bluuebunny/crossref_metadata_2025 huggingface dataset:
Preliminary Plant design and Economic Analysis for Conversion of Human Hair Waste to Organic Fertiliser
Authors: Shahbaz Laiba , Abdullah Muhammad , Farzain Muhammad , Batool Aliza , Waheed Khalid
Published: December 2024

The disposal of human hair waste is becoming a global nuisance, leading to a range of environmental problems. One solution to this challenge is to convert this human hair waste to an organic amino acid-based fertilizer after pre-processing. This paper provides a preliminary plant design for production of one tonne of organic amino acid-based fertilizer from human hair waste, based on existing experimental lab-scale methodologies. The raw materials include waste human hair, potassium hydroxide (KOH), water and phosphoric acid (H3PO4). The plant design is based on optimal production conditions, using specialised equipment with detailed equipment sizing to ensure product quality and efficiency. Results from an economic analysis suggest an approximate total generated revenue of PKR 300 million, with an annual production cost of PKR 180 million. An annual profit of PKR 90 million is expected after tax deductions, with a payback period of 3.5 months. Thus, the plant is economically and technologically feasible while being sustainable and environmentally friendly.
LiDAR-Camera Range-View fusion for 3D Object Detection in Autonomous Driving
Authors: Hu Xuzhong , Duan Zaipeng , An Pei , Zhang Jun , Ma Jie
Published: December 2024

In recent years, LiDAR-Camera fusion for 3D object detection has emerged as a research hotspot, owing to its superior performance compared to single-sensor approaches. However, the vast majority of methods adopt fusion in the point, voxel, or BEV domains. The distinct representations of LiDAR-Camera data lead to domain discrepancies and misalignment of their features, resulting in suboptimal detection accuracy and slow inference speeds. In contrast, this paper introduces a novel range-view fusion strategy, leveraging its unique advantages --- data homogeneity, accurate feature alignment, and high efficiency --- over other methods. We propose the Range-view Pyramidal Fusion network (RPfusion), in which two modules are specifically designed to address the inherent problems of range-view fusion: the significant scale variations of objects and the feature vanishment of occluded objects. First, Appearance Feature Fusion (AFF) module adaptively integrates complementary geometric and semantic information across different scales using dilated cross-attention. Next, a Range-Guided Cross-Layer Modulation (RGCLM) module is proposed to extract rich contextual information for comprehensive perception and enhance features of occluded targets. The output features can globally decorate raw point cloud, serving as input to any LiDAR-based detectors. Additionally, we propose RPfusion-Det, which employs a RoIfusion module with grid-wise self-attention for local fusion, leading to more precise box refinement. Extensive experiments on the KITTI and NuScenes datasets demonstrate that RPfusion can consistently enhance various detection models. Meanwhile, RPfusion-Det achieves superior accuracy while maintaining efficient inference.
Dual-branch Feature Fusion Network for image denoising
Authors: Gao Lijun , Jin Xiao , Zhang Youzhi , Wang Suran , Sun Zeyang , Wu Jiehong
Published: December 2024

The goal of image denoising is to reduce or eliminate noise in images, thereby restoring and enhancing the true details and quality of the images. This process is essential for improving the accuracy of image analysis, enhancing image recognition, and optimizing visual effects. Despite the widespread application and notable success of deep convolutional neural networks (CNNs) in image denoising tasks, existing methods often encounter challenges such as overfitting and limited flexibility. To address these issues, this paper proposes a Dual-Branch Denoising Network (DFFNet) designed to enhance feature extraction capabilities and improve adaptability to noise. Specifically, the proposed DFFNet comprises two distinct parallel branches. In the first branch, a novel Multi-Scale Convolutional Block (MCB) is introduced, which significantly increases the receptive field while simultaneously preserving local details and the overall structure of the image. In the second branch, a Flexible Pooling Attention mechanism (FCA) is designed to reduce computational complexity while enhancing the effectiveness of feature representation. The two branches are then weighted and fused, achieving the dual objectives of noise removal and the preservation of critical image details, thereby improving overall image quality. Extensive experiments on multiple datasets demonstrate that the proposed DFFNet achieves superior denoising performance.
Hospital prevalence of colorectal cancer in Butembo: a retrospective study at Matanda Hospital
Authors: Muyisa Roland , Watumwa Emile , Munzombo Maxime
Published: December 2024

Background
Colorectal cancer (CRC) represents a significant global health burden, ranking as the third most common cancer diagnosed worldwide and the second leading cause of mortality. This study seeks to address this knowledge gap by examining the demographic and clinical characteristics of CRC patients treated at Matanda Hospital, in Butembo, Est DR Congo.
Methods
this was a retrospective study of medical records of patients diagnosed with CRC at Matanda Hospital between January 1, 2020, and December 31, 2022.
Results
The data obtained from Matanda Hospital for the years 2020 to 2022 indicates that out of 4079 patients who sought consultation in the surgery department, 30 were diagnosed with colorectal cancer, constituting 0.74% of the total patients. The majority of the affected individuals were male, aged 30 and above, and a significant proportion were farmers with a primary school education. Most patients with colorectal cancer presented with abdominal pain, with the sigmoid colon being the most commonly affected organ. Chemotherapy was administered in 30% of cases, while excision and stomas were performed in 53.33% and 46.67% of cases, respectively. A majority of patients (76.67%) had a hospitalization duration of less than 1 month, and 63.33% showed improvement in their condition whereas 10.0% died.
Conclusion
The concern of colorectal cancer persists in Butembo. Further research is necessary to determine the true epidemiology of the disease in the town.
High-temperature Raman spectroscopy of K2Ca(CO3)2 bütschliite and Na2Ca2(CO3)3 shortite
Authors: Zeff Garrett , Williams Quentin
Published: December 2024

Raman spectra of Na2Ca2(CO3)3 shortite and K2Ca(CO3)2 bütschliite were measured to 715°C and 740°C respectively, under vacuum. The vibrational spectra demonstrate that shortite converts to nyerereite (Na2Ca(CO3)2) and calcite at 535°C. This assemblage is stable to ∼700°C, where nyerereite begins to decompose. Bütschliite converts to the isochemical phase fairchildite at 570°C, which is stable to 665°C, where it decomposes to an assemblage of K2CO3 and CaO. The variation of anharmonicity between different vibrational modes of each of the low temperature phases is assessed, and these yield insights into inter-carbonate group couplings. Both fairchildite and nyerereite exhibit spectral features consistent with extensive disordering.
Práticas empreendedoras desenvolvidas na educação profissional e tecnológica
Authors: Dos Santos Oliveira Régis Ester , Lizote Suzete Antonieta , Palacios-Marqués Daniel
Published: December 2024

O objetivo do estudo foi analisar a percepção do público interno quanto às práticas empreendedoras desenvolvidas na educação técnica e tecnológica do Instituto Federal do Paraná (IFPR). Teve abordagem quantitativa, descritiva e survey com técnicas uni e multivariadas para a análise dos dados. A pesquisa caracteriza-se como pesquisa essencialmente de natureza quantitativa, a qual teve, em sua fase inicial, o suporte à análise documental, onde foram analisados documentos institucionais que instituíram a política de inovação e empreendedorismo e a criação da AGIF – Agência de Inovação do IFPR em 2019 e os anais do Seminário de Extensão, Ensino, Pesquisa e Inovação da instituição de 2018. Os resultados apontaram que a menor correlação está entre a gestão estratégica empreendedora e a internacionalização, e, das práticas empreendedoras desenvolvidas no IFPR a maior média ficou na extensão. Salienta-se que o resultado de maior expressividade está na confirmação da missão institucional, uma vez que o público interno do IFPR concorda que a instituição é uma força motriz para o desenvolvimento empreendedor nos ambientes regionais, sociais e comunitários em geral.
La metodología STEAM: una experiencia interdisciplinar para fomentar la actitud de los estudiantes hacia el aprendizaje
Authors: Rodríguez de la Barrera Adrián Enrique , Genes Quintero Carlos Farid
Published: December 2024

El propósito de esta experiencia fue analizar el impacto de la metodología STEM, bajo la implementación de un proyecto de robótica, en la actitud hacia los aprendizajes en los alumnos de undécimo en la Escuela Normal Superior Santa Teresita. Se propone usar como estrategia central mediaciones pedagógicas que susciten la unificación de las distintas áreas como matemáticas, ciencias y tecnología, en este caso. La metodología adoptada siguió el paradigma experimental analítico, y también se utilizó el modelo cuasiexperimental. Se tomaron como población los grados undécimos del año 2023, con 72 estudiantes en total. Se aplicó un análisis de ANOVA de mediciones repetidas con el propósito de calcular las variaciones a nivel de intragrupos e intergrupos a través del software SPSS versión 29 libre. Los resultados arrojaron que, con el enfoque STEAM, los estudiantes mejoran sus actitudes, por lo que, trabajan de un modo activo y práctico. En conclusión, STEAM se establece como una técnica novedosa, en donde los escolares trabajan habilidades importantes como la creatividad, el trabajo interaccionista, el pensamiento reflexivo y la capacidad de resolución de problemas.
Educación física, sedentarismo y espacios disponibles en los hogares comunitarios de bienestar tradicionales
Authors: Romero Lozano Herney , Romero Cuestas Carlos Alberto , Quintero Reina Maximiliano , Bustos Viviescas Brian Johan
Published: December 2024

En Colombia existe un programa liderado por el ICBF que presta atención integral a la primera infancia, denominado Hogares Comunitarios Tradicionales de Bienestar Familiar. En ellos los agentes educativos atienden las necesidades de los niños incluyendo las motrices. Esta investigación buscó establecer la apreciación de los agentes educativos sobre la actividad física y el sedentarismo y las características de los espacios destinados para tal fin, se desarrolló con enfoque mixto, predominio cualitativo, diseño no experimental, de campo y transversal, abordando las variables actividad física, sedentarismo y espacios disponibles. Para la muestra se eligieron 16 hogares, siendo los informantes clave de la investigación sus respectivos agentes educativos, se utilizó la técnica de entrevista semi estructurada y una planilla de recolección de datos. Los datos cuantitativos fueron sometidos a procesamiento mediante paquete estadístico IBM SPSS V. 25. El estudio evidencia que el 69 % de los hogares realiza las actividades al interior del hogar, el 31 % utiliza la sala, el piso más frecuente es la baldosa (38 %) y siete hogares (44 %) presentan condiciones inseguras para la práctica de la actividad física. Se concluye además que los agentes conocen la importancia de la actividad física y las implicaciones del sedentarismo.
Roteirização Turística na Comunidade Indígena Catu dos Eleotérios em Canguaretama/RN, Brasil
Authors: Fontes Virginio Darlyne , Fernandes da Silva Geyson , Mayara Marinho Xavier da Silva Aline , Valéria Pereira de Araújo Maria
Published: December 2024

O objetivo deste estudo foi compreender o processo de roteirização turística no Catu dos Eleotérios, uma comunidade indígena localizada no litoral sul do Rio Grande do Norte. Como percurso metodológico, a pesquisa é exploratória, de caráter qualitativo, o universo se configurou pelos atores do turismo na comunidade investigada. A coleta dos dados ocorreu, a partir de uma intervenção de capacitação, em que um Workshop de Roteirização Turística foi realizado e, posteriormente, avaliado conforme metodologia Phillips ROI. Além disso, realizou-se entrevistas com os atores do turismo local, visitas técnicas aos atrativos, observação participante e registro fotográfico como complementos da pesquisa, onde foi possível espelhar a metodologia de roteirização turística ROTURIS. Como resultados percebe-se que boa parte dos atores locais são jovens e com renda familiar baixa, sendo o turismo uma possibilidade de mudança socioeconômica. Contudo, ainda não se encontram preparados, apesar de já comercializar roteiros, para receber o turismo e gerir toda a complexidade que o envolve. A capacitação se revelou importante, conforme etapa 3 - fase 2 da ROTURIS, e identificou a resistência dos atores em participar das ações, além de pessimismo acerca dos reais benefícios que o turismo pode trazer. Espelhando a etapa 3 - fase 1 da ROTURIS, encontrou-se possibilidades de melhorias para o turismo local. Mediante aos desafios em se trabalhar o turismo de forma organizada, integrada e sustentável, sugere-se que a metodologia ROTURIS e o Turismo de Base Comunitária sejam incorporados no fazer local.
Competitive Advantage in the Hotel Industry
Authors: Monteiro de Oliveira Paloma , Cristina Rodrigues Salgado Camila
Published: December 2024

When well managed and aligned, the resources and capabilities of an organization guarantee sustainable competitive advantage and success. In this respect, using the Resource-Based View framework, this article aimed to analyze the strategic resources that sustain the competitive advantage of a hotel in Brejo Paraibano, Brazil. This is a descriptive case study that used a semistructured interview as the main data collection technique. A qualitative approach was applied, and the results were analyzed using the following techniques: content analysis and the VRIO framework. The results show that accommodations exhibited competitive parity, while the resources work team and formal integrated structure demonstrated temporary competitive advantage. Leisure infrastructure, geographic location, the restaurant, and financial capability showed potential in creating a sustainable competitive advantage. Thus, it is essential to conduct studies on competitive advantage within the hotel industry, given that it could help hotel managers make more assertive decisions to guarantee the best strategic positions and a sustainable competitive advantage.
Espaço do Turismo nos Planos de Governo da Campanha Presidencial no Brasil
Authors: Velozo Juarez , Lacerda Paulo Henrique Ferreira , Sousa Eriberto do Nascimento , Tomazzoni Edegar Luis
Published: December 2024

Para um candidato participar das eleições à Presidência da República no Brasil, ele deve, obrigatoriamente, apresentar um plano de Governo com as principais pautas que nortearão um possível mandato. Por consequência, temas não abordados denotam desinteresse por parte da campanha. Com o objetivo de analisar o espaço que o Turismo ocupou na campanha presidencial de 2022, todas as candidaturas foram analisadas e seus candidatos foram inseridos nesse diálogo. Em uma abordagem apartidária, utilizou-se de documentos oficiais da Justiça Eleitoral, combinados com uma revisão narrativa da literatura e a análise das entrevistas com candidatos. Seus resultados apontam para um cenário onde: nem todos os planos contemplam o Turismo; em conversas todos os políticos reforçam a importância do setor; existem falas genéricas sobre a área; não são apresentadas propostas concretas para o setor; e que nenhum plano coloca o turismo em papel de destaque. Diante da importância do Brasil como receptor e emissor de turistas, especialmente no contexto da América Latina onde é o quinto país mais visitado, este estudo mostra-se relevante, inclusive podendo ser replicado em outros países para entender sobre o olhar ao Turismo de postulantes ao cargo do executivo.
Immunopharmacological Insights into Cordyceps spp.: Harnessing Therapeutic Potential for Sepsis
Authors: Saxena Juhi , Agarwal Gaurang , Das Sarvjeet , Kumar Anshu , Thakkar Krish , Kaushik Sanket , Srivatsava Vijay Kumar , Siddiqui Arif Jamal , Jyoti Anupam
Published: December 2024

Cordyceps spp. (CS), a well-known medicinal mushroom that belongs to Tibetan medicine and is
predominantly found in the high altitudes in the Himalayas. CS is a rich reservoir of various bioactive substances
including nucleosides, sterols flavonoids, peptides, and phenolic compounds. The bioactive compounds
and CS extract have antibacterial, antioxidant, immunomodulatory, and inflammatory properties in
addition to organ protection properties across a range of disease states. The study aimed to review the potential
of CS, a medicinal mushroom, as a treatment for sepsis. While current sepsis drugs have side effects, CS
shows promise due to its anti-inflammatory, antioxidant, and antibacterial properties. We have performed an
extensive literature search based on published original and review articles in Scopus and PubMed. The keywords
used were Cordyceps, sepsis, and inflammation. Studies indicate that CS extract and bioactive compounds
target free radicals including oxidative as well as nitrosative stress, lower inflammation, and modulate
the immune system, all of which are critical components in sepsis. The brain, liver, kidneys, lungs, and heart
are among the organs that CS extracts may be able to shield against harm during sepsis. Traditional remedies
with anti-inflammatory and protective qualities, such as Cordyceps mushrooms, are promising in sepsis.
However, more research including clinical trials is required to validate the usefulness of CS metabolites in
terms of organ protection and fight infections in sepsis.
A Novel Effective Models for Identifying BRCA Patients and Optimizing Clinical Treatments
Authors: Luo Yi , Liu Li , Hou Zeyu , Xiong Daigang , Chen Rui
Published: December 2024

Objective:

This study aimed to develop an effective model that identifies high-risk breast cancer
(BRCA) patients and optimizes clinical treatments.

Methods:

This study includes five public datasets, TCGA-BRCA as the training dataset and other cohorts as the
validation datasets. Machine learning algorithms for finding key tumor-associated immune gene pairs (TAIGPs).
These TAIGPs were used to construct tumor-associated immune gene pair index (TAIGPI) by multivariate analysis
and further validated on the validation datasets. In addition, the differences in clinical prognosis, biological
characteristics, and treatment benefits between high and low TAIGPI groups were further analyzed.

Results:

The TAIGPI was established by 36 TAIGPs. Better clinical outcomes in the low TAIGPI patients, with
consistent results, were also obtained in the validation datasets. The study showed that patients in the low TAIGPI
group had a high infiltration of immune cells and low proliferative activity of tumor cells. In contrast, patients in
the high TAIGPI group exhibited low infiltration of immune cells and high proliferative activity of tumor cells. In
addition, patients in the low TAIGPI group are more likely to benefit from chemotherapy, adjuvant chemotherapy,
or immunotherapy.

Conclusions:

The TAIGPI can be an effective predictive strategy for the clinical prognosis of breast cancer patients,
providing new insights into personalized treatment options for breast cancer patients.
Phytochemicals as Therapeutic Agents for ESKAPE Pathogens
Authors: Ghosh Indrani , Khanra Moumita , Banerjee Tanmoy , Sar Shuvam , Chakraverty Raja , Halder Amit Kumar , Chaki Rituparna , Ghosh Nilanjan
Published: December 2024

Background:

The worldwide increase of antimicrobial resistance in ESKAPE pathogens, which includes Enterococcus faecium, Staphylococcus aureus,
Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter sp., constitutes a substantial public health hazard,
constraining treatment alternatives and elevating morbidity and mortality rates. As traditional antibiotics diminish in efficacy, phytochemicals are
capturing interest due to their varied antibacterial characteristics and decreased susceptibility to developing antibiotic resistance. Phytochemicals,
such as alkaloids, terpenes, phenolics, flavonoids, and organosulfur compounds, have multi-target processes that might provide innovative
strategies for addressing infections caused by ESKAPE pathogens.

Objective:

The investigation sought to evaluate the effectiveness and mechanisms via which different phytochemicals could hinder and destroy the resistance
pathways of ESKAPE bacteria, emphasizing their potential to serve as therapeutic agents in combating antimicrobial resistance.

Results:

Investigation demonstrates that some phytochemicals may disrupt many bacterial functions, such as cell wall production, membrane integrity,
quorum sensing, and biofilm development in ESKAPE pathogens. For example, carvacrol from essential oils has shown efficacy against S. aureus
by reducing staphyloxanthin synthesis and altering regulatory proteins, including SarA. Furthermore, conessine has altered resistance in A.
baumannii by inhibiting the AdeIJK efflux pump. Flavonoids like resveratrol and curcumin have shown synergistic benefits with conventional
antibiotics by improving their effectiveness while minimizing toxicity. These chemicals address several resistance pathways, impairing the ability
of infections to build resistance.

Conclusion:

Phytochemicals provide an opportunity to facilitate the development of novel therapies targeting antimicrobial resistance in ESKAPE bacteria.
Extensive efficacy and distinctive multi-target mechanisms of phytochemicals provide them promising candidates for combination therapy,
possibly reinstating antibiotic effectiveness and decelerating the development of resistance. Additional investigation into the increase of
bioavailability and clinical usage is essential to fully exploring the medicinal potential of phytochemicals.
Polymers Used in Personalized Medicines
Authors: Boraste Sahebrao , Bhandari Kartiki , Derle Deeliprao , Pingale Prashant
Published: December 2024

Personalized medicine (PM) is revolutionizing healthcare by tailoring
treatments to individual patients' unique biological compositions and lifestyles. This
approach considers various factors, including genetic data, lifestyle, and environmental
influences, to create customized therapeutic strategies. Polymers play a crucial role in
PM formulations, allowing for the creation of personalized dosage patterns without
adverse effects. Smart polymers, such as thermo-responsive, photo-responsive, selfrepairing, and shape-memory polymers, have garnered attention for their ability to
adapt to environmental changes and stimuli. Thermo-responsive polymers like
pluronics and poly(N-isopropyl acrylamide) exhibit temperature-dependent behavior,
making them suitable for drug delivery and tissue engineering. Photo-responsive
polymers offer spatial adaptability, allowing precise control over drug release and
tissue engineering processes. Self-repairing hydrogels, with dynamic covalent and noncovalent bonds, can regenerate their structure post-injury, holding promise for various
clinical applications. Shape-memory polymers can temporarily adopt multiple forms
and return to their original shape upon stimulation, offering versatility in biomedical
applications. Common polymers used in PM include polyvinyl alcohol (PVA),
polylactic acid (PLA), and polycaprolactone (PCL). The applications of these polymers
range from 3-D printing for personalized medical devices to controlled drug delivery
systems. Future advancements in polymer science and genomic understanding will
further enhance the effectiveness and scope of personalized medicine, leading to
improved patient outcomes and reduced treatment side effects.
Metaphor Diffusion in Online Health Communities: Infodemiology Study in a Stroke Online Health Community
Authors: Khoshnaw Sara , Panzarasa Pietro , De Simoni Anna
Published: December 2024

Background

Online health communities (OHCs) enable patients to create social ties with people with similar health conditions outside their existing social networks. Harnessing mechanisms of information diffusion in OHCs has attracted attention for its ability to improve illness self-management without the use of health care resources.

Objective

We aimed to analyze the novelty of a metaphor used for the first time in an OHC, assess how it can facilitate self-management of post-stroke symptoms, describe its appearance over time, and classify its diffusion mechanisms.

Methods

We conducted a passive analysis of posts written by UK stroke survivors and their family members in an online stroke community between 2004 and 2011. Posts including the term “legacy of stroke” were identified. Information diffusion was classified according to self-promotion or viral spread mechanisms and diffusion depth (the number of users the information spreads out to). Linguistic analysis was performed through the British National Corpus and the Google search engine.

Results

Post-stroke symptoms were referred to as “legacy of stroke.” This metaphor was novel and appeared for the first time in the OHC in the second out of a total of 3459 threads. The metaphor was written by user A, who attributed it to a stroke consultant explaining post-stroke fatigue. This user was a “superuser” (ie, a user with high posting activity) and self-promoted the metaphor throughout the years in response to posts written by other users, in 51 separate threads. In total, 7 users subsequently used the metaphor, contributing to its viral diffusion, of which 3 were superusers themselves. Superusers achieved the higher diffusion depths (maximum of 3). Of the 7 users, 3 had been part of threads where user A mentioned the metaphor, while 2 users had been part of discussion threads in unrelated conversations. In total, 2 users had not been part of threads with any of the other users, suggesting that the metaphor was acquired through prior lurking activity.

Conclusions

Metaphors that are considered helpful by patients with stroke to come to terms with their symptoms can diffuse in OHCs through both self-promotion and social (or viral) spreading, with the main driver of diffusion being the superuser trait. Lurking activity (the most common behavior in OHCs) contributed to the diffusion of information. As an increasing number of patients with long-term conditions join OHCs to find others with similar health-related concerns, improving clinicians’ and researchers’ awareness of the diffusion of metaphors that facilitate self-management in health social media may be beneficial beyond the individual patient.
Dimensions and Subcategories of Digital Maturity in General Practice: Qualitative Study
Authors: Neunaber Timo , Mortsiefer Achim , Meister Sven
Published: December 2024

Background

The status of the digitalization of companies and institutions is usually measured using maturity models. However, the concept of maturity in general practice is currently unclear, and herewith we examine the question of how maturity can be measured. There is a lack of empirical work on the dimensions and subcategories of digital maturity that provide information on the assessment framework.

Objective

The aim of the study was to answer the question of how many and which dimensions and subcategories describe digital maturity in general practice.

Methods

An explorative, qualitative research design based on semistructured expert interviews was used to investigate the dimensions of digital maturity. Twenty experts from various areas of the health care sector (care providers, interest groups, health care industry, and patient organizations) were interviewed. The interviews were analyzed based on a content-structuring analysis according to Kuckartz and Rädiker using MAXQDA software (VERBI GmbH).

Results

In total, 6 dimensions with a total of 26 subcategories were identified. Of these, 4 dimensions with a total of 16 subcategories (1) digitally supported processes, (2) practice staff, (3) organizational structures and rules, and (4) technical infrastructure and were deductively linked to digital maturity. In addition to the use of digital solutions, digital maturity included, for example, individual, organizational, and technical capabilities and resources of the medical practice. The 2 further dimensions, (5) benefits and outcomes and (6) external framework conditions of the medical practice, were identified inductively with a total of 10 subcategories. Digital maturity was associated with the beneficial use of digitalization, for example, with efficiency benefits for the practice, and external framework conditions were associated with influencing factors such as the local patient situation in the medical practice.

Conclusions

The results indicate that digital maturity is a multidimensional construct that is associated with many dimensions and variables. It is a holistic approach with human, organizational, and technical factors and concerns the way digitalization is used to shape patient care and processes. Furthermore, it is related to the maturity of the organizational environment as well as the benefits of a digitalized medical practice; however, this still needs to be confirmed. To measure the level of digital maturity in outpatient care as accurately as possible, maturity models should therefore be multilayered and take external influencing factors into account. Future research should statistically validate the identified dimensions. At the same time, correlations and dependencies between the measurement dimensions and their subcategories should be analyzed.
Characteristics of In-Flight Medical Emergencies on a Commercial Airline in Mainland China: Retrospective Study
Authors: Shi Ruizi , Jiang Weisong , Yang Jing , Dong Xiaomei , Yu Pei , Zhou Shuai , Shang Hanbing , Xu Wanying , Chen Er-zhen , Yang Zhitao , Zhou Ying
Published: December 2024

Background

In-flight medical emergencies (IMEs) can have severe outcomes, including the deaths of passengers and aircraft diversions. Information is lacking regarding the incidence rate and characteristics of IMEs in most countries, especially in mainland China.

Objective

The objective of this study was to investigate the incidence, patterns, and associated risk factors of IMEs in mainland China and to provide medical suggestions for the evaluation and management of IMEs.

Methods

This population-based retrospective study examined electronic records for all IME reports between January 1, 2018, and December 31, 2022, from a major airline company in mainland China. Outcome variables included the medical category of the IMEs, the outcomes of first aid, and whether or not the IMEs led to a flight diversion. We calculated the incidence rate and death rate of IMEs based on the number of passengers and flights, respectively. A logistic regression model was used to investigate the factors associated with aircraft diversions.

Results

A total of 199 IMEs and 24 deaths occurred among 447.2 million passengers, yielding an incidence rate of 0.44 (95% CI 0.39‐0.51) events per million passengers and 66.56 (95% CI 50.55‐86.04) events per million flights, and an all-cause mortality rate of 0.05 (95% CI 0.03‐0.07) events per million passengers and 7.50 (95% CI 4.81‐11.16) events per million flights. From 2018 to 2022, the highest incidence and mortality rates were observed in 2019 and 2020, respectively, while the lowest were in 2020 and 2021, respectively. Additionally, the highest incidence and mortality rates were observed between 6 PM to 6 AM and noon to 6 PM, respectively. There was a higher incidence rate of IMEs in the winter months. Moreover, the highest case-fatality rates were observed in 2019 (12/74, 16.2%), on flights traveling ≥4000 km (9/43, 20.9%), and on wide-body planes (10/52, 19.2%). Seizures (29/199, 14.6%), cardiac symptoms (25/199, 12.6%), and syncope or presyncope (19/199, 9.6%) were the most common medical problems and main reasons for aircraft diversion. The incidence of aircraft diversion was 42.50 (95% CI 37.02‐48.12) events per million flights. Narrow-body planes (odds ratio [OR] 5.69, 95% CI 1.05-30.90), flights ≥4000 km (OR 16.40, 95% CI 1.78‐151.29), and the months of December to February (OR 12.70, 95% CI 3.09‐52.23), as well as the months of March to May (OR 23.21, 95% CI 3.75‐143.43), were significantly associated with a higher risk of diversion.

Conclusions

The occurrence of and deaths associated with IMEs are rare in mainland China, but a temporal trend shows higher incidence rates at night and in winter. The leading IMEs are cardiac symptoms, seizures, and syncope. The establishment of a unified reporting system for IMEs and ground-to-air medical support are of great value for reducing IMEs and deaths in the global community.
From English to “Englishes”: A Process Perspective on Enhancing the Linguistic Responsiveness of Culturally Tailored Cancer Prevention Interventions (Preprint)
Authors: Davis Alexis , Martin Joshua , Cooks Eric , Vilaro Melissa , Wilson-Howard Danyell , Tang Kevin , Raup Krieger Janice
Published: December 2024

UNSTRUCTURED

Linguistic accommodation refers to the process of adjusting one’s language, speech, or communication style to match or adapt to that of others in a social interaction. It is known to be vital to effective health communication. Despite this evidence, there is little scientific guidance on how to design linguistically adapted health behavior interventions for diverse English-speaking populations. This study aims to document the strategies used to develop a culturally grounded cancer prevention intervention with the capabilities to linguistically accommodate to speakers of African American English (AAE). We describe the iterative process of developing a cancer prevention intervention with contributions of racially and linguistically diverse colleagues representing various community and institutional perspectives, including communication scientists, linguists, a community advisory board, professional voice talents, and institutional representatives for scientific integrity. We offer a detailed description of the successes and, in some cases, failures of strategies. Social stereotypes associated with AAE were prevalent at both institutional and community levels, resulting in unanticipated challenges and delays during intervention development. The diversity of linguistic, racial, and role identities within the message development team was integral to successfully addressing and identifying opportunities for process improvement. Language is a vital but often overlooked aspect of intervention development. Message designers should consider implicit social stereotypes that unintentionally shape linguistic choices. This study provides a novel overview of how various types of expertise and iterative message development processes contribute to successfully navigating cultural grounding when sensitive or stigmatized issues are salient.
Parental Information-Use Strategies in a Digital Parenting Environment and Their Associations With Parental Social Support and Self-Efficacy: Cross-Sectional Study (Preprint)
Authors: Onishi Ryuta
Published: December 2024

BACKGROUND

In today’s digital society, the acquisition of parenting information through online platforms such as social networking sites (SNSs) has become widespread. Amid the mix of online and offline information sources, there is a need to discover effective information-seeking methods for solving parenting problems.

OBJECTIVE

This study aimed to identify patterns of information use among parents of young children in the digital age and elucidate the characteristics of these patterns through a comparative analysis of parental social support and self-efficacy.

METHODS

An internet-based survey was administered to fathers and mothers of children aged 0-3 years. Convenience sampling, facilitated by an internet-based survey company, was adopted, and data from 227 fathers and 206 mothers were analyzed. The survey included questions on personal characteristics, frequency of use of different sources of parenting information (websites, SNSs, parenting apps, family, friends, and professionals), availability of parental social support, and parental self-efficacy. The Partitioning Around Medoids (PAM) clustering algorithm was used to identify patterns in parenting information use.

RESULTS

A total of 4 clusters were identified: multisource gatherers (n=161), offline-centric gatherers (n=105), online-centric gatherers (n=86), and minimal information gatherers (n=68). The availability of parental social support was perceived to be relatively higher among multisource and offline-centric gatherers compared with online-centric and minimal information gatherers. Parental self-efficacy was highest among multisource gatherers, followed by offline-centric and online-centric gatherers, and lowest among minimal information gatherers.

CONCLUSIONS

This study contributes to the evidence that online information can effectively complement offline information in addressing parenting challenges, although its ability to fully replace offline sources remains limited. Parenting support professionals are encouraged to understand parents’ current information use strategies and actively foster their social relationships, helping them to adopt more diverse and comprehensive approaches to information use.
Selective head-and-neck cooling on biomarker
levels and symptom rating following a boxing bout-
protocol for an exploratory randomized trial (Preprint)
Authors: Al-Husseini Ali
Published: December 2024

BACKGROUND

Head impacts are common in contact sports such as boxing and occur at times of elevated core
body and brain temperatures induced by the exercise. Following impact, elevated brain
temperature may lead to the development of exacerbated brain injury that can be monitored by
blood biomarkers.

OBJECTIVE

We hypothesized that acute head-and-neck cooling, recently shown to shorten
return-to-play in concussed ice hockey players, applied acutely following a boxing bout is
associated with an attenuated release of blood biomarkers and improved symptom rating.

METHODS

The trial is academically driven and funded by external and hospital research funds. Young,
healthy elite boxers ≥ 18 years old are recruited. Prior to, and immediately after a competitive
boxing bout over 3x2 or 3x3 minutes, blood samples are drawn. Boxers are randomized to
intervention or control management by 1:1 allocation prior to baseline testing. After the initial
post-fight blood sample is drawn and symptom rating using the sports concussion assessment
tool-5 (SCAT-5) has been collected, the boxers receive either acute selective head-and-neck
cooling for 45 min, or routine post-fight management. The number of head impacts are counted
in all boxers on match video recordings. In both groups, blood samples are drawn 45 minutes
after the initial post-bout blood sample, as well as 3 and 6 days post-fight. At all time points for
blood sampling, the number of symptoms (NOS) and symptom severity score (SSS) are assessed
using the symptom rating part of the SCAT-5.

RESULTS

The primary endpoint is the difference in biomarker levels (GFAP, NF-L, tau, UCH-L1, neuronal-specific enolase) between immediately post-fight and pre-intervention levels, to those obtained at 6 days post-fight. The post-fight SCAT-5 NOS and SSS are secondary endpoints.

CONCLUSIONS

There is no treatment available for boxing-induced brain injury. Biomarkers are surrogate yet
objective marker of brain injury, and the head-and-neck cooling treatment may attenuate the
release of brain injury-related biomarkers as well as reduce symptoms induced by head impacts
attained during a boxing fight. Potentially, head-and-neck cooling is a treatment option acutely
following a boxing bout.

CLINICALTRIAL

ClinicalTrials.gov, ClinicalTrials.gov Identifier NCT06386484. Registered April 23, 2024.
Quality assessment of synthetic data in healthcare: a critical appraisal (Preprint)
Authors: Chatzichristos Christos , Katsimpokis Dimitris , Lai Congting , Van Santvliet Lore , Camarrone Flavio , Knoors Daan , Geleijnse Gijs , Van Speybroek Michel , Lewi Martine , Vannieuwenhuyse Bart , De Vos Maarten
Published: December 2024

BACKGROUND

The creation of synthetic data in healthcare research has emerged as a compelling solution to address challenges related to data privacy, in case of data-sharing, and data scarceness for training machine learning models.

OBJECTIVE

Unlike technical discussions, this review delves into the fundamental factors that govern the circumstances under which synthetic data is beneficial or contraindicated for addressing health research questions. The current manuscript offers a comprehensive exploration of the role of synthetic data generation in the healthcare domain, with a focus on providing a conceptual understanding of its determinants for utility and applicability.

METHODS

By examining the landscape of synthetic data adoption in healthcare, we highlight the methodological and utility considerations that shape its integration into the research ecosystem. We elucidate how synthetic data can expedite research initiatives, support data-driven decision-making, and facilitate innovative methodologies while safeguarding sensitive patient information. Conversely, while many papers focus only on the advantages of synthetic data, we aim to highlight also the potential constraints of using synthetic data in a real-world case involving lung cancer patient level data. Our analysis centers on identifying situations where synthetic data might introduce biases or inaccuracies that hinder the generation of meaningful clinical insights.

RESULTS

We demonstrate the limitations of using synthetic data in a lung cancer case study, especially when dealing with small subgroups from the original dataset. While high fidelity and utility metrics are achieved when considering the entire dataset, significant discrepancies arise in cross-classification performance when examining subsets. Different features become crucial in classification, and fidelity metrics drop. Additionally, visual inspection reveals spurious correlations in the synthetic data that are not present in the real data.

CONCLUSIONS

In addition to examining the current state of synthetic data utilization in healthcare, this manuscript offers a forward-looking perspective on approaches for synthetic data generation. Ultimately, this critical review aims to serve as a valuable resource for researchers, policymakers, and healthcare professionals seeking to navigate the evolving landscape of synthetic data in the healthcare domain. It provides a nuanced understanding of the pivotal factors that guide the judicious use of synthetic data in addressing clinical research questions and shaping the future of healthcare research.
Online recruitment of young people for research on problematic sexual behavior (Preprint)
Authors: Bright Melissa A. , Bodi Csenge , Boyce Sabrina C.
Published: December 2024

BACKGROUND

Older youth are responsible for approximately 30% of the sexual harm cases involving children under age nine. Because such deeply rooted stigma, shame, and criminalization that surrounds problematic sexual behavior (PSB), young people with PSB who may cause sexual harm to children are not easily reached with prevention services or research.

OBJECTIVE

To assess the feasibility of online recruitment of young people aged 14-21 years with PSB to participate in a longitudinal survey study.

METHODS

Recruitment of young people with PSB was part of a larger, ongoing study on the effectiveness of a helpline for young people with PSB.A single animated advertisement that included brightly colored slides with emojis in and short questions about concerns for sexual interests and behaviors was used. The advertisement ran on Snapchat for approximately 2.5 weeks. Outcome measures included advertisement reach, impressions, and engagement. We then reviewed the number of participants who completed each stage of participation (initiate screener, screener complete, eligible and consented, and completed main survey) and calculated the cost to obtain a participant at each stage based on the total advertisement spend during the study period.

RESULTS

Advertisements were viewed 136,588 times (i.e., impressions) by 86,746 users (i.e., reach) and achieved 1,572 click/swipes. The overall click-thru rate was 1.15% and cost per click was $.59 USD. With an overall spend of $921.64 USD, the advertisement cost to recruit a potential participant to the survey landing page was $1.07 USD. The cost to get a potential participant to each stage of participation incrementally increases with the final cost to attain a survey completion of $10.34 USD.

CONCLUSIONS

This study provides evidence that is both feasible and cost effective to recruit the highly stigmatized, hidden population of youth at-risk for sexually harming children for research using a social media platform.
A user-experience study of an online parenting program for rural and Appalachian caregivers of young childhood cancer survivors (Preprint)
Authors: Moscato Emily L. , Darow Eva , Quach Jessica , Winning Adrien , Schmidt Matthew , Wade Shari L. , Wade Shari L. , Gerhardt Cynthia A. , Sezgin Emre
Published: December 2024

BACKGROUND

Young childhood cancer survivors (YCCS) diagnosed and treated before age 7 are at heightened risk of developmental difficulties. As a result, their caregivers may experience stress as they navigate various educational and hospital systems, and advocate for their child’s needs. To our knowledge, there are no tailored early intervention or support programs to address the unique and multifaceted needs of YCCS and their caregivers. Digital platforms can provide anticipatory guidance and developmental resources, which may be especially impactful for families at increased risk for health and educational disparities, particularly in underserved rural and Appalachian areas.

OBJECTIVE

Thus, this study describes the development and usability testing of an online responsive parenting program for caregivers of YCCS, called the Preparing for Life and Academics for Young cancer survivors (PLAY) program.

METHODS

Twelve caregivers of YCCS (9 biological parents, 2 grandfathers, 1 adoptive parent; 33% rural; 33% Appalachian; 83% White) participated in a virtual usability session utilizing a task-based think-aloud method. This session was followed by completion of the System Usability Scale (SUS), responses to reaction cards to describe their experiences with the platform and a semi-structured interview. Two trained coders used rapid analysis and consensus methods to identify themes.

RESULTS

Overall, caregivers found the platform easy to use (92% SUS>68; M = 82.2, SD= 14.45). Most caregivers provided positive feedback in response to reaction cards (e.g., useful, appealing, valuable) to describe the platform. Qualitative findings highlighted that most caregivers perceived the platform as easy to use, and several participants described it as a helpful educational tool. Participants noted potential platform improvements should include accessibility features (e.g., closed captioning for videos), content, and usability on mobile devices.

CONCLUSIONS

With further improvements, digital platforms such as PLAY may be a promising avenue to bridge access to care for high-need groups and ultimately, to improve child neurodevelopmental outcomes.  

CLINICALTRIAL

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