bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating Complexity: A Tailored Question-Answering Approach for PDFs in Finance, Bio-Medicine, and Science
Authors: Kumar Teerath , Bhujbal Rutu , Raj Kislay , Roy Arunabha M.
Published: October 2024

Understanding complex Portable Document Format (PDF) files, such as research papers, clinical reports, and scientific manuals, is often a time-consuming endeavor. While significant progress has been made in developing question-answering (QA) systems that yield contextually relevant responses, the creation of a comprehensive end-to-end machine learning model capable of addressing intricate questions remains a formidable challenge. These systems typically rely on substantial labeled training data to effectively train their foundational models for specific tasks. However, assembling such datasets is particularly challenging for complex documents, including annual reports from major technology companies. In this paper, we address this issue by developing a QA system specifically designed for PDF documents, focusing on the domains of finance, biomedicine, and scientific literature. We manually curated datasets from these areas for evaluation purposes and utilized pre-trained Bidirectional Encoder Representations from Transformers (BERT) models from the Hugging Face library. The models were evaluated using the F1 score, achieving a notable score of 44% with the BERT Large model.
Origins and Unifying of Four Fundament Forces of Nature
Authors: Liu Shangqing
Published: October 2024

Four fundamental forces of nature are too important to say because they dominate the formation and evolution of the universe. However, until now, their origins and physical essences have not been answered with wide acceptations. This paper gives new explanations for the origins and essences of these four forces based on different understandings, which can easily explain that all of the four fundamental forces of nature are originated from the electric force only and so can be unified to be one force. First of all, the gravitational force is a synthesized electric force produced by a huge amount of electric charges via particular movements and distributions. Depending on inference of nuclear structure, which has strong supports by observed phenomena, the strong and weak forces are deduced to be electric forces too. The introduced new understandings can explain observed confusing phenomena simply and effectively, such as “galaxy shape”, “dark matter”, “dark energy”, “gamma-ray bursts” in nuclear fission or fusion and from black holes, and so on. The author wrote this paper is for helping to find the natural truth earlier.
Assessing Overall Performance of Sports Clubs and Decomposing into Their On-Field and Off-Field Efficiency
Authors: Galagedera Don U.A. , Tan Pei Pei (Joan)
Published: October 2024

Generally playing group management performance and financial management performance of sports clubs are assessed separately. We adopt a non-parametric methodology to assess overall performance first conceptualising overall management as a production process comprising of two serially-linked subprocesses; playing group management and financial management. Thereafter, we decompose overall performance to obtain estimates of performance at the subprocess level. Through this procedure it is possible to determine whether it is a sports club’s on-field performance or off-field performance or both may contribute towards its inefficiency, if any, in overall management. Further, a model is developed to determine targets for inefficient clubs to become overall efficient. The method is applied to 18 clubs in Australian rules football league. In 2021 season, the results reveal that on-field performance, on average, is better than off-field performance and variability in off-field performance is higher than that of on-field performance. Observed overall management inefficiency is mainly due to inefficiency in financial management. Results are robust to weighting scheme adopted in overall efficiency configuration.
Therapeutic Potential of Psychedelic Compounds for Substance Use Disorders
Authors: Valdez Tamara , Patel Valbhi , Senesombath Dally , Hatahet-Donovan Zayd , Hornick Mary Grace
Published: October 2024

Psychedelics have recently (re)emerged as therapeutics of high potential for multiple mental health conditions, including substance use disorders (SUDs). Despite early mid-20th century anecdotal reports and pilot studies demonstrating the possibility of these substances in efficaciously treating conditions such as alcohol and opioid use disorders, legal restrictions and social stigma have historically hindered further research into this area. Nevertheless, concurrent with the rise in SUDs and other mental health conditions, researchers have again turned their attention to these compounds, searching for differing pharmacological targets as well as more holistic treatments that might increase patient adherence and efficacy. The aim of this review is to examine the emerging evidence with regards to the therapeutic treatment of SUDs with the psychedelic compounds psilocybin, ketamine, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA), ayahuasca, ibogaine and peyote.
Recommendation Algorithm for Graph Convolutional Collaborative Filtering Based on Multivariate Sampling
Authors: Yan Hai , Tao Zheng Ji , Zhong Liu Zhi , Yang Wang Dong , Rui Ding Cheng
Published: October 2024

In the field of recommender systems, difficult negative samples that are easily misclassified by classifiers have higher learning value. In order to solve the problem that the existing graph convolutional network lacks the exploration of negative sampling strategy, a multivariate sampling based on graph convolution collaborative filtering recommendation model was proposed. Firstly, part of the information in the positive sample was injected into the negative sample, and the high quality difficult negative sample was selected by the inner product method. Then, contrastive learning is used to maximize the similarity between the difficult negative samples and the positive samples, so that the difficult negative samples are as close to the positive samples as possible in the feature space. Ultimately, a multi-task approach was employed to concurrently enhance both the recommendation supervision task and the contrastive learning task. To validate the effectiveness of our approach, we conducted comparative evaluations utilizing three publicly accessible datasets. The experimental outcomes indicate that our proposed model surpasses the baseline model in terms of performance.
Growth, Safety and Tolerance in Infants Fed Rice Protein Hydrolysate Formula: The GRITO Randomized Control Trial
Authors: Lemoiné Anaïs , Nieto-García Antonio , Nieto-Cid María , Espín-Jaime Beatriz , Mazón Ángel , Salhi Hocine , Salamouras Dimitrios , Kalach Nicolas , De Castellar-Mansó Roser , Delgado-Ojeda Jesús , Navas-López Víctor Manuel
Published: October 2024

Aims: To compare the growth, safety, and tolerance acquisition in infants with cow's milk protein allergy (CMPA) when fed a hydrolyzed rice formula (HRF) versus an extensively hydrolyzed milk protein formula (EHF). Methods: A prospective, multicenter, randomized, double-blind, controlled trial was conducted with infants diagnosed with CMPA, both IgE-mediated and non-IgE-mediated (up to grade II anaphylaxis). Infants were assigned to receive either a HRF or an EHF over a 12-month follow-up period. The primary outcomes assessed were anthropometric measurements and safety. Infants who had a negative Open Oral Food Challenge (at 6, 9, and 12 months) were allowed to transition to a standard milk formula. Compliance, tolerability, and adverse events (AEs) were also evaluated. Results: A total of 105 children from six centers were enrolled in the study. Measurements of weight, length, weight-for-length, BMI, and head circumference z-scores indicated normal growth, with no significant differences between the HRF and EHF groups at baseline or during follow-up visits. Additionally, triceps skinfold thickness, mid-arm circumference, and arm muscle area showed no significant differences between the groups. Overall, 29 product-related adverse events were reported (12 in the HRF group and 17 in the EHF group). Five children in the HRF group and eleven in the EHF group experienced serious adverse events; none were attributed to the intervention. There was a trend toward faster acquisition of tolerance in HRF-fed infants compared to EHF-fed infants, but this did not reach statistical significance (median age 20.4 months versus 16.3 months, respectively, p=0.1753). Conclusions: Both EHF and HRF demonstrated appropriate growth, acquisition of tolerance, and a good safety profile in infants with CMPA, with no significant differences between the formulas.
EL TÚNEL CARPIANO: Riesgo ergonómico en trabajadoras de cultivo de flores
Authors: Piñeda Geraldo Aldo
Published: October 2024

El presente artículo es el resultado de la segunda etapa del proyecto de investigación titulado: factores de riesgo relacionados con el síndrome del túnel carpiano de origen ocupacional en trabajadores del sector floricultor de la sabana de Bogotá.Inicialmente se realizó una revisión de fuentes secundarias sobre esta patología y su asociación con agentes de riesgos ergonómicos. El objetivo fue analizar factores de riesgo en un grupo de trabajadoras en un cultivo de flores de la sabana de Bogotá.Así mismo, se observaron e identificaron los factores ergonómicos para contribuir a reducir esta enfermedad e incrementar las acciones y la cultura de la prevención contra el síndrome del túnel carpiano. El estudio fue exploratorio-descriptivo transversal.La muestra estuvo compuesta por 10 trabajadoras adultas, todas del género femenino, seleccionadas por un muestreo aleatorio simple. Para la recopilación de los datos, se realizaron observaciones directas, entrevistas y encuestas. Los factores más sobresalientes del estudio fueron las posturas inadecuadas, movimientos repetitivos, el uso excesivo de las manos.
DESEMPEÑO TÉRMICO-ENERGÉTICO DE AULAS EN LA FACULTAD DE CIENCIAS EXACTAS Y TECNOLOGIAS-UNSE-AR
Authors: Giuliano Raimondi Gabriela María del Carmen , Alende Carolina , Cascio Carlos
Published: October 2024

Faced with the challenge of the race to limit carbon dioxide emissions until the year 2050, to stop climate change, universities, as houses of higher education, must lead by example by applying sustainable solutions in their own infrastructure. The present work analyzes the thermal-energy behavior of buildings of the Facultad de Ciencias Exactas y Tecnologías de la Universidad Nacional de Santiago del Estero (FCEyT-UNSE), located in the great north of Argentina. The objective is to evaluate and find the building alternative whose combination of layout and conformation of the construction envelope results in greater energy efficiency, better integrating active and passive environmental conditioning strategies appropriate to the climate of the area. To do this, the implantation site of the university campus was characterized, and the particularities in the functionality, construction techniques and facilities of each block. Thermal balances were determined in steady, quasi-stationary, and dynamic regimes. With these results, the degree of compliance with the recommendations established in the series of IRAM 11,600 thermal conditioning standards and 11,900 building energy efficiency labeling was verified, identifying the Energy Performance Indices (EPI), in all the cases analyzed. It is concluded that it is necessary to propose, evaluate and adjust proposals for natural and artificial conditioning, prior to the construction stage of educational buildings. Thus, it is feasible to propose improvements to optimize the comfort of the university community, promote the reduction of energy consumption, and contribute to a healthy and sustainable development of the local educational habitat.
Key words: university infrastructure, thermal-energy efficiency.
Nuchal Ligament Reconstruction Surgery for Dropped Head Syndrome
Authors: Endo Kenji , Kanai Hiroshi , Sawaji Yasunobu , Aihara Takato , Suzuki Hidekazu , Konishi Takamitsu , Nishimura Hirosuke , Yamamoto Kengo
Published: October 2024

Case:

An 86-year-old woman suffered from dropped head syndrome (DHS). As she was not willing to undergo fusion surgery, we proposed a novel nuchal ligament reconstruction surgery, which is not a direct correction of the malalignment but rather a recovery of the function of extensor muscles under local anesthesia. Twelve months after surgery, the patient remains satisfied and is able to maintain a horizontal gaze.

Conclusion:

This is the first report regarding a less invasive nuchal ligament reconstruction surgery successfully performed for DHS.
Management of Rotator Cuff Tears in Severely Osteoporotic Patients
Authors: Maez Devin A. , Marquez Bryan A. , Shultz Christopher L. , Acheson Sheila N. , Richter Dustin L.
Published: October 2024

Management of rotator cuff tears (RCT) in osteoporotic patients presents significant challenges for treating clinicians because of compromised bone quality. We present a case series of 2 patients with RCT and severe osteoporosis highlighting the complexities of operative and nonoperative management and underscoring the importance of preoperative optimization and careful surgical planning in this vulnerable population. Patient 1 experienced initial improvement postarthroscopic RCT repair but required revision surgery because of anchor pullout, with eventual conversion to reverse total shoulder arthroplasty. Patient 2 faced intraoperative challenges because of previously undiagnosed osteoporosis, leading to difficulties in securely placing suture anchors, and was referred to the fracture liaison service (FLS) for osteoporosis management postoperatively. A multifaceted approach integrating preoperative optimization, advanced surgical techniques, and postoperative management is advised to improve operative success. Extensive perioperative bone quality assessments and augmentation strategies are warranted, including medication comanagement through an FLS if available. Detailed surgical planning is crucial, focusing on arthroscopic repair technique while considering various anchor factors to mitigate failure including proper placement, design, and pullout analysis. Intraoperative bone augmentation with materials such as calcium phosphate, magnesium phosphate, and polymethyl methacrylate cements significantly improves anchor fixation strength in osteoporotic bone. Consideration of a transosseous approach and potential for conversion to an open procedure is also an option when necessary. This review highlights the unique challenges and potential options available to treating clinicians when managing RCT in osteoporotic patients. Continued research and refinement of emerging treatment strategies are essential to improve outcomes and quality of life in this patient population.
Automated change detection in ground-penetrating radar using machine learning in R
Authors: Slone Scott Michael , Torres Marissa , Lamie Nathan , Cook Samantha , Perren Lee
Published: October 2024

Ground-penetrating radar (GPR) is a useful technique for subsurface change detection but is limited by the need for a subject matter expert to process and interpret coincident profiles. Use of a machine learning model can automate this process to reduce the need for subject matter expert processing and interpretation. Several machine learning models were investigated for the purpose of comparing coincident GPR profiles. Based on our literature review, a Siamese Twin model using a twinned convolutional network was identified as the optimum choice. Two neural networks were tested for the internal twinned model, ResNet50 and MobileNetV2, with the former historically having higher accuracy and the latter historically having faster processing time. When trained and tested on experimentally obtained GPR profiles with synthetically added changes, ResNet50 had a higher accuracy. Thanks to this higher accuracy, less computational processing was needed, leading to ResNet50 needing only 107 s to make a prediction compared to MobileNetV2 needing 223 s. Results imply that twinned models with higher historical accuracies should be investigated further. It is also recommended to test Siamese Twin models further with experimentally produced changes to verify the changed detection model’s accuracy is not merely specific to synthetically produced changes.
RELATO DE EXPERIÊNCIA
Authors: Medeiros Marcílio , Pereira Raimundo , Barreiros Jarleson , Silva Joaquim , Santos Cinthia , Silva-Filho Erivaldo , Lucena Regina
Published: October 2024

Este artigo tem o objetivo de relatar a experiência de realização da Oficina de Formação de Agentes de Limpeza Urbana no município de Uarini, Amazonas, realizada nos dias 30 e 31 de mês de março de 2023. Buscou-se descrever as impressões dos participantes e facilitadores em relação aos conteúdos e metodologia utilizados no processo de ensino-aprendizagem. A Oficina foi realizada em nove sequências de conteúdos pedagógicos, e a coleta das informações aconteceu por meio da observação direta. O processo pedagógico buscou empregar recursos e dinâmicas de natureza participativa, de forma a estimular a visão crítica sobre direitos e políticas públicas. Concluiu-se que o processo contribuiu para refletir questões relacionadas com o reconhecimento dos territórios de atuação e das relações entre saúde, ambiente e trabalho, e sobre o reconhecimento da utilidade e da relevância social dos agentes de limpeza urbana
Development of System for Underbalanced Drilling Offshore, Approach for Planning and Execution
Authors: Nessa Dag Oluf , Tangedahl Michael J. , Saponja Jeff
Published: October 2024

Being one of the major actors in the oil and gas contracting industry, we have acknowledged and recognized the underbalanced drilling technology and the interest created for its implementation. Together with North-American interests we have been working jointly in developing the onshore system to accomplish operations offshore with system introduction from platforms, jack-ups and semi-submersible vessels. The concept is based on the use of jointed pipe operations from existing rigs or by workover rigs, but does as well include working with coiled tubing and snubbing units.
Lactobacillus rhamnosus GG affects spaceflight-induced helper T cell disorder by modulating the gut microbiota and microbial-derived metabolites
Authors: Liu Zizhong , Luo Gui , Li Yixuan , Du Ruikai , Cui Ying , Zhang Hanwen , Li Jianwei , Zhong Guohui , Sun Weijia , Li Yuheng , Xing Wenjuan , Zhao Dingsheng , Yuan Xinxin , Jin Xiaoyan , Ling Shukuan , Han Yanping , Li Yingxian
Published: October 2024

Spaceflight is physically demanding and has negative effects on the health of astronauts. Previous studies demonstrated that the human gut microbiota and immunity were affected by spaceflight and simulated spaceflight. Changes in the abundance of beneficial taxa might influence immunity by disrupting the microbiome network balance. This study investigated the effects of Lactobacillus rhamnosus GG (LGG) on simulated spaceflight-induced helper T cell disorder in hindlimb unloading (HU) mice. Helper T cell ratios in control mice were affected by transplantation of the fecal microbiota from HU mice, and the abundance of LGG in the gut microbiota was affected by both true and simulated spaceflight. The gut microbiota composition, fecal metabolites, and helper T cell ratios were markedly affected by LGG in HU mice, and there was a correlation between helper T cell ratios and gut microbial-derived short-chain fatty acids (SCFAs). Our findings indicate that spaceflight adversely affects helper T cell ratios, and demonstrates that LGG impacts simulated spaceflight-induced helper T cell disorder by modulating microbial-derived SCFAs.
WITHDRAWN: Optimized Cost Estimation in Software Project Planning using Fuzzy Logic and Genetic Algorithm
Authors: Jaiswal Ajay , Raikwal Jagdish , Raikwal Pushpa
Published: October 2024

The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
The Effect of a Portative Glass Waterfall and a White Noise App On Pain, Anxiety, and Physiological Parameters During Gastroscopy Procedure: A Double Blind Randomized Clinical Trial
Authors: GENÇ Hasan , TANRIVERDİ Seher
Published: October 2024

Background
The procedure of gastroscopy is a difficult and stressful method of diagnosis and treatment for the patient. The test can cause an unpleasant sensation of pain as it passes through the mouth and throat. The aim of this study was to investigate the effect of a Portative Glass Waterfall (PGW), which is an artificial natural waterfall device, and a White Noise (WN) mobile application on patient pain, anxiety, and physiological parameters during gastroscopy procedure
Methods
This study was a double blind randomized clinical trial. The study was completed with a total of 135 participants, 45 in the PGW group, 45 in the WN group, and 45 in the control group. Data were collected using a Patient Information Form, a Physiological Parameters Record Form and a Visual Analog Scale to assess pain, and the State-Trait Anxiety Inventory.
Results
The results of study showed that there were significant decreases in pain, anxiety, heart rate, systolic and diastolic blood pressures and significant increases in respiratory rate, and oxygen saturation levels in both PGW and WN groups (p < .05). In the control group, no significant difference was found between the means of the variables before and after the procedure (p > .05).
Conclusion
According to the results of the study, PGW and WN applied during the gastroscopy procedure decreased pain and anxiety in patients and had a positive effect on physiological parameters.
Trial registration
: ClinicalTrials.gov Identifier NCT06333431 Registration date: 13.03.2024.
Evaluating effects of Community-based Social Healing Model on Ubuntu, mental health and psychosocial functioning in post-genocide Rwanda: Protocol for Cluster Randomized Control Trial
Authors: Jansen Stefan , Niyonzima Jean Bosco Bosco , Gerbarg Patricia , Brown Richard P. , Nsengiyumva Alice , Niyonsenga Japhet , Nsabimana Epaphrodite
Published: October 2024

Background: The Community-Based Social Healing (CBSH) model by Ubuntu Centre for Peace aims to help those with traumatic experiences and mental health issues achieve better mental health. CBSH integrates BREATH-BODY-MIND™ (BBM) practices with collective narrative and rituals through Community Healing Assistants in therapeutic groups. An earlier pilot study showed significant mental health improvements among1,889 Rwandans who participated in the CBSH, including reduced depression, anxiety, and PTSD, improved work productivity and decreased intimate partner violence. The trial focuses on CBSH’s impact on Ubuntu This trial focuses on CBSH's impact on Ubuntu—a philosophy of humanness, compassion, and interconnectedness deeply rooted in the African philosophy––and mental health.
Methods/Design: This cluster randomized controlled trial, This cluster randomized controlled trial involves 54 randomly selected villages in Kirehe district, with 1080 participants allocated equally to the CBSH intervention or a wait-list control group. Outcomes are measured at the person-level, with primary outcomes being Ubuntu and mental health. Ubuntu is assessed using a context-adapted Ubuntu measurement scale. Mental health measures include the Patient Health Questionnaire for depression (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), Warwick-Edinburgh Mental Wellbeing scale (WEMWS), 10-item Connor-Davidson Resilience scale (CD-RISK-10), and Patient Health Questionnaire 15-item Somatic Symptom Severity Scale (PHQ-15). Secondary outcomes include the Revised Conflict Tactics scale short form (CTS2S SHORT FORM) and the Adapted Social Capital Assessment Tool (SASCAT).
Conclusion
This Trial explores the CBSH model’s impacts on Ubuntu, mental health, and social functioning among trauma-affected Rwandans, including those impacted by the 1994 Genocide against the Tutsi, mass killings, sexual abuse, and domestic abuse. The results will be valuable for the Ubuntu Centre for Peace, policymakers, healthcare practitioners, and other stakeholders, highlighting the significance of promoting Ubuntu in addressing mental health and psychosocial trauma consequences.Top of Form
Bottom of Form
Trial registration: ISRCTN with ID: ISRCTN17659369. It was registered on February 09, 2024.
The indispensability of non-instrumental strategy in surgical operation teaching
Authors: Zhu Xiuling , Sun Shuping , Xiong Qianying , Wang Fengge , Zhao Yingdi , Zong Yongli
Published: October 2024

This study aims to investigate the influence of ‘non-instrumental strategies’ and demonstrate their effect and educational value for basic surgical teaching. In addition, it seeks to establish the insufficiency of educational technology using an ‘instrumental strategy’, to determine the effect of ‘Four Tips’ on surgical operation, and to ultimately reform surgical teaching.Undergraduates majoring in medical sciences at a local medical school in 2016 were randomly divided into experimental and control groups (30 students per group). Both groups received identical surgical training and operation instructions. Four additional tips were incorporated into training the experimental group. Thereafter, participants were examined and surveyed to evaluate their operation fatigue and satisfaction with team collaboration, communication, and technical operation quality. The data were evaluated by a T test, which provided a result of α = 0.05.The experimental group performed significantly better than the control group on the following: communication satisfaction (P = 0.012), operation quality (P = 0.001), teamwork (P = 0.000), and low operation fatigue (P = 0.004).This ‘non-instrumental strategy’ featuring ‘Four Tips’ contributes significantly to promoting students’ technical grasp and increases their satisfaction with learning effects, thus achieving an irreplaceable educational value.
Effect of Early-onset Posterior Capsule Opacification on Visual Outcomes in Trifocal Diffractive Pseudophakic Eyes: A Multicenter Prospective Study
Authors: Yang Jin , Zhang Limei , Shi Runhan , Chen Xuanzhu , Gu Xuefen , Shen Jiying , Wang Aijun , Ni Shuang , Cai Lei , Guo Haike
Published: October 2024

Objective To elucidate the impact of early-onset PCO on the visual outcomes in patients with hydrophilic trifocal IOLs, and to ascertain the optimal timing for the application of Nd:YAG laser capsulotomy.Methods This is a prospective observational study. 189 patients implanted trifocal IOL who underwent Nd:YAG laser posterior capsulotomy were recruited. Patients were classified into four grades according to PCO morphology. The distance, intermediate, and near visual acuity (VA), dysfunction lens index (DLI), contrast sensitivity(CS) and visual function (VF-14) scores were measured before and 1 month after Nd:YAG laser capsulotomy.Results Before Nd:YAG laser capsulotomy, a significant correlation was observed between PCO grading and uncorrected distance (UDVA), intermediate (UIVA), near (UNVA) visual acuity, corrected distance VA (CDVA), DLI, and VF-14 scores (All P < 0.001). However, in patients with PCO grade 1 (early-onset), post-capsulotomy UNVA, DLI, medium and high spatial frequency contrast sensitivity under photopic condition and VF-14 scores were significantly improved compared with pre-capsulotomy values (all P < 0.05). The area under the receiver operating characteristic curve for DLI was 0.833 (P < 0.001), with a corresponding cut-off value of 7.28, indicating its usefulness in assessing the need for Nd:YAG laser capsulotomy in cases of early-onset PCO.Conclusions Early-onset PCO initially impairs near visual acuity in patients with trifocal IOLs and concurrently diminishes both subjective and objective of visual quality. DLI can effectively assess the severity of PCO, particularly in cases of early-onset PCO, and further determine the optimal timing for Nd:YAG laser capsulotomy.
WITHDRAWN: Pilot Testing and Histomorphometric Evaluation of a Novel Mini Implant System(n)
Authors: Dave harsh
Published: October 2024

The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Assessing the feasibility of using GPT models for clinical decision support in patients suspected of prostate cancer: a comparative study
Authors: Liang Xuan , Wang Xiaoyi , Li Yuanyuan , Liao Wenfeng , Zhang Zhenting , Zhu Guohui , Wei Xi
Published: October 2024

Background
Large Language Models (LLMs), such as the GPT model, leverage supervised learning and reinforcement learning with human labels for fine-tuning. Despite showing promise in various medical fields, the feasibility and safety of using GPT models for clinical decision support (CDS) in prostate cancer remain unverified. This study aims to evaluate the feasibility of GPT models in providing CDS for patients suspected of prostate cancer by comparing the recommendations generated by GPT models with those provided by real-world urologists.
Methods
Patient data were collected from March 2022 to December 2023 from Tianjin Medical University Cancer Institute and Hospital and Tianjin Medical University Second Hospital. A total of 113 cases with comprehensive clinical and imaging data were selected. Clinical recommendations were generated by GPT models (ChatGPT and GPT-3.5) and compared with those provided by a non-oncology specialized urologist. The recommendations were evaluated by three prostate cancer experts for coherence, factual consistency, comprehensiveness, and potential medical harm using a 5-point Likert scale. Mann-Whitney U tests were employed to determine significant differences.
Results
The GPT models demonstrated high factual consistency (98.1% in high consistency group) and coherence in generating clinical recommendations. In terms of medical harm, no significant difference was observed overall between GPT models and the non-oncology urologist (p ≥ 0.05). However, in cases rated neutral (score = 3), the non-oncology urologist showed higher rates of ambiguous recommendations (10.5%) compared to GPT models (2.8%, p < 0.05). The GPT models' response time was significantly faster, averaging 5–15 seconds per case versus approximately 1 minute for the urologist.
Conclusion
GPT models show promise in providing clinical decision support for patients suspected of prostate cancer, with high factual consistency and efficient response times. However, challenges such as comprehensiveness and potential medical harm need to be addressed before widespread clinical application. Further research is warranted to validate the empowering effect of GPT models on non-specialist clinicians in clinical decision-making.
Muscle Strength at Discharge as Predictor of Functional Outcome in Ischemic Stroke Patients Following Endovascular Therapy: Observational Study in Two Comprehensive Stroke Centers
Authors: Zhou Sijie , Chen Zhikai , Tang Jinyan , Chen Gan , Ouyang Ziqi , Wang Jian , Luo Senrong , Su Minyi , Huang Jianhui , Dmytriw Adam A , Carvallo José Fidel Baizabal , Liao Xuxing
Published: October 2024

Background
Endovascular thrombectomy (EVT) has emerged within the last few years as a safe and efficacious method to achieve arterial recanalization in patients with acute ischemic stroke (AIS). However, there are few clinical methods to predict functional outcome. We aimed to investigate whether the muscle strength (MS) at discharge assessed by the Medical Research Council (MRC) scale for muscle strength/weakness predicted functional outcome in patients with AIS undergoing EVT.
Methods
We enrolled 264 consecutive patients from two large comprehensive stroke centers in China from 2018 to 2022. A total of 248 patients were analyzed. We measured and analyzed muscle strength by means of the MRC scale at discharge. Patients were divided in two groups: normal to mildly abnormal muscle strength (MRC ≥ 4), and markedly decreased muscle strength (MRC < 4). A poor outcome was defined as a modified Ranking Score (mRS) of 3–6 at 90-days.
Results
Logistic regression showed that older age (p = 0.014), higher pre-EVT NIHSS score (p = 0.006), greater ASPECTS (p = 0.052), longer door-to-recanalization time (p = 0.016) and post-EVT revascularization ≥ 2b (p = 0.025), were independently associated with MRC < 4. Patients with poor muscle strength at discharge (MRC < 4) had a significantly higher frequency of poor outcome at 90-days: 91.37% vs. 13.76% (p < 0.001). Both lower and upper limb strength in the most paretic side showed high accuracy in predicting the functional outcome at 90 days: area under the curve: 0.924 and 0.874, respectively. An MRC of 0 (plegia or complete paralysis), was associated with a 70% mortality rate within 3 months of AIS.
Conclusion
Muscle strength is a reliable, easy to assess and reproducible clinical method to predict functional outcome and mortality at 90-days in patients treated with EVT and it is influenced by age, NIHSS score, extend of tissue involvement and time for recanalization.
Evaluation of Cadaver- and Manikin-Based Surgical Airway Simulation Training in Emergency Medicine Resident Doctors
Authors: Altintas Emel , Beser Ceren Gunenc , Abbasoglu Tugce Taskindere
Published: October 2024

Introduction:
Endotracheal intubation may not always be possible. Therefore, in rare cases where endotracheal intubation is not possible, surgical airway interventions may be needed. In this context, we aimed to evaluate and compare manikin- and cadaver-based surgical airway simulation training programs developed using the ADDIE (Analyze, Design, Develop, Implement, and Evaluate) model for emergency medicine resident doctors (EMRDs).
Materials & Methods
Thirty-one EMRDs included in the study were first administered a pretest and they were divided into a manikin-based surgical airway simulation training group (group M) and a cadaver-based surgical airway simulation training group (group C), depending on whether they had less or more than two years of experience and based on their pretest scores.16 EMRDs practiced the skill on the whole body cadaver and 15 EMRDs practiced the skill on the 3D printed cricothyrotomy model. An evaluation was made based on the first two levels of the Kirkpatrick model.1stLevel - Reaction: EMRDs’ reactions were evaluated with a 5-point Likert-type surgical airway simulation training program satisfaction survey. 2ndLevel- Learning: EMRDs’ learning levels were evaluated via the cricothyrotomy skill assessment guide at baseline and one month later. 5 participants in each group left the study during the skill assessment 1 month later.
Results
The average of the satisfaction survey scores of the Group C was 4.85 ± 0.16, and the average of the satisfaction survey scores of the Group M was 4.82 ± 0.20. There was no statistical difference between the average satisfaction survey scores of both groups (p = 0.623). More than half of the EMRDs in both groups successfully performed the cricothyrotomy procedure at first application (Group C success rate %56.3, Group M success rate %73.3).Yet, the EMRDs in group M were significantly more successful than those in group C (p < 0.01). One month later, all EMRDs in both groups completed the procedure successfully.
Conclusions
The average of the satisfaction survey scores of the Group C was 4.85 ± 0.16, Group M was 4.82 ± 0.20. In the first application of cricothyrotomy, the success rate of Group C was 56.3%, the success rate of Group M was 73.3%, and in the application 1 month later, the success rate of both groups was determined as 100.
WITHDRAWN: Techniques for Building Internal Target Volumes (ITV) in CT Imaging Through Calibration, Artifact Management, Image Registration, and 4DCT Incorporating Motion-Encompassing Methods
Authors: Solomon Girma Biniyam , Kide Kinfe Gebremedhin , Cavedon Carlo
Published: October 2024

The full text of this preprint has been withdrawn by the authors as it was submitted and made public without the full consent of all the authors. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Family formation among adolescent Rohingya refugees; Trajectories into adolescent marriage and childbearing in Cox’s Bazaar Bangladesh
Authors: Zimmerman Linnea A , Elnakib Shatha , Ali Anam , Akter Rumana , Hossain Tofajjel , Traill Tom , Mieth Kate , Hasan Tahia , Hasan Tanvir , Robinson W. Courtland
Published: October 2024

Background Although both marriage and childbearing are potentially influenced by humanitarian emergencies, and for many individuals are intrinsically linked life-course events, they are rarely explored together in the literature on humanitarian emergencies. Additionally, literature on child marriage focuses largely on females, neglecting the experiences of males.
Objective To understand how trajectories of family formation for adolescent females and males have been affected by mass displacement. We compare time to first marriage and time to first birth following marriage between age cohorts of 15-19 and 20-24 year-old female and male Forcibly Displaced Myanmar Nationals.
Methods We use data from 1,565 females and 722 males aged 15-24, collected within fifteen camps in Cox’s Bazaar, to estimate hazard of first marriage and of child marriage and data from 643 married females to estimate hazard from marriage to first birth.
Results Females aged 20-24 had a 31% increased hazard of marriage overall and 42% increased hazard of child marriage relative to females aged 15-19 (95% CI: 1.07-1.87) and an 84% higher incidence rate (95% CI: 1.46-2.33). For males, there was a higher hazard of marriage by age 25 amongst males aged 20-24 relative to age 15-19 (HR: 1.80, 95% CI: 1.10-2.94), but no statistically significant difference in the hazard of marriage by age 18. Approximately 20% of females gave birth within a year of marriage and 70-75% within three years post-marriage, across age cohort and age at marriage. There were no statistically significant differences in hazard of first birth by either age cohort or age at marriage.
Discussion Displacement may have increased risk of child marriage for adolescents, as evidenced by higher child marriage rates amongst males and females who were age 14-18 at the time of displacement. Displacement did not affect time to childbirth following marriage, which remains high amongst both age cohorts. Efforts to reduce child marriage and adolescent child marriage must address limited opportunities for adolescents in situations of displacement.
Investigation of melatonin effect on the outcome of moderate and severe diffuse axonal injury (DAI) - A randomized, placebo-controlled clinical trial
Authors: Ghaedamini Alireza , Karamoozian Saeed , Hadad Mohammad Khaksari , Ghaedamini Hossein , Soltani Zahra , Hojati Ali , Soleimani Amin , Karimabadi Reza , Mayel Masod , Sabet Nazanin , Ahmadinejad Mohammad Mehdi , Asadikorom Gholamreza , Mofid Behshad , Nakheie Nozar , Khazaeli Payam , Jafari Elham
Published: October 2024

Objective
The efficacy of melatonin in improving diffuse axonal injury has not been evaluated. This study investigated the melatonin effect on moderate and severe diffuse axonal injury outcomes.
Methods
This was a randomized clinical trial. The case group (N = 35) received 3mg of oral melatonin, and the control group (N = 35) received Placebo. extended-Glasgow Outcome Scale (e-GOS) and Functional Independence Measure (FIM) scores at baseline, 1 month, 3 months, and 6 months after injury were defined as primary outcomes, and Glasgow Coma Scale (GCS) at baseline, 24 hours, 48 hours, 1 week, 2week until discharge defined as secondary outcomes.
Results
A total of 70 patients were enrolled and were randomly allocated into the intervention (n = 35) and placebo (n = 35) groups. The results showed that there was no statistically significant difference between melatonin and placebo in GOS (P > 0.05) and FIM (P > 0.05) at 3 months and 6 months after hospitalization but the mean E-GOS (P = 0.001) and FIM (P = 0.001) at the first month was significantly higher in the melatonin group.
Conclusions
The use of melatonin as a low-cost and safe medicine complementary treatment in people with DAI can accelerates functional recovery.
Estimating the hole surface area of insecticide-treated nets using image analysis, manual hole counting and exact hole measurements
Authors: Mbuba Emmanuel , Chavernas Natalia Mañas , Moore Sarah J. , Ruzige Philipo David , Kobe Dickson , Moore Jason , Philipo Rose , Kisoka Noela , Pontiggia Gianpaolo , Chacky Frank , Mwalimu Charles Dismasi , Cattin Philippe Claude , Wolleb Julia , Sandkuehler Robin , Ross Amanda
Published: October 2024

Background
The physical integrity of insecticidal-treated nets (ITNs) is important for creating a barrier against host-seeking mosquitoes, and therefore influences people's perception of the net's effectiveness and their willingness to use it. Monitoring the physical integrity of ITNs over time, provides information for replenishment schedules and purchasing decisions. Currently, the assessment is conducted by manually counting holes and estimating their size to class the net as functional or not. This approach is laborious to routinely conduct during field surveys of ITNs. Automated image analysis may provide a rapid assessment of the physical integrity of ITNs but it is not known if the images can capture sufficient information. As a first step, this study aimed to determine the agreement between estimated hole surface areas derived from 1) manually segmented images, 2) manual hole counting compared to 3) ground truth obtained by calibrated close-up shots of individual holes.
Methods
The physical integrity of 75 ITNs was assessed by manual hole counting, image analysis and ground truth, and these methods were compared. For the image analysis, a graphical user interface was developed and used for the segmentation of holes visible in photographs taken from each side of the net. The hole surface area was then computed from this data. The agreement between the estimates from image analysis and manual hole counting was compared to the ground truth using the Bland-Altman method.
Results
There was substantial agreement between the manually segmented image analysis estimates and the ground truth hole surface areas. The overall bias was small, with a mean ratio of the hole surface area from image analysis to the ground truth of 0.70, and the 95% limits of agreement ranging from 0.35 to 1.38. Manual hole counting underestimated the hole surface area compared to the ground truth, particularly among nets with holes above 10 cm in diameter.
Conclusion
Images coupled with manual segmentation contain sufficient information to calculate hole surface area. This lays the groundwork for incorporating automatic hole detection, offering a fast and objective method for routine assessment of physical integrity of ITNs.
BRCA2 germline mutation carrier with five malignancies: a case study
Authors: Su Elena , Christinat Yann , McKee Thomas , Azzarello-Burri Silvia , Jochum Wolfram , Fischer Stefanie , Rothermundt Christian
Published: October 2024

Background
BRCA2 germline mutations are known to predispose carriers to various cancer types, including breast, ovarian, pancreatic and prostate cancer. An association with melanoma has also been reported. However, the full tumour spectrum associated with BRCA mutations, especially in patients with other concurrent pathogenetic mutations, is unexplored.
Case presentation:
We present a 70-year-old female patient with a pathogenic BRCA2 c.5946del variant. Over a period of 15 years, she has developed two independent breast cancers, well-differentiated liposarcoma, clear cell renal cell carcinoma and myeloproliferative neoplasia. This unusual tumour spectrum and the staggered occurrence of these tumours required multiple rounds of genetic testing and lead to a delayed diagnosis of the BRCA2-associated tumour predisposition. In addition to the BRCA2 mutation, extended germline testing revealed an APC c.3920T > A variant and variants of unknown significance in the BRIP1 and ATR genes. The molecular analysis of the tumours revealed distinct profiles with differences in HRD status and in copy number variations but no common origin.
Conclusions
Our case study revealed that the pathogenic BRCA2 c.5946del germline variant can be associated with an unusual tumour spectrum, which may lead to a delayed diagnosis of a hereditary tumour predisposition. Thus, upfront genetic testing using large multigene panels or whole-genome sequencing could be encouraged, especially in cases with a prominent family history.
Viral Genome Surveillance via Modifiable Microarray Sequencing and a Supervised Stack Ensemble Neural Network Model: SARS-CoV-2 as a Case Study
Authors: Plackowski Kenneth , Ebinumoliseh Ifeoma , Ogbuewu Emmanuel , Hoff Kendall , Edwards Jeremy S.
Published: October 2024

Background
Viral outbreaks, including Dengue, Zika, Ebola, and particularly SARS-CoV-2, have caused significant global impacts and unprecedented losses of life. SARS-CoV-2, in particular, continues to be a leading cause of death worldwide and in the United States, with many individuals experiencing prolonged symptoms. In this study, we present a novel genomic surveillance approach that combines a stack-ensembled neural network and microarray genome resequencing by hybridization.
Results
The resequencing microarray features ~ 240,000 probes for approximately 30,000 nucleotides per genomic sample. The data utilized were derived from our previously reported cost-effective and rapid full-genome tiling array technology. Our base-calling algorithms were enhanced with 48 input features per base position and multiple scanning exposure times. The training dataset included 570,000 data points from which over 12,000 neural network models were developed. To assess the accuracy of our stack-ensembled models in base-calling and variant identification, we analyzed genomic data from four clinical samples with a cycle threshold value ≤ 24 via neural network and logistic regression meta-models.
Conclusions
Our models demonstrated accuracies exceeding 99% and coverages comparable to existing standards. Microarray genome resequencing of clinical viral samples provides significant benefits in terms of cost-effectiveness, speed, and flexibility, allowing for the surveillance of diverse viral genomes without the need for extensive algorithm retraining.