Tag: pubmed

PLoS One. 2025 Apr 9;20(4):e0315149. doi: 10.1371/journal.pone.0315149. eCollection 2025.

ABSTRACT

This study aims to determine the waiting time and the forms of access to specialized health services in public hospitals in Ecuador. A representative sample of 32 hospitals under the Ministry of Public Health was considered, with 26 selected by accessibility convenience. Data will be collected using a structured questionnaire. Patients will be asked about the number of days they waited for their medical appointments and the method used to schedule their appointments. The study distinguishes between standardized access, based on Ecuador’s formal referral and counter-referral system, and non-standardized access methods, such as personal connections or hospital staff involvement. The data of this protocol are registered and publicly accessible at: https://dx.doi.org/10.17504/protocols.io.261ge5z7wg47/v1. We expect to identify a correlation between waiting times and the type of access to specialized medical services, with non-standardized access potentially leading to shorter waiting times. This research may highlight disparities in the system and suggest areas for improvement in equity and efficiency within the healthcare referral process. To do so, a structured survey will be used. Since a construct is not needed to determine the waiting time or the forms of access, it was not necessary to validate the instrument. However, we did validate the understanding of the questions and the response options in several places in the country. According to the results of the validation of the instrument, pollsters will be instructed to inform users about the meaning of the question on ethnic identification, which was difficult to understand in the country’s coastal areas.

PMID:40203222 | DOI:10.1371/journal.pone.0315149

J Hosp Palliat Nurs. 2025 Apr 7. doi: 10.1097/NJH.0000000000001117. Online ahead of print.

ABSTRACT

Providing ethical, timely, and goal-concordant care for critical patients who are incapacitated with no evident advance directives or surrogates (INEADS) can pose challenges to nursing staff and other care team members and may delay or alter care trajectories. In a nested case-control study, we aimed to determine whether critical care patients who are INEADS have different hospitalization timelines, consultative services, and discharge dispositions relative to matched control subjects. Data were obtained from the publicly accessible Medical Information Mart for Intensive Care III database of 23 904 adult critical care hospitalizations in a Boston, Massachusetts, hospital from 2001 to 2012. Using natural language processing and verifying by manual chart review, we identified 40 patients in this cohort who were INEADS and matched them 1:1 with control subjects based on age, sex, and comorbidity index. Average length of hospitalization was 11 days for patients and 9 days for control subjects; average time until code status documentation was 8 days for patients and 6 days for control subjects, and average time until documentation of social work involvement was 9 days for patients and 2 days for control subjects. Although these differences were not statistically significant, procedures to support timely ethical decision-making for patients who are INEADS require attention.

PMID:40203195 | DOI:10.1097/NJH.0000000000001117

Chaos. 2025 Apr 1;35(4):043110. doi: 10.1063/5.0259937.

ABSTRACT

Analytical solutions of space-time fractional partial differential equations (fPDEs) are crucial for understanding dynamics features in complex systems and their applications. In this paper, fractional sub-equation neural networks (fSENNs) are first proposed to construct exact solutions of space-time fPDEs. The fSENNs embed the solutions of the fractional Riccati equation into neural networks (NNs). The NNs are a multi-layer computational models that are composed of weights and activation functions between neurons in the input, hidden, and output layers. In fSENNs, every neuron of the first hidden layer is assigned to the solutions of the fractional Riccati equation. In this way, the new trial functions are obtained. The exact solutions of space-time fPDEs can be obtained by fSENNs. In order to verify the rationality of this method, space-time fractional telegraph equation, space-time fractional Fisher equation, and space-time fractional CKdV-mKdV equation are investigated, and generalized fractional hyperbolic function solutions, generalized fractional trigonometric function solutions, and generalized fractional rational solutions are obtained. Since the fractional sub-equation is applied to the NNs model for the first time, more and new solutions can be obtained in this paper. The dynamic characteristics of some solutions corresponding to waves have been demonstrated through some diagrams.

PMID:40198253 | DOI:10.1063/5.0259937

Chaos. 2025 Apr 1;35(4):043118. doi: 10.1063/5.0264243.

ABSTRACT

Understanding how cooperation evolves in multi-subpopulation is crucial for addressing social challenges. While previous studies show that payoff-neutral subpopulations in structured populations can enhance cooperation, the role of broader inter-subpopulation relationships remains unclear. We extend this framework to include generalized relationships-competition, mutualism, and parasitism-modeled by inter-subpopulation payoffs α and β. Within subpopulations, individuals play the prisoner’s dilemma, while inter-subpopulation interactions yield payoffs based on α and β. Evolutionary analysis and simulations reveal that, in fully connected networks, generalized relationships yield outcomes almost indistinguishable from the payoff-neutral scenario (α=0,β=0). However, in structured populations, these relationships introduce additional pathways for sustaining cooperation beyond those observed under payoff neutrality. When the network structure alone can support cooperation, only mutualistic relationships (α>0,β>0) enable the full dominance of cooperative strategies. Conversely, when the network structure alone cannot maintain cooperation, competitive (α<0,β<0) or parasitic (α>0,β<0) relationships allow cooperation to persist or even achieve complete dominance, whereas mutualism offers only limited support. These findings provide deeper insights into how diverse inter-subpopulation relationships shape the evolution of cooperation in multi-subpopulation social systems.

PMID:40198246 | DOI:10.1063/5.0264243

Chaos. 2025 Apr 1;35(4):043114. doi: 10.1063/5.0248658.

ABSTRACT

Due to their relevance to geophysical systems, the investigation of multiscale systems through the lens of statistical mechanics has gained popularity in recent years. The aim of our work is the characterization of the nonequilibrium properties of the well-known two-scales Lorenz96 model, a dynamical system much used for testing ideas in geophysics, by studying either higher-order correlation functions or response to external perturbations of the energy. These tools in both equilibrium (inviscid) or non-equilibrium (viscous) systems provide clear evidence of their suitability for detecting time-reversal symmetry breaking and for characterizing transport properties also in this class of models. In particular, we characterize how localized energy perturbations are transported between the different scales, highlighting that perturbations of synoptic variables greatly impact advective variables but perturbations of the latter have a practically negligible effect on synoptic scales. Finally, we show that responses of global observables to finite size perturbations strongly depend on the perturbation protocol. This prevents the physical understanding of the system from observations of the relaxation process alone, a fact often overlooked.

PMID:40198243 | DOI:10.1063/5.0248658

STAR Protoc. 2025 Apr 7;6(2):103738. doi: 10.1016/j.xpro.2025.103738. Online ahead of print.

ABSTRACT

Functional impact of noncoding variants can be predicted using computational approaches. Although predictive scores can be insightful, implementing the scores for a custom variant set and associating scores with complex traits require multiple phases of analysis. Here, we present a protocol for prioritizing variants by generating deep-learning-predicted functional scores and relating them with brain traits. We describe steps for score prediction, statistical comparison, phenotype correlation, and functional enrichment analysis. This protocol can be generalized to different models and phenotypes. For complete details on the use and execution of this protocol, please refer to Mondragon-Estrada et al.¹.

PMID:40198216 | DOI:10.1016/j.xpro.2025.103738

Eye Contact Lens. 2025 Apr 8. doi: 10.1097/ICL.0000000000001182. Online ahead of print.

ABSTRACT

PURPOSE: To present the long-term visual outcomes and factors affecting treatment success in children with congenital cataract surgery in infancy followed by optical correction by contact lens (CL).

METHODS: We retrospectively analyzed data from 30 eyes of 26 pediatric aphakic patients followed by visual habilitation primarily by CL between 2004 and 2023. The patients were evaluated for factors affecting final best-corrected visual acuity (VA), need for additional surgery, and adherence to CL and occlusion therapy.

RESULTS: The study included 16 eyes with idiopathic congenital cataract, 12 eyes with congenital cataract associated with persistent fetal vasculature, and two eyes with concomitant retinopathy of prematurity. Adherence to CL use was evaluated as poor in 13.3%, moderate in 40%, and good in 46.7% of the eyes, while adherence to occlusion therapy was poor in 33.3%, moderate in 20.8%, and good in 45.8% of the eyes. Final VA was 20/50 or better in 50% of the eyes, between 20/50 and 20/400 in 16.7% of the eyes, and 20/400 or worse in 33.3% of the eyes. There was no statistically significant relationship between the presence of strabismus and final VA, whereas the need for additional surgery; the presence of posterior segment pathologies, nystagmus, and glaucoma; and poor treatment adherence were associated with significantly lower final VA.

CONCLUSION: Good long-term visual outcomes can be achieved with effective CL and occlusion therapy in cases of infantile aphakia not accompanied by glaucoma, severe anterior and posterior segment pathologies, or the need for additional surgery.

PMID:40198200 | DOI:10.1097/ICL.0000000000001182

Medicina (B Aires). 2025;85(2):388-403.

ABSTRACT

Vaccination is recognized as one of the most impactful public health interventions, providing significant benefits in terms of disease eradication, prevention of infectious diseases, herd immunity, antimicrobial resistance, years of life gained, morbidity and mortality reduction, and cost-effectiveness. In recent years, vaccination coverage rates have decreased due to multiple factors. The aim of this article is to provide updated information on the benefits of vaccination at both the individual and public health levels, to identify the barriers to vaccination, and to present evidence based global and in-office strategies for implementation in daily medical practice for adults, with the goal of improving vaccination coverage rates.

PMID:40198174

Medicina (B Aires). 2025;85(2):337-347.

ABSTRACT

INTRODUCTION: In-hospital mortality is influenced by various factors. Despite the trend toward decreased mortality from acute stroke in the Northern Hemisphere, reports in our region show variable figures. This study reports in-hospital mortality for the second time from a medical center in Ciudad de Buenos Aires. Factors associated with mortality in these patients were also identified.

MATERIALS AND METHODS: A retrospective study was conducted using data from the FLENI Stroke Database between 2010 and 2019, analyzing clinical characteristics, risk factors, complications, and mortality of hospitalized patients. Univariable and multivariable statistical analyses were used to identify risk factors associated with in-hospital mortality.

RESULTS: Data from 1645 patients were analysed, of which 1476 (90%) had ischemic stroke, 95 (6%) had hemorrhagic stroke, and 74 (4%) had aneurysmal subarachnoid hemorrhage (aSAH). There were 45 in-hospital deaths (2%): 26 deaths (1%) from ischemic stroke, 11 deaths (11%) from hemorrhagic stroke, and 8 deaths (10%) from aSAH. Factors associated with mortality include advanced age, low hemoglobin levels at admission, higher scores on the NIHSS scale at admission, and a history of diabetes mellitus.

DISCUSSION: In-hospital mortality from stroke remains low in our institution, with differences between ischemic and hemorrhagic stroke. Factors such as stroke severity, hemoglobin levels, and a history of diabetes mellitus are independent predictors of mortality.

PMID:40198170

Medicina (B Aires). 2025;85(2):314-321.

ABSTRACT

INTRODUCTION: Iodine is an essential micronutrient for the synthesis of thyroid hormones, crucial for neurological development. In 2002, a mild iodine deficiency was identified in schoolchildren from La Pampa, Argentina. This study aims to reassess iodine intake in the same rural school population in 2023 by analyzing urinary iodine concentration (UIC), goiter prevalence, and salt iodization.

MATERIALS AND METHODS: A cross-sectional study was conducted in 6- to 12-year-old schoolchildren from School No. 45 in Ataliva Roca, La Pampa. Parents provided informed consent. UIC, weight, height, blood pressure, and goiter were assessed. UIC was measured using the modified Sandell-Kolthoff method, and salt iodization was analyzed using sodium thiosulfate titration. The results were compared with those from 2002.

RESULTS: A total of 74 schoolchildren were evaluated in 2023. The median UIC was 145.45 υg/L, with 28.8% of students showing levels below 50 υg/L. Goiter prevalence was 21.6%, compared to 17.9% in 2002. In 85.5% of the salt samples, iodine levels were adequate. There were no statistically significant differences between the 2002 and 2023 cohorts in the prevalence of goiter or iodine fortification of salt.

DISCUSSION: Despite improvements in iodine intake since 2002, a considerable percentage of schoolchildren still show moderate iodine deficiency.

PMID:40198167