bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility of a quality improvement project to increase adherence to evidence-based pulmonary embolism diagnosis in the emergency department
Authors: Germini Federico , Hu Yang , Afzal Sarah , Al-Haimus Fayad , Puttagunta Srikanth A. , Niaz Saghar , Chan Teresa M. , Clayton Natasha , Mondoux Shawn , Thabane Lehana , Wit Kerstin de
Published: November 2024

Background

Many evidence-based clinical decision tools are available for the diagnosis of pulmonary embolism (PE). However, these clinical decision tools have had suboptimal uptake in the everyday clinical practice in emergency departments (EDs), despite numerous implementation efforts. We aimed to test the feasibility of a multi-faceted intervention to implement an evidence-based PE diagnosis protocol.

Methods

We conducted an interrupted time series study in three EDs in Ontario, Canada. We enrolled consecutive adult patients accessing the ED with suspected PE from January 1, 2018, to February 28, 2020. Components of the intervention were as follows: clinical leadership endorsement, a new pathway for PE testing, physician education, personalized confidential physician feedback, and collection of patient outcome information. The intervention was implemented in November 2019. We identified six criteria for defining the feasibility outcome: successful implementation of the intervention in at least two of the three sites, capturing data on ≥ 80% of all CTPAs ordered in the EDs, timely access to electronic data, rapid manual data extraction with feedback preparation before the end of the month ≥ 80% of the time, and time required for manual data extraction and feedback preparation ≤ 2 days per week in total.

Results

The intervention was successfully implemented in two out of three sites. A total of 5094 and 899 patients were tested for PE in the period before and after the intervention, respectively. We captured data from 90% of CTPAs ordered in the EDs, and we accessed the required electronic data. The manual data extraction and individual emergency physician audit and feedback were consistently finalized before the end of each month. The time required for manual data extraction and feedback preparation was ≤ 2 days per week (14 h).

Conclusions

We proved the feasibility of implementing an evidence-based PE diagnosis protocol in two EDs. We were not successful implementing the protocol in the third ED.
2023 Society for Academic Emergency Medicine Consensus Conference on Precision Emergency Medicine: Development of a policy-relevant, patient-centered research agenda
Authors: Strehlow Matthew , Gisondi Michael A. , Caretta-Weyer Holly , Ankel Felix , Brackett Alexandria , Brar Pawan , Chan Teresa M. , Garabedian Adrene , Gunn Bridget , Isaacs Eric , von Isenburg Megan , Jarman Angela , Kuehl Damon , T. Limkakeng Alexander , Lydston Melis , McGregor Alyson , Pierce Ava , Raven Maria C. , Salhi Rama A. , Stave Christopher , Tan Josephine , Taylor Richard Andrew , Nei Wong Hong , Yiadom Maame Yaa A. B. , Zachrison Kori S. , Vogel Jody
Published: November 2024

Objectives: Precision medicine is data-driven health care tailored to individual patients based on their unique attributes, including biologic profiles, disease expressions, local environments, and socioeconomic conditions. Emergency medicine (EM) has been peripheral to the precision medicine discourse, lacking both a unified definition of precision medicine and a clear research agenda. We convened a national consensus conference to build a shared mental model and develop a research agenda for precision EM.

Methods: We held a conference to (1) define precision EM, (2) develop an evidence-based research agenda, and (3) identify educational gaps for current and future EM clinicians. Nine preconference workgroups (biomedical ethics, data science, health professions education, health care delivery and access, informatics, omics, population health, sex and gender, and technology and digital tools), comprising 84 individuals, garnered expert opinion, reviewed relevant literature, engaged with patients, and developed key research questions. During the conference, each workgroup shared how they defined precision EM within their domain, presented relevant conceptual frameworks, and engaged a broad set of stakeholders to refine precision EM research questions using a multistage consensus-building process.

Results: A total of 217 individuals participated in this initiative, of whom 115 were conference-day attendees. Consensus-building activities yielded a definition of precision EM and key research questions that comprised a new 10-year precision EM research agenda. The consensus process revealed three themes: (1) preeminence of data, (2) interconnectedness of research questions across domains, and (3) promises and pitfalls of advances in health technology and data science/artificial intelligence. The Health Professions Education Workgroup identified educational gaps in precision EM and discussed a training roadmap for the specialty.

Conclusions: A research agenda for precision EM, developed with extensive stakeholder input, recognizes the potential and challenges of precision EM. Comprehensive clinician training in this field is essential to advance EM in this domain.
What the COVID-19 Pandemic Can Teach Health Professionals About Continuing Professional Development
Authors: Sklar David , Yilmaz Yusuf , Chan Teresa M.
Published: November 2024

The world’s health care providers have realized that being agile in their thinking and growth in times of rapid change is paramount and that continuing education can be a key facet of the future of health care. As the world recovers from the COVID-19 pandemic, educators at academic health centers are faced with a crucial question: How can continuing professional development (CPD) within teams and health systems be improved so that health care providers will be ready for the next disruption? How can new information about the next disruption be collected and disseminated so that interprofessional teams will be able to effectively and efficiently manage a new disease, new information, or new procedures and keep themselves safe? Unlike undergraduate and graduate/postgraduate education, CPD does not always have an identified educational home and has had uneven and limited innovation during the pandemic. In this commentary, the authors explore the barriers to change in this sector and propose 4 principles that may serve to guide a way forward: identifying a home for interprofessional continuing education at academic health centers, improving workplace-based learning, enhancing assessment for individuals within health care teams, and creating a culture of continuous learning that promotes population health.
The Promise and Perils of Artificial Intelligence in Health Professions Education Practice and Scholarship
Authors: Patino Gustavo A. , Amiel Jonathan M. , Brown Megan , Lypson Monica L. , Chan Teresa M.
Published: November 2024

Artificial intelligence (AI) methods, especially machine learning and natural language processing, are increasingly affecting health professions education (HPE), including the medical school application and selection processes, assessment, and scholarship production. The rise of large language models over the past 18 months, such as ChatGPT, has raised questions about how best to incorporate these methods into HPE. The lack of training in AI among most HPE faculty and scholars poses an important challenge in facilitating such discussions. In this commentary, the authors provide a primer on the AI methods most often used in the practice and scholarship of HPE, discuss the most pressing challenges and opportunities these tools afford, and underscore that these methods should be understood as part of the larger set of statistical tools available.Despite their ability to process huge amounts of data and their high performance completing some tasks, AI methods are only as good as the data on which they are trained. Of particular importance is that these models can perpetuate the biases that are present in those training datasets, and they can be applied in a biased manner by human users. A minimum set of expectations for the application of AI methods in HPE practice and scholarship is discussed in this commentary, including the interpretability of the models developed and the transparency needed into the use and characteristics of such methods.The rise of AI methods is affecting multiple aspects of HPE including raising questions about how best to incorporate these models into HPE practice and scholarship. In this commentary, we provide a primer on the AI methods most often used in HPE and discuss the most pressing challenges and opportunities these tools afford.
From Slow Shifts to Fast Flips: Unraveling problem-based learning group function dynamics
Authors: Mellon Matthew , Dunn Nicholas , Azim Arden , Chan Teresa M. , Sibbald Matthew
Published: November 2024

Purpose

Problem-Based Learning (PBL) relies on self-directed learning in small groups in the presence of a tutor. While the effectiveness of PBL is often attributed to the dynamics of group function, change in group function over time and factors influencing group function development are less understood. This study aims to explore the development of PBL group function over time to better understand the factors that give rise to high-functioning groups.

Method

We examined time-function graphs of group function and conducted semi-structured focus group discussions in 2023 with medical students enrolled in a PBL curriculum. Students reflected on their experiences in four different PBL groups, creating time-function graphs to characterize development of group function over 8–12-week periods. We analyzed graphs and transcripts in a staged approach using qualitative description and direct content analysis, sensitized by two frameworks: Tuckman’s Stages of Group Development and the Dimensions of PBL Group Function.

Results

Three archetypes of PBL group function development were identified: Slow Shifters, Fast Flippers, and Coasters. (1) Slow Shifters were characterized by a complex and extended pattern of growth consistent with Tuckman’s model, typically occurring amongst inexperienced groups, or groups faced with a novel task. (2) Fast Flippers were characterized by abrupt state changes in group function arising from internal or external disruptions. (3) Coasters were characterized by plateaus, where maintenance of group function was a frequently cited challenge. Abrupt changes and plateaus occurred more among mature groups and groups with significant PBL experience.

Conclusions

PBL group function varies over time in 3 different patterns. Classic Tuckman’s stages are apparent among inexperienced groups, or groups facing novel tasks, whereas experienced groups often face abrupt change or plateaus. PBL educators and students should consider the need for novelty and disruption in more experienced groups to incite growth.
A cross-sectional description of open access publication costs, policies and impact in emergency medicine and critical care journals
Authors: Dove Chante , Chan Teresa M. , Thoma Brent , Roland Damian , Bruijns Stevan R.
Published: November 2024

Introduction: Finding journal open access information alongside its global impact requires access to multiple databases. We describe a single, searchable database of all emergency medicine and critical care journals that include their open access policies, publication costs, and impact metrics.

Methods: A list of emergency medicine and critical care journals (including citation metrics) was created using Scopus (Citescore) and the Web of Science (Impact Factor). Cost of gold/hybrid open access and article process charges (open access fees) were collected from journal websites. Self-archiving policies were collected from the Sherpa/RoMEO database. Relative cost of access in different regions were calculated using the World Bank Purchasing Power Parity index for authors from the United States, Germany, Turkey, China, Brazil, South Africa and Australia.

Results: We identified 78 emergency medicine and 82 critical care journals. Median Citescore for emergency medicine was 0.73 (interquartile range, IQR 0.32-1.27). Median impact factor was 1.68 (IQR 1.00-2.39). Median Citescore for critical care was 0.95 (IQR 0.25-2.06). Median impact factor was 2.18 (IQR 1.73-3.50). Mean article process charge for emergency medicine was $2243.04, SD = $1136.16 and for critical care $2201.64, SD = $1174.38. Article process charges were 2.24, 1.75, 2.28 and 1.56 times more expensive for South African, Chinese, Turkish and Brazilian authors respectively than United States authors, but neutral for German and Australian authors (1.02 and 0.81 respectively). The database can be accessed here: http://www.emct.info/publication-search.html.

Conclusions: We present a single database that captures emergency medicine and critical care journal impact rankings alongside its respective open access cost and green open access policies.
Attending Emergency Physicians' Perceptions of a Programmatic Workplace-Based Assessment System: The McMaster Modular Assessment Program (McMAP)
Authors: Acai Anita , Li Shelly-Anne , Sherbino Jonathan , Chan Teresa M.
Published: November 2024

Construct: The McMaster Modular Assessment Program (McMAP) is a programmatic workplace-based assessment (WBA) system that provides emergency medicine trainees with competency judgments through frequent task-specific and global daily assessments. Background: The longevity of McMAP relative to other programmatic WBA systems affords a unique view that precedes large-scale transitions to competency-based medical education (CBME), particularly in North America. Although prior work has described the perspective of residents using this system, the in-depth experiences of assessors using the system have yet to be explored. This perspective is important for understanding the validity of the competency judgments the system produces. Approach: We conducted a qualitative study that used semi-structured interviews analyzed using interpretive description (Thorne) to explore 16 attending physicians' experiences using McMAP. Data analysis was completed independently by 2 researchers, who met regularly to discuss codes and resolve any disagreements. Results: Having a structured assessment framework for a range of clinical tasks has helped encourage what attendings perceived to be more frequent and better-quality assessments, with the added advantages of being holistic, flexible, and learner-driven. However, attendings also perceived a number of challenges of McMAP and programmatic WBA more broadly. These included a reluctance to give and to document negative feedback, "gaming" of the system by both attendings and residents, and a variety of logistic and technology-related concerns. Conclusions: Based on our findings, we offer several key recommendations that can help programs maximize the benefits of programmatic WBA as they transition to CBME.
I'm Clear, You're Clear, We're All Clear: Improving Consultation Communication Skills in Undergraduate Medical Education
Authors: Kessler Chad S. , Chan Teresa M. , Loeb Jennifer M. , Malka S. Terez
Published: November 2024

Requesting and providing consultations are daily occurrences in most teaching hospitals. With increased attention on transitions of care in light of the recent scrutiny of duty hours, consultations and other interphysician interactions, such as handoffs, are becoming increasingly important. As modern medicine increases in complexity, the skill of communicating with medical colleagues throughout the continuum of care becomes more challenging. Like many of the other skills acquired by medical students, consultation communication is often learned by casual observation and through trial and error. Without formal training, however, miscommunications will continue to occur, nearly ensuring that medical errors happen. Interphysician communication skills, therefore, need to be emphasized in undergraduate and graduate medical education instead of being left to happenstance or hit-or-miss practice. In this article, the authors review two models for understanding and teaching the consultation process--5Cs and PIQUED--both of which were developed for specific subsets of learners. They then combine the two to create a consultation model that may be more widely applied.
Coached Peer Review: Developing the Next Generation of Authors
Authors: Sidalak Daniel , Purdy Eve , Luckett-Gatopoulos S. , Murray Heather , Thoma Brent , Chan Teresa M.
Published: November 2024

Problem: Publishing in academic journals is challenging for learners. Those who pass the initial stages of internal review by an editor often find the anonymous peer review process harsh. Academic blogs offer alternate avenues for publishing medical education material. Many blogs, however, lack a peer review process, which some consumers argue compromises the quality of materials published.

Approach: CanadiEM (formerly BoringEM) is an academic educational emergency medicine blog dedicated to publishing high-quality materials produced by learners (i.e., residents and medical students). The editorial team has designed and implemented a collaborative "coached peer review" process that comprises an open exchange among the learner-author, editors, and reviewers. The goal of this process is to facilitate the publication of high-quality academic materials by learner-authors while providing focused feedback to help them develop academic writing skills.

Outcomes: The authors of this Innovation Report surveyed (February-June 2015) their blog's learner-authors and external expert "staff" reviewers who had participated in coached peer review for their reactions to the process. The survey results revealed that participants viewed the process positively compared with both traditional journal peer review and academic blog publication processes. Participants found the process friendly, easy, efficient, and transparent. Learner-authors also reported increased confidence in their published material. These outcomes met the goals of coached peer review.

Next steps: CanadiEM aims to inspire continued participation in, exposure to, and high-quality production of academic writing by promoting the adoption of coached peer review for online educational resources produced by learners.
Thinking Outside the Inbox: Use of Slack in Clinical Groups as a Collaborative Team Communication Platform
Authors: Montrief Tim , Haas Mary R. C. , Alvarez Al'ai , Gottlieb Michael , Siegal Deborah , Chan Teresa M.
Published: November 2024

[para. 1]: "Academic faculty commonly collaborate across organizations located in multiple time zones, rendering in-person communication impractical. Furthermore, local access to content experts may be limited at many institutions, and multiple competing commitments may preclude attendance at relevant networking events. This is especially true during public health crises such as the COVID-19 pandemic, which has accelerated the incorporation of digital alternatives into workflow. Therefore, it is important for teams to develop easily accessible, reliable, and cloud-based collaborative tools to facilitate communication. Although e-mail remains a viable option for short, intermittent communications, the time spent reading and responding to e-mails among larger teams discussing disparate topics may impair productivity. E-mail creates multiple synchronous discussions, making it difficult for individual team members to follow and distinguish topics or projects. At academic medical centers, high volumes of e-mails risk effective team communication due to important e-mails being overlooked or inadvertently deleted."
The Revised METRIQ Score: A Quality Evaluation Tool for Online Educational Resources
Authors: Colmers-Gray Isabelle N , Krishnan Keeth , Chan Teresa M. , Trueger N. Seth , Paddock Michael , Grock Andrew , Zaver Fareen , Thoma Brent
Published: November 2024

Background: With the rapid proliferation of online medical education resources, quality evaluation is increasingly critical. The Medical Education Translational Resources: Impact and Quality (METRIQ) study evaluated the METRIQ-8 quality assessment instrument for blogs and collected feedback to improve it.

Methods: As part of the larger METRIQ study, participants rated the quality of five blog posts on clinical emergency medicine topics using the eight-item METRIQ-8 score. Next, participants used a 7-point Likert scale and free-text comments to evaluate the METRIQ-8 score on ease of use, clarity of items, and likelihood of recommending it to others. Descriptive statistics were calculated and comments were thematically analyzed to guide the development of a revised METRIQ (rMETRIQ) score.

Results: A total of 309 emergency medicine attendings, residents, and medical students completed the survey. The majority of participants felt the METRIQ-8 score was easy to use (mean ± SD = 2.7 ± 1.1 out of 7, with 1 indicating strong agreement) and would recommend it to others (2.7 ± 1.3 out of 7, with 1 indicating strong agreement). The thematic analysis suggested clarifying ambiguous questions, shortening the 7-point scale, specifying scoring anchors for the questions, eliminating the "unsure" option, and grouping-related questions. This analysis guided changes that resulted in the rMETRIQ score.

Conclusion: Feedback on the METRIQ-8 score contributed to the development of the rMETRIQ score, which has improved clarity and usability. Further validity evidence on the rMETRIQ score is required.
Temperature-related developmental plasticity, not selection, affects offspring body size and shape in a bird of prey
Authors: Corregidor-Castro Alejandro , Romano Andrea , Butler Michael , Cecere Jacopo , Morinay Jennifer , Morganti Michelangelo , Rubolini Diego , Pilastro Andrea
Published: November 2024

Recent climate warming has led to a reduction in bird body size and a relative elongation of their appendages, consistent with Bergmann’s and Allen’s ecogeographical rules. These changes are generally interpreted as thermoregulatory adaptations for more efficient passive heat dissipation; however, direct evidence supporting this assumption is currently missing, and laboratory studies failed to find significant thermoregulatory benefits associated with body size or appendage length. To test whether body shrinking and shape-shifting provide a fitness advantage under climate warming, we experimentally altered nest temperatures in a lesser kestrel (Falco naumanni) population exposed to high temperatures during the nestling stage. We found that nest temperature was associated with nestling mortality. Among nestlings that survived to fledging, temperature was negatively correlated with their near-fledging body size (mass and tarsus length) and positively correlated with their relative bill length. Contrary to the thermoregulation hypothesis, we found that nestlings that were larger at hatching had higher survival, irrespective of the nest temperature, whereas relative bill length did not confer any significant survival advantage. Collectively, our findings suggest that temperature-related developmental plasticity, rather than selection, is a key driver of observed morphological changes in natural bird populations, and that these changes are not adaptive.
Home of the brave: is similarity of defensive behavior of Neotropical snakes (Dipsadidae: Pseudoboini) predicted by sympatry?
Authors: Serrano Filipe , Diaz-Ricaurte Juan , Antúnez-Fonseca Cristopher , Garavito-David Yulfreiler , Garcia Aida , Díaz-Morales Rolland , Travaglia-Cardoso Silvia
Published: November 2024

Predation is a strong driver of prey behavior and sympatric species are exposed to similar selective predatory pressures.We test the hypothesis that this leads to similar anti-predator behaviors using the widespread Neotropical snake tribe Pseudoboini. We reviewed and compiled documented defensive behaviors for all species, adding new unreported behaviors for three species. We used a cluster analysis to generate a matrix of defensive behavior dissimilarity between species. We then used a PGLMM to test how behavior dissimilarity changed with range overlap, similarity in ecological traits and phylogenetic relatedness. Only 41 species had available data on defensive behavior, with only 22 of those represented in the phylogeny. We found that similarity in defensive behavior is significantly (albeit not strongly) correlated with range overlap, but only for species with similar body sizes. Phylogenetic relatedness by itself was a poor predictor of behavior dissimilarity. This corroborates our hypothesis that defensive behaviors are spatially structured at larger scales but that it can be modulated by morphological differences.. Our study tests inter-species ecogeographical differences of defensive behavior, and its implications can be broadly applied to other taxa.
Toxicity of acaricides to kanzawa spider mite Tetranychus kanzawai Kishida (Acari: Tetranychidae)
Authors: Villacencio Jerzon
Published: November 2024

Kanzawa spider mites Tetranychus kanzawai, are among the most widespread and serious pests that infest economically important crops such as cassava. It is important to screen the toxicity of the available agrochemicals with acaricidal effects because chemical control remains an integral part in the management of these pests. This study presents the results of laboratory-based experiments that examined how T. kanzawai responded to six acaricides, namely abamectin, emamectin benzoate, fenpyroximate, hexythiazox, spirotetramat, and chlorfenapyr through leaf disk assay. Diluted concentrations of each of the six acaricides were prepared at 0.0001, 0.001, 0.01, 0.1, 1, 10, 100, and 1000mg of active ingredient per liter of solution. The study revealed that among the six registered acaricides in the Philippines, fenpyroximate has the most potent toxic effects on the mites’ eggs, but it shows lower toxicity towards the adults. Conversely, hexythiazox exhibits high toxicity to adults but, based on a previous study, does not surpass the toxicity of the biorational alternatives abamectin and emamectin benzoate. The results of this study contribute to greater evidence that some acaricides are ineffective against T. kanzawai. The study revealed that hexythiazox and fenpyroximate can alternatively be used in managing T. kanzawai. Considering cassava’s importance as a vital root crop, educating farmers on the responsible use of these acaricides is vital for the effective management of T. kanzawai, thereby ensuring cassava crop yield preservation and food security. These efforts can contribute to the development of targeted and sustainable pest management strategies for T. kanzawai in cassava cultivation.
Pengaruh Aplikasi Pojok Remaja terhadap Pengetahuan Remaja tentang Kesehatan Reproduksi di SMA Muhammadiyah 01 Medan
Authors: Syari Mila , Harahap Novy Ramini , Nasution Pratiwi , Rauda Rauda
Published: November 2024

ABSTRACT Adolescents are a rental group that must be given information about reproductive health, adolescents who are an active group using the Internet can be used to use the application to obtain information about adolescent health, 34.5% of adolescents are boys and 33.3% of adolescent girls start dating who have sexual intercourse and transmit sexual diseases. This study aims to determine weight loss in adolescents. The design of the study is a quasi-experimental design, with the One Group Pretest and Posttest designs. The population in this study was all eleventh-grade students in Muhammadiyah High School 01 Field of 63 students using total sampling techniques. The data used are primary data and secondary data. The data was analyzed using a t-test pair analysis test. Study results: The study results obtained a t-pair value of 6,740 and p-value=0.001, this proves p-value=0.001<α=0.05, then Ha was accepted and Ho was rejected, which means there was an influence of the Poker Application on adolescent knowledge about adolescent reproductive health. The behavioral signs of parents and minors can be well identified by parents. Keywords: Application “POKER” Knowledge Reproductive Health, Adolescents   ABSTRAK Remaja merupakan kelompok rentan yang harus diberikan informasi tentang kesehatan reproduksi, remaja yang merupakan kelompok aktif penggunaan internet dapat dimanfaat untuk menggunakan aplikasi untuk mendapatkan informasu tentang kesehatan remaja, 34,5% remaja laki laki dan 33,3% remaja perempuan mulai berpacaran yang bersiko melakukan seks pranikah dan menularkan penyakit sesksual. Penelitian ini bertujuan untuk mengetahui pengaruh aplikasi pojok remaja terhadap pengetahuan remaja tentang kesehatan reproduksi pada remaja. Desain penelitian ini adalah quasi experimental designs, dengan rancangan One Group Pretest dan Posttest. Populasi dalam penelitian ini seluruh siswa kelas XI di SMA Muhammadiyah  01 Medan sebanyak 63 siswa dengan menggunakan teknik total populasi. Data yang digunakan adalah data primer dan sekunder. Data dianalisis dengan menggunakan uji analisis paired t-test. Hasil penelitian didapatkan nilai t-paired sebesar 6,740  dan p-value=0.001, hal ini membuktikan p-value=0.001< α=0.05, maka Ha diterima dan Ho ditolak, yang berarti ada pengaruh Aplikasi POKER terhadap pengetahuan remaja tentang kesehatan reproduksi remaja. Diharapkan Aplikasi POKER ini dapat dimanfaat dengan baik oleh remaja, keluarga serta dapat memberikan pemahaman yang baik sehingg siswa dapat memahaminya dengan benar Kata Kunci: Aplikasi “POKER” Pengetahuan Kesehatan Reproduksi, Remaja
Hubungan Kepemimpinan Transformasional Dosen terhadap Produktivitas Kerja Mahasiswa Keperawatan Universitas Malahayati Kota Bandar Lampung
Authors: Ryalita Novindri , Zainaro M. Arifki , Triyoso Triyoso
Published: November 2024

ABSTRACT Transformational leadership of lecturers plays a crucial role in influencing the work productivity of students across various fields of study, including nursing. This leadership approach is essential in supporting the learning and development of nursing students. This study aims to explore and analyze the relationship between transformational leadership of lecturers and the work productivity of nursing students. By understanding the dynamics and influence of this leadership style, it is hoped to provide deep insights into the factors affecting the work productivity of nursing students. To know the relationship between transformasional leadership and work productivity of nursing students at Malahayati University, with a sample of 123 respondents. The sample approach used in this study is Simple Random sample. The analysis results indicate that the majority of lecturer’s exhibit non-transformasional leadership, and most nursing students are not productive. The p-value is 0.001 (<0.05), which means there is a significant relationship between the serving leadership of lecturers and the work productivity of students. It would be better for lecturers to be more nurturing, inspiring and motivating for students. Keywords: Transformasional Leadership, Work Productivity, Nursing Students  ABSTRAK Kepemimpinan transformasional dosen memiliki peran penting dalam mempengaruhi produktivitas kerja mahasiswa di berbagai bidang studi, termasuk studi keperawatan. pendekatan kepemimpinan ini diperlukan dalam mendukung pembelajaran dan pengembangan mahasiswa keperawatan. Penelitian ini bertujuan untuk mengeksplorasi dan menganalisis hubungan antara kepemimpinan transformasional dosen dengan produktivitas kerja mahasiswa keperawatan. Dengan memahami dinamika dan pengaruh dari jenis kepemimpinan ini, diharapkan dapat memberikan wawasan yang mendalam mengenai faktor-faktor yang memengaruhi produktivitas kerja mahasiswa keperawatan. Diketahui hubungan gaya kepemimpinan transformasional terhadap produktivitas kerja mahasiswa keperawatan di universitas malahayati Kota Bandar Lampung. Jenis penelitian yang digunakan adalah kuantitatif dimana rancangan dalam penelitian ini menggunakan survey analitik dengan pendekatan cross-sectional. Populasi dalam penelitian ini adalah seluruh mahasiswa keperawatas universitas malahayati, dengan sampel berjumlah 123 responden. Teknik sampling dalam penelitian ini adalah Simple Random  Sampling. Pada penelitian ini hasil analisis menunjukan sebagian besar kepemimpinan dosen tidak transformasional, dan Sebagian besar mahasiswa keperawatan tidak produktif, p-value 0,001 (<0,05) yang berarti ada hubungan antara kepemimpinan transformasional dosen terhadap produktivitas kerja mahasiswa.  Sebaiknya untuk dosen lebih mengayomi, mengispirasi serta memotivasi mahasiswa. Kata Kunci: Kepemimpinan Transformasional, Produktivtas Kerja, Mahasiswa Keperawatan
Exploring Sustainable Strategies for Education through the Adoption of Digital Circular Economy Principles
Authors: Meria Lista , Bangun Cicilia Sriliasta , Edwards John
Published: November 2024

This study investigates sustainable strategies in education by examining the adoption of digital circular economy principles, aiming to address the growing need for resource efficiency within educational systems. As educational institutions face pressures to reduce environmental impact and enhance sustainability, integrating circular economy practices offers promising pathways. The objective of this research is to explore how digital tools and circular principles can be effectively applied to minimize waste and promote resource regeneration in academic settings. A mixed-method approach was employed, combining qualitative case studies and quantitative surveys across several institutions actively implementing circular economy initiatives. Data was collected from educators, administrators, and students to assess the impact of digital circular models on resource management, cost-efficiency, and environmental awareness. Findings indicate that digital circular economy strategies, including digital resource sharing platforms and waste reduction initiatives, significantly enhance both operational sustainability and educational outcomes by fostering a culture of environmental responsibility. Furthermore, the adoption of these strategies has led to measurable reductions in material waste and increased awareness of sustainable practices among students and staff. The research concludes that digital circular economy principles are not only viable but also essential for creating a sustainable educational environment that aligns with global sustainability goals. These findings provide valuable insights for policymakers, educators, and stakeholders in education seeking to develop sustainable frameworks and underline the importance of continued investment in digital circular economy initiatives to support long-term educational and environmental objectives.
Harnessing Artificial Intelligence in Higher Education: Balancing Innovation and Ethical Challenges
Authors: Aprianto Ronal , Lestari Etty Puji , Sadan  , Fletcher Eamon
Published: November 2024

The development of Artificial Intelligence (AI) in higher education has created new opportunities while presenting major challenges. This research aims to explore the impact of AI on higher education, both in terms of benefits and risks that may arise in the future. AI has opened up opportunities to personalize learning experiences, automate administrative processes, and support innovation in curriculum development, potentially improving educational effectiveness. However, there are also concerns regarding the digital divide, data privacy, ethical considerations, and the readiness of educators and institutions to deal with these technological changes. This research uses a literature review approach by analyzing current research on AI implementation in higher education institutions. It also compares case studies from several developed and developing countries to gain a broader picture of the global influence of AI in the education sector. The results show that while AI can have a positive impact in terms of more efficient learning and more effective operations, challenges in terms of equitable access and transparency must be addressed. The novelty of this research lies in the comprehensive analysis of the long-term implications of AI on higher education, as well as the strategies that institutions need to implement to maximize the benefits of AI and minimize the risks. This research makes an important contribution to education stakeholders in understanding the importance of responsible AI adoption to create an inclusive and sustainable educational environment.
Reviewing Healthcare Biases and Recommendations
Authors:   Franciscan Alliance Hospital Rensselaer IN, USA, Ungar-Sargon Julian
Published: November 2024

Unconscious biases can shape physician behavior and decisionmaking, often without their awareness. For example, studies have
shown that physicians may be more likely to recommend certain
treatments to male patients over female patients, or to provide less
pain medication to Black or Hispanic patients compared to their
White counterparts, even when clinical presentations are similar
Purpose and Structure on New Health Clinic: Organization Models
Authors:   Franciscan Alliance Hospital Rensselaer IN, USA, Ungar-Sargon Julian
Published: November 2024

In attempting to rethink the way we have adapted rational thinking in modern medicine to a mechanical, technological and mathematical
model of medicine, and having reviewed the way patients have suffered by being reduced to mechanical biological machines, we need
to borrow from other disciplines as to how to affect adaptive ingrained responses to open caregivers to another paradigm
Minor Girl died not due to wild Animals but, was murdered after Rape Bid in Rural Maharashtra - Proved by incorporation of ABO grouping & DNA Typing
Authors: S R Khairkar , B T Shah , C U Chavan , V V Patil , S V Ghumatkar ,   Directorate of Forensic Science Laboratories Mumbai, Maharashtra, India
Published: November 2024

Increasing crime rate, in the modern era, has prompted the scientists to update fast and effective forensic blueprint to
distinguish between guilty and innocent. In a rape and murder case, confirming the victim's identity is a critical step in the
investigation. Additionally, DNA evidence can be pivotal in identifying potential suspects and linking them to the crime.
If a suspect's DNA matches the DNA evidence found at the crime scene or on the victim, it can provide strong evidence
of their involvement in the crime.
Herein, the incident you described appears to be a tragic and unfortunate event. It seems that there was initially confusion
surrounding the cause of the girl's death, with authorities suspecting that she may have been attacked by a wild animal.
This suspicion led some individuals to mistakenly admit to her murder, believing that she had already been killed by
the animal. In such cases, it is crucial for law enforcement agencies to conduct a thorough investigation to determine
the actual cause of death and gather evidence to identify any responsible parties. Autopsies, forensic examinations,
and interviews with witnesses and potential suspects are standard procedures in such cases. It's essential to allow the
investigative process to take its course to ensure that justice is served and that the facts surrounding the incident are
established accurately. Additionally, efforts should be made to prevent similar incidents from occurring in the future, such
as enhancing safety measures in forested areas or educating the public about wildlife encounters.
Digital Forensics in Law: Unravelling the Challenges and Advancements
Authors:   Assistant Professor, Maharishi University of Information Technology, India, Mohsin Kamshad , Asthana Dr. K. B. ,   Dean, School of Law, Maharishi University of Information Technology, India
Published: November 2024

Digital forensics has emerged as a vital discipline within the legal domain, enabling the identification, preservation,
and analysis of digital evidence in criminal and civil investigations. This research paper delves into the significance of
digital forensics in law, examining its applications, challenges, and recent advancements. The paper discusses the role
of digital forensics in cybercrime investigation, evidence gathering, data recovery, and expert testimony. Moreover, it
explores the complexities of authenticating digital evidence and maintaining its integrity. Lastly, the paper explores recent
technological advancements in the field and their potential implications for the future of digital forensics in law.
RGB Analysis for Forensic Discrimination of Blue Fountain Pen Inks
Authors:   Chemical Engineering Department, Faculty of Engineering and Natural Sciences, Uskudar University, Istanbul, Turkey, Simsek Ozlem ,   Graduate School of Addiction and Forensic Sciences, Uskudar University, Istanbul, Turkey, Seker S. Selim ,   Electrical-Electronics Engineering Department, Faculty of Engineering and Natural Sciences, Uskudar University, Istanbul, Turkey,   Electrical and Electronics Engineering Department, Bogazici University, Istanbul, Turkey
Published: November 2024

This article intends to present a novel and rapid technique for distinguishing inks on disputed papers. The data was acquired
by developing specialised image analysis software to assess thin-layer chromatograms (TLC-IA). This study marks Turkey's
inaugural application of TLC-IA to analyse fountain pen inks, employing RGB profiles for ink differentiation. This work
represents the inaugural investigation into fountain pen inks, employing TLC-IA with RGB analysis for ink differentiation.
The ink spot was removed from the document with methanol and isolated by thin-layer chromatography utilising a plastic
sheet coated with silica gel 60, devoid of fluorescent indicator, employing a mobile phase composed of ethyl acetate, ethanol,
and water in a ratio of 70:35:30 (v/v/v). A novel software was developed to differentiate fountain pen inks based on the
intensity profiles of red, green, and blue (RGB) attributes. Subsequently, following the development of the chromatogram,
the chromatograms were digitised using a standard office scanner, and the intensity profiles of RGB attributes along the
development line of each sample were generated and analysed with bespoke software. The RGB profiles of fountain pen inks
from different manufacturers exhibited markedly varied patterns in most instances.
This pioneering work in Turkey facilitates the forensic utilisation of TLC-IA for ink analysis, notably focussing on fountain
pen inks for the first time.
Skepticism in al-Ghazālī and Descartes: A Reply to Sami M. Najm
Authors: Taşkın Zeyneb Betül
Published: November 2024

This paper examines Sami M. Najm’s claim that Abū Ḥāmid al-Ghazālī’s (1058-1111) and Descartes’ (1596-1650) skeptical arguments are similar in the following respect: (1) the process of doubt that depends on the distrust of sense perception and reason, (2) the motivation to arrive at certainty, (3) the nature of doubt being methodological and philosophical at the same time, and (4) their solution to doubt. I argue that while Najm’s first and second claim are to the point, Najm’s third and fourth points are not correct. This is because while al-Ghazālī’s skepticism was philosophical, Descartes’s doubt was methodological. It is true that their solution to doubt depends on intuition, but the character of their intuition is different because for al-Ghazālī it is a divine intuition whereas for Descartes it has a mental character. Although Descartes as a theist might ground the intuition on God, this does not change its mental character.
The Third Part of The Studies on Arche: The Principle of Law
Authors: Alan Ebubekir
Published: November 2024

In Ancient Greece, apart from skeptics and ethicists, practicing philosophy essentially meant engaging science, particularly physics and cosmology. The primary goal of this philosophy-science was to explain nature through three fundamental principles, which Aristotle identified as the material cause, the efficient cause, and the formal cause. Aristotle argued that these principles had been inadequately addressed by his predecessors, with the formal cause often overlooked. While Plato developed all three principles in Timaeus, Aristotle complicated the history of the studies on arche by ignoring Timaeus and claiming that Plato was not a physicist. This article focuses on the evolution of the third principle -the formal cause- within this framework, tracing its evolution from Thales to Plato.
Gençlerin Sosyal Yardım ve Sosyal Güvenlikle İlgili Görüşlerinin İncelenmesi
Authors: İştar Işıklı Emel , Yaşar Mazlum
Published: November 2024

Bu çalışmada Düzce Üniversitesi öğrencilerinin, “sosyal yardım” ve “sosyal güvenlik” ile ilgili görüşlerinin incelenmesi amaçlanmaktadır. Bu kapsamda, Düzce Üniversitesi’nde okuyan 15 öğrenciyle görüşme yapılmıştır. Görüşme yapılan öğrencilerin sosyal güvenlik tanımı yapmaları istendiğinde, en fazla kullandıkları ifadeler sırasıyla; “güvence”, “düzenleyici” ve “devlet yardımları” olmuştur. Sosyal yardım tanımı yapıldığında; “devlet yardımı”, “geliri düşük ailelere yardım” ve “ayni – nakdi yardım” ifadeleri kullanılmıştır. Katılımcıların en fazla “gıda yardımı”, “yakacak yardımı” ve “nakit yardımından” haberdar olduğu tespit edilmiştir. Gerçekleştirilen görüşmeler neticesinde gençlerin sosyal yardımlarından yararlanabilmek amacıyla başvurabilecekleri kaynaklar hakkında bilgi sahibi oldukları tespit edilmiştir. Katılımcıların sosyal güvenlik sisteminin daha iyi işlemesi için önerileri, “gerçek ihtiyaç sahiplerinin tespit edilmesi”, “denetim ve kontrollerin artırılması” ve “sosyal güvenlikle ilgili toplumu bilinçlendirmek” olmuştur.
White matter hyperintensity patterns in vascular cognitive impairment
Authors:   , Coenen Mirthe
Published: November 2024

The overarching aim of the work described in this thesis was to study white matter hyperintensity (WMH) patterns in order to better understand vascular cognitive impairment (VCI). We focused on memory clinic patients (part I) and patients with ischemic stroke (part II). More specifically, our objectives were 1) to evaluate different aspects of lesion patterns, in particular volume, 3D distributions and tract-based distributions, 2) to assess the relation between WMH patterns and cognition, and 3) to assess the relation between WMH patterns and dementia etiologies. Prior to the research projects described in this thesis, the knowledge on the clinical relevance of 3D WMH patterns in memory clinic patients and patients with ischemic stroke was limited.

To enable studies of WMH patterns in VCI in sufficiently powered datasets, we pooled individual patient data from multiple cohorts through the Meta VCI Map Consortium. This way we were able to achieve high lesion coverage, both in memory clinic patients and patients with ischemic stroke, allowing us to perform comprehensive studies of WMH patterns in terms of causes and consequences. In memory clinic patients (part I) WMH distribution patterns were highly variable, and when assessing unusual patterns the total WMH distribution pattern should be considered. We also showed that different dementia etiologies have distinct WMH patterns, in particular vascular risk factors were associated with more anterior and infratentorial WMH, whereas amyloid-1-42 (Aβ42) pathology was associated with posterior WMH. We established WMH location as an important determinant of cognitive impairment. In particular, we identified four strategic white matters tracts and developed a strategic WMH score based on these tracts which was strongly associated with cognitive performance. In patients with ischemic stroke (part II), we showed that total WMH volume was associated with post-stroke cognitive functioning. We also showed that the concept of strategic WMH locations, as observed in memory clinic patients in part I, also applies to patients with ischemic stroke.

The knowledge gained through these studies thus provides new leads on WMH patterns in VCI with regard to the following aspects:
WMH lesion patterns:
• For lesion symptom studies, to obtain sufficient WMH lesion coverage studies should scale up to sample sizes of thousands of patients
• WMH distribution patterns are highly variable and when assessing unusual WMH patterns the total distribution pattern should be considered
WMH patterns and cognition:
• WMH volume is associated with post-stroke cognitive functioning
• WMH location is an important determinant of cognitive impairment in memory
clinic patients and patients with ischemic stroke
WMH patterns and dementia etiologies:
• Different dementia etiologies have distinct WMH patterns