bluuebunny/crossref_metadata_2025_split huggingface dataset:
Proton-Pump Inhibitors and Cardiovascular Adverse Events: A Meta-Analysis of Randomized Controlled Trials
Authors: Mosholder Andrew D. , Hada Manila , Leishear Kira 
Published: August 2024

INTRODUCTION:
Some observational studies suggest a cardiovascular risk from proton-pump inhibitor (PPI) treatment, but observational data may be subject to bias. We conducted a meta-analysis of randomized controlled trial data on cardiovascular events during PPI treatment.

METHODS:
Manufacturers of PPIs provided data from their PPI clinical trial programs. We included randomized trials with at least 100 subjects, treatment duration >30 days, and a non-PPI comparator (active or placebo). We obtained person-time of exposure per trial, to calculate summary incidence rate ratios (primary analysis) and incident rate differences (secondary analysis). Our primary composite outcome was major adverse cardiovascular events-plus (MACE+), which included nonfatal myocardial infarction, nonfatal stroke, fatal cardiovascular adverse events, hospitalization for unstable angina, or coronary revascularization; events were adjudicated blindly.

RESULTS:
Cardiovascular outcomes were infrequent in randomized trials of PPIs, and our primary analysis found no overall association (summary incident rate ratio, MACE+ events, PPI:placebo, 0.72) (95% confidence interval 0.42–1.26). There was some heterogeneity by indication category, and by the incidence rate difference metric, gastroesophageal reflux disorder trials had 1.04 (95% confidence interval 0.58–1.50) excess MACE+ events per 100 person-years of treatment vs placebo. Comparisons with active controls generally showed positive incidence rate differences with PPI treatment.

DISCUSSION:
Overall, we found no association of cardiovascular events with PPI treatment. Cardiovascular events appeared more frequent with PPI treatment in gastroesophageal reflux disorder trials, but results from this subgroup should be interpreted with the limitations of the analysis in mind, including sparse outcome counts and lack of individual patient data.
Was mir heilig ist
Authors: Minta Anna 
Published: August 2024

Zusammenfassung
Der Beitrag fokussiert auf architektonische und soziokulturelle Aneignungsprozesse des Sakralen und Profanen im Zusammenhang mit Räumen der Gemeinschaftsstiftung. Im Reformkirchenbau des 20. Jahrhunderts mit dem Bemühen, inszenierte Heiligkeit zu entkräften, sowie in den Ambitionen profaner Institutionen, über sakral anmutende Assoziationen die soziale Bedeutung zu steigern, wird die Verhandelbarkeit von Heiligkeit deutlich.
Apotheose der Nation?
Authors: Illert Martin 
Published: August 2024

Zusammenfassung
Die Gestaltung der Methodius-Gedenkstätte im baden-württembergischen Ellwangen erfolgte 1987 als Gemeinschaftsprojekt der örtlichen Kommune, der damaligen Volksrepublik Bulgarien und der Bulgarischen Orthodoxen Kirche. Die Ikonographie und die Stifterinschrift bulgarisieren und säkularisieren die Figur des transnationalen orthodoxen Heiligen und geben dem Ort ein national-sakrales Gepräge.
Treatment of gestational diabetes by Acroptilon repens leaf aqueous extract green-formulated iron nanoparticles in rats
Authors: Yang Caixia , Song Zhiying 
Published: August 2024

Abstract
In recent years, researchers have been utilizing nanotechnology more and more to study diabetic complications, with a particular emphasis on prevention and treatment. In this investigation, we analyzed the effects of Acroptilon repens extract on iron nanoparticles (FeNPs), which demonstrated significant anti-diabetic characteristics both in living organisms and in laboratory settings. To assess the effectiveness of the FeNPs produced through the interaction of iron salt solutions stabilized by A. repens extract, we utilized a range of methodologies. The FeNPs were manufactured in a spherical shape, ranging in size from 10 to 60 nm. During the in vivo experiment, gestational diabetes was induced through streptozotocin (STZ) intraperitoneal injection. The animals were then categorized into four groups: FeNPs-60 μg/kg group, FeNPs-120 μg/kg group, normal pregnancy group, and gestational diabetes mellitus group (n = 10). FeNPs were administered intragastrically for 25 days. On the final day, the levels of ALP, AST, ALT, and blood glucose in the serum samples were assessed. Following tissue processing, 5 μm liver sections were prepared and the overall volume of the hepatic arteries, bile ducts, central vein, portal vein, sinusoids, hepatocytes, and liver, were approximated. FeNPs have the potential to reduce the elevated levels of ALP and AST enzymes. In gestational diabetes rats, the administration of FeNPs lead to a decrease in blood glucose levels. The administration of STZ significantly increased the volume of sinusoids and hepatocytes. However, after the treatment with a high dose of FeNPs, there was a notable decrease in their volume. In contrast, the volume of the bile ducts and portal vein remained unchanged in the experimental groups. Nevertheless, the volume of the hepatic arteries and central vein exhibited changes due to the presence of FeNPs. The current study showcases the hepatoprotective and anti-diabetic characteristics of FeNPs, providing a potential option as a supplement to prevent gestational diabetes mellitus while also offering hepatoprotective benefits.
An efficient hybrid spectrum sensing algorithm to enhance the performance of optical NOMA waveforms using 256-QAM
Authors: Sharma Himanshu , Yadav Surendra , Kumar Arun 
Published: August 2024

Abstract
The ever-increasing demand for bandwidth in optical networks necessitates efficient spectrum utilization. To address this challenge, this paper proposes a novel hybrid spectrum sensing algorithm tailored explicitly for 256-QAM (Quadrature Amplitude Modulation) optical communication waveforms. The proposed algorithm combines the strengths of energy detection and cyclostationary feature detection to overcome the limitations of individual methods. Energy detection (ED) provides fast and low-complexity sensing, while cyclostationary feature detection offers higher accuracy and sensitivity. First, ED is employed for rapid initial spectrum assessment. Subsequently, matched filter (MF) detection is selectively applied only to frequency bands identified as potentially occupied by primary users based on the energy detection results. This selective approach significantly reduces computational complexity while maintaining high detection accuracy. The results demonstrate significant improvements in detection accuracy, sensitivity, and computational efficiency compared to existing methods. In particular, the hybrid algorithm performs better in scenarios where weak 256-QAM signals coexist with strong primary users, showcasing its effectiveness in dynamic spectrum-sharing applications. This work contributes significantly to optical spectrum sensing by offering an efficient and accurate solution for advanced radio systems. The proposed hybrid algorithm paves the way for improved spectrum utilization and facilitates the development of high-performance, next-generation optical networks. The projected method obtained a gain of −200 as compared with the existing methods.
Dual-control of incubation effect for efficiently fabricating surface structures in fused silica
Authors: Wang Zhi , Xiang Zhikun , Li Xiaowei , Wu Mengnan , Yi Peng , Zhang Chao , Yan Yihao , Li Xibiao , Zhang Xiangyu , Wang Andong , Huang Lingling 
Published: August 2024

Abstract
Fused silica with surface structures has potential applications in microfluidic, aerospace and other fields. To fabricate structures with high dimensional accuracy and surface quality is of paramount importance. However, it is indeed a challenge to strike a balance between accuracy and efficiency at the same time. Here, a temporally shaped femtosecond laser Bessel-beam-assisted etching method with dual-control of incubation effect is proposed to achieve this balance. Instead of layer-by-layer ablation continuously with Gaussian pulses, silica is modified discretely by double pulse Bessel beam with one single layer. During the modification process, incubation effect is dual-controlled in single shot process and spatial scanning process to generate even modified region efficiently. Then, the modified region is etched to form designed structures such as microholes, grooves, etc. The proposed method exhibits high efficiency for fabrication of surface structures in fused silica.
Wafer-scale nanofabrication of sub-5 nm gaps in plasmonic metasurfaces
Authors: Gour Jeetendra , Beer Sebastian , Paul Pallabi , Alberucci Alessandro , Steinert Michael , Szeghalmi Adriana , Siefke Thomas , Peschel Ulf , Nolte Stefan , Zeitner Uwe Detlef 
Published: August 2024

Abstract
In the rapidly evolving field of plasmonic metasurfaces, achieving homogeneous, reliable, and reproducible fabrication of sub-5 nm dielectric nanogaps is a significant challenge. This article presents an advanced fabrication technology that addresses this issue, capable of realizing uniform and reliable vertical nanogap metasurfaces on a whole wafer of 100 mm diameter. By leveraging fast patterning techniques, such as variable-shaped and character projection electron beam lithography (EBL), along with atomic layer deposition (ALD) for defining a few nanometer gaps with sub-nanometer precision, we have developed a flexible nanofabrication technology to achieve gaps as narrow as 2 nm in plasmonic nanoantennas. The quality of our structures is experimentally demonstrated by the observation of resonant localized and collective modes corresponding to the lattice, with Q-factors reaching up to 165. Our technological process opens up new and exciting opportunities to fabricate macroscopic devices harnessing the strong enhancement of light–matter interaction at the single nanometer scale.
Robustness and dynamical features of fractional difference spacecraft model with Mittag–Leffler stability
Authors: Sultana Sobia 
Published: August 2024

Abstract
Spacecraft models that mimic the Planck satellite’s behaviour have produced information on cosmic microwave background radiation, assisting physicists in their understanding of the composition and expansion of the universe. For achieving the intended formation, a framework for a discrete fractional difference spacecraft model is constructed by the use of a discrete nabla operator of variable order containing the Mittag–Leffler kernel. The efficacy of the suggested framework is evaluated employing a numerical simulation of the concerning dynamic systems of motion while taking into account multiple considerations such as exterior disruptions, parameterized variations, time-varying feedback delays, and actuator defects. The implementation of the Banach fixed-point approach provides sufficient requirements for the presence of the solution as well as a distinctive feature for such mechanisms Furthermore, the consistent stability is examined. With the aid of discrete nabla operators, we monitor the qualitative behavioural patterns of spacecraft systems to provide justification for structure’s chaos. We acquire the fixed points of the proposed trajectory. At each fixed point, we calculate the eigenvalue of the spacecraft system’s Jacobian matrix and check for zones of instability. The outcomes exhibit a wide range of multifaceted behaviours resulting from the interaction with various fractional orders in the offered system. To maintain stability and synchronize the system, nonlinear controllers are additionally provided. The study highlights the technique’s vulnerability to fractional-order factors, resulting in exclusive, changing trends and equilibrium frameworks. Because of its diverse and convoluted behaviour, the spacecraft chaotic model is an intriguing and crucial subject for research.
Chromosomal breakage and sister chromatid exchange analysis in breast cancer patients with heterozygous BLM gene variants
Authors: Yararbas Kanay , Sayar Ceyhan , Tavukcu Cemre , Korkmaz Taner , Çankaya Dilara Çakmak , Mutlu Elif Karabacak , Özbek Uğur 
Published: August 2024

Abstract

Objectives

BLM, a member of the RecQ helicase family, plays an important role in DNA repair, and its biallelic mutations cause autosomal recessive Bloom syndrome, a disease characterized by elevated levels of sister chromatid exchange (SCE) in affected individuals and hereditary cancer susceptibility in carriers. This study aims to investigate genomic instability in breast cancer patients carrying heterozygous variants in the BLM gene.

Methods
Spontaneous chromosome breakage count and SCE counting were performed on newly drawn blood cultures, both spontaneous and stimulated. The spontaneous breakage count was conducted alongside control samples. In SCE analysis, 0–10 per metaphase was considered normal, 10–40 borderline, and counts above 40 were considered high.

Results
The study included 26 patients and one healthy control at each session. The clinical and pathological characteristics of the patients were evaluated. The analyses revealed borderline-level increased SCE rates in only one patient. No increase in spontaneous breakage count or SCE analysis was observed in other individuals compared to controls.

Conclusions
Increased genomic instability was not observed in the analyzed patient group. These results can lead to multiple interpretations. The variants carried in the BLM gene in the patient group may be of low pathogenicity, or increased instability compared to controls may not be necessary for heterozygous variants. Additionally, our patient group may not have been exposed to a genotoxic effect causing genomic instability. These results could also indicate a favorable position in terms of avoiding chemotherapy and radiotherapy complications.
Leitura e tradução
Authors: Lúcia Pires Vera , Brisolara Valeria 
Published: August 2024

A investigação da linguagem como prática social mediadora da experiência do relacionamento entre os seres humanos tem sido uma opção de muitos pesquisadores da linguagem, tributários da filosofia de Mikhail Bakhtin e seu Círculo. O objetivo deste artigo é discutir a questão de o ato de autoria, bem como o de leitura e o de tradução, serem processos dialógicos de interação. São dialógicos por serem práticas discursivas realizadas pela interação entre interlocutores social e historicamente situados. A leitura e a tradução são vistas como práticas culturais situadas que atuam não só mediando, mas também criando cultura. Sob essa perspectiva, são práticas de natureza eminentemente dialógica e autoral. Ao ler e ao traduzir, é necessário que sejam feitas escolhas e estas acabam por produzir um novo texto e um novo autor.
O teste TOEFL-ITP dentro do Programa Ciências Sem Fronteiras
Authors: Marcuzzo Patricia , Azambuja Francine 
Published: August 2024

Este trabalho analisa o teste TOEFL versão ITP dentro do programa Ciências sem Fronteiras (CsF) a fim de identificar em que medida e como este testa a proficiência em língua inglesa dos candidatos ao programa CsF. O teste foi analisado em termos de estrutura, seções, subseções, tempo de duração e número de questões. Além disso, foram identificadas as competências exploradas, os textos e os gêneros abordados nessa versão do TOEFL. Este trabalho pode fornecer subsídios para professores de língua inglesa que preparam estudantes para prestar esse teste.
Caregiver and Care Team Perceptions of Online Collaborative Care Planning for CMC
Authors: Moore Clara , Adams Sherri , Beatty Madison , Dharmaraj Blossom , Desai Arti D. , Bartlett Leah , Culbert Erin , Cohen Eyal , Stinson Jennifer N. , Orkin Julia 
Published: August 2024

BACKGROUND AND OBJECTIVES
Care plans summarize a child with medical complexity’s (CMC) medical history and ongoing care needs. Often, the health care team controls the care plan content, limiting caregivers’ ability to edit the document in real time and potentially compromising accuracy and utility. With this study, we aimed to provide caregivers of CMC with online access and shared editing control of their child’s care plan and to explore the experiences of caregivers and care team members (CTMs) after using an online collaborative care plan (OCCP).

METHODS
Caregivers of CMC were recruited from a tertiary complex care program to use an online, patient-facing platform for 6 months, which included the ability to edit and share their child’s care plan. Caregivers and CTMs participated in semi-structured interviews to explore their experiences in using the OCCP. Consistent with grounded theory methodology, a constant comparative analysis was used, which allowed for theoretical sampling and theory generation.

RESULTS
A total of 15 caregivers and 20 CTMs completed interviews. Interviews revealed 3 major themes and 9 subthemes, including (1) the navigation of uncharted roles (trust, responsibility), (2) the requirements for success (electronic medical record integration, online access, collaborative care plan review), and (3) cohesive care (accessibility and convenience, being on the same page, autonomy). Themes informed the creation of a theoretical model for the implementation and utility of OCCPs.

CONCLUSIONS
Online, collaborative care plans, when implemented safely and thoughtfully, promote shared understanding, improve caregiver autonomy, and increase the accessibility of health information. Together, these benefits facilitate cohesive care and authentic partnership between caregivers and CTMs in the care of CMC.
Improving patient flow in free medical service by introducing a process map: a quality improvement study
Authors: Buranda Lucky Sarjono 
Published: August 2024

Introduction: The tradition of charitable medical treatment can be drawn back to the early years of Christianity when the Church growth closely related to the care for the sick as well as other charitable activities. Though its purpose is charity, free medical service should also improve the quality of service. It can be achieved through the implementation of lean six sigma tools. One of its tools is a process map. Process map in Lean Six Sigma is commonly used as a diagnostic tool to determine the possible bottlenecks in the system.
Methods: This is a brief pre and post quality improvement study. Before the implementation of a process map suggested by the researcher (period I), the patient flow was not properly organized. After the lunch break, the researcher introduced a new process map and briefed it to the committee. The patients flow in the afternoon (Period II) was using the process map. Patient numbers and wait times were measured within the time interval of this study.
Results: Out of 159 patients who served during the period of this study, 63 (40%) were male and 96 (60%) were female. During Period I of the medical service, 50 patients (31%) were treated with average 17 patients per hour and approximate waiting time 36 minutes. After implementation of process map (Period II) the number of patients served were 109 (69%) with an average 36 patients per hour and an approximate waiting time of 17 minutes.
Conclusion: The implementation of process map in free medical service may assist in increasing the number of patients served and reduce the waiting time as a result. Apart from reducing the confusion of where the patients were to go next, the process map also help the committee to identify possible hinderances and address the impediments to efficient charitable medical care.
Analisis Model Rendaman Rob di Desa Tambakbulusan Kabupaten Demak Sebagai Evaluasi Rencana Pengembangan Kawasan Wisata Bahari
Authors: Claus Berril , Nugraha R. Bambang Adhitya , Gultom Iqbal S. , Anggoro Tri Danny , Jayawiguna Muhammad Hikmat , Setiyono Heryoso , Wirasatriya Anindya 
Published: August 2024

Kabupaten Demak salah satu kawasan pesisir di utara Jawa Tengah yang sering mengalami banjir rob akibat kenaikan muka air laut dengan dampak yang siginifikan di wilayah tersebut seperti terganggunya kegiatan pariwisata yang dikelola oleh masyarakat pesisir. Penelitian ini bertujuan untuk memperkirakan potensi genangan rob yang terjadi di Desa Tambakbulusan dan akan digunakan sebagai referensi rencana pengembangan wisata bahari di kawasan tersebut. Penelitian ini menggunakan metode kajian model genangan rob dari pasang surut dengan periode pengumpulan data sekunder selama 5 tahun dan uji akurasi hasil uji lapangan. Elevasi muka air laut lokasi kajian menggunakan prediksi pasang surut global MIKE 21 dan selanjutnya diolah untuk mendapatkan nilai bilangan Formzhal untuk mengetahui tipe pasang surut lokasi, dan selisih nilai HHWL dan MSL tertinggi selama 5 tahun periode. Model genangan rob kemudian dibuat dengan bantuan raster calculator pada ArcMap 10.8. Hasil penelitian menunjukan bahwa model genangan memiliki nilai accuracy sebesar 0,89 atau akurasi model 89%, nilai precision sebesar 1 atau presisi prediksi nilai positif 100%, dan recall sebesar 0.87 atau model dapat menangkap kasus positif sebanyak 87%. Hal ini menunjukkan bahwa algoritma memberikan hasil klasifikasi kondisi pesisir Tambakbulusan saat banjir rob terjadi dengan sangat baik. Pengolahan elevasi muka air laut menunjukan kawasan pesisir Desa Tambakbulusan yang memiliki tipe pasang surut campuran condong harian tunggal dengan bilangan Formzhal sebesar 1,526, dikategorikan memiliki tingkat kerentanan sedang. Genangan rob dengan tinggi muka laut 78 cm saat pasang menjangkau 72,11% luas Tambakbulusan dimana terdapat are tambak seluas 410,91 Ha dan area sawah seluas 3,88 Ha, sedangkan untuk pemukiman warga tidak terkena dampak dari banjir rob.
Diagnosis and Management of Adrenocortical Carcinoma with co-secretion of Cortisol and Aldosterone
Authors: Aliño Meghan Marie , Tam-Go Lyzanne Maryl 
Published: August 2024

Adrenocortical carcinoma (ACC) accounts for 0.05-2% of all malignant tumors. Forty-five percent of ACCs with secretory function have excess glucocorticoids alone and only less than 1% secrete aldosterone.
This is a case of a 44-year-old Filipino female with hypertension and a 12-year-history of an incidentaloma of the left adrenal gland, with recent-onset complaints of increasing abdominal girth, purple striae, amenorrhea, moon facies and a dorsocervical fat pad. Laboratory findings revealed low potassium levels, non-suppressed cortisol on dexamethasone test suggesting Cushing’s syndrome and elevated aldosterone-renin ratio and plasma aldosterone concentration pointing to primary hyperaldosteronism. A computed tomography scan revealed a left-sided adrenal mass measuring approximately 23 cm in largest diameter suggestive of carcinoma without metastasis or lymph node involvement. Complete resection via open adrenalectomy was performed and histopathologic assessment revealed Adrenocortical Carcinoma with Weiss score of 4. The Ki-67 proliferative index was found to be >20%. Radiotherapy was done as an adjuvant treatment.
Although rare, co-secretion of cortisol and aldosterone can occur in functional tumors of adrenocortical carcinoma. Malignancy should always be considered in patients who present with a history of a unilateral adrenal mass and/ or in those with signs and symptoms of adrenal hormone excess. Thus, a proper assessment derived from a thorough medical history, physical examination and laboratory work-up is warranted in patients with an adrenal mass to ascertain the diagnosis and provide adequate management.
Comprehensive management of a child with X-linked lymphoproliferative disease undergoing stem cell transplantation: a case report
Authors: Rathee Anjali , Jangid Rinkal , Dixit Priyanshi 
Published: August 2024

An uncommon immunodeficiency disease known as X-linked lymphoproliferative disease (XLP) has been associated with severe immunological dysfunction and a high susceptibility to Epstein-Barr virus (EBV) infections. This case report describes a four-year-old boy who had X-linked lymphoproliferative illness and died from multiple system organ failure (MSOF) after receiving treatment with a haploidentical hematopoietic stem cell transplant (halo-HSCT). While providing care in such circumstances, rational-based care, prompt identification, primary nursing care, health education, and emotional assistance for parents of individuals with X-linked lymphoproliferative diseases are vital.