bluuebunny/crossref_metadata_2025 huggingface dataset:
Research on improved Rider Optimization Algorithm based on kernel density estimation
Authors: Ling Huanzhang , Tan Xufeng , Gu Chenglei , Bi Hongjiao , Liu Shuang
Published: March 2023

Combining the randomness of the solution convergence process due to the random search of the solution space by the Estimation of the Distribution Algorithm and the characteristics of fast convergence and high accuracy of the Rider Optimization Algorithm, a hybrid Estimation of Distribution Algorithm combining them is proposed. In order to further accelerate the convergence speed of the algorithm, the strategy adopted by the original Rider Optimization Algorithm is adjusted. The kernel density estimation is used to properly select the iteration cycle of the two algorithms, the bandwidth adopted by the Estimation of Distribution Algorithm and other relevant parameters, and the Estimation of Distribution Algorithm is used to adjust the historical optimal position and maximum speed required in the Rider Optimization Algorithm. The numerical results of benchmark test functions show that the proposed optimization algorithm can achieve a certain balance between exploring the global optimal solution and characterizing the local optimal solution, and can quickly converge to the global optimal solution of complex optimization problems.
Nationwide projections of heat- and cold-related mortality impacts under climate change and population development scenarios in Switzerland
Authors: de Schrijver Evan , Sivaraj Sidharth , Raible Christoph C. , Franco Oscar H. , Chen Kai , Vicedo-Cabrera Ana M.
Published: March 2023

Climate change and progressive population development (i.e., ageing) are altering the temporal patterns in temperature-related mortality in Switzerland. However, limited evidence exists on how current trends in heat- and cold-related mortality would evolve in future decades under composite scenarios of global warming and population development. Moreover, the contribution of these drivers to future mortality impacts is not well-understood. Therefore, we aimed to project heat- and cold-related mortality in Switzerland under various warming scenarios based on a set of emission and population development pathways and to disentangle the contribution of each of these two drivers using high-resolution mortality and temperature data. We combined age-specific (< 75 and ≥75years) temperature-mortality associations in each district in Switzerland (1990–2010), estimated through a two-stage time series analysis, with 2-km downscaled CMIP5 temperature data and population and mortality rate projections under two scenarios: RCP4.5/SSP2 and RCP8.5/SSP5. We derived heat and cold-related mortality for different warming scenarios (1.5°C, 2.0°C and 3.0°C) using different emission and population development trends and compared this to the historical period (1990–2010). We estimated that heat-related mortality will increase from 312 (116; 510) in the 1990–2010 period to 1,274 (537; 2284) annual deaths under 2.0°C scenario (RCP4.5/SSP2) and to 1,871 (791; 3,284) under 3.0°C scenario (RCP8.5/SSP5). Cold-related mortality will substantially increase from 4069 (1898; 6016) to 6558 (3223; 9589) annual deaths under 2.0°C scenario (RCP4.5/SSP2) and to 5997 (2951; 8759) under 3.0°C scenario (RCP8.5/SSP5). Moreover, while the increase in cold-related mortality is solely driven by population development, for heat, both components (i.e., changes in climate and population) have a similar share of around 50% to the projected heat-related mortality trends. In conclusion, our findings suggest that both heat- and cold-related mortality will substantially increase under all scenarios of climate change and population development in Switzerland. Population development will lead to an increase in cold-related mortality despite the decrease in cold temperature under warmer scenarios. Whereas the combination of the progressive warming of the climate and population development (i.e., ageing) will further exacerbate heat-related mortality, leading to a substantial increase in the total temperature-related mortality burden in Switzerland.
Reference-free Bayesian model for pointing errors-of-type in neurosurgical planning
Authors: Baxter John S.H. , Croci Stéphane , Delmas Antoine , Bredoux Luc , Lefaucheur Jean-Pascal , Jannin Pierre
Published: March 2023

Purpose: Many neurosurgical planning tasks rely on identifying points of interest in volumetric images. Often, these points require significant expertise to identify correctly as, in some cases, they are not visible but instead inferred by the clinician. This leads to a high degree of variability between annotators selecting these points. In particular, errors-of-type are when the experts fundamentally select different points rather than the same point with some inaccuracy. This complicates research as their mean may not reflect any of the experts’ intentions nor the ground truth.
Methods: We present a regularised Bayesian model for measuring errors-of-type in pointing tasks. This model is reference-free, in that it doesn’t require a priori knowledge of the ground truth point but instead works on the basis of the level of consensus between multiple annotators. We apply this model to simulated data and clinical data from transcranial magnetic stimulation for chronic pain.
Results: Our model estimates the probabilities of selecting the correct point in the range of 82.6-88.6% with uncertainties in the range of 2.8-4.0%. This agrees with the literature where ground truth points are known. The uncertainty has not previously been explored in the literature, and gives an indication of the dataset’s strength.
Conclusions: Our reference-free Bayesian framework easily models errors-of-type in pointing tasks. It allows for clinical studies to be performed with a limited number of annotators where the ground truth is not immediately known, which can be applied widely for better understanding human errors in neurosurgical planning.
Proximate and Elisa Determination of Aflatoxin B1 Levels in Chrozophora Tinctoria from Malakand, Khyber Pakhtunkhwa Pakistan
Authors: Ullah Farhan , Khan Babar Ali , Hussain Altaf
Published: March 2023

To investigate the proximate and Aflatoxin B1 analysis in Chrozophora Tinctoria leaves were shade dried in the lab. The proximate composition of leaves was analyzed by standard methods. Mineral contents in this plant were analyzed by using atomic absorption spectrophotometer. The result revealed that Chrozophora Tinctoria leaves contained 86.68% dry matter, 9.80% moisture, 10.01% ash, 21.05% crude protein, Aflatoxin 14%, crude fibers, 14.05% carbohydrate, 44.87% crude fats and energy (243.65 kcal/100g). The analysis of Chrozophora Tinctoria revealed that this plant contains high amount of mycotoxin The type of mycotoxin in present in thise plant is known as Aflatoxin B1. Aflatoxin caused by high doses in short intervals or low doses in high intervals 1961 caused the death of over 100000 Turkey poults. Naturally produesd aflatoxins-B1,B2,G1,G2. Chrozophora Tinctoria also contained a high amount of aflatoxin (ppb). Aflatoxin a various poisous carcinogens and mutagens that are produeced by certain molds particularly aspergillus species the fungi grow in soil, decaying vegetation and various staple foodstuffs and commodities such as hay, sweetcorn, wheat ,millet, sorghum, and various species.This plant contains a huge amount of carbohydrates, and a good source of proteins and fibers.
The Foreign Policy of US President James E. Carter on the Peoples Republic of China, 1980-1981
Authors: Goncharenko Anatoliy
Published: March 2023

The article researches the US foreign policy towards the PRC during the presidency of James E. Carter in 1980–1981. The practical implementation of pre-election initiatives by the administration of the President James E. Carter in the Chinese direction in 1980–1981 was studied. There were analysed reasons, course and consequences of intensification of Washington's foreign policy strategy towards Beijing during the investigated period. The role of various groups in the American establishment in the process of forming the foreign policy course of the new administration towards China in 1980–1981 is outlined. It is described the specific US foreign policy actions towards communist China of James E. Carter presidential period.
INVESTIGATION ON THE NATURE AND PROVENANCE OF PAH FOUND IN SEDIMENTS OF THE SOLIMÕES RIVER AND SOME ASSOCIATED LAKES
Authors: de Oliveira Tereza , Scofield Arthur , Silva Luana , Lopes Alcinei , Wagener Angela
Published: March 2023

The present work aimed at evaluating indicators of hydrocarbon sources to sediments from the Solimões River region, in the central Amazon. The 16PAH, the alkylated homologs and molecular markers were investigated. The entire series of alkylated PAH were present and, in some cases, with a distribution observed when oil residues dominate. Nevertheless, hopanes characterizing immature environments undergoing diagenetic transformation were identified in samples from the Solimões River and in surface as well as in core sediment samples from Preto Lake, in the Coari-Manaus stretch. Investigation suggests early diagenesis of the organic matter confirmed by identifying biogenic markers produced during organic matter transformation. Some of these markers derive from incomplete combustion of biomass and are contained in particulate matter formed during forest burning. In the sediments of an industrial area near the city of Manaus, the entire series of mature hopanes was present indicating anthropogenic source of hydrocarbons. The results so far obtained point out the complexity of PAH source appraisal.
Satellite gravity observation and hydrological modelling-based integrated groundwater storage change in Northwestern India
Authors: Pranjal Pranshu , Chatterjee R. S. , Kumar D. , Dwivedi S. , Jally Sujit K. , Kumar Bipin
Published: March 2023

This paper presents a novel approach for an improved estimate of regional groundwater storage (GWS) change in Northwestern India by integrating satellite-based Gravity Recovery and Climate Exchange (GRACE) gravity observation and hydrological modelling of satellite/in situ hydrometeorological data. Initially, GRACE observation-based terrestrial water storage (TWS) change and hydrological model-based TWS change products were integrated using weight coefficients derived from multi-linear regression analysis of TWS change vs governing hydrological components. Later, the monthly average soil moisture change was subtracted from the monthly average individual and integrated TWS change products to obtain GWS change products. By spatial correlation analysis, three GWS change products were then compared with groundwater level (GWL) fluctuation-based in situ GWS change. Hydrological model, spaceborne GRACE observation, and integrated GWS change products show a positive correlation in ∼59, ∼69, and ∼73% of the area with in situ GWS change. While a hydrological model-based estimate considers geology, terrain, and hydrometeorological conditions, GRACE gravity observation includes groundwater withdrawal from aquifers. All the factors are included in the integrated product. The approach overcomes the limitations of GRACE observation (spatial resolution, geology, terrain, and hydrometeorological factors), hydrological modelling (groundwater withdrawal conditions), and conventional GWL fluctuation-based method (inadequate spatial continuity and cumbersome, labour-intensive exercise).
Variability in trends of streamflow and precipitation in the Narmada River Basin over the past four decades
Authors: Waikhom Sahita I. , Yadav Vipin Kumar , Chadee Aaron Anil , Varma Vipul
Published: March 2023

Hydrological climate variables such as precipitation, temperature, humidity, evapotranspiration, infiltration, and streamflow provide useful information for the effective planning, design, and management of water resources. In the present study, monthly precipitation and streamflow data were analyzed to assess the variability in trends of precipitation over the Upper Narmada Basin (UNB), Middle Narmada Basin (MNB), and Lower Narmada Basin (LNB) for 41 years (1981–2021) using the widely accepted Mann–Kendall Test (MKT), Innovative Trend Analysis (ITA), and magnitude by Sen's Slope estimator, thereby extending further by a decade, the last study by Thomas and others in 2015. The inclusion of more factors affecting the streamflow in response to the rainfall often makes the model very complex and unreliable. In the present study, to overcome this limitation, a simple yet most definite correlation was established between rainfall and streamflow, which can serve as a meaningful indicator of basin behavior. Poor correlation was observed for the UNB and the MNB compared to the LNB, which may be attributed to the presence of tributaries. The result of this study will be helpful to policymakers and water resource managers to plan and adopt suitable schemes of water conservation and management in the Narmada basin.
К проблеме адаптации студентов-первокурсников высших учебных заведений гуманитарного профиля
Authors: Вороная Виктория Д. , Проненко Евгений А.
Published: March 2023

Во «Введении» говорится о том, что ввиду динамичной смены образовательных условий вопрос адаптации студентов-первокурсников остается актуальным. С одной стороны, проблемы остаются теми же, с другой – возникают трудности, связанные с изменениями общественной обстановки. Целью данного исследования является анализ трудностей и проблем, характерных для студентов-первокурсников, и оценка их субъективной трудности. Новизна исследования заключается в дополнении существующих исследований проблемами, ранее не поднимающимися или мало освещенными авторами (например, негативные чувства у студентов после ответа на семинаре, сравнение себя с одногруппниками). Методы: использован авторский опросник из 14 вопросов, позволяющий с помощью семантического дифференциала оценить субъективную трудность воспринимаемых студентами проблем; результаты были проанализированы с помощью математической обработки и контент-анализа. Результаты: трудностями, характерными для половины всех опрошенных, выступают ощущение неопределенности времени начала семестра (особо тревожащий 22% опрошенных), страх ошибаться (особо значимый для 33% студентов) и страх не найти контакт с одногруппниками (также значимый для 33% студентов). На момент исследования 68% первокурсников отмечают стабилизацию ситуации и решение проблем, однако 32% указывают на оставшиеся беспокоящие трудности. Из них 21% студентов отмечают негативные переживания после ответов на семинаре, 15% - страх ошибиться, 15% - проблему сравнения себя с одногруппниками, 13% и 10% - проблемы внутригрупповой сплоченности и планирования времени соответственно.  63% первокурсников указали на значительную помощь в адаптации кураторов и наставников. В обсуждении результатов указывается на определенную согласованность ряда проблем, что отсылает к актуальности практического применения исследований.
Ciência da informação e privacy by design
Authors: Melo Jonas Ferrigolo , Rockembach Moisés , Silva Armando Manuel Barreiros Malheiro da
Published: March 2023

Este artigo apresenta o mapeamento das possibilidades de pesquisa no âmbito da Ciência da Informação (CI) que tratam sobre o conceito de Privacy by Design (PbD). Se busca responder como a CI e os usos da teoria do PbD podem influenciar no alcance de maior privacidade aos usuários de sistemas de informação desde a concepção de produtos científicos até a pesquisa aplicada. Para responder esta pergunta, foram analisados 202 artigos, que balizaram a composição do mapa de possibilidades de pesquisa. O mapeamento abrange temas como o controle e o acesso aos dados, privacidade como um bem social e a visão de que a privacidade toma forma de acordo com as tecnologias. Foram problematizados os aspectos éticos da privacidade no ambiente tecnológico e contextualizada a presença do conceito de PbD nas legislações de proteção de dados. Conclui-se que este estudo contribui ao reunir proposições para o ponto de partida na busca por pesquisas científicas transdisciplinares em CI e privacidade, que os profissionais de CI podem estar envolvidos na observância da privacidade em todas as camadas de negócio no desenvolvimento de sistemas, e que a área pode contribuir com os debates relacionados ao PbD em razão da privacidade ser bem social fundamental.
Memória Coletiva diante um painel bibliometrico
Authors: Costa Rosa da Penha Ferreira da , Modolo Philippe Peterle , Miguel Marcelo Calderari
Published: March 2023

O Brasil, diz Millôr Fernandes, tem um enorme passado pela frente e, esse projeto de nação ergue-se com a memória coletiva. Nessa via, o objetivo do estudo é analisar bibliometricamente como a temática ‘memória coletiva’ se apresenta indexada no acervo da literatura científica da Ciência da Informação - Brapci. A pesquisa estabelece métricas sobre o quantitativo anual de publicações, os periódicos e os autores envolvidos, as palavras chaves mais frequentes. Estabelecido o recorte dos últimos dez anos completos, são recuperados 50 artigos. O diagnóstico nota a sustentabilidade da produção científica relacionada ao tema memória coletiva e, com o debate das práticas patrimoniais e memorialistas alinham-se ações em prol da visibilidade, do acautelamento e da proteção do Patrimônio Cultural. Conclui-se que entre os anos de 2017 e 2021 a temática memória coletiva adentra na Ciência da Informação, cingindo construtos em prol da ética, da transparência e dos direitos humanos. A temática processa amplas provocações e reflexões que, por meio das narrativas da memória e do esquecimento estão ligadas ao status teórico-linguístico inerente às interfaces do Ser Informação.
Morte e vida democrática
Authors: Callegari José Antonio
Published: March 2023

Após o dia 08 de janeiro de 2023, quando se deu a invasão na Praça dos Três Poderes, no Distrito Federal, numa tentativa de destituir o governo legitimado pelas urnas, formou-se uma rede de resistência e de restauração democrática, seguindo manifestações anteriores como a Carta às brasileiras e aos brasileiros e a Frente Ampla pela Democracia. A resistência democrática propõe manter viva a democracia. Nesse contexto, examinam-se aspectos teóricos sobre o autoritarismo e o totalitarismo que ameaçam de morte as democracias constitucionais. Indicando situações concretas, no caso brasileiro, procura-se identificar elementos que dão vida e sustentação à democracia, tais como esfera pública, pedagogia democrática, e ativismos sociais.
valor da desinformação no contexto do capital informação
Authors: Silva André Januário da , Wilke Valéria Cristina Lopes
Published: March 2023

O fenômeno da desinformação tem tomado centralidade no debate público nos últimos tempos. As discussões e ações de combate a conteúdos desinformativos têm sido impulsionadas pelos mais diversos setores da sociedade, motivadas, sobretudo, pela massificação da produção, circulação e consumo de fake news. Entretanto, a desinformação não se restringe apenas ao ambiente da circulação de notícias falsas por pseudo mídias jornalísticas, nem tampouco se caracteriza como um fenômeno novo. É possível remontar outros contextos históricos onde o viés desinformativo tem sido utilizado como política de Estado, estratégia de guerra e produção de consenso em torno de verdades anunciadas. Nesse sentido, o que torna a desinformação um problema tão urgente e atual? Buscando responder essa questão nossa proposta parte de uma discussão teórico-analítica ancorada em uma perspectiva marxiana de economia política. Para tanto, iremos operar com duas noções que consideramos essenciais para elucidar essa questão, sendo elas: a lógica do Capital Informação e a noção de valor no ambiente de uma economia política das plataformas sócio-digitais.
Metachronous Single Pulmonary Metastasis of Prostate Cancer: Report of a Rare Case and Literature Review
Authors: KOKKALIS ALEXANDROS , SAMARA ATHINA A. , PAPADOPOULOS VASILEIOS , TOLIA MARIA , TSOUKALAS NIKOLAOS , TSAPAKIDIS KONSTANTINOS
Published: March 2023

Background: Prostate cancer recurrence after definitive local therapy usually involves the bone and regional lymph nodes. Case Report: We present the case of a 72-year-old male patient with an isolated lung nodule, seven years after radical prostatectomy for prostate cancer, pT2bN0 and Gleason score 7(4+3), and prostatic-specific antigen (PSA) levels within normal limits. The nodule was considered as a primary lung cancer and the patient was subjected to lobectomy. The immunohistochemical staining showed that the tumor was PSA(+) and NKX3.1 (+), revealing that it was metastasis from prostatic cancer and that wedge resectomy was the proper procedure. Three years later the patient is disease-free, suggesting the importance of aggressive treatment of oligometastatic disease. Conclusion: Metastasis to the lung is present in more than 40% of men with metastatic prostate cancer; however, lung metastases without any bone or lymph node involvement are extremely rare and only a handful of cases are reported in the literature. Surgical excision of the metastatic lung site is the most common therapeutic approach associated with a good prognosis.
Clinical Outcomes and Toxicity of CT-guided High Dose-rate Brachytherapy in Women With Locally-advanced Cervical Cancer
Authors: DE SANCTIS VITALIANA , FACONDO GIUSEPPE , VULLO GIANLUCA , ANZELLINI DIMITRI , SANGUINETI GIUSEPPE , NARDANGELI ALESSIA , MARMIROLI LUCA , TORTORETO FRANCESCA , GENTILE PIERCARLO , ANNESSI IVAN , DONATO VITTORIO , CHIOSTRINI CINZIA , TOMBOLINI VINCENZO , DE FELICE FRANCESCA , VALERIANI MAURIZIO , OSTI MATTIA FALCHETTO
Published: March 2023

Background/Aim: To evaluate the outcome and toxicities in patients with locally advanced cervical cancer (LACC) treated with radiochemotherapy and intracavitary brachytherapy. Patients and Methods: This study included 67 patients with LACC treated between 2010 and 2018. The most represented stage was FIGO IIB. The patients were treated with external beam radiotherapy (EBRT) to the pelvis and boost to the cervix and parametrials. Concomitant chemotherapy (CHT) with cisplatin (CDDP) 40 mg/mq was planned. Subsequently, the patients underwent CT-based endouterine brachytherapy (BT). The response was evaluated at 3 months with PET-CT and/or pelvic magnetic resonance imaging (MRI). Since then, the patients have been followed with clinical instrumental controls every 4 months for the first 2 years and every 6 months for the following 3 years. Local response was assessed with pelvic MRI and/or PET-CT scan at the end of intracavitary BT) according to RECIST 1.1 criteria. Results: The median duration of treatment was 55 days (range=40-73 days). The prescription dose to the planning target volume (PTV) was delivered in 25 to 30 (median 28) daily fractions. The EBRT median dose to the pelvis and gross tumor volume were 50.4 Gy (range=45-56.25) and 61.6 Gy (range=45-70.4), respectively. The 1-year, 2-year, 3-year, and 5-year overall survival rates were 92.44%, 80.81%, 78.84%, and 76.45% respectively. The actuarial 1-year, 2-year, 3-year, and 5-year disease-free survival rates were 89.5%, 83.6%, 81%, and 78.2% respectively. Conclusion: This study analyzed acute and chronic toxicity, survival, and local control in cervical cancer patients treated with IMRT followed by CT-planned high dose rate-brachytherapy. Patients demonstrated satisfactory outcomes and incidence of acute and late toxicities.
Long-term Prognostic Impact of Metachronous Rectal Cancer in Patients With Familial Adenomatous Polyposis: A Single-center Retrospective Study
Authors: TATSUTA KYOTA , SAKATA MAYU , IWAIZUMI MORIYA , SUGIYAMA KOSUKE , KOJIMA TADAHIRO , AKAI TOSHIYA , SUZUKI KATSUNORI , MORITA YOSHIFUMI , KIKUCHI HIROTOSHI , HIRAMATSU YOSHIHIRO , KURACHI KIYOTAKA , TAKEUCHI HIROYA
Published: March 2023

Aim: To evaluate the risk factors and long-term prognosis of metachronous rectal cancer in the remnant rectum of patients with familial adenomatous polyposis (FAP). Patients and Methods: Sixty-five patients (49 families) who underwent prophylactic surgery, including bowel resection, for FAP between January 1976 and August 2022 at Hamamatsu University Hospital were included and divided into two groups based on the presence of metachronous rectal cancer. Risk factors for metachronous rectal cancer development were analysed in cases treated with total colectomy with ileorectal anastomosis (IRA) and stapled total proctocolectomy with ileal pouch anal anastomosis (IPAA) (IRA, n=22; stapled IPAA n=20; total, n=42). Results: The median surveillance period was 169 months. Twelve patients developed metachronous rectal cancer (IRA, n=5; stapled IPAA, n=7), of which six with advanced cancer died. Patients who temporarily dropped out of surveillance were significantly more likely to have metachronous rectal cancer (metachronous vs. non-metachronous rectal cancer: 33.3% vs. 1.9%, p<0.01). The mean duration of surveillance suspension was 87.8 months. Cox regression analysis revealed that temporary surveillance drop-out independently affected the risk (p=0.04). The overall survival associated with metachronous rectal cancer was 83.3% at 1 year and 41.7% at 5 years. Overall survival was significantly worse in advanced cancer than in early cancer cases (p<0.01). Conclusion: Temporary drop-out from surveillance was a risk factor for metachronous rectal cancer development, and advanced cancer had a poor prognosis. Continuous surveillance of patients with FAP, without temporary drop-out, is strongly recommended.
Pretreatment Hemoglobin Levels and Platelet-to-Lymphocyte Ratio Predict Survival Benefit from Pembrolizumab in Advanced Urothelial Carcinoma
Authors: KURASHINA RYO , ANDO KIYOHIRO , INOUE MASAHARU , MARUYAMA RIKO , MITANI KOUKI , TAKENOBU HISANORI , HARUTA MASAYUKI , ONUKI RITSUKO , MATSUOKA YOH , KAMIJO TAKEHIKO , KAGEYAMA YUKIO
Published: March 2023

Background/Aim: Several prognostic risk factors have been recognized when using cisplatin-based conventional chemotherapy for the treatment of advanced urothelial carcinoma (UC); these include performance status (PS), liver metastasis, hemoglobin (Hb) levels, time from prior chemotherapy (TFPC), and other systemic inflammation scores including neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR). However, the benefit of these indicators for predicting outcome of immune checkpoint inhibitors is not fully understood. Here, we investigated the predictive value of the indicators in patients who received pembrolizumab for the treatment of advanced UC. Patients and Methods: Seventy-five patients who received pembrolizumab treatment for advanced UC were included. The Karnofsky PS, liver metastasis, hemoglobin levels, TFPC, NLR, and PLR were analyzed, and their relationship with overall survival (OS) was determined. Results: All factors were highlighted as significant prognostic indicators for OS in the univariate proportional regression analysis (p<0.05 for each). Multivariate analysis revealed that Karnofsky PS and liver metastasis were independent prognostic indicators for OS (p<0.01) but were applicable only for a small number of patients. Notably, the combined analysis with low Hb levels and high PLR was significantly associated with OS in patients who could gain less benefit from pembrolizumab at a median of 6.6 [95% confidence interval (CI)=4.2-9.0] versus 15.1 (95% CI=12.4-17.8) months (p=0.002). Conclusion: The combination of Hb levels and PLR may be a broadly applicable indicator for the outcome of pembrolizumab as second-line chemotherapy in patients with advanced UC.
Does Pathological T-Factor Affect Long-term Prognosis of Locally Advanced Colorectal Cancer Treated With Laparoscopic Multivisceral Resection?
Authors: ISHIYAMA YASUHIRO , HIRANO YASUMITU , TANAKA HIROTO , YONEZAWA HIROKI , SASAKI MEGUMI , FUJII TAKATUGU , OKAZAKI NAOTO , ISHII TOSHIMASA , DEGUCHI KATSUYA
Published: March 2023

Background/Aim: Locally advanced colorectal cancer (LACC) has poor long-term outcomes. Our hypothesis was that the pathological tumor depth would affect postoperative outcomes in patients who underwent multivisceral resection with clear margins (R0). The aim of this study was to analyze short- and long-term outcomes in patients who underwent multivisceral resection for LACC, comparing between T3 and T4 stages. Patients and Methods: This was a propensity score-matched, retrospective study. All 8,764 consecutive patients who underwent surgery for colorectal cancer between April 2007 and January 2021 at the Saitama Medical University International Medical Center were screened; 572 underwent multivisceral resection for LACC. We compared the T3 and T4 groups to evaluate outcomes. Results: The 5-year disease-free survival (DFS) rates did not significantly differ between the two groups (hazard ratio=1.344, 95% confidence interval=0.638-2.907, p=0.33). The 5-year overall survival (OS) rates were significantly worse for the T4 group than for the T3 group (hazard ratio=3.162, 95% confidence interval=1.077-11.44), p=0.037). To determine the association between American Society of Anesthesiologists (ASA) score, transfusion, pathological T and OS, we performed univariate and multivariate analyses. ASA, transfusion, and pathological T-stage were associated with worse OS in univariate analysis (T4 vs. T3, respectively). Conclusion: Our study showed that postoperative complications and DFS of the T4 group were similar to those of the T3 group of locally advanced colorectal cancer treated with laparoscopic multivisceral resection. However, OS was worse in the T4 group compared with the T3 group. Multivariate risk factors for poor OS were ASA>2, transfusion, and T4 stage.
Refusal of Subsequent Treatment in Patients With EGFR-mutant Non-small-cell Lung Cancer After Response to EGFR-TKIs
Authors: HASHIMOTO SAORI , FUJII YOKO , UJIIE MIDORI , MIYAZAKI KUNIHIKO , SATO SHINYA , KODAMA TAKAHIDE , NAGATSU TAKAKO , KAYAUCHI NAOMI , SATOH HIROAKI
Published: March 2023

Background/Aim: During the course of effective and long-term treatment with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), some elderly patients might decline further treatment after EGFR-TKI. We conducted a study to try and understand the reasons for this treatment decision. Patients and Methods: We analyzed the medical records of all patients diagnosed with non-small-cell lung cancer with EGFR mutations between 2016 and 2021. Results: There were 108 patients who received EGFR-TKIs. Of these, 67 patients responded to TKI. These responding patients were divided into two groups according to whether they received subsequent TKI treatment. At their request, 24 patients (group A) did not receive further anticancer treatment following TKI. The other 43 patients (group B) received anticancer therapy following TKI. Progression-free survival in group A patients was significantly longer (median=18 months, range=1-67 months) than in group B patients. The reasons for not wanting subsequent treatment after TKI were older age, reduced general condition, deterioration of physical comorbid disease and dementia. Dementia was the most common reason for patients over 75 years of age. Conclusion: Some elderly patients with well-controlled disease might express their refusal of all subsequent anticancer therapy after TKIs. Medical staff should respond seriously to these requests.
The Impact of Social Media on COVID-19 Vaccine Hesitancy and Acceptance: Data Analytic Approach
Authors: Alsaid Manar , Hawamdeh Sumer
Published: March 2023

There is still a great deal of vaccination hesitancy among different populations in the U.S. including health workers, government officials, minorities and marginalized communities. The politicization of the COVID-19 issue made it difficult to contain the infection and led to an increase in the spread of COVID-19 misinformation and conspiracy theories on the internet and social media. Misinformation about COVID-19 and its vaccine hindered efforts to fight the disease and continue to impact measures to contain the pandemic. In this paper, we examine the factors impacting vaccine hesitancy and acceptance in the United States. Data collected from CDC website and Twitter hashtags, #COVIDvaccines was analyzed, and the results have shown that vaccine hesitancy is largely influenced by personal opinion rather than scientific knowledge. Safety and side effect was the major impacting factor followed by misinformation and conspiracy theories. 

ALISE RESEARCH TAXONOMY TOPICS

big data; data visualization; information literacy; information use; social media.

AUTHOR KEYWORDS

COVID-19 vaccine; misinformation; conspiracy theory; fake news; vaccine hesitancy.
Efficacy of Web-Based, Guided Self-help Cognitive Behavioral Therapy–Enhanced for Binge Eating Disorder: Randomized Controlled Trial
Authors: Melisse Bernou , Berg Elske van den , Jonge Margo de , Blankers Matthijs , Furth Eric van , Dekker Jack , Beurs Edwin de
Published: March 2023

Background

Owing to the gap between treatment supply and demand, there are long waiting periods for patients with binge eating disorder, and there is an urgent need to increase their access to specialized treatment. Guided self-help cognitive behavioral therapy–enhanced (CBT-E) may have great advantages for patients if its efficacy can be established.

Objective

The aim of this study was to examine the efficacy of guided self-help CBT-E compared with that of a delayed-treatment control condition.

Methods

A single-blind 2-arm randomized controlled trial was designed to evaluate guided self-help CBT-E according to an intention-to-treat analysis. A total of 180 patients were randomly assigned to guided self-help CBT-E (n=90, 50%) or the delayed-treatment control condition (n=90, 50%) for which guided self-help CBT-E was provided after the initial 12-week delay. The primary outcome was reduction in binges. The secondary outcome was full recovery at the end of treatment, as measured using the Eating Disorder Examination during the last 4 weeks of treatment. A linear mixed model analysis was performed to compare treatment outcomes at the end of treatment. A second linear mixed model analysis was performed to measure between- and within-group effects for up to 24 weeks of follow-up. The Eating Disorder Examination–Questionnaire and clinical impairment assessment were conducted before and after treatment and during follow-up. In addition, dropout rates were assessed in both conditions.

Results

During the last 4 weeks of treatment, objective binges reduced from an average of 19 (SD 16) to 3 (SD 5) binges, and 40% (36/90) showed full recovery in the guided self-help CBT-E group. Between-group effect size (Cohen d) was 1.0 for objective binges. At follow-up, after both groups received treatment, there was no longer a difference between the groups. Of the 180 participants, 142 (78.9%) completed treatment. The overall treatment dropout appeared to be associated with gender, level of education, and number of objective binges at baseline but not with treatment condition.

Conclusions

This is the first study to investigate the efficacy of guided self-help CBT-E. Guided self-help CBT-E appeared to be an efficacious treatment. This study’s findings underscore the international guidelines recommending this type of treatment for binge eating disorder.

Trial Registration

Netherlands Trial Registry (NTR) NL7994; https://trialsearch.who.int/Trial2.aspx?TrialID=NL7994

International Registered Report Identifier (IRRID)

RR2-10.1186/s12888-020-02604-1
Telemedicine Use by Age in Louisiana Medicaid During COVID-19: Claims-Based Longitudinal Analysis
Authors: Park Sooyeol , Walker Brigham , Anderson Andrew , Shao Yixue , Callison Kevin
Published: March 2023

Background

Limited availability of in-person health care services and fear of contracting COVID-19 during the pandemic promoted an increased reliance on telemedicine. However, long-standing inequities in telemedicine due to unequal levels of digital literacy and internet connectivity among different age groups raise concerns about whether the uptake of telemedicine has exacerbated or alleviated those inequities.

Objective

The aim of this study is to examine changes in telemedicine and in-person health service use during the COVID-19 pandemic across age groups for Medicaid beneficiaries in the state of Louisiana.

Methods

Interrupted time series models were used on Louisiana Medicaid claims data to estimate trends in total, in-person, and telemedicine monthly office visit claims per 1000 Medicaid beneficiaries between January 2018 and December 2020. Changes in care pattern trends and levels were estimated around the infection peaks (April 2020 and July 2020) and for an end-of-year infection leveling off period (December 2020). Four mutually exclusive age categories (0 to 17, 18 to 34, 35 to 49, and 50 to 64 years) were used to compare the differences.

Results

Prior to the COVID-19 pandemic, telemedicine services accounted for less than 1% of total office visit claim volume across the age groups. Each age group followed similar patterns of sharp increases in April 2020, downward trends until sharp increases again in July 2020, followed by flat trends thereafter until December 2020. These sharp increases were most pronounced for older patients, with those aged 50 to 64 years seeing increases of 184.09 telemedicine claims per 1000 Medicaid beneficiaries in April 2020 (95% CI 172.19 to 195.99) and 120.81 in July 2020 (95% CI 101.32 to 140.31) compared with those aged 18 to 34 years, seeing increases of 84.47 (95% CI 78.64 to 90.31) and 57.00 (95% CI 48.21 to 65.79), respectively. This resulted in overall changes from baseline to December 2020 levels of 123.65 (95% CI 112.79 to 134.51) for those aged 50 to 64 years compared with 59.07 (95% CI 53.89 to 64.24) for those aged 18 to 34 years.

Conclusions

Older Medicaid beneficiaries in Louisiana had higher rates of telemedicine claim volume during the COVID-19 pandemic compared with younger beneficiaries.
Developing an Inpatient Electronic Medical Record Phenotype for Hospital-Acquired Pressure Injuries: Case Study Using Natural Language Processing Models (Preprint)
Authors: Nurmambetova Elvira , Pan Jie , Zhang Zilong , Wu Guosong , Lee Seungwon , Southern Danielle A , Martin Elliot A , Ho Chester , Xu Yuan , Eastwood Cathy A
Published: March 2023

BACKGROUND

Surveillance of hospital-acquired pressure injuries (HAPI) is often suboptimal when relying on administrative health data, as International Classification of Diseases (ICD) codes are known to have long delays and are undercoded. We leveraged natural language processing (NLP) applications on free-text notes, particularly the inpatient nursing notes, from electronic medical records (EMRs), to more accurately and timely identify HAPIs.

OBJECTIVE

This study aimed to show that EMR-based phenotyping algorithms are more fitted to detect HAPIs than ICD-10-CA algorithms alone, while the clinical logs are recorded with higher accuracy via NLP using nursing notes.

METHODS

Patients with HAPIs were identified from head-to-toe skin assessments in a local tertiary acute care hospital during a clinical trial that took place from 2015 to 2018 in Calgary, Alberta, Canada. Clinical notes documented during the trial were extracted from the EMR database after the linkage with the discharge abstract database. Different combinations of several types of clinical notes were processed by sequential forward selection during the model development. Text classification algorithms for HAPI detection were developed using random forest (RF), extreme gradient boosting (XGBoost), and deep learning models. The classification threshold was tuned to enable the model to achieve similar specificity to an ICD-based phenotyping study. Each model’s performance was assessed, and comparisons were made between the metrics, including sensitivity, positive predictive value, negative predictive value, and F1-score.

RESULTS

Data from 280 eligible patients were used in this study, among whom 97 patients had HAPIs during the trial. RF was the optimal performing model with a sensitivity of 0.464 (95% CI 0.365-0.563), specificity of 0.984 (95% CI 0.965-1.000), and F1-score of 0.612 (95% CI of 0.473-0.751). The machine learning (ML) model reached higher sensitivity without sacrificing much specificity compared to the previously reported performance of ICD-based algorithms.

CONCLUSIONS

The EMR-based NLP phenotyping algorithms demonstrated improved performance in HAPI case detection over ICD-10-CA codes alone. Daily generated nursing notes in EMRs are a valuable data resource for ML models to accurately detect adverse events. The study contributes to enhancing automated health care quality and safety surveillance.

CLINICALTRIAL
Spatiotemporal Changes in Pulmonary Tuberculosis Incidence in a Low-Epidemic Area of China in 2005-2020: Retrospective Spatiotemporal Analysis (Preprint)
Authors: Zhang Qi , Ding Huan , Gao Song , Zhang Shipeng , Shen Shiya , Chen Xiaoyan , Xu Zhuping
Published: March 2023

BACKGROUND

In China, tuberculosis (TB) is still a major public health problem, and the incidence of TB has significant spatial heterogeneity.

OBJECTIVE

This study aimed to investigate the temporal trends and spatial patterns of pulmonary tuberculosis (PTB) in a low-epidemic area of eastern China, Wuxi city, from 2005 to 2020.

METHODS

The data of PTB cases from 2005 to 2020 were obtained from the Tuberculosis Information Management System. The joinpoint regression model was used to identify the changes in the secular temporal trend. Kernel density analysis and hot spot analysis were used to explore the spatial distribution characteristics and clusters of the PTB incidence rate.

RESULTS

A total of 37,592 cases were registered during 2005-2020, with an average annual incidence rate of 34.6 per 100,000 population. The population older than 60 years had the highest incidence rate of 59.0 per 100,000 population. In the study period, the incidence rate decreased from 50.4 to 23.9 per 100,000 population, with an average annual percent change of –4.9% (95% CI –6.8% to –2.9%). The incidence rate of pathogen-positive patients increased during 2017-2020, with an annual percent change of 13.4% (95% CI 4.3%-23.2%). The TB cases were mainly concentrated in the city center, and the incidence of hot spots areas gradually changed from rural areas to urban areas during the study period.

CONCLUSIONS

The PTB incidence rate in Wuxi city has been declining rapidly with the effective implementation of strategies and projects. The populated urban centers will become key areas of TB prevention and control, especially in the older population.
Technology, Training, and Task Shifting at the World’s Largest Mass Gathering in 2025: An Opportunity for Antibiotic Stewardship in India (Preprint)
Authors: Chan Isaac H Y , Gofine Miriam , Arora Shitij , Shaikh Ahmed , Balsari Satchit
Published: March 2023

UNSTRUCTURED

The role of antibiotic overuse in intensifying selection pressures and contributing to the emergence of antimicrobial resistance is well established. The Kumbh Mela, a religious festival that occurs in 4 Indian cities of spiritual significance, is the world’s largest mass gathering, attracting over 80 million pilgrims in 2013. Digital syndromic surveillance from the 2013 and 2015 Melas demonstrated a consistent pattern of antibiotic overuse, with an antibiotic prescribing rate of up to 31% for all patient encounters. As preparations for the 2025 Kumbh Mela begin, task shifting, point-of-care diagnostic and digital tools, robust clinician training, and community awareness can promote the restrained and evidence-based use of antibiotics, minimizing the potential for the emergence of antimicrobial resistance at the world’s largest mass gathering.
Monitoring of Khapra Beetle in Jakarta, Tangerang, and Bekasi as Part of Khapra Beetle Free Area Maintenance Program in Indonesia
Authors: Permada Johan , Witjaksono Witjaksono , Wagiman F. X.
Published: March 2023

Khapra beetle, Trogoderma granarium Evert (Coleoptera: Dermestidae) is the most important stored pest and was first discovered in Jakarta grain storages in 1972. Since then, quarantine procedures have been massively carried out to prevent khapra beetles to spread in Indonesia. In 2009, Indonesia has been declared as free area from Khapra beetle. However, Indonesia still import grain from non-Khapra beetle free countries and supervision must be carried out continuously to prevent Khapra beetle reinfestation. This survey was conducted at warehouses in five areas of Jakarta, Tangerang, and Bekasi from October 2016 to February 2017 with high risk due to its role as one of the main entry ports and storage of imported grains. Observation was done using probe sampling, direct observation and traps with attractant. Results showed that several insects were found from imported seeds in the surveyed area, but no Khapra beetles were found. It showed that non-Khapra free countries have implemented the required Sanitary Phytosanitary. In addition, it implies that survey methods using attractant traps could complement the probe sampling methods and direct observation that are currently used.
The Concept of the Mechanism of Power in Suzanne Collin’s Trilogy The Hunger Games
Authors: Tariq Ainaab , Asmi Dr.
Published: March 2023

The notion of the mechanism of power is analyzed in Suzanne Collin’s trilogy The Hunger Games in this paper. The author takes an analytical approach to how power is exercised, a measure that contributes in the establishment of a theory of power relations that impact people's lives, mindset, politics, and even the economy. According to Collins, power is the core, if not the elixir of life, on which the authoritarian regime led by President Snow's existence is premised. The paper goes on to explain why it is important to retain power in place in order to keep the government in power. The novel's power mechanism works on a lot of different levels. Divide and rule is the first and most significant dividing tactic, aimed at eliminating any possible unity among people who may use that unity to revolt against the totalitarian regime.
“Outside of here, It’s Death or Hope?!”: Exploring despair and Hope in T.S. Eliot’s ‘The Waste Land’ and Samuel Beckett’s ‘Endgame’
Authors: Shastri Tanisha
Published: March 2023

T.S Eliot’s masterpiece poem, The Waste Land, and Samuel Beckett’s absurdist play, Endgame were both written in the shadow of great disasters. The Waste Land has tones of desolation and despair and humanity is shown at the brink of extinction. Beckett is known for his association with the Theatre of the Absurd where suffering and the meaninglessness of life were stressed on. Endgame presents the disillusionment of man in a decayed and meaningless modern world. Written after World War I, Eliot shows a bleak world in the wasteland of Europe. Beckett published Endgame fifty-five years after The Waste Land and had the dubious benefit of having witnessed the second World War. Living under post-atomic threat, Beckett’s vision appears conspicuously darker than Eliot’s. The purpose of this paper is to explore despair and dejection in both the works; the isolation of modern man; the meaninglessness of relationships; and the spiritual barrenness in a post-war world. At the same time, the study attempts to look for glimpses of hope and redemption in the barren lands. Through the utter despair that makes up both works, they paradoxically promote an acceptance of our fate and teach us to value life in all its imperfections.