bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative Bleeding Risk in Older Patients With HIV and Atrial Fibrillation Receiving Oral Anticoagulants
Authors: Quinlan Claire M. , Avorn Jerry , Kesselheim Aaron S. , Singer Daniel E. , Zhang Yichi , Cervone Alex , Lin Kueiyu Joshua 
Published: February 2025

ImportancePeople living with HIV and atrial fibrillation (AF) often receive anticoagulation that may interact with their antiretroviral therapy (ART). No studies exist comparing the safety of oral anticoagulants in this population.ObjectiveTo compare the bleeding risks among warfarin, rivaroxaban, and apixaban users in a national US cohort with AF and HIV.Design, Setting, and ParticipantsA new-user, active-comparator, propensity score overlap-weighted cohort study using the target trial emulation framework including Medicare claims database data (January 1, 2013, to December 31, 2020) was carried out. The analysis was conducted from July 2023 to April 2024.ExposureNew initiators of warfarin vs apixaban, rivaroxaban vs apixaban, and rivaroxaban vs warfarin aged 50 years or older with nonvalvular AF and HIV.Main Outcomes and MeasuresThe primary outcome was hospitalization for major bleeding. Secondary outcomes included hospitalization for gastrointestinal bleeding, ischemic stroke, and all-cause mortality.ResultsOverall, 2683 individuals (mean [SD] age, 66.22 [8.97] years; 580 female individuals [21.6%]) in the warfarin vs apixaban cohort, 2176 (mean [SD] age, 66.61 [8.87] years; 455 female individuals [20.9%]) in the rivaroxaban vs apixaban cohort, and 1787 (mean age, 65.47 years; 377 female individuals [21.1%]) in the rivaroxaban vs warfarin cohort. After propensity score overlap weighting, warfarin initiation was associated with a higher rate of major bleeding than initiation of apixaban (hazard ratio [HR], 2.60; 95% CI, 1.51-4.49), including major gastrointestinal bleeding (HR, 2.99; 95% CI, 1.52-5.90). This association was intensified in the 71% of patients taking concurrent ART (major bleeding, HR, 6.68; 95% CI, 2.78-16.02; gastrointestinal bleeding, HR, 5.28; 95% CI, 2.08-13.42). Rivaroxaban vs apixaban was also associated with a higher rate of major bleeding (HR, 2.15; 95% CI, 1.18-3.94) and gastrointestinal bleeding (HR, 3.38; 95% CI, 1.57-7.25), with a stronger association in those using ART (major bleeding, HR, 4.83; 95% CI, 2.11-11.08; gastrointestinal bleeding, HR, 4.76; 95% CI, 1.78-12.70). Estimates were similar when comparing rivaroxaban with warfarin. No significant difference was observed in the rate of ischemic stroke or mortality among the 3 oral anticoagulants.Conclusions and RelevanceThis study found that in patients with HIV and AF, especially those treated with ART, warfarin and rivaroxaban were associated with higher rates of major bleeding compared with apixaban, suggesting a superior safety profile for apixaban in this high-risk population.
Teleneurorehabilitation and Motor and Nonmotor Symptoms and Quality of Life in Parkinson Disease
Authors: Dhamija Rajinder K. , Saluja Alvee , Garg Divyani , Chauhan Sonal , Majumdar Ritu , Bhardwaj Shikha Bhatnagar , Preenja Ravi , Kashyap Dimple , Owolabi Mayowa O. 
Published: February 2025

ImportanceTo our knowledge, no randomized clinical trials have compared the efficacy and safety of teleneurorehabilitation (TNR) with in-person rehabilitation in Parkinson disease (PD) during the COVID-19 pandemic lockdown.ObjectiveTo assess the efficacy and safety of TNR among patients with PD during the COVID-19 lockdown.Design, Setting, and ParticipantsThe TELEPARK single-center, assessor-blinded, randomized clinical trial was conducted over 11 months from September 2020 to July 2021, with follow-up after 12 weeks. Final data could be analyzed on July 1, 2024. Patients aged 18 years or older diagnosed with idiopathic PD with Hoehn and Yahr stage 1 to 2.5, Mini-Mental State Examination score of 24 or higher, and who possessed a smartphone allowing videocalling were eligible for inclusion and randomized to in-person or TNR therapy.InterventionThe in-person group received physiotherapy, aerobic, and breathing exercises for 30 minutes in person once a week for 4 weeks and then once every 2 weeks for 8 weeks. The TNR group received in-person sessions on day 1, followed by supervised sessions via videocalling once a week for the first 4 weeks, then once every 2 weeks for 8 weeks.Main Outcome and MeasuresThe primary outcome was mean change in the Movement Disorder Society–Unified Parkinson’s Disease Rating Scale III (MDS-UPDRS III) postintervention score from baseline. Mean changes in postintervention MDS-UPDRS II and III, Non-Motor Symptom Scale (NMSS), Parkinson’s Disease Questionnaire-8 Summary Index (PDQ8-SI), 6-minute walk test (6MWT), and functional reach test (FRT) scores from baseline between groups was assessed using unpaired t tests.ResultsA total of 63 participants (28 in-person and 35 TNR) were analyzed. Mean (SD) ages in the in-person and TNR groups were 60.50 (7.08) years and 62.80 (12.46) years, respectively. Twelve of 28 patients in the in-person group (42.9%) and 16 of 35 patients in the TNR group (45.7%) were female. Mean (SD) MDS-UPDRS III scores were significantly lower following TNR (pre-TNR: 35.17 [17.72] vs post-TNR: 28.6 [19.7]; P = .001). Mean (SD) change in postintervention MDS-UPDRS III scores was not significantly different between the 2 groups (TNR: −6.74 [11.07] vs in-person: −7.54 [10.52]; P = .39). Median changes in NMSS and PDQ8-SI scores were similar between the groups.Conclusions and RelevanceTNR is safe and effective in improving motor and nonmotor symptoms and quality of life among Indian patients with PD.
Phonoangiographic Diagnosis of Stenosed Arteries: A Computational Fluid Flexible‐Structure Acoustic Interaction Study
Authors: Morab Sumant R. , Murallidharan Janani S. , Sharma Atul 
Published: February 2025

ABSTRACTThe present article is on pulsatile hemodynamics‐induced sound‐based diagnosis of stenosis in compliant arteries of three types: Coronary, carotid, and femoral. Considering axisymmetric stenosis in straight arteries along with clinically observed dimensions of the arteries and enveloping tissue, the present numerical study considers blood as a Newtonian fluid and both artery and tissue as isotropic and geometrically nonlinear (materialistically linear) solid. For the physiological fluid flexible‐structure acoustic interaction (FfSAI) study, an in‐house multiphysics solver is used for a parametric study—using various stenosis level (60%, 70%, and 80%) and stenosis length (2D and 4D); for each of the arteries. With increasing , an increase in acoustic acceleration's FFT spectrum‐based cut‐off frequency is found—indicating possibility of quantitative phonoangiographic diagnosis. The variation of this frequency with follows similar trend as that of frequency calculated by pressure fluctuation's FFT spectrum, thus correlating the hemodynamics as the cause for generation of the sound/bruits. Also, a flow‐visualization‐based frequency, which is calculated using vortex length and velocity during vortex dissipation stage, matches reasonably (≤ 15% difference) with the cut‐off frequency of pressure fluctuation. For the first time in the literature, our sound velocity level‐based study shows over‐prediction of stenosis by neglecting flow‐induced tissue deformations. This implies the importance of modeling structural flexibility, along with flow and acoustics while developing a computational Point‐of‐Care diagnostic tool. Finally, using analytical method for acoustics, a computationally efficient semi‐analytical FfSAI approach is proposed. The present work is significant since an accurate and computationally efficient framework and flow‐physics‐based analysis are presented for phonoangiographic diagnosis of stenosed arteries of three types.
Machine Learning Methods for Predicting Syncope Severity in the Emergency Department: A Retrospective Analysis
Authors: Martínez‐Licort Rosmeri , Sahelices Benjamín , de la Torre Isabel , Vegas Jesús 
Published: February 2025

ABSTRACTBackground and AimsSyncope is a frequent reason for hospital emergency admissions, presenting significant challenges in determining its cause and associated risks. Despite its prevalence, research on using artificial intelligence (AI) to improve patient outcomes in this context has been limited. The main objective of current study is to predict the severity of syncope cases using machine learning (ML) algorithms based on data collected during on‐site treatment and ambulance transportation.MethodsThis study analyzed 572 records from five Spanish public hospitals (2018−2021), focusing on hospitalization, ICU admission, and mortality. A three‐phase strategy was used: data preprocessing, model exploration, and model selection. In the exploration phase, three data transformations techniques were applied and in each of them, models were evaluated using stratified 10‐fold cross‐validation, optimizing AUC, accuracy, and recall, with emphasis on minimizing false negatives (FN). The top‐performing models were fine‐tuned and tested. The strategy was implemented using Python libraries and a diverse set of ML classifiers were applied, including linear discriminant analysis (LDA), random forest (RF), dummy classifier (DC), and gradient boosting (GB).ResultsThe RF classifier performed best for predicting hospitalization, reducing FN to 37% and achieving a true negative rate (TN) of 78%, with a recall of 0.63 and accuracy of 0.74. For ICU, DC showed FN = 29%, TN = 57%, recall = 0.625, and accuracy = 0.58. The LDA classifier excelled in predicting hospital mortality, with FN = 40%, TN = 89%, recall = 0.6, and accuracy = 0.88. These results indicate that RF was superior for predicting hospitalization, while DC for ICU and LDA performed better for predicting mortality.ConclusionsThis study provides an experimental foundation for the application of ML techniques in managing syncope in ED. The intention is to stimulate AI research in this area, with a view to integrating these models into clinical workflows in the future.
Comparative Evaluation of Superb Microvascular Imaging and Dynamic Contrast‐Enhanced Magnetic Resonance Imaging in Differentiating Benign and Malignant Breast Masses
Authors: Yitik Ahmet Yasin , Sabir Nuran , Yılmaz Sevda 
Published: February 2025

ObjectivesOur study aims to compare the diagnostic performance of superb microvascular imaging (SMI) and dynamic contrast‐enhanced magnetic resonance imaging (MRI) in differentiating benign from malignant breast masses, using histopathological findings as the reference standard.MethodsThis prospective study was conducted from April 2022 to March 2024. A total of 112 breast lesions from 110 patients were evaluated using gray‐scale ultrasonography, SMI, and dynamic contrast‐enhanced MRI. The vascular index (VI) obtained during SMI examination and kinetic curve patterns from MRI were analyzed.ResultsHistopathological analysis revealed 62 benign and 50 malignant lesions. The VI showed a statistically significant difference between benign and malignant lesions, with a mean VI of 5.12 ± 4.66 in benign masses and 10.13 ± 5.48 in malignant masses (P < .001). The ROC analysis demonstrated an AUC of 0.79 for SMI with a VI cut‐off value of 4.15, yielding a sensitivity of 92%, specificity of 60%, and accuracy of 74%. A statistically significant correlation was found between VI values and MRI contrast enhancement kinetic curve types (P < .05). MRI demonstrated superior diagnostic performance, with an AUC of 0.89 and sensitivity, specificity, and accuracy of 98, 80.65, and 88.39%, respectively.ConclusionsSMI, when used in conjunction with conventional ultrasonography and MRI, provides significant diagnostic value in differentiating benign from malignant breast masses. The study supports the potential integration of SMI into routine breast cancer diagnostic workflows, particularly in settings where MRI is less accessible.
Computationally Efficient Approach for 6G‐AI‐IoT Network Slicing and Error‐Free Transmission
Authors: Qi Yunxiang 
Published: February 2025

ABSTRACTMany smart gadgets are connecting to the Internet, and Internet‐of‐Things (IoT) technologies are enabling a variety of applications. Artificial intelligence (AI) of Things (AIoT) devices are anticipated to possess human‐like decision‐making, reasoning, perception, and other capacities with the combination of AI and IoT. AIoT gadgets are expected to be extensively utilized across several domains, as anticipated by 6G networks. With AI's steady advancements in speech recognition, computer vision, and natural language processing—not to mention its ability to analyze large amounts of data—semantic communication is now feasible. A new paradigm in wireless communication is opened by semantic communication, which seeks to explore the meaning behind the bits and only transmits the information that may be used, as opposed to attaining error‐free transmission. The combination of IoT with AI provides prominent features to overcome various important issues in cloud computing networks. However, there is bottleneck of delay and precision. Therefore, this paper proposed a new method to overcome this problem. First, the network slicing feature maps were extracted by convolutional neural networks. Next, the processing delay is reduced by semantic compression. Simulation results show that the proposed approach makes 99.2% reduction in communication complexity and an 80% reduction in transmission delay as compared with traditional methods. Taking the Resnet18 network as an example, the running time of the semantic communication method is only 0.8% of the traditional method.
Metabolomics Analysis of Urine and 16S rRNA Sequencing of Gut Microbiota in Rats With Blood Stasis Syndrome After Intervention With Danggui‐Guizhi Decoction and Dispensing Granules
Authors: Yu Jiwei , Wang Qianyi , Nong Yunyuan , Feng Linlin , Huang Shulin , Su Zhiheng 
Published: February 2025

ABSTRACTIntroductionBlood stasis syndrome (BSS) is one of the common syndromes in traditional Chinese medicine. The Chinese medicine compound composed of “Danggui‐Guizhi (DG‐GZ)”as the core has the effect of reducing blood stasis and promoting blood circulation. However, the difference of efficacy of DG‐GZ traditional decoction and dispensing granules in reducing blood stasis are still unclear.ObjectiveInvestigation of the difference of decoction and dispensing granules of Danggui (DG) and Guizhi (GZ) in blood stasis syndrome (BSS) in an animal study (Six groups, n = 6).MethodologyAll rats were randomly divided into six groups: control, model, Danggui—Guizhi dispensed granules ( DGK–GZK), Danggui—Guizhi decoction (DG–GZ), Danggui granules—Guizhi decoction (DGK–GZ), and Danggui decoction —Guizhi granules (DG‐GZK) groups (n = 6). The blood stasis model was constructed by exposing rats to ice‐cold water. Whole blood viscosity (WBV) was used to compare the effects of DG–GZ (4:3 w/w) decoction and dispensing granules in improving BSS. Metabolomics analysis of urine and 16S rRNA gene sequencing were used to investigate metabolic analysis and gut microbiota changes in rats with BSS.ResultsThe results of WBV showed that DG‐GZ and its granules exhibited efficacy against blood stasis, and the effect of DGK‐GZK in relieving blood stasis was greater than that of other administration groups. Urine metabolomics demonstrated that DGK–GZK could reverse the abnormal levels of butyrate, citrate, taurine, creatinine, glucose, and other metabolites in BSS rats. DGK–GZK could promote the enrichment of the g__Prevotellaceae_NK3B31_group, g__Ligilactobacillus, and g__Roseburia.ConclusionsThe effect of DGK‐GZK intervention in BSS was stronger than that of other compound groups. This study also provides basic experimental data for exploring the difference in efficacy between traditional decoction and dispensing granules.
Collaborative Approach to Cancer Care in Patients Who Have Co‐Existing Severe Mental Illness With Psychotic Features
Authors: Lipinski Lindsay , Carozza Desi , Kemp Alex , Gupta Sanjay 
Published: February 2025

ABSTRACTSevere and persistent mental illness with psychotic features as a comorbidity to a cancer diagnosis presents unique challenges to delivery of cancer care. Current literature suggests that there are poorer outcomes and higher mortality in patients with severe mental illness, partly explained by barriers to access of screening services and social vulnerability factors. However, cancer care is also delivered differently in patients with SMI, and often less aggressive care is offered. These healthcare disparities could be addressed in part by preparing for the ethical issues that can arise during the course of care. Cancer care staff may have limited experience and knowledge about treatment of psychiatric symptoms and may feel troubled in scenarios when patients lack capacity and become unwilling to participate in their care. Conversely, patients may benefit from early involvement of their mental health team for psychiatric optimization and contingency preparation. Specifically, preemptive planning between the cancer care team and the mental healthcare team can alleviate distress for the patient and healthcare teams alike. This is especially important when medical decision‐making capacity can fluctuate during treatment. A person‐centered, team‐based approach to care delivery provides bidirectional empowerment. A process is proposed to enhance medical decision‐making in patients with severe mental illness and cancer. It is imperative to acknowledge the disparities that exist in this patient population and create a process that will improve care and alleviate distress for the patient and the cancer care team.
The Anthropocene and International Political Order: Towards an Integrated Analysis
Authors: Brauch Hans Günter 
Published: February 2025

Abstract
TheAnthropoceneis thusfar the only epochin Earth history in which humankindas a “geologicalactor” has directly intervened in and thus impacted on the Earth system. In the early twenty-first century two totally different narratives co-exist: The peaceand securityorwar and peace narrativeand theecological and environmental narrative. This author argues that an integrated analysis of both narratives is needed in the social sciences and humanities on peace and security, and in the natural and social sciences on environmental issue areas and ecological concerns in the Anthropocene, the start of which represents both a new epoch in Earth historyand a new global international order since 1945. Peace and securityproblemsand environmental issuesand ecological concerns are interrelated and must thus be analysed and addressed from a common political strategy if we are to face and cope with fundamental threats to human history that are associated with the atomic bomb and the Anthropocene. This chapter addresses twothreats for the survival of humankind: (a)the nuclear threat, the securitydilemma and the logicof nuclear deterrence and (b) the impacts of global climate change that create threats to human survival. When the third phase of post-World War II order began is disputed, and the assessments have differed among policy analysts. For the USA, the 9/11 attack by terrorists on its territory was perceived as the key turning point by which its “war on terror” (especially the War against Iraq and Libya) was justified. The US and Western use of force in the Balkans (in Bosnia in 1995, and Serbia in 1999) and in the extended Middle East conflict(in Afghanistan in 2001, Iraq in 2003, Libya in 2011) set a precedent of a unilateral use of force that was not endorsed by the UNSC or the UN Charter. The Russian invasion of Ukraine in 2014 and the war against Ukraine which began on 24 February 2022 were also severe violations of international law. The response to the Russian warin Europe has already resulted in a downgrading of the response to the effects ofglobal environmental change to fragmentation and uncertainty during the third phase of the Anthropocene. This author calls for a rethinking of ‘politics’, ‘policy’ and ‘polity’ in the Anthropocene, “thinking geologicaland geographic time together”, “combining the peaceand securitynarrativewith the ecological and Anthropocenenarrative” and “integrating Earth Systems Science” (ESS) with the “history of structures and events” (Braudel).
Peace and Security Discourses on the Anthropocene: An International Relations Perspective
Authors: Simangan Dahlia 
Published: February 2025

Abstract
TheAnthropocene has become more than a philosophical byword; it has also entered the vernacular of international policy circles. What are the implications of the Anthropocene for our understanding and pursuits of peace and security, and how does the International Relations (IR) discipline engage with peace and security discourses in this new geological age? A combination of bibliometric and thematic analyses presented in this chapter reveals that prominent discourses on the Anthropocene are generally anchored in traditional notions of peace and security. However, the IR discipline provides a spacefor a critique of these notions, thereby expanding conceptions of agency, challenging linearity and modernity, and unpacking the political motivations and implications of conceptual expansion. This chapter closes with several recommendations for advancing interdisciplinary conversations among IR, Peace Studies, and Security Studies, as well as with other disciplines.
Governance and Politics in the Anthropocene
Authors: Grin John 
Published: February 2025

Abstract
This chapter contends that the key factor that has driven humankind and its planet into the Anthropocene is the modernist idea to achieve human progress through controlling nature and society on basis of universal principles, without paying attention to or even suppressing local conditions of both ‘nature’ and ‘society’. An alternative orientation for development is to (i) replace theinstrumentalisation of nature to serve human needs by mutual alignment of human and social needs with nature through (ii) re-appreciating opportunities for regeneration of energy, resources and the atmosphere. The chapter elaborates this building on two examples: modern, productivist agriculture and associate water management and food consumption practices in Europe and the US; and energy, water and waste disposal systems in American and European cities. These will show how place-based, regenerative development, creating synergy with rather than exploiting nature offers a promising way to remedy society’s adverse impacts on the planet during the Anthropocene, and may help improve and maintain a fair and sustainable level of well-being of current and future generations globally. Guiding principles for associateplace-based governance include new constitutional understanding of notions like equity and accountability; new finance arrangements and standards that allow for synergy and adaptive governance.
Beginnings
Authors: Woodin Tom , Vernon Keith , Shaw Linda 
Published: February 2025

Abstract
Education has always been a core principle of the co-operative movement. As with other working-class organisations in the nineteenth century, there was a need to complement and counter the restricted forms of education offered by established authorities. Education was enshrined as one of the founding principles of the Rochdale Pioneers and and extensive system of education by and for co-operators would be established. There was always an aspiration for a higher level organisation that would become the apex for co-operative education. Through the early years of the twentieth century, spurred by internal enthusiasm and external pressure, a vigorous campaign for a full Co-operative College sought to convert the aspiration into reality.