bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring community- and systemic-level gender-based violence in visible minority women across five countries from an intersectionality lens: protocol for a mixed-methods systematic review
Authors: Chowdhury Nashit , Erman Didem , Raihan Mohammad , Marshall Zack , Datta Ranjan , Aghajafari Fariba , Shankar Janki , Sehgal Kamal , Rashid Ruksana , Turin Tanvir C
Published: August 2024

Introduction

The intersection of sexism with racism and xenophobia disproportionately exposes visible minority women to gender-based violence (GBV) at the community and systemic levels. This study aims to understand the knowledge strengths and gaps on GBV against visible minority women with an intersectional lens, revealing systemic barriers to accessing support and how these barriers intensify GBV and its effects. It will also identify effective and ineffective policies and practices in the literature to develop strategies addressing the root causes of GBV and supporting survivors.

Methods and analysis

We will conduct a mixed-methods systematic review using a convergent integrated approach to examine current literature on community- and systemic-level GBV against visible minority women. We will follow Joanna Briggs Institute’s guidelines to converge data from both qualitative and quantitative studies to obtain an integrated qualitative synthesis on GBV in five countries: Canada, the USA, the UK, Australia and New Zealand. This analysis will be conducted following Thomas and Harden’s thematic synthesis guidelines. Community members with lived experience of GBV will actively contribute to improving the relevance and interpretation of results, following a community-engaged research approach. Themes are expected to unveil various aspects of community- and systemic-level GBV due to the intersection of racism, xenophobia and sexism, alongside barriers in addressing GBV and research gaps.

Ethics and dissemination

Since this study does not involve primary data collection or the use of identifiable human data, no ethical approval will be needed. Results will be disseminated through integrated knowledge translation, involving collaboration with participants who have lived experience of GBV. The findings will be used to identify specific areas of policy intervention, including adopting culturally sensitive approaches, improving school and workplace policies and promoting rights of visible minority women.
Scoping review of healthcare professionals’ views on intimate partner violence in the Middle East and North Africa
Authors: Al-Salmi Sabrina , Aly Farah W , Najeeb Farah S N , Shaikh Zoya , Zuaiter Farah A O A , Doherty Sally , Sefen Jessica Atef Nassef
Published: August 2024

Objectives

This scoping review aims to survey healthcare providers (HCPs) in the Middle East and North Africa (MENA) about their knowledge, attitudes and barriers to working with women who have experienced intimate partner violence (IPV). This review aims to map the breadth of available peer-reviewed literature that may inform future educational training programmes.

Design

Scoping review.

Data sources

The scoping review included studies up to December 2023 from PUBMED, Medline, COCHRANE, Cumulative Index of Nursing and Allied Health Literature, PsycINFO and Arabic medical journals.

Eligibility criteria

Selected articles were restricted to those carried out in the MENA region, available in full text and with no date restrictions.

Data extraction and synthesis

Data were extracted from all studies to include research location, year of publication, type of journal, methodology, design, participants, knowledge, attitudes and barriers. By charting the information into a table, the data were analysed using frequency, counts and descriptive content analysis.

Results

Of the 1060 articles reviewed, 29 eligible studies were included in this scoping review. 27% of the articles reported HCPs’ lack of knowledge about IPV protocols. The dominant attitude reported was a preference to treat the presenting health complaint and avoid discussing IPV. Finally, 30% of articles reported HCPs’ lack of training as the main barrier.

Conclusion

Our paper concluded that there is a lack of research in understanding the knowledge, attitudes and barriers surrounding HCPs in the MENA region and IPV. This scoping review highlights the need for further research, informed interventions and training for HCPs in the region.
Needs of family caregivers of hospitalised adults with dementia during care transitions: a qualitative study in a US Department of Veterans Affairs Hospital
Authors: Horstman Molly J , Evans Tracy L , Guo Crystal , Sonnenfeld Mandi , Naik Aanand D , Stevens Alan , Kunik Mark E
Published: August 2024

Objective

To identify the needs of caregivers of hospitalised adults with dementia in the hospital and during care transitions.

Design

Pragmatic qualitative inquiry with semi-structured interviews.

Setting

Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, USA.

Participants

12 family caregivers (family member (n=11); friend (n=1)) and 15 health professionals (hospital medicine physicians (n=4), inpatient nurse case managers (n=2), social workers (n=4), outpatient geriatrics providers (n=2), a primary care provider (n=1), geriatric psychiatrists (n=2)) were interviewed. Caregivers were recruited while their care recipient was hospitalised and were interviewed at least 2 weeks after the care recipient was discharged from the hospital. Health professionals were eligible for the study if they provided care to patients with dementia in the inpatient or outpatient setting.

Results

Four recommendations emerged from the analysis: (1) engage caregivers as partners in the care team, (2) provide dementia-specific information and training, (3) connect caregivers to home and community-based services and (4) provide care navigation and support for the caregiver posthospitalisation.

Conclusions

Hospital care transitions are challenging for caregivers of hospitalised adults living with dementia. Care transition interventions designed to support caregivers with tailored, dementia-specific information and services are needed.
Trial to assess the tolerability of using felodipine to upregulate autophagy as a treatment of Huntington’s disease (FELL-HD): a phase II, single-centre, open-label, dose-finding trial protocol
Authors: Andresen Katie , Cutting Emma , Apostolopoulos Dimitrios , Evans Amy H , Oakley Laura , Dayimu Alimu , Demiris Nikolaos , Bongaerts Katherine , Staples Robyn , Gooding Wendy , Rubinsztein David C , Barker Roger A
Published: August 2024

Introduction

Huntington’s disease (HD) is an autosomal dominant neurodegenerative disorder that presents with a progressive movement disorder along with cognitive and psychiatric problems. It is caused by a Cytosine-adenin-guanine (CAG) expansion in exon 1 of the huntingtin gene which codes for mutant huntingtin (mHTT) that over time accumulates in cells, causing dysfunction and then death through new toxic gain-of-function mechanisms. Autophagy has been shown to be critical for the degradation of diverse intracytoplasmic aggregate-prone proteins that cause neurodegenerative disease, including mHTT. From a screen of a library enriched in approved drugs, felodipine was selected as the most suitable candidate showing strong autophagy-inducing effects in preclinical models of HD. We are, therefore, conducting a trial to assess the safety and tolerability of felodipine in people with early HD.

Methods and analysis

FELL-HD is a phase II, single-centre, open-label, dose-finding trial in people with early HD. 18 participants with early clinical features of the disease will be treated with felodipine for 58 weeks, with a further 4-week follow-up. The primary outcome measure is the number of adverse events attributable to felodipine. Exploratory outcomes include additional measures of motor and cognitive function, non-motor symptoms and quality of life scales, as well as peripheral and central disease biomarkers assessed through brain MRI. Analysis of blood and cerebrospinal fluid will also be performed through an associated sample study, FELL HD-s.

Ethics and dissemination

The study was approved by the London-Brent Research Ethics Committee (reference 22/LO/0387) and has been accepted by the Medicines and Healthcare products Regulatory Agency for clinical trials authorisation (reference CTA 12854/0256/001-0001). A lay summary of the results of the trial will be uploaded to our research group website which is publicly accessible. A webinar or in-person open day, to present results of the trial to participants and our wider cohort of patients who attend our centre, will be held once the trial is completed. The results of the trial will also be published in scientific journals and presented at national and international conferences.

Trial registration numbers

EudraCT-2021-000897-27,ISRCTN56240656.
The Myth of the Coder
Authors: Bullynck Maarten , De Mol Liesbeth
Published: August 2024

Dek :

Considering the historical distinction between coder and programmer.
A Comprehensive Analysis of Exosome‐Related Long Noncoding RNAs as Prognostic Biomarkers and Therapeutic Targets in Head and Neck Squamous Cell Carcinoma
Authors: Liu Tianyi , Zhao Zhan , Chen Huidong , Huang Fu , Jiang Yang , Xiao Binbin , Wang Yuqing , Hua Qingquan
Published: August 2024

Background. Long noncoding RNAs (lncRNAs) often facilitate cellular communication via exosomes. However, their specific roles in head and neck squamous cell carcinoma (HNSCC) are not well understood. Methods. We extracted data on exosome‐related lncRNAs from exoRBase and collected transcriptional profiles and clinical details for HNSCC from the TCGA database. Data preprocessing and analyses incorporated Tumor Mutation Burden and Microsatellite Instability from Researcher’s Home and drug sensitivity information from Genomics of Drug Sensitivity in Cancer database. We developed a prognostic model using Cox regression and LASSO regression analysis, with subsequent multivariate analysis to identify significant prognostic indicators. We also constructed a nomogram to evaluate the model’s clinical relevance, performed Gene Set Enrichment Analysis (GSEA), and analyzed the immune microenvironment and therapy sensitivity using CIBERSORT and TIDE algorithms. Supporting in vitro experiments and statistical analyses were conducted. Results. Our comprehensive investigation revealed 17 exosome‐associated lncRNAs critical for patient survival in HNSCC. This enabled the development of a prognostic model that effectively stratifies patients into high‐risk and low‐risk categories. These lncRNAs correlate with patient demographics and clinical characteristics such as age, gender, and tumor stage. GSEA highlighted significant gene expression differences between the risk groups, particularly in pathways related to muscle formation, cellular transition, and immune response. The analysis of the immune microenvironment showed distinct immune cell infiltration patterns in high‐risk patients, indicative of compromised immune defenses. In addition, we explored the expression of critical immune checkpoints and their impact on immunotherapy efficacy, demonstrating that risk scores may predict treatment responses. Notably, LINC01564 was overexpressed in HNSCC, associated with poorer prognosis, enhanced xenobiotic metabolism, and altered immune cell infiltration. Experimental validation confirmed LINC01564’s role in promoting tumor cell proliferation, invasion, and migration, highlighting its therapeutic potential. Conclusions. Our study highlights the importance of exosome‐associated lncRNAs in HNSCC, identifying 17 critical lncRNAs as vital prognostic markers. The upregulation of LINC01564, associated with poor outcomes and increased tumor aggressiveness, underscores its potential as a therapeutic target.
Figure 6 from Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun
Published: August 2024

A, ROC curve indicated that the diagnostic AUC of MCT was 0.694. B, Calibration curve showed that the predicted line was close to the reference line. C, Decision curve analyses demonstrated that except for a small range of low thresholds, the diagnostic model showed higher benefits compared with diagnosing all patients with OSCC or diagnosing none with OSCC. D, ROC curve indicated an AUC of 0.822 for prognostic evaluation. E, Calibration curve showed that the predicted line matched well with the reference line. F, Decision curve analyses demonstrated that except for a small range of low thresholds, the prognostic model and each of the prognostic markers showed higher benefits compared with predicting all patients with OSCC or predicting none with OSCC.
Figure 3 from Mast Cell Infiltration and Subtype Promote Malignant Transformation of Oral Precancer and Progression of Oral Cancer
Authors: Cai Xin-Jia , Peng Chao-Ran , Zhang Jian-Yun , Li Xue-Fen , Wang Xu , Han Ying , Zhang He-Yu , Peng Xin , Li Tie-Jun
Published: August 2024

Correlations between the different types of immune cells in A, OLK and B, OSCC. MCs were negatively correlated with CD8 T cells in C, the GSE41613 dataset and D, the TCGA HNSC cohort.
A Systematic Review Comparing Radiofrequency versus Focused Ultrasound Pallidotomy in the Treatment of Parkinson’s Disease
Authors: Guidera Jennifer A. , Kondapavulur Sravani , Wang Doris D.
Published: August 2024

Introduction: Focused ultrasound (FUS) pallidotomy is a promising new therapy for Parkinson’s disease (PD). The efficacy, motor outcomes, and side effects of FUS pallidotomy compared to radiofrequency (RF) pallidotomy are unknown. Methods: We performed a systematic review of the outcomes and side effect profiles of FUS versus RF pallidotomy in patients with PD. Results: Across four RF reports and one FUS report, putative contralateral UPDRS III scores were not significantly different following RF versus FUS pallidotomy. Across 18 RF and 2 FUS reports, the mean failure rate was 14% following RF pallidotomy versus 24% following FUS pallidotomy. Across 25 RF and 3 FUS reports, cognitive deficit was significantly more prevalent following RF pallidotomy (p = 0.004). Conclusion: At present, limited data and heterogeneity in outcome reporting challenges comparisons of FUS and RF pallidotomy efficacy and safety. Available evidence suggests FUS pallidotomy may have broadly similar efficacy and a lower risk of cognitive impairment relative to RF pallidotomy. Standardized reporting of post-lesion outcomes in future studies would improve power and rule out potential confounders of these results.
Serum Chloride and the Response to Acetazolamide in Patients With Acute Heart Failure and Volume Overload: A Post Hoc Analysis From the ADVOR Trial
Authors: Van den Eynde Jef , Martens Pieter , Dauw Jeroen , Nijst Petra , Meekers Evelyne , ter Maaten Jozine M. , Damman Kevin , Filippatos Gerasimos , Lassus Johan , Mebazaa Alexandre , Ruschitzka Frank , Dupont Matthias , Mullens Wilfried , Verbrugge Frederik H.
Published: August 2024

BACKGROUND:

Chloride plays a crucial role in renal salt sensing. This study investigates whether serum chloride is associated with clinical outcomes and decongestive response to acetazolamide in patients with acute decompensated heart failure.

METHODS:

This post hoc analysis includes all 519 patients from the ADVOR trial (Acetazolamide in Decompensated Heart Failure With Volume Overload), randomized to intravenous acetazolamide or matching placebo on top of intravenous loop diuretics. The impact of baseline serum chloride on the main trial end points and the treatment effect of acetazolamide was assessed, as was the evolution of serum chloride under decongestive treatment.

RESULTS:

Hypochloremia (<96 mmol/L) and hyperchloremia (>106 mmol/L) were present in 80 (15%) and 53 (10%), respectively, at baseline. Hypochloremia was associated with significantly slower decongestion, a longer length of hospital stay, and increased risk of all-cause mortality and heart failure readmissions. Acetazolamide increased the odds of successful decongestion and reduced length of stay irrespectively of baseline serum chloride levels. No statistically significant interaction between serum chloride levels and the effect of acetazolamide on death or heart failure readmissions was observed. The placebo group exhibited a progressive decline in serum chloride, which was effectively prevented by acetazolamide (
P
<0.001).

CONCLUSIONS:

Hypochloremia is associated with diuretic resistance and worse clinical outcomes. Add-on acetazolamide therapy improves decongestion across the entire range of serum chloride and prevents the drop in chloride levels caused by loop diuretic monotherapy.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03505788
Hintonelmis spila sp. nov. (Elmidae: Elminae): a new species of riffle beetle from Amazonian region
Authors: PINEDO-GARCIA RAUL BISMARCK , HAMADA NEUSA , NASCIMENTO JEANE MARCELLE CAVALCANTE DO
Published: August 2024

A new species, Hintonelmis spila sp. nov. from Brazil, Guyana, and Suriname, is described, illustrated, and diagnosed. The new species can be distinguished from all known species of the genus by the coloration pattern of the elytra (a pair of elongated yellowish-brown patches near the humeral region, a second pair is shorter than the first one, and situated approximately on apical 3/5, and an apical patch along the elytral suture). The combination of characters of the male genitalia can be helpful to distinguish species: the parameres are 3/5 the length of the penis, the phallobase is shorter than the penis, and it is three times longer than wide, and the penis is 6.2 times longer than wide.
The Changing Morphology of Global Precipitation Systems during the Last Two Decades
Authors: Zhang Yan , Wang Kaicun
Published: August 2024

The morphology of global precipitation systems can enhance our comprehension of precipitation patterns and the underlying physical processes. However, several unresolved issues remain in the existing studies of precipitation system morphology. This study employs Integrated Multi-satellitE Retrievals for Global Precipitation Measurement (GPM) (IMERG)-derived precipitation system dataset to investigate the climatological and changing characteristics of global precipitation system morphology from 2001 to 2022. The results show that precipitation systems with larger scales tend to be more flattened in morphology, while no clear differences in morphological characteristics are observed across systems with different intensities. In terms of geographic distributions, a notable land–sea contrast is observed, with land systems more circular than those over oceans. Due to the impact of the Coriolis force, the orientation distribution of precipitation systems shows obvious hemispherical contrast. Precipitation systems over tropical regions are more regular in shape and more likely to be organized convective systems. During the period of 2001–22, there is a significant trend of global precipitation systems becoming more flattened and are more likely to manifest as organized convective systems. Our results also indicate that the precipitation system morphology is under combined influence of subtropical highs, lateral stretching influences of wind, and the organizing effects of moisture transport and convergence. Moreover, the increasing flattening of precipitation systems could be attributed to enhanced atmospheric stability which constrains vertical expansion and increased moisture availability which favors wider horizontal extension. This study could provide new insights into precipitation changes under global warming.
Efficient and Accurate Shortcuts for Calculating the Extended Heat Index
Authors: Lanzante John R.
Published: August 2024

The heat index (HI), based on Steadman’s model of thermoregulation, has found wide applicability for estimating human heat stress. It has proven useful in research endeavors aimed at estimating future changes associated with global climate change as well as operationally for the issuance of heat advisories by the U.S. National Weather Service (NWS). The actual computation of the HI based on ambient temperature and humidity has been streamlined by the use of a polynomial fit by Rothfusz to Steadman’s model output. Recently, Steadman’s model has been updated by Lu and Romps to provide applicability to temperature and humidity values that were “out of range” of Steadman’s model. The authors of this extended HI (EHI) have provided computer code to enable application. However, because of the complexity of the model, execution of the code would be relatively costly for use in applications involving dense grids and multimodel ensembles covering decades such as those appropriate for assessing the range of possible changes in human heat stress. Here, shortcuts are provided in the form of a “lookup table” and polynomials that provide computational savings of several orders of magnitude. Error analyses provide estimates of accuracy.

Significance Statement

Over 40 years ago, an index was developed to estimate the heat stress on the human body due to the combined effects of temperature and humidity. It has been used widely both to issue public heat advisories and in studies aimed at assessing possible future changes in heat stress due to climate change. Recently, that index has been updated and extended to handle higher temperatures that are becoming more common due to climate change. This work provides efficient and accurate shortcuts to compute the new index which require much less computing time and can be beneficial for more demanding tasks such as estimating the range of possibilities in the future.
The Representative Kanpur Tannery’s Ganges Water Pollution Problem
Authors: Batabyal Amitrajeet A.
Published: August 2024

In this research note, we focus on a representative leather-producing tannery in Kanpur, India and shed light on two specific questions that, to the best of our knowledge, have not been studied previously in the literature. First, what is the deadweight loss from water pollution caused by this tannery? Second, how might an effluent fee be used to ensure that the socially optimal amount of leather is produced by this same tannery? Our linear model provides answers to these two questions and also shows how our results can be used to guide pollution regulation policy.

JEL Codes: Q53, R11
The mediating effect of resilience between work fatigue and psychological distress among healthcare workers in Brazil, Lebanon, Nigeria, Pakistan, Poland, Qatar, Serbia, and Tunisia
Authors: Fekih-Romdhane Feten , Hallit Souheil , Mohammed Irfan , El Khatib Sarah , Brytek-Matera Anna , Eze Shadrach Chinecherem , Egwu Kenneth , Jabeen Rawshan , Pavlović Nebojša , Salameh Pascale , Cherfane Michelle , Younes Samar , Akel Marwan , Haddad Chadia , Choueiry Randa , Iskandar Katia
Published: August 2024

Objectives

To test the hypothesis that resilience has a mediating effect on the association between work fatigue and psychological distress.

Methods

A cross-sectional survey was conducted online in eight countries in 2021: Brazil, Lebanon, Nigeria, Pakistan, Poland, Qatar, Serbia, and Tunisia. A total of 1094 healthcare professionals specialized in medicine, pharmacy, and nurse practitioners that were exposed to/worked with COVID-19 patients were included (age: 33.89 ± 10.79 years; 59.6% females).

Results

After adjusting for potential confounders (i.e., country, gender, primary work in emergency department, primary work in infectious disease, primary work in intensive care unit, working in a COVID-19 ward, and working voluntary hours), the results of the mediation analysis showed that resilience fully mediated the association between physical work fatigue and psychological distress and partially mediated the associations between mental and emotional work fatigue and psychological distress. Higher work fatigue was significantly associated with less resilience; higher resilience was significantly associated with less psychological distress. Finally, higher mental and emotional, but not physical, work fatigue, were directly and significantly associated with more psychological distress.

Conclusion

Identifying resilience as an important mediator in the path from fatigue to distress helps elucidate underlying mechanisms and pathways leading to the mental health-alteration process among healthcare workers during COVID-19. New strategies targeting resilience may be developed to further improve mental health outcomes among healthcare workers.
The influence of life transitions on Danish adults’ physical activity beliefs and behaviour: A qualitative study
Authors: Dalgas Birgitte Westerskov , Hamilton Kyra , Elmose-Østerlund Karsten , Bredahl Thomas
Published: August 2024

Using a qualitative design, we explored how life transitions influence Danish adults’ physical activity beliefs and behaviour adopting the Theory of Planned Behaviour as a guiding framework. Life story interviews with 42 participants revealed 6 salient life transition periods which affected physical activity behaviour, either in a disruptive way resulting in decreased activity levels or in a facilitative manner, providing opportunities for increased activity engagement. The identified life transition periods uniquely influenced individuals’ attitudes, subjective norms and perceived behavioural control (PBC) beliefs, thus affecting motivations toward physical activity. Specifically, starting primary school or a career, forming a romantic relationship, and having a child primarily shaped subjective norm and PBC, while leaving home was especially influential on PBC and retirement on attitudes and PBC. Consistent themes across the transition periods included time constraints and opportunities to be active, supportive social contexts, access to facilities and having a need to be active.
Implementing the organizational readiness for change survey during a novel midwifery preceptor program in Sierra Leone: stakeholder results
Authors: van de Water Brittney J. , Longacre Ashley H. , Hotchkiss Jenny , Sonnie Mustapha , Mann Julie , Lemor Elizabeth
Published: August 2024

Background

Sierra Leone has one of the world’s highest maternal and infant mortality rates and suffers from a shortage of well-trained health professionals, including midwives. Prior to engaging in systematic interventions, it is critical to measure organizational readiness to gauge members’ psychological and behavioral preparedness to implement change. We aimed to measure the organizational readiness for implementing change and compare results among midwives and administrative leaders at two schools of midwifery in Sierra Leone prior to the rollout of a midwifery preceptor program.

Methods

The Organizational Readiness for Implementing Change (ORIC) survey is a validated 12-item questionnaire designed to assess two domains of organizational readiness for change: change commitment (motivation) and change efficacy (capacity). All survey items begin with the same prompt and a five-item Likert scale response, with seven questions about change commitment and five about change efficacy. Data collection occurred in two schools of midwifery in Sierra Leone during two day-long meetings with stakeholders. Statistical analysis was conducted using descriptive statistics and Wilcoxon rank-sum test to compare independent samples: School 1 versus School 2 (site), midwife versus other roles (role).

Results

Participants included 42 respondents (mean age 41 years, 95% female). Surveys were distributed evenly between the two sites. Occupations included midwifery faculty (n = 8), administrators (n = 5), clinicians (n = 25), and clinical educators (n = 4). Domain 1 (change commitment) had a mean score of 4.72 (SD 0.47) while Domain 2 (change efficacy) had a mean score of 4.53 (SD 0.54) out of a total potential score of five. There were no statistically significant differences between site responses for Domain 1 (p = 0.5479) and Domain 2 (p = 0.1026) nor role responses for Domain 1 (p = 0.0627) and Domain 2 (p = 0.2520).

Conclusion

Stakeholders had very high overall readiness for change across all ORIC questions for both change commitment and change efficacy. Mean scores for change commitment were slightly higher which is not surprising given the low-resourced settings stakeholders work in while training students. High mean scores across sites and roles is encouraging as this novel preceptor program is currently being rolled out.
Predictive digital twin driven trust model for cloud service providers with Fuzzy inferred trust score calculation
Authors: John Jomina , K John Singh
Published: August 2024

Cloud computing has become integral to modern computing infrastructure, offering scalability, flexibility, and cost-effectiveness. Trust is a critical aspect of cloud computing, influencing user decisions in selecting Cloud Service Providers (CSPs). This paper provides a comprehensive review of existing trust models in cloud computing, including agreement-based, SLA-based, certificate-based, feedback-based, domain-based, prediction-based, and reputation-based models. Building on this foundation, we propose a novel methodology for creating a trust model in cloud computing using digital twins for CSPs. The digital twin is augmented with a fuzzy inference system, which computes the trust score of a CSP based on trust-related parameters. The architecture of the digital twin with the fuzzy inference system is detailed, outlining how it processes security parameter values obtained through penetration testing mechanisms. These parameter values are transformed into crisp values using a linear ridge regression function and then fed into the fuzzy inference system to calculate a final trust score for the CSP. The paper also presents the outputs of the fuzzy inference system, demonstrating how different security parameter inputs yield various trust scores. This methodology provides a robust framework for assessing CSP trustworthiness and enhancing decision-making processes in cloud service selection.
Automated Extraction of Patient-Centered Outcomes After Breast Cancer Treatment: An Open-Source Large Language Model–Based Toolkit
Authors: Luo Man , Trivedi Shubham , Kurian Allison W. , Ward Kevin , Keegan Theresa H.M. , Rubin Daniel , Banerjee Imon
Published: August 2024

PURPOSE

Patient-centered outcomes (PCOs) are pivotal in cancer treatment, as they directly reflect patients' quality of life. Although multiple studies suggest that factors affecting breast cancer–related morbidity and survival are influenced by treatment side effects and adherence to long-term treatment, such data are generally only available on a smaller scale or from a single center. The primary challenge with collecting these data is that the outcomes are captured as free text in clinical narratives written by clinicians.

MATERIALS AND METHODS

Given the complexity of PCO documentation in these narratives, computerized methods are necessary to unlock the wealth of information buried in unstructured text notes that often document PCOs. Inspired by the success of large language models (LLMs), we examined the adaptability of three LLMs, GPT-2, BioGPT, and PMC-LLaMA, on PCO tasks across three institutions, Mayo Clinic, Emory University Hospital, and Stanford University. We developed an open-source framework for fine-tuning LLM that can directly extract the five different categories of PCO from the clinic notes.

RESULTS

We found that these LLMs without fine-tuning (zero-shot) struggle with challenging PCO extraction tasks, displaying almost random performance, even with some task-specific examples (few-shot learning). The performance of our fine-tuned, task-specific models is notably superior compared with their non–fine-tuned LLM models. Moreover, the fine-tuned GPT-2 model has demonstrated a significantly better performance than the other two larger LLMs.

CONCLUSION

Our discovery indicates that although LLMs serve as effective general-purpose models for tasks across various domains, they require fine-tuning when applied to the clinician domain. Our proposed approach has the potential to lead more efficient, adaptable models for PCO information extraction, reducing reliance on extensive computational resources while still delivering superior performance for specific tasks.
Cancer Care Disparities: Overcoming Barriers to Cancer Control in Low- and Middle-Income Countries
Authors: Bamodu Oluwaseun Adebayo , Chung Chen-Chih
Published: August 2024

The rising global burden of cancer disproportionately affects low- and middle-income countries (LMICs), which account for over half of new patients and cancer deaths worldwide. However, LMIC health systems face profound challenges in implementing comprehensive cancer control programs because of limited health care resources and infrastructure. This analytical review explores contemporary evidence on barriers undermining cancer control efforts in resource-constrained LMIC settings. We conducted a comprehensive literature review of peer-reviewed evidence on cancer control challenges and solutions tailored to resource-limited settings. We provide a conceptual framework categorizing these barriers across the cancer care continuum, from raising public awareness to palliative care. We also appraise evidence-based strategies proposed to overcome identified obstacles to cancer control in the published literature, including task-shifting to nonspecialist health workers, strategic prioritization of high-impact interventions, regional collaborations, patient navigation systems, and novel financing mechanisms. Developing strong primary care delivery platforms integrated with specialized oncology care, alongside flexible and resilient health system models tailored to local contexts, will be critical to curb the rising tide of cancer in resource-limited settings. Urgent global commitments and investments are needed to dismantle barriers and expand access to prevention, early detection, diagnosis, treatment, and palliation services for all patients with cancer residing in LMICs as an ethical imperative. The review elucidates priority areas for policy actions, health systems strengthening, and future research to guide international efforts toward more equitable cancer control globally.
Lymphoid Structure Presenting as a Hypermetabolic Adrenal Incidentaloma
Authors: Gilis Xavier , Servais Thomas , Pierman Guillaume , Nollevaux Marie-Cécile , Delgrange Etienne
Published: August 2024

Adrenal incidentalomas are a frequent cause for consultation in endocrinology. Current guidelines provide an algorithm for their evaluation to determinate the risk of hormonally active or malignant condition. We report a unique case of benign adrenal incidentaloma in a 53-year-old woman with multiple malignancy criteria on contrast-free computed tomography and [18F]fluorodeoxyglucose positron emission tomography–computed tomography, leading to a left adrenalectomy. Histopathologic analysis showed a 15-mm intra-adrenal lymphoid organ localized in the medulla, without any cellular atypia and organized with a capsule and multiple germinal centers. The surrounding adrenal tissue was unremarkable, and the patient did not develop any inflammatory, infectious, or neoplastic disease during the 2 following years. This is the first described case of a well-organized intra-adrenal ectopic lymphoid organ in the absence of any evident stimulus.
Reformulation of Policies to Prevent Land Conversion of Rice Fields In Achieving Indonesia's National Food Security
Authors: kholik saeful , Nurlinda Ida , Muttaqin Zainal , Priyanta Maret
Published: August 2024

Background Increased population growth and imbalance between the need for rice are driving the conversion of numerous rice fields into non-agricultural zones and posing a significant threat to national food security. Therefore, this research is carried out to effectively address Indonesian government’s policy in preventing conversion of rice fields due to the lack of harmonization between cross-sectoral policies. Method A juridical-normative research method is used to analyze policy problems through legal theory and reality. The method is studying regulations against social phenomenon in food security sourced from the unconformity between the policies and the reality. It started by elaborating a way of thought, synthesizing conclusions, stating errors, and advising the re-formulation of policies to change the appropriation of land that in turn will affect national food security. Results The results show that there is proposed concept for reformulating rice field policies to integrate policies across sectors, ensure coherence in policy planning, and enhance the efficiency policies. The addition and harmonization of the components will strengthen the protection of the rice fields while preventing inconsistency and overlapping of authority from different sectors. The realization of this re-formulation will in time manifest national food security. Conclusions Indonesian government stipulates various policies to prevent the conversion of rice fields and to manifest national food security. However, of inconsistency and overlapping authority persist in its practice. Further close examination and reviews show the need reformation of policy for a transfer of land appropriation.
Women migrant workers’ (WMWS) deskilling
Authors: Ruiz Marie , Donato Stellamarina
Published: August 2024

Women are key actresses in sending and receiving countries’ developments, and their contributions includes social and financial remittances, education and the transmission of social and cultural values (United Nations, 2006). Despite, women migrants’ undeniable contributions, they too often undergo deskilling, a process defined as the employment of workers in a different field or below their qualifications. The factors influencing deskilling include the lack of recognition of skills and qualifications, difficult access to information and employment opportunities, lack of support in the destination country and linguistic barriers. Migration can impact the social mobility of women migrants, yet not always positively (Nowicka, 2012). In the labour market, women migrants are generally disadvantaged because of occupational gender segregation, the lack of network support and childcare responsibilities (EU Commission, 2022), with higher risks of deskilling and downward social mobility. The objective of the brief is to shed light on WMWs’ deskilling and explore the impact of gender and ethnicity in labour segmentation, de-emancipation being a consequence of WMWs’ deskilling and overrepresentation in reproductive unskilled jobs.
Liquid Levothyroxine: Efficacy and Application in the Treatment of Myxoedema Coma - A Narrative Review
Authors: Nowoświat Patrycja , Maślankiewicz Maria , Muzyk Magdalena , Mrowczyk Patrycja , Bado Michał , Bednarczyk Paulina , Malaka Ewa Katarzyna , Duda Weronika , Pilawska Sandra Agnieszka , Goncerz Michał , Bilecki Krzysztof
Published: August 2024

Introduction: Myxoedema coma is a severe and rare manifestation of hypothyroidism that requires immediate and effective intervention. Traditional treatment involves the use of levothyroxine, a synthetic thyroid hormone. Liquid levothyroxine presents an alternative formulation that may offer advantages in the critical care setting, particularly when gastrointestinal absorption is impaired.
Aim of the Study: This narrative review aims to evaluate the efficacy and application of liquid levothyroxine in the treatment of myxoedema coma, comparing it to other available forms and providing insights into its clinical use.
Materials and Methods: A comprehensive literature search was conducted using databases such as PubMed, Medline, and Cochrane Library. Studies, clinical trials, case reports, and reviews were included if they addressed the use of liquid levothyroxine in myxoedema coma. Data were extracted and analyzed to assess the pharmacokinetics, administration protocols, outcomes, and comparative efficacy of liquid levothyroxine.
Results: The review identified several key studies and case reports indicating that liquid levothyroxine offers superior bioavailability and faster onset of action compared to oral tablets, particularly in patients with compromised gastrointestinal function. Case studies demonstrated improved clinical outcomes and recovery times with liquid levothyroxine, highlighting its potential benefits in the acute management of myxoedema coma.
Conclusion: Liquid levothyroxine appears to be a promising alternative for the treatment of myxoedema coma, offering enhanced absorption and rapid therapeutic effects. While preliminary data are encouraging, further research and clinical trials are necessary to establish standardized treatment protocols and confirm its efficacy. Understanding the role of liquid levothyroxine in this critical condition can enhance treatment strategies and improve patient outcomes.
Vaping and e-cigarette's as a danger of 21st century - overview of the lately reported side effects
Authors: Bieganek Paula , Tokarski Michał , Tokarska Angelika
Published: August 2024

Introduction and purpose: Vaping devices have gained popularity among youth and young adults due to their appealing flavors and the perception that they are less harmful than traditional tobacco cigarette’s. However, emerging evidence suggests that vaping may expose users to high level of hazardous chemicals, potentially leading to severe lung injuries and other side effects. The purpose of this review is to look closely to the dangers. The aim of this review is to look closely at the various side effects of vaping and usage of e-cigarette’s.
Materials and methods: This article is a literature review based on publications from PubMed and Cochrane Library, keywords included: vaping; e-cigarette’s; cardiovascular effect; pulmonary effect; oral health.
The state of knowledge: Smoking is a major contributor to cardiovascular disease (CVD), including atrial fibrillation (AF) and venous thromboembolism (VTE). People who currently smoke have an increased rate of hospitalization for heart failure (HF). The surge in vaping and e-cigarette use has resulted in an epidemic of hospitalizations and fatalities among e-cigarette users due to acute lung injury, a newly identified condition known as e-cigarette or vaping use-associated lung injury (EVALI). Beside cardiovascular and pulmonary effects vaping and e-cigarette’s are linked to various immediate and long-term health hazards.
Conclusions: Vaping poses significant health risks, particularly for young people. Side effects include respiratory problems, cardiovascular issues, and an increased risk of nicotine addiction. Additionally, exposure to harmful chemicals in e-cigarette aerosols can lead to long-term health complications. Despite its popularity as a safer alternative to smoking, the negative impacts of vaping are substantial and warrant serious attention and preventive measures.
Key words: vaping; e-cigarett’s; cardiovascular effect,;pulmonary effects; oral health
Health effects of using popular alternatives to smoking - a review of the literature
Authors: Oronowicz Radoslaw , Kmiotek Weronika , Różańska-Smuszkiewicz Gabriela , Smuszkiewicz-Różański Paweł , Karuś Aleksandra , Jama Grzegorz , Staszczak Paweł , Jaworska Barbara , Ragan Dagmara , Długosz Joanna
Published: August 2024

Introduction and Purpose: More and more alternatives to traditional smoking are available on shop shelves. Are other ways of using nicotine healthier for us? What are the advantages and disadvantages? The aim of this article is to trace the health effects of new, popular alternatives to the traditional cigarette.
Materials and methods: A literature search was conducted using the medical databases PubMed and Google Scholar. Articles were retrieved in English, employing the key words: “Iqos”, “Glo”, „ e-cigarette” and „ tobacco” appropriate configurations.
Conclusions: Modern tobacco devices, such as IQOS and Glo, emit significantly less harmful substances than traditional cigarettes. In particular, emissions of carbon monoxide, formaldehyde and polycyclic aromatic hydrocarbons are significantly lower. Nevertheless, nicotine remains the main ingredient in these products, with serious health risks. Regular use of nicotine can lead to addiction, cardiovascular disease and problems with the nervous system and oral cavity. Inhaling aerosol from tobacco devices such as IQOS, Glo and disposable e-cigarettes can lead to damage to lung cells and other respiratory health problems. Despite the lower risks, the use of alternative smoking methods is still harmful to our health.
effects of active commuting on cardiovascular disease incidence and mortality - a literature review
Authors: Pędras Marek , Perenc Helena , Majka Karolina , Krawczyk Kornelia , Pasieka Karolina , Kosar Michał , Kupniewski Kuba , Korzonek Urszula , Kosiorowska Paulina
Published: August 2024

Objective: Cardiovascular disease (CVD) remains a leading cause of death in developed countries, with physical inactivity identified as a major risk factor. Despite widespread promotion of physical activity by health organizations and general awareness of its benefits, inactivity is increasing. Active commuting, such as walking or cycling to replace driving or public transport, offers a practical way to integrate physical activity into daily routines without requiring additional time. This study aims to evaluate the impact of active commuting on reducing CVD incidence and mortality, considering the duration and mode of commuting.
Methods: An extensive literature review was conducted using PubMed, focusing on studies from 2000 to 2023.
Results: The review revealed mixed findings on the effects of active commuting on cardiovascular health. Studies such as Celis-Morales et al., indicated significant reductions in CVD incidence and mortality with longer durations of walking and cycling. Conversely, studies like Barengo et al. and Lopirinzi et al. reported no significant benefits from active commuting alone. Differences in study design, population demographics, and measurement methods likely contribute to these inconsistencies.
Conclusions: Overall, evidence suggests that while active commuting, particularly cycling, can reduce CVD risk, its benefits are influenced by the intensity and duration of activity and individual fitness levels. Active commuting may be most effective when combined with other forms of physical activity. The review highlights the need for more standardized research to accurately quantify the health benefits of active commuting and inform policy development.
Quality of life corrected by osteoarthritis of the hip and knee - therapeutic options for athletes
Authors: Dutka Martyna , Bernacki Piotr , Bernacki Radosław , Zardzewiały Witold , Zaremskyi Oleksii , Białogłowski Konrad , Skrzyńska Klaudia , Mendyk Krzysztof , Mordasiewicz Dominika , Fuszara Kamil
Published: August 2024

Osteoarthritis (OA) is the most common chronic joint disease that causes slow degeneration of the articular cartilage of each joint component. For years, treatments have been sought to halt the progression of OA. Modern medicine has not yet found such a cure, but it has therapies to offer that make life more comfortable for a short period of time. Oral therapies with non-steroidal anti-inflammatory drugs and paracetamol effectively relieve only minor joint pain in the early stages of OA. Hyaluronic acid (HA) and corticosteroid (GCS) delivery therapies may result in clinically significant benefits in a significant number of patients, but emerging evidence suggests that the apparent efficacy of these treatments is largely due to other factors, including the placebo effect. The paucity of high-level evidence of action and methodological limitations make it difficult to consider delivery injections with stem cell preparations as effective in treating the causes of OA. Although many promising pharmacological treatments are currently in clinical trials, the best therapeutic option for OA to date is joint alloplasty. The most common surgical access when performing hip alloplasty is the posterior access. Replacing the diseased hip joint has many benefits for the patient including pain relief, improved quality of daily life and more efficient mobility.