzy ontology-based CBR demonstrated high performance in diagnosing stomach dystemperament in Persian medicine. This system shows promise in improving diagnostic accuracy and facilitating the identification of similar cases. While initial results are encouraging, further evaluation in a real clinical environment is recommended to fully assess its practical utility.
The experience of people living with heart failure in Ethiopia: A qualitative descriptive study
Authors: Mulugeta Henok , Sinclair Peter M. , Wilson Amanda 
Published: October 2024

Background
Heart failure is a serious chronic medical condition that negatively impacts daily living. Living with heart failure can be challenging due to the physical symptoms, unpredictable nature of the disease, and lifestyle changes required. The objective of this study was to explore and describe the experiences of people living with heart failure and how it affects their health-related quality of life in Ethiopia.

Methods
A qualitative descriptive design was employed to explore the experience of people living with heart failure, guided by the Theory of Symptom Management. A purposive sample of 14 participants was recruited from the cardiac outpatient clinics at two tertiary-level public hospitals in Ethiopia. Data were collected using a semi-structured interview. The recorded interviews were transcribed verbatim in Amharic, translated into English, and entered NVivo statistical software for analysis. An inductive-deductive hybrid thematic analysis method was used to analyse the data.

Results
Three themes were identified deductively, while an additional three themes emerged inductively:—“Journey from diagnosis to daily life with heart failure”; “Symptom experience”; “Impact of heart failure on health-related quality of life”; “Perception of health-related quality of life and influencing factors”; “Symptom management and coping strategies”; and “Challenges faced in the journey of living with heart failure”. Fatigue, and depression were the most frequently reported symptoms. Participants described how their condition affected their overall physical functioning. Participants utilized consistent follow up-care, adhered to their medications, ensured adequate rest, made dietary modifications, sought social support and engaged in spiritual activities to manage their symptoms and cope with their condition. Challenges they faced included financial difficulties, unavailability of medications, and a lack of continuity of care.

Conclusion
People living with heart failure in Ethiopia experience various symptoms. The impact of heart failure on various aspects of their lives, combined with the challenges they face while living with heart failure, significantly affect their health-related quality of life. Health care providers caring for these people need to understand their experiences and the impact on their daily life. Effective multimodal interventions are needed to reduce the impact of heart failure and improve health-related quality of life in this population.
The mediation of the dynamic capacity for innovation between managerial skills and organizational performance in MSMEs located in the department of Caquetá, Colombia
Authors: Penagos Guzman Fernando , García Solarte Mónica 
Published: October 2024

Objectives
The purpose of this study is to analyze how the dynamic capacity for innovation mediates the relationship between the managerial skills and organizational performance of micro, small and medium-sized enterprises (MSMEs) located in the department of Caquetá.

Methods
The hypotheses are statistically tested via structural equation modeling (SEM), where the dynamic capacity for innovation mediates the relationship between the managerial skills and organizational performance of MSMEs located in the department of Caquetá, with a cross-sectional sample of 496 MSMEs.

Results
The results indicate that the relationship between managerial skills and organizational performance is mediated by the dynamic capacity for innovation of the MSMEs of the department of Caquetá, Colombia. In addition, the robust adjustment values obtained for this model are an RMSEA of 0.044 and a CFI of 0.862. Both values meet the requirements to conclude that the model has a good fit and is therefore reliable.

Conclusions
This study shows that managers, administrators or legal representatives use the constructs presented in this publication. In addition, it is shown that the dynamic capacity for innovation mediates the relationship between managerial skills and the organizational performance of MSMEs located in the department of Caquetá, Colombia.
Weekends admitted adult medical patients have higher in-hospital mortality in Ethiopia: An implication for quality improvement
Authors: Arega Balew , Solela Gashaw , Tewabe Elias , Agunie Asnake , Zeleke Amanuel , Tefera Ermiyas , Minda Abraham , Getachew Yitagesu 
Published: October 2024

Background
Weekend effect’ is a term used to describe the increased mortality associated with weekend emergency admissions to hospitals compared with admissions on weekdays. This effect was not investigated in Ethiopia among adult patients admitted to hospitals. We aimed to find out whether the weekend effect exists in the country’s a teaching hospital.

Methods
The study was conducted among adult medical patients admitted at Yekatit 12 Hospital Medical College, Addis Ababa, Ethiopia, from September 2020 to September 2023. We extracted the data from the electronic medical records, and those with missed outcomes, length of hospital stays, and diagnosis were excluded. We used a multivariable logistic regression model to determine the association between the outcome and risk factors. The Cox proportional hazard model was utilized to establish the correlation between admission times and mortality risk incidence. Statistical significance was determined using a P value of less than 0.05. The Kaplan-Meier curve was utilized to estimate the risk of in-hospital mortality over the duration of the hospital stay.

Results
A of 5564 patients were admitted to medical wards (n = 5001) and intensive care unit (ICU) (n = 563) during the study periods. In binary multivariable analysis, weekend medical wards and ICU admitted adult medical patients had a 38% (AOR, 1.38, 95% CI, 1.17, 1.65) and 50% (AOR, 1.50, 95% CI, 1.02, 2.20) higher in-hospital mortality compared weekdays admitted patients, respectively. The cumulative mortality risk incidence was higher among medical ward-admitted patients (AHR, 1.26, 95% CI, 0.09, 1.46, P value = 0.051) and significantly higher among ICU-admitted adult patients (AHR, 1.28, 95% CI, 1.21, 1.75, P value = 0.01) during the weekends. There was no statistically significant mortality difference among night versus day or office hours versus off-office hours admitted patients. Moreover, we did identify significant differences in the duration of hospital stays between weekends and weekdays.

Conclusions
In this study, weekend-admitted adult medical patients in wards or ICUs have higher in-hospital mortality rates. This underscores a need for comprehensive nationwide data to improve weekend admitted patients’ quality of care and treatment outcomes.
The clinical features and operation experience of multilobar involved congenital lung malformation: A retrospective cohort study
Authors: Cheng Kaisheng , Yuan Miao , Yang Gang , He Taozhen , Luo Dengke , Liu Chenyu , Wang Zongyu , Yang Jiayin , Xu Chang 
Published: October 2024

Background
Congenital lung malformation (CLM) is usually characterized by single-lobe involvement and multilobe involvement is uncommon. There is a lack of experience in the clinical features and surgical treatment of unilateral multilobar CLM. Therefore, this study aims to summarize the clinical characteristics and evaluate the safety and feasibility of thoracoscopic lung sparing resection in the treatment of unilateral multilobar CLM.

Methods
A retrospective study was conducted on 34 patients with unilateral multilobar CLM, and 34 unilobar patients were randomly selected as the control group in West China Hospital of Sichuan University from 2014.1 to 2021.1. Clinical, operation and follow-up outcomes were compared between the two groups.

Results
Twelve (35.2%) patients developed preoperative symptoms in the multilobar group more than 4(11.7%) the unilobar group (p = 0.02), the main preoperative symptom was infection; The multilobar group and unilobar group showed significant differences in mean intraoperative blood loss (13.3 mL vs. 7.5 mL; p = 0.02) and mean surgical time (95.6 min vs. 47.5 min; p = 0.037). The median length of postoperative hospital stay and the median chest tube placement time in the multilobar group were significantly longer (5 d vs.3 d, p = 0.045; 2 d vs.1 d, p = 0.031). There were one (2.9%) patient in unilobar group and 4(11.7%) patients in multilobar group developed complications postoperatively, which is no significant differences between the two groups(p = 0.16). No complications such as thoracic deformity, mediastinal deviation, scoliosis or recurrence were observed in either group at follow-up.

Conclusions
Unilateral multilobar CLM cases are more susceptible to develop symptoms than unilobar cases. Thoracoscopic lung sparing resection in the treatment of unilateral multilobar CLM has high safety and can effectively avoid serious complications of unilateral multiple lobectomy or pneumonectomy.