bluuebunny/crossref_metadata_2025 huggingface dataset:
Jazz Cosmopolitanism in Accra: Five Musical Years in Ghana
Authors: Weerasinghe Dilshan
Published: July 2024

Review of: Jazz Cosmopolitanism in Accra: Five Musical Years in Ghana. Stephen Feld, 2012. Durham, North Carolina: Duke University Press. 78 b/w illustrations, bibliography, index, 311 pages.
Impact of capital structure and free cash flow on the efficiency of energy firms in Saudi Arabia
Authors: Rahman Shaik Abdul
Published: July 2024

The components of free cash flow and a firm’s capital structure affect the value of the firm. A firm with efficient cash management and optimum capital structure tends to have a better firm value. The current study examines the effect of capital structure and free cash flow on energy firms’ efficiency in Saudi Arabia. The data required for analysis were collected from a sample of seven energy companies from 2014 through 2022. The study used Data Envelopment Analysis to measure the efficiency of energy firms. Further, the simple regression and Generalized Linear Model were used to estimate the results. The study reports an average efficiency score of 1.13 for the energy companies, showing an efficiency increase. The results of simple regression are consistent with the results of the Generalized Linear Model. The study findings demonstrate that the association of firms’ capital structure is positive and significant (with a coefficient of 41.60, significant at a p-value of 0.01) to the efficiency of Saudi Arabian energy firms. Further, current research results indicate that firms’ free cash flows negatively affect the efficiency (with a coefficient of –0.79 and insignificant) of Saudi Arabian energy firms with no evidence. Therefore, the study accepts the association of free cash flow and firms’ efficiency as positive and rejects the alternative hypothesis that there is a negative association between free cash flow and efficiency in Saudi Arabian energy firms.
AcknowledgmentThe researcher extends appreciation to Prince Sattam Bin Abdulaziz University for funding this research through the project number 2023/02/25856.
Corneal xerosis in a skin ichthyosis patient: a clinical case
Authors: Altynbaeva G. R. , Azamatova G. A. , Gilvanova A. A. , Avhadeeva S. R. , Shaikhutdinova O. V.
Published: July 2024

A clinical case of ocular surface xerosis in a patient with previously undiagnosed skin ichthyosis is presented. Clinical manifestations of change occurring in the eyes of the patient disease are outlined, and a complex of therapeutic measures to maintain the eye surface in ichthyosis is proposed.
Diagnosis and treatment of optic neuritis as a manifestation of persistent herpesvirus infection: a clinical case
Authors: Issakhanova J. Y. , Duisenova A. K. , Kurmasheva A. Zh. , Zhumabek D. E.
Published: July 2024

A clinical case of bilateral descending optic neuritis in a 63-year-old patient is presented. The patient, whose age is beyond the normal limit for this pathology, was previously treated for neuritis of the right eye, which had no effect and led to a complete atrophy of the optic nerve (ON). A timely correct diagnostics of the left eye, which revealed structural disorders of the optic nerve accompanied by inflammatory viral changes of brain tissue, was a key factor in choosing an adequate treatment, which helped retain visual functions. The clinical observation illustrates the polyetiological nature of inflammation of the ON, the viral agent playing a leading role. Importantly, ophthalmic manifestations of the herpesvirus infection may remain the only sign of this pathology for a long time, so the ophthalmologist must always be on the alert regarding the viral genesis of the disease.
EDUCAÇÃO QUÍMICA PARA UM FUTURO SUSTENTÁVEL: DESVENDANDO A CINÉTICA QUÍMICA DA PIRÓLISE DO RESÍDUO DA CULTURA DE PIMENTA-DO-REINO (Piper Nigrum L.) PARA A POTENCIAL PRODUÇÃO DE BIO-ÓLEO
Authors: Welsing Gyovana , Damm Bruna , Lelis Maria , Machado Marta , Moura Paulo
Published: July 2024

CHEMICAL EDUCATION FOR A SUSTAINABLE FUTURE: UNRAVELING THE CHEMICAL KINETICS OF PYROLYSIS OF BLACK PEPPER (Piper Nigrum L.) CROP RESIDUE FOR THE POTENTIAL PRODUCTION OF BIO-OIL. The Sustainable Development Goals (SDGs) provide a comprehensive framework to guide actions towards a more sustainable future, emphasizing the need for sustainable production and consumption patterns (SDG 12), urgent measures to combat climate change and its impacts (SDG 13), and ensuring inclusive, equitable, and quality education (SDG 4). In this context, environmental education (EE) becomes crucial to empower present and future generations to address complex environmental challenges. Promoting EE can be enhanced through Chemistry education, encouraging the use of biomass as a primary energy source, a significant ally in addressing the SDGs. This study integrates experimental and educational chemical knowledge on the pyrolysis reaction of black pepper waste, aiming at higher education in Chemistry in an Environmental Chemistry class at Federal University of Espírito Santo. It aims to provide an in-depth understanding of chemical kinetics, connected to sustainable development through the theoretical-methodological strategy of problematized experimental activity (PEA). The developed PEA comprised five theoretical-experimental classes, including thermogravimetric analysis (TGA) simulation and pyrolysis furnace testing. The results indicate significant learning in Chemical Kinetics and themes related to the pyrolysis process associated with sustainable development, highlighting the contribution of the utilized PEA.
Influence of institutions and internationalization on environmental performance of metallurgical MNEs
Authors: Ermolaeva Lyubov A. ,   Graduate School of Management, St. Petersburg State University, Klishevich Daria S. , Garanina Olga L. , Panibratov Andrei Yu. ,   Graduate School of Management, St. Petersburg State University,   Graduate School of Management, St. Petersburg State University,   Graduate School of Management, St. Petersburg State University
Published: July 2024

Goal: the paper aims to uncover how institutions and internationalization influence the environmental performance of metallurgical multinational enterprises (MNEs). More specifically we pose the following research questions: what is the effect of internationalization and institutions in both home and host market on MNEs environmental performance; whether MNEs mitigate institutional pressure in their home countries by expanding their internationalization. Metodology: the paper builds on quantitative analysis based on panel data regression. We analyze a dataset of the largest metallurgical MNEs from different countries, covering the period from 2017 to 2020. We focus on metals and mining sector which is a major contributor to the global greenhouse gas emissions. Findings: we find that internationalization and stringent climate policies in home country are positively associated with environmental performance of metallurgical MNEs. Additionally, we observe that general institutional factors in the home country, such as the protection of minority shareholders also contribute to the environmental advancement of MNEs. Though, the extensive internationalization of metallurgical firms negatively moderates the relationship between stringent climate regulations in the home country and their environmental performance. Originality and contribution of the authors: our findings indicate that despite the overall trend of improving environmental performance, metallurgical MNEs with a higher proportion of foreign sales exhibit worse environmental performance hinting that they may adopt “carbon haven” logic when faced with stringent climate regulations in their home country.
The impact of organizational ambidexterity on performance of diversified industrial enterprises
Authors: Trachuk Arkady V. ,   Financial University under the Government of the Russian Federation, Kolobov Alexander V. , Linder Natalia V. ,   JSC Goznak,   Financial University under the Government of the Russian Federation,   JSC Severgroup,   Financial University under the Government of the Russian Federation,   JSC Goznak
Published: July 2024

Goal: to identify an optimal set of tools that allow multibusiness diversified enterprises to achieve organizational ambidexterity to assess two aspects of improvement activities — search and operational. The second goal is to establish the influence of organizational ambidexterity on the efficiency of doing business by multibusiness diversified enterprises. Metodology: the search for the optimal set of tools was carried out by the construction of regression models and using mathematical optimization methods. The impact of operational ambidexterity on a company performance was assessed by means of statistical tests. The empirical basis of the study became 327 completed projects in 16 multibusiness diversified enterprises in the manufacturing industry. Findings: a model has been developed that allows to select the optimal set of tools in order to improve production and form the basis for the development of new types of activities, i.e. to achieve organizational ambidexterity. The study showed that the effectiveness of search activities influences mostly labor productivity and the number of new competencies, while the improvement of operational activities affects the share of products certified according to the international standards in the enterprise's total production volume and the quantity of new competencies of the organization’s employees aimed to achieve organizational ambidexterity. Originality and contribution of the authors: the study identifies the conditions for achieving organizational ambidexterity by multibusiness enterprises. A new model has been proposed to determine the optimal set of tools for improving production and developing new types of activities that ensure the achievement of organizational ambidexterity and the increase of efficiency in multibusiness diversified enterprises.
Identification of oil contamination in process water using fluorescence excitation emission matrix (FEEM) and parallel factor analysis (PARAFAC)
Authors: Madhav Heena , Gilmore Adam
Published: July 2024

Fuel oil is widely used within Eskom, a power generation company in South Africa. Eskom's coal-fired power stations use up to 30,000 L of fuel oil per hour during a cold start-up, a consequence of which results in oil leaks to the dams. Oil contamination in water treatment plants causes irreversible membrane fouling, requiring costly replacement. This research work focused on the development of a rapid method for the identification of low concentrations of the water-soluble oil component fraction of crude fuel oil. For the developed method, known volumes of the water-soluble fraction of crude oil were spiked into various matrices of process water. FEEMs were collected using the patented HORIBA Aqualog spectrometer and data were modelled with PARAFAC. The results were well described with a four-component model, which included an oil component and three natural organic matter components, with a split-half validation match of 90%. The oil component was verified using linear regression of the PARAFAC component scores yielding an R2 value of 0.98. From the scores, a qualitative pass/fail test was developed such that process water can be analysed and subjected to the model to indicate the presence of oil contamination beyond a damaging threshold.
Study of Heavy Metal Removal with Porous Nanocomposite Scaffolds based on Hybrid Inorganic/Organic Nanoparticles (MSN@COF)
Authors: Rezaii Ebrahim , Mahkam Mehrdad , Rezaii Mohammad
Published: July 2024

Introduction:

Hybrid inorganic/organic nanoparticles are used to make nanocomposites. These nanocomposites combine the different properties of the organic polymer and the inorganic nanoparticles, which improves the overall system properties.

Methods:

In this research work, Mesoporous Silica Nanoparticle (MSN), amino-functionalized MSNs, and Covalent Organic Frameworks (COFs) were synthesized using a special approach. In this work, in order to take advantage of the properties and characteristics of both porous nanomaterials and porous nanocomposites of COF-grown MSN were synthesized by a special method and with two approaches, and the porosity of the nanocomposites and synthesized nanomaterials was analyzed by BET analysis.

Results:

The synthesis of the products was confirmed by XRD, TGA, EDS, FT-IR, FE-SEM, TEM, and Zeta potential analyses. The heavy metals zinc and cadmium were removed using these nanomaterials as an inorganic/organic hybrid adsorbent in the following, and various ab-sorption properties were examined in these nanoabsorbents.

Conclusion:

The removal of heavy metals from these hybrid nanoabsorbents is particularly effective.
Validation, Reliability, and Clinical Significance of the Arabic Version of Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional Questionnaire
Authors: Aglan Loay , Kamal Mohammed , Mokhtar Mona , Abdelrahman Eman Kamel , Gaafar Sherine M.
Published: July 2024

Background:

Clinically relevant fatigue in rheumatoid arthritis (RA) patients significantly
affects their quality of life. Almost all studies have assessed fatigue in this population using
non-specific scales. The present multi-centric study aimed to assess the validity, reliability, and
clinical significance of the Arabic version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional
Questionnaire (BRAF-MDQ).

Methods:

The present cross-sectional multicentric study was conducted at Aswan, Mansoura, Port
Said, and Al-Azhar University Hospitals over a 6-month duration. The study included 311 patients
with RA diagnosed according to the 2010 criteria of the American College of Rheumatology. The
Arabic version of BRAF-MDQ was developed to assess fatigue in these patients. All patients were
subjected to careful history taking, thorough clinical assessment, and standard laboratory work-up.
The obtained Arabic BRAF-MDQ was tested for construct validity, internal consistency, testretest
reproducibility, and criterion validity. Construct validity was evaluated using factor analysis
with the Kaiser Meyer Olkin tool of sampling adequacy and Bartlett's sphericity test. Internal consistency
of subscales was assessed using Cronbach’s alpha. Test-retest reproducibility was assessed
after a 1-week interval using the intraclass correlation coefficient. Pearson’s correlation coefficient
was used to correlate numerical variables. Predictors of fatigue were identified using binary
logistic regression analysis.

Results:

The present study included 311 RA patients. Construct validity assessment showed a
high loading of questionnaire items within the proposed construct subscales with a KMO measure
of sphericity of 0.927 and Bartlett's test of sphericity p-value < 0.001. Internal consistency assessment
showed adequate Cronbach’s alpha of Arabic BRAF-MDQ subscales. Total Arabic BRAFMDQ
had excellent criterion validity, as indicated by the high correlations with MAFS (r=0.95, p
< 0.001) and SF-36 vitality subscale (r=-0.91, p < 0.001). Clinically significant fatigue was identified
in 214 patients (68.8%). Multivariate logistic regression analysis revealed age (OR (95% CI):
1.07 (1.02-1.12), p < 0.001), disease duration (OR (95% CI): 1.82 (1.43-2.33), p < 0.001),
DAS28CRP (OR (95% CI): 8.62 (4.63-16.02), p < 0.001), and mHAQ (OR (95% CI): 3.85
(1.07-13.9), p = 0 .039) as significant predictors of fatigue development in the studied patients.

Conclusion:

The Arabic version of the Bristol Rheumatoid Arthritis Fatigue Multi-Dimensional
Questionnaire is a valid, consistent, and reliable tool for the assessment of fatigue in Egyptian
rheumatoid arthritis patients. Clinically significant fatigue was identified in 214 patients (68.8%).
Further, risk factors for fatigue included older age, longer disease duration, and higher disease activity.
Association Between Respiratory Infections and Risk of Autism Spectrum Disorder: An Overview
Authors: Turriziani Laura , Mancini Arianna , Midiri Maria , Albertini Maria Ludovica , Butera Ambra
Published: July 2024

:

Autism Spectrum Disorder (ASD) is a complex and heterogeneous neurodevelopmental
disorder. Its incidence has dramatically risen during the last few decades. ASD is a multifactorial
disorder. In addition to genetic factors, the environment plays a key role during critical periods
of neurodevelopment. The prenatal environment, as well as perinatal and postnatal exposures
to infection and inflammation, are increasingly identified as potential risk factors for autism and
can influence development and increase neurodevelopmental disorders.
Immune dysfunction and dysregulation are considered an important factor contributing to the
pathogenesis of autism and may influence the course and severity of the disease.
This study aims to analyze the data available in the scientific literature regarding the correlation
between respiratory infections and autism.
Conceptual Framework for the Psychosocial Management of Depression in Adolescents in the North West Province, South Africa
Authors: Chukwuere Precious Chibuike , Sehularo Leepile Alfred , Manyedi Mofatiki Eva
Published: July 2024

Background

A conceptual framework is imperative in the understanding of the psychosocial management of depression in adolescents, owing to the ability to effectively present and demonstrate the linking of concepts for an in-depth understanding of the phenomenon.

Objectives

This study aims To develop and validate a conceptual framework for the psychosocial management of depression in adolescents in the North West Province, South Africa.

Methods

A qualitative, exploratory, descriptive, contextual research design was followed in two phases: the empirical phase (phase 1) and the development of a conceptual framework phase (phase 2). Phase 1 consisted of two steps: firstly, a systematic review (referred to as step 1), followed by qualitative, exploratory, descriptive, and contextual research (referred to as step 2). The outcomes from the empirical phase served as the foundation for developing a conceptual framework for the psychosocial management of depression in adolescents, North West Province, South Africa. In Phase 2, the development of this conceptual framework was guided by addressing the six crucial questions introduced by Dickoff et al. (1968) regarding Practical Orientation and validated by Chinn and Kramer’s five criteria questions.

Results

The conceptual framework focused on mental health practitioners, immediate and extended family members of adolescents, social workers, psychologists and peer groups of adolescents, adolescents diagnosed with depression, mental health institutions, homes of adolescents, schools, religious institutions, and communities.

Conclusion

The conceptual framework for the psychosocial management of depression in adolescents provides comprehensive insights capable of enhancing the recovery process for adolescents dealing with depression. Implementing this conceptual framework has the potential to enhance professional practice, elevate the quality of care provided, and contribute to expanding the body of knowledge within the field of mental health.
Effect of Non-Square Potential Profile on Electron Transport Lifetime in AlxGa1-xAs-Based Double Quantum Well Structures
Authors: Sahoo Narayan , Sahu Ajit K. , Palo Sangeeta K. , Sahu Trinath
Published: July 2024

The electron transport lifetime τ in low-dimensional semiconductor devices
based on quantum well structures is an important parameter that decides the transport
as well as optical properties. In recent times, the utilization of non-square quantum well
structures has boosted the optoelectronic device performance. This chapter reports the
variation of τ with the applied electric field Fapp in Alx Ga1-x As-based modulation doped
double quantum well (DQW) structures by considering non-square potential profiles
such as parabolic (P), V-shaped (V), semi-parabolic (SP), and semi-V-shaped (SV).
Here, τ is analyzed by adopting ionized impurity (imp) and alloy disorder (al)
scatterings. In the case of DPQW and DVQW systems, two subbands are occupied
from Fapp = 0 up to |Fapp| = 5.6 kV/cm. After that, only one subband is occupied. On the
other hand, in the case of DSPQW and DSVQW, there occurs the occupation of only a
single lowest subband energy level for all Fapp. It is significant to note that the effect of
the scattering mechanism on the subband transport lifetime differs by changing the
structure potential. For example, when both lower and upper subbands are filled, in the
case of DPQW, the imp-scattering decides τ, whereas, in the case of DVQW, both impand al-scatterings equally contribute. The results of τ in the structures given below are
compared with the conventional double square quantum well (DSQW) structure and
show that τ (DPQW) > τ (DVQW) > τ (DSQW) at Fapp = 0. The results of τ in nonsquare DQW structures will be very helpful in understanding the intricacies of the
electro-optical properties of emerging low-dimensional semiconductor devices.
InAs Raised Buried Oxide SOI-TFET with N-type Si1-xGex Pocket for Low-Power Applications
Authors: Singh Ashish Kumar , Jit Satyabrata
Published: July 2024

In this chapter, we studied the device-level performance based on
electrostatic parameters of a source pocket engineered raised buried oxide (RBOX) SOI
tunnel field-effect transistor (SP-RBOX-SOITFET). Using Si1-xGex
pockets between the
channel and the source, steep subthreshold swing transistors can be obtained. In the
pocket, a narrow n+ region is formed by a tunneling junction between the p+
region of
the source. In order to reduce subthreshold swing, the tunneling width must be
narrowed, and the lateral electric field must be increased. So, the studied structure can
be used to design the dielectric modulated biomolecule biosensors for IOTs
applications. Simulation analyses of the proposed work has been conducted using the
Silvaco ATLAS TCAD tool.
Elimination of the Impact of Trap Charges through Heterodielectric BOX in Nanoribbon FET
Authors: Teja Lakshmi Nivas , Chaudhary Rashi , Tiwari Shreyas , Saha Rajesh
Published: July 2024

In this study, a heterodielectric BOX (HDB) Nanoribbon FET (NR-FET) is
built using the TCAD device simulator to reduce the effect of trap charges on
numerous electrical properties in traditional NR-FETs. Initially, a reasonable study in
terms of transfer characteristics of NR-FET is highlighted between homodielectric and
HD BOX. Because of the existence of high-k dielectric below the drain area, it is
assumed that the impact of trap charges is insignificant in HDB NR-FET. Furthermore,
the trap charge effect on transconductance (gm
), total gate capacitance (Cgg), and cut-off
frequency (fc
) in HDB NR-FETs are investigated. Higher-order harmonics of gm
(gm2
and gm3) and linearity parameters are studied for HDB NR-FET in a series of steps.
Finally, the effect of temperature on input characteristics, gm
, Cgg, fc
, gm2, gm3, and
linearity behavior for HDB NR-FET is investigated in the presence of trap charges.
How Can Libraries Support Student Research?
Authors: Siti Hafsyah Idris ,   Universiti Teknologi MARA Malaysia, Ridwan Arifin , Heri Prayitno ,   Univeristas Negeri Semarang,   Library of Universitas Brawijaya
Published: July 2024

Libraries have long been recognized as vital institutions for supporting student research endeavors across various educational levels. This study explores the multifaceted ways in which libraries can effectively bolster student research. Drawing from a comprehensive review of literature, surveys, interviews with librarians, and case studies of successful library programs, this research provides valuable insights into the role libraries play in enhancing the research skills and academic success of students. The findings underscore the importance of library resources, including access to scholarly databases, interlibrary loans, and research assistance, in facilitating students' information retrieval and literature review processes. Additionally, libraries' instructional programs and workshops are shown to empower students with research methodologies, information literacy, and critical thinking skills. Furthermore, this study delves into the evolving role of digital technologies and online resources in supporting student research, highlighting how libraries adapt to the changing landscape of information dissemination. Collaboration between librarians and faculty is also examined as a key factor in promoting research opportunities for students. In a rapidly evolving academic landscape, this research serves as a valuable resource for librarians, educators, and institutions seeking to optimize library services for the benefit of student researchers. By offering practical recommendations and best practices, it underscores the essential role libraries play in nurturing the next generation of scholars and fostering a culture of research excellence.
Analisis Cost of Illness pada Pasien Diabetes Mellitus Dengan Terapi Glimepiride-Metformin Rawat Jalan Peserta BPJS di Puskesmas Ketapang II Kota Sampit
Authors: Apriliana Nur Ghina ,   Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Malang, Malang, Indonesia, Pristianty Liza , Hidayati Ika Ratna ,   Fakultas Farmasi, Universitas Airlangga, Surabaya, Indonesia,   Fakultas Ilmu Kesehatan, Universitas Muhammadiyah Malang, Malang, Indonesia
Published: July 2024

Diabetes mellitus is a chronic disease that affects the costs incurred by patients during illness. The financingissuedfor the treatment of diabetes mellitus diseases can be measured using Cost of Illness analysis. Research objectivestofind out the total cost of treatment of diabetes mellitus patients BPJS participants with Glymepiride-Metformintherapy for one year. The method this study used a non-probability sampling technique with an accidental sampling method. This research conducted at Ketapang II Health Center with sample total 45 people. The instrument usedastructured interview which was previously tested for validity. Data were analyzed using Microsoft Excel. Result andconclusion, the estimate total cost of treatment of diabetes mellitus with outpatient glimepiride-metformin therapyofIndonesia Health Insurance participants at Ketapang II Health Center in Sampit city for one year is Rp.623.760-Rp.4.475.520. The direct medical cost per patient is Rp.143.760 - Rp.2.787.120. Non-medical direct cost is Rp.0-Rp.188.400. Indirect cost is Rp.480.000 - Rp.1.500.000. High cost are more expensive but the frequencyof visitsand patient compliance are orderly so that the therapeutic effect achieved is good, while the lowcost is cheaper butthe frequency of patient visits and patient compliance are not orderly so that the therapeutic effect achievedislessgood and not maximal.
Religious Affiliation and the Elective Abortion Attitudinal Variations Among Young Adults
Authors: Velez Don Antonio , Angcla Clydesdale
Published: July 2024

This study aims to determine if there is a significant difference in attitudes toward elective abortion as a social taboo among young adults when considering their religious affiliation and their extent of religious adherence by drawing from the Social Learning Theory and the Moral Communities Hypothesis. The findings highlight the importance of recognizing the diverse attitudes toward elective abortion among individuals within the predominantly Catholic Philippines. A self-administered online survey questionnaire was utilized in this study. A non-probability convenience sampling method was employed ensuring the major religious groups are represented. To examine whether an attitudinal variation exists when considering religious affiliation and the extent of religious adherence among the sample population of sixty (n = 60), a chi-square (χ²) test of independence was employed. The same was done considering the classificatory variables of sex and marital status. The results showed that attitudes toward elective abortion varied significantly among respondents when considering their religious affiliations (p = < .001), and when dichotomized into Catholic and non-Catholic groups, proportions still varied significantly (p = < .001), with most of the Catholic respondents exhibited a pro-choice attitude. Conversely, most of the non-Catholic respondents exhibited a pro-life attitude. Likewise, attitudes toward elective abortion varied significantly among respondents when considering their extent of religious adherence (p = < .001). Understanding this diversity is crucial for evidence-based policy recommendations and interventions related to bodily autonomy and sexual and reproductive rights, as well as for promoting transparency and well-informed discussion on taboos such as abortion.
Prognostic Role of Platelet-to-Lymphocyte and Neutrophil-to-Lymphocyte Ratios in Patients Irradiated for Glioblastoma Multiforme
Authors: ZEMSKOVA OKSANA , YU NATHAN Y. , LÖSER ANASTASSIA , LEPPERT JAN , RADES DIRK
Published: July 2024

Background/Aim: Previous studies suggested pre-operative platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) to be predictive factors in patients with glioblastoma multiforme (GBM). This study investigated the prognostic role of PLR and NLR prior to or at the beginning of radiotherapy. Patients and Methods: In 80 patients with GBM receiving conventionally fractionated radiotherapy plus concurrent temozolomide following resection or biopsy, 12 factors including PLR and NLR were retrospectively evaluated regarding progression-free survival (PFS) and overall survival (OS). Results: On multivariable analyses, PLR ≤150, Karnofsky performance score (KPS) 90-100, and O6-methylguanine-DNA methyltransferase promoter methylation were significantly associated with improved PFS. Single lesion, KPS 90-100, and adjuvant chemotherapy were significantly associated with OS; PLR ≤150 showed a trend. NLR ≤3 showed a trend for associations with PFS and OS on univariable analyses. Conclusion: PLR prior to or at the beginning of radiotherapy was associated with treatment outcomes in patients irradiated for GBM and should be considered in future clinical trials.
BMP Signaling Is a Prognostic Marker in Patients With Colorectal Cancer and Associates With Frailty
Authors: SAWATA SHOHEI , SHIMIZU SHOTA , MATSUMI YOSHIAKI , KONO YUSUKE , KIHARA KYOICHI , YAMAMOTO MANABU , SAKAMOTO TERUHISA , UMEKITA YOSHIHISA , FUJIWARA YOSHIYUKI
Published: July 2024

Background/Aim: Bone morphogenetic proteins (BMPs) are members of the transforming growth factor-β superfamily of ligands and have been shown to promote or suppress colorectal cancer (CRC) growth. Developing treatments that target BMPs is challenging due to their multiple roles, including involvement in the inflammatory response and nutritional status. The present study evaluated the prognostic value of BMP-4, which is believed to be highly expressed in CRC, and its correlation with inflammatory and nutrition statuses in patients with CRC. Materials and Methods: We analyzed BMP-4 expression in tumor tissues from 144 patients who underwent CRC surgery using immunohistochemistry and evaluated the relationship between BMP-4 levels and clinical outcomes. Results: Kaplan–Meier analysis revealed that patients with high expression levels of BMP-4 exhibited a shorter overall survival rate than those with low levels of expression. Multivariate analysis revealed that BMP-4 expression was an independent prognostic factor for overall survival and death from other diseases in CRC patients. Furthermore, high BMP-4 expression was significantly correlated with high C-reactive protein/Albumin ratio, sarcopenia, and osteopenia. Conclusion: BMP-4 is a significant prognostic factor in CRC, particularly in predicting death from other diseases, while also showing associations with inflammatory and nutritional statuses.
Comprehensive Analysis of Craniopharyngioma: Epidemiology, Clinical Characteristics, Management Strategies, and Role of Radiotherapy
Authors: MUSHTAQ AMIR , FAYAZ MOHSIN , BHAT ABDUL RASHID , ABDUL HUSSEIN ABBAS F. , FERINI GIANLUCA , UMANA GIUSEPPE EMMANUELE , SCALIA GIANLUCA , MIR FEROZE AHMAD , KHURSHEED AIZUL , CHAURASIA BIPIN
Published: July 2024

Background/Aim: Craniopharyngiomas pose challenges in diagnosis and management due to their rare occurrence and diverse clinical manifestations. This study aimed to provide a comprehensive analysis of cranio-pharyngioma, including its epidemiological trends, clinical presentations, radiological characteristics, surgical interventions, and the role of radiotherapy. Patients and Methods: A retrospective observational study was conducted on 23 patients diagnosed with craniopharyngioma at our hospital from August 2017 to July 2019. Data regarding demographics, clinical presentation, radiological findings, surgical interventions, and adjuvant therapies were collected and analyzed. Results: Craniopharyngiomas exhibited a bimodal age distribution, with peaks in childhood and late adulthood. Clinical presentations varied between pediatric and adult patients, with headache and nausea/vomiting predominant in children, and visual disturbances and hypogonadism more common in adults. Radiological imaging revealed predominantly suprasellar localization and varying tumor consistency. Surgical resection was the primary treatment modality, with post-operative complications including diabetes insipidus and cerebrospinal fluid leak. Histological analysis showed distinct subtypes, with the adamantinomatous subtype predominant in children and the papillary subtype in adults. Adjuvant radiotherapy was administered in cases of incomplete resection or tumor recurrence. Conclusion: This study provides comprehensive insights into the epidemiology, clinical characteristics, radiological features, surgical interventions, and role of radiotherapy in craniopharyngioma management. Understanding these aspects is crucial for tailoring optimal treatment strategies and improving patient outcomes in this complex clinical scenario.
Therapeutic Resistance in G-CSF Producing Lung Cancer With EGFR Mutation
Authors: ITO KOKI , KAIRA KYOICHI , IMAI HISAO , SHIONO AYAKO , HASHIMOTO KOSUKE , YAMAGUCHI OU , KAGAMU HIROSHI
Published: July 2024

Background/Aim: Granulocyte colony-stimulating factor (G-CSF)-producing neoplasms are relatively rare; however, little is known on the clinical features of G-CSF-producing lung cancer harboring activating epidermal growth factor receptor (EGFR) mutations. Case Report: A 66-year-old female was definitively diagnosed with G-CSF-producing lung cancer that was positive for EGFR mutations. She repeatedly received epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), such as osimertinib and afatinib. However, she developed resistance to these molecular-targeting drugs within 2 to 3 months after immediate shrinkage. Thus, the patient was treated with chemoimmunotherapy including bevacizumab, and demonstrated a slight survival benefit. Conclusion: Overall, G-CSF-producing lung cancers positive for EGFR mutations were resistant to different treatment modalities. Clinicians should be attentive to the potential resistance of G-CSF-producing EGFR mutant lung cancer to EGFR-TKI therapy.
Data Set and Benchmark (MedGPTEval) to Evaluate Responses From Large Language Models in Medicine: Evaluation Development and Validation
Authors: Xu Jie , Lu Lu , Peng Xinwei , Pang Jiali , Ding Jinru , Yang Lingrui , Song Huan , Li Kang , Sun Xin , Zhang Shaoting
Published: July 2024

Background

Large language models (LLMs) have achieved great progress in natural language processing tasks and demonstrated the potential for use in clinical applications. Despite their capabilities, LLMs in the medical domain are prone to generating hallucinations (not fully reliable responses). Hallucinations in LLMs’ responses create substantial risks, potentially threatening patients’ physical safety. Thus, to perceive and prevent this safety risk, it is essential to evaluate LLMs in the medical domain and build a systematic evaluation.

Objective

We developed a comprehensive evaluation system, MedGPTEval, composed of criteria, medical data sets in Chinese, and publicly available benchmarks.

Methods

First, a set of evaluation criteria was designed based on a comprehensive literature review. Second, existing candidate criteria were optimized by using a Delphi method with 5 experts in medicine and engineering. Third, 3 clinical experts designed medical data sets to interact with LLMs. Finally, benchmarking experiments were conducted on the data sets. The responses generated by chatbots based on LLMs were recorded for blind evaluations by 5 licensed medical experts. The evaluation criteria that were obtained covered medical professional capabilities, social comprehensive capabilities, contextual capabilities, and computational robustness, with 16 detailed indicators. The medical data sets include 27 medical dialogues and 7 case reports in Chinese. Three chatbots were evaluated: ChatGPT by OpenAI; ERNIE Bot by Baidu, Inc; and Doctor PuJiang (Dr PJ) by Shanghai Artificial Intelligence Laboratory.

Results

Dr PJ outperformed ChatGPT and ERNIE Bot in the multiple-turn medical dialogues and case report scenarios. Dr PJ also outperformed ChatGPT in the semantic consistency rate and complete error rate category, indicating better robustness. However, Dr PJ had slightly lower scores in medical professional capabilities compared with ChatGPT in the multiple-turn dialogue scenario.

Conclusions

MedGPTEval provides comprehensive criteria to evaluate chatbots by LLMs in the medical domain, open-source data sets, and benchmarks assessing 3 LLMs. Experimental results demonstrate that Dr PJ outperforms ChatGPT and ERNIE Bot in social and professional contexts. Therefore, such an assessment system can be easily adopted by researchers in this community to augment an open-source data set.
A Machine Learning Approach for Identifying People with Neuroinfectious Diseases in Electronic Health Records: Original Research Article (Preprint)
Authors: Singh Arjun , Fernandes Marta , Sun Haoqi , Milde Rebecca , Quinn Carson , Harrold G Kyle , Gillani Rebecca , Turbett Sarah , Das Sudeshna , Zafar Sahar , Westover M Brandon , Mukerji Shibani S
Published: July 2024

BACKGROUND

Identifying NID cases using manual chart review is time-consuming, and billing codes are imprecise. EHR-based ML models for NID identification have yet to be investigated.

OBJECTIVE

To develop and validate a machine learning (ML) model to identify neuroinfectious diseases (NID) from unstructured patient notes.

METHODS

Clinical notes from patients who had undergone lumbar puncture were obtained using the EHR of an academic hospital network (Mass General Brigham, MGB), with half associated with NID-related diagnostic codes. Ground-truth was established by chart review with six NID-expert physicians. NID keywords were generated with regular expressions, and extracted texts were converted into bag-of-words representations using n-grams (n=1, 2, 3). Notes were randomly split into training (80%) and hold-out testing (20%) sets. Feature selection was performed using logistic regression with L1 regularization. An extreme gradient boosting (XGBoost) model classified NID cases, and performance was evaluated using the Area Under the Receiver Operating Curve (AUROC) and the Precision-Recall Curve (AUPRC). The model was validated in an external dataset from an independent hospital (Beth Israel Deaconess Medical Center, BIDMC).

RESULTS

This study included 3,000 patient notes from MGB from January 22, 2010, to September 21, 2023. Of the initial 1,284 n-gram features, 342 were selected, with the most significant features being ‘meningitis,’ ‘ventriculitis,’ and ‘meningoencephalitis.’ The XGBoost model demonstrated an AUROC of 0.977 (0.964 - 0.988) and AUPRC of 0.894 (0.831 - 0.943) on the MGB hold-out test set. On 600 notes from BIDMC, the model performance based on AUROC and AUPRC was 0.976 (0.961 - 0.989) and 0.779 (0.655 - 0.885), respectively.

CONCLUSIONS

Our ML model identifies NID cases using clinical notes tested on two independent hospitals, thereby enhancing efficiency in future large-scale NID research and cohort generation. Future studies incorporating patient notes from different regions are needed to ensure generalizability.
Using Transformer-based Language Models to Identify Publications from Clinical Trials that Use Nested Designs (Preprint)
Authors: Elaheh Elaheh , Murray David
Published: July 2024

BACKGROUND

For the public health community, monitoring recently published articles is crucial for staying informed about the latest research developments and advancements. However, identifying publications with specific research designs from the extensive body of public health publications is a challenge with currently available methods. Using search queries to retrieve publications of this type often yields low sensitivity, failing to identify many qualifying publications. While document classification techniques like classical and deep learning machine learning models have been widely used for categorizing biomedical documents, the use of state-of-the-art language models for this purpose has yet to be explored. The language models pre-trained on biomedical data that do exist have suboptimal performance in predicting categories in specialized tasks like identifying publications from clinical trials that use nested designs.

OBJECTIVE

Our objective is to develop a fine-tuned pre-trained language model that can accurately identify publications from clinical trials that use a Group- or Cluster-Randomized Trial (GRT), Individually Randomized Group-Treatment Trial (IRGT), or Stepped Wedge Group- or Cluster-Randomized Trial (SWGRT) design within the biomedical literature.

METHODS

We fine-tuned the BiomedBERT language model using a dataset of biomedical literature from the Office of Disease Prevention at the National Institutes of Health. The model was trained to classify publications into three categories of clinical trials that use nested designs. The model performance was evaluated on unseen data and demonstrated high sensitivity and specificity for each class.

RESULTS

When our proposed model was tested for generalizability with unseen data, it delivered high sensitivity and specificity for each class as follows: Non-randomized trials (0.95 and 0.93), GRTs (0.94 and 0.90), IRGTs (0.81 and 0.97), and SWGRTs (0.96 and 0.99), respectively.

CONCLUSIONS

This model offers a valuable tool for the public health community to directly identify publications from clinical trials that use one of three classes of nested designs.
Examining the Role of AI in Changing the Role of Nurses in Patient Care: Systematic Review (Preprint)
Authors: Al Khatib Inas , Ndiaye Malick
Published: July 2024

BACKGROUND

This review investigates the relationship between artificial intelligence (AI) use and the role of nurses in patient care. AI exists in health care for clinical decision support, disease management, patient engagement, and operational improvement and will continue to grow in popularity, especially in the nursing field.

OBJECTIVE

We aim to examine whether AI integration into nursing practice may have led to a change in the role of nurses in patient care.

METHODS

To compile pertinent data on AI and nursing and their relationship, we conducted a thorough systematic review literature analysis using secondary data sources, including academic literature from the Scopus database, industry reports, and government publications. A total of 401 resources were reviewed, and 53 sources were ultimately included in the paper, comprising 50 peer-reviewed journal articles, 1 conference proceeding, and 2 reports. To categorize and find patterns in the data, we used thematic analysis to categorize the systematic literature review findings into 3 primary themes and 9 secondary themes. To demonstrate whether a role change existed or was forecasted to exist, case studies of AI applications and examples were also relied on.

RESULTS

The research shows that all health care practitioners will be impacted by the revolutionary technology known as AI. Nurses should be at the forefront of this technology and be empowered throughout the implementation process of any of its tools that may accelerate innovation, improve decision-making, automate and speed up processes, and save overall costs in nursing practice.

CONCLUSIONS

This study adds to the existing body of knowledge about the applications of AI in nursing and its consequences in changing the role of nurses in patient care. To further investigate the connection between AI and the role of nurses in patient care, future studies can use quantitative techniques based on recruiting nurses who have been involved in AI tool deployment—whether from a design aspect or operational use—and gathering empirical data for that purpose.
Digital Bites: Using Visual Feedback to Manage Overeating Amidst Screen Distractions (Preprint)
Authors: Yessenbayev Olzhas , Ahmed Tanvir , Nandakumar Rajalakshmi
Published: July 2024

BACKGROUND

The prevalence of overweight and obesity has surged, doubling since 1980 to affect one-third of the global population. Digital distractions, such as screen use during meals, have been implicated in this rise, as they divert attention from food consumption and impair memory encoding, leading to overeating. Traditional interventions focus on reducing eating rates but often require significant user motivation and effort.

OBJECTIVE

This study aimed to explore whether visual feedback on chewing behavior and the amount of food consumed, overlaid on digital content, can help regulate eating behavior during digital distractions and prevent overeating.

METHODS

We recruited 21 participants who attended two sessions, one with (intervention) and one without (control) visual feedback, while consuming a meal and reading an online article. Visual feedback included chewing rate and food consumption cues overlaid on the content. We measured physical metrics, recorded the eating process, and collected data on food consumption, appetite, and attention to food. The effects of the intervention were analyzed using mixed ANOVA, Linear Mixed Models (LMM), and correlation analyses.

RESULTS

The intervention significantly decreased the amount of pizza consumed (p=0.007), with participants eating 48 grams (16%) less on average (255 grams vs. 305 grams). Memory for the meal (p=0.017) and attention to food (p=0.025) also increased in the intervention condition. However, changes in hunger (p=0.085) and fullness (p=0.789) post-meal did not differ significantly between conditions. The intervention led to a reassessment of food palatability, with a significant decrease in palatability ratings (p=0.038) post-intervention. Individual eating patterns remained consistent across conditions (Y=0.88X + 77.42). Qualitative feedback indicated that most participants found the system easy to use and felt it enhanced their awareness of food consumption.

CONCLUSIONS

The visual feedback intervention successfully reduced food intake during digital distractions by increasing attention to and memory of food consumption. These findings suggest potential for developing tools to mitigate overeating in the context of digital distractions by emphasizing key visual cues.