bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medication adherence and needs among patients with schizophrenia in China: a qualitative study
Authors: Li Xuping , Xiao Shuiyuan , Sun Yajun , Zheng Ying , Huang Jiaju , Wei Ning , Mao Chun , Zhang Shengjun , Teng Yongyong 
Published: January 2025

ObjectivesTo explore the factors influencing medication adherence and the medication needs of patients with schizophrenia when living in a community in China.DesignA qualitative study.SettingCommunity and psychiatric ward in Zhuhai city, Guangdong province.ParticipantsPatients with schizophrenia and (or) their primary caregivers.Primary and secondary outcome measuresFacilitators and barriers of medication adherence and the medication needs.ResultsA total of 20 patients with schizophrenia and 12 primary caregivers participated in the study. Based on the Health Ecology Model, the analysis identified four levels of factors influencing medication adherence, categorised as individual (facilitators: effective treatment, positive expectation, establishing a routine and assistive tools; barriers: side effects, inadequate knowledge, forgetfulness and irregular daily schedule), interpersonal (facilitators: caregiver assistance and psychiatrist’s recommendation; barriers: lack of social support), community (facilitators: community mental health services and reducing medication use frequency; barriers: limited medication accessibility and affordability) and policy and culture related (facilitators: collectivist culture and social security policy; barriers: stigma). Additionally, five medication needs (managing side effects, applying for social security, improving medication accessibility, transitioning to long-acting injections and getting health education) were recognised.ConclusionsThese findings offer valuable insights for healthcare providers and policymakers, underscoring the need for targeted interventions to enhance medication adherence among patients with schizophrenia in China.
Predictors of response to low-dose amitriptyline for irritable bowel syndrome and efficacy and tolerability according to subtype: post hoc analyses from the ATLANTIS trial
Authors: Wright-Hughes Alexandra , Ow Pei-Loo , Alderson Sarah L , Ridd Matthew J , Foy Robbie , Bishop Felicity L , Chaddock Matthew , Fernandez Catherine , Guthrie Elspeth A , Muir Delia P , Taylor Christopher A , Farrin Amanda J , Everitt Hazel A , Ford Alexander C 
Published: January 2025

BackgroundLow-dose amitriptyline, a tricyclic antidepressant (TCA), was superior to placebo for irritable bowel syndrome (IBS) in the AmitripTyline at Low-dose ANd Titrated for Irritable bowel syndrome as Second-line treatment (ATLANTIS) trial.ObjectiveTo perform post hoc analyses of ATLANTIS for predictors of response to, and tolerability of, a TCA.DesignATLANTIS randomised 463 adults with IBS to amitriptyline (232) or placebo (231). We examined the effect of baseline demographic and disease-related patient characteristics on response to amitriptyline and the effect of amitriptyline on individual symptoms and side effects by subtype.ResultsThere was a quantitative difference in amitriptyline effectiveness in those ≥50 years vs <50 on the IBS severity scoring system (IBS-SSS) (interaction p=0.048, mean difference in ≥50 years subgroup −46.5; 95% CI −74.2 to −18.8, p=0.0010), and subjective global assessment of relief (interaction p=0.068, OR in ≥50 years subgroup 2.59; 95% CI 1.47 to 4.55, p=0.0010), and those in the 70% most deprived areas of England compared with the 30% least deprived for a ≥30% improvement in abdominal pain (interaction p=0.021, OR in 70% most deprived subgroup 2.70; 95% CI 1.52 to 4.77, p=0.0007). Stronger treatment effects were seen in men, with higher Patient Health Questionnaire-12 scores, and with IBS with diarrhoea. Mean differences in individual IBS-SSS components favoured amitriptyline, and side effects were similar, across almost all IBS subtypes.ConclusionThese exploratory analyses demonstrate there are unlikely to be deleterious effects of amitriptyline in any particular IBS subtype and could help identify patients in whom amitriptyline may be more effective.Trial registration numberISRCTN48075063.
Assessing the performance of ChatGPT in medical ethical decision-making: a comparative study with USMLE-based scenarios
Authors: Khan Ali A , Khan Ali R , Munshi Saminah , Dandapani Hari , Jimale Mohamed , Bogni Franck M , Khawaja Hussain 
Published: January 2025

IntroductionThe integration of artificial intelligence (AI) into healthcare introduces innovative possibilities but raises ethical, legal and professional concerns. Assessing the performance of AI in core components of the United States Medical Licensing Examination (USMLE), such as communication skills, ethics, empathy and professionalism, is crucial. This study evaluates how well ChatGPT versions 3.5 and 4.0 handle complex medical scenarios using USMLE-Rx, AMBOSS and UWorld question banks, aiming to understand its ability to navigate patient interactions according to medical ethics and standards.MethodsWe compiled 273 questions from AMBOSS, USMLE-Rx and UWorld, focusing on communication, social sciences, healthcare policy and ethics. GPT-3.5 and GPT-4 were tasked with answering and justifying their choices in new chat sessions to minimise model interference. Responses were compared against question bank rationales and average student performance to evaluate AI effectiveness in medical ethical decision-making.ResultsGPT-3.5 answered 38.9% correctly in AMBOSS, 54.1% in USMLE-Rx and 57.4% in UWorld, with rationale accuracy rates of 83.3%, 90.0% and 87.0%, respectively. GPT-4 answered 75.9% correctly in AMBOSS, 64.9% in USMLE-Rx and 79.6% in UWorld, with rationale accuracy rates of 85.4%, 88.9%, and 98.8%, respectively. Both versions generally scored below average student performance, except GPT-4 in UWorld.ConclusionChatGPT, particularly version 4.0, shows potential in navigating ethical and interpersonal medical scenarios. However, human reasoning currently surpasses AI in average performance. Continued development and training of AI systems can enhance proficiency in these critical healthcare aspects.
Submaximal versus aggressive angioplasty with drug-coated balloons for symptomatic intracranial arterial stenosis
Authors: Li Guangwen , Liu Yayue , Sun Xiaofei , Sun Yujie , Liu Peng , Zhang Xianjun , Anmu Xie , Zhang Yong 
Published: January 2025

BackgroundDrug-coated balloons (DCB) can decrease the incidence of restenosis in the treatment of intracranial atherosclerotic stenosis (ICAS). This study aimed to assess the safety and efficacy of submaximal angioplasty with DCB dilation compared with aggressive angioplasty in patients with symptomatic ICAS.MethodsThis study prospectively and consecutively enrolled patients with symptomatic ICAS who underwent DCB angioplasty between January 2021 and December 2023. Based on the balloon size, the patients were divided into submaximal (50–80% of normal vessel diameter) or aggressive (80–100% of normal vessel diameter) angioplasty groups. The efficacy and safety of angioplasty including ischemic stroke/intracranial hemorrhage, death, arterial dissection, and follow-up outcomes were compared between the two groups.ResultsThe patients were divided into submaximal (n=55) and aggressive (n=62) angioplasty groups. All the balloons were successfully delivered to the lesion location and expanded. The dissection rate (3.6% vs 17.7%, P=0.018) and incidence of remedial stenting (7.3% vs 21.0%, P=0.040) after balloon dilation were significantly greater after aggressive angioplasty than after submaximal angioplasty. A residual stenosis rate of ≥30% was more common in the submaximal angioplasty group than in the aggressive angioplasty group (27.3% vs 8.1%, P=0.006). Periprocedural complications (1.8% vs 8.1%, P=0.212), recurrent ischemic events (1.8% vs 4.8%, P=0.621), and restenosis (3.6% vs 8.1%, p=0.445) were comparable between the groups.ConclusionsSubmaximal angioplasty has a favorable technical profile, periprocedural safety, and long-term efficacy, suggesting that it is a promising alternative treatment for symptomatic ICAS.
Epidemiology and impact of travellers’ diarrhoea differs during UK military training exercises in Kenya and Oman
Authors: Toriro Romeo , Tabberer B , Davis S I , Reece N L , Woolley S D , O'Shea M K , Fletcher T E , Burns D S , Beeching N J 
Published: January 2025

BackgroundGastrointestinal illnesses are common during military training and operational deployments. We compared the incidence and burden of travellers’ diarrhoea (TD) reported by British service personnel (SP) during recent training exercises in Kenya and Oman.MethodsSP completed a validated anonymous questionnaire regarding clinical features of any diarrhoeal illness, associated risk factors and impact on work capability after 6-week training exercises in 2018 in Kenya and 2018–2019 in Oman. Responses were tabulated for descriptive comparisons.ResultsQuestionnaires were received from 388 (32%) SP in Kenya and 627 (52%) in Oman. The cumulative incidence of reported diarrhoea over 6-weeks was 14.2% (95% CI 8.02% to 22.61%) in Kenya compared with 3.9% (95% CI 1.10% to 9.91%) in Oman (OR 3.56, 95% CI 2.18 to 5.8; p<0.0001). Attack rates were 9.45 SP/100 exposure-months in Kenya and 2.66/100 in Oman. The number of workdays lost was greater in Kenya (6.26 per 1000 days) compared with Oman (4.13 per 1000 days) (p<0.01). In Kenya, 52.3% of those experiencing diarrhoea became ill during the first 14 days of deployment, but in Oman, 50% were ill in the last deployment week. The strongest risk factor associated with TD at both locations was contact with a colleague experiencing diarrhoea, followed in Kenya by eating locally sourced food and swimming in local water, which had weaker protective associations in Oman.ConclusionsThe epidemiology, risk factors and burden of TD in Kenya were similar to previous descriptions, where overall incidence continues to decline. Incidence and burden were significantly lower in Oman, where both were much lower than historical descriptions. Peak timing of illness and associated risk factors differed between Kenya and Oman. Continued documentation and review of TD during training exercises at different geographical locations is essential to inform the chain of command about risks to operational effectiveness.
Electroweak quantum numbers in the $$D_4$$ root system
Authors: Jansson Henrik 
Published: January 2025

Abstract
We introduce four fundamental quantum numbers based on the

$$D_4$$

D
4

root system, giving a unified description of quarks and leptons. These numbers will make it possible to define electric charge in a simple way. By postulating a fundamental symmetry given by the binary tetrahedral group acting on this root system, we can easily prove conservation of electric charge. Also, possible electroweak interactions are given by a simple rule where the 24-cell acts on itself by quaternion multiplication. The three generations of fermions in the Standard Model are hereby identified with the three imaginary dimensions of the quaternions.
Automatic Generation of Fast and Accurate Performance Models for Deep Neural Network Accelerators
Authors: Lübeck Konstantin , Jung Alexander , Wedlich Felix , Müller Mika , Peccia Federico , Thömmes Felix , Steinmetz Jannik , Biermaier Valentin , Frischknecht Adrian , Palomero Bernardo Paul , Bringmann Oliver 
Published: January 2025

Implementing Deep Neural Networks (DNNs) on resource-constrained edge devices is a challenging task that requires tailored hardware accelerator architectures and a clear understanding of their performance characteristics when executing the intended AI workload. To facilitate this, we present an automated generation approach for fast performance models to accurately estimate the latency of a DNN mapped onto systematically modeled and concisely described accelerator architectures.
Using our accelerator architecture description method, we modeled representative DNN accelerators such as Gemmini, UltraTrail, Plasticine-derived, and a parameterizable systolic array. Together with DNN mappings for those modeled architectures, we perform a combined DNN/hardware dependency graph analysis, which enables us, in the best case, to evaluate only 154 loop kernel iterations to estimate the performance for 4.19 billion instructions achieving a significant speedup. We outperform regression and analytical models in terms of mean absolute percentage error (MAPE) compared to simulation results, while being several magnitudes faster than an RTL simulation.
Evaluating the Psychological Implications of the COVID‐19 Pandemic Among Healthcare Workers: A Cross‐Sectional Study
Authors: Hamza Wafaa S. , Almutairi Ali Ghazi , Ali Lamiaa A. 
Published: January 2025

Background and Aim: Healthcare workers (HCWs) faced challenges due to COVID‐19 pandemic, which had a short‐term and long‐term effects on their psychological health. The study aimed to assess the long‐term effect of the pandemic on HCWs’ health.Methods: A cross‐sectional study was conducted to measure the psychological outcome (insomnia, depression, and anxiety), their associations with COVID‐19 pandemic, and the possible predictors. Validated scales were the tools of the study: insomnia severity index (ISI), Patient Health Questionnaire (PHQ‐9), and generalized anxiety disorder (GAD‐7). Three hundred fifty‐seven participants were recruited through an online survey. Analysis done using forward stepwise linear regression.Results: 54.3% were younger than 40 years, 83.2% were married, and females represented 63.3%. Nurses comprised 47.3%, followed by doctors or dentists (25.5%). About 74.8% worked at general hospitals. The prevalence of clinical insomnia, moderate to severe levels of depression, and anxiety were 14.3%, 10.6%, and 9.0%, respectively. Significantly higher levels of anxiety and depression were detected among females and HCWs with psychological problems. Besides, more depression was observed among participants who experienced the death of family members or friend due to COVID‐19. Insomnia was more prevalent among HCWs who had confirmed COVID‐19, and higher anxiety was reported by those who needed hospitalization (p  < 0.05). The common significant predictors were included history of mental health problem, history of COVID‐19, and the death of family member or friend due to COVID‐19.Conclusion: COVID‐19 pandemic caused long‐term psychological burden among HCWs. Further longitudinal researches are necessary to explore specific interventions to support HCWs’ mental health.
Enhancing Empathy and Self‐Awareness in Psychiatric Nursing Students Through High‐Fidelity Simulation: A Quasi‐Experimental Study
Authors: Abdalrahim Asem 
Published: January 2025

Background: Positive patient outcomes result from increased empathy and self‐awareness. One of the strategies utilized to improve empathy and self‐awareness was a high‐fidelity simulation (HFS).Purpose: This study aimed to see how HFS impacted students’ empathy and self‐awareness before and after HFS intervention in Jordanian university psychiatric nursing classes.Methods: A quasi‐experimental research with a pretest–posttest design was conducted on 235 undergraduate students registered in a psychiatric course at Al al‐Bayt University’s Faculty of Nursing from September to December 2023. The HFS was held in the form of 5 weeks’ scenarios. The study data collection tools included a demographic questionnaire, The Empathy Toward the Mentally Ill Scale and the Self‐Consciousness Scale: A Revised Version. The data were analyzed using descriptive statistics (frequency, mean, and standard deviation), and inferential statistics (t‐test).Results: Before and after the HFS intervention, a significant difference in students′ empathy (t234 = −26.90, p < 0.001) and self‐awareness (t234 = −19.70, p < 0.001) was found.Conclusions: HFS interventions, particularly in psychiatric courses, can be used to close the gap in nursing education and enhance traditional clinical learning.
Geomorfologia antropogênica e cartografia geomorfológica em uma área urbana do município de Diadema – Sudeste do Brasil
Authors: Morari Eduardo Luiz , Villela Fernando Nadal Junqueira 
Published: January 2025

O presente estudo tem como objetivo investigar e mapear a geomorfologia antropogênica de uma área urbana de Diadema, SP. Sendo parte da Região Metropolitana de São Paulo, até meados da década de 1950, o município apresentava características rurais de uso e ocupação do solo e sofreu rápida transformação para atividades urbanas e industriais a partir de 1960. Assim, a intervenção antropogênica no relevo apresenta características bastante distintas da cidade de São Paulo, pois as tecnologias e interesses econômicos eram diferentes dos inícios da urbanização da metrópole. Essas características foram valorizadas na seleção da área de estudo, região central de Diadema, que abrange uma zona de morros cristalinos do Planalto Paulistano. Adotando uma quadrícula de 700 m², mapeada na escala 1:5.000, a área emoldura importantes modificações antropogênicas no relevo, tais como cortes de talude, aterros, retificações de drenagem e escavações na planície fluvial para reservatórios de contenção de cheias, modificando a topografia, volumes de materiais mobilizados e processos vigentes. Segundo pressupostos da abordagem retrospectiva e a cartografia geomorfológica, foram investigadas as fases de perturbação pré-urbana e de urbanização consolidada, quantificando o material mobilizado pelas intervenções antrópicas diretas por meio da criação de formas positivas e negativas. Assim, este estudo obteve como resultado, a partir do mapeamento geomorfológico do período pré-urbanização (original) e da urbanização consolidada, a qualificação e quantificação das intervenções antropogênicas no relevo, sendo possível o reconhecimento das modificações no relevo e estimativas dos volumes de materiais mobilizados, apontando as intervenções antrópicas nos domínios dos interflúvios e planícies consideradas.
O Geopatrimônio no licenciamento ambiental do Estado do Rio Grande do Sul, Brasil
Authors: Kormann Tanice Cristina , Wolff Claudia Bos , Bilhar Jaqueline Dickel , Silva Rafael Fernandes e , Ribeiro Glaucus Vinicius Biasetto , Spolavori Cleber Arruda , Anele Luciana Regina Petry , Midugno Rafael 
Published: January 2025

In the same year that Rio Grande do Sul became the Brazilian state with the largest number of geoparks recognized by UNESCO, regulation was published to include the issue in environmental permits at state level. Environmental impact assessment is a support mechanism for decision-making on major construction projects aimed at avoiding significant impacts on the health and safety of communities or compromising the balance of environmental systems. Following the current legislation and aiming to promote geoconservation within environmental management in the state of Rio Grande do Sul, the State Environmental Protection Foundation Henrique Luis Roessler (FEPAM) published the Technical Guideline no. 12/2023 establishes procedures for identifying and assessing geosites and geodiversity sites. This article aims to introduce the instrument that FEPAM has adopted in the environmental permits for activities that have the potential to impact or pollute the environment. The technical guideline seeks to mitigate conflicts between economic activities and the geoheritage. Key challenges and advancements of the guideline include: i) proposing a methodology for inventorying and evaluating sites of relevance; ii) inclusion of the issue in the routine environmental impact assessment within the state environmental permits system; and iii) fostering inter-institutional dialogue to share the highlighting areas of geoconservation interest during environmental permits system. Therefore, this initiative is pioneering in explicitly incorporating this issue in the analysis of public organization, establishing mechanisms to safeguard of regional geoheritage.
Função paterna em Lacan: análise de dois casos na ausência do genitor
Authors: Cherer Evandro de Quadros , Ferrari Andrea Gabriela , Piccinini Cesar Augusto 
Published: January 2025

Este trabajo investigó la función paterna a través del estudio de caso de dos madres y sus bebés, a los 3 y 8 meses de vida, que no cohabitaban con sus padres. Para este estudio se realizaron entrevistas sobre los diferentes aspectos de la maternidad y sobre la relación con el bebé. Los relatos maternos fueron analizados a partir de la concepción lacaniana de función paterna. Los análisis revelaron que los bebés ocuparon un lugar privilegiado en el deseo materno y, a pesar de la ausencia física del padre, fue posible la instauración de una ley que indicó un efecto de corte entre la madre y el bebé, aspecto asociado a la función paterna en los relatos maternos.
O equilíbrio pontuado: proposta, fundamentação e recepção (1972-1993)
Authors: Rodrigues Gabriel Vanzo , Martins Lilian Al-Chueyr Pereira 
Published: January 2025

A escassez de formas transicionais no registro geológico representou um problema para as teorias que admitiam a transmutação das espécies, durante o século XIX. Para Charles Robert Darwin (1909-1882), foi talvez a objeção mais séria à sua teoria apresentada nas várias edições da Origem das Espécies, a partir de 1859. Embora Darwin e outros estudiosos tenham proposto explicações, esse problema persistiu até o século XX, durante a Síntese Moderna. Na década de 1970, dois paleontólogos norte-americanos, Niles Eldredge e Stephen Jay Gould (1941-2002), apresentaram a hipótese do equilíbrio pontuado como uma alternativa ao gradualismo admitido por Darwin e pela Síntese Moderna. O presente artigo tem como objetivo discutir a proposta do equilíbrio pontuado. Além disso, sua fundamentação, bem como qual foi a reação da comunidade científica. A análise desenvolvida mostrou que o equilíbrio pontuado complementou a proposta de Darwin e da Síntese Moderna. Assim, críticas como oposição a essas ideias são injustificadas. Os autores procuraram fundamentar sua hipótese em evidências de suas investigações e de outros autores. As reações à proposta variaram durante o período estudado (1972-1993). Ainda assim, ela obteve maior aceitação entre os paleontólogos e encontrou restrições mais significativas entre aqueles que se dedicavam à genética, principalmente à genética de populações.
Darcilla e Sandra, artesãs de “horizontes sem tamanhos”
Authors: Pereira José Carlos 
Published: January 2025

A indagação através da memória e da história oral pode atualizar o passado, revelar tempos, espaços, e experiências de pessoas socialmente marginalizadas, invisibilizadas. O objetivo deste trabalho é apresentar trajetórias da Ir. Darcilla e da Ir. Sandra, com ênfase na história da primeira, e apontar como suas ações individuais e coletivas contribuíram para a transformação do sentido da história para pessoas e grupos sociais, especialmente mulheres, flageladas pela negação de direitos. A metodologia da pesquisa baseia-se na história oral. Ir. Sandra atuou junto a esposas, irmãs e filhas de trabalhadores migrantes do Vale do Jequitinhonha-MG; Ir. Darcilla, com famílias de trabalhadores rurais sem-terra e imigrantes, no Norte e Nordeste do Brasil. Os resultados indicam que, apesar do caráter patriarcal de instituições que (re)produzem a discriminação e violência de gênero, etnia/raça e classe, ambas contribuíram para a construção de brechas e horizontes possíveis de geração de trabalho remunerado, formação de lideranças, e, sobretudo, de recuperação da autoestima por pessoas que saíram da condição de subalternos e sem história, para a de protagonistas. Consideramos que o acionamento da memória, a partir do presente, permite (re)visitar o passado, buscar a gênese da realidade atual, interpretá-la e informar possibilidades para o futuro, recolocando no centro da história os sujeitos dela alijados.