bluuebunny/crossref_metadata_2025 huggingface dataset:
Synthesis Characterization and Adsorption of doxorubicin hydrochloride on SiO2 nanoparticle for drug delivery
Authors: Hammadi Asmaa H. , Aysa Noor Hadi , Gassim Fattima Al-Zahra Gabar
Published: August 2024

في هذه الدراسة، تم استخدام رباعي إيثيل أورثوسيليكات (TEOS) والبولي إيثيلين جلايكول 5٪ وحمض الهيدروكلوريك 0.001 نورمالي لإنشاء جسيمات السيليكا النانوية كيميائيا (SiO2 NPs). تم تصنيع جسيمات السيليكا النانوية المحملة بدوكسوروبيسين (DOX) (DOX / SiO2) ، والتي يتم تطبيقها بشكل شائع كجزء من أنظمة توصيل الأدوية في علاج السرطان ، باستخدام طريقة سول جل. تمت دراسة التشكل والمحتوى السطحي للجسيمات النانوية المحملة ب DOX / السيليكا المنتجة باستخدام تقنيات مختلفة بما في ذلك حيود الأشعة السينية (XRD) ، والمجهر الإلكتروني الماسح (SEM) ، وطيف التحليل الطيفي بالأشعة تحت الحمراء (FTIR). يبلغ قطر DOX / SiO2 المركب 38 نانومتر. يتبع الامتزاز متساوي الحرارة متساوي الحرارة Freundlich وحركية الامتزاز المناسبة للترتيب الثاني الزائف. كانت قيم R2 لنماذج Freundlich و Langmuir 0.9931 و 0.9731 ، على التوالي ، مما يدل على أن متساوي الحرارة Freundlich يميل إلى أن يكون أكثر ملاءمة مع البيانات التجريبية مقارنة بنموذج Langmuir. تهدف هذه الدراسة إلى استخدام تقنية النانو في توصيل الدواء، وبالتالي التغلب على عيوب DDS الشائعة.
Enhancing Student Performance Evaluation Through Optimized Fuzzy Rule Techniques
Authors: Hussein Mohammed Khaleel , Ali Ali Abdullah , Subhi Mohammed Ahmed , Mohammed Saleh Mahdi
Published: August 2024

رصد الأداء في منصات التعلم الإلكتروني هو عملية حرجة تساعد المعلمين في تقييم وتعزيز نتائج تعلم الطلاب. ومع ذلك، فإنها تأتي مع عدة تحديات يجب معالجتها. تشمل هذه التحديات ضمان خصوصية وأمان البيانات، والحفاظ على جودة البيانات وتوفرها، وتوسيع رصد الأداء لعدد كبير من المتعلمين، ومعالجة تشتت البيانات، وضمان التفسيرية والإفصاح، والنظر في العوامل السياقية، ومعالجة الاعتبارات الأخلاقية، وإنشاء البنية التحتية التكنولوجية القوية. لمواجهة هذه التحديات، يمكن استخدام طرق وتقنيات مختلفة. تشمل هذه تنفيذ إجراءات قوية لحماية خصوصية البيانات، واستخدام تقنيات التحقق وتنظيف البيانات، واستخدام إطارات معالجة وتخزين البيانات الموسعة، واستخدام أساليب التحليل المتقدمة للتعامل مع أنواع متنوعة من البيانات، واستخدام نماذج التعلم الآلي المفسرة وتقنيات غير معتمدة على النموذج للتفسير، ودمج العوامل السياقية في نماذج رصد الأداء، والالتزام بالإرشادات الأخلاقية وإجراء استعراضات أخلاقية منتظمة، والاستثمار في البنية التحتية التكنولوجية القوية. علاوة على ذلك، يمكن استخدام القواعد الضبابية للتحكم في المتعلمين في منصة التعلم الإلكتروني. توفر القواعد الضبابية نهجاً مرنًا ومتكيفًا لإدارة وتوجيه تفاعلات وسلوكيات المتعلمين داخل المنصة. يقوم هذا البحث بدراسة الطرق والأدوار لتحسين تجارب التعلم من خلال تعزيز وسائل رصد المتعلم.
Synthesis, Antibacterial, Molecular Docking, and ADEMT Studies of New Mannich Bases of Curcumin
Authors: G. Sager Athra , Kadhim Abaies Jawad , Ferman Abbood Ammar
Published: August 2024

يعد استخدام المنتجات الطبيعية في تطوير الأدوية موضوعًا مثيرًا للاهتمام في مجال العلوم الطبية البشرية. في العمل الحالي، تم تحضير أربعة من مشتقات الكركمين (M4-M1 ) عن طريق تفاعل مانخ وشخصت  بواسطة مطيافية الاشعة تحت الحمراء  FT-IR و   الرنين النووي المغناطيسي NMR.  أظهرت البيانات التي تم الحصول عليها من الدراسة المختبرية للمركبات (M4-M1 ) نشاطا مقنعا ضد سلالات البكتيريا (السالمونيلا، المكورات العنقودية الذهبية، المتقلبة، والكلبسيلا) بالتوازي مع الأموكسيسيلين كدواء قياسي.   اضهرت المركبات  M2 و M4 نشاطا مضادا للبكتريا عاليا. تم دراسة النشاط المثبط لانزيم( DNA gyrase) المحتمل لهذه المركبات (M1-  M4)  بواسطة  الكمبيوتر  باستخدام طريقة محاكاة الالتحام الجزيئي. تم استخدام برنامج  PyMOL)) لحساب ألفة الارتباط kcal/mol) ) للمركبات المحضرة مع البروتين .(1KZN)  وكانت أعلى قيم الارتباط (كيلو كالوري/مول) مع البروتين وجد أنها (8.2-) مع المركب  M4 و (8.1-) مع  المركب  M2، في حين أن أقل القيم وجدت (7.1-) مع المركب M1. علاوة على ذلك، أظهرت النتائج ارتباط  الأحماض الأمينية مع  المركبات المحضرة من خلال الروابط الهيدروجينية والتفاعلات الكارهة للماء(أرين-آرين). كما تم تسجيل  الكثافات الإلكترونية للمركبات المحضرة من خلال التعرف على الخصائص المميزة للاحماض الامينية التي تحيط بهذه المركبات . تم إجراء دراسة السلوك الشبيه بالادوية ودراسة تنبؤات ADMET بما في ذلك الامتصاص والتوزيع والتمثيل الغذائي والإفراز وسمية المركبات المرغوبة. كشفت النتائج التي تم الحصول عليها أن غالبية المعلمات الدوائية كانت جيدة وضمن المعدل الطبيعي.
Recyclable Fiber Reinforced Thermoplastic Sucker Rods for Improving Rod Pumping
Authors: Saponja J. , David S. , Pipchuk D. , Hari R. , Gothrup J. , Bentsen J. , Smith C. , Kubacak T.
Published: August 2024

Sucker rods are an essential system component for artificial lift rod pumping or rod lifting of oil and gas wells, but they have been limited by use of metals and thermoset based non-metal composites (i.e., existing fiberglass sucker rods).

Steel (metal) sucker rods have been limited, relatively, by a low corrosion resistance, a low strength to weight ratio (i.e., too heavy), a low fatigue endurance limit, and a low lifecyclei environmental, social and governance (ESG) rating.

Composite thermoset glass fiber (fiberglass) sucker rods surround the fibers with a brittle epoxy resin matrix. They have offered a high strength to weight ratio and greater corrosion resistance but have been limited by a relatively low tensile modulus of elasticity (i.e., too stretchy relative to steel), a high cost (i.e., higher cost relative to steel), and a low mechanical toughness (i.e., low tolerance to compressional loads, high impact forces/loads and torsional shear forces). Metal end fittings have also been a costly challenge for thermoset composite rods. Composite thermoset sucker rods using carbon fibers have proposed a tensile modulus of elasticity comparable to steel but have been limited primarily by a very high relative cost to steel sucker rods and a relatively low mechanical toughness. Thermoset composites have shown to possess an operationally risky failure mode, as the material fails in a brittle manner with extensive fiber splintering commonly referred to as "broom sticking".
If It's not Broken, Should You Fix It? A Case Study on the Replacement of a Functional Gas Lift Valve in a Deepwater Well
Authors: Perovano T. G. , Quintino A. W. , Renato B. S. , Bastos S. X.
Published: August 2024

This study presents a case where a decision was made to replace a seemingly functional Gas Lift valve. Despite its apparent functionality after 15 years of operation, the valve exhibited signs of degradation, potentially compromising the well's production stability. The study was conducted through multiphase flow simulations, risk analyzes and investigations of historical events. The occurrence of a complete valve blockage, which was successfully resolved by implementing a pressure oscillation procedure, led to a revision of the risk analysis. As a result, the team recommended proceeding with the intervention, which was subsequently approved by management. Post valve replacement, an increase in injected flow was observed, even at lower injection pressures. This resulted in stable production and generated an initial additional revenue exceeding $1.75 million per month. This event exemplifies the advantages of proactive offshore interventions in deep waters to replace Gas Lift valves, even before equipment failure. Despite the high costs associated with such interventions, they can yield significant short-term gains.
Coated Continuous Sucker Rod Reduces Fatigue Failures in Progressing Cavity Pumping Applications
Authors: Dunn L. , Rowan R. , Shanmugam K. , Clarke D. , Orban T. , Giesbrecht C. , Jen N. , Benavides L.
Published: August 2024

Continuous sucker rod is used in progressing cavity (PC) pump applications to minimize the tubing wear and connections failures that can occur with conventional jointed sucker rods. While PC pumps are often assumed to have relatively steady state loading conditions, rod string rotation combined with local curvature results in high frequency low magnitude cyclic bending stresses. Variations in produced fluids and certain modes of pump friction also give rise to lower frequency moderate to higher magnitude cyclic torsional and axial loads. These cyclic stresses, particularly when combined with corrosive downhole environments, can result in rod fatigue failures at loads well below their specified load ratings often with short runtimes. Alloyed rod materials can slow the impact of corrosion but usually the failures persist. Corrosion inhibitors can reduce downhole equipment corrosion but their effectiveness on continuous rod can be diminished due to the rotational contact impairing the build-up of a protective layer on the rod surface. Rod coatings can provide barrier protection to the underlying bare rod material from production fluid exposure eliminating corrosion and its impact on accelerating fatigue failures. Certain coatings can also protect the rod body against mechanical damage that contributes to fatigue as well as reduce rod and tubing wear and its associated contact friction.

Summarized in this paper is ten plus years of experience with a first-generation coated continuous rod product that employs a thick durable polyethylene coating. Deployment of several thousand rod strings in an area with highly directional heavy oil wells reduced rod fatigue failures from multiple breaks a year to multi-year runtimes. Broader application deployment also demonstrated reductions in fatigue failures but identified well depth and produced fluid limitations that significantly limited the products application range leading to a second-generation development.

This paper provides an overview of the second-generation coated rod development including design requirements, materials development and laboratory testing, product prototyping and validation, new coated rod manufacturing processes and service equipment testing. In support of this development were evaluations using custom rotary tribology equipment and multiaxial fatigue equipment select findings of which are included. Lastly it details field testing and initial commercial deployment that confirms benefits like those with the first-generation design but over an expanded application range.
Review of Causes and Remedial Actions of Gas-Induced ESP Downtime in Unconventional Wells
Authors: Camilleri L
Published: August 2024

In unconventional wells, free gas and slugging have a large negative impact on ESP production and run-lives. With depletion, GOR increases and both rates and pressures decrease, which causes an increase in gas void fraction, slugging, and repeated zero flow events. Utilizing real-time data sets, the causes of gas-induced instability are cataloged along with the recommended remedial actions for both operations and future ESP design improvements to provide field engineers with a rapid response methodology.

Well and ESP transient rates were initially modeled by Vieira and Prado (2013), who resolved partial differential equations for the entire well. Subsequently, Camilleri (2020) considered the ESP power equilibrium equation to directly measure the amplitude of ESP rate fluctuations. With the understanding of the physics provided by both authors, field data sets were reviewed to classify both causes and remedial actions into three groups: Horizontal drain slugging upstream of the ESP.Severe head degradation caused by changes in pump operating point.Insufficient lift, which is also commonly known as "gas locking".

To explain the underlying physics, data sets were identified where only one cause is present at any one time, however, in most cases, several causes coexist, which can be difficult to diagnose. To address this challenge, a multiple-parameter dashboard was used to visualize contextual data alongside directly measured data. For instance, in addition to plotting production rates and ESP gauge data versus time, key ESP-specific ratios were considered, such as pump operating point relative to the best efficiency point. It was also necessary to provide the ability to zoom in and out on the time axis as each cause can occur sequentially in time. Such visualization enables rapid diagnosis and examples of these hybrid cases were also discussed. One of the key findings is that irrespective of the cause, the best-suited pumps are those with a steeply rising head-flow curve as they dampen the impact of slugging and reduce the number of no-flow events, thereby increasing ESP run life. Finally, by integrating inflow analysis (reservoir pressure and productivity index), it was also possible to determine when and how to plan the next workover to switch to a lower flow rate ESP design, which improves drawdown and ESP gas handling.

Data signatures supported by field data sets have been identified, which enable rapid diagnostics and remedial action for field engineers managing unconventional wells in undersaturated conditions without the need for extensive modeling, although there is no escaping RTA (rate transient analysis) when planning workovers. While this has demonstrated the importance of real-time discharge pressure, the next challenge for the industry is to find a workaround where the completion precludes discharge pressure measurement. The ultimate question for the industry is whether it will be possible for artificial intelligence to automate the diagnostics and remedial action of such complex phenomena.
Apokatastasis in Russian philosophical and theological thought
Authors:   Russian Christian Humanitarian Academy named after F. M. Dostoevsky, Svyatchenko Priest Nikolay ,   St. Petersburg Theological Academy,   Herzen State Pedagogical University of Russia
Published: August 2024

The doctrine of apocatastasis in the era of early Christianity was debatable, in the era of the Ecumenical Councils, the discussion ended with the decisions of the Fifth Ecumenical Council. In modern times, a religious and ideological need arose for a new understanding of Christian doctrine. The revival of the theory of apocatastasis has theological, philosophical and psychological prerequisites that arose at the turn of the 19th and 20th centuries. This article describes the understanding of the idea of apocatastasis in the Russian philosophical and theological thought of the twentieth century, analyzes the elements of the doctrine of apocatastasis in the works of V. V. Rozanov, N. A. Berdyaev, V. V. Zenkovsky, N. O. Lossky, A. E. Zhurakovsky, P. Florensky, P. N. Evdokimov, archpriest S. Bulgakov, L. A. Zander et al. According to the research, Orthodox philosophers of the twentieth century prepared important prerequisites for rethinking the idea of apocatastasis, but none of the thinkers gave a complete doctrine of universal salvation — neither the time nor the style of thought of Orthodox theology of that period contributed to this. The author has identified the most important prerequisites and components of building a theoretical basis for the hope of universal salvation in the Orthodox context, which provides the necessary material for finalizing the idea of apocatastasis in modern theology. The article introduces numerous Russian authors, classical writers and theologians, the vision of theologians of European thought and Christian saints.
Basic concepts of missionary service in the perception of the modern priesthood of the Russian Orthodox Church in the Asian regions of Russia
Authors:   Banzarov Buryat State University, Alekseeva Maria S.
Published: August 2024

The status of the missionary activity of the modern Russian Orthodox Church, its condition is characterized by ambiguous assessments even within the Orthodox priesthood itself. The identification of mission and social service, the denial of the effectiveness and even the very existence of an Orthodox mission, diametrically opposed assessments regarding the planning and control of the mission — all these discrepancies affect the strategies of modern missionary activity. The purpose of the study is to analyze the understanding of the basic concepts of missionary activity, tasks and principles of mission realization by the modern priesthood in the Asian regions of Russia. The geographical focus of the study, the regions of Inner Asia, predetermined the priority choice of such regions as: Altai, Irkutsk region, Buryatia, Tyva, Khakassia; outside Russia — Mongolia. The main method of forming an empirical base was an expert survey in the form of a series of semi-standardized interviews with Orthodox priests of Asian regions. of Russia. The experts also included participants of missionary expeditions and teachers of missiology from non-Asian dioceses. As a result of the expert survey, the understanding of the status of missionary activity in modern society, the relationship between mission and social service became clearer, and the attention of the priesthood to the distinction between mission and catechism was reflected. The priority of the internal mission has been highlighted. The principles of missionary service are considered.
Comparison of Two Clinical Approaches FDI Vs Cars Visual Criteria for Secondary Caries Evaluation in Permanent Posterior Teeth
Authors: Aqsa Waheed  , Khokhar Sheharyar Akhtar , Minhal  , Sheejia Asif
Published: August 2024

Background: Secondary caries arise at the contact of a natural tooth and a prosthetic repair. The present investigation employed two clinical methodologies, namely Caries associated with restoration or sealants (CARS) and the International Dental Federation (FDI), to evaluate and manage secondary caries in permanent posterior teeth.
Objective: The goal of this research  is to compare the diagnostic efficacy of FDI and CARS visual criteria for assessing secondary caries in permanent posterior teeth, to identify the more reliable and effective clinical approach for improved treatment planning and patient outcomes.
Method: This was conducted at the School of Dentistry Pakistan institute of medical sciences Islamabad, after approval from the ethical committee. The sample size is 160 patients. In this study, two clinical criteria being assessed included one representing the FDI system which includes the marginal staining, marginal adaptation, and caries’ recurrence, while another one was Caries associated with restoration or sealants (CARS) based on ICCMS (International Caries Classification and Management System) for evaluation and treatment of secondary caries.
Results: A total 650 restorations were assessed,  with a mean age of 30.83 years (SD±2.68). While comparing, there was a strong correlation to the presence of caries lesions (Rho=0.64), and for Marginal adaptation, it was (Rho= -0.45), which depicts a weak inverse correlation. There was a moderate correlation between the two criteria (Rho=0.64,) The majority of CARS visual criteria decisions recommended no treatment in comparison to FDI criteria
Conclusion: It is concluded that the FDI system is a more aggressive approach, suggesting a higher number of restoration replacements than the CARS which is less invasive. As a result, the method used to assess secondary caries may result in more or less invasive suggestions for treatment.
Modelling an urban wastewater system via a space–time multivariate calibration to understand and improve water bodies quality
Authors: Mendes Fernanda Cavalcanti Albuquerque , Maruéjouls Thibaud , Pierre Frédéric , Valentin Claude
Published: August 2024

The European Water Framework Directive requires good quality status for water bodies remaining solely attainable through a global approach. Urban wastewater integrated modelling is a promising tool for this purpose. However, certain barriers still hinder its application, such as the significant amount of data required and specifically in the sewer system, the issues with data quality or the monitoring and maintenance costs. This study develops an integrated model for Dijon Metropole in France using multiple hydraulic and quality data sources (e.g. sensors, analysers, laboratory measurements) and calibration criteria. The results show that long-term trends can be predicted for hydraulic and quality variables. The scenarios demonstrate that combined sewer overflows are responsible for most of the anoxic and ammonium high concentration periods in the rivers during rain events compared to the Water Resources Recovery Facility (WRRF). Therefore, adding storm tanks in the wastewater system will reduce stress on aquatic organisms during rainfall events. Reducing WRRF discharge during wet weather can also reduce the average and percentile of ammonium in the river. These results indicate that strategies should be adapted depending on the water quality objective (biological and/or physico-chemical) and the sensitivity of the organisms present in the river.
FOOTBALL: DO FLEXIBILITY, AGILITY, AND BALANCE CORRELATE TO DRIBBLING ABILITY?
Authors: Paryadi Paryadi , Jupri Jupri , Huda Much Samsul , Yudhistira Dewangga , Sulistiyono Sulistiyono , Virama Laode Adhi
Published: August 2024

This study aims to 1) determine the relationship of flexibility to dribbling ability. 2) Know the relationship of agility to dribbling ability. 3) Knowing the relationship of balance to dribbling ability. 4) Know the relationship of flexibility, agility, and balance to dribbling ability. The research method is a quantitative descriptive correlational approach, The Participants are male sports students totaling 109 taken through purposive sampling, observation, and test data collection techniques, data analysis is correlation and multiple regression assisted by the SPSS 23 application. As a result, the significance value of dependent and independent variables is 0.000 – 0.0010.05. In conclusion, 1) There is a relationship between flexibility to dribbling ability. 2) There is a relationship between agility and dribbling ability. 3) There is a balanced relationship with dribbling ability. 4) There is a simultaneous relationship between flexibility, agility, and balance to dribbling ability. This finding is expected as knowledge of sports students who study related to football courses, as well as material to strengthen previous research with a more comprehensive study. Further research is expected to use a sample of women and use different research methods.
KINEMATIC COMPARISON BETWEEN NATIONAL AND AMATEUR TAEKWONDO ATHLETES IN THE AP HURIGI (AXE KICK
Authors: Hidayat Iwa Ikhwan , Rusdiana Agus , Haryono Tono , Kurniawan Tian , Imanudin Iman , Umaran Unun , Syahid Angga M , Salman Salman
Published: August 2024

Taekwondo is a Korean martial art characterized by rapid kicks. In the combat category, technical ability is the key to success in gaining points. The aphurigi technique (axe kick) is one of the important techniques in taekwondo because the technique gives a point contribution of around 20% in the match. Thus, it is necessary to investigate kinematic analysis to determine the kinematic parameters that contribute to the success of the aphurigi (axe kick) kick technique. 24 athletes were involved in this research, divided into 2 groups, namely the national level group and the regional group. All samples performed aphurigi kicks, then recorded using a camera and analyzed using skill spector software in 2 dimensions. There are 6 parameters analyzed consisting of kick speed, hip position, angular speed, and kick range. From the measurements that have been carried out, the results show that national-level athletes have significant differences compared to regional athletes in kick speed in the upswing phase, p-0.003, hip position, p-0.045, and knee angle in the upswing phase, p-0.026. However, there were no significant differences in other parameters, including kick speed in the upswing phase, kick range, and knee angle in the upswing phase. The results show the importance of a specific training program to train kinematic parameters that can influence aphurigi kick performance, therefore amateur athletes can master effective kick techniques and compete at the national level.
Impact of Telemedicine Versus In-Person Pediatric Outpatient Type 1 Diabetes Visits on Immediate Glycemic Control: Retrospective Chart Review
Authors: Ferber Christopher , Mittelman Steven D , Moin Tannaz , Wilhalme Holly , Hicks Rebecca
Published: August 2024

Background

Children and adolescents with type 1 diabetes require frequent outpatient evaluation to assess glucose trends, modify insulin doses, and screen for comorbidities. Continuous glucose monitoring (CGM) provides a detailed glycemic control assessment. Telemedicine has been increasingly used since the COVID-19 pandemic.

Objective

To investigate CGM profile parameter improvement immediately following pediatric outpatient diabetes visits and determine if visit modality impacted these metrics, completion of screening laboratory tests, or diabetic emergency occurrence.

Methods

A dual-center retrospective review of medical records assessed the CGM metrics time in range and glucose management indicator for pediatric outpatient diabetes visits during 2021. Baseline values were compared with those at 2 and 4 weeks post visit. Rates of completion of screening laboratory tests and diabetic emergencies following visits were determined.

Results

A total of 269 outpatient visits (41.2% telemedicine) were included. Mean time in range increased by 1.63% and 1.35% at 2 and 4 weeks post visit (P=.003 and .01, respectively). Mean glucose management indicator decreased by 0.07% and 0.06% at 2 and 4 weeks post visit (P=.003 and .02, respectively). These improvements in time in range and glucose management indicator were seen across both telemedicine visits and in-person visits without a significant difference. However, patients seen in person were 2.69 times more likely to complete screening laboratory tests (P=.03). Diabetic emergencies occurred too infrequently to analyze.

Conclusions

Our findings demonstrate an immediate improvement in CGM metrics following outpatient visits, regardless of modality. While statistically significant, the magnitude of these changes was small; hence, multiple visits over time would be required to achieve clinically relevant improvement. However, completion of screening laboratory tests was found to be more likely after visits occurring in person. Therefore, we suggest a hybrid approach that allows patient convenience with telemedicine but also incorporates periodic in-person assessment.
The Dual Task Ball Balancing Test and Its Association With Cognitive Function: Algorithm Development and Validation (Preprint)
Authors: Greene Barry , Tobyne Sean , Jannati Ali , McManus Killian , Gomes Osman Joyce , Banks Russell , Kher Ranjit , Showalter John , Bates David , Pascual-Leone Alvaro
Published: August 2024

BACKGROUND

Dual task paradigms are thought to offer a quantitative means to assess cognitive reserve and the brain’s capacity to allocate resources in the face of competing cognitive demands. The most common dual task paradigms examine the interplay between gait or balance control and cognitive function. However, gait and balance tasks can be physically challenging for older adults and may pose a risk of falls.

OBJECTIVE

We introduce a novel, digital dual-task assessment that combines a motor-control task (the “ball balancing” test), which challenges an individual to maintain a virtual ball within a designated zone, with a concurrent cognitive task (the backward digit span task [BDST]).

METHODS

The task was administered on a touchscreen tablet, performance was measured using the inertial sensors embedded in the tablet, conducted under both single- and dual-task conditions. The clinical use of the task was evaluated on a sample of 375 older adult participants (n=210 female; aged 73.0, SD 6.5 years).

RESULTS

All older adults, including those with mild cognitive impairment (MCI) and Alzheimer disease–related dementia (ADRD), and those with poor balance and gait problems due to diabetes, osteoarthritis, peripheral neuropathy, and other causes, were able to complete the task comfortably and safely while seated. As expected, task performance significantly decreased under dual task conditions compared to single task conditions. We show that performance was significantly associated with cognitive impairment; significant differences were found among healthy participants, those with MCI, and those with ADRD. Task results were significantly associated with functional impairment, independent of diagnosis, degree of cognitive impairment (as indicated by the Mini Mental State Examination [MMSE] score), and age. Finally, we found that cognitive status could be classified with >70% accuracy using a range of classifier models trained on 3 different cognitive function outcome variables (consensus clinical judgment, Rey Auditory Verbal Learning Test [RAVLT], and MMSE).

CONCLUSIONS

Our results suggest that the dual task ball balancing test could be used as a digital cognitive assessment of cognitive reserve. The portability, simplicity, and intuitiveness of the task suggest that it may be suitable for unsupervised home assessment of cognitive function.
Characteristics of Existing Online Patient Navigation Interventions: Scoping Review (Preprint)
Authors: Marsh Meghan , Shah Syeda Rafia , Munce Sarah E P , Perrier Laure , Lee Tin-Suet Joan , Colella Tracey J F , Kokorelias Kristina Marie
Published: August 2024

BACKGROUND

Patient navigation interventions (PNIs) can provide personalized support and promote appropriate coordination or continuation of health and social care services. Online PNIs have demonstrated excellent potential for improving patient knowledge, transition readiness, self-efficacy, and use of services. However, the characteristics (ie, intervention type, mode of delivery, duration, frequency, outcomes and outcome measures, underlying theories or mechanisms of change of the intervention, and impact) of existing online PNIs to support the health and social needs of individuals with illness remain unclear.

OBJECTIVE

This scoping review of the existing literature aims to identify the characteristics of existing online PNIs reported in the literature.

METHODS

A scoping review based on the guidelines outlined in the Joanna Briggs Institute framework was conducted. A search for peer-reviewed literature published between 1989 and 2022 on online PNIs was conducted using MEDLINE, CINAHL, Embase, PsycInfo, and Cochrane Library databases. Two independent reviewers conducted 2 levels of screening. Data abstraction was conducted to outline key study characteristics (eg, study design, population, and intervention characteristics). The data were analyzed using descriptive statistics and qualitative content analysis.

RESULTS

A total of 100 studies met the inclusion criteria. Our findings indicate that a variety of study designs are used to describe and evaluate online PNIs, with literature being published between 2003 and 2022 in Western countries. Of these studies, 39 (39%) studies were randomized controlled trials. In addition, we noticed an increase in reported online PNIs since 2019. The majority of studies involved White females with a diagnosis of cancer and a lack of participants aged 70 years or older was observed. Most online PNIs provide support through navigation, self-management and lifestyle changes, counseling, coaching, education, or a combination of support. Variation was noted in terms of mode of delivery, duration, and frequency. Only a small number of studies described theoretical frameworks or change mechanisms to guide intervention.

CONCLUSIONS

To our knowledge, this is the first review to comprehensively synthesize the existing literature on online PNIs, by focusing on the characteristics of interventions and studies in this area. Inconsistency in reporting the country of publication, population characteristics, duration and frequency of interventions, and a lack of the use of underlying theories and working mechanisms to inform intervention development, provide guidance for the reporting of future online PNIs.
Newly Qualified Canadian Nurses’ Experiences With Digital Health in the Workplace: Comparative Qualitative Analysis (Preprint)
Authors: Kleib Manal , Arnaert Antonia , Nagle Lynn M , Sugars Rebecca , da Costa Daniel
Published: August 2024

BACKGROUND

Clinical practice settings have increasingly become dependent on the use of digital or eHealth technologies such as electronic health records. It is vitally important to support nurses in adapting to digitalized health care systems; however, little is known about nursing graduates’ experiences as they transition to the workplace.

OBJECTIVE

This study aims to (1) describe newly qualified nurses’ experiences with digital health in the workplace, and (2) identify strategies that could help support new graduates’ transition and practice with digital health.

METHODS

An exploratory descriptive qualitative design was used. A total of 14 nurses from Eastern and Western Canada participated in semistructured interviews and data were analyzed using inductive content analysis.

RESULTS

Three themes were identified: (1) experiences before becoming a registered nurse, (2) experiences upon joining the workplace, and (3) suggestions for bridging the gap in transition to digital health practice. Findings revealed more similarities than differences between participants with respect to gaps in digital health education, technology-related challenges, and their influence on nursing practice.

CONCLUSIONS

Digital health is the foundation of contemporary health care; therefore, comprehensive education during nursing school and throughout professional nursing practice, as well as organizational support and policy, are critical pillars. Health systems investing in digital health technologies must create supportive work environments for nurses to thrive in technologically rich environments and increase their capacity to deliver the digital health future.
Dose-Response Relationship Between Physical Activity and the Morbidity and Mortality of Cardiovascular Disease Among Individuals With Diabetes: Meta-Analysis of Prospective Cohort Studies (Preprint)
Authors: Chen Yang , Jin Xingsheng , Chen Guochong , Wang Ru , Tian Haili
Published: August 2024

BACKGROUND

Diabetes, a chronic condition affecting various organs, is frequently associated with abnormal lipid metabolism, notably increased cholesterol and triglyceride levels. These lipid abnormalities are closely linked to the development and advancement of cardiovascular disease (CVD). Although regular physical activity (PA) has consistently shown benefits in reducing CVD risk in the general population, its precise influence on CVD risk among patients with diabetes remains uncertain, particularly regarding dose-response relationships.

OBJECTIVE

This study aimed to summarize the evidence from prospective studies on the association between PA and CVD morbidity and mortality in individuals with diabetes and explore the optimal levels for public health recommendation.

METHODS

We systematically reviewed prospective cohort studies in PubMed, Embase, and Web of Science up to December 2022, with inclusion criteria specifying the studies published in English and included adult participants diagnosed with diabetes. A random effects model was used to pool the relative risk (RR) with the corresponding 95% CI comparing the highest with the lowest PA categories in each study for qualitative evaluation. In addition, linear and spline regression analyses were used to estimate dose-response associations.

RESULTS

The meta-analysis included 12 prospective cohort studies, involving a total of 109,820 participants with diabetes. The combined results revealed that higher levels of PA were associated with a reduced risk of CVD. The RR of CVD for the highest compared with the lowest PA category was 0.62 (95% CI 0.51-0.73). In addition, there were 4 studies describing leisure-time PA, and the pooled RR was 0.68 (95% CI 0.52-0.83) for the highest versus the lowest activity. The linear regression model revealed that each 10 MET (metabolic equivalent of task)-hours per week of incrementally higher PA was associated with a 19% (95% CI 11.6-25.7) and a 6.9% (95% CI 4.5-9.3) reduction in CVD morbidity and mortality. Additionally, spline regression curves showed nonlinear relationships between PA levels and the risk of CVD and CVD mortality (both Pnonlinearity<.001), with a limited reduction in CVD risk and some further reduction in CVD mortality above 20 MET-hours per week of PA levels.

CONCLUSIONS

For patients with diabetes, especially type 2 diabetes, there was a dose-response relationship between increased PA and reduced risk of CVD morbidity and mortality. The observed PA threshold is consistent with the recommended level for the general population. Gradually moving from inactivity to a guideline-recommended PA level could therefore significantly reduce the burden of CVD in patients with diabetes.

CLINICALTRIAL
Evaluating Literature Reviews Conducted by Humans Versus ChatGPT: Comparative Study (Preprint)
Authors: Mostafapour Mehrnaz , Fortier Jacqueline H , Pacheco Karen , Murray Heather , Garber Gary
Published: August 2024

BACKGROUND

With the rapid evolution of artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT-4 (OpenAI), there is an increasing interest in their potential to assist in scholarly tasks, including conducting literature reviews. However, the efficacy of AI-generated reviews compared with traditional human-led approaches remains underexplored.

OBJECTIVE

This study aims to compare the quality of literature reviews conducted by the ChatGPT-4 model with those conducted by human researchers, focusing on the relational dynamics between physicians and patients.

METHODS

We included 2 literature reviews in the study on the same topic, namely, exploring factors affecting relational dynamics between physicians and patients in medicolegal contexts. One review used GPT-4, last updated in September 2021, and the other was conducted by human researchers. The human review involved a comprehensive literature search using medical subject headings and keywords in Ovid MEDLINE, followed by a thematic analysis of the literature to synthesize information from selected articles. The AI-generated review used a new prompt engineering approach, using iterative and sequential prompts to generate results. Comparative analysis was based on qualitative measures such as accuracy, response time, consistency, breadth and depth of knowledge, contextual understanding, and transparency.

RESULTS

GPT-4 produced an extensive list of relational factors rapidly. The AI model demonstrated an impressive breadth of knowledge but exhibited limitations in in-depth and contextual understanding, occasionally producing irrelevant or incorrect information. In comparison, human researchers provided a more nuanced and contextually relevant review. The comparative analysis assessed the reviews based on criteria including accuracy, response time, consistency, breadth and depth of knowledge, contextual understanding, and transparency. While GPT-4 showed advantages in response time and breadth of knowledge, human-led reviews excelled in accuracy, depth of knowledge, and contextual understanding.

CONCLUSIONS

The study suggests that GPT-4, with structured prompt engineering, can be a valuable tool for conducting preliminary literature reviews by providing a broad overview of topics quickly. However, its limitations necessitate careful expert evaluation and refinement, making it an assistant rather than a substitute for human expertise in comprehensive literature reviews. Moreover, this research highlights the potential and limitations of using AI tools like GPT-4 in academic research, particularly in the fields of health services and medical research. It underscores the necessity of combining AI’s rapid information retrieval capabilities with human expertise for more accurate and contextually rich scholarly outputs.
Systematic evaluation of an Internet-based health economics study of remote interventions for hypertension (Preprint)
Authors: 李 娜
Published: August 2024

BACKGROUND

The purpose of this study was to conduct a systematic review of Internet-based teleinterventions for patients with hypertension and to evaluate the cost-effectiveness of Internet-based teleinterventions for the management of hypertension.

OBJECTIVE

The purpose of this study was to conduct a systematic review of Internet-based teleinterventions for patients with hypertension and to evaluate the cost-effectiveness of Internet-based teleinterventions for the management of hypertension.

METHODS

A computerized search of the literature on health economics studies of remote interventions for hypertensive patients via the Internet in national and international databases was conducted from database construction to March 2023, and a qualitative systematic evaluation was performed by 2 researchers after independently screening the literature, extracting information, and evaluating the risk of bias of included studies. The risk of bias evaluation referred to the entries in the Consensus of Health Economic Evaluation Reporting Standards 2022 (CHEERS 2022) list that addressed the risk of bias.

RESULTS

The final 14 included literature on Internet-based remote blood pressure monitoring systems, mobile applications, and e-mail blood pressure management;7 literature underwent cost-benefit analysis, 3 literature underwent cost-utility analysis, 1 literature underwent cost-effectiveness analysis, and 1 literature underwent both cost-effectiveness analysis and cost-utility analysis; 2 literature conducted both cost effectiveness and cost-utility analysis; A total of 8 studies modeled health economics. all studies used quality-adjusted life-years as the primary output outcome indicator and 88% of the studies considered the intervention cost-effective and concluded that the teleintervention increased Quality-adjusted life years（QALY）; there were also cost-effectiveness analysis studies that included systolic blood pressure and blood pressure control rates, new cardiovascular events as health output indicators.An assessment of the included literature based on CHEERS 2022 found that the quality of included studies was high.

CONCLUSIONS

The current study allows to conclude that Internet-based remote intervention for hypertensive patients may be economical and effective in controlling blood pressure levels and improving the quality of life of hypertensive patients. The number of studies on the economics of Internet-based remote interventions for hypertension is high, but the quality of some of them needs to be improved, and there is still a need for higher quality, larger samples, and more standardized health economics evaluation studies to provide evidence for policy makers in the future.

CLINICALTRIAL
Identification of Design Requirements and User Needs for a Software Application that Collects Acute Stroke Treatment Data During Clinical Workflow (Preprint)
Authors: Forward Adam , Koca Gizem , Sahli Aymane , Kamal Noreen
Published: August 2024

BACKGROUND

Clinical registries are critical for monitoring processes of care in diseases and driving quality improvements. However, many smaller hospitals do not have the required resources to gather the necessary data to contribute to registries. This study aims to design and evaluate a data collection tool for acute stroke treatment. The evaluation will identify key design requirements that facilitates prospective data collection and adds value to clinicians.

OBJECTIVE

The objective of this study was to identify the design requirements for the collection of acute ischemic stroke data during clinical workflow.

METHODS

A prototype tool was developed for testing. Clinicians were recruited through convenience sampling to observe the prototype’s use in a simulated clinical field experiment, then follow-up interviews were conducted to gain feedback. Qualitative data analysis identified design requirements that were implemented to iterate the design and finalize the design requirements.

RESULTS

Three participants were recruited from two hospitals in the simulated field experiment. The simulated scenario times took between 10-12 minutes, with 1.2 to 3.7 minutes spent using the prototype. The simple and condensed layout, features such as calculators and timers, and the final pop-up summary received the most positive feedback. Issues identified included the small target sizes leading to higher error rates, the lack of coloring in important features reducing their visibility, and the grouping of mandatory and optional information layouts led to a disjointed flow. The key design requirements include prioritizing simple dynamic layouts, sufficient target sizes to prevent errors, useful features with clear visual cues, and prompt data feedback to facilitate seamless integration.

CONCLUSIONS

A prospective data collection tool for clinicians to use during stroke treatment can add value for clinicians and, with further testing, can be integrated into workflow.
Efficacy and Safety of a Therapy Combining Sintilimab and Chemotherapy With Cryoablation in the First-Line Treatment of Advanced Nonsquamous Non–Small Cell Lung Cancer: Protocol for a Phase II, Pilot, Single-Arm, Single-Center Study (Preprint)
Authors: Gao Zhiqiang , Teng Jiajun , Qiao Rong , Qian Jialin , Pan Feng , Ma Meili , Lu Jun , Zhang Bo , Chu Tianqing , Zhong Hua
Published: August 2024

BACKGROUND

Immunotherapy has significantly advanced lung cancer treatment, particularly in nonsquamous non–small cell lung cancer (NSCLC), with overall response rates between 50% and 60%. However, about 30% of patients only achieve a stable disease state. Cryoablation has shown potential to enhance immunotherapy by modifying the tumor’s immune microenvironment through the release of antigens and immune factors. Addressing how to boost the immune response in these patients is critical.

OBJECTIVE

This study aims to investigate the efficacy and safety of immunochemotherapy in combination with cryoablation as a first-line treatment for advanced NSCLC.

METHODS

This is a phase II, pilot, open-label, single arm, single center, interventional study. Patients with stage IIIB to IIIC or IV NSCLC with T staging ranging from T1 to T2b will receive sintilimab (200 mg/m2 every 3 weeks) and chemotherapy. After 2 cycles, the feasibility of cryoablation will be considered for those with stable disease by a multidisciplinary team. Cryoablation with 3 freeze-thaw cycles will be performed for the main lesion. The third cycle of systemic therapy will begin 7 (SD 3) days after cryoablation. A total of 20 patients will be enrolled. Treatment will continue until the disease progresses, there is unacceptable toxicity, a participant withdraws consent, other discontinuation criteria are met, or the study reaches completion. The primary objective is to assess progression-free survival (PFS). The secondary objective is to assess efficacy through duration of response, disease control rate, overall survival (OS), and the safety profile. The exploratory objective is to investigate and compare immune factor changes after 2 cycles of immunochemotherapy and at 1, 3, and 7 days after cryoablation. Survival time will be estimated using the Kaplan-Meier method to calculate median PFS and OS. Any adverse events that occur during the trial will be promptly recorded.

RESULTS

The project was funded in 2024, and enrollment will be completed in 2025. The first results are expected to be submitted for publication in 2027.

CONCLUSIONS

This study will provide evidence for the efficacy and safety of the combination of immunochemotherapy and cryoablation as a first-line treatment for advanced NSCLC. Although it has a limited sample size, the findings of this study will be used in the future to inform the design of a fully powered, 2-arm, larger-scale study.

CLINICALTRIAL

ClinicalTrials.gov NCT06483009; https://clinicaltrials.gov/study/NCT06483009

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/64950