bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Vertical Stiffness of Scrap Tyre Pad Base Isolator with Change in Aspect Ratio
Authors: M. Anandhakrishnan , Basheer Asif , Mathew Ancy
Published: September 2023

Earthquake has severe effect on all kinds of structures. Usually, seismic isolation is done in case of high-rise buildings. But from the past experiences it can be observed that the effect of earthquake is not only restricted to high rise framed structures, but also to the low rise unreinforced masonry structures. In developing nations, it is very expensive to finance earthquake isolation measures to safeguard buildings which are not classified as important buildings, such as houses or other minor structures, making the adoption of this type of system almost unfeasible. By incorporating low horizontal stiffness devices into the structure, it is possible to reduce the impact of seismic loads on those structures. The elastomeric bearings, sliding bearings and hybrid systems are the most commonly used type of base isolators. Due to the presence of synthetic or natural rubber and high strength reinforcing cords, the Scrap Tyre Pad (STPs) exhibits substantial vertical stiffness and horizontal flexibility. Hence it can be used as a suitable seismic isolation material for structures. In the present study, experimental evaluation of variation of vertical stiffness of STPs is conducted and an empirical modal relating the percentage increase in stiffness to percentage increase in aspect ratio is proposed.
Numerical Analysis of PVC Foam-filled Honeycomb Hybrid Core Sandwich Wall Panels with Aluminium Face Sheets
Authors: R. Umarohini S. , Thowsif Mohammed , P Ramaswamy K
Published: September 2023

In this study, a numerical analysis of PVC foam-filled honeycomb hybrid core sandwich wall panels with aluminium face sheets was done. The effect of core thickness, skin thickness, and honeycomb cell size were investigated. The panel combinations of varying core thicknesses of 40 mm, 50 mm, and 60 mm, skin thicknesses of 2.4 mm, 2.6 mm, and 2.8 mm, and honeycomb cell sizes of 40 mm, 60 mm, and 80 mm were analyzed using ANSYS workbench. The panels under both axial loading and eccentric loading were done. The load-carrying capacity of sandwich wall panels under axial load is almost 3 times higher than that under eccentric loading. It was found that the load-carrying capacity of panels increased with the increase in core thickness and skin thickness. Also, the core shear stresses, skin stresses, and total deformations decreased. The panel is compared with a panel without PVC foam. It was observed that the load-carrying capacity of the panel with PVC foam is double of the panel without PVC foam. When the sandwich wall panel of cell size increases from 40 mm to 60 mm, the load‑carrying capacity is reduced by one-third.
Experimental Evaluation of Compression Properties of Reclaimed Rubber Base Isolator
Authors: S Reshma , R. Sajeeb , Mathew Ancy
Published: September 2023

Traditional rubber seismic isolators are rarely employed for residential buildings as they are big in size, heavy and expensive. Fiber reinforced elastomeric isolators (FREIs) have been identified to provide cost effective base isolation. In this paper, base isolators are developed using reclaimed rubber reinforced with carbon fiber reinforcement polymer (CFRP). Vertical stiffness of the isolator is determined experimentally. Isolators with 4, 6, 8, 10 11 and 12 layers of reclaimed rubber pads with and without CFRP reinforcement are considered in the study. Effect of aspect ratio on vertical stiffness is also investigated.
Net-zero Energy Retrofit of an Existing Commercial Building in Temperate Climate Zone of India
Authors: Azeem Aaliya , Thomas Albert
Published: September 2023

Buildings being responsible for a considerable amount of worldwide energy usage, and that too mainly in the form of electricity and space cooling. This study targets to integrate efficient building envelope materials and energy systems to reduce the building energy consumption significantly based on tropical climate context. The paper aims in retrofitting an office building in Bangalore, India into a nearly -zero energy building by roof-top PV installation. Design.builder integrated.with Energy-plus simulation software is used to accomplish the energy simulations. A three-storey commercial building was analysed using simulations in Indian temperate climate zone, where space cooling is required. This study proposes net-zero energy retrofit guidelines for existing small sized, low-rise commercial buildings in temperate climate zone of India.
Review on Factors Influencing Passenger Behavior on Vehicle Sharing
Authors: K Kavitha A , A Jijin , C Munavar Fairooz
Published: September 2023

Transportation experts are attempting to promote a variety of sustainable travel alternatives in order to mitigate the negative effects of private vehicle use and traffic congestion. One of the widely accepted solutions is to endorse the public transit system. The vehicle share system introduced in recent times is proving to be another way by which the same can be achieved without compromising people’s utility and convenience as in the case of public transit. The purpose of this review paper was to convey the necessity of a thorough study of the elements that influence vehicle share demand. Several studies have focused on relevant factors that influence traveler’s mode selection, as well as their attitudes and traits about choosing various vehicle-sharing systems. This paper reviews recent studies in the literature on non-motorized (bicycle) bike-sharing, motorized (bike-taxi) bike-sharing, and car-sharing.
Proactive Approach to Assess Road Safety Audit on Collector Roads
Authors: S. Shahnaz Beegum , S. Karthik
Published: September 2023

It is important to ensure the safety on collector roads, as most of the safety audits are done mainly on highways and expressways, but as a result of the increasing number of vehicles in this scenario, and to avoid the queuing and congestion and to reach the destination in least time through easy route, most of the drivers nowadays choose these collector roads. But the implement of improvement programs on these roads are difficult due to the limitations on funding, expertise, time, and less availability of land. So, the better option for supporting the local transportation agencies about the safety issues is by conducting RSA. Through proactive approach, this project give rise to simple and cost-effective way of conducting the local RSA program. The study area was examined to analyse the existing condition of the road with reference to IRC manuals then based on observation certain ratings were provided and then given to experts to receive their judgements and it is analyzed by Analytical Hierarchy Process (AHP) in identifying the parameters which causes more road safety risk. The five parameters considered here are sight distance, drainage, signs and markings, cross sections, lighting and nighttime issues. As a result, this study prioritizes the parameters which need to give more importance at the time of design which is expected to be useful to various decision makers.
Influence of Billboards on Driver’s Behaviour under Mixed Traffic Condition
Authors: J Bhadra , S. Karthik
Published: September 2023

In the past few years, billboards on the roadside have grown rapidly, creating a change in drivers' behavior. In addition to roadside advertising being a source of distractions, there were many growing problems that pose a threat to road safety. As a competing factor that attracts drivers, it can result in vehicle collisions and accidents. The paper discusses the impact of billboards, finding those factors that influence drivers' behavior, and developing a model that can predict those characteristics that influence driver behavior. Method: A Driver Behaviour questionnaire survey was conducted to collect data for about 512 participants. The data were analysed with SEM to determine the relationship between the variables (Endogenous and Exogenous). In this model, the exogenous latent variables are the human factors (Gender, Age, Driving Experience), the billboard characteristics (Size, colour, Font size, Celebrity image, Content), and the road characteristics (intersection, Sight distance) and the endogenous variable is distraction. Results: Using SEM, it was found that the DBQ data obtained helped determine the influence of each factor that led to distraction through a coefficient of Human factor, Billboard characteristics and Road factors. Based on estimates of the coefficients for each factor, the human factor is more effective for causing driver distraction, i.e., the tendency to get distracted differs with age, gender, and driving experience.
Online impulse buying on TikTok platform: Evidence from Indonesia
Authors: Rizqi Febriandika Nur , Putri Utami Alfinna , Nur Millatina Afifah
Published: September 2023

TikTok Shop boosts TikTok’s huge potential as an e-commerce platform that encourages sellers and buyers to increase the number of transactions. The emergence of this feature encourages the online impulse buying phenomenon on the TikTok platform. This study aims to examine the factors that influence online impulse buying on TikTok in Indonesia through the constructs of brand review, sales promotion, customer satisfaction, religiosity, and brand expectation. This quantitative research uses a questionnaire that is distributed randomly online and collected from 312 respondents in Indonesia. Using structural equation modeling (SEM), data analysis was conducted and hypotheses were examined. The results show that customer satisfaction (β: 0.501) and brand review (β: 0.358) play an important role in increasing brand expectation. At the same time, sales promotion (ρ-value > 0.05) has no impact on brand expectation. This study highlights that religiosity (β: –0.239) and brand expectation (β: –0.510) can reduce online impulse buying behavior. Brand expectation (β: –0.510) is the most dominant variable in reducing online impulse buying behavior on TikTok.
Financial distress and stock price crash risk in Egyptian firms
Authors: Samir Asmaa , AbdElRasheed Nofal Medhat , Rashed Ahmed , Khalil Manal
Published: September 2023

Economic policy uncertainty intensified as a result of the global financial crisis. To overcome these obstacles, firms handle issues with financial distress and crash risk more proactively. This paper offers new insights into the relationship between financial distress and crash risk on the Egyptian stock market during the period of 2014–2021 and presents how managers strengthen the bad news hoarding mechanism to their advantage. Data were collected via financial statements and reports obtained from the Thomson Reuters database using 824 annual observations of 103 Egyptian firms via the generalized method of moments and ordinary least squares. Results show a strong positive impact of financial distress on crash risk using OLS and GMM. Results support the role of managerial opportunism to cover up bad news that undermines a firm’s economic fundamentals. The findings support an agency theory of how financial distress affects crash risk. The findings support conducting robust tests for alternative financial distress and crash risk measures.
Ground water quality evaluation using hydrogeochemical characterization and novel machine learning in the Chikun Local Government Area of Kaduna State, Nigeria
Authors: Vivan Ezra Lekwot , Bashir Faizah Mohammed , Eziashi Augustine Chukuma , Gammoudi Taha , Dodo Yakubu Aminu
Published: September 2023

The investigation collected 50 random water samples from wells and bore holes in the five wards. In the meantime, the Water Quality Index (WQI) in this region was assessed using a novel machine learning model. In this sphere of science, the Emotional Artificial Neural Network (EANN) was used as an innovative technique. The training dataset comprised 80% of the available data, while the remaining 20% was used to assess the performance of the network. The laboratory analysis revealed that the levels of magnesium (0.581 mg/L), mercury (0.0143 mg/L), iron (0.82 mg/L), lead (0.69 mg/L), calcium (2.03 mg/L), and total dissolved solid (105 mg/L) in the water sample were quite high and exceeded the maximum permissible limits established by the National Standard Water Quality (NSWQ) and Water Quality Association (WQA). Except for magnesium, mercury, iron, and lead, all physicochemical parameters are below the utmost permissible limit. Results showed that hydrogeological effects and anthropogenic activities, such as waste management and land use, impact groundwater pollution in the Chikun Local Government Area of Kaduna State up to 60 m deep. The results of the EANN showed that R2 index and normalized root mean square error (RMSENormalized) values for the training and test stages are 0.89 and 0.18, and 0.83 and 0.23, respectively.
Mono-metallic, Bi-metallic and Tri-metallic Biogenic Nanoparticles Derived from Garlic and Ginger with their Applications
Authors: Farooq Saba , Munawar Munawar Ali , Ngaini Zainab
Published: September 2023

Biogenic metallic nanoparticles (NPs) produced from garlic and ginger have a wide range of applications in the pharmaceuticals, biotechnology and electronics industries. Despite many commercial NPs reported, NPs made from natural extracts are more affordable, straightforward and environmentally friendly than synthetic approaches. Biogenic metallic NPs derived from garlic and ginger have superior biocompatibility, better dispersion, higher stability, and stronger biological activities. This is due to the fact that garlic and ginger possess significant activities against multi-drug resisted pathogens and are in high demand, especially for the prevention of microbial diseases. This review placed a substantial emphasis on comparative investigations of the synthesis of mono-, bi-, and tri-metallic NPs with a variety of sizes and forms, as well as applications using materials like ginger and garlic. The benefits and drawbacks of mono-metallic, bi-metallic, and tri-metallic biogenic NPs produced from garlic and ginger are also comprehensively highlighted. Recent improvements have opened the way to site-specific targeting and drug delivery by these metallic NPs.
Nuclear Imaging Modalities in the Diagnosis and Management of
Thyroid Cancer
Authors: Singh Namit Kant , Hage Neemu , Ramamourthy Balaji , Nagaraju Sushmitha , Kappagantu Krishna Medha
Published: September 2023

In this review we have brought forward various nuclear imaging modalities
used in the diagnosis, staging, and management of thyroid cancer. Thyroid cancer is the
most common endocrine malignancy, accounting for approximately 3% of all new cancer
diagnoses. Nuclear imaging plays an important role in the evaluation of thyroid cancer,
and the use of radioiodine imaging, FDG imaging, and somatostatin receptor imaging
are all valuable tools in the management of this disease. Radioiodine imaging involves
the use of Iodine-123 [I-123] or Iodine-131 [I-131] to evaluate thyroid function and detect
thyroid cancer. I-123 is a gamma-emitting isotope that is used in thyroid imaging to
evaluate thyroid function and detect thyroid nodules. I-131 is a beta-emitting isotope that
is used for the treatment of thyroid cancer. Radioiodine imaging is used to detect the
presence of thyroid nodules and evaluate thyroid function. FDG imaging is a PET
imaging modality that is used to evaluate the metabolic activity of thyroid cancer cells.
FDG is a glucose analogue that is taken up by cells that are metabolically active, such
as cancer cells. FDG PET/CT can detect primary thyroid cancer and metastatic disease,
including lymph nodes and distant metastases. FDG PET/CT is also used to monitor
treatment response and detect the recurrence of thyroid cancer. Somatostatin receptor
imaging involves the use of radiolabeled somatostatin analogues to detect
neuroendocrine tumors, including thyroid cancer. Radiolabeled somatostatin analogues,
such as Indium-111 octreotide or Gallium-68 DOTATATE, are administered to the
patient, and a gamma camera is used to detect areas of uptake. Somatostatin receptor
imaging is highly sensitive and specific for the detection of metastatic thyroid cancer.

:

A comprehensive search of relevant literature was done using online databases of
PubMed, Embase, and Cochrane Library using the keywords "thyroid cancer," "nuclear
imaging," "radioiodine imaging," "FDG PET/CT," and "somatostatin receptor imaging" to
identify relevant studies to be included in this review.

:

Nuclear imaging plays an important role in the diagnosis, staging, and management of
thyroid cancer. The use of radioiodine imaging, thyroglobulin imaging, FDG imaging, and
somatostatin receptor imaging are all valuable tools in the evaluation of thyroid cancer.
With further research and development, nuclear imaging techniques have the potential
to improve the diagnosis and management of thyroid cancer and other endocrine
malignancies.
The Angiotensin Type 1 Receptor: A Drug Target to Reduce the Risk of Organ Transplant Rejection
Authors: Moslem Alireza , Aliakbarian Mohsen , Khodashahi Rozita , Tavakkoli Mahmoud , Ferns Gordon A. , Rahimi Hoda , Ashrafzade Kiarash , Arjmand Mohammad-Hassan
Published: September 2023

:

Allograft rejection is one of the main problems that must be overcome. Evidence suggests a role of the local renin-angiotensin system (RAS) in the progress of chronic allograft injury. Angiotensin II, generated by the renin-angiotensin system, is well-known as a major regulator molecule to control the blood pressure and fluid system. Evidence suggests that this bioactive molecule and its receptor increase the risk of tissue injuries and organ transplant rejection through different molecular mechanisms such as activation of innate and cellular immunity, upregulation of inflammatory pathways, and accumulation of extracellular matrix by expression pro-fibrotic molecules like transforming growth factor β (TGF-β) to increase the risk of fibrosis. Based on these findings, AT1R antagonists might have therapeutic potential to prevent the risk of tissue injuries and allograft rejection by regulating immune response, inflammation pathway, and fibrogenesis to improve organ functions.
Photochemistry of Riboflavin: The Primary Transients
Authors: Khudyakov Igor V.
Published: September 2023

Primary photoreactions of riboflavin (Rf) are considered. The goal was to present data on
the transients formed under photoexcitation of Rf: excited singlet and triplet states, triplet reactions
with the formation of Rf neutral free radicals, and a radical anion. The absorption spectra of transients
are presented, as are the rate constants of their decay. Special attention is devoted to Rf in water
(aerobic and anaerobic reactions).
Foreign Body Aspiration in Children: Retrospective Case Series and
Literature Update
Authors: Tosto Monica , Giugno Andrea , Sciuto Laura , Parisi Giuseppe Fabio , Papale Maria , Terminella Alberto , Cusumano Giacomo , Manti Sara , Leonardi Salvatore
Published: September 2023

Background:

Foreign body aspiration is common among older infants and toddlers and
is an important cause of morbidity and mortality. It may escape notice by the physicians due to
lack of knowledge of the exact history, high variability of clinical presentation, variable latency of
the onset of symptoms, and inconclusive radiographical findings.

Case report:

We present a case series about children diagnosed with foreign body aspiration referred
to the Pediatric Respiratory Unit of San Marco Hospital in Catania between January 2018
and November 2022. Data regarding demographic characteristics, symptoms, and type of foreign
body were collected and analyzed.

Conclusion:

Early diagnosis is the key to therapeutic success and effective management of foreign
body aspiration. We will review the literature to highlight the diagnostic difficulties related to this
condition and the useful tools to recognize and manage it. The most essential part of foreign body
aspiration treatment is prevention and the need to educate parents and primary care physicians. It
is, therefore, of the utmost importance to consider airway foreign bodies as a cause of cough unresponsive
to therapy, recurrent wheezing, and relapsing pneumonia.
Assembling High-quality Lymph Node Clinical Target Volumes for Cervical
Cancer Radiotherapy using a Deep Learning-based Approach
Authors: Jiang Xiaoxuan , Zhang Shengyuan , Fu Yuchuan , Yu Hang , Tang Huanan , Wu Xiangyang
Published: September 2023

Aim:

The study aimed to explore an approach for accurately assembling high-quality lymph node clinical target volumes (CTV) on CT images in cervical cancer radiotherapy with the encoder-decoder 3D network.

Methods:

216 cases of CT images treated at our center between 2017 and 2020 were included as a sample, which were divided into two cohorts, including 152 cases and 64 controls, respectively. Para-aortic lymph node, common iliac, external iliac, internal iliac, obturator, presacral, and groin nodal regions were delineated as sub-CTV manually in the cohort including 152 cases. Then, the 152 cases were randomly divided into training (96 cases), validation (36 cases), and test (20 cases) groups for the training process. Each structure was individually trained and optimized through a deep learning model. An additional 64 cases with 6 different clinical conditions were taken as examples to verify the feasibility of CTV generation based on our model. Dice similarity coefficient (DSC) and Hausdorff distance (HD) metrics were both used for quantitative evaluation.

Results:

Comparing auto-segmentation results to ground truth, the mean DSC value/HD was 0.838/7.7mm, 0.853/4.7mm, 0.855/4.7mm, 0.844/4.7mm, 0.784/5.2mm, 0.826/4.8mm and 0.874/4.8mm for CTV_PAN, CTV_common iliac, CTV_internal iliac, CTV_external iliac, CTV_obturator, CTV_presacral, and CTV_groin, respectively. The similarity comparison results of six different clinical situations were 0.877/4.4mm, 0.879/4.6mm, 0.881/4.2mm, 0.882/4.3mm, 0.872/6.0mm, and 0.875/4.9mm for DSC value/HD, respectively.

Conclusion:

We have developed a deep learning-based approach to segmenting lymph node sub-regions automatically and assembling high-quality CTVs according to clinical needs in cervical cancer radiotherapy. This work can increase the efficiency of the process of cervical cancer detection and treatment.
Medicinal Plant-rich Diet: A Potential Therapeutic Role in Colorectal Cancer
Authors: Tripathi Pankaj Kumar , Jain Chakresh Kumar
Published: September 2023

Background:

Colorectal cancer is estimated to become the leading cause of cancer
death worldwide. Since most of the available therapies affect vital organs such as heart and liver,
herbal remedies as a substitute therapy have been reported in several evidence-based studies.

Objective:

Medicinal plants exhibit a diverse range of bioactive elements known for their medicinal
properties, such as anti-inflammatory, anticancer, antioxidant, and antimicrobial effects. Phytochemicals
present in medicinal plants significantly trigger different signaling pathways, contributing
to their therapeutic activities. This review covers a comprehensive summary of the therapeutic
potential of an herbal diet in treating colorectal cancer and other ailments. Special attention will
be given to exploring the interactions of medicinal plants with the microbiota and their associations
with cancer pathways.

Conclusion:

A medicinal plant rich in bioactive compounds is a therapeutic option for colorectal
cancer and potent cardioprotective and hepatoprotective agents. These bioactive compounds have
demonstrated the ability to impede the growth of cancerous cells and trigger apoptosis. Our findings
suggest that pomegranate, garlic, soybean, olive, green tea, papaya, and grapes are potential
medicinal plants for combating cancer and related side effects. Bioactive compounds can modulate
the gut microbiota's metabolism, and short-chain fatty acid production shows cardioprotective effects
and reduces the risk of colorectal cancer. Hence, it can be stated that the interaction between
a medicinal plant-rich diet and the gut microbiota plays a crucial role in preventing colorectal cancer
and cardiac arrest.
Emerging Insights and Global Trends in the Relationship between Selenium
and Thyroid Diseases: A Bibliometric Analysis
Authors: Wu Yuqing , Cai Tiantian , Tao Yuan , Zhao Jing , Zhang Jinan
Published: September 2023

Objective:

Selenium, a significant trace element needed by the human body, is closely
related to thyroid. Therefore, this study aimed to explore the status of selenium and thyroid diseases,
analyze emerging insights, and predict future trends.

Methods:

Literature on selenium and thyroid included in the core database of Web of Science
from January 1992 to October 2022 was retrieved. CiteSpace and VOSviewer software were used
for visual analysis in terms of publication, author, country, institution, co-citation, and keywords.

Results:

A total of 1,142 works of literature were included after the screening, and the annual publication
showed a fluctuating upward trend. The country and the institution with the highest publication
volume were the United States and Charité Universitätsmedizin Berlin, respectively. In
terms of authors, Schomburg L has formed a cooperative network and has published the largest
number of papers and made great contributions in this field. The biggest cluster of keywords was
trace elements, and the hot keywords in recent years were oxidative stress, Hashimoto's thyroiditis,
cadmium, copper, etc.

Conclusion:

This paper analyzes the current status, insights, and trends of the studies on selenium
and thyroid diseases by the method of bibliometrics and delivers ideas and methods for subsequent
research in this field. The therapeutic effect of selenium on Hashimoto's thyroiditis is controversial
and needs further research, and oxidative stress is also a research hotspot in this field. The crossstudy
of multiple trace elements and diseases may be the development trend in the future.
PF-04449913 Inhibits Proliferation and Metastasis of Colorectal Cancer Cells by
Down-regulating MMP9 Expression through the ERK/p65 Pathway
Authors: Ruan Yejiao , Lu Guangrong , Yu Yaojun , Luo Yue , Wu Hao , Shen Yating , Gao Zejun , Shen Yao , Cai Zhenzhai , Li Liyi
Published: September 2023

Introduction:

Colorectal cancer remains a life-threatening malignancy with increasing morbidity and mortality worldwide. Therefore, new and effective anti-colorectal cancer therapeutics are urgently needed.

Methods:

In this study, we have studied the anti-tumor properties and potential mechanisms of PF-04449913. Colorectal cancer cell viability was reduced by PF-04449913 in a dose-dependent manner. The migration and invasion ability of malignant colon cells were attenuated by the drug, as demonstrated by the Transwell test. Moreover, PF-04449913 repressed the phosphorylation levels of ERK and other proteins, and the expression levels of MMP9. The anti-tumor effects of the drug in vivo were demonstrated in BALB/c-nude mice models, and PF-04449913 inhibited the malignant phenotype of colorectal cancer cells, including reduction of tumor size and promotion of apoptosis. At the molecular level, PF-04449913 induced a significant decrease in ERK and p65 protein phosphorylation levels and inhibited MMP9 protein expression.

Results:

Both in vivo and in vitro results showed PF-04449913 to demonstrate antitumor effects, which have been proposed to be mediated through blockade of the ERK/p65 signaling pathway, and subsequent repression of MMP9 expression.

Conclusion:

Our study provides a new perspective on the potential clinical application of PF-04449913 in the treatment of colorectal cancer.
Hemorrhoid (Pile) and its Treatment with Botanicals: An Overview
Authors: Shukla Ajay Kumar , Mishra Manoj Kumar
Published: September 2023

:

Hemorrhoid disease is a common condition that can have a significant impact on an individual's
quality of life due to its associated symptoms. A wide range of management options are
available for the treatment of hemorrhoid disease, including various yogic kriyas, herbal remedies,
flavonoids, tocotrienols, topical treatments, hydrotherapy, dietary approaches, and surgical procedures.
This review aims to focus specifically on the use of botanicals for the treatment of hemorrhoid
disease, covering various aspects of its treatment.
Incorporate Artificial Intelligence into the Fitness Field to Curb Diabetes in Malaysia: Current and Future
Authors: Xin Yi Wong , May Chong Mien , A/L Subarmaniyan Sivaguru
Published: September 2023

With the rapid technological change, most people are living an unhealthy
lifestyle and consuming processed food. Additionally, most people spend time on their
mobile phones instead of working on other activities such as exercise. Beginners
should have at least 2 to 3 days of working out per week, and the intermediate should
have 3 to 4 days of strength training. A set of stretching exercises is required after each
workout. Approximately 3.9 million people aged 18 and above are diagnosed with
diabetes in Malaysia. This means that 1 in 5 adults will be diagnosed with diabetes. The
prevalence rate has increased from 13.4% in 2015 to 18.3% in 2019. Some of the main
factors that can cause a person to acquire diabetes are obesity and consuming excessive
amounts of food with high sugar levels. The two types of diabetes are type 1 diabetes
and type 2 diabetes. Type 1 diabetes results in the body not producing insulin, whereas
type 2 diabetes causes the body to not respond to insulin even though it produces
insulin.
MASI, a Smartphone App to Improve Treatment Adherence Among South African Adolescents and Young Adults With HIV: Protocol for a Pilot Randomized Controlled Trial
Authors: Mulawa Marta I , Hoare Jacqueline , Knippler Elizabeth T , Mtukushe Bulelwa , Matiwane Mluleki , Muessig Kathryn E , Al-Mujtaba Maryam , Wilkinson T Harper , Platt Alyssa , Egger Joseph R , Hightow-Weidman Lisa B
Published: September 2023

Background

Adolescents and young adults with HIV repeatedly demonstrate low rates of antiretroviral therapy (ART) adherence as well as low rates of viral suppression. Digital health interventions are a promising way to engage adolescents and young adults with HIV to support ART adherence. However, few digital health interventions have been developed and tested with adolescents and young adults in countries like South Africa, where the HIV burden among adolescents and young adults is greatest. Masakhane Siphucule Impilo Yethu (MASI; Xhosa for “Let's empower each other and improve our health”) is a comprehensive ART adherence-supporting app for South African adolescents and young adults with HIV. It was culturally adapted using the HealthMpowerment platform.

Objective

The aim of this paper is to describe the protocol for a pilot randomized controlled trial examining the feasibility, acceptability, and preliminary efficacy of MASI on self-reported ART adherence and social support.

Methods

We will enroll 50 adolescents and young adults with HIV ages 15-21 years. Participants will be recruited from public ART clinics linked to a large government-funded teaching hospital in Cape Town, South Africa. Participants will be randomized 1:1 into either the intervention arm receiving a full version of MASI or the control arm receiving an information-only version of the app (n=25 per arm). Participants will be asked to engage with MASI daily for 6 months. All participants will complete baseline and follow-up assessments at 3 and 6 months.

Results

Study screening began in May 2022 and the first participant was enrolled on June 21, 2022. As of June 12, 2023, 81 participants have completed screeners, and 36 eligible participants have been enrolled in the pilot randomized controlled trial. Recruitment is anticipated to last through August 31, 2023, with study activities anticipated through February 29, 2024.

Conclusions

There is an urgent need for innovative interventions to improve ART adherence among adolescents and young adults in settings like South Africa. If found to be feasible and acceptable, MASI could be implemented with adolescents and young adults with HIV in other parts of the country.

Trial Registration

ClinicalTrials.gov NCT04661878; https://clinicaltrials.gov/ct2/show/study/NCT04661878

International Registered Report Identifier (IRRID)

DERR1-10.2196/47137
Prompt Engineering as an Important Emerging Skill for Medical Professionals: Tutorial
Authors: Meskó Bertalan
Published: September 2023

Prompt engineering is a relatively new field of research that refers to the practice of designing, refining, and implementing prompts or instructions that guide the output of large language models (LLMs) to help in various tasks. With the emergence of LLMs, the most popular one being ChatGPT that has attracted the attention of over a 100 million users in only 2 months, artificial intelligence (AI), especially generative AI, has become accessible for the masses. This is an unprecedented paradigm shift not only because of the use of AI becoming more widespread but also due to the possible implications of LLMs in health care. As more patients and medical professionals use AI-based tools, LLMs being the most popular representatives of that group, it seems inevitable to address the challenge to improve this skill. This paper summarizes the current state of research about prompt engineering and, at the same time, aims at providing practical recommendations for the wide range of health care professionals to improve their interactions with LLMs.
Dashboard of Short-Term Postoperative Patient Outcomes for Anesthesiologists: Development and Preliminary Evaluation (Preprint)
Authors: Sreepada Rama Syamala , Chang Ai Ching , West Nicholas C , Sujan Jonath , Lai Brendan , Poznikoff Andrew K , Munk Rebecca , Froese Norbert R , Chen James C , Görges Matthias
Published: September 2023

BACKGROUND

Anesthesiologists require an understanding of their patients’ outcomes to evaluate their performance and improve their practice. Traditionally, anesthesiologists had limited information about their surgical outpatients’ outcomes due to minimal contact post discharge. Leveraging digital health innovations for analyzing personal and population outcomes may improve perioperative care. BC Children’s Hospital’s postoperative follow-up registry for outpatient surgeries collects short-term outcomes such as pain, nausea, and vomiting. Yet, these data were previously not available to anesthesiologists.

OBJECTIVE

This quality improvement study aimed to visualize postoperative outcome data to allow anesthesiologists to reflect on their care and compare their performance with their peers.

METHODS

The postoperative follow-up registry contains nurse-reported postoperative outcomes, including opioid and antiemetic administration in the postanesthetic care unit (PACU), and family-reported outcomes, including pain, nausea, and vomiting, within 24 hours post discharge. Dashboards were iteratively co-designed with 5 anesthesiologists, and a department-wide usability survey gathered anesthesiologists’ feedback on the dashboards, allowing further design improvements. A final dashboard version has been deployed, with data updated weekly.

RESULTS

The dashboard contains three sections: (1) 24-hour outcomes, (2) PACU outcomes, and (3) a practice profile containing individual anesthesiologist’s case mix, grouped by age groups, sex, and surgical service. At the time of evaluation, the dashboard included 24-hour data from 7877 cases collected from September 2020 to February 2023 and PACU data from 8716 cases collected from April 2021 to February 2023. The co-design process and usability evaluation indicated that anesthesiologists preferred simpler designs for data summaries but also required the ability to explore details of specific outcomes and cases if needed. Anesthesiologists considered security and confidentiality to be key features of the design and most deemed the dashboard information useful and potentially beneficial for their practice.

CONCLUSIONS

We designed and deployed a dynamic, personalized dashboard for anesthesiologists to review their outpatients’ short-term postoperative outcomes. This dashboard facilitates personal reflection on individual practice in the context of peer and departmental performance and, hence, the opportunity to evaluate iterative practice changes. Further work is required to establish their effect on improving individual and department performance and patient outcomes.

CLINICALTRIAL
Feasibility of a 2-Part Substance Use Screener Self-Administered by Patients on Paper: Observational Study (Preprint)
Authors: Kramer Joanna , Wilens Timothy E , Rao Vinod , Villa Richard , Yule Amy M
Published: September 2023

BACKGROUND

Measurement-based care in behavioral health uses patient-reported outcome measures (PROMs) to screen for mental health symptoms and substance use and to assess symptom change over time. While PROMs are increasingly being integrated into electronic health record systems and administered electronically, paper-based PROMs continue to be used. It is unclear if it is feasible to administer a PROM on paper when the PROM was initially developed for electronic administration.

OBJECTIVE

This study aimed to examine the feasibility of patient self-administration of a 2-part substance use screener—the Tobacco, Alcohol, Prescription medications, and other Substances (TAPS)—on paper. This screener was originally developed for electronic administration. It begins with a limited number of questions and branches to either skip or reflex to additional questions based on an individual’s responses. In this study, the TAPS was adapted for paper use due to barriers to electronic administration within an urgent care behavioral health clinic at an urban health safety net hospital.

METHODS

From August 2021 to March 2022, research staff collected deidentified paper TAPS responses and tracked TAPS completion rates and adherence to questionnaire instructions. A retrospective chart review was subsequently conducted to obtain demographic information for the patients who presented to the clinic between August 2021 and March 2022. Since the initial information collected from TAPS responses was deidentified, demographic information was not linked to the individual TAPS screeners that were tracked by research staff.

RESULTS

A total of 507 new patients were seen in the clinic with a mean age of 38.7 (SD 16.6) years. In all, 258 (50.9%) patients were male. They were predominantly Black (n=212, 41.8%), White (n=152, 30%), and non-Hispanic or non-Latino (n=403, 79.5%). Most of the patients were publicly insured (n=411, 81.1%). Among these 507 patients, 313 (61.7%) completed the TAPS screener. Of these 313 patients, 76 (24.3%) adhered to the instructions and 237 (75.7%) did not follow the instructions correctly. Of the 237 respondents who did not follow the instructions correctly, 166 (70%) answered more questions and 71 (30%) answered fewer questions than required in TAPS part 2. Among the 237 patients who did not adhere to questionnaire instructions, 44 (18.6%) responded in a way that contradicted their response in part 1 of the screener and ultimately affected their overall TAPS score.

CONCLUSIONS

It was challenging for patients to adhere to questionnaire instructions when completing a substance use screener on paper that was originally developed for electronic use. When selecting PROMs for measurement-based care, it is important to consider the structure of the questionnaire and how the PROM will be administered to determine if additional support for PROM self-administration needs to be implemented.
Hubungan Nilai Rasio Neutrofil-Limfosit Pra Pembedahan dengan Prognosis Kanker Ovarium Jenis Epitelial di RSUP Dr. Sardjito
Authors: Rifqi Rifqi , Alkaff Muhammad Lutfi , Pradjatmo Heru
Published: September 2023

LATAR BELAKANG: Kanker ovarium merupakan salah satu keganasan pada perempuan yang paling sering dan mematikan. Angka kejadian kanker ovarium di Indonesia mencapai 15 per 100.000 dan menempati urutan kelima penyebab kematian terbanyak akibat kanker pada wanita di Indonesia. Lebih dari 75% pasien kanker ovarium terdiagnosis pada stadium lanjut. Setelah menjalani tatalaksana primer, 50% pasien akan mengalami rekurensi dalam waktu 1 tahun, dan angka 5 years survival rate kurang dari 50%. Secara umum, prognosis kanker ovarium epitelial secara independen dipengaruhi oleh stadium, tipe dan derajat histologis, serta diameter residu maksimum setelah operasi sitoreduktif. Rasio neutrofil-limfosit (RNL), suatu prediktor status inflamasi, telah terbukti menjadi penanda prognostik yang efektif untuk sebagian keganasan, termasuk keganasan ovarium. Nilai RNL yang tinggi menggambarkan kecenderungan peningkatan inflamasi pro-tumor dan penurunan kapasitas imun anti-tumor.TUJUAN: Mengetahui hubungan antara Rasio Neutrofil-Limfosit (RNL) pra pembedahan primer dengan prognosis kanker ovarium epitelial pada pasien kanker ovarium di RSUP Dr. Sardjito, Yogyakarta.METODE: Penelitian ini merupakan penelitian uji prognosis dengan rancangan kohort retrospektif yang melibatkan 106 penderita kanker ovarium di RSUP Sardjito yang memenuhi kriteria inklusi. Sumber data berasal dari data sekunder yang diambil dari Instalasi Catatan Medik (ICM) dalam kurun waktu Januari 2016 sampai dengan Maret 2019.HASIL: Dari 106 subjek, didapatkan rerata usia pasien adalah 48.58 dengan 69.8% subjek merupakan multipara. Sebanyak 50.94% subyek didapatkan dalam stadium lanjut (III dan IV) dan 71.7% merupakan tumor high grade. Risiko relatif subyek dengan RNL ≥ 3,1 yang mengalami Progression Free Survival (PFS) < 12 bulan adalah sebesar 9.896 (CI 95% = 1.646-101.413, p = 0.003). Analisis hubungan antara umur, indeks massa tubuh, paritas, kadar CA-125 pre operatif, stadium, dan tumor grade dengan RNL menunjukkan bahwa secara statistik maupun klinis hanya stadium yang memiliki hubungan yang bermakna dengan RNL (RR = 1.618, CI 95% = 1.179-2.220, p = 0.002). Analisis hubungan antara umur, indeks massa tubuh, paritas, kadar CA-125 pre operatif, stadium, dan tumor grade dengan PFS menunjukkan bahwa secara statistik maupun klinis hanya stadium yang memiliki hubungan yang bermakna dengan PFS (RR = 3.370, CI 95% = 1.187-9.573, p = 0. 012). Hasil analisis multivariat menunjukkan bahwa secara bersamaan RNL > 3.1 dan stadium lanjut berhubungan dengan PFS secara klinis maupun statistik. KESIMPULAN: RNL pra pembedahan > 3.1 berhubungan dengan kejadian PFS <12 bulan pada pasien kanker ovarium epitelial di RSUP Dr. Sardjito. Pasien kanker ovarium epitelial dengan RNL > 3.1 dan stadium lanjut mengalami PFS < 12 bulan.KATA KUNCI: Kanker ovarium epitelial, Rasio Neutrofil-Limfosit, progression free survival.
Perilaku Seksual Berisiko serta Kaitannya dengan Keyakinan Diri Remaja untuk Mencegah: Studi Deskriptif
Authors: Simak Valen Fridolin , Kristamuliana Kristamuliana , Sekeon Crista Gretasia
Published: September 2023

Background: The misuse of media or technology (smartphones, internet) to access various information including pornographic sites can increase adolescents to engage in sexual activity because adolescents continue to feel challenged to do so in real life.Objective: Describe risky sexual behavior and its relation to adolescent self-efficacy to prevent itMethod: The method used in this research is descriptive analytic conducted online by distributing questionnaire links to prospective respondents. The data analysis process used the Pearson testResults and Discussion: There is an increase in the number of incidents of risky sexual behavior, 39% of adolescents are not at risk, 8.1% are low risk, 27.7% are at moderate risk and 25.2% are at high risk. The majority of adolescents have the confidence to prevent risky sexual behavior by 64.8%. Furthermore, the results found that there was a significant relationship between risky sexual behavior and adolescent self- efficacy with a p value of 0.005.Conclusion: The increasing number of cases of risky sexual behavior can be of particular concern for all of us, especially health workers, to be able to develop educational program methods for adolescents, considering that this age is the nation's successor. Keywords: adolescent; risky sexual behavior; self- efficacy
Perbandingan Efek antara Pemberian Nifedipin dan Salbutamol sebagai Tokolitik pada Ibu Hamil dengan Ancaman Persalinan Prematur
Authors: Irwan Andi Alamanda , Kabo Peter , Wahyudi Elly , Mappaware Nasrudin Andi , Djabir Yulia Yusrini
Published: September 2023

Latar belakang: Ancaman persalinan prematur dapat terjadi pada usia kehamilan 22 – 37 minggu. Hal ini menjadi penyebab meningkatnya angka kematian dan kesakitan pada neonatus/bayi masih sangat tinggi di beberapa negara. Salah satu upaya yang dilakukan untuk mencegah kelahiran prematur pemberian tokolitik.Objektif: Penelitian ini bertujuan untuk mengetahui perbandingan efek antara  Nifedipin dan Salbutamol sebagai tokolitik pada ibu hamil dengan ancaman persalinan prematur.Metode: Desain penelitian adalah cross sectional dengan metode simple random sampling. Hasil dan Pembahasan: Sampel terdiri dari 20 kelompok Nifedipin dan 20 kelompok Salbutamol. Analisis bivariat digunakan untuk menilai hubungan antara efek pemberian obat tokolitik terhadap kontraksi. Hasil menunjukan nilai yang signifikan (p=0,000) pada semua sampel, dimana mengalami penurunan kontraksi setelah diberikan nifedipin dan salbutamol. Hal ini sesuai dengan teori tentang mekanisme kerja tokolitik yang menghambat kontraksi otot polos.Kesimpulan: Nifedipin dan Salbutamol efektif dalam mencegah kontraksi pada ancaman persalinan prematur. Efek samping ditemukan pada penggunaan Nifedipin.Kata Kunci: Tokolitik, Nifedipin, Salbutamol, Ibu Hamil, Kardiotokografi
Penerapan Robert Buckman's Six-step Protocol pada Kehamilan dengan Kanker Ovarium
Authors: Darmayasa I Made , Sugiharta Amelia Dwi Nurulita , Siahaan Sarah Endang S
Published: September 2023

Latar Belakang: Penyampaian berita buruk merupakan salah satu materi penting dalam ketrampilan komunikasi medis. Diperlukan pendekatan khusus dalam penyampaian informasi medis yang dapat menimbulkan respon buruk. Diagnosis kanker ovarium sendiri disertai kehamilan yang tidak direncanakan merupakan berita buruk yang sangat stress full, apalagi akan dilakukan terminasi kehamilan. Diperlukan protokol yang bisa dijadikan panduan untuk menyampaikannya kepada pasien.Tujuan: Untuk mempelajari dan menerapkan Robert Buckman's Six-step Protocol dalam menyampaikan satu laporan kasus berita medis yang buruk (medical breaking bad news) yang dialami seorang perempuan yang menderita kanker ovarium dan hamil, serta akan dilakukan terminasi kehamilan.Metode: Sebuah laporan kasus tentang penderita Kanker Ovarium, hamil tanpa perencanaan dan akan dilakukan terminasi.Hasil dan Pembahasan: Pada saat dilakukan pendekatan klinik dengan diagnosis multiaxial, pada axis I didapatkan penderita dengan Gangguan Penyesuaian dengan Reaksi Campuran Cemas (F32.2), pada axis II dtemukan adanya ciri kepribadian cemas, MPE acting out, dan displacement. Pada axis III pasien hamil ketiga usia kehamilan 16 Minggu + Kista Ovarium curiga Ganas. Pada axis IV, pasien harus menghadapi masalah dengan penyakitnya disertai adanya kehamilan. Serta pada avis V Global Assessment of Functioning didapatkan 61-50 sedangakan Global Assessment of Functioning 1 tahun terakhir 90-81. Diterapkan Robert Buckman's Six-step Protocol sebagai panduan dalam menyampaikan informasi buruk tersebut.Kesimpulan: Pasien-pasien kanker ovarium dengan kehamilan yang tidak direncanakan dan akan dilakukan terminasi kehamilan merupakan kelainan medis yang berat dapat diikuti dengan kecemasan dan depresi. Perlu pendekatan khusus mulai dari penyampaian informasi/diagnosis, rencana tindakan dan menghadapi risiko maupun komplikasi yang mungkin dapat terjadi. Terhadap kecemasan dan depresi yang tetap muncul, dilakukan terapi farmakologis dan dikombinasikan dengan non-farmakologi seperti Mindfulness-based cognitive behavioral therapy, dan cognitive behavior therapy. Kata kunci: Robert Buckman's Six-step Protocol; kehamilan tidak direncanakan; kanker ovarium