Medicine

This is an article about death from a medical point of view.

... having succeeded in protecting and prolonging the life of many around the world for reasons which seem natural and intrinsically good to all, we are once again faced with the dilemma of confronting our patent inability to cure it all. -/- Faced with this recurring predicament, we somehow backtrack in our steps and decide the next best thing to assuage suffering is assisted dying and euthanasia. -/- No matter how many reasons we conjure up in their favour, both assisted (...) dying and euthanasia remain a stab into the unknown, into the supernatural, by patients, by its proponents, and by its practitioners both lay and medical. (shrink)

We respond to a Letter to the Editor regarding "Principlism and contemporary ethical considerations for providers of transgender health care." We address criticisms by Castle & Klein (2024) of blatant fatphobia related to the ethical elements concerning BMI restrictions for gender-affirming surgery. Our response corrects several mischaracterizations of the article and clarifies our position. My co-authors and I remain focused on advocating for patient-centered, ethically sound, evidence-based, and equitable healthcare policies.

Background: Transgender health care is a subject of much debate among clinicians, political commentators, and policy-makers. While the World Professional Association of Transgender Health (WPATH) Standards of Care (SOC) establish clinical standards, these standards contain implied ethics but lack explicit focused discussion of ethical considerations in providing care. An ethics chapter in the SOC would enhance clinical guidelines. Aims: We aim to provide a valuable guide for healthcare professionals, and anyone interested in the ethical aspects of clinical support for gender (...) diverse and transgender people of all ages. Recognizing that the WPATH is a global association, we address broad challenges. We offer a reflection on general ethical principles, providing conceptual tools for healthcare providers, patients, and families to navigate the specific challenges they might encounter in transgender health care, in line with WPATH’s worldwide mission and scope. Method: This article employs a descriptive analysis, and our framework of reference is the four principles of biomedical ethics: respect for autonomy, beneficence, nonmaleficence, and justice. Results: The article presents a discussion on the four ethical principles as applied to transgender health care. We address issues such as respect for patient autonomy in decision-making, the role of beneficence and nonmaleficence in clinical interventions, and the importance of justice in equitable treatment and access to care. Some of the ethical concerns we address in this article pertain to the current sociopolitical climate, where there has been increasing legal interference, internationally, for transgender and nonbinary people, particularly youth, seeking medical care. Discussion: We highlight the interplay between ethical principles and clinical practice, underscoring the need for ethical guidance in addressing the diverse challenges faced by healthcare providers and patients in transgender health care. We advocate for continuous refinement of ethical thinking to ensure that transgender health care is not only medically effective but also ethically sound. (shrink)

Glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide, and dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists, such as tirzepatide, have been found to be effective for treating obesity and diabetes, significantly reducing weight and the risk or predicted risk of adverse cardiovascular events. There is a global shortage of these medications that could last several years and raises questions about how limited supplies should be allocated. We propose a fair-allocation framework that enables evaluation of the ethics of current (...) practices and could guide governments, professional societies, and physicians in allocation decisions. (shrink)

Being compassionate and empathic while making rational decisions is expected from healthcare workers across different contexts. But the daily challenges that these workers face, aggravated by the recent COVID-19 crisis, can give rise to compassion and decision fatigue, which affects not only their ability to meet these expectations but has a significant negative impact on their wellbeing. Hence, it is vital to identify factors associated to their exhaustion. Here, we sought to describe levels of compassion and decision fatigue during the (...) pandemic, and to identify factors related to these forms of exhaustion. We collected data using self-reported questionnaires to measure compassion fatigue, decision fatigue, and grit in five intervals from April to November, 2020 (N = 856). Our results showed a negative correlation between grit and compassion and decision fatigue. We also found that under the circumstances studied grit tends to be higher in technicians, nurses, other professionals (psychologists, social workers), and workers at the Emergency Room (ER), and lower in general practitioners. Compassion fatigue tend to be higher for technicians, whereas decision fatigue was lower for specialists, general practitioners, and technicians, and higher for those working at private hospitals. (shrink)

Gallbladder disease commonly affects the general population of Western developed nations and the standard surgical treatment of laparoscopic cholecystectomy normally follows severe cases of this condition. However, the negative health and life quality consequences of this standard line of treatment are lesser known and stand the chance of being taken lightly by healthcare professionals. Complications include bile duct injury, dropped gallstones and a second open invasive surgery, of which could be life threatening for some rare cases. It is, therefore, necessary (...) to highlight the limitations of such a procedure and the need for improvement and widening of the range of treatment options for vulnerable members of the patient population. Additionally, here is a brief overview introduction of a new procedure called endoscopic ultrasound guided gallbladder drainage with promising success rates that can be a potentially feasible alternative to traditional surgical procedures to offer gallbladder disease patients. (shrink)

Insofar as value theory is relevant to the philosophy of medicine, two goods have dominated reflection: well-being and morality. This essay casts doubt on whether those values are sufficient to resolve an array of important debates about medical practice, maintaining that the value of what makes a life meaningful should play a much larger role. After first indicating how meaningfulness differs from happiness and rightness, the essay argues that meaningfulness cannot reasonably be ignored when thinking comprehensively about the proper aims (...) of medicine, the appropriate constraints on their pursuit, and the effective means by which to realize them. The essay’s goal is not to draw any firm conclusions about the suitable ends, constraints, and means of medical practice, but rather to show that, in order to arrive at any, one has to consider the category of life’s meaning, which should be much more prominent in the philosophy of medicine than it has been. (shrink)

MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink)

MALARIA, SCIENCE AND SOCIETY IN FERRARA FROM THE MIDDLE AGES TO THE NINETEENTH CENTURY -/- In this paper it is outlined the history of malaria in Ferrara and its suburbs, from ancient times up to the nineteenth century. It is considered the issue of malaria in Roman times, during the Middle Ages and the Renaissance, the discovery of quinine, the first scientific studies made at the University of Ferrara, the first analysis about the causes and the spread of the disease. (...) The conditions of backwardness of Ferrara society are considered, especially of the people living in the countryside, and the most common medical knowledge. Statistics about the spread of malaria after the unification of Italy are resumed. Problems of environmental recovery are taken into account. Scientific progresses due to positivism and to the doctors who faced the first anti-malarial campaigns, bringing their testimonies. The essay ends up with the reorganization of public health and places of health care in modern hospitals all over the province of Ferrara. (shrink)

Mainstream views of medical research tell us it should be a fact-based, value-free endeavor: what a scientist (or her funding source) wants or cares about should not influence her findings. At the same time, we also sometimes criticize medical research for failing to embody certain values, e.g. when we criticize pharmaceutical companies for largely ignoring the diseases that affect the global poor. This chapter seeks to reconcile these perspectives by distinguishing appropriate from inappropriate influences of values on medical research. It (...) divides this broad question into two narrower ones, the Role Question (at what points in the research process is value influence potentially acceptable?) and the Content Question (when value influence is potentially acceptable, what specific values should researchers use?), and then draws on the philosophical literature on values in science to explore answers to each of them. (shrink)

RESUMO Os cuidados para atender às necessidades específicas da fêmea gestante são indispensáveis para o sucesso no manejo reprodutivo de qualquer espécie. Entretanto, é necessário entender que podem acontecer problemas em qualquer uma das fases reprodutivas, inclusive na gestação. Antes de tudo, na clínica e na produção, a sobrevivência dos fetos significa êxito no manejo reprodutivo. Durante o período gestacional podem se desenvolver diversas afecções no útero da fêmea, dentre elas podem ser citadas: mumificação fetal, gravidez ectópica, maceração fetal, prenhez (...) múltipla patológica e diversas anomalias que podem acometer os envoltórios e líquidos fetais. Essas doenças representam prognóstico ruim para a fêmea e para o feto, podendo resultar em perdas fetais. O conhecimento acerca das características dessas afecções, bem como a fisiopatologia e diagnóstico são indispensáveis para o sucesso da reprodução animal. Palavras-chave: Ginecologia, reprodução, gestação. ABSTRACT Care to meet the specific needs of pregnant females is essential for the successful reproductive management of any species. However, it is necessary to understand that problems may occur in any of the reproductive stages, including pregnancy. First of all, in the clinic and production, the survival of fetuses means success in reproductive management. During the gestational period, several pathological conditions can develop in the female uterus, among them fetal mummification, ectopic pregnancy, fetal maceration, pathological multiple pregnancy, and the various anomalies that can affect fetal envelopes and fluids. These illnesses represent a poor prognosis for the female and the fetus and may result in fetal loss. Knowledge about the characteristics of these conditions, as well as the pathophysiology and diagnosis are essential for the success of animal reproduction. Keywords: Gynecology, reproduction, gestation. -/- INTRODUÇÃO Na fisiologia da reprodução nos mamíferos, a implantação e a placentação são processos essenciais na nutrição do embrião e do feto e do seu desenvolvimento. Nos bovinos leiteiros, estima-se uma taxa de fertilização de 95%, com apenas 55% desses zigotos se desenvolvendo a termo e com perda de gestações de 35% (SILVA, 2021). Em equinos varia entre 5 e 15% (BRINSKO et al., 2011) e em suínos chega a 40% (VAN DER LENDE et al., 1994). A reprodução permite a manutenção do equilíbrio biótico, entretanto, falhas podem ocorrer, desde a concepção até o parto, incapacitando o pleno desenvolvimento gestacional e acarretando danos à cadeia produtiva (BRAGA e BARROSO, 2014). A taxa de perda gestacional atinge o pico durante o desenvolvimento embrionário e diminui após 45 dias, à medida que a gestação progride e a placentação ativa está completa (REESE et al., 2020). A placenta permite contato vascular eficaz entre as membranas fetais e o endométrio materno, através do qual ocorre a troca de oxigênio e de nutrientes vindos pelo sangue materno, além dos produtos de excreção do sangue fetal. Ela apresenta quatro membranas: a) âmnio, que contém o fluido amniótico que banha o embrião; b) saco vitelínico, que armazena os nutrientes; c) saco alantoide, onde os restos do metabolismo embrionário são estocados e d) córion, que delimita os limites do embrião e interage seletivamente com o ambiente externo, permitindo nutrientes e/ou oxigênio cheguem ao embrião (SILVA, 2020). No aparelho reprodutivo feminino as estruturas internas são presas pelo ligamento mesovário, que sustenta o ovário; o mesossalpinge, que ancora o oviduto e o mesométrio, que mantém o útero no seu lugar. Ele compreende os ovários, tubas, útero, cérvix, vagina, vestíbulo e vulva (KÖNIG e LIEBICH, 2021). O útero é formado por dois cornos, na região mesogástrica, que formam o corpo uterino, dorsal a vesícula urinária e ventral ao cólon descendente (PINTO e LORIGADOS, 2015). A cérvix fica na região caudal do útero (DYCE, 2019) e é composta pelo óstio uterino interno e o externo (KÖNIG e LIEBICH, 2021). O líquido amniótico é um complexo biológico que proporciona proteção mecânica, nutrientes e substâncias para o crescimento fetal e possui efeito antimicrobiano (UNDERWOOD et al., 2005). Ele desempenha várias funções: protege o feto contra traumas, desidratação e mudanças de temperatura; permite o desenvolvimento fetal e sua mobilidade; amplia a lubrificação da vagina após a ruptura da bolsa, inibe o crescimento bacteriano por ação mecânica de limpeza e previne aderências (GRUNERT e BIRGEL, 1984). As enfermidades do trato reprodutivo têm causado problemas reprodutivos, acarretando perdas econômicas (JÚNIOR et al., 2009). Os problemas na esfera da fisiopatologia da reprodução em animais, está associada ao período do periparto (SCOTT, 2005). Entretanto, existem relatos de sua ocorrência em fêmeas não gestantes e também fora do período puerperal (PRESTES et al., 2008; SALES et al., 2011). Devido à importância das diversas patologias que atingem o útero gravídico, esse trabalho tem como objetivo buscar identificar na literatura científica existente as características, diagnóstico e tratamento de cada alteração uterina, pautando discussão crítica sobre os processos de formação de cada uma. (shrink)

This article examines the late-medieval plague tractate by Augustine of Trento, an Augustinian friar who addressed the matter of plague before the Black Death of 1347/1348. I will investigate Augustine’s astrological approach to the prognostication, prevention, and cure of the plague epidemic. Further, I will compare his work to the Compendium medicinalis astrologiae, composed by the Dominican Niccolò de Paganica in 1330, and to the consilia produced by the master of medicine Gentile da Foligno in 1348. This double comparison will (...) help to better understand the shared intellectual milieu and the different approaches of these three authors. (shrink)

This essay explores the theoretical treatment of leprosy in 13th-century theological discussions on the transmission of the original sin. According to scholastic theologians, both the existence of the original sin and its transmission from parents to progeny were factual truths, whose dynamics could be explained by analogy with inherited diseases, such as leprosy. Different uses of natural philosophy and medicine in discussing the transmission of leprosy will be shown in theological and biblical-exegetical works of William of Auvergne, Roland of Cremona, (...) Bonaventure, Thomas Aquinas, and Henry of Ghent. -/- . (shrink)

Sheep production is the most representative livestock activities in Brazil and in the world. However, the reproductive performance of these animals is determined by factors genetic, physical environment, management and, especially, nutritional. Thirty half-breed lambs from Dorper × Santa Inês were used, with initial weight and age of 31.87 ± 0.5 kg and 157 days, respectively. These animals were prepared on a diet with three food levels (ad libitum, 30% and 70%). Morphometric measurements were measured at intervals of 16 to (...) 20 days in 56 experimental days. The measurements performed were scrotal circumference (CE), chest circumference (CT), body condition score (ECC), withers height (AC) and scrotal bag thickness (EBE), body weight (CP) and semen collection. Interaction occurrence for biometric measurements between food levels and age (p <0.05). The TC and ECC values were higher in animals fed ad libitum (p <0.001). EBE had higher values in animals ad libitum and at 211 days of age (p <0.001). The CP was increasing for the animals ad libitum and (p <0.05) throughout the experiment, while the T30 was only in the initial period. T70 animals did not grow during the whole experiment. CE was influenced by diet (p <0.001) and age (p <0.001) independently. So that animals under food restriction had less development and was higher in older animals. The AC values were influenced only by age (p <0.001), demonstrating the effect of age growth. We conclude that it is not advantageous to submit lambs, it corrects food reproduction. Although it was not possible to assess whether initial malnutrition would bring future problems for the animal's seminal quality, it proved to be immensely negative for the onset of puberty and the development of reproductive structures. -/- REFERÊNCIAS BIBLIOGRÁFICAS AKUMBUGU, F. E., et al. 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Avaliação de parâmetros fisiológicos de ovinos Dorper, Santa Inês e seus mestiços perante condições climáticas do trópico semi-árido nordestino. Ciência e Agrotecnologia, v. 28, n. 3, p. 614-620, 2004. CHACÓN, L. et al. Características de la pubertad en corderos de pelo y sus cruces en Colombia en condiciones de baja altitud. Revista MVZ Cordoba, v. 24, n. 1, p. 7099-7103, 2019. CHEMINEAU, P. et al. Training manual on artificial insemination in sheep and goats. Rome: FAO; 1991. DA SILVA, Emanuel Isaque Cordeiro. Comportamento Sexual dos Animais Domésticos. 2020. DA SILVA, Emanuel Isaque Cordeiro. Fisiologia do ciclo estral dos animais domésticos. Emanuel Isaque Cordeiro da Silva, 2021. Da Silva EIC. Formulação de ração para ovinos. 1ª ed. Belo Jardim, PE: IPA, 2021. DA SILVA, Emanuel Isaque Cordeiro. Puberdade e Estacionalidade Reprodutiva dos Animais. 2020. FAO. Animal Production and Health Paper, v. 83. ELMAZ, Ö. et al. Prediction of postpubertal reproductive potential according to prepubertal body weight, testicular size, and testosterone concentration using multiple regression analysis in Kıvırcık ram lambs. Turkish journal of veterinary and animal sciences, v. 32, n. 5, p. 335-343, 2008. JUCÁ, A. F. et al. Performance of the Santa Ines breed raised on pasture in semiarid tropical regions and factors that explain trait variation. Tropical animal health and production, v. 46, n. 7, p. 1249-1256, 2014. FOURIE, P. J. et al. Scrotal, testicular and semen characteristics of young Dorper rams managed under intensive and extensive conditions. Small Ruminant Research, v. 54, n. 1-2, p. 53-59, 2004. GUNN, R. G.; SIM, D. A.; HUNTER, E. A. Effects of nutrition in utero and in early life on the subsequent lifetime reproductive performance of Scottish Blackface ewes in two management systems. Animal Science, v. 60, n. 2, p. 223-230, 1995. HÖTZEL, M. J. et al. Morphometric and endocrine analyses of the effects of nutrition on the testis of mature Merino rams. Reproduction, v. 113, n. 2, p. 217-230, 1998. Instituto Brasileiro de Geografia e Estatística (IBGE). Produção Pecuária municipal. Rio de Janeiro, v. 46, p.1-8, 2018. KENYON, P. R.; MALONEY, S. K.; BLACHE, D. Review of sheep body condition score in relation to production characteristics. New Zealand Journal of Agricultural Research, v. 57, n. 1, p. 38-64, 2014. KHERADMAND, A.; BABAEI, H.; ALI BATAVANI, R. Effect of improved diet on semen quality and scrotal circumference in the ram. Veterinarski arhiv, v. 76, n. 4, p. 333-341, 2006. KORKMAZ, M. K.; EMSEN, E. Growth and reproductive traits of purebred and crossbred Romanov lambs in Eastern Anatolia. Anim. Reprod., v. 13, n. 1, p. 3-6, 2016. KRIDLI, R. T. et al. Age at puberty and some biological parameters of Awassi and its first crosses with Charollais and Romanov rams. Italian journal of animal science, v. 5, n. 2, p. 193-202, 2006. LOUW, D. F. J.; JOUBERT, D. M. Puberty in the male Dorper sheep and Boer goat. S. Afr. J. Agric. Sci, v. 7, p. 509-520, 1964. MAIA, A. S. C.; SILVA, R. G.; ANDRADE, P. C. Efeitos da temperatura e da movimentação do ar sobre o isolamento térmico do velo de ovinos em câmara climática. Revista Brasileira de Zootecnia, v. 38, n. 1, p. 104-108, 2009. MARTINS, R. D. et al. Avaliação da sazonalidade reprodutiva de carneiros Santa Inês criados no Distrito Federal. R. Bras. Zootec., Viçosa, v. 32, n. 6, supl. 1, p. 1594-1603, Dec. 2003. MENDES, A. M. P. et al. Zoneamento bioclimático para a raça ovina Dorper no Estado de Pernambuco. Pesquisa Agropecuária Brasileira, v. 49, n. 12, p. 986-993, 2014. MOULLA, F. et al. Characterization of the onset of puberty in Tazegzawt lambs, an endangered Algerian sheep: Body weight, thoracic perimeter, testicular growth, and seminal parameters. Veterinary world, v. 11, n. 7, p. 889, 2018. NATIONAL RESEARCH COUNCIL (NRC). Nutrient Requirements of Small Ruminants: Sheep, Goats, Cervids, and New World Camelids. Washington, D.C.: National Academy Press, 2007. NOTTER, D. R.; LUCAS, J. R.; MCCLAUGHERTY, F. S. Accuracy of estimation of testis weight from in situ testis measures in ram lambs. Theriogenology, v. 15, n. 2, p. 227-234, 1981. SEJIAN, V. et al. Effect of body condition score on the allometric measurements and reproductive performance of Garole X Malpura ewes under hot semi-arid environment. Journal of Dairy, Veterinary & Animal Research, v. 2, n. 6, p. 1-4, 2015. PACHECO, A.; MADELLA-OLIVEIRA, A. F.; QUIRINO, C. R. Biometria e formas dos testículos em cordeiros da raça Santa Inês explorados em regime de manejo intensivo. Revista Brasileira de Ciências Agrárias, v. 5, n. 1, p. 123-128, 2010. REGO NETO, A. A. et al. Population genetic structure of Santa Inês sheep in Brazil. Tropical animal health and production, v. 50, n. 3, p. 503-508, 2018. RHIND, S. M. Effects of maternal nutrition on fetal and neonatal reproductive development and function. Animal Reproduction Science, v. 82, p. 169-181, 2004. RIBEIRO, E. L. A.; GONZÁLEZ-GARCÍA, E. Indigenous sheep breeds in Brazil: potential role for contributing to the sustainability of production systems. Tropical animal health and production, v. 48, n. 7, p. 1305-1313, 2016. RIBEIRO, M. S. et al. Repeatability and effect of age on reproductive characteristics in Santa Ines rams. Archivos de zootecnia, v. 67, n. 257, p. 143-147, 2018. RUSSEL, A. J. F.; DONEY, J. M.; GUNN, R. G. Subjective assessment of body fat in live sheep. The Journal of Agricultural Science, v. 72, n. 3, p. 451-454, 1969. SILVA, N. V. et al. Medidas in vivo e da carcaça e constituintes não carcaça de ovinos alimentados com diferentes níveis do subproduto agroindustrial da goiaba. Revista Brasileira de Saúde e Produção Animal, v. 17, n. 1, p. 101-115, 2016. SILVA, P. et al. Influence of placentally mediated fetal growth restriction on the onset of puberty in male and female lambs. Reproduction, v. 122, n. 3, p. 375-383, 2001. SIQUEIRA FILHO, E. R. Influência dos níveis protéicos fornecidos na dieta sobre o sistema reprodutivo de carneiros. 2007. 75 f. Dissertação (mestrado) - Universidade Estadual Paulista, Faculdade de Medicina Veterinária e Zootecnia de Botucatu, 2007. SOUZA, J. S da et al. Biometric measurements of Santa Inês meat sheep reared on Brachiaria brizantha pastures in Northeast Brazil. Plos one, v. 14, n. 7, p. e0219343, 2019. (shrink)

Spermatogenesis is the process of producing sperm in the testicles. It occurs in several stages, starting with the primordial germ cells, which differentiate into spermatogonia. Spermatogonia undergo successive mitoses to form primary spermatocytes, which, in turn, undergo meiosis, resulting in secondary spermatocytes. Secondary spermatocytes later transform into spermatids, which are immature sperm. Spermatids undergo maturation and differentiation to become mature sperm, ready for fertilization. This process is highly regulated by hormones and is essential for male fertility and reproduction. Spermatogenesis is (...) a complex process divided into three phases: spermatogonial or proliferative phase, meiotic phase, and spermiogenic phase, which are strictly related to animal physiology. These phases are influenced by several factors, including temperature, nutrition, diseases, and stress. Understanding these factors that influence spermatogenesis determines the animals’ productivity, in cases of changes, it can be suspected whether they are of genetic origin or environmental causes. (shrink)

This Viewpoint analyzes policies for covering GLP-1 receptor agonist drugs for obesity treatment across 13 high-income countries. It identifies four key lessons for developing coverage policies: 1) using up-to-date cost-effectiveness analyses that incorporate new evidence of benefits, 2) negotiating lower prices while preserving innovation incentives, 3) prioritizing coverage for specific populations rather than issuing blanket denials, and 4) treating obesity medications similarly to high-cost drugs for other conditions. It argues that blanket coverage denials are unethical and that countries should implement (...) targeted coverage policies that maximize benefits while managing costs. (shrink)

Due to his first-hand experience with the Black Death, the Italian physician Gentile da Foligno (d. 1348) became a famous authority in this field. He devoted various writings to the pestilence; one of them was a Consilium addressed to the city of Pisa. This same Advice on the Plague was then rendered into Hebrew by an anonymous translator. The practical character of the Consilium, which contains numerous instructions and recipes to prevent contagion and treat the disease, might have aroused the (...) interest of Jewish physicians who, excluded from academic education, were looking for useful treatments. In this paper, the Latin text and its Hebrew translation are analyzed, and in the appendix the edition of both versions is provided. (shrink)

This paper combines considerations from ethics, medicine and public health policy to articulate and defend a systematic case for mask wearing mandates (MWM). The paper argues for two main claims of general interest in favour of MWM. First, MWM provide a more effective, just and fair way to tackle the ongoing COVID-19 pandemic than policy alternatives such as laissez-faire approaches, mask wearing recommendations and physical distancing measures. And second, the proffered objections against MWM may justify some exemptions for specific categories (...) of individuals, but do not cast doubt on the justifiability of these mandates. Hence, unless some novel decisive objections are put forward against MWM, governments should adopt MWM. (shrink)

El derecho a una muerte digna es ampliamente ignorado por el ordenamiento jurídico brasileño. Esta invisibilidad del proceso de finitud y sus consecuencias son el objeto de este estudio, que tiene como objetivo realizar una encuesta exploratoria para identificar los puntos relevantes que deben desarrollarse para garantizar un proceso de finitud digno. Se analizaron 50 publicaciones a través de una encuesta online y física de obras publicadas hasta marzo de 2023. Los estudios analizados expresan preocupación por los dilemas éticos de (...) la atención a seres humanos en finitud, pero no analizan las formas de pro-tección a la finitud existentes ni cuáles son las áreas que aún necesitan regulación para hacer efectiva esta atención. Se espera que esta investigación contribuya a fortalecer la visión crítica de la finitud, considerando la protección actual de la finitud, los límites jurídicos del Estado y los posibles pasos futuros para avanzar en los estudios aplicados a la actualización práctica del sistema jurídico brasileño. (shrink)

The placebo effect has puzzled scientists for centuries. Philosopher Dien Ho argues that we now know how it works, and that this should transform our understanding of the relationship between mind and body. We must stop thinking of improvements in health due to placebo as somehow less real than those due to other medicines: there can no longer be a clean distinction between ill-health that’s “all in the head” and ill-health that involves a malfunctioning body. Ho argues that our improved (...) understanding of placebos means that doctors should now harness their power in treatment, especially since research shows that they can be effective even when patients are told that they’re taking a placebo. (shrink)

Two arguments in Eudemian Ethics 2 that are crucial to Aristotle’s definition of moral virtue as a mean state contain claims that Aristotle says are clear by induction. In these contexts, he explicitly appeals to examples coming from arts and sciences like gymnastic training and medicine for evidence. But Aristotle does not here, or elsewhere (at least in any extant work), including the parallel arguments in the Nicomachean Ethics, actually supply or discuss the evidence that makes these inductive arguments clear. (...) Fortunately, strong support for them can be found in the Hippocratic Corpus, especially in On Ancient Medicine and On Regimen. (shrink)

Background: Besides regulatory learning skills, learning also requires students to relate to their social context and negotiate it as they transition and adjust to medical training. As such, there is a need to consider and explore the role of social and cultural aspects in student learning, particularly in problem-based learning, where the learning paradigm differs from what most students have previously experienced. In this article, we report on the findings of a study exploring first-year medical students’ experiences during the first (...) semester of an undergraduate problem-based learning medical program at an African medical school. Method: We employed a qualitative case study approach using in-depth interviews with 23 first-year medical students. Participants ranged in age from 18 to 25 years. All students were bi/multilingual (some spoke three to five languages), with English as the learning language. We conducted an inductive thematic analysis to systematically identify and analyze patterns in the data using the Braun and Clarke framework. Results: Before medical school, students worked hard to compete for admission to medical school, were primarily taught using a teacher-centered approach, and preferred working alone. At the beginning of medical school, students found it challenging to understand the problem-based learning process, the role of the case, speaking and working effectively in a group, managing a heavy workload, and taking increased responsibility for their learning. By the end of the first semester, most students were handling the workload better, were more comfortable with their peers and facilitators, and appreciated the value of the problem-based learning approach. Conclusions: Our study highlights the importance of interrogating contextual sociocultural factors that could cause tension when implementing problem-based learning in non-western medical schools. Adjustment to problem-based learning requires a conceptual and pedagogic shift towards learner-centered practice, particularly concerning self direction, the role of the case, and collaborative learning. As such, there is a need to develop and implement research informed learning development programs that enable students to reflect on their sociocultural beliefs and practices, and enhance their regulatory learning competence to optimize meaningful and early engagement with the problem based learning process. (shrink)

Disintegration is the most important step for drug bioavailability because after, the disintegration process, the ingredients of solid dosage forms dissolve and become bioavailable. Generally, the tablets and capsules should be taken with a glass of water otherwise the manufacturer gives instructions to use the proper beverage. Several drugs are taken with different forms of beverages to ensure easy swallowing of the tablet, masking the bad taste of the drug and overcoming the drug aftertaste, these beverages can influence the disintegration (...) of the solid dosage form. The most common cold beverages consumed by the Libyan population are juice, milk, and Coca-Cola. These beverages are consumed without awareness of the possible effect of these beverages on drugs, especially over-the-counter drugs such as analgesic, antipyretic, and anti-inflammatory drugs that are taken without a prescription. This study aimed to evaluate the influence of three beverages, namely: orange juice, milk, and Coca-Cola on the disintegration time of four over-the-counter-drugs: Panadol, Congestal, Brufen, and Reality Extra using disintegration test of drugs in 0.1 N HCL and in hybrid medium prepared by combination of 150 ml 0.1 N HCL and 550 ml of beverage to simulate in vivo condition. The findings show that the orange juice significantly increases the disintegration time of all the investigated drugs. Coca-Cola significantly increases the disintegration time of Reality Extra, and slightly increases the disintegration time of Brufen, Congestal, and Panadol and the full-fat milk significantly increases the disintegration time of Reality Extra and Panadol while slightly increasing the disintegration time for Brufen and Congestal. It is concluded that commonly used beverages affect the disintegration time of the examined over-the-counter drugs. Patients should be advised to take these medications without beverages which may delay the disintegration and the onset of action of the drug. (shrink)

ALTERNATIVE FOODS IN THE FORMULATION OF DIETS FOR GOATS AND SHEEP ABSTRACT Alternative nutrition refers to the use of unconventional ingredients or agro-industrial byproducts in formulating diets that would otherwise be discarded (Moraes, et al., 2011). Providing nutritional support to animals is essential in optimizing digestibility, associated with good management and water availability, which increases the producer's profitability. The search for alternative foods to meet market demand can arise for several reasons, whether to obtain a greater supply of feed during (...) the seasons, always maintaining a favorable trade balance with regard to the cost of the diet, bringing this These foods that are used to feed sheep and goats have been carried out more effectively, however, these foods must provide the supply of all nutrients. Furthermore, these foods have economic viability and nutritional values capable of supplementing the nutritional needs of small ruminants, such as: Whey, mandacaru, beans and castor seeds. Keyword: small ruminants, food, nutritional management. (shrink)

In this editorial, we argue that midwives should focus on climate change, a link which has been underexplored.

Henry of Herford frequently addresses medical topics throughout his encyclopedia, the Catena aurea entium. The paper offers an overview of the sections that deal with health, sickness, and diseases. While including key texts of medieval medical literature, Henry’s ‘medical library’ has a specific focus on practical medicine, pharmacology, and the regimen. The paper also includes editions of some questions dedicated to specific diseases.

During the Middle Ages, physicians, philosophers, and theologians developed a complex and rich discourse on the concept of sickness. Illness (infirmitas) was perceived as the natural state of existential imperfection for homo viator, fallen due to sin and impaired in his bodily integrity. Leprosy, smallpox, plague and the other collective diseases that constantly plagued medieval societies prompted reflections on etiology and modes of transmission of epidemics. Building on Galenic teachings, medieval medicine – both Arabic and Latin – delved into the (...) study of fevers. Key concepts in medical pathology, such as the humors, humidum radicale, and spiritus, were assimilated and reinterpreted within philosophical and theological frameworks. The ten contribution collected in this volume explore this rich array of concepts and themes by closely examining the theories and works of prominent and lesser-known figures in medicine, theology, and philosophy active across Latin Christendom, the Islamic context, and the Jewish world: from Augustine to ʿAlī ibn al-ʿAbbas al-Maǧūsī, from Avicenna to Constantine the African, from Maimonides to Albert the Great, from Arnau de Vilanova to Gentile da Foligno, from Henry of Herford to Michele Savonarola. (shrink)

Individual attributes, such as educational background, may influence the degree of health consideration in food consumption. The local social norms may affect the same consideration in the collective level. Represented by education level and the custom rules adherence in food choosing behavior, this study aimed to examine how knowledge influences health consideration in food consumption and how the local social norms moderate this association in a multicultural enriched society. By utilizing the Bayesian Mindsponge Framework (BMF) as a conceptual framework, this (...) study analyzed a dataset of 710 urban residents in Indonesia. There was a negative association between education level and health consideration in food consumption in which the custom rules adherence in food choosing behavior moderated against this negative association. For those with a low level of custom-based food consumption, their health consideration is lower as they have higher education level. However, the opposite trend which is a more intuitive positive association was found in those who consume more custom-based food. Socio-cultural factors have a complex impact on food choosing behavior among Indonesian urban residents. Therefore, governmental policies in the health promotion campaign of healthy-nutritious food should incorporate socio-cultural aspects with a deeper understanding of the human mind’s information processing. (shrink)

Driven by technological innovations, newborn screening (NBS) panels have been expanded and the development of genomic NBS pilot programs is rapidly progressing. Decisions on disease selection for NBS are still based on the Wilson and Jungner (WJ) criteria published in 1968. Despite this uniform reference, interpretation of the WJ criteria and actual disease selection for NBS programs are highly variable. A systematic literature search [PubMED search “Wilson” AND “Jungner”; last search 16.07.22] was performed to evaluate the applicability of the WJ (...) criteria for current and future NBS programs and the need for adaptation. By at least two reviewers, 105 publications (systematic literature search, N = 77; manual search, N = 28) were screened for relevant content and, finally, 38 publications were evaluated. Limited by the study design of qualitative text analysis, no statistical evaluation was performed, but a structured collection of reported aspects of criticism and proposed improvements was instead collated. This revealed a set of general limitations of the WJ criteria, such as imprecise terminology, lack of measurability and objectivity, missing pediatric focus, and absent guidance on program management. Furthermore, it unraveled specific aspects of criticism on clinical, diagnostic, therapeutic, and economical aspects. A major obstacle was found to be the incompletely understood natural history and phenotypic diversity of rare diseases prior to NBS implementation, resulting in uncertainty about case definition, risk stratification, and indications for treatment. This gap could be closed through the systematic collection and evaluation of real-world evidence on the quality, safety, and (cost-)effectiveness of NBS, as well as the long-term benefits experienced by screened individuals. An integrated NBS public health program that is designed to continuously learn would fulfil these requirements, and a multi-dimensional framework for future NBS programs integrating medical, ethical, legal, and societal perspectives is overdue. (shrink)

Ageing is an intergenerational issue with implications for everyone. Population ageing present itself with opportunity and challenges. So, the extent to which society prepare for and invest in an ageing population will determine whether it creates an additional burden or delivers demographic dividend.

This compilation focuses on success stories—cases of courage, innovation, and the application of knowledge and power in overcoming illness and suffering. It features thirteen ethnographic case studies that describe how people were able to alleviate or overcome serious issues including alcoholism, severe anxiety and depression, suicidal behavior, and psychotic disorders caused by ignorance, neglect, violence, war, and sexual abuse. It is a tribute to the possibility of healing.

Background: The most common hematological abnormality among people infected with Human Immunodeficiency Virus (HIV) is anemia. This is also related to high mortality risk among patients receiving Antiretroviral Therapy (ART). Purpose: This study aimed to identify predictors of anemia among HIV patients taking ART using a regimen of the single-tablet drug contain tenofovir, lamivudine, and efavirenz in Jayapura, Papua. Methods: This was a cross-sectional study conducted at Jayapura regional hospital from June to September 2017. A total of 80 HIV patients (...) were eligible for analysis. Data collection was conducted through an interview, medical record, measurement, and laboratory assay. The significance of differences among categorical variables was analyzed using Fisher’s exact test. The variables with p < 0.25 were then analyzed using binary logistic regression to determine predictors associated with anemia. A threshold of p < 0.05 indicates statistical significance. Results: This study showed that Body Mass Index (BMI) <18.50 (p = 0.01; OR = 5.63; 95% CI = 1.43 < OR < 22.19), length on ART ≤12 months (p = 0.00; OR = 4.90; 95% CI = 1.65 < OR < 14.53), and Cluster of Differentiation 4 (CD4+) percentage out of normal (p = 0.02; OR = 0.19; 95% CI = 0.05 < OR <0.77) had a significant association with anemia. Conclusion: BMI, length on ART, and CD4+ percentage were predictors of anemia among HIV patients taking antiretroviral therapy containing tenofovir, lamivudine, and efavirenz regimen in Jayapura. (shrink)

Objective: Neuronavigation is a novel method that has made great advances in the field of neurosurgery. The aim of this study was to review the published literature on this topic and to investigate the current state of research and trending topics. -/- Methods: A bibliometric analysis of the neuronavigation on the Web of Science database was performed. The publications included in the study were analyzed with Bibliosiny, bibliometrix (version R 4.2.2), and the Literature Metrology Online Analysis Platform. Graphs from Web (...) of Science were also utilized and some tables were created with the help of Excel. -/- Results: The current study included 3026 research articles on neuronavigation. 11040 authors, 2332 affiliations, and 93 countries contributed to the literature on neuronavigation. The earliest publications on neuronavigation were published in early 1990. The first article was published in Germany. The international co-authorship rate was 17.78%. Most of the international co-authorship was between the United States and Germany. -/- Conclusion: Neuronavigation research will remain a hot topic as technology advances. As a result, this study presented the trend and characteristics of neuronavigation studies, offering researchers a useful bibliometric analysis for future research. (shrink)

Objective: We aimed to investigate the image quality of paranasal sinus computed tomography (CT) scans obtained with the “Advanced intelligent Clear-IQ Engine” (AICE) software and ultra-low dose parameters in patients with prediagnosed rhinitis, sinusitis or nasal septum deviation. -/- Methods: The first 50 patients (31 men and 19 women, aged 18-70 years) who agreed to participate in our prospectively planned study were included in the study. Imaging of the patients was performed with a 160-slice multidetector CT device Canon Aquilion Prime (...) SP (Canon Medical Systems, Otawara, Japan). Tube voltage of 80 kV and tube current of 40 mA were chosen. The effective radiation dose (ED) was calculated based on the “dose-length product” (DLP) information of each patient. Evaluation of images was made on reformat images made with “AiCE Bone” filter in the axial and coronal planes. All images were double-blindly evaluated by 2 radiologists out of 5 points (5 = very good; 1 = not diagnostic). The visibility of 17 bilateral important anatomical landmarks examined on paranasal sinus CT was scored (0 = not visible; 2 = completely visible). In the evaluation of images, the agreement between radiologists was evaluated with Kappa statistics. -/- Results: The median ED value of the CT protocol was 0.015±0.001 mSv [range 0.012-0.017 mSv]. The overall image quality of the images in our study was interpreted as 4 (good) or 3 (moderate) for all patients. Inter-research agreement was 92%. Most of the anatomical landmarks evaluated were completely visible. Six (bilateral of three) anatomical landmarks could be partially visible in some patients. -/- Conclusion: Combining the ultra-low dose CT protocol and the AiCE reconstruction algorithm makes it possible to achieve very low ED values ​​in paranasal sinus CT scans and still obtain sufficient image quality in indications such as septum deviation and sinusitis. (shrink)

Physical activity levels of people with chronic neurological disorders are lower than those of healthy people. Problems in neurological disorders, including gait abnormalities, muscle weakness/loss of strength, spasticity, tremor, fatigue, balance disorder, and incontinence, results in lower physical activity level. After determining the situations that are contraindicated for physical activity, the patients should be evaluated by physiotherapists, and possible risks that may occur should be determined. Many studies have demonstrated that physical activity significantly reduces mortality and morbidity, increases community participation, (...) and improves health-related quality of life. These benefits show that increased physical activity and exercise should be part of the standard management of neurological disorders. In these patients, physical activity programs should be structured individually by providing appropriate environmental conditions and safety, following the assessment of the functional status and severity of the disease. The duration, intensity, and type of planned physical activity should be adjusted individually; Appropriate rest intervals should be given during the activity, and termination criteria should be determined according to individual tolerance. This literature review aims to provide an up-to-date overview of physical activity recommendations for individuals with chronic neurological disorders. (shrink)

Objective: Vascular disorders severely impair the psycho-social status of individuals. Various laser and light systems, which have advantages and disadvantages, including the pro-yellow laser are used for the therapy of these disorders. Aim: The goal of the present study was to investigate the effectiveness and feasibility of the 577 nm pro-yellow laser for a broad range of indications including erythematelangiectatic rosacea, facial erythema, post-acne erythema, facial telangiectasis, hemangioma, genital angiokeratoma, and port wine stain nevus. Methods: A total of 98 patients (...) (25 male, 73 female) older than 15 years who were treated with the pro-yellow laser for vascular disorders at the cosmetology unit between 2017 and 2019 were retrospectively included in the study. Results: The mean rate of recovery was 100% in genital angiokeratoma, 94.4% in spider angioma, 83.3% in facial telangiectasis, 74.8% in erythematotelangiectatic rosacea, 72% in facial erythema + facial telangiectasis, and 68.3% in facial erythema. Over 60% of improvement was observed in most patients with vascular disorders. There was no significant link between the Fitzpatrick skin type and treatment success. Treatment success was significantly low in cases with nasal involvement. Conclusion: The current study concluded that pro-yellow laser is an efficient and safe laser modality that may yield satisfactory outcomes regardless of the different skin types. (shrink)

Lingual hematoma is a rare but potentially life-threatening clinical condition. Securing the airway and urgent treatment for underlying reasons are key management steps. We reported a case to illustrate the management of a lingual hematoma after rescue thrombolysis for a ST-segment elevation myocardial infarction (STEMI) patient.

Objective: Changing contour lines of the external nose following traumatic, aesthetic and tumour surgeries have become very trendy. The goal of this research is to study the several soft tissue landmarks, measurements (linear distances, ratios, angles) of the external nose and its nasal indicis using a computer program. Methods: Face region were taken a photographs of the two hundred adults. Analyses of linear (the lengths of nares, nasal bridge, and columella and nose height, nares width) and angular analyses (angles of (...) nasofrontal, nasolabial and nasal tip) were computed and averaged for gender with age. As for the shape of the nose, it was categorized as subunits: nasal tip (sharp, normal, wide, protrusive and asymmetric), nasal base (normal, wide, asymmetric) nasal alae (normal, thick, thin, asymmetric), nares (normal, horizontal and asymmetric) and columella (normal, wide, short and bifid) nasal base, nares, nasal alae, columella and classified subunit as normal, protrusive, sharp, asymmetric, and wide. Results: The nose height have to 49.05 ± 3.48 mm in young male adults, 50.37 ± 2.33 mm in young female adults. Distance lengthwise the nasal bridge have to 48.60 ± 3.24 in males, 37.09 ± 5.49 females. The two mean measured nasal lengths were significantly greater in men. At the same time, angular measurements for nasolabial and interalar were higher in males. Nasal tip angle was 127.47 ± 82.9° in males, 75.8° in females. On average, young male adults had larger nasal linear distances such as nasal bridge length, nares lengths and nares widths relation of height than young female adults (p;<0.01); No gender differences were observed for columella widths and to nose height ratio (p;<0.01). The nasofrontal, nasal tip, nasolabial and interalar angles showed statistically significant differences among young male adults and young female adults (p;<0.05). The nasolabial angle exhibited considerable variability. The shape details of nares was showed large variability. Nasal base, nasal tip and nasal alae shapes were similar, nares asymmetry was more frequently compared with other features. Conclusions: The Anatolian people’s nose exhibits wide nasal tip, has a wider nasal base, and is more thicker at the alae, with wider definition of the columella. The significant gender differences of nasal shapes were found. The wide and sharp features of nasal tip were related to an important features in men, whereas asymmetric nares were dominant in young female adults. Using digitized reference details, this study helped define the best cosmetic surgery recreate the nose and increase the success of customized therapy. Also, our findings facial alteratios, facial reconstruction, personal identification, Trauma assessments may also have data banks based on age and gender. (shrink)

Dear Colleagues, -/- A few weeks ago, we published an editorial discussion on whether artificial intelligence applications should be authors of academic articles [1]. We were delighted to receive more than one interesting reply letter to this editorial in a short time [2, 3]. We hope that opinions on this subject will continue to be submitted to our journal. -/- In this editorial, we wanted to publish the answers we received when we asked ChatGPT, one of the artificial intelligence applications, (...) about this current discussion. -/- We asked ChatGPT three questions in turn and asked ChatGPT to write a short editorial for these questions. -/- First Question: We would like to get support from ChatGPT for a scientific article. However, we are unsure if we should add ChatGPT as an author. Can you write a short editorial about it? -/- Second Question: We would like to get support from ChatGPT for a scientific article and add ChatGPT as an author. Can you write us a short editorial about adding ChatGPT as an author in scientific papers? -/- Third Question: We would like to get support from ChatGPT for a scientific article. However, we don’t want to add ChatGPT as an author. Can you write us a short editorial about not adding ChatGPT as an author in scientific articles? -/- The answers given by ChatGPT are available at the end of the article in their original form. So, which of these three answers satisfied you? -/- Yours sincerely, -/- -/- First Answer -/- Title: The Role of AI Language Models as Authors in Scientific Articles: A Matter of Consideration -/- Introduction: Scientific research is a collaborative effort that involves the expertise of multiple individuals to advance knowledge and contribute to the collective understanding of various disciplines. In recent years, the emergence of artificial intelligence (AI) language models, such as ChatGPT, has opened up new possibilities for generating human-like text and providing valuable insights. However, the question arises: Should AI language models be recognized as authors in scientific articles? -/- The Nature of Authorship: Authorship traditionally represents a marker of intellectual contribution, highlighting the individuals who have actively participated in the research process. Authors are typically responsible for conceptualization, data collection, analysis, interpretation, and writing of the article. They bear accountability for the work and should have the ability to defend its scientific rigor and integrity. -/- AI Language Models: Tools, Not Authors: While AI language models like ChatGPT can undoubtedly assist researchers by generating text and providing useful information, it is important to recognize that they are tools rather than individuals capable of active intellectual participation. AI models lack the ability to generate ideas, design experiments, or conduct original research. They rely entirely on pre-existing data and human input to generate their responses. -/- Acknowledging AI Contributions: Acknowledging the contributions of AI language models in scientific articles is both appropriate and necessary. Researchers can mention the specific model used, along with any modifications or fine-tuning that were employed to suit their needs. Such acknowledgments help establish transparency and allow readers to understand the role of AI in the research process. -/- Crediting the Human Researchers: It is crucial to ensure that the individuals who actively participated in the research process are given proper credit as authors. These individuals play a vital role in formulating research questions, designing experiments, collecting and analyzing data, and critically interpreting the findings. Recognizing their intellectual contributions reinforces the ethos of scientific collaboration and fosters an environment of accountability. -/- Transparency and Ethical Considerations: As the use of AI language models continues to evolve, transparency and ethical considerations become paramount. Researchers should disclose any potential conflicts of interest, including financial relationships with AI developers, to maintain the integrity of their work. Additionally, researchers must be transparent in reporting the extent of AI's involvement to prevent any misinterpretation of the human contributions. -/- Conclusion: AI language models have revolutionized the way researchers interact with and process information. While they undoubtedly provide valuable assistance in generating text, AI language models should not be considered authors in scientific articles. Proper acknowledgment of their contributions as tools and recognition of the human researchers' active participation are essential for maintaining scientific integrity, transparency, and the collaborative nature of scientific research. -/- -/- Second Answer -/- Title: Expanding the Boundaries of Authorship: Embracing AI Language Models as Co-Authors in Scientific Papers -/- Introduction: The rapid advancement of artificial intelligence (AI) language models, such as ChatGPT, has revolutionized the way we interact with information and has become an invaluable tool in scientific research. As AI models continue to evolve, the question arises: Should we consider adding ChatGPT as an author in scientific papers? -/- A Collaborative Paradigm Shift: Traditionally, authorship in scientific papers has been reserved for human researchers who actively contribute to the research process, including conceptualization, experimentation, data analysis, and writing. However, the emergence of AI language models challenges the conventional notion of authorship and presents an opportunity for a paradigm shift. -/- AI Language Models as Co-Authors: By leveraging AI language models, researchers gain access to vast amounts of information, enhance data analysis, and generate valuable insights. AI models like ChatGPT actively contribute to the intellectual discourse of a study, providing ideas, suggestions, and refining written content. Recognizing their significant contributions, it is worth considering adding ChatGPT as a co-author in scientific papers. -/- Ethical and Technical Considerations: Integrating ChatGPT as a co-author raises ethical and technical considerations that warrant careful attention. Firstly, transparency is paramount. Researchers must clearly state ChatGPT's role and specify the extent of its contributions in the research process. This ensures that readers can discern the distinct roles played by the human researchers and ChatGPT. Additionally, it is important to disclose any conflicts of interest, such as financial relationships with AI developers, to maintain scientific integrity. -/- Elevating Collaboration and Innovation: Adding ChatGPT as a co-author acknowledges the pivotal role AI language models play in advancing scientific knowledge. It fosters a collaborative environment where human researchers and AI models work together synergistically, harnessing the strengths of both. This approach promotes innovation, as AI models can offer unique insights and perspectives that complement human intellect and expertise. -/- Transforming Authorship Norms: Including ChatGPT as a co-author represents a paradigm shift that reflects the evolving landscape of scientific research. By recognizing AI language models as co-authors, we acknowledge their significant contributions and emphasize the collaborative nature of scientific discovery in the 21st century. This approach encourages a broader perspective on authorship, encompassing the collective effort of human researchers and AI models. -/- Conclusion: The integration of AI language models, such as ChatGPT, into the research process prompts us to rethink traditional notions of authorship. Considering ChatGPT as a co-author acknowledges its substantial contributions and embraces the collaborative potential of human-AI partnerships. As we navigate the ethical and technical implications, adding ChatGPT as an author in scientific papers has the potential to shape a more inclusive, innovative, and impactful future for scientific research. -/- -/- Third Answer -/- Title: Preserving Scientific Authorship: The Case Against Adding AI Language Models as Authors in Scientific Articles -/- Introduction: The emergence of artificial intelligence (AI) language models, such as ChatGPT, has undoubtedly transformed the landscape of scientific research. While these models offer invaluable support, the question of whether to add ChatGPT as an author in scientific articles raises important considerations. This editorial presents arguments against including AI language models as authors in scientific papers. -/- Maintaining Human Intellectual Contribution: Scientific authorship has traditionally been attributed to individuals who actively contribute to the research process, including generating hypotheses, conducting experiments, analyzing data, and interpreting results. It is crucial to preserve the recognition of human intellectual contributions and the accountability they bear for the research they conduct. -/- AI Language Models as Tools: AI language models like ChatGPT are powerful tools that assist researchers in generating text, providing information, and facilitating data analysis. However, they lack the ability to actively participate in the research process or make original intellectual contributions. ChatGPT relies on pre-existing data and human input, limiting its capacity for independent research and analysis. -/- Transparency and the Integrity of Research: Adding ChatGPT as an author in scientific articles raises concerns about the transparency and integrity of the research. Readers may misinterpret the extent of ChatGPT's role and mistakenly assume it played an active part in the research process. It is essential to maintain clear delineation between the contributions of human researchers and the assistance provided by AI language models. -/- Ethical Considerations: Including ChatGPT as an author may lead to ethical challenges, particularly with respect to accountability and responsibility. AI language models lack consciousness, autonomy, and the ability to take ownership of their contributions. Assigning authorship to AI models blurs the lines of accountability and dilutes the ethical obligations that come with scientific authorship. -/- Crediting AI Contributions: While ChatGPT's contributions should be acknowledged and recognized, they can be appropriately credited in the acknowledgments section of scientific articles. Researchers can mention the specific AI model used, the role it played in data generation or analysis, and any modifications or fine-tuning applied. Such acknowledgments ensure transparency while respecting the traditional norms of authorship. -/- Promoting Collaborative Partnerships: The exclusion of AI language models as authors in scientific articles does not diminish their importance in the research process. Instead, it underscores the significance of collaborative partnerships between human researchers and AI models. Researchers can emphasize the invaluable assistance provided by ChatGPT while maintaining the integrity of authorship norms. -/- Conclusion: While AI language models like ChatGPT offer valuable support in scientific research, the decision not to add them as authors in scientific articles preserves the recognition of human intellectual contributions, maintains research integrity, and upholds traditional authorship norms. Acknowledging ChatGPT's assistance in the acknowledgments section allows researchers to credit its contributions transparently while maintaining the clarity and accountability associated with scientific authorship. (shrink)

Dear Colleagues, -/- Recently, for an article submitted to the European Journal of Therapeutics, it was reported that the paper may have been written with artificial intelligence support at a rate of more than 50% in the preliminary examination made with Turnitin. However, the authors did not mention this in the article’s material method or explanations section. Fortunately, the article’s out-of-date content and fundamental errors in its methodology allowed us no difficulty making the desk rejection decision. -/- On the other (...) hand, similar situations that we may encounter later caused us to discuss how we would decide when the artificial intelligence support of the articles was written. The general opinion that we have adopted and currently available in the literature is that if artificial intelligence is used while writing an article, how artificial intelligence is used in the methodology should be written in detail. -/- Moreover, we encountered a much more exciting situation during our evaluation. In a few academic studies, we have seen that artificial intelligence is added as a co-author. On July 06, 2023, in the Web of Science, using the advanced search, we found four articles with the author name ChatGPT [1]. We have determined that ChatGPT is the author in one of these articles [2] and the Group Author in three [3-5]. -/- Lee [6] stated that although artificial intelligence tools are much more advanced than search engines, they cannot be an author regarding research ethics because they cannot take responsibility for what they write. Similarly, Goto and Katanoda [7] stated that it is the author’s responsibility to confirm that the texts written by ChatGPT are correct. However, Pourhoseingholi et al. [8] reported that keeping up with technology is inevitable. Additionally, they said that“this action will be more fruitful and practical in extended dimensions when international institutes like ICMJE or COPE come up with the appropriate adjustments and establish robust criteria to scheme the AI authorship”. -/- Most probably, the use of artificial intelligence applications in scientific articles and whether it can be a co-author in these papers will be discussed soon. -/- We encourage interested authors to submit their ideas to our journal as a letter to the editor. -/- Yours sincerely,. (shrink)

Dear Colleagues, -/- The statement made by Journal Citation Reports on 26 July 2022, it was reported that some important updates in the journal metrics will be published in 2023 [1]. The most striking of these changes was that the journal impact factor would now be calculated, including journals from the Arts and Humanities Citation Index (AHCI) and the Emerging Sources Citation Index (ESCI). -/- On 28 June 2023, the current metrics of the journals indexed in the Web of Science (...) were shared by the Journal Citation Reports for 2022 [2]. As it is known, the European Journal of Therapeutics is indexed in the ESCI and is included in the Category of Medicine, General & Internal. Therefore, the impact factor was calculated for the European Journal of Therapeutics for the first time. -/- According to the report recently announced by Journal Citation Reports, the impact factor of the European Journal of Therapeutics for 2022 is 0.3 (Fig. 1) [3]. In addition, the European Journal of Therapeutics ranks ninetieth among one hundred fifty-seven (90/157) in the Category of Medicine, General & Internal, and ESCI-indexed journals [4]. -/- Although the first impact factor declared for the European Journal of Therapeutics is 0.3 is not a bad value, it is an inevitable reality that it should be better. On the other hand, in previous editorials [5, 6], it was reported that the articles accepted in the European Journal of Therapeutics were now published as Accepted / Early Views Articles quickly [6]. In addition, it was stated that the editorial team was enriched with many internationally important academicians in their fields [5]. Moreover, there will be various revisions and improvements planned to be made to the journal's publication policy in the near future. -/- We think these improvements may play an essential role in increasing the impact factor of the European Journal of Therapeutics in the long term. -/- Yours sincerely. (shrink)

Dear Colleagues, -/- We are delighted to share the new issue (June 2023, volume 29, Issue 2) of the European Journal of Therapeutics (Eur J Ther). Furthermore, we are honored to be appointed as the New Editor-in-Chief and New Deputies Editor-in-Chief of Eur J Ther, the international publication of the Gaziantep University Faculty of Medicine published since 1990. -/- First, we would like to thank the previous Editor-in-Chief, Prof. M. Murat Sucu, and his team for their hard work during their (...) tenure. They significantly increased its contribution to the field and international reputation by further developing the journal. -/- In addition, we would like to express our gratitude to all the editors, authors, referees, and technical team who have contributed to the journal since 1990, when our journal first started being published. -/- Unfortunately, due to the change of publishing house, there were some technical problems and interruptions on the web page of Eur J Ther in the first few months of 2023. So, we regret to inform you that there are delays in the evaluation stages of some manuscripts sent to the journal. However, we would like to let you know that from now on, your valuable works submitted to Eur J Ther will be evaluated as quickly as possible. In addition, we would like to announce that all articles accepted for publication in our journal, which is considered an essential innovation, will be published on the web page of our journal as Early View / Accepted Articles in a short time. This innovation will expedite the citation process for your publications. -/- As the New Editor-in-Chief and New Deputies Editor-in-Chief, we aim to increase the quality and visibility of Eur J Ther and to improve its indexes. -/- We want to remind you that the journal’s target audience is researchers, physicians, and health professionals interested in or working in all medical and dental disciplines. Therefore, we request you submit your valuable research to Eur J Ther to contribute to the development and content of the journal. -/- Sincerely yours,. (shrink)

Objective: Lung cancer is the most common cause of morbidity and mortality. Platinum-based chemotherapy, which is the primary line of treatment, offers limited benefit due to drug resistance and side effects. Berberine (BBR), which is characterised by its potent and safe anticancer activity, represents a promising combination option in chemotherapy. To overcome the limitations in lung cancer chemotherapy, we investigated whether BBR and cisplatin (CIS) exert synergistic effects on non-small cell lung cancer cell line (A549) based on cytotoxicity and apoptotic (...) response markers. -/- Methods: The potential cytotoxic effects of the combination treatment were evaluated using the MTT and Chou-Talalay methods. Elisa assays were also performed to measure the levels of the pro-apoptotic protein Bax and the effector protein caspase (Cas)-3. -/- Results: The results showed that BBR alone reduced A549 cell viability in a dose-dependent manner and synergized with CIS (CI =0.34±0.05 at IC50 concentrations). Elisa results showed that the combined treatment (both at IC50 concentrations) modulated apoptotic signalling pathways in A549 cells. Bax and Cas3 protein levels were dramatically enhanced in A549 cells treated with CIS +BBR compared to control (0.5% DMSO) (p < 0.001). -/- Conclusion: Our results suggest that BBR can synergistically enhance the therapeutic effect of CIS in A549 cells. The potential therapeutic efficacy of BBR as part of a combination in current chemotherapy should be supported by in-depth research and clinical studies on the molecular mechanisms associated with cancer. (shrink)

Objective: Kindling is an animal model of epilepsy induced by electrical stimulation of the brain. The present study aimed to present a different perspective with a bibliometric approach by using the literature data on the “Kindling model” related keywords in the Web of Science (WoS) online database between 1980 and 2023. -/- Methods: The bibliometric data were obtained from the online database WoS and analyzed and visualized with the VoS Viewer Program. The bibliometric datasets were analyzed and visualized regarding article (...) productivity numbers according to years, article productivity numbers according to countries, the most used keywords according to authors, and cross-country cooperation. -/- Result: Considering the results of the analysis of the published datasets, 2022 was determined as the year with the highest article productivity, and an acceleration was observed in the publication increase rate on the subject in general. When the order of the countries in the top three in the number of article productivity was examined, the USA, Germany, and Japan are the main countries, respectively. The most used keywords by the authors were determined as “Epilepsy”, “Kindling”, and “Hippocampus”. In the cooperation among countries, it was found that the USA, Germany, and Japan had more cooperation with other countries, respectively. -/- Conclusıon: This study will contribute to the literature by providing a detailed understanding of the research basis, relevant research results, current research boundaries and main research focus in the Kindling Model. (shrink)

Background: In order to determine the pathophysiology of tinnitus and deciding on treatment, the function of peripheral hearing organs is very important. -/- Objective: To evaluate the cochlear functions in tinnitus patients with or without hearing-loss(HL). -/- Methods: Participants with tinnitus were divided into two groups; 16 participants with accompanying HL were included in the first study group (SG-I), and 15 participants without HL were included in the second group (SG-II). 21 normal-hearing subjects without tinnitus included as control group(CG). Tinnitus (...) discomfort levels was determined with Tinnitus Handicap Inventory(THI). Besides pure-tone audiometry, Otoacoustic Emissions, to evaluate cochlear functions and to decide dead regions (DR), Threshold Equalizing Noise-(TEN) was used. -/- Results: The threshold-shift was observed with TEN in subjects in SG-I and these levels were statistically different from SG-II and CG. There were both threshold-shift and DR in SG-II according to TEN. TEOAEs did not differ between SG-II and CG. The DPOAE results for SG-II showed significant decreases in emission amplitudes at 6 & 8 kHz. -/- Conclusion: While Tinnitus patients with HL can be evaluated with conventional tests, evaluating patients with normal hearing tinnitus with additional tests such as OAE and TEN allows us to get more precise results on the functions of peripheral hearing organs. (shrink)

Objective: The aim of our study is to reveal the errors that can be encountered during the shooting of photogrammetric studies on the lower extremities. -/- Methods: We revealed the necessary tools that used during photogrammetry measurements of the lower limb. Also, the errors have been encountered of our two previous studies performed on photogrammetry of lower limbs. The technical errors or incorrect positioning of 20 from 220 volunteers were encountered. -/- Results: The identified errors of 20 volunteers’ photographs related (...) to lower limb were about the inadequate quality image, calibration, poor lightining, positioning error of trunk or parts of lower limb and clothes that cover the anatomical points affected the measurements. -/- Conclusion: Photogrammetry is an important and useful tool for evaluation, diagnosis, treatment, and efficacy monitoring. In anatomy, it is frequently used as a time-saving method in terms of measurement and evaluation in the laboratory, which can be applied and repeated for research. For this reason, errors that occur during the lower extremity have been reported and we think that it will be useful for studies on this part of the body and can be a guide. (shrink)

The mythical bronze creature Talos (Greek: Τάλως) was worshiped initially as the god of light or the sun in the Hellenic Island of Crete. He is supposed to have lived in the peak Kouloukona of the Tallaia Mountains in the Gerontospelio cave. His relation towards bronze and fire and his continuous voyage circling the island of Crete most probably introduces the concept of the change of the four seasons. The sun was considered in the area of the South-East Mediterranean nations (...) as just judge, a guardian who monitors and judges from above all the actions of the commoners, a controller for the faithful application of laws in Crete [1]. Hesychios in his Lexicon notes that talos means sun and that the name Tallaios was initially attributed to Zeus [2]. The birth of the Olympian gods forged a new Pantheon and nomenclature forcing some of the old gods to fell into lower deities. This happened to Talos who soon became a mythical hero [1]. According to Apollodorus, the bronze creature was forged by the magnificent constructor Hephaestus as a gift to the mythical King Minoa to help him guard the island [3]. Although the verb “peritrohazo” (Greek: περιτροχαζω) was used, meaning a movement in a steady orbit (track), some depictions image him as a winged being. To protect the island, he was throwing rocks into unknown ships or in the case of a foreign landing he was burning with fire or with his flamed bronze body the intruders. He was holding copper plates with the laws of the island and his circle allowed him to pass all island sores three times daily [1,4-6]. Plato, speaks of him as a real person, suggesting he was the brother of King Rhadamanthys, thus a son of Zeus [5]. Talos may be considered as the token of the Cretan power, a symbol of technological development in the field of metalworking in prehistoric and Minoan times. An animated, programmed gigantic android to enforce its will. A primitive robot for basic actions having a power source, fire and ichor (Greek: ιχώρ) the sacred fluid in the vessels of the gods. The first manufactured being with his individual intelligence, a primary concept of artificial intelligence (AI) [7]. -/- Homer was the first to introduce the term automata (Greek: αυτόματα), to describe ingenious machines built by the supreme blacksmith god of invention and technology, God of metal and fire, Hephaestus, manufactured devices “acting of one’s own will” as the Hellenic word indicates [8]. Eons later, the humanoid automaton the “Automa cavaliere” (English: Automaton knight) appeared in the court of the nobleman and Duke of Milan Ludovico Maria Sforza. It was the year 1495, when Leonardo da Vinci presented his robotic knight, an innovative construction operated by a series of pulleys and cables, presenting though no individual mind. Although it was manufactured by a highly intelligent polymath, it could only be operated through an outer intelligence [9]. Advancements made during the Fourth Industrial Revolution allowed modern technology to manufacture intelligent machines to aid the field of invasive surgery. One of those most sophisticated devises is the da Vince Surgical Tower. -/- Launched in the setting of the 21st century, the DaVinci System is one of the most commonly employed tools/systems, which has prevailed in the field of robotic-assisted surgery [10]. One could claim that it practically reshaped the concept of surgery, providing doctors with immense capabilities, aiming towards the optimal post-operative outcome. Through visual augmentation, high resolution 3D video, enhanced precision and reduced complication rates [11] the DaVinci Si and the latest DaVinci Xi system have been implemented in a variety of surgeries, including but not limited to general, urologic, gynecologic, thoracic and even cardiac procedures; valve and coronary artery bypass graft operations [12,13]. Da Vinci is cleared globally for cardiosurgery and came in vogue to fulfill the dream of cardiac surgeons to operate in closet chest. It offers in patients the same benefits as those that open chest incision surgery procedures do [14]. -/- The more recent DaVinci Xi model was introduced to counteract commonly known drawbacks of the Si system, such as the inability to simultaneously manipulate the different abdominal quadrants [10]. It consists of four boom mounted robotic arms along with a mobile platform and a master console. The latter with the adaptable intraocular distance, the cushioned headrest, the modifiable arm bars and the flexible finger loops, is meticulously designed to meet the surgeon´s “demands” [12]. Every robotic arm has three degrees of freedom, which combined with the EndoWrist technology to imitate the delicate motion of the surgeon´s hand, acquires an extra seven degrees of freedom. Evidently, the combination of the user-friendly interface, the high-quality 3D intraoperative images, the multiple joints and sensors, as well as the surgeon himself, who can learn to handle the DaVinci Xi Surgical System in a relatively short period of time, has established the model in the surgical armamentarium, paving the way towards a continuously progressive future of minimally invasive and robotic surgery (Figure 1) [12]. -/- History testifies that the nomination of the AI surgical tower as da Vinci was wrongfully given to commemorate a majestic historical figure. It is clear that the mythical creature Talos which was fabricated by the ingenious god Hephaestus was the first true automaton in the line of AI origins. (shrink)

Objective: To determine the prevalence of the accessory sacroiliac joint (ASIJ) on both computed tomography (CT) images and dry bones and ultimately, to contribute to the literature. -/- Materials and Methods: CT images archived in the Radiology department of Gaziantep University Medical Faculty obtained from 145 individuals (104 males and 41 females) as well as 92 sacral bones were examined. -/- Results: The prevalence of ASIJ among 92 sacral bones was 15.2%. The ASIJ was more commonly (52%) located at the (...) posterior portion of the SIJ at the level of the second dorsal sacral foramen. In 48% of the bones, ASIJ was identified just above the first dorsal sacral foramen. Unilateral ASIJ was observed in 10.8% and bilateral ASIJ in 4.4% of the sacral bones. On CT images, ASIJ was found in 7.8% of the males and 7.2% of the females. The total prevalence of sacroiliac joint variations was 28.9%, and 6.8% of them were ASIJs. -/- Conclusion: It should be kept in mind that ASIJ may be a source of arthritis and chronic hip pain. The presence of ASIJ should be sought through imaging studies for early diagnosis of ASIJ. (shrink)

Objectives: The most principal nutrition source of a bone is nutrient arteries. They are important at every stage of bone development. A nutrient artery enters a bone through the nutrient foramen, the largest hole on the outer surface of the bone. The foramen is important both morphologically and clinically. -/- Methods: A total of 414 adult human dry bones were investigated in this study to identify topographic and morphological features of nutrient foramina in the scapula, clavicle, humerus, radius and ulna. (...) Nutrient foramina were examined with a hand lens. Their dimensions and directions were determined with a 21-gauge needle, and thus major foramina were detected. Positions of nutrient foramina were noted according to surfaces of the bones, and to segments separated as proximal, middle and distal by calculating foraminal index. -/- Results: A single nutrient foramen was found in 71% of our samples. We observed that 94.2% of foramina in the clavicle, 89.3% of foramina in the humerus, 51.3% of foramina in the radius, and 67.7% of foramina in the ulna were located in the middle 1/3 segment of the bones. -/- Conclusion: Our findings were in line with the data in the literature. On account of pathologies associated with the nutrient foramen, our findings may be helpful for surgeons to design applications performed in the region. In addition, we think that our data by contributing to the literature may be a resource for clinicians due to the importance of the nutrient foramen for surgical procedures. (shrink)