bluuebunny/crossref_metadata_2025_split huggingface dataset:
Will the use of anabolic androgenic steroids become a significant cardiovascular risk factor in the future?
Authors: Pawłucki Piotr , Maciak Anna , Andrasz Ewelina , Cuper Paulina , Sekuła Michał , Dziurowicz Błażej 
Published: August 2023

Introduction and purpose: Cardiovascular diseases are the leading cause of mortality in many European countries. Major modifiable risk factors include dyslipidemia, hypertension, smoking and diabetes. The aim of our study is to draw attention to the possible impact of the use of anabolic androgenic steroids on increased cardiovascular risk.
Brief description of the state of knowledge: Currently, an increasing proportion of the population uses anabolic-androgenic steroids (AAS). This situation applies not only to athletes, but also to amateurs. The use of AAS may be associated with numerous complications. These include an increased risk of cardiovascular disease. The literature describes the effect of AAS use on the occurrence of dyslipidemia, insulin resistance, hypertension and metabolic syndrome. All these metabolic disorders result in increased cardiovascular risk. To prevent complications, it seems best to withdraw AAS gradually under medical supervision to minimize withdrawal effects.
Conclusion: The use of AAS may cause cardiovascular disease, but additional long-term studies are needed to prove this. It is necessary to sensitize patients and doctors to the problem of AAS abuse in society, because this issue can become a significant risk factor for cardiovascular diseases in near future.
Mandatory and recommended immunizations. Contraindications to vaccination and adverse reaction to vaccination in the context of liability for failure to vaccinate a minor (Article 115 § 2 of the Code of Offenses.)
Authors: Ćwik-Błotnicka Dominika , Błotnicki Maciej 
Published: August 2023

Introduction: the issue of immunizations constantly raises discussion. Undoubtedly, they are an effective preventive measure and play a key role in protecting public health. However, the public still holds the view that the measles, mumps and rubella vaccine causes autism, despite numerous studies refuting its effect on the development of autism. Adverse vaccine reactions are also a cause of concern, although they are most often a mild bodily reaction.
The purpose of the study: was to analyze the research problem, which is, in principle, the exclusion of liability of a person having custody of a minor for the offense of failing to vaccinate him/her with mandatory immunization in the presence of a contraindication to vaccination. The law on compulsory vaccination is discussed, taking into account the occurrence of a medical reason for non-vaccination. The scope of the subject of vaccination, adverse reaction to vaccination and contraindications to vaccination are presented.
Materials and methods: databases such as PubMed and Legal Information Systems (LEX and Legalis) were searched. They relied on the Immunization Program in effect in 2023 and current criminal and medical literature and court decisions.
Results: there is a collision of goods of an individual nature in the form of restriction of the right to self-determination, manifested in the obsolescence of the obligation to obtain the patient's consent to undergo a qualifying examination and immunization, with a good of a supra-individual nature in the form of public health security by ensuring the highest possible level of collective immunity.
Conclusions: it is important to find a balance between the right to decide about the health of one's child and the duty to take care of public health, in order to ensure optimal results for both individuals and society as a whole.
Skin aging from the medical point of view, literature review in the aspect of tissue stimulants
Authors: Branewska Justyna , Imioło Jan , Ostrowska Barbara , Matysek Mikołaj , Olszanicka Anna , Maciąg Anna , Niemiec Rafał , Hop Izabela , Kołodziejczyk Kacper , Galas Adam 
Published: August 2023

Introduction and purpose of the work. Aesthetic medicine currently has many methods to keep our skin in the best possible condition, and one of these methods is the use of tissue stimulators. The purpose of the following paper is to analyze, present and apply tissue stimulators in anti-aging prevention.
Review methods. The paper is based on a review of literature about tissue stimulators, aesthetic medicine and anti-aging therapy. Most of the publications used were from Pubmed and Google Scholar electronic databases.
State of the art description. Aesthetic medicine is a department that over the past few years has been closely associated with the slowing down of skin aging processes. In humans, over the years, proliferative processes slow down, the rate of collagen and elastin degradation increases, and the intercellular matrix is reduced. Substances known as tissue stimulators used in anti-aging therapies mean that the above processes can be delayed.
Conclusion. The expectations of patients visiting aesthetic medicine clinics regarding activities that improve their appearance are increasing. They are unable to accept their own aesthetic defects, which is why they often strive for unnatural effects. Tissue simulator treatments can be a valuable way for patients to maintain healthy and rejuvenated skin.
Selective Androgen Receptor Modulators - A Review of Potential Uses, Benefits, Side effects and Limitations
Authors: Ostafin Kamil , Edyko Krzysztof , Petryla Piotr , Minkner Mikołaj , Bienkowski Borys , Feja Krzysztof , Suwała Zuzanna , Rektor Natalia , Łuczak Ewa , Marchewka Urszula 
Published: August 2023

Introduction: Selective Androgen Receptor Modulators (SARMs) are a group of chemical compounds capable of selectively activating androgen receptors (ARs) in the body. These substances can play a significant role in a new therapeutic approach in various fields of medicine, limiting the side effects associated with traditional anabolic steroids. In this article, we will focus on an overview of the current scientific knowledge on SARMs, their mechanisms of action, potential therapeutic applications, risks and challenges related to their use.
Aim of the study: The primary aim of this study was to to present potential use of selective androgen receptor modulators in sport and treatment focusing on its benefits and limitations as well as side effects aspects.
State of Knowledge: SARMs in research show therapeutic benefits in the treatment of diseases such as osteoporosis, benign prostatic hyperplasia, muscle diseases and some types of cancer. Some studies suggest that few SARMs may be hepatotoxic. Most research on SARMs has been short-term, so the long-term effects of their use remain poorly understood.
Conclusion: The popularity of SARMs is constantly growing, and research on their use in medicine and sports provides more and more new ways to use them. Despite promising results, these compounds still pose many scientific challenges and raise legitimate concerns about their long-term effects on human health.
Utilizing Artificial Intelligence Tools Using the GPT Chatbot in Medicine - A Review of Flaws, Advantages, and Limitations
Authors: Edyko Krzysztof , Petryla Piotr , Ostafin Kamil , Minkner Mikołaj , Bieńkowski Borys , Feja Krzysztof , Suwała Zuzanna , Rektor Natalia , Łuczak Ewa , Marchewka Urszula 
Published: August 2023

Introduction: Artificial Intelligence (AI), including Large Language Models (LLM), is becoming increasingly significant in the field of medicine. Chat GPT, the most popular tool based on LLM technology, utilizes deep learning techniques. Currently, there is a growing body of research evaluating the potential applications of Chat GPT in medicine, and our study is based on an analysis of review articles from the largest medical database, PubMed.
Aim of the study: The primary aim of this study was to conduct a comprehensive analysis of the utilization of Chat GPT in medicine, focusing on identifying its positive and negative aspects as well as limitations.
State of Knowledge: Previous studies have demonstrated a rapid improvement in the efficacy of responses provided by Chat GPT. It has the potential to support diagnostics, therapy, patient communication, and medical education, thereby enhancing the quality of healthcare. However, there are certain issues associated with the implementation of this technology in the field of medical sciences, such as concerns regarding data sources, responsibility, and ethics when relying on responses generated by bots. Moreover, evident and concerning algorithmic flaws need to be addressed.
Conclusions: Chat GPT, due to its accessibility and continuous improvement, has become one of the greatest hopes for the development of various industries, including medicine. It can be widely used to support educational processes and enhance efficiency in medicine. However, the use of such tools entails numerous challenges and issues, as they still have several drawbacks and limitations, such as ethical considerations and source verification. Further research on the utility of this tool is therefore necessary.
The Impact of Vertical Integration on Physician Behavior and Healthcare Delivery: Evidence from Gastroenterology Practices
Authors: Saghafian Soroush , Song Lina , Newhouse Joseph , Landrum Mary Beth , Hsu John 
Published: August 2023

The U.S. healthcare system is undergoing a period of substantial change with hospitals purchasing many physician practices (“vertical integration”). In theory, this vertical integration could improve quality by promoting care coordination but could also worsen it by impacting the care delivery patterns. The evidence quantifying these effects is limited because of the lack of understanding of how physicians’ behaviors alter in response to the changes in financial ownership and incentive structures of the integrated organizations. We study the impact of vertical integration by examining Medicare patients treated by gastroenterologists, a specialty with a large outpatient volume and a recent increase in vertical integration. Using a causal model and large-scale patient-level national panel data that includes 2.6 million patient visits across 5,488 physicians, we examine changes in various measures of care delivery. We find that physicians significantly alter their care process (e.g., in using anesthesia with deep sedation) after they vertically integrate, and there is a substantial increase in patients’ postprocedure complications. We further provide evidence that the financial incentive structure of the integrated practices is the main reason for the changes in physician behavior because it discourages the integrated practices from allocating expensive resources to relatively unprofitable procedures. We also find that, although integration improves operational efficiency (e.g., measured by physicians’ throughput), it negatively affects quality and overall spending. Finally, to shed light on potential mechanisms through which policymakers can mitigate the negative consequences of vertical integration, we perform both mediation and cost-effectiveness analyses and highlight some useful policy levers.This paper was accepted by Stefan Scholtes, healthcare management.Supplemental Material: The online appendix and data are available at https://doi.org/10.1287/mnsc.2023.4886 .
The effect of ambient outside temperatures on scoop stretchers
Authors: Haley Anthony , Gibson Iain , Graham Christine , Guthrie Iain , Newins Dominique 
Published: August 2023

Background: Scoop stretchers are commonly used in the prehospital care of trauma patients. Patients' clothing is often removed early in the care pathway. There may be unidentified risks if scoop stretchers are particularly cold. Aims: The primary aim of this research was to establish if there is a positive correlation between scoop temperatures and outside temperatures when this equipment is stored without access to vehicle heating. Methods: The authors recruited volunteers at ambulance locations across Scotland to measure scoop temperatures using infrared thermometers. These were compared to outside temperatures at that time. Data were subject to bivariate quantitative analysis to assess correlation strength. Findings: Results demonstrated that there was a moderate-to-strong correlation between scoop temperatures and outside temperatures (mean +3.0°C; P<0.001). There was no significant difference for other variables measured. Conclusion: Without active heating, scoop stretchers will be only marginally warmer than the outside temperature, sometimes colder than the outside temperature and sometimes below freezing point.
Laser-induced molecular contamination de-risking activity for the Laser Interferometer Space Antenna
Authors: Bartels Nils , Vogel Moritz , Riede Wolfgang , Dahl Christian , Voss Kai-Cristian , Ciapponi Alessandra , Martins Ricardo , Mondin Linda 
Published: August 2023

The Laser Interferometer Space Antenna (LISA) will be the first
space-based gravitational wave observatory. LISA uses continuous-wave,
infrared laser beams propagating among three widely separated
spacecrafts to measure their distances with picometer accuracy via
time-delay interferometry. These measurements put very high demands on
the laser wavefront and are thus very sensitive to any deposits on
laser optics that could be induced by laser-induced molecular
contamination (LIMC). In this work, we describe the results of an
extensive experimental test campaign assessing LIMC related risks for
LISA. We find that the LIMC concern for LISA, even considering the
high demands on the laser wavefront, may be greatly reduced compared
to that observed at shorter wavelengths or with pulsed laser
radiation. This result is very promising for LISA as well as for other
space missions using continuous-wave, infrared laser radiation,
e.g., in free space laser communication or quantum key
distribution.
Central and local arterial stiffness in White Europeans compared to age-, sex-, and BMI-matched South Asians
Authors: van der Sluijs Koen M. , Thannhauser Jos , Visser Iris M. , Nabeel P. M. , Raj Kiran V. , Malik Afrah E. F. , Reesink Koen D. , Eijsvogels Thijs M. H. , Bakker Esmée A. , Kaur Prabhdeep , Joseph Jayaraj , Thijssen Dick H. J. 
Published: August 2023

Background
Ethnicity impacts cardiovascular disease (CVD) risk, and South Asians demonstrate a higher risk than White Europeans. Arterial stiffness is known to contribute to CVD, and differences in arterial stiffness between ethnicities could explain the disparity in CVD risk. We compared central and local arterial stiffness between White Europeans and South Asians and investigated which factors are associated with arterial stiffness.

Methods
Data were collected from cohorts of White Europeans (the Netherlands) and South Asians (India). We matched cohorts on individual level using age, sex, and body mass index (BMI). Arterial stiffness was measured with ARTSENS® Plus. Central stiffness was expressed as carotid-femoral pulse wave velocity (cf-PWV, m/s), and local carotid stiffness was quantified using the carotid stiffness index (Beta) and pressure-strain elastic modulus (Epsilon, kPa). We compared arterial stiffness between cohorts and used multivariable linear regression to identify factors related to stiffness.

Results
We included n = 121 participants per cohort (age 53±10 years, 55% male, BMI 24 kg/m2). Cf-PWV was lower in White Europeans compared to South Asians (6.8±1.9 vs. 8.2±1.8 m/s, p<0.001), but no differences were found for local stiffness parameters Beta (5.4±2.4 vs. 5.8±2.3, p = 0.17) and Epsilon (72±35 vs. 70±31 kPa, p = 0.56). Age (standardized β, 95% confidence interval: 0.28, 0.17–0.39), systolic blood pressure (0.32, 0.21–0.43), and South Asian ethnicity (0.46, 0.35–0.57) were associated with cf-PWV; associations were similar between cohorts (p>0.05 for interaction). Systolic blood pressure was associated with carotid stiffness in both cohorts, whereas age was associated to carotid stiffness only in South Asians and BMI only in White Europeans.

Conclusion
Ethnicity is associated with central but not local arterial stiffness. Conversely, ethnicity seems to modify associations between CVD risk factors and local but not central arterial stiffness. This suggests that ethnicity interacts with arterial stiffness measures and the association of these measures with CVD risk factors.
Intensive care nurse managers’ experiences during the first wave of the Covid-19 pandemic: Implications for future epidemiological crises
Authors: Dobrowolska Beata , Gutysz-Wojnicka Aleksandra , Dziurka Magdalena , Ozdoba Patrycja , Ozga Dorota , Penar-Zadarko Beata , Markiewicz Renata , Markiewicz-Gospodarek Agnieszka , Palese Alvisa 
Published: August 2023

BackgroundNurse managers play an important role in coordinating the multidisciplinary teamwork, which is specifically important in emergency and crises situations like the COVID-19 pandemic. The aim of this qualitative study is twofold: (1) to explore the experiences of the Intensive care units (ICU) nurse managers regarding their work during the first wave of the COVID-19 pandemic, and (2) to analyse what implications might be provided based on experiences of nurse managers for future possible epidemiological crises.MethodsIn-depth phone interviews were conducted to explore the experiences of ward managers–nurses (n = 15) working in different hospitals across Poland. Interviews were taped and transcribed verbatim, and then qualitatively analysed.ResultsThree main categories were identified:(1)Challenge of working with the unknown,(2)Nurse managers’ expectations, and(3)Methods of coping and received support. The COVID-19 pandemic strongly affected the work of ICU nurse managers and uncovered the malfunctioning of the healthcare system.ConclusionIt is important to improve the knowledge and competence of hospital management personnel through exercises and in-service training on how to handle emergencies in order to improve the management of healthcare facilities, increase the safety of patients and employees, and the quality of healthcare.
Teaching hospitals and their influence on survival after valve replacement procedures: A retrospective cohort study using inverse probability of treatment weighting (IPTW)
Authors: Maldonado-Cañón Kevin , Buitrago Giancarlo , Molina Germán , Rincón Tello Francisco Mauricio , Maldonado-Escalante Javier 
Published: August 2023

Background
The effect of teaching hospital status on cardiovascular surgery has been of common interest in recent decades, yet its magnitude on heart valve replacement is still a matter of debate. Given the ethical and practical unfeasibility of randomly assigning a patient to such an exposure, we use the inverse probability of treatment weighting (IPTW) to assess this marginal effect on the survival of Colombian patients who underwent a first heart valve replacement between 2016 and 2019.

Methods
A retrospective cohort study was conducted based on administrative records. The time-to-death event and cumulative incidences of death, readmission, and reoperation are presented as outcomes. An artificial sample is configured through IPTW, adjusting for sociodemographic variables, comorbidities, technique, and intervention weight.

Results
Of a sample of 3,517 patients, 1,051 (29.9%) were operated on in a teaching hospital. The median age was 65.0 (18.1–91.5), 38.5% of patients were ≤60, and 6.9% were ≥80. The cumulative incidences of death at 30, 90 days, and one year were 5.9%, 8%, and 10.9%, respectively. Furthermore, 23.5% of the patients were readmitted within 90 days and 3.6% underwent reintervention within one year. The odds of 30-day mortality are lower for patients operated in a teaching hospital (OR 0.51; 95% CI 0.29–0.92); however, no effect on survival was identified in terms of time-to-event of death (HR 1.07; 95%CI 0.78–1.46).

Conclusions
After IPTW, the odds of 30-day mortality are lower for patients operated in a teaching hospital. There was no effect on survival, 90-day or one-year mortality, 90-day readmission, or one-year reintervention. Together, we offer an opening for investigating an exposure that has yet to be explored in Latin America with potential value to understand teaching hospitals as the essential nature of reality of an academic-clinical synergy.
Employment Trends and Relative Influence of U.S. Retail Subsector Employments on GDP
Authors: Khan Abdullah 
Published: August 2023

This paper studies employment trends of the U.S. retail industry and its twelve subsectors for the period 1998 through 2021. The retail subsectors are: motor vehicle and parts dealers (NAICS 441), furniture and home furnishing stores (NAICS 442), electronics retail stores (NAICS 443), building material retail stores (NAICS 444), food and beverage stores (NAICS 445), health and personal care retail stores (NAICS 446), gasoline stations (NAICS 447), clothing and accessories retail stores (NAICS 448), sporting goods, hobby goods, books, and music retail stores (NAICS 451), general merchandise stores (NAICS 452), miscellaneous retail stores (NAICS 453), and nonstore retail stores (NAICS 454). Comparing the pre-pandemic (2017-19) and post-pandemic (2019-21) employment growth rates, this study finds nonstore retailers (NAICS 454) and Food and beverages stores (NAICS 445) to be the most pandemic-proof subsectors in terms of retail employment. Besides multi-jurisdictional employment trends of this industry, this paper also explores the state-level influence of retail sub-sectoral employments on U.S. GDP using a fixed panel regression model. The retail subsectors that displayed statistically significant positive correlation with GDP are motor vehicle dealerships, health and personal care stores, clothing stores, and nonstore retailers such as electronic shopping and mail order businesses. Among the control variables, state-level total patent counts had statistically significant positive correlation with GDP.
Theories of Consciousness and Emergent Technologies: The Impact of Personality on Approaches to Change and Choice
Authors: Benjamin Colin , Bitetto Paul 
Published: August 2023

This article delves into the nature of consciousness, aiming to reconcile conflicting theories beyond dualism and panpsychism by addressing differences between early and late adopters of emerging technologies. We propose a new perspective on the integrity of consciousness that transcends binary divisions and embraces the unity of all life forms. Their contributions embrace the interplay between subjective and objective elements, acknowledging that changes and choices arise from complex interactions between known and unknown broader systemic influences. Appreciating the synthesis of traditional and progressive elements, alternative thinkers encourage a dynamic and balanced perspective, where truth is not confined to a singular perspective but emerges from the richness of diverse viewpoints. This paves the way for a more inclusive and comprehensive understanding of attitudes and opinions fostering a greater appreciation for the intricate interconnectedness of life's complexities.