bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic accuracy of Truenat MTB Plus, Truenat MTB Ultima and Xpert MTB/RIF Ultra for the diagnosis of pulmonary TB in an HIV-endemic setting
Authors: Abdulgader Shima M , Chiwaya Arthur M , Reeve Byron W P , Palmer Zaida , Mishra Hridesh , Mbu Desiree L , Lushozi Nondumiso , Nkwanyana Zola , Ruhwald Morten , Penn-Nicholson Adam , Warren Robin , Theron Grant
Published: September 2024

Background: Truenat MTB Plus (MTB Plus) and MTB Ultima (Ultima) are World Health Organization-endorsed low-complexity tuberculosis (TB) tests, however, performance data are scarce.
Methods: Adults (≥18 years; n=498) self-presenting with symptoms to primary care clinics in Cape Town, South Africa (19/02/2016-22/02/2023) provided sputa. We evaluated the accuracy of MTB Plus and Ultima, with Xpert MTB/RIF Ultra (Ultra) as a comparator, vs. a single culture (TB reference standard) or MTBDRplus on an isolate (rifampicin susceptibility reference standard).
Results: The proportion of MTB Plus and Ultima unsuccessful results was 20% (95% confidence interval 17, 23) and 14 (11, 16), respectively, with ≥half resolving upon retesting the same eluate. In a three-way analysis, MTB Plus, Ultima and Ultra had sensitivities of 84% (78, 88), 90% (85, 93), and 92% (87, 95), and specificities of 95% (92, 97), 85% (80, 88) and 95% (92, 97) for TB. The proportion of unsuccessful results for MTB-RIF Dx done the same day as DNA extraction was 9% (3, 16; MTB Plus-positives) and 18% (10, 26; Ultima-positives) [if after day-of-extraction, these were 27% (18, 35) and 44% (35, 51)]. Same-day rifampicin susceptibility testing was often unsuccessful in samples with “very low” load [73% (58, 89) MTB Plus, 75% (65, 86) Ultima] but had 100% (40, 100) sensitivity and 99% (96, 100) specificity (for both MTB Plus- or Ultima-positive DNA). Lot variation in unsuccessful and false-positive results was observed.
Conclusion: Ultima showed comparable sensitivity to Ultra but specificity, lot variation, and, like MTB-RIF Dx, unsuccessful result rates were suboptimal.
Funding: European & Developing Countries Clinical Trials Partnership, and South African Medical Research Council.
Relationship Between the Weight Function and Number of Active Sensors in a Sensor Array
Authors: Patwari Ashish , Bhattacharya Budhaditya
Published: September 2024

It is well-known that sensor arrays (antenna arrays) possess better directional properties than a single sensor. Unlike individual sensors, they provide higher gain, sensitivity, and a sense of direction. However, failure of sensors in a sensor array is a common problem that can disturb the array operation. Hence, quick identification of failed sensors is an important task to restore the array’s functionality. Even before knowing the exact positions of the failed sensors, it is important to know how many sensors have failed. Toward this end, we show how the array’s weight function can be used to determine the number of failed sensors. Numerical examples in MATLAB confirm the correctness of the proposed method. The suggested method works equally well for linear and planar arrays regardless of whether they are full or sparse.
Correlation of Metabolic Age with Chronological Age and Physical Examination Score from BIA in Male and Female Patients with Type 2 Diabetes Mellitus
Authors: Yücel Hasan Esat , Ulcay Tufan , Görgülü Özkan , Öncü Ruken
Published: September 2024

Background:Metabolic age is an important risk marker that can be easily understood by patients in clinical practice. In this study, we aimed to investigate the association of metabolic age with chronological age and physical examination score in male and female patients with type 2 diabetes mellitus.
Material and Method:Male (n:50) and female patients (n:72) with T2DM were included in the study. Anthropometric measurements were obtained with Tanita MC-780MA device, waist/hip and waist/height ratios were calculated, variables were compared between groups and correlation with met age was analyzed. Linear regression analysis was used to determine the factors affecting met age.
Results:The difference between met-age and chronological age was significantly higher in female patients with T2DM (age difference: 6.0∓3.79 in female group, 3.38∓2.80 in male group) (p<0.001). BMI values, degree of obesity and fat mass were significantly higher in women (p<0.001), waist/hip ratios were lower (p<0.001) and waist/height ratios were higher (p=0.001). Physical examination score, muscle mass, lean mass and BMR were higher in men than in women (p<0.001).There was a significant positive association of met age with chronological age and a significant negative association with physical examination score in both sexes (p<0.05). According to the linear regression model, it was found that met age was positively affected by chronological age and waist/height ratio and negatively affected by physical examination score in the female group (R2 =0.983).In the male group, it was observed that it was positively affected by chronological age, obesity degree, body mass index (BMI) and negatively affected by physical examination score (R2 =0.974).
Conclusions:Met age increases with increasing chronological age and decreasing physical examination score in male and female patients with T2DM.
Linking regional investments and revenues at the provincial level to investment loan decisions by local government banks in Indonesia
Authors: Aswan Andi , Dahham Sabbar Sabbar , Bashir Shahid , Ratna Sari Dewi Andi
Published: September 2024

This study aims to analyze how two different types of investments (local domestic and foreign direct investments at the provincial level) and revenues (booked by the provincial governments, general allocation funds, special allocation funds, local taxes, and retribution) affect investment loan decisions by local government banks in Indonesia. The study uses panel data applying ordinary least squares and multiple linear regression. Thus, 144 data were sampled from 2013 to 2021 from 16 local government banks out of Java Island in 21 provinces in Indonesia. The study found that local domestic investment at the provincial level affects investment loan decisions by local government banks. In contrast, foreign direct investment did not affect lending decisions, indicating that local domestic investment contributes to the real local economy at the provincial level. Different results were found in provincial revenues in the form of general and special allocation funds, which negatively affected loan investment decisions, possibly due to provincial revenues utilized to cover the financial deficit and capital expenditure spent chiefly on imported goods. Additionally, local taxes at the provincial level also negatively affect investment loan decisions, possibly due to fluctuations in local tax collection during COVID-19. However, the study found that local retribution contributes to predicting loan investment decisions, suggesting revenue collection by the governments considering local economic conditions. The study findings suggest that provincial governments should direct investments that can impact the local economy and spend their revenues on goods and services that can drive local economic growth.
AcknowledgmentThe investment loan made by local government banks, which is associated with local investment and revenue, is part of a research grant project from the Economics and Business Faculty of Hasanuddin University. This project is a result of collaboration with national and international researchers. In carrying out this research, some inputs from people working in local government banks, financial service authorities, and provincial and regency governments are addressed.Thanks to Ahmadi Usman for secondary data and Syahidah Ulhaq for some application programs enabling mapping literature, as well as Israa Natiq Jabar for supervising the result and applied some inputs in the section of research method.
Experimental study on single-cylinder two-stroke piston expander based on in-cylinder spray heat transfer
Authors: Yu Qihui , Zhang Jiabao , Li Xiaodong , Sun Guoxin , Qin Ripeng , Li Feng
Published: September 2024

Compressed air energy storage stands as a highly promising technology within the realm of energy retention. The piston expander finds applicability in smaller-scale compressed air energy storage systems. In compressed air energy storage systems, the expansion process is critical in energy discharge and significantly impacts overall performance. Isothermal expansion techniques are effective in enhancing the operational efficiency of piston expanders, in contrast to adiabatic expansion methodologies. Previous simulations by our research group show that the isothermal expansion model has a lower power output than the adiabatic expansion model due to its higher exhaust pressure. To further validate the accuracy of the simulation results, an experimental platform was constructed and the uncertainty of the experimental system as well as the measured data was evaluated. This study conducted experimental research using the single-variable method, focusing on different load conditions and spray parameters. The study findings indicate that the exhaust pressure during isothermal expansion consistently exceeds that of adiabatic expansion. The exhaust pressure of isothermal expansion increased by 3.85 % to 14.9 %. Under varying load conditions, the average rotational speed and output power of isothermal expansion were noted to be inferior to those of adiabatic expansion. Despite changes in nozzle diameter or spray temperature when the spray timing is set at 0°-180°, the average rotational speed and output power of isothermal expansion remain lower than that of adiabatic expansion. The average output power of isothermal expansion decreased by 1.29 % to 5.24 %. Nevertheless, if the spray timing is set between 0°-120°, the average output power of the isothermal expansion surpasses the adiabatic expansion with an improvement of 1.84 %.
New record of Velvety Black Tyrant Knipolegus nigerrimus (Vieillot, 1818) (Passeriformes, Tyrannidae) at low altitude, in a Caatinga area, Paraíba, Brazil
Authors: Ricardo Henrique Pereira da Silva  , José Alan Sales Souza  , Bruno Pinho de Lucena  , Erich de Freitas Mariano
Published: September 2024

Knipolegus nigerrimus is a widely distributed bird species in the Caatinga and has been recorded at altitudes between 560 and 1000 m. Here, we describe the occurrence of K. nigerrimus at an altitude lower than that recorded in the literature. A male individual was recorded during an avifauna study conducted in 2022 in the municipality of Passagem, Paraíba, Brazil. The individual was observed making short flights near a rocky wall and landing on rocks in the vicinity. At that time, the individual was photographed and photographs were used to identify the species. One possible explanation for what happened is that it moved to a low-altitude environment in search of a watercourse present at the site. However, the observed behaviour is described in the literature as parental care behaviour, which may indicate the presence of a nest at the site. This record is important because it shows a possible behavioural adaptation.
Memória, ruína e paisagem cultural do trabalho e da produção industrial no Piauí
Authors: Do Nascimento Veras Alexandra Sablina , Ramos Nogueira Antonio Gilberto
Published: September 2024

O presente artigo tem como objetivo analisar as relações entre memória, ruína e paisagem cultural, focando na cidade de Parnaíba, localizada no litoral do Piauí, região do nordeste brasileiro. Por meio de memórias orais associadas ao patrimônio industrial, compreende-se que a atividade industrial deixa suas marcas nas paisagens urbanas, não apenas relacionadas aos vários vestígios de estruturas e instalações obsoletas e/ou adaptadas a novos usos, mas também às formas como essas paisagens são significadas e ressemantizadas pelos trabalhos da memória: é a memória na paisagem. Memória na paisagem é aquilo que permanece como ruína, resistindo entre a lembrança e o esquecimento, nas paisagens da cidade e nas paisagens da memória.
Trabalho fabril, movimento operário e patrimônio industrial em Florianópolis: roteiros e percursos
Authors: Gonçalves Janice
Published: September 2024

Este artigo toma como referência fundamental ações de extensão universitária que envolveram, entre 2009 e 2023, a elaboração e o aperfeiçoamento de roteiros de caminhadas pelo centro de Florianópolis, alguns deles voltados especificamente para as relações entre trabalho fabril, movimento operário e patrimônio industrial. Considerados os pontos de percurso propostos nos roteiros (cuja elaboração envolveu a consulta a estudos sobre a cidade e sobre os processos históricos em questão), são discutidas diferentes formas de percebê-los e de se relacionar com eles, por meio de: estudos acadêmicos estrito senso; políticas públicas de preservação ou de ações que envolvem o reúso ao menos de parte dos elementos materiais associados a esses temas; ações de extensão ou, mais especificamente, de história pública.
Salientam-se, ainda, os fluxos e refluxos de valorização de bens móveis e imóveis que, na área central da cidade, podem ser assimilados ao patrimônio industrial em Florianópolis, implicando, entre outros processos sociais, ocupação/esvaziamento de lugares e esquecimento/ativação de memórias. Entende-se que o caminhar atento e reiterado pela cidade, de forma a integrar conhecimentos históricos, vivências dos caminhantes e o compartilhamento de percepções do espaço citadino, é uma ferramenta poderosa para reconectar as pessoas à cidade (entendida como locus de exercício de cidadania) e, no caso das caminhadas discutidas no artigo, para dar visibilidade às questões que envolvem o patrimônio industrial.
Elucidating the Significance of Zonulin in the Pathogenesis of Chronic Inflammatory Disorders: Emphasis on Intestinal Barrier Function and Tight Junction Regulation
Authors: Mohammadi-kordkhayli Marziyeh , Javad Mousavi Mohammad , R Camara-Lemarroy Carlos , Noorbakhsh Farshid , Saboor-Yaraghi Ali Akbar
Published: September 2024

The intestinal barrier, a critical component of the body's defense system,
plays a vital role in maintaining homeostasis by preventing the translocation of harmful
substances from the gut lumen into the bloodstream. Disruptions in this barrier, often
characterized by increased intestinal permeability, are increasingly recognized as contributors
to the development and progression of various Chronic Inflammatory Disorders
(CIDs). Zonulin, a key regulator of intestinal Tight Junctions (TJs), has emerged as a pivotal
player in this process. Dysregulation of zonulin, leading to increased intestinal
permeability, has been implicated in the pathogenesis of a wide range of CIDs, including
Inflammatory Bowel Disease (IBD), celiac disease, and Multiple Sclerosis (MS).
This review examines the intricate relationship between zonulin and intestinal permeability,
emphasizing its role in regulating TJ integrity and its association with various CIDs.
Recent research has demonstrated the therapeutic potential of targeting zonulin, specifically
through the use of larazotide acetate, a zonulin antagonist. Preclinical and clinical
studies have shown promising results in improving gut barrier integrity and reducing inflammation
in patients with CIDs. These findings underscore the significance of zonulin
as a potential biomarker for intestinal barrier function and a promising therapeutic target
for managing CIDs. Further research is needed to elucidate the precise mechanisms of
action of zonulin antagonists and evaluate their efficacy and safety in clinical trials. A
deeper understanding of the complex interplay among zonulin, intestinal permeability,
and CIDs is crucial, paving the way for novel therapeutic strategies and personalized approaches
to patient care.
Exploring the Therapeutic Potential of Traditional Medicinal Foods in Cancer Treatment: Molecular Evidence and Bioactivities
Authors: Thakur Kulbhushan , Singh Tejveer , Sharma Deepika , Padha Nipun , Mir Bilal Ahmad , Chandra Atika , Rajpal Vijay Rani
Published: September 2024

Traditional medicinal foods derived from natural sources have gained increasing attention
in recent years due to their perceived health benefits and potential therapeutic properties
and are deeply rooted in cultural practices. This review aimed at understanding their potential
health benefits, emphasizes the need to identify the key bioactive substances in traditional home
medicine. We have discussed the bioactive properties, molecular targets, and anti-cancer effects
of various compounds such as curcumin, genistein, berberine, resveratrol, and, quercetin present
in traditional medicinal foods. Our study highlights the potential of traditional medicinal food in
the prevention and management of various health conditions, including cardiovascular diseases,
cancer and neurodegenerative disorders as evident from in vitro, in vivo and clinical trials. Additionally,
our study explores the mechanistic action of various bioactive constituents of grapes,
rosemary, barberry, turmeric and garlic that have been shown to interfere with cancer growth,
proliferation, metastasis, angiogenesis, and induce apoptosis by targeting various pathways and
the cell cycle. Additionally, a wide range of healing abilities of medicinal foods including their
impact on cancer cells demonstrate their direct anti-tumor potential along with antioxidant and
antiinflammatory properties. To summarize, the present review highlights that integrating the
insights of contemporary science with the age-old wisdom of traditional medicine in a systematic
way holds immense potential for developing alternate and effective approaches to cancer therapeutics
and offering evidence-based dietary recommendations.
Nadolol Attenuates Brain Cell Ferroptosis in Ischemic Stroke Rats by Targeting the HOIL-1/IRP2 Pathway
Authors: Yang Xiao-Yan , Zhu Wen-Jun , Di-Chen  , Peng Dan , Peng Jun , Zhou Zhi-Jun , Luo Xiu-Ju
Published: September 2024

Introduction:

Heme-oxidized iron regulatory protein 2 (IRP2) ubiquitin ligase-1
(HOIL-1) is believed to contribute to the ubiquitination of IRP2, which facilitates the transcription
of transferrin receptor 1 (TfR1) while preventing the transcription of ferroportin-1 (FPN-1). Bioinformatics
analysis predicts that nadolol (a β-blocker) interacts with the HOIL-1.

Method:

The present study is intended to explore whether nadolol suppresses ferroptosis in the
brains of rats suffering from ischemic stroke via targeting the HOIL-1/IRP2 pathway. A rat model
of ischemic stroke was established by blocking the middle cerebral artery for 2 h plus 24 h reperfusion,
and nadolol (2.5 or 5 mg/kg) was given at 1h after reperfusion. HT22 cells were subjected to
12 h of hypoxia, followed by 24 h of reoxygenation for simulating ischemic stroke, and nadolol
(0.1 or 0.25 μM) was administered to the culture medium before reoxygenation.

Results:

The stroke rats showed evident brain injury (increases in neurological deficit score and
infarct volume) and ferroptosis, along with up-regulation of IRP2 and TfR1 while downregulation
of HOIL-1 and FPN-1; these phenomena were reversed in the presence of nadolol. In the cultured
HT22 cells, hypoxia/reoxygenation-induced LDH release, ferroptosis, and changes in the levels of
relevant proteins (IRP2, TfR1, HOIL-1, and FPN-1) were also reversed by nadolol.

Conclusion:

In terms of these findings, it is concluded that nadolol can protect the ischemic rats’
brains against ferroptosis by targeting the HOIL-1/IRP2 pathway, thereby preventing intracellular
iron overload. Thus, nadolol may be a novel indication for treating patients with ischemic stroke.
Understanding the Bidirectional Relationship between Alzheimer's and Depression
Authors: Pannu Arzoo , Goyal Ramesh K.
Published: September 2024

With an ageing global population, understanding the potential links between
mental health and neurodegenerative disorders has become increasingly crucial for comprehensive
patient care. A comprehensive search of electronic databases yielded a selection
of studies encompassing clinical trials, longitudinal cohorts, and cross-sectional analyses,
published between 2000 and 2023. Key inclusion criteria focused on investigations
involving both Alzheimer's disease and depression, encompassing a range of methodologies,
including neuroimaging, epidemiological surveys, and clinical assessments. The
analysis reveals compelling evidence of a bidirectional relationship, where depression
serves as a potential precursor to Alzheimer's disease, and vice versa. Neurobiological
mechanisms, including neuroinflammation, neurotransmitter imbalances, and genetic predispositions,
emerge as significant contributors to this complex association. Furthermore,
psychosocial factors, such as chronic stress and social isolation, are identified as potential
accelerators of cognitive decline in individuals with co-occurring depression and Alzheimer's.
Additionally, therapeutic interventions targeting both conditions concurrently exhibit
promising outcomes in mitigating cognitive decline and ameliorating depressive symptoms.
Approaches encompassing cognitive behavioural therapy, pharmacological interventions,
and lifestyle modifications demonstrate potential avenues for integrated treatment
strategies. This review underscores the imperative for a multidisciplinary approach to patient
care, emphasizing the importance of early detection and intervention for individuals
presenting with symptoms of depression and cognitive impairment. Future research avenues
should prioritize longitudinal studies with larger cohorts to delineate the causal pathways
and further elucidate effective treatment modalities for this intricate comorbidity. By
unravelling the complexities of the Alzheimer's-depression nexus, we pave the way for
more targeted and comprehensive interventions to improve the lives of those affected by
these debilitating conditions.
Impact of Biochar on Soil Organisms
Authors: Khan Bushra Nisar
Published: September 2024

Soil organisms are very important to improve soil fertility and maintain a
natural balance between soil nutrient cycles, enzyme activities and biological
transformation of complex substances. Typically, one gram of soil contains more than
90 million bacteria, which helps plants in nutrient uptake by converting them into
forms that are available to the plants. People tend to think negatively of microbes
because they are unaware of how important they are, even though they frequently
behave as disease-causing agents. Similarly, the role of soil macroorganisms in
improving soil structure and nutrient movement is equally significant. The use of
biochar as an exuberant carrier of soil organisms in the soil ecosystem has been widely
studied. Therefore, in this chapter, we will emphasis the types and functions of macro
and microorganisms in the soil, the impact of biochar on soil organisms, nutrient
cycling and enzyme activities.
Impact of Biochar on Crop Yield and Production
Authors: Ali Sajid , Zahid Adnan , Ahmed Mukhtar , Fatima Ammara , Ayub Asma , Zahra Aisha , Shahzad Aamir
Published: September 2024

Urbanization and population growth have significantly impacted the health
and fertility of the soil, putting more strain on farming systems. It is becoming
increasingly necessary to use chemical pesticides and fertilizers in order to meet the
world's growing food demand. There is a significant contribution to greenhouse gas
emissions from these practices. The use of biochar as a multifunctional carbon material
is being extensively investigated in order to address the problems of improving soil
fertility and lowering climate change at the same time. In order to enhance seed
germination and seedling growth, biochar is applied at a low level. In addition to
changing the abiotic and microbial activities of the rhizosphere, biochar increase the
mineralization of nutrients and make them more available to plants. By reducing heavy
metals and increasing plant resistance to environmental stresses, biochar increases plant
resistance to pathogens and abiotic challenges. By providing an in-depth analysis of
biochar's impacts on crop physio-morphological traits, soil’s physio-chemical
properties and productivity, as well as ways toreduce environmental problems were
determined. As a result of this chapter, biochar can be produced in a way that is
efficient and serves the purpose that crops and soil need. Increasing crop production,
assuring food security, and improving environmental management may all benefit from
it.
Environmental Implications of Biochar
Authors: Naseem Munaza , Iqbal Shazia , Malik Hina , Awais Muhammad , Jehan Sarvet , Jabeen Shazia
Published: September 2024

Biochar is a form of charcoal that is produced by heating organic material in
the absence of oxygen. It has been studied as a potential tool for mitigating climate
change by sequestering carbon in the soil, improving soil fertility, and reducing
greenhouse gas emissions from agriculture. However, the environmental implications
of biochar production and use are complex and depend on various factors, such as the
feedstock used, the production process, and the intended use. One potential benefit of
biochar is its ability to sequester carbon in the soil for long periods, potentially
reducing greenhouse gas emissions. However, the amount of carbon sequestered and
the duration of sequestration may vary depending on factors such as soil type, climate,
and management practices. Additionally, there is a risk of releasing greenhouse gases
during production, particularly if the feedstock is not properly managed. It can also
improve soil fertility by increasing nutrient retention and reducing nutrient leaching.
However, the effectiveness of biochar for this purpose may depend on factors such as
soil type, climate, and the properties of the biochar itself. There is also a risk that the
use of biochar could lead to soil acidification or other unintended consequences. The
use of biochar in agriculture could also have implications for water resources. While
biochar has the potential to reduce nutrient leaching, it could also increase runoff and
erosion if not properly managed. Additionally, the production process could require
significant amounts of water, particularly in areas where water resources are already
limited. Overall, the environmental implications of biochar depend on various factors
and require careful consideration. While biochar has the potential to provide a range of
environmental benefits, it is important to ensure that its production and use are
sustainable and do not lead to unintended consequences.
Conference Report: Leveraging the Global Malnutrition Composite Score for Quality Improvement, Health Equity, and Better Patient Outcomes
Authors: Mitchell Kristi R. , Dittloff Margaret , Larson Jasmine , Belcher Donna
Published: September 2024

Effective January 2024, the United States Centers for Medicare & Medicaid Services (CMS) for the first time has included a nutrition-focused quality measure in the Hospital Inpatient Prospective Payment System (IPPS) Inpatient Quality Reporting (IQR) Program: the Global Malnutrition Composite Score (GMCS). The GMCS is an electronic clinical quality measure (eCQM) that hospitals can choose to report voluntarily to meet the requirements for IPPS IQR payments. The GMCS can help improve hospital malnutrition care and help advance hospital health equity goals. This conference report summarizes a panel discussion at the Academy of Nutrition and Dietetics Food and Nutrition Conference & Expo in October 2023. During the panel, four health and nutrition experts described strategies for integrating the GMCS into hospital electronic health records (EHRs). They also outlined how GMCS data can be used to facilitate successful patient transitions to post-acute care through addressing food insecurity and other reasons for malnutrition. Such strategies can serve to help avoid preventable complications and readmissions, improve patient outcomes and health, and meet quality and health equity objectives, while helping reduce overall healthcare costs.
User Experiences of Transitioning From a Homegrown Electronic Health Record to a Vendor-Based Product in the Department of Veterans Affairs: Qualitative Findings From a Mixed Methods Evaluation
Authors: Anderson Ekaterina , Moldestad Megan , Brunner Julian , Ball Sherry , Helfrich Christian , Orlander Jay , Rinne Seppo , Sayre George
Published: September 2024

Background

The Department of Veterans Affairs (VA), the largest nationally integrated health system in the United States, is transitioning from its homegrown electronic health record (EHR) to a new vendor-based EHR, Oracle Cerner. Experiences of the first VA site to transition have been widely discussed in the media, but in-depth accounts based on rigorous research are lacking.

Objective

We sought to explore employee perspectives on the rationale for, and value of, transitioning from a VA-tailored EHR to a vendor-based product.

Methods

As part of a larger mixed methods, multisite, formative evaluation of VA clinician and staff experiences with the EHR transition, we conducted semistructured interviews at the Mann-Grandstaff VA Medical Center before, during, and after going live in October 2020. In total, we completed 122 interviews with 26 participants across multiple departments.

Results

Before the new vendor-based EHR went live, participants initially expressed cautious optimism about the transition. However, in subsequent interviews following the go-live, participants increasingly critiqued the vendor’s understanding of VA’s needs, values, and workflows, as well as what they perceived as an inadequate fit between the functionalities of the new vendor-based EHR system and VA’s characteristic approach to care. As much as a year after going live, participants reiterated these concerns while also expressing a desire for substantive changes to the transition process, with some questioning the value of continuing with the transition.

Conclusions

VA’s transition from a homegrown EHR to a vendor-based EHR system has presented substantial challenges, both practical and cultural in nature. Consequently, it is a valuable case study for understanding the sociotechnical dimension of EHR-to-EHR transitions. These findings have implications for both VA leadership and the broader community of policy makers, vendors, informaticists, and others involved in large-scale health information technology implementations.
Detection of Sleep Apnea Using Wearable AI: Systematic Review and Meta-Analysis
Authors: Abd-alrazaq Alaa , Aslam Hania , AlSaad Rawan , Alsahli Mohammed , Ahmed Arfan , Damseh Rafat , Aziz Sarah , Sheikh Javaid
Published: September 2024

Background

Early detection of sleep apnea, the health condition where airflow either ceases or decreases episodically during sleep, is crucial to initiate timely interventions and avoid complications. Wearable artificial intelligence (AI), the integration of AI algorithms into wearable devices to collect and analyze data to offer various functionalities and insights, can efficiently detect sleep apnea due to its convenience, accessibility, affordability, objectivity, and real-time monitoring capabilities, thereby addressing the limitations of traditional approaches such as polysomnography.

Objective

The objective of this systematic review was to examine the effectiveness of wearable AI in detecting sleep apnea, its type, and its severity.

Methods

Our search was conducted in 6 electronic databases. This review included English research articles evaluating wearable AI’s performance in identifying sleep apnea, distinguishing its type, and gauging its severity. Two researchers independently conducted study selection, extracted data, and assessed the risk of bias using an adapted Quality Assessment of Studies of Diagnostic Accuracy-Revised tool. We used both narrative and statistical techniques for evidence synthesis.

Results

Among 615 studies, 38 (6.2%) met the eligibility criteria for this review. The pooled mean accuracy, sensitivity, and specificity of wearable AI in detecting apnea events in respiration (apnea and nonapnea events) were 0.893, 0.793, and 0.947, respectively. The pooled mean accuracy of wearable AI in differentiating types of apnea events in respiration (normal, obstructive sleep apnea, central sleep apnea, mixed apnea, and hypopnea) was 0.815. The pooled mean accuracy, sensitivity, and specificity of wearable AI in detecting sleep apnea were 0.869, 0.938, and 0.752, respectively. The pooled mean accuracy of wearable AI in identifying the severity level of sleep apnea (normal, mild, moderate, and severe) and estimating the severity score (Apnea-Hypopnea Index) was 0.651 and 0.877, respectively. Subgroup analyses found different moderators of wearable AI performance for different outcomes, such as the type of algorithm, type of data, type of sleep apnea, and placement of wearable devices.

Conclusions

Wearable AI shows potential in identifying and classifying sleep apnea, but its current performance is suboptimal for routine clinical use. We recommend concurrent use with traditional assessments until improved evidence supports its reliability. Certified commercial wearables are needed for effectively detecting sleep apnea, predicting its occurrence, and delivering proactive interventions. Researchers should conduct further studies on detecting central sleep apnea, prioritize deep learning algorithms, incorporate self-reported and nonwearable data, evaluate performance across different device placements, and provide detailed findings for effective meta-analyses.
Study on Basic Requirements and Critical Success Factors (CSF) of Implementing Availability Payment in Public-Private Partnership (AP PPP) in Regency/Municipal Government
Authors: Shodiqi Alia Zata Izzati , Tamin Rizal Z. , Mahani Iris
Published: September 2024

Referring to PPP Books 2017-2023 issued by The Ministry of National Development Planning of Indonesia, there is only 1 out of 16 AP PPP projects at the municipal/regency level that have successfully reached the operational stage (6% success rate), i.e. Madiun Regency Public Street Lighting. Several municipal/regency AP PPP projects have failed, for example, Bandung Municipal Public Street Lighting. The widespread failures indicate that the application of AP in regional infrastructure has so far not been successful in Indonesia. This paper aims to identify the basic requirements, critical success factors, and lessons learned from AP PPP implementation in Municipal/Regency Governments. Thus, it is hoped that the future provision of regional infrastructure with the AP scheme can proceed seamlessly. This study used a mixed-method approach that combines qualitative and quantitative data from literature reviews, questionnaires, and interviews. The results showed that the basic requirements for AP PPP include the existence of regulations and institutions. The five main success factors of AP PPP in the Municipal/Regency Government are (1) a well-organized and committed public agency; (2) political support; (3) favorable and efficient legal framework; (4) stable political and economic situation; and (5) public and private sector commitments and responsibilities. The lesson learned from the case study is that fiscal capacity is not the main factor in the success of PPP in Madiun Regency, but rather the willingness of the local government to implement PPP by regularly holding capacity building and maintaining good relationships and communication with each stakeholder involved.
AI and Cloud Computing in Healthcare: Transforming Patient Care with AWS and Java
Authors: Saitala Srinivas
Published: September 2024

A new era in healthcare is being ushered in by the convergence of artificial intelligence (AI) and cloud computing, which will significantly improve patient care through improved diagnosis, individualized treatment planning, and effective patient management. This article explores the potent combination of Java and Amazon Web Services (AWS) and how these technologies may be used to develop cutting-edge AI-driven healthcare solutions that optimize healthcare operations and dramatically enhance patient outcomes. Together with Java's robust and flexible programming environment, healthcare providers can leverage AWS's scalable infrastructure and advanced machine learning capabilities to create and implement sophisticated AI models that analyze massive amounts of medical data at a speed and accuracy never seen before. These developments are making it possible to make more accurate diagnoses, customized treatment plans, and proactive patient monitoring, which can result in better clinical judgment and possibly life-saving measures. But even as we consider the enormous positive effects these technologies have on society, we also have to face the ethical problems they raise, such as issues with data privacy, potential biases in algorithms, and unequal access to cutting-edge medical treatments. The goal of this thorough investigation is to present a fair assessment of the revolutionary potential of artificial intelligence (AI) and cloud computing in the healthcare industry, while also discussing the wider ramifications and obligations associated with incorporating these formidable technologies into our healthcare systems.
Application of Statistical Process Control in Automotive Manufacturing
Authors: jha Aryan
Published: September 2024

This research looks at how “statistical process control”, or SPC, is used in the automotive sector and highlights how it can improve production efficiency, lower defect rates, and improve process quality. SPC is crucial to the monitoring and control of the complex assembly processes and strict quality standards that define the automobile sector. The efficiency of several SPC methods, including control charts and process capability analysis (Cp and Cpk), in preserving process stability and fulfilling quality criteria is assessed in this study. The study shows how these technologies may detect process variations and direct appropriate adjustments to optimize output using simulated data analysis. The results highlight how crucial SPC is to attaining consistent product quality and reliability, which raises performance and safety requirements in the automotive sector.
Gender in the EU-Canada Comprehensive Economic Trade Agreement – third generation trade agreement as a gateway to policy coordination?
Authors: Viju-Miljusevic Crina , Weinar Agnieszka
Published: September 2024

This article considers the place of trade and gender in EU-Canada relations, with a particular focus on CETA and its functioning in a broader sense. More specifically, the authors seek to understand the process of defining the trade and gender agenda under the CETA framework and the practical ways the EU and Canada have sought to respond to them. The authors examine the challenges and opportunities related to women’s participation in the EU-Canada trade flows, what the instruments developed to support them were, what tools were at their disposal, whether CETA had had a real impact on their business activities, as well as the dynamics of the policy exchange and learning. The authors find that CETA delivers solid structures to design and implement concrete actions, leading to more policy coordination between the EU and Canada on trade and gender issues. However, there are still several gaps that need to be addressed, with the lack of disaggregated data being the most important.
Le genre dans l’Accord économique et commercial global entre le Canada et l’Union européenne : un accord commercial de troisième génération qui débuterait une coordination des politiques ?
Cet article s’intéresse à la place qu’occupent le commerce et le genre dans les relations entre le Canada et l’Union européenne (UE), et plus particulièrement à la place de l’Accord économique et commercial global (AECG) et de son implémentation au sens large. Plus spécifiquement, nous cherchons à comprendre les processus de définition du commerce et du genre dans le cadre de l’AECG et les façons concrètes dont l’UE et le Canada y répondent. Nous nous interrogeons sur les défis et les opportunités de la participation des femmes aux flux commerciaux entre l’UE et le Canada, sur les outils créés pour les soutenir, sur les outils tels qu’ils ont été mis à leur disposition, sur l’impact réel de l’AECG sur leurs activités commerciales, ainsi que sur les dynamiques d’échange de politiques et d’apprentissage.
Penanggulangan Tindak Pidana Pencurian Sepeda Motor (Studi Kasus Di Polsek Blahbatuh, Kabupaten Gianyar)
Authors: I Putu Aris Wiradinata  , I Nyoman Gede Sugiartha  , I Made Minggu Widyantara
Published: September 2024

Dalam kehiduan masyarakat angkat kejahtan sangat besar dan termasuk dalam gejala sosial yang akan terus dihadapi oleh setiap manusia, masyarakat dan negara secara umum. Tindak pidana pencurian sepeda motor merupakan salah satu penyakit terbuka yang menimbulkan rasa kesengsaraan dan kegelisahan dalam kehidupan individu, maka sangat penting untuk mengambil pengamanan yang ketat dalam mengantisipasi tuntutan kepolisian baik pelaku maupun masyarakat setempat dalam mengantisipasi kejadian tersebut.Adapun rumusan masalah dari penulisan skripsi ini adalah Faktor-faktor apa saja yang menyebabkan tindak pidana pencurian sepeda motor di kecamatan Blahbatuh, Kabupaten Gianyar? Bagaimana penanggulangan tindak pidana pencurian sepeda motor di polsek Blahbatuh, Kabupaten Gianyar? tipe penelitian yang digunakan adalah penelitian empiris, yakni melakukan penelitian lapangan di polsek blahbatuh melalui wawancara dengan didukung beberapa peraturan perundang-undangan yang berlaku. Suatu tindak pidana dapat berupa perbuatan yang melanggar hukum dan perbuatan tersebut bukan merupakan perbuatan melawan hukum. Dalam penelitian ini, khususnya pencurian sepeda motor, kejahatan ini sangat mengerikan dan terus menerus meresahkan masyarakat, khususnya di wilayah Blahbatuh, Kabupaten Gianyar.
Implementasi Pengaturan Disiplin Kerja Pegawai Negeri Sipil pada Lingkungan Kantor Dinas Perpustakaan dan Kearsipan Kota Denpasar di Era New Normal Covid-19
Authors: I Putu Ade Setiadi  , Ni Komang Arini Sityawati  , I Wayan Arthanaya
Published: September 2024

Implementasi pengaturan â€œdisiplin kerja pegawai negeri sipil pada lingkungan kantor dinas perpustakaan dan kearsipan kota Denpasar di era new normal covid-19 diatur dalam Surat Edaran nomor 58 tahun 2020 tentang sistem Kerja Pegawai Aparatur Sipil Negara dalam Tatanan Normal baru, Sistem kerja ASN akan berbeda seperti sistem sebelumnya yakni dengan mengedepankan pencegahan penularan Covid-19. Penelitian ini bertujuan untuk meneliti bagaimanakah implementasi penetapan standar disiplin kerja terhadap pegawai negeri sipil pada lingkungan kantor dinas perpustakaan dan kearsipan kota denpasar ? dan bagaimanakah sanksi hukum terhadap pegawai negeri sipil yang melakukan tindak pelanggaran disiplin pada lingkungan kantor dinas perpustakaan dan kearsipan kota denpasar ? Metode penelitian yang digunakan adalah metode penelitian hukum empiris, serta sumber data primer dan sumber data sekunder. Peraturan Pemerintah No 94 Tahun 2021 dan Surat Edaran Nomor 800/2471/BKPSDM terdapat 3 klasifikasi sanksi hukum bagi pegawai pada Kantor Dinas Perpustakaan dan Kearsipan Kota Denpasar berdasarkan Peraturan Pemerintah Nomor 94 Tahun 2021 yaitu: pelanggaran disiplin ringan yang terdapat dalam Pasal 9â€, pelanggaran disiplin sedang terdapat dalam Pasal 10, dan pelanggaran disiplin berat terdapat dalam Pasal 11
Pertanggungjawaban Pidana tanpa Sifat Melawan Hukum dalam Perspektif Pembaharuan Hukum Pidana
Authors: Ferdinandus Kila  , I Nyoman Gede Sugiartha  , Ni Made Puspasutari Ujianti
Published: September 2024

Salah satu unsur dari tindak pidana adalah unsur sifat melawan hukum. Unsur tersebut merupakan suatu penilaian obyektif terhadap perbuatan. Perbuatan seseorang yang dapat dikatakan melawan hukum yaitu  apabila perbuatan itu masuk dalam rumusan delik sebagaimana yang dirumuskan dalam undang-undang, namun adakalanya perbuatan seseorang yang telah memenuhi rumusan delik (undang-undang pidana) itu tidak senantiasa bersifat melawan hukum, sebab mungkin ada hal yang menghilangkan sifat melawan hukumnya perbuatan tersebut. Berdasarkan pokok pemikiran di atas maka dapat dirumuskan beberapa permasalahan yaitu bagaimana kebijakan hukum pidana positif terhadap asas tiada pertanggungjawaban pidana tanpa sifat melawan hukum dan bagaimana kebijakan hukum pidana yang akan datang terhadap asas tiada pertanggungjawaban pidana tanpa sifat melawan hukum? Asas Tiada Pidana Tanpa Kesalahan atau Asas Kesalahan merupakan asas yang fundamental dalam hukum pidana dan menjadi salah satu unsur pertanggungjawaban pidana dari suatu subjek hukum pidana. Dengan kata lain sifat merlawan hukum yang formil itu ada dalam pasal-pasal perundang-undangan dan sifat melawan hukum yang materiil hanya ada dalam teori saja atau hanya terdapat di luar perundang-undangan. Serta Kebijakan Hukum Pidana Asas tiada pertanggungjawaban pidana tanpa sifat melawan hukum dalam hukum pidana nasional yang akan datang menerapkan adanya batasan/pengertian.
Kedudukan Anak Astra dalam Mewaris Menurut Hukum Waris Adat Bali di Desa Adat Bengkel Tabanan
Authors: I Putu Aldi Wiryatama  , I Nyoman Putu Budiartha  , Diah Gayatri Sudibya
Published: September 2024

Berdasarkan hukum waris bersama Bali, status hukum anak Astra mengikuti status hukum ayah mereka setelah orang tua mereka menikah secara sah. Dalam kehidupan bermasyarakat, kemunculan anak oleh perempuan yang belum menikah secara sah dapat menimbulkan masalah. 1) status hukum anak Astra dalam pengertian hukum waris adat di Bali; 2) status hukum anak Astra dalam hal pewarisan setelah sahnya perkawinan. Hukum Waris Adat Bali  Orang Tua. Untuk pembahasan ini, penelitian ini dilakukan dengan menggunakan penelitian hukum empiris. Sumber data dalam penelitian ini adalah sumber primer seperti penelitian lapangan dan sumber sekunder yang ditulis oleh para ahli, dan hasil para ilmuwan  diolah dan dianalisis secara deskriptif untuk mencapai kesimpulan. Penyelidikan membuktikan bahwa status hukum anak Astra setelah Undang-Undang Nomor 1 Tahun 1974 mulai berlaku secara hukum hanyalah hubungan perdata dengan ibu dan keluarganya. Hak Anak Astra dalam Hukum Adat Bali Setelah orang tua kandung menikah secara sah di Bali, setelah anak Astra lahir dalam perkawinan yang sah, hak dan statusnya didasarkan pada ayahnya (Pursa).
Sanksi Pidana Terhadap Pelaku Penjarahan pada Saat Bencana Alam
Authors: I Made Ary Supartawan  , Anak Agung Sagung Laksmi Dewi  , Ni Made Sukaryati Karma
Published: September 2024

Tindak pidana penjarahan dapat diklasifikasikan sesuai dengan yang terangkum pada Pasal 363 KUHP yaitu tindak pidana pencurian dengan pemberatan karena dilakukan pada saat keadaan tertentu seperti gempa bumi. Rumusan permasalahan ini, 1) Bagaimana kebijakan pengaturan hukum tindak pidana penjarahan dalam hukum pidana? dan 2) Bagaimana sanksi tindak pidana penjarahan terhadap pelaku penjarahan pada saat bencana alam gempa bumi dalam perspektif hukum pidana? Dalam penelitian ini memakai metode hukum normatif dan pendekatan perundang-undangan. Simpulan dari penelitian ini yaitu kebijakan pengaturan hukum tindak pidana penjarahan dalam hukum pidana berdasarkan Pasal 363 KUHP pihak yang berwenang menangkap berdasarkan bukti, masa waktu yang cukup dan sanksi tindak pidana penjarahan terhadap pelaku penjarahan pada saat bencana alam gempa bumi dalam perspektif hukum pidana berdasarkan Pasal 363 ayat (1) ke-2 KUHP dikenakan 7 tahun penjara. Saran dalam penelitian ini kepada pemerintah sebaiknya aturan mengenai tindak pidana penjarahan ditingkatkan kembali, dari segi sanksinya agar memberi efek jera terhadap pelaku tindak pidana penjarahan.