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Large language models including GPT-4 (OpenAI) have opened new avenues in health care and qualitative research. Traditional qualitative methods are time-consuming and require expertise to capture nuance. Although large language models have demonstrated enhanced contextual understanding and inferencing compared with traditional natural language processing, their performance in qualitative analysis versus that of humans remains unexplored. We evaluated the effectiveness of GPT-4 versus human researchers in qualitative analysis of interviews with patients with adult-acquired buried penis (AABP). Qualitative data were obtained from semistructured interviews with 20 patients with AABP. Human analysis involved a structured 3-stage process-initial observations, line-by-line coding, and consensus discussions to refine themes. In contrast, artificial intelligence (AI) analysis with GPT-4 underwent two phases: (1) a naïve phase, where GPT-4 outputs were independently evaluated by a blinded reviewer to identify themes and subthemes and (2) a comparison phase, where AI-generated themes were compared with human-identified themes to assess agreement. We used a general qualitative description approach. The study population (N=20) comprised predominantly White (17/20, 85%), married (12/20, 60%), heterosexual (19/20, 95%) men, with a mean age of 58.8 years and BMI of 41.1 kg/m . Human qualitative analysis identified \"urinary issues\" in 95% (19/20) and GPT-4 in 75% (15/20) of interviews, with the subtheme \"spray or stream\" noted in 60% (12/20) and 35% (7/20), respectively. \"Sexual issues\" were prominent (19/20, 95% humans vs 16/20, 80% GPT-4), although humans identified a wider range of subthemes, including \"pain with sex or masturbation\" (7/20, 35%) and \"difficulty with sex or masturbation\" (4/20, 20%). Both analyses similarly highlighted \"mental health issues\" (11/20, 55%, both), although humans coded \"depression\" more frequently (10/20, 50% humans vs 4/20, 20% GPT-4). Humans frequently cited \"issues using public restrooms\" (12/20, 60%) as impacting social life, whereas GPT-4 emphasized \"struggles with romantic relationships\" (9/20, 45%). \"Hygiene issues\" were consistently recognized (14/20, 70% humans vs 13/20, 65% GPT-4). Humans uniquely identified \"contributing factors\" as a theme in all interviews. There was moderate agreement between human and GPT-4 coding (κ=0.401). Reliability assessments of GPT-4's analyses showed consistent coding for themes including \"body image struggles,\" \"chronic pain\" (10/10, 100%), and \"depression\" (9/10, 90%). Other themes like \"motivation for surgery\" and \"weight challenges\" were reliably coded (8/10, 80%), while less frequent themes were variably identified across multiple iterations. Large language models including GPT-4 can effectively identify key themes in analyzing qualitative health care data, showing moderate agreement with human analysis. While human analysis provided a richer diversity of subthemes, the consistency of AI suggests its use as a complementary tool in qualitative research. With AI rapidly advancing, future studies should iterate analyses and circumvent token limitations by segmenting data, furthering the breadth and depth of large language model-driven qualitative analyses.

IntroductionBreast cancer survivors (BCSs) experience more severe symptoms of genitourinary syndrome of menopause (GSM) than healthy postmenopausal women. As hormonal therapy with oestrogen should be avoided in BCSs, finding an effective and safe therapy to address vaginal symptoms and sexual dysfunction is urgently needed. Physical methods may be promising alternatives for the specificities of this group of women. This review aims to evaluate the efficacy and safety of physical methods (laser and radiofrequency) for treating GSM in BCSs.Methods and analysisThe PubMed, Embase, Web of Science, SciELO, LILACS, Scopus, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov databases will be searched. A search strategy was developed to retrieve clinical trials that evaluate the efficacy and safety of any physical method (laser or radiofrequency) used for GSM in BCSs. No date or language restrictions will be imposed. Two authors will independently select studies by title, abstract and full text to meet the inclusion criteria. Data will be extracted, and the risk of bias will be evaluated using the Cochrane risk-of-bias tool (RoB 2). Review Manager 5.4.1 will be used for data synthesis. The Grading of Recommendations, Assessment, Development and Evaluation will be used to assess the strength of the evidence.Ethics and disseminationThis study reviews the published data; thus, obtaining ethical approval is unnecessary. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42023387680.

Background Cancer patients incur high care costs; however, there is a paucity of literature characterizing unmet financial obligations for patients with urologic cancers. Kidney cancer patients are particularly burdened by costs associated with novel systemic treatments. This study aimed to ascertain the characteristics of GoFundMe® crowdfunding campaigns for patients with kidney cancer, in order to better understand the financial needs of this population. Methods We performed a cross‐sectional, quantitative, and qualitative analysis of all kidney cancer GoFundMe® campaigns since 2010. Fundraising metrics such as goal funds and amount raised, were extracted. Eight independent investigators collected patient, disease and campaign‐level variables from campaign stories (κ = 0.72). In addition, we performed a content analysis of campaign narratives spotlighting the primary appeal of the patient's life story. Results A total of 486 GoFundMe® kidney cancer campaigns were reviewed. The median goal funds were 10,000USD [IQR = 5000, 20,000] and the median amount raised was 1450USD [IQR = 578, 4050]. Most campaigns were for adult males (53%) and 62% of adults had children. A minority were for pediatric patients (17%). Thirty‐seven percent of adult patients were primary wage earners and 43% reported losing their job or substantially reducing hours due to illness. Twenty‐nine percent reported no insurance or insufficient coverage. Campaigns most frequently sought funds for medical bills (60%), nonmedical bills (27%), and medical travel (23%). Qualitative campaign narratives mostly emphasized patients’ hardship (46.3%) or high moral character (35.2%). Only 8% of campaigns achieved their target funds. Conclusions Despite fundraising efforts, patients with kidney cancer face persistent financial barriers, incurring both medical and nonmedical cost burdens. This may be compounded by limited or no insurance. Cancer care providers should be aware of financial constraints placed on kidney cancer patients, and consider how these may impact treatment regimens. This work spotlights online crowdfunding campaigns for patients with kidney cancer. By elucidating patient and campaign characteristics, we are able to better understand the financial needs of this population.

The objective is to evaluate a nutrition educational intervention in a work place. This is a quasi-experimental and four-month longitudinal study in 90 participants (44 women and 46 men), average age 29.3 +/- 5.4 years, from a telephone company in Asuncion, Paraguay. Anthropometry, nutritional assessment and physical activity evaluation were carried out at the beginning and at the end of the intervention. For food habits, a food frequency questionnaire and one-week food consumption registration system were applied, both validated and used previously in other studies. The level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ) which divides physical intensity in three levels (low, moderate and high). Anthropometry included weight, height and waist circumference. Nutrition education consisted in individual lifestyle counseling, a contest to lose weight, collective support actions and environmental intervention at the work place. A significant increase of intakes of fruits and vegetables (p<0.001 y p= 0.001 respectively); a 56% reduction in bread consumption (p= 0.001); significantly (p<0.001) improvement of nutritional status, and waist circumference reduction (p<0.001) were observed al the end of the study. High and moderate physical activity improved from 43.4% to 59%. This integral nutrition intervention at the work place with a weight loss contest improved the nutritional status and had a positive impact in the workers life styles.

Mobile health (mHealth) apps may provide an efficient way for patients with lower urinary tract symptoms (LUTS) to log and communicate symptoms and medication side effects with their clinicians. The aim of this study was to explore the perceptions of older men with LUTS after using an mHealth app to track their symptoms and tamsulosin side effects. Structured phone interviews were conducted after a 2-week study piloting the daily use of a mobile app to track the severity of patient-selected LUTS and tamsulosin side effects. Quantitative and qualitative data were considered. All 19 (100%) pilot study participants completed the poststudy interviews. Most of the men (n=13, 68%) reported that the daily questionnaires were the right length, with 32% (n=6) reporting that the questionnaires were too short. Men with more severe symptoms were less likely to report changes in perception of health or changes in self-management; 47% (n=9) of the men reported improved awareness of symptoms and 5% (n=1) adjusted fluid intake based on the questionnaire. All of the men were willing to share app data with their clinicians. Thematic analysis of qualitative data yielded eight themes: (1) orientation (setting up app, format, symptom selection, and side-effect selection), (2) triggers (routine or habit and symptom timing), (3) daily questionnaire (reporting symptoms, reporting side effects, and tailoring), (4) technology literacy, (5) perceptions (awareness, causation or relevance, data quality, convenience, usefulness, and other apps), (6) self-management, (7) clinician engagement (communication and efficiency), and (8) improvement (reference materials, flexibility, language, management recommendations, and optimize clinician engagement). We assessed the perceptions of men using an mHealth app to monitor and improve management of LUTS and medication side effects. LUTS management may be further optimized by tailoring the mobile app experience to meet patients' individual needs, such as tracking a greater number of symptoms and integrating the app with clinicians' visits. mHealth apps are likely a scalable modality to monitor symptoms and improve care of older men with LUTS. Further study is required to determine the best ways to tailor the mobile app and to communicate data to clinicians or incorporate data into the electronical medical record meaningfully.

Political and institutional attitudes towards undocumented immigrants in the US have been both hostile and ambiguous throughout the history of immigration. Despite the criminalization of immigration, the lack of opportunities for legalization as well as the institutional and structural barriers that impact everyday living, undocumented immigrants are nevertheless actively finding ways to incorporate themselves into the community. This thesis explores issues such as ambiguous national identity, socioeconomic struggles, the importance of inclusion, and the coping mechanisms of four undocumented immigrants through recorded interviews that will be made into an episodic podcast series. The purpose of this thesis and project is to provide undocumented immigrants with a platform for their stories that will hopefully foster relationships with people outside of the community who are unaware of the array of challenges their undocumented neighbors face. Awareness can then prompt a variety of different actors to take action and support the undocumented community both on an interpersonal and institutional level. The theoretical implication is that undocumented narratives circulated in the host society shape the integration of undocumented people. Therefore, allies and researchers should not ignore these narratives that seek to uplift the undocumented experience.Undocumented identity is varied because of undocumented people's diverse lived experiences and different statuses. Many undocumented people are critical of the undocumented narratives that society produces. Undocumented people use their skills and knowledge to resist barriers they encounter to define themselves within the community. The study expands the perception of what it means to be an undocumented person.

IntroductionIt is estimated that 1.8 million pregnant women worldwide are infected with syphilis and less than 10% are diagnosed and treated. In Brazil, about 30 thousand cases/year with progressive growth are related to social inequalities and lost opportunities of diagnosis and prevention. Considering the importance of a faster detection of this disease, an analysis is necessary because such data could contribute to the development of new syphilis control strategies in this population.MethodsThis retrospective case-control study included 170 women (34 cases and 136 controls), where the presence of VDRL and TPHA have defined as a case. The study was based on analyses of medical records of women admitted to the Women’s Hospital Prof.Dr.José Aristodemo Pinotti/Unicamp-São Paulo-Brazil, matched by age over a period of 24 months. Statistical analysis was performed using chi-square and Fisher’s exact tests. For the quantitative variables, descriptive measures were obtained and to verify a significant difference between the mean values, a Mann-Whitney test was used.ResultsThe prevalence was 1.04% and the mean age was 27.5a. 58.8% of women cases were white, 52.9% with a fundamental education and were in the 3.24 gestation (or 6.77). 70.6% of the controls were white with 45.6% average education and were at 2.27 gestation. In women with syphilis, the average number of sexual partners was 7, the beginning of the sexual activity was 15.3a, 29.5% were drug users (or 0.0001), and 35.3% had a history of STDs. Controls had an average of 2.6 sexual partners, sex at 17.1a, 11.1% used drugs and 7.4% had a history of STDs. The cases had 6.2 consultations (p=0.0664). Half of the partners were not treated. There was 1 neonatal death. Of the 34 women diagnosed with syphilis, only 5 achieved follow-up and cure.ConclusionA high prevalence of syphilis was identified, which was associated with white, young and multiparous women. Socio-demographic vulnerability and difficulty in diagnosis seem to influence the disease, it is noteworthy that only 1 in 7 women obtained a cure.

Extrachromosomal rDNA circles (ERCs) and recombinant origin-containing plasmids (ARS-plasmids) are thought to reduce replicative life span in the budding yeast Saccharomyces cerevisiae due to their accumulation in yeast cells by an asymmetric inheritance process known as mother cell bias. Most commonly used laboratory yeast strains contain the naturally occurring, high copy number 2-micron circle plasmid. 2-micron plasmids are known to exhibit stable mitotic inheritance, unlike ARS-plasmids and ERCs, but the fidelity of inheritance during replicative aging and cell senescence has not been studied. This raises the question: do 2-micron circles reduce replicative life span? To address this question we have used a convenient method to cure laboratory yeast strains of the 2-micron plasmid. We find no difference in the replicative life spans of otherwise isogenic cir + and cir 0 strains, with and without the 2-micron plasmid. Consistent with this, we find that 2-micron circles do not accumulate in old yeast cells. These findings indicate that naturally occurring levels of 2-micron plasmids do not adversely affect life span, and that accumulation due to asymmetric inheritance is required for reduction of replicative life span by DNA episomes.

Iontophoresis is the movement of charged molecules in solution under applied current using pulled multibarrel glass capillaries drawn to a sharp tip. The technique is commonly used in neuroscience as a localized drug delivery tool to target select brain regions. A major limitation of the technique is its non-quantitative nature and inherent variability between probes. In this dissertation, iontophoretic delivery has been coupled to fast-scan cyclic voltammetry for real-time monitoring of ejections. The ejection of charged and neutral species has been characterized with carbon-fiber microelectrodes coupled to iontophoresis barrels to reveal the mechanisms underlying drug delivery: iontophoretic and electroosmotic forces. With the use of the neutral, electroactive molecule 2-(4-nitrophenoxy) ethanol (NPE), which is only transported by electroosmotic flow (EOF), electroosmosis (EO) was identified as the major contributor to observed variability from probe to probe. In addition, differences in mobility for charged compounds were positively correlated to differences in electrophoretic mobility as determined by capillary electrophoresis (CE). Thus, CE can be used to predict the rate of transport for compounds that cannot be electrochemically monitored. With this information, quantitative iontophoresis is possible for electrochemically inactive drugs by using a marker molecule. This approach was validated in vivo in a well-understood biological system. Carbon-fiber/iontophoresis probes were used to measure and modulate electrically evoked dopamine release in the striatum of anesthetized rats. Dopamine release in this brain region is highly regulated by autoreceptors and the dopamine transporter. Iontophoretic ejections of an autoreceptor antagonist and a dopamine transporter inhibitor demonstrate that this technique can be used to locally modulate presynaptic release. Additionally, the experiments demonstrate that use of an internal marker molecule do not interfere with the biological results. The final chapters of this dissertation focus on the use of quantitative iontophoresis in novel applications, such as presynaptic regulation of norepinephrine and dopaminergic signaling in awake animals performing behaviors related to drug addiction.

The objective is to evaluate a nutrition educational intervention in a work place. This is a quasi-experimental and four- month longitudinal study in 90 participants (44 women and 46 men), average age 29.3 ± 5.4 years, from a telephone company in Asunción, Paraguay. Anthropometry, nutritional assessment and physical activity evaluation were carried out at the beginning and at the end of the intervention. For food habits, a food frequency questionnaire and one-week food consumption registration system were applied, both validated and used previously in other studies. The level of physical activity was measured using the International Physical Activity Questionnaire (IPAQ) which divides physical intensity in three levels (low, moderate and high). Anthropometry included weight, height and waist circumference. Nutrition education consisted in individual lifestyle counseling, a contest to lose weight, collective support actions and environmental intervention at the work place. A significant increase of intakes of fruits and vegetables (p<0.001 y p= 0.001 respectively); a 56% reduction in bread consumption (p= 0.001); significantly (p<0.001) improvement of nutritional status, and waist circumference reduction (p<0.001) were observed al the end of the study. High and moderate physical activity improved from 43.4% to 59%. This integral nutrition intervention at the work place with a weight loss contest improved the nutritional status and had a positive impact in the workers life styles.