bluuebunny/crossref_metadata_2025 huggingface dataset:
Emotional Meanings of Clinical Practice with Head and Neck Cancer Patients: a qualitative study with Brazilian professionals
Authors: Bispo Adriana Consuelo Oliveira , Sant'Ana Ricardo Souza Evangelista , Bastos Rodrigo Almeida , Silva Sarah Adriely da , Suedt Milena Rossi , Rodrigues Jéssica Renata Ponce de Leon , Santos Claudiane dos , Guerra Luciane Miranda , Lima Carmen Silvia Passos , Turato Egberto Ribeiro
Published: March 2024

Objective
To interpret emotional meanings attributed by healthcare professionals to the clinical management of patients with Head and Neck Cancer, in a university-specialised outpatient service at a public general hospital.
Method
A qualitative study was carried out using semi-directed interviews with open-ended questions in-depth. The sample was closed by the saturation strategy. Data treatment was conducted by Clinical-Qualitative Content Analysis technique under theoretical framework of psychodynamic concepts from Medical Psychology, and validation by peers from a research group.
Results
Ten clinical professionals were interviewed: four physicians and six nurses. From the analysis of the interviews, three categories are constructed for this article: (01) – An Instituted Stigmatization; (02) Wide-Open Reality; (03) Naturalization without Trivialization. The aggressivity of these tumours, the association with harmful lifestyle habits, and the great concern of family members call for clinical-psychological management, in which subjective mechanisms such as denial or other more primitive psychological defences have no sufficient resolution.
Conclusions
The stigma is a symbolic entity that takes distress for the clinicians, but also seems to highlight a higher level of awareness and reflection. This awareness can be a starting point for the development of healthier strategies for emotional coping, contributing to a more balanced work and personal harmonic relationship of care.
Characterization of Time Toxicity in Older Patients with Metastatic Breast Cancer
Authors: Atre Swarali Y. , Soulos Pamela R. , Kuderer Nicole M. , Gross Cary P. , Baum Laura VM. , Dinan Michaela A. , Lustberg Maryam B.
Published: March 2024

Purpose
Recognizing that receiving healthcare can be time intensive and burdensome, time toxicity has been conceptualized as the time spent by patients seeking healthcare. This study investigates the association between age at diagnosis and time toxicity for patients with Metastatic Breast Cancer (MBC) and identifies major components of care that confer the greatest time toxicity.
Methods
We conducted a retrospective cohort study among patients with MBC aged 67 or older using the SEER-Medicare database. We assessed time toxicity using the number of encounter days patients interacted with the healthcare system per 100 days, within the first year of starting cancer treatment. We used a Poisson model to analyze the association between age and encounter days, adjusting for clinical and sociodemographic factors. We stratified the mean encounter days for each age cohort by treatment types.
Findings:
The final sample included 2,949 patients; 51.4% were between 70–79 years old, and 81.3% were white. Although unadjusted analysis showed an association between older age and more encounter days (Rate Ratio (RR): 1.12; 95% CI: 1.02, 1.22), there was no significant association after adjusting for comorbidities and treatment type. Patients with more than three comorbidities had significantly higher encounter days compared to those without comorbidities [RR: 1.36 (95% CI: 1.26, 1.46)]. Receipt of radiotherapy [RR: 1.45 95% CI: (1.37, 1.54)] was associated with more encounter days compared to not receiving radiotherapy, while receipt of Bone modifying agents was associated with fewer encounter days compared to not using Bone modifying agents [RR: 0.75 (95% CI: 0.70, 0.79)].
Conclusion
Our study identified comorbidities and cancer treatment modality, including radiotherapy, as the factors affecting time toxicity in older patients with MBC. Assessment of an individual’s comorbid medical conditions and types of treatment planned are crucial to understanding age-related impacts on encounter days and to support shared decision making in older patients.
The Impact of Body Mass Index on Clinical Outcomes in Elderly Sepsis Patients: A Retrospective Study Based on the MIMIC IV Database
Authors: Shen Ying-ying , Yi Ru-qin , Feng Wen , Li ChengEn , Chen Wei , Zhang Zhirong , Fan Zhaokun
Published: March 2024

Background
Sepsis represents a critical challenge in global healthcare, particularly affecting the elderly population. The incidence and mortality of sepsis among individuals aged 60 and above are increasingly significant public health concerns. This study examines the relationship between Body Mass Index (BMI) and key clinical outcomes in elderly sepsis patients, considering the complexity of managing this demographic due to various underlying conditions and physiological characteristics.
Methods
A retrospective cohort study was conducted using data from the MIMIC IV 2.2 database, encompassing adult sepsis patients and focusing on those aged 60 and above. Patients were categorized based on BMI according to WHO standards into underweight, normal weight, overweight, and three classes of obesity. The study analyzed the association between BMI categories and clinical outcomes including 28-day, 90-day, and 180-day mortality rates, in-hospital mortality, length of hospital and ICU stays, and duration of mechanical ventilation.
Results
The study included 11,343 elderly sepsis patients. The findings reveal a lower mortality rate in patients with higher BMI categories, suggesting a protective effect of higher BMI against sepsis mortality in the elderly, aligning with the concept of the "obesity paradox." Survival analysis was used to explore the relationship between different Body Mass Index (BMI) categories and survival rates at 28 days, 90 days, and 180 days. The analysis revealed that obese patients generally had longer survival times compared to those with normal or low weight (logrank chi2 186.09, p < 0.001). Furthermore, the analysis indicated that obese patients generally had longer survival times and differentially impacted hospitalization metrics, including length of stay and duration of mechanical ventilation.
Conclusion
This study underscores the intricate relationship between BMI and the prognosis of sepsis in the elderly, highlighting the obesity paradox in this context. It emphasizes the need for personalized treatment strategies that consider the patient's BMI, potentially improving clinical outcomes for elderly sepsis patients. Future research should aim to further elucidate this relationship across diverse populations and validate these findings in prospective clinical trials.
The Remote Provision of Pharmaceutical Products and Services by Retail Pharmacies in Kampala, Uganda; Practices and Challenges
Authors: Fauzi Ibrahim Ali , Kintu Jafari , Luyima Martin , Kyeyune Henry , Rajab Kalidi , Asiimwe Lydia Irene , Bukenya Isah , Kitutu Freddy Eric , Mwawule Fredrick Wadulo , Kutyabami Paul
Published: March 2024

Background:The COVID-19 pandemic significantly increased the demand for remote healthcare services delivery, including remote access to medications. This study explored the practices and challenges associated with remote pharmacy services in Kampala, Uganda.
Methods:A cross-sectional study was conducted from July to September 2022, enrolling 174 out of 198 sampled retail pharmacies. Data was collected using a pre-tested questionnaire on remote service provision, platforms used, products offered, delivery methods, and challenges faced.
Results:Over 58% of pharmacies provided remote services, primarily through social media (especially WhatsApp) and phone calls. OTCs and POMs were the most commonly dispensed products remotely. Key challenges identified included high internet costs, labor shortages, poor internet quality, and a lack of specific regulations for remote provision of pharmaceutical products and services.
Conclusion:Remote pharmacy services are becoming increasingly common in Kampala, but they face challenges that need to be addressed. Regulations are crucial to ensure responsible dispensing practices and rational medicine use. Addressing internet affordability and quality, staffing issues, and delivery logistics is essential for sustainable and effective remote pharmacy operations.
A Joint Model of Multiple Intent Recognition and Slot Filling Based on Graph Neural Network
Authors: Huang Jinjie , Tang Huashuai
Published: March 2024

Intention recognition and slot filling tasks are two important tasks in oral comprehension, and they are closely related. The study of joint models for both tasks is a current research hotspot. However, most current joint models are based on a single information flow model, only considering the impact of intention on slot information and ignoring the information flow from slot to intention. In response to this issue, this article proposes a joint model based on graph neural networks for multi-intention recognition and slot filling to achieve bidirectional information flow modeling. Among them, BERT is used as a shared encoder to improve the quality of semantic feature extraction. An adaptive graph convolutional network is proposed to extract slot information in intention recognition tasks, facilitating information exchange from slot to intention. In the slot filling task, feature fusion and a graph attention mechanism are employed to aggregate intention information, achieving information flow from intention to slot. Through experimental verification, the bidirectional information exchange effect is evident. Compared with the current GL-GIN model, the total accuracy of the proposed model has been improved by 1.7% and 2.1% on two common datasets, respectively.
Thermosolutal Stationary and Oscillatory Convection under Hall Currents of a Rivlin- Ericksen Nanofluid Confined between Horizontal Planes
Authors: Bishnoi Jaimala , Kumar Shubham
Published: March 2024

The goal of this research is to investigate the combined impact of Hall currents and Salt gradient on an elastico-viscous nanofluid saturated in a continuous medium. To characterize the rheological behavior of an elastico-viscous nanofluid, the Rivlin-Ericksen type fluid model is used. The presence of nanoparticles enhances the thermal conductivity of the fluid, and the model used for the nanofluid incorporates the effects of Brownian motion and thermophoresis. For the linear stability analysis, the Galerkin-type weighted residual approach has been applied. The effect of non-dimensional parameters such as concentration Rayleigh number, solutal Rayleigh number, Lewis number, modified diffusion ratio, magnetic number, and Hall parameter is explored numerically. It has been observed that the Hall currents have a dual effect on the system in the presence of salt. It is also analyzed that oscillatory convection exists for aluminum nanoparticles. The results are shown graphically and numerically.
WITHDRAWN: A recent perspective on the potential of grid-connected renewable energy systems including optimal design for the pharmaceutical industry of North Indian Himalayan, India
Authors: Gupta Ankush , Suhag Prof. Sathans
Published: March 2024

The objective of the research is to assess the techno-economic potential of a structure designed to meet the energy requirements of the Indian pharmaceutical industry (PMI) for the North Indian Himalayan (NIH) region, India, and the same structure is implemented for one site in each state and each union territory of the NIH. Besides, several grid-connected and off-grid hybrid renewable energy system (RES) configurations are evaluated using the HOMER software for the sake to figure out which configuration has the most technical and economic potential. Grid-WECS-PV has been found to be the optimal configuration for each NIH site, and it has been recognised that hybrid RESs have a substantial impact on the economic aspect, the cost of electricity (COE) of this configuration for the sites in Solan, Samba, Kargil, and Jadhang is lower than their respective grid tariff, and the difference between COE and the corresponding grid tariff varies based on the climate of site. As therefore, this investigation explores the potential to develop dynamic behaviour for energy utilization for PMI building in NIH, India, with a decline in overall manufacturing costs, which also adheres to the target of "Promotion of Bulk Drug Parks" that has been announced by the Indian government and promotes hybrid industrialization.
Protective effect of lactic acid bacteria intervention on copper-induced liver injury
Authors: Guo Xiaoyin , Liu Yuncai , Zheng Jiahong , Jiang Menghui , Zhao Yanjie , Piao Jinmei
Published: March 2024

Purpose
Although copper (Cu) is an essential trace element, health damages caused by Cu overdose have occurred with the widespread use of Cu in industry and agriculture, among others. Excessive exposure to Cu can lead to liver accumulation and cytotoxicity. To address the growing risk of Cu exposure, a safe and effective method to remove Cu is needed. Recent studies have shown that lactic acid bacteria (LAB) are effective in binding and removing heavy metals from liquids. The aim of this study was to investigate the damaging effects of long-term low-dose Cu exposure on the liver and the protective effects of LAB intervention on the liver.
Methods
we exposed Wistar rats to different Cu concentrations and intervened with LAB. Results demonstrated that Cu exposure caused liver tissue damage and impaired liver function, which were partially alleviated by LAB intervention.
Results
Cu exposure increased liver inflammation and oxidative stress, evidenced by elevated IL-1β, IL-6, and IL-10 mRNA levels, and reduced SOD and MDA expression. LAB intervention mitigated these effects, reducing Nrf2 downstream gene expression (Keap-1, GCLC, HO-1, TrxR, NQO1), indicative of hepatocyte oxidative stress protection. Cu exposure altered upstream (PP65, PJNK) and downstream (Bax, Bcl-2) Nrf2 pathway genes, implicating oxidative stress and apoptosis. LAB intervention attenuated these effects, suggesting a protective role against Cu-induced liver damage via Nrf2 pathway modulation.
Conclusion
Our study demonstrates that Cu exposure impairs the structure and function of rat liver, whereas Nrf2 regulates Cu exposure-induced inflammation, oxidative stress and apoptosis. LAB intervention effectively protects the liver and mitigates Cu-induced damage.
Association between Sputum Culture Conversion and Body Mass Index among Multidrug- Resistant Tuberculosis Patients in Punjab, Pakistan: A multicenter retrospective study
Authors: Akhtar Abdul Majeed , Khan Iqra Hamid , Shah Fatima Iftikhar , Kanwal Shamsa , Majeed Sufia , Aremu Abdulmujeeb Babatunde
Published: March 2024

Background:The global challenge of multidrug-resistant tuberculosis (MDR-TB) presents a substantial public health concern, requiring extended and complex treatment regimens. It is crucial to understand the factors impacting treatment results, particularly sputum culture conversion and body mass index (BMI). This retrospective cohort investigation conducted in Punjab, Pakistan, sought to explore the correlation between BMI and sputum culture conversion in individuals diagnosed with MDR-TB.
Material and Methodology: Data from 2663 confirmed MDR-TB patients across multiple Programmatic Management of Drug-Resistant Tuberculosis PMDT sites in Punjab, Pakistan, were retrospectively analyzed. Demographic and clinical characteristics, BMI, comorbidities, previous TB treatments, and drug resistance were evaluated. Cox proportional hazards regression models were employed to assess the association between time to sputum culture conversion and patient characteristics.
Results: The study compared MDR-TB treatment outcomes based on BMI categories (≥18.5 vs. <18.5 Kg/m^2). It involved 1626 employed patients, with a mean age of 33 ± 15 years, displaying baseline body weights averaging 48±7 kg (normal weight) and 37±6 kg (underweight). On average, sputum culture conversion occurred at 4 months, with approximately 37% achieving conversion within this period. Among several factors studied, univariate analysis identified BMI <18.5 Kg/m^2, prior first-line drug treatment, and comorbidities as significantly associated with failure to achieve sputum culture conversion within 6 months. In multivariate analysis, failure to achieve conversion was notably linked to BMI <18.5 Kg/m^2, previous first-line drug treatment, and resistance to fluoroquinolone drugs.
Conclusion: This study provided valuable insights between sputum culture conversion, BMI, and drug resistance among MDR-TB patients. While around half of the patients achieved sputum culture conversion within six months, factors such as comorbidities, previous TB treatment, and drug resistance significantly influenced treatment outcomes.
Patterns of Internet Addiction in an Italian sample: 100% of the sample experience Nomophobia
Authors: Marcolini Federica , Buffa Gabriele , Valenta Silvia Tempia , De Ronchi Diana , Atti Anna Rita
Published: March 2024

Background and Objectives: Internet Addiction Disorder, a concept introduced for the first time by Ivan Goldberg in 1995, is one of the most recently identified forms of addiction, but already considered a real psychosocial phenomenon, capable of having a profound impact on different aspects of social and psychological life of individuals. One of its most recently identified manifestations is Nomophobia, a neologism formed from the combination of terms such as "no mobile", "phone" and "phobia”, that can be understood as the fear of feeling disconnected. It is today considered a situational phobia, characteristic of contemporary times. The most common symptoms include excessive cell phone use, and constant anxiety at the thought of losing the internet connection. Others are, for example, the “Ringxiety”, or ringing anxiety, or the “phantom vibration syndrome”.
This study aims to examine the spread of Nomophobia in the Italian population, evaluating psychopathological correlations that can explain its diffusion.
Methods: Between January and May 2023, an anonymous online questionnaire was randomly sent to the general population. Alongside with tests to evaluate psycho-social features, the instrument used to study Nomophobia was the Nomophobia Questionnaire(NMP-Q), in its Italian version.
Results: The sample consists of 253 people (145 F, 108 M), with an average age 33.5 years (sd 14). In our sample, 100% of the subjects tested positive for Nomophobia. Values indicating a state of severe Nomophobia are found in 11.5% of the sample (F 57.9%, M 24.1%). The young population, between 18 and 25 years old, represents 46.6% of the affected population, but more than 55.2% of severe cases. The severe cases correlate positively (p<0,05) with findings of high impulsiveness. There are no other studies that investigate the psychopathological correlates of Nomophobia among Italians.
Conclusions: Despite possible biases, the data obtained are an alarming sign of the spread of internet addiction that characterizes our times, of which the excessive use of cell phones in the form of Nomophobia is an expression. Despite their now undisputed usefulness, mobile devices are capable of causing the onset of serious health problems, starting from exposure to radiation capable of causing dermatitis. Furthermore, they dramatically interfere with driving safety, becoming a major cause of road accidents. Considering these consequences, it appears to be extremely important to characterize the phenomenon, as well as its psychosocial determinants, in order to proceed with its better definition and prevention.
Comparability of NARX Model to SWAT Model in Simulating Future Water Resources Scenarios using CMIP6 Climate Model Outputs over UASB, Ethiopia
Authors: Balcha Yonas Abebe , Kaveh Kevian , Alamirew Tena , Malcherek Andreas
Published: March 2024

Quantifying water resource potential is crucial for making well-informed decisions in planning, managing, and developing water resources within a given study area. This study utilizes an ensemble of climate variables derived from five CMIP6 climate models (ECEARTH3, GFDL-ESM4, MPI-ESM1-2-HR, MRIESM2, and INM-CM5-0) to simulate future monthly streamflow conditions over the Upper-Awash Sub-Basin (UASB) for three Shared Socioeconomic Pathway (SSP) scenarios (SSP1.26, SSP2.45, & SSP5.85) until the end of the 21st century. Streamflow simulations are conducted using both a non-linear data-driven model, NARX, and a physically based model, SWAT. These models are trained and validated using observed streamflow data from a gauging station at the outlet of the sub-basin. During training, the NARX model exhibits a Nash-Sutcliffe Efficiency (NSE) of 94%, while the SWAT model achieves 88%. In validation, NARX maintains a high NSE of 92%, compared to SWAT's 82%. Overall, the NARX model demonstrated superior performance and applicability for quick streamflow simulation with fewer input variables. However, it struggles with peak flow simulations due to its sensitivity to outliers in the training phase. Despite differences in their capabilities, both models project an increase in future monthly streamflow across all scenarios and time periods. Seasonal projections indicate a rise in streamflow during the rainy seasons of spring and summer, while dry periods (Dec-Jan-Feb) experience a decrease. The anticipated increase in streamflow during rainy seasons may exacerbate flood incidences, especially when combined with escalating industrialization and population growth within the sub-basin.
Impact of Extraction Method on the Properties of Polymer Composites Reinforced with Natural Fiber from Agave Americana L
Authors: Mansouri Afef , Nasr Jalel Ben , Hentati Fatma , Amar Mohamed Ben
Published: March 2024

In this study, we introduce a novel extraction technique involving burying lignocellulosic fibers from the leaves of Agave Americana L in soil. These fibers are then used to reinforce a polymer epoxy, aiming to enhance the mechanical and physical properties of the composite material. The aim is to valorize Agave Americana L, which is abundant and available in large quantities in Tunisia. The fiber content for the composites was chosen (0%, 10%, and 20%) to enhance the properties of the polymer composite. The mechanical, physical, and morphological properties of the composites were evaluated using SEM and EDX. Results showed that the flexural properties of the composites, based on biological and raw fibers (RFE10, FE10, RFE20, and BFE20), increased with the higher content of agave fibers. Furthermore, the mechanical findings revealed flexural strength varying between 141.74 and 161.92 MPa, and a modulus strength ranging between 8902 and 13674 MPa for biological fiber weights of 10% and 20%, respectively.
In Silico Investigation of Mandibular Reconstruction: Tissue Differentiation Dynamics with Particulate-Cancellous Bone Marrow Grafts under Varied Bite Forces and Implant Elastic Moduli
Authors: Sulaiman Muhammad Yusril , Wicaksono Satrio , Dirgantara Tatacipta , Mahyuddin Andi Isra , Sadputranto Seto Adiantoro , Oli'I Eka Marwansyah
Published: March 2024

Mandibular defects caused by disease, congenital, or other causes affect the patient's quality of life, and mandibular reconstruction is important to restore the functional and aesthetic aspects. Particulate-cancellous bone marrow (PCBM) as the grafting material of the reconstruction offers promising outcomes with fewer surgical complication risks. However, a stable mechanical environment is required for effective healing, while implant failures are still encountered. This paper explores tissue differentiation during mandibular reconstruction with PCBM graft healing using biphasic mechanoregulation theory under four bite force magnitudes and four implant elastic moduli to examine its implication on healing rate, implant stress distribution, and various biomechanical properties. The numerical model used in this study was a half Canis lupus mandible, symmetrical about the midsagittal plane, with two marginal defects in which filled by PCBM graft and stabilized by porous implants. The results showed bone tissue origin and propagation to the experimental findings, where it propagates from the superior side and the buccal and lingual sides in contact with the native bone, starting from the outer regions and progressing inward. Faster healing and quicker development of bone graft elastic modulus and mandible equivalent stiffness were observed in the variants with lower bite force magnitude and or larger implant elastic modulus. A load-sharing condition was found as the healing progressed. This study has implications for a better understanding of mandibular reconstruction mechanobiology and demonstrated a novel in silico framework that can be used for post-operative planning and implant design.
Generating Attribute Similarity Graphs: A User Behavior-Based Approach from Real- Time Microblogging Data on Platform X
Authors: Hasan Md Ahsan Ul , Bakar Azuraliza Abu , Yaakub Mohd Ridzwan
Published: March 2024

Social network analysis is a powerful tool for understanding various phenomena, but it requires data with explicit connections among users. However, such data is hard to obtain in real-time, especially from platforms like X, commonly known as Twitter, where users share topic-related content rather than personal connections. Therefore, this paper tackles a new problem of building a social network graph in real-time where explicit connections are unavailable. Our methodology is centred around the concept of user similarity as the fundamental basis for establishing connections, suggesting that users with similar characteristics are more likely to form connections. To implement this concept, we extracted easily accessible attributes from the Twitter platform and proposed a novel graph model based on similarity. We also introduce an Attribute-Weighted Euclidean Distance (AWED) to calculate user similarities. We compare the proposed graph with synthetic graphs based on network properties, online social network characteristics, and predictive analysis. The results suggest that the AWED graph provides a more precise representation of the dynamic connections that exist in real-world online social networks, surpassing the inherent constraints of synthetic graphs. We demonstrate that the proposed method of graph construction is simple, flexible, and effective for network analysis tasks.
Lessons learned from the launch and implementation of the COVID-19 contact tracing program in New York City: a qualitative study
Authors: Paul Margaret , Kwok Lorraine , Massar Rachel E. , Chau Michelle , Larson Rita , Bendik Stefanie , Thorpe Lorna E. , Bershteyn Anna , Islam Nadia , Berry Carolyn A.
Published: March 2024

On June 1, 2020, NYC Health + Hospitals, in partnership with the NYC Department of Health and Mental Hygiene, other city agencies, and a large network of community partners, launched the New York City Test & Trace (T2) COVID-19 response program to identify and isolate cases, reduce transmission through contact tracing, and provide support to residents during isolation or quarantine periods. In this paper, we describe lessons learned with respect to planning and implemention of case notification and contact tracing. Our findings are based on extensive document review and analysis of 74 key informant interviews with T2 leadership and frontline staff, cases, and contacts conducted between January and September 2022. Interviews elicited respondent background, history of program development, program leadership and structure, goals of the program, program evolution, staffing, data systems, elements of community engagement, trust with community, program reach, timeliness, equity, general barriers and challenges, general facilitators and best practices, and recommendations/improvement for the program. Facilitators and barriers revealed in the interviews primarily revolved around hiring and managing staff, data and technology, and quality of interactions with the public. Based on these facilitators and barriers, we identify suggestions to support effective planning and response for future case notification and contact tracing programs, including recommendations for planning during latent periods, case management and data systems, and processes for outreach to cases and contacts.
Exploring the Correlation Between Varied Serum Iodine Nutritional Levels and Anti-Thyroglobulin Antibodies
Authors: Song Qiuyi , Xu Tingting , Wang Yu , Wei Hongyan , Chen Yanting , Fang Fang , Cui Tingkai , Pan Ziyun , Guo Xiaohui , Chen Wen , Shen Jun , Zhang Wanqi , Tan Long
Published: March 2024

Objective
Iodine deficiency results in elevated thyroglobulin (Tg) concentrations, with high iodine Tg being more immunogenic than low iodine Tg. The study investigated the correlation between serum iodine concentration and thyroglobulin autoantibody (TgAb) levels across diverse iodine nutritional statuses as determined by urine iodine concentration (UIC).
Methods
Demographic information was collected from 1,482 participants through a questionnaire. Blood and spot urine were collected to measure thyroid-stimulating hormone (TSH), TgAb, thyroid anti-peroxidase antibody (TPOAb), serum iodine (SIC), serum non-protein-bound iodine (snPBI), urine iodine (UIC), creatinine (UCr).
Results
The median UIC and SIC were 146.5 µg/L and 74.9 µg/L, respectively. A linear relationship was observed between SIC, snPBI, and serum-protein-bound iodine (sPBI) (P < 0.001). The 90% reference intervals for SIC, snPBI, and sPBI were 50.7-120.7 µg/L, 21.9–52.9 µg/L, and 19.7–77.9 µg/L, respectively. The prevalence of elevated TgAb levels was significantly higher in women than in men (P < 0.001). Both low and high levels of snPBI and sPBI were associated with an increased risk of elevated TgAb levels. In women, the risk of positive TgAb in the group below the reference value of snPBI (OR = 2.079, 95%CI: 1.166, 3.705) and sPBI (OR = 2.578, 95%CI: 1.419, 4.684) was higher. In men, the risk of positive TgAb in the group below the reference value of StI was higher (OR = 3.395, 95%CI: 1.286, 8.962).
Conclusion
Iodine might exert an influence on TgAb levels through its binding to proteins, primarily Tg, thereby altering the iodine content of Tg. The interplay of gender factors further enhanced the risk of TgAb emergence.
Development of a disease diagnostic model to predict the occurrence of central precocious puberty of female
Authors: Zhao Manman , Feng Guoshuang , Cao Bingyan , Zheng Yannan , Gong Chunxiu
Published: March 2024

Objective
To develop a clinical model for predicting the occurrence of Central Precocious Puberty based on the breast development outcomes in chinese girls.
Methods
We established a retrospective cohort of girls with early breast development aged 6–9 years who visited the outpatient clinic of Beijing Children's Hospital from January 2017 to October 2022. Based on their breast development outcomes, the patients were divided into a pubertal development(PD) group and a premature thelarche (PT) group. Anthropometry, clinical, laboratory, and imaging variables ascertained were screened using Least Absolute Shrinkage and Selection Operator (LASSO) and logistic regression to construct a disease diagnostic model. Accuracy of the model was measured by the area under the receiver operating characteristic curve (AUC).
Results
The development cohort included 1001 girls aged 6–9 years. The mean (SD) age of patients was 7.86 (0.54) years, 36.4% of patients were finally diagnosed with PD, the other 63.6% were diagnosed with PT. From 14 potential predictors, 4 variables (bone age (BA)/chronological age (CA), basal luteinizing hormone (LH) level, uterine diameter and ovarian volume) were independent predictive factors. Body mass index (BMI) were considered to have some clinical significance. So the 5 variables included in the disease diagnostic model. BA/CA (OR, 2.04; 95% CI, 0.80–4.56; P < 0.001), basal LH level (OR, 8.08; 95% CI, 3.63–11.03; P < 0.001), uterine diameter (OR, 0.59; 95% CI, 0.34–1.22; P = .0006), ovarian volume (OR, 0.41; 95% CI, 0.03–1.09; P = 0.07), BMI (OR, 0.06; 95% CI, -0.06-0.15; P = 0.27), The mean AUC in the development cohort was 0.97 (95% CI, 0.88–1.05) and the AUC in the validation cohort was 0.94 (95% CI, 0.79–1.08).
Conclusions : In this study, a disease diagnostic model was developed that may help predict a girl’s risk of diagnosing central precocious puberty.
Food and water access predictors of food security among rural households in Langai district, North-Central Nigeria
Authors: Adeoye Philip Adewale , Afolaranmi Tolulope Olumide , Banwat Mathilda Edmond , Adeleke Esther Oluwapelumi , Oladejo Afolabi , Ogundijo Daniel A.
Published: March 2024

Background
Research has shown that food insecurity in households and communities is increasing globally. More people are reported to now having difficulty accessing safe and quality foods.
Objective
This study assessed household food and water access as predictors of food security among rural households.
Methods
This is a cross-sectional community survey which used validated tools to collect data among 201 households representing a total population of 1,284 in Langai district. Levels of household food and water access were determined, and factors associated with food security were assessed using chi-square. Predictors of food security were assessed using multivariable logistic regression. P < 0.05 was adjudged significant.
Results
About 90% of households own a farm; with almost two-thirds (62.2%) of households acquiring their food from both self-production and market; and 73.6% engaging in household agriculture. The majority (82.1%) of the households sourced their water from boreholes and pipe-borne sources. Significant predictors of food security were lower expenditure on food (AOR: 2.19[95%CI: 1.05,4.61]; P = 0.038); not engaged in household agriculture (AOR: 2.88[95%CI: 1.09,7.59]; P = 0.032); had access to pipe-borne/borehole water (AOR: 2.76[95%CI: 1.15,6.44]; P = 0.023) and experienced little or no adverse coping behaviour (AOR: 6.07[95%CI: 1.74,21.23]; P = 0.005). Time did not influence food acquisition in the majority of households.
Conclusions
As reported and showcased in this study, the relationship between food security and rural household development is directly proportional in many local communities of a developing country. Efforts should be garnered towards rural household empowerment through improvement in livelihood and security to have sustainable foods and water.
Impact of internal control system managers’ education on financial reporting: Focusing on manager-auditor disagreement
Authors: Kim Suyon
Published: March 2024

The purpose of this study is to explore the correlation between internal control system (ICS) managers and the quality of financial reporting, assessed through the disagreements observed between managers and auditors. Using the regression model, an analysis of 5,007 firms from 2018 to 2021 shows a negative relationship. This suggests that as the education level of ICS managers increases, their proficiency in preparing initial financial statements improves, resulting in fewer errors and more accurate application of accounting policies. Consequently, a higher level of alignment between managers and auditors is anticipated, contributing to an overall enhancement in the quality of financial reporting. Additionally, this study thoroughly examines the correlation within firms operating in environments characterized by increased complexity and a heightened susceptibility to financial statement vulnerabilities. This evaluation is predicated upon the engagement in research and development (R&D) investments. The result suggests that higher education levels of ICS managers mitigate the disagreement between managers and auditors, even within intricate business environments.
Random Variable
Authors: Abderrahmane Horimek
Published: March 2024

After the great progress in the theory of probability as a science, the passage towards
more flexible and representative definitions and the possibility to be implemented numerically
gave the need for a new formulation. From there, the random variable came into existence.
Although random problems can be of different kinds, the random variable can be discrete or
continuous, qualitative or quantitative. This chapter is dedicated to its extended definition and
its exploitation in a simplified way.
Estudio bibliométrico y cienciométrico sobre gestión de la calidad
Authors:   Universidad Nacional Autónoma de Honduras, Aguilar Aguilar Leslie
Published: March 2024

Introducción: La gestión de la calidad tiene importancia estratégica para la competitividad y sostenibilidad de las organizaciones. Objetivo: Analizar el comportamiento de la producción científica en gestión de la calidad para el período 2011-2022. Metodología: Estudio bibliométrico y cienciométrico de 998 artículos obtenidos de la base de datos Scopus. Para el análisis se utilizaron indicadores de producción, concentración, colaboración, impacto y relacionales. Resultados: Entre los hallazgos se destaca que la producción científica refleja una línea de tendencia exponencial con valor de ajuste de R2 = 0.80. Los autores con mayor producción de artículos son Bäckström, I., Gremyr, I. y Tari J.J. Se identificaron 14 revistas que conforman el núcleo, sobresaliendo la revista Total Quality Management and Business Excellence por la cantidad de artículos publicados, número de citas y emparejamiento bibliográfico. Conclusiones: Las tendencias de investigación contemporáneas y emergentes de investigación son la Gestión de la Calidad Total, el modelo de la Fundación Europea para la Gestión de la Calidad, ventajas competitivas, gestión de la cadena de suministro, seis sigma, excelencia empresarial y sostenibilidad.
Departamento del Cauca : anexo 6
Authors: Villareal Héctor , Castillo Jennifer , Vila Flórez Otto , Cepeda Mónica , Aristizabal Quintero Diego , Guzmán Muñoz Cindy Marcela , Moreno Valderrama María Nancy , Sánchez German David , Amado Gina Marcela , Osorio Jairo Antonio , Mateus Julián Fernando , Ramírez Durán Julio , García Gómez Gustavo , Pavas Tabares Cesar Andrés
Published: March 2024

El presente documento se preparó con el fin de proveer información básica departamental sobre el desempeño sectorial, sus vínculos con la orientación de la ciencia, la tecnología y la innovación y las demandas del sector sobre conocimiento técnico para focalizar la inversión pública, articular capacidades, superar problemas productivos, mejorar la competitividad y aprovechar oportunidades de mercado en las cadenas productivas priorizadas. Esta información se consolidó a través del proceso de revisión y ajuste de la Agenda Dinámica Nacional de Investigación, Desarrollo Tecnológico e Innovación (Agenda l+D+i), como insumo para orientar las estrategias del PECTIA en el ámbito departamental.
Plan de Manejo Agroclimático Integrado del Sistema Productivo ají topito (Capsicum chinense)
Authors: Castelblanco Rivera Luis Felipe , Martinez Maldonado Fabio Ernesto
Published: March 2024

El Plan de Manejo Agroclimático Integrado, construido como concepto novedoso por el proyecto Reducción del Riesgo y Adaptación al Cambio Climático-Modelos de Adaptación y Prevención Agroclimática (MAPA), desarrollado por Corpoica y financiado por el Fondo Adaptación, contiene herramientas que sustentan la toma de decisiones para enfrentar eventos climáticos limitantes para los sistemas productivos y contribuir a la reducción de su vulnerabilidad en el mediano y largo plazos. Esto constituye una propuesta de gestión de técnicas y tecnología a escala local, con proyección municipal, que permiten minimizar los impactos que tienen las condiciones restrictivas de humedad del suelo sobre los sistemas productivos
Impact of Gold-Standard Label Errors on Evaluating Performance of Deep Learning Models in Diabetic Retinopathy Screening: Nationwide Real-World Validation Study
Authors: Wang Yueye , Han Xiaotong , Li Cong , Luo Lixia , Yin Qiuxia , Zhang Jian , Peng Guankai , Shi Danli , He Mingguang
Published: March 2024

Background

For medical artificial intelligence (AI) training and validation, human expert labels are considered the gold standard that represents the correct answers or desired outputs for a given data set. These labels serve as a reference or benchmark against which the model’s predictions are compared.

Objective

This study aimed to assess the accuracy of a custom deep learning (DL) algorithm on classifying diabetic retinopathy (DR) and further demonstrate how label errors may contribute to this assessment in a nationwide DR-screening program.

Methods

Fundus photographs from the Lifeline Express, a nationwide DR-screening program, were analyzed to identify the presence of referable DR using both (1) manual grading by National Health Service England–certificated graders and (2) a DL-based DR-screening algorithm with validated good lab performance. To assess the accuracy of labels, a random sample of images with disagreement between the DL algorithm and the labels was adjudicated by ophthalmologists who were masked to the previous grading results. The error rates of labels in this sample were then used to correct the number of negative and positive cases in the entire data set, serving as postcorrection labels. The DL algorithm’s performance was evaluated against both pre- and postcorrection labels.

Results

The analysis included 736,083 images from 237,824 participants. The DL algorithm exhibited a gap between the real-world performance and the lab-reported performance in this nationwide data set, with a sensitivity increase of 12.5% (from 79.6% to 92.5%, P<.001) and a specificity increase of 6.9% (from 91.6% to 98.5%, P<.001). In the random sample, 63.6% (560/880) of negative images and 5.2% (140/2710) of positive images were misclassified in the precorrection human labels. High myopia was the primary reason for misclassifying non-DR images as referable DR images, while laser spots were predominantly responsible for misclassified referable cases. The estimated label error rate for the entire data set was 1.2%. The label correction was estimated to bring about a 12.5% enhancement in the estimated sensitivity of the DL algorithm (P<.001).

Conclusions

Label errors based on human image grading, although in a small percentage, can significantly affect the performance evaluation of DL algorithms in real-world DR screening.
Exploring the Performance of ChatGPT-4 in the Taiwan Audiologist Qualification Examination: Preliminary Observational Study Highlighting the Potential of AI Chatbots in Hearing Care
Authors: Wang Shangqiguo , Mo Changgeng , Chen Yuan , Dai Xiaolu , Wang Huiyi , Shen Xiaoli
Published: March 2024

Background

Artificial intelligence (AI) chatbots, such as ChatGPT-4, have shown immense potential for application across various aspects of medicine, including medical education, clinical practice, and research.

Objective

This study aimed to evaluate the performance of ChatGPT-4 in the 2023 Taiwan Audiologist Qualification Examination, thereby preliminarily exploring the potential utility of AI chatbots in the fields of audiology and hearing care services.

Methods

ChatGPT-4 was tasked to provide answers and reasoning for the 2023 Taiwan Audiologist Qualification Examination. The examination encompassed six subjects: (1) basic auditory science, (2) behavioral audiology, (3) electrophysiological audiology, (4) principles and practice of hearing devices, (5) health and rehabilitation of the auditory and balance systems, and (6) auditory and speech communication disorders (including professional ethics). Each subject included 50 multiple-choice questions, with the exception of behavioral audiology, which had 49 questions, amounting to a total of 299 questions.

Results

The correct answer rates across the 6 subjects were as follows: 88% for basic auditory science, 63% for behavioral audiology, 58% for electrophysiological audiology, 72% for principles and practice of hearing devices, 80% for health and rehabilitation of the auditory and balance systems, and 86% for auditory and speech communication disorders (including professional ethics). The overall accuracy rate for the 299 questions was 75%, which surpasses the examination’s passing criteria of an average 60% accuracy rate across all subjects. A comprehensive review of ChatGPT-4’s responses indicated that incorrect answers were predominantly due to information errors.

Conclusions

ChatGPT-4 demonstrated a robust performance in the Taiwan Audiologist Qualification Examination, showcasing effective logical reasoning skills. Our results suggest that with enhanced information accuracy, ChatGPT-4’s performance could be further improved. This study indicates significant potential for the application of AI chatbots in audiology and hearing care services.
Strategies to Mitigate Age-Related Bias in Machine Learning: Scoping Review (Preprint)
Authors: Chu Charlene , Donato-Woodger Simon , Khan Shehroz S , Shi Tianyu , Leslie Kathleen , Abbasgholizadeh-Rahimi Samira , Nyrup Rune , Grenier Amanda
Published: March 2024

BACKGROUND

Research suggests that digital ageism, that is, age-related bias, is present in the development and deployment of machine learning (ML) models. Despite the recognition of the importance of this problem, there is a lack of research that specifically examines the strategies used to mitigate age-related bias in ML models and the effectiveness of these strategies.

OBJECTIVE

To address this gap, we conducted a scoping review of mitigation strategies to reduce age-related bias in ML.

METHODS

We followed a scoping review methodology framework developed by Arksey and O’Malley. The search was developed in conjunction with an information specialist and conducted in 6 electronic databases (IEEE Xplore, Scopus, Web of Science, CINAHL, EMBASE, and the ACM digital library), as well as 2 additional gray literature databases (OpenGrey and Grey Literature Report).

RESULTS

We identified 8 publications that attempted to mitigate age-related bias in ML approaches. Age-related bias was introduced primarily due to a lack of representation of older adults in the data. Efforts to mitigate bias were categorized into one of three approaches: (1) creating a more balanced data set, (2) augmenting and supplementing their data, and (3) modifying the algorithm directly to achieve a more balanced result.

CONCLUSIONS

Identifying and mitigating related biases in ML models is critical to fostering fairness, equity, inclusion, and social benefits. Our analysis underscores the ongoing need for rigorous research and the development of effective mitigation approaches to address digital ageism, ensuring that ML systems are used in a way that upholds the interests of all individuals.

CLINICALTRIAL

Open Science Framework AMG5P; https://osf.io/amg5p