bluuebunny/crossref_metadata_2025 huggingface dataset:
ChatGPT (GPT-4) versus doctors on complex cases of the Swedish family medicine specialist examination: an observational comparative study
Authors: Arvidsson Rasmus , Gunnarsson Ronny , Entezarjou Artin , Sundemo David , Wikberg Carl
Published: December 2024

Background

Recent breakthroughs in artificial intelligence research include the development of generative pretrained transformers (GPT). ChatGPT has been shown to perform well when answering several sets of medical multiple-choice questions. However, it has not been tested for writing free-text assessments of complex cases in primary care.

Objectives

To compare the performance of ChatGPT, version GPT-4, with that of real doctors.

Design and setting

A blinded observational comparative study conducted in the Swedish primary care setting. Responses from GPT-4 and real doctors to cases from the Swedish family medicine specialist examination were scored by blinded reviewers, and the scores were compared.

Participants

Anonymous responses from the Swedish family medicine specialist examination 2017–2022 were used.

Outcome measures

Primary: the mean difference in scores between GPT-4’s responses and randomly selected responses by human doctors, as well as between GPT-4’s responses and top-tier responses by human doctors. Secondary: the correlation between differences in response length and response score; the intraclass correlation coefficient between reviewers; and the percentage of maximum score achieved by each group in different subject categories.

Results

The mean scores were 6.0, 7.2 and 4.5 for randomly selected doctor responses, top-tier doctor responses and GPT-4 responses, respectively, on a 10-point scale. The scores for the random doctor responses were, on average, 1.6 points higher than those of GPT-4 (p<0.001, 95% CI 0.9 to 2.2) and the top-tier doctor scores were, on average, 2.7 points higher than those of GPT-4 (p<0.001, 95 % CI 2.2 to 3.3). Following the release of GPT-4o, the experiment was repeated, although this time with only a single reviewer scoring the answers. In this follow-up, random doctor responses were scored 0.7 points higher than those of GPT-4o (p=0.044).

Conclusion

In complex primary care cases, GPT-4 performs worse than human doctors taking the family medicine specialist examination. Future GPT-based chatbots may perform better, but comprehensive evaluations are needed before implementing chatbots for medical decision support in primary care.
Postnatal foot length measurement as a proxy to identify low birth weight for frontline health workers in rural Sindh Province, Pakistan: a diagnostic accuracy study
Authors: Tikmani Shiyam Sunder , Brown Nick , Inayat Ali Alijaan , Martensson Andreas , Saleem Sarah , Martensson Thomas
Published: December 2024

Objective

To assess the diagnostic accuracy of postnatal foot length (FL) measurements as a proxy to identify low birth weight (LBW) for frontline healthcare workers in rural Sindh Province, Pakistan.

Design

A community-based cross-sectional study.

Setting

This study was conducted in the catchment area of Global Network’s Maternal and Newborn Health Registry, Thatta, Sindh Province, Pakistan, from January to June 2023.

Participants

Singleton live births irrespective of gestational age at birth.

Reference standard

Birth weight was measured using calibrated digital weighing scales in grams based on the average of three readings with minimal clothing.

Index test

FL was measured within 48 hours of birth using a rigid transparent plastic ruler in centimetres based on the average of three measurements.

Primary outcome

Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), receiver operating characteristics curve and area under the curve with 95% CI were calculated. Euclidean distance was used to identify the cutoff of FL to identify LBW. A simple linear equation was created to predict the birth weight.

Results

Out of 336 analysed newborns, 179 (53.3%) were male and 157 (46.7%) were female. The median birth weight was 2801 g (IQR: 2465–3057), of whom 88 (26.2%) were LBW. The median foot length was 7.9 cm (IQR: 7.6–8.1). For identifying LBW, the foot length cutoff was ≤7.6 cm with 90.3% sensitivity, 81.8% specificity, 63.8% PPV and 96.0% NPV. A FL of 7.6 cm predicted birth weight of 2459.4 g.

Conclusion

Postnatal FL cutoff of ≤7.6 cm has adequate predictive value served as a simple, low-cost and reliable method to identify LBW for frontline healthcare providers in the rural settings of Thatta without calibrated weighing scales to triage LBW newborns in need of higher-level care.

Trial registration number

NCT05515211.
Identifying the population to be targeted in a lung cancer screening programme in Denmark
Authors: Fernández Montejo María Del Pilar , Saghir Zaigham , Bødtger Uffe , Jepsen Randi , Lynge Elsebeth , Lophaven Søren
Published: December 2024

Introduction

We assessed the impact of recruitment criteria on lung cancer detection in a future Danish screening programme with low-dose CT.

Methods

We combined data from two Danish population-based health examination surveys with eligibility criteria from seven randomised controlled trials on lung cancer screening. Incident lung cancers were identified by linkage with the National Pathology Data Bank (Patobank). For an average of 4.4 years of follow-up, we calculated sensitivity, specificity, efficient frontier and number needed to screen (NNS) for lung cancer detection.

Results

When applying the different eligibility criteria to the 48 171 persons invited to the two surveys, the number of lung cancer cases identified in the target groups varied from 46 to 68. The National Lung Screening Trial (NLST) criteria had the highest sensitivity of 62.6% (95% CI 52.7 to 71.8) and the Dutch-Belgian NEderlands-Leuvens Screening ONderzoek (NELSON) criteria had the highest specificity 81.6% (95% CI 81.0 to 82.1). Sensitivity was higher for men than for women (NLST criteria 71.7% (95% CI 57.7 to 83.2) and 53.7% (95% CI 39.6 to 67.4), respectively). The NLST criteria identified the target population obtaining the lowest NNS with 46.3. The application of the NLST criteria showed that the higher the sensitivity, the lower the number of false-negative cases and, thus, the lower the NNS.

Conclusions

This study highlights the impact of the definition of the at-risk population on lung cancer screening efficacy. We found lower sensitivity among women regardless of screening criteria used. This should be carefully addressed in a possible screening programme.
Deployment to bases with open burn pits and mortality of US Military Veterans
Authors: Hoover Christian , Trivedi Amal N , Bello Anila , Culpepper William J , Gasper Joseph , Gaither Rachel , Jiang Lan , Rennix Christopher , Schneiderman Aaron , Wellenius Gregory A , Woskie Susan R , Savitz David A
Published: December 2024

Introduction

Five million US Veterans had possible exposure to open burn pits used for waste disposal through service in Iraq (2003–2011) and Afghanistan (2001–2014). Burn pits generate toxic exposures that may be associated with adverse health outcomes. We examined all-cause and cause-specific mortality in relation to deployment to bases with open burn pits.

Methods

We analysed a cohort of 474 634 Veterans who received some healthcare from the Veterans Health Administration, linked to Department of Defense deployment records to identify assignments to bases with burn pits. In multivariable logistic regression models, we assessed the association between duration of deployment to bases with burn pits and all-cause mortality and cause-specific mortality from the six most common causes among this population of Veterans.

Results

Duration of deployment to bases with burn pits was modestly related to all-cause mortality, with adjusted ORs of 1.07 (95% CI 0.99 to 1.15), 1.08 (95% CI 1.00 to 1.16) and 1.16 (95% CI 1.06 to 1.27) across tertiles, but not associated with mortality due to cancer, heart disease or chronic liver disease/cirrhosis. Positive associations were also found for unintentional injuries, suicide and stroke.

Discussion

These data are suggestive of an association between duration of deployment to bases with burn pits and overall mortality, but not from cancer or heart disease. Unexpected associations with injury and suicide call for a more detailed evaluation. Conclusions are restricted by the broad aggregations of causes of death, a limited number of deaths in this relatively young cohort and the lack of more detailed information on exposure to burn pits.
Production and Reserve Strategies of Relief Materials Based on Post-Disaster Spot Market
Authors: Zhou Kun , Tian Jun , Liu Yang
Published: December 2024

The government’s proactive deployment of emergency stocks is vital for disaster management. However, in the aftermath of a disaster, if reserves are depleted, government may request manufacturers to produce emergency supplies or purchase from the spot market. This situation presents challenges such as whether manufacturers can make emergency production? What is the situation in the spot market? To address these challenges, we develop two relief supply chain models involving government and manufacturer: one with emergency production capacity (E-SC) and one without (N-SC). The government can either purchase emergency supplies from manufacturer at wholesale prices and reserve independently or enter into option contract with manufacturer to jointly store supplies. Additionally, we incorporate random spot market prices and difficulty coefficients for spot market purchases. By establishing and solving the revenue models for both model, we analyze the optimal strategies for government and manufacturer. We further explore how fluctuation in spot price, procurement difficulty, and inventory cost impact optimal decisions and expected returns through mathematical analysis and numerical simulation. This approach provides valuable insights for government and manufacturers to enhance their disaster relief efforts and improve their response to challenges in managing relief materials.
Casimir–Lifshitz adhesion between Si and Ru measured by the method of adhered cantilever
Authors: Postnikov Alexander V. , Uvarov Ilia V. , Morozov Oleg V. , Svetovoy Vitaly B.
Published: December 2024

Measurements of the Casimir–Lifshitz (dispersion) forces at distances below 50 nm are difficult due to the snap-in effect, and precision is poor due to increasing relative uncertainty in the distance. In this paper, a method of adhered cantilever that avoids the loss of stability is used to measure the interaction energy between Si and Ru surfaces in direct contact. Background capillary and short-range interactions are strongly suppressed because surface roughness significantly deviates from a normal distribution. Electrostatic interaction is not fully compensated, but the potential is limited to a value less than 29.8[Formula: see text]mV. Adhesion energy is measured directly, and the average equilibrium distance is predicted theoretically. The ability to achieve high precision in this type of experiment is demonstrated.
Personal recollections of Vaughan Jones
Authors: Lambropoulou Sofia
Published: December 2024

Personal recollections of meetings with Vaughan Jones.
EFFECTS OF BALANCE TRAINING EXERCISE ON PAIN INTENSITY AND DISABILITY IN CHRONIC LOW BACK PAIN INDIVIDUALS: A CLINICAL TRIAL
Authors: Dinesh R. , Antony Leo Aseer P. , Soundararajan K.
Published: December 2024

Background: Chronic Low Back Pain (CLBP) has been the leading cause of disability globally for at least three decades. Totally, 10% to 20% of people who experience acute lower back pain episodes often develop CLBP. In CLBP, there is an altered sensorimotor pathway which impairs body the balance. There are lacunae in studies prescribing balance exercise to CLBP individuals. This study aims to determine the effects of balance exercises on pain intensity, back physical performance, trunk extensor muscle endurance, and disability in CLBP individuals.

Methods: A qualified therapist unaware of the study assessed all outcome measures (Visual Analogue scale– VAS, Oswestry Disability Index — ODI, Back Performance Scale — BPS, Biering Sorenson test — BST) at baseline, end of 4th week, and 8th week. All participants underwent balance exercise intervention for 30 min/day, 3 days a week, for 8 weeks. Repeated measures ANOVA was performed at [Formula: see text] < 0.05.

Results: Out of 65 screened participants, 40 (24 females, 16 males) fulfilled the study criteria and performed the balance exercise. The BPS score for back physical performance, VAS score for patient-reported pain intensity, BST value for trunk extensor muscle endurance, and ODI score for low back disability domains significantly improved after the balance exercise intervention at the end of 4th week and 8th week ([Formula: see text] < 0.05).

Conclusions: Balance exercise effectively improves back physical performance, reducing pain and back-related impairments. Further, the controlled trial is warranted to add the level of evidence.
Stability analysis of isotropic compact stars in Rastall theory of gravity
Authors: Malik Adnan , Shafaq Attiya , Shamir M. Farasat , Mofarreh Fatemah
Published: December 2024

This paper explores the cracking phenomenon within the framework of Rastall gravity, focusing on how local density perturbations influence the stability of stellar objects. To achieve this, we assumed an isotropic matter configuration and derived the field equations and equilibrium conditions for spherically symmetric spacetime in the context of Rastall gravity. Our analysis utilized the barotropic equation of state along with the Krori–Barua spacetime metric coefficients. The equilibrium state of the configuration was then subjected to local density perturbations to assess its stability. To validate our methodology, we analyzed several stellar objects, including 4U 1820-30, Her X-1, SAX J1808.4-3658, PSR J1614-2230, RX J1856-37, Vela X-1, and Cen X-3. The results demonstrate that cracking occurs in these stars for specific ranges of Rastall parameters. This study highlights the importance of the cracking approach as a powerful tool for conducting a detailed stability analysis of stellar structures.
Exploring modular multiplicative divisor labeling to expand graph families
Authors: Kalarani P. , Revathi R. , Rathour Laxmi , Mishra Lakshmi Narayan
Published: December 2024

The graph [Formula: see text] is a trivial graph consisting of a single vertex with no edges. In contrast, the graph [Formula: see text] is a complete bipartite graph with one internal node and [Formula: see text] leaf vertices. The join of two graphs [Formula: see text] and [Formula: see text] (with central vertex [Formula: see text]), represented as [Formula: see text], is a graph including vertices [Formula: see text] and edges [Formula: see text]. When two graphs, [Formula: see text] and [Formula: see text] are joined, the result is a graph in which vertex in graph [Formula: see text] is linked to every vertex in graph [Formula: see text]. Modular multiplicative divisor (MMD) labeling is a vertex and edge labeling scheme with the following key features: Vertex labeling: MMD labeling establishes a bijection between the vertices of the graph [Formula: see text] and the natural numbers from 1 to [Formula: see text]. This bijection ensures a one-to-one correspondence, providing a unique label for each vertex. Edge labeling: The labeling of edges follows a specific rule, the edge’s label is determined by calculating the result of multiplying the labels assigned to its connected vertices, with the outcome adjusted by modulo [Formula: see text]. We demonstrate the modular multiplication labeling when combining two graphs through their join (assuming [Formula: see text] is even) and also on the even arbitrary super subdivision (EASS) of the join of two graphs. Additionally, we explore a related research question that arises in this particular context. The findings have potential applications in network topology design and optimization.
Ways to search for new functional materials — alternatives to ferroactive PZT compositions
Authors: Dudkina S. I. , Glazunova E. V. , Andryushin K. P. , Andryushina I. N. , Shilkina L. A. , Verbenko I. A. , Reznichenko L. A.
Published: December 2024

This paper discusses ways to search for lead-free functional materials for various applications. Using the example of the solid solution systems based on alkali metal niobates, the influence of the position on the phase diagram of the corresponding systems, the number of the components in them, and modification with mono- and combined metal oxides on their characteristics is shown. It has been established that the most effective in terms of piezoelectric characteristics are the solid solution systems in or near the morphotropic region, with 3 or 4 components. A number of materials have been developed to create highly sensitive electromechanical transducers, ultrasonic delay lines and other applications.
Generative Resolution of Proportional Analogies between Sentences
Authors: Wang Liyan , Pan Zhicheng , Wang Haotong , Lepage Yves
Published: December 2024

In this paper, we address the task of solving proportional analogies between sentences in a generative manner. To this end, we use pre-trained word or sentence embedding models or fine-tune several pre-trained language models. Experiments on analogies between short sentences show that fine-tuning GPT-2 achieves the best performance, while combining a word embedding model with its vector-to-sequence decoder delivers competitive accuracy. However, the increased sizes of large-scale language models might not be worth the slight increase in performance observed when compared with lightweight models to simple analogy tasks. To extend this, we develop a data pipeline for collecting semantico-formal analogies between long sentences, spotting parallel associations beyond individual words. We create a complex set of analogies, each validated with evidence of relational matches on underlying concepts. Comparative analyses of three language models demonstrate that the autoregressive framework is particularly effective at learning analogy structures when sequences are long.
Outcome Measures after Peripheral Nerve Injury: Past, Present and Future
Authors: RANDALL Zachary D. , NAVARRO Brendan , DY Christopher J.
Published: December 2024

Peripheral nerve injuries (PNI) present substantial challenges due to variability in injury severity and limited regenerative capabilities. Historically, PNI research has focussed on measures such as subjective surgeon outcome grading, two-point discrimination (2PD) and the Medical Research Council (MRC) grading system. While these methods have use, there are also limitations related to subjectivity and sensitivity. Electrophysiological studies, including electromyography (EMG) and nerve conduction studies (NCS), provide detailed insights but are invasive and resource intensive. Currently, the landscape of outcome measurements in PNI research is diverse, incorporating a mix of surgeon-scored, patient-reported and objective measures. Advancements in wearable devices and motion-tracking technologies offer the potential for continuous, real-time monitoring of patient recovery. These innovations can provide a more comprehensive and objective view of functional recovery, moving beyond the limitations of periodic clinical assessments. The primary limitation in current PNI research is the lack of standardisation in outcome measures and the arbitrary timing of assessments. This variability complicates data interpretation and comparative effectiveness research. Standardising the selection and timing of outcome measures is crucial for enhancing the reliability of research findings and facilitating collaborative studies.

Level of Evidence: Level V (Diagnostic)
Short and Medium-Term Clinical and Radiographic Outcomes Following Arthroscopic Partial Wrist Arthrodeses – A Systematic Review
Authors: DE LA MOTTE Genevieve L. , XU Joshua , HALASZ-VALVERDE Tahlia , GRAHAM David J. , SIVAKUMAR Brahman S.
Published: December 2024

Background: Partial wrist arthrodesis (PWA) is a salvage procedure used in advanced wrist arthritis and has traditionally been performed via an open dorsal approach. In recent years, surgeons have moved towards arthroscopic fusions to minimise soft tissue damage and preserve vascular supply, increase union rates and hasten recovery. The purpose of this study is to synthesise the current literature on the outcomes of arthroscopic PWA.

Methods: A systematic review was performed to survey the literature regarding outcomes of PWA. English language studies that reported original data and commented on at least one postoperative measure of function were eligible for inclusion. Data collected included patient demographics, operation time and technique, complications and postoperative patient outcomes in the form of patient-rated surveys, grip strength, range of motion and the pain visual analogue scale (VAS).

Results: Twelve studies were eligible for inclusion, with a total of 191 patients. 94% of patients achieved union, with a mean time to fusion of 12.5 weeks. VAS, Disabilities of the Arm, Shoulder and Hand (DASH) and Mayo Wrist scores were significantly improved after the procedure, and complication rates were comparable to open procedures. Range of motion varied greatly across studies, due to heterogeneity in carpal intervals fused.

Conclusions: Arthroscopic PWA is a safe and effective procedure in the treatment of advanced arthritis of the wrist. Further comparative studies would be useful in assessing benefits of arthroscopic arthrodesis over an open approach.

Level of Evidence: Level III (Therapeutic)
From a Unipolar to a Multipolar World: What’s in it for Australia?
Authors: Esposto Alexis , Quintero Juan Felix Agudelo
Published: December 2024

Since the dissolution of the Soviet Union in 1991 the world experienced a transformation from bipolarity to unipolarity, where the United States has become the global hegemon. However, the world appears to be evolving into a “multipolar world” where nations such as the BRICS 1 block are likely to have strong economic influence in their respective geopolitical regions. Events currently taking place in Ukraine and Gaza seem to have accelerated this process, where nations such as Brazil, Russia, India, China, and South Africa are exercising stronger influence in world affairs. According to the literature, several factors have been identified as major drivers of multipolarity, namely, China’s booming economic growth and rapid technological change throughout many parts of the world. These transformations pose challenges and opportunities to “middle sized” nations such as Australia. In order to analyze these, a SWOT analysis methodology was conducted for Australia, which found that Australia has much to gain in an emerging multipolar world, however, it needs to navigate these troubled waters with very astute diplomatic care.
Political Polarization and Climate Policy Implementation: An Analysis Based on Panel Data of Carbon Dioxide Emissions in U.S. States
Authors: He Jiajiong , Wang Tingge , Zhang Peng
Published: December 2024

The U.S. attitude toward global climate governance is volatile, and its behavior is often constrained by its domestic politics. Studying the implementation of climate policy at the state level in the United States from the perspective of party politics and political polarization in the United States can provide important lessons for climate governance practices. Through a panel data model, this research analyzes the relationship between the party affiliations of governors in all 50 U.S. states and carbon dioxide emissions from 1997 to 2020. Based on this, the connection between political polarization and climate governance is discussed. Results indicate that the party affiliations of U.S. state governors significantly impact carbon dioxide emissions in their respective states; American democracy has the inherent flaw of failing to fulfill electoral promises; U.S. party politics is not conducive to the stable, long-term development of climate policies. These results reflect deeper societal contradictions and divides in the U.S., and the political polarization epitomized by the climate governance issue will have serious spillover effects on global climate governance.
China’s BRI: Toward Common Prosperity or New Hegemony?
Authors: Zhang Mengtian , Wang Min
Published: December 2024

The Belt and Road Initiative (BRI) has been a subject of considerable debate since its inception. Existing assessments of BRI’s implementation have often concentrated on economic or political aspects in isolation, which does not provide a comprehensive evaluation of the initiative. This paper employs a multi-dimensional approach to analyze the potential influencing factors, encompassing economic, political, military and geopolitical dimensions, from the perspectives of neoliberalism and neoclassical realism. In this study, we evaluate the effectiveness of BRI based on the case of Angola. The findings suggest that BRI has been highly effective in stimulating economic growth, while its impacts on politics, military, and geopolitics have been relatively limited. Although current research has not corroborated the hypothesis that China is pursuing shared prosperity, it is evident that China is following a distinct path from the United States’ quest for hegemony. The available evidence indicates that this path is moving toward the pursuit of shared prosperity.
Changes in H-reflex, V-wave, and contractile properties of the plantar flexors following concurrent exercise sessions—the acute interference effect
Authors: Gomes Miguel , Gonçalves André D. , Pezarat-Correia Pedro , Mendonca Goncalo V.
Published: December 2024

All exercise modalities reduced maximal isometric strength; however, endurance exercise led to greater decreases in the rate of torque development. Resistance exercise negatively impacted supraspinal central neural drive, whereas both endurance and concurrent exercise significantly impaired spinal motoneuron responsiveness. Endurance and concurrent exercise also significantly reduced twitch contractile properties and evoked octet responses, with the most pronounced impairments observed following endurance-only exercise.
Repeated hyperbaric oxygen exposure accelerates fatigue and impairs SR-calcium release in mice
Authors: Gasier Heath G. , Kovach Jack , Porter Kris
Published: December 2024

Breathing hyperoxic gas during prolonged and repeated dives causes fatigue but the mechanisms are unknown. Here, we show in mice exposed to repeated hyperbaric oxygen that running fatigue is accelerated and accompanied by increased skeletal muscle oxidant stress and reduced caffeine-induced sarcoplasmic reticulum (SR)-calcium release. The latter may be due to increased S-nitrosylation of ryanodine receptor 1 (RyR1) and be a mechanism for impaired physical performance after repeated oxygen diving.
Habitual preexercise caffeine supplementation prevents exercise training-induced attenuation of exercising systolic blood pressure and double product
Authors: West Kylee S. , Helwig Nate J. , Schwager Laura E. , Hart Thomas W. , Zucker Anna C. , Venenga Jacob S. , Flores Mark , Jenkins Nathaniel D. M.
Published: December 2024

Habitual preexercise caffeine consumption prevented reductions in exercising systolic blood pressure and double product induced by 6 wk of high-intensity exercise in women. Therefore, our findings indicate that habitual preexercise caffeine supplementation may impede beneficial hemodynamic adaptations of exercise training in healthy, young women.
Experimental Study on Similarity Simulation of Mechanical Properties of Coal Rock Mass in Folded Structural Zones
Authors: Xu Dayang , Hu Qianting , Liang Yunpei , Liu Han , Yang Zili
Published: December 2024

To thoroughly investigate the mechanisms behind coal and gas outbursts in folded structural areas, we conducted similarity simulation experiments using a custom‐built apparatus designed to replicate these structures. The objective was to analyze the stress distribution characteristics of coal rock masses under horizontal structural stress within folded zones. The experimental outcomes reveal that, under horizontal loading, shear cracks progressively develop along layer directions within the anticline wing, anticline axis, and syncline axis, evolving continuously along the interlayer direction. In these folded structures, horizontal stress consistently remains compressive, with the highest compressive stress concentrations observed at the anticline axis, followed by the wings and turning points of the anticline, and the lowest in the syncline axis area. The stress coefficient (k) in the anticline axis reached values as high as 3.18, while the syncline axis exhibited much lower stress concentrations, with k values of 0.66. Vertically, the anticline axis and its wings primarily experience tensile stress, whereas the syncline and its wings mainly undergo vertical compressive stress. The anticline axis region, subjected to horizontal structural stress, tends to develop tension cracks, which adversely affect gas retention. The combination of horizontal tension and vertical tensile stress in this region reduces the risk of coal and gas outbursts. Conversely, the syncline axis area, experiencing triaxial compressive stress, exhibits a higher degree of stress concentration and superior gas sealing capacity, rendering it more vulnerable to coal and gas outbursts. These findings provide essential insights for refining coal mining methodologies in fold structures, particularly for addressing the safety challenges posed by coal and gas outbursts.
Blockchain‐Based Electronic Health Record: Systematic Literature Review
Authors: Ettaloui Nehal , Arezki Sara , Gadi Taoufiq
Published: December 2024

Electronic health records (EHRs) represent an innovative approach to constructing a distributed data analysis framework for managing health data within its original location. The integration of blockchain technology into EHR systems offers substantial improvements in security, privacy, and transparency, thus enhancing overall management efficiency. Our research spanned from January 2017 to December 2022, conducting a meticulous systematic literature review across reputable databases such as Scopus, IEEE Xplore, Springer, PubMed Central, and ScienceDirect. This comprehensive search, finalized in December 2022, utilized stringent inclusion and exclusion criteria to ensure the selection of high‐quality articles, thereby guaranteeing transparency and unbiased results. Through this systematic review, our primary objective was to explore, assess, and analyze the diverse architectures, proposed models, limitations, and future trajectories of blockchain‐enabled EHR systems. Our emphasis was on highlighting blockchain’s adaptability and robustness in healthcare contexts while identifying potential challenges and areas for further investigation. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis guidelines, we scrutinized more than 600 scientific studies, culminating in the selection of 31 articles that met our rigorous inclusion standards. Our technical and architectural evaluations delved into critical aspects such as privacy, security, authentication, availability, data control, storage, and resource consumption. Our research outcomes underscore the effective resolution of security, privacy, and availability concerns in EHRs through blockchain integration. However, we observed potential trade‐offs, including impacts on performance, resource utilization, and regulatory compliance. To address these complexities, we introduce an integrated framework designed to mitigate key challenges and deliver substantial value within this domain.
Decoupling Structure for High‐Bandwidth Multiport Monopole Antennas in K‐Band and 5G Applications
Authors: Sehrai Daniyal Ali , Kiani Saad Hassan , Ali Tanweer , Abbasi Muhammad Inam , Kamarudin Muhammad Ramlee , Algarni Abeer D. , Elmannai Hela
Published: December 2024

This paper introduces a multiport monopole antenna featuring high isolation and a broad operating bandwidth, specifically designed for K‐band and 5 G applications. The proposed antenna configuration comprises four antenna elements assembled to achieve a compact design. A 0.254 mm thick Rogers RT‐5880 substrate is used, with an overall size of 24 × 22 mm. Each antenna element is supported by a truncated ground plane, and four symmetrical slots are introduced into the radiating structures. As a result, the proposed multiport antenna covers a frequency band of approximately 18–27 GHz, based on the −10 dB criterion, providing a wide bandwidth of nearly 9 GHz. The separation between the antenna elements is about 4.5 mm. Additionally, a decoupling structure is inserted between the radiating elements to enhance isolation within the desired band, also resulting in a minor improvement in the operating bandwidth. Several performance metrics, including total active reflection coefficient (TARC), diversity gain (DG), envelope correlation coefficient (ECC), and channel capacity loss (CCL), are evaluated and show satisfactory performance within the operating bandwidth. The proposed antenna achieves more than 75% radiation efficiency. The overall performance of the multiport antenna indicates its potential for K‐band and 5 G applications.
Nerve Segmentation of Ultrasound Images Bayesian U‐Net Models
Authors: Michael Taryn , Obagbuwa Ibidun Christiana
Published: December 2024

Ultrasound imaging is a widely adopted method for noninvasive examination of internal structures, valued for its cost‐effectiveness, real‐time imaging capability, and absence of ionizing radiation. Its applications, including peripheral nerve blocking (PNB) procedures, benefit from the direct visualization of nerve structures. However, the inherent distortions in ultrasound images, arising from echo perturbations and speckle noise, pose challenges to the accurate localization of nerve structures, even for experienced practitioners. Computational techniques, particularly Bayesian inference, offer a promising solution by providing uncertainty estimates in model predictions. This article focused on developing and implementing an optimal Bayesian U‐Net for nerve segmentation in ultrasound images, presented through a user‐friendly application. Bayesian convolution layers and the Monte Carlo dropout method were the two Bayesian techniques explored and compared, with a specific emphasis on facilitating medical professionals’ decision‐making processes. The research revealed that integrating the Monte Carlo dropout technique for Bayesian inference yields the most optimal results. The Bayesian model demonstrates an average binary accuracy of 98.99%, an average dice coefficient score of 0.72, and an average IOU score of 0.57 when benchmarked against a typical U‐Net. The culmination of this work is an application designed for practical use by medical professionals, providing an intuitive interface for Bayesian nerve segmentation in ultrasound images. This research contributes to the broader understanding of Bayesian techniques in medical imaging models and offers a comprehensive solution that combines advanced methodology with user‐friendly accessibility.
A Nationwide Population-based Study for Audio-vestibular Disorders Following COVID-19 Infection
Authors: Ko Hye Yeon , Kim Min Hee
Published: December 2024

Introduction: To date, no study has reported the various otologic conditions associated with COVID-19 using population-based design. The aim of this study was to investigate the incidence and risk of audio-vestibular disorders (benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere’s disease, vestibular neuritis, and tinnitus) increase after COVID-19 infection.
Methods: This retrospective population-based study was conducted using National Health Insurance Service (NHIS)-COVID-19 cohort database of South Korea. We identified participants in the COVID-19 group using real-time reverse transcription-polymerase chain reaction tests. A matched cohort without COVID-19 was randomly selected in a 1:1 ratio. Benign paroxysmal positional vertigo, sudden sensorineural hearing loss, Meniere’s disease, vestibular neuritis, and tinnitus were defined using diagnostic, medication, and procedure codes. The incidence and risk of these disorders were assessed in both groups using univariate and multivariate Cox proportional hazard analyses.
Results: In total, 4,976,589 COVID-19 patients and an equivalent number of matched non-infected controls were analyzed. COVID-19 patients faced an increased risk of developing benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus compared to controls in univariate and multivariate Cox hazard analyses. COVID patients were at an increased risk of Meniere’s disease in the univariate analysis; however, the risk of Meniere’s disease after COVID-19 did not reach statistical significance in the multivariate analysis.
Conclusion: COVID-19 infection may increase the risk of benign paroxysmal positional vertigo, sudden sensorineural hearing loss, vestibular neuritis, and tinnitus.
Analysis of Corporate Social Responsibility at PT. Plantation X Based on the Perspective of "CSR Hierarchical Pyramid”
Authors: Fu'adah Silvissifa'il , Sukoharsono Eko Ganis
Published: December 2024

This study aims to analyze the implementation of CSR at PT Perkebunan Nusantara X (PTPN X) based on the CSR Hierarchical Pyramid perspective. This research is a qualitative library research with a case study approach. The data in this study are secondary data in the form of annual reports and sustainability reports of PTPN X for the 2020-2022 period collected through documentation. The results of this study indicate that (1) The results of the study indicate that almost all of PTPN X's CSR practices are in accordance with the CSR Hierarchical Pyramid which includes legal, economic, social philanthropy, environmental, and spiritual responsibilities. (2) PTPN X has fulfilled economic, environmental, and spiritual responsibilities (3) In legal responsibility, PTPN X has not disclosed the company's efforts to integrate with the customary laws of the community (4) In fulfilling social philanthropy responsibilities, gender equality indicators cannot be implemented optimally due to the inequality of employee gender ratios. Indicators of improving education and health quality have not been implemented consistently. (5) PTPN X has carried out spiritual responsibilities, this is reflected in policies and various activities based on policy values as God commands. (5) The results also prove that the concept of CSR Hierarchical Pyramid can be used as a model for implementing corporate CSR.
The Effect of Company Size, Profitability, Leverage, and Institutional Ownership on the Timeliness of Public Company Financial Reporting
Authors: Khusnah Zakiyah Ma'rifatul , Subroto Bambang
Published: December 2024

This study aims to determine the effect of firm size, profitability, leverage, and institutional ownership on the financial reporting timeliness. The population includes all companies listed on the Indonesia Stock Exchange (IDX) between 2021 and 2022, from which 1.156 samples are selected through purposive sampling technique. The secondary data of the companies’ annual reports are analyzed by logistic regression utilizing SPSS 25. The study results exhibit that a company's financial reporting timeliness is determined by larger firm size and/or greater institutional ownership. Whilst, profitability and leverage have no effect on the financial reporting timeliness. The implication of this study reveal that firms with larger size and shares majorly owned by institutional shareholders are likely to be on time in reporting their financial statement to the public. As such, investors should consider making investment decisions on larger companies and/or those with greater institutional ownership.
The Effect of Debt Default, Profitability, and Financial Distress on Going Concern Audit Opinion Acceptance
Authors: Rohmawati Siti Aminah , Djamhuri Ali
Published: December 2024

This study aims to analyze the effect of debt default, profitability, and financial distress on going concern audit opinion. The objectt of this research includes the manufacturing company listed on the Indonesia Stock Exchange in 2019 -2022. Independent variables in this research are debt default, profitability. The dependent variabel in this research is going concern audit opinion. This study utilizes samples of 248 secondary data of audited financial reports obtained from 62 manufacturing companies in 2019 – 2022 according to predetermined criteria, selected through purposive sampling. The debt default and profitability are measured by the Current Ratio and Return on Assets ratio, respectively, and financial distress is represented by the Altman Z-score model. The results of the logistic regression analysis exhibit that debt default and financial distress have a significant effect on going concern audit opinion while profitability has no effect on going concern audit opinion.
Impact of Bifurcation Lesions on Outcomes After FFR-Guided PCI or CABG
Authors: Dillen Daimy M.M. , Otsuki Hisao , Takahashi Kuniaki , Kobayashi Yuhei , Piroth Zsolt , Noiseux Nicolas , Nakadi Badih El , Kalinauskas Gintaras , Szekely Laszlo , Davidavičius Giedrius , Teeuwen Koen , Tonino Pim A.L. , Pijls Nico H.J. , De Bruyne Bernard , Fearon William F. , Zimmermann Frederik M.
Published: December 2024

BACKGROUND:

In the era of first-generation drug-eluting stents and angiography-guided percutaneous coronary intervention (PCI), the presence of a bifurcation lesion was associated with adverse outcomes after PCI. In contrast, the presence of a bifurcation lesion had no impact on outcomes following coronary artery bypass grafting (CABG). Therefore, the presence of a coronary bifurcation lesion requires special attention when choosing between CABG and PCI. The aim of this study is to assess whether the presence of a bifurcation lesion still influences clinical outcomes after contemporary PCI using second-generation drug-eluting stent and fractional flow reserve (FFR) guidance versus CABG.

METHODS:

The randomized FAME 3 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared FFR-guided PCI using current drug-eluting stents with CABG in patients with 3-vessel coronary artery disease. The prespecified key end point at 3-year follow-up was the composite of death, myocardial infarction, or stroke. In this substudy, the impact of bifurcation lesions on outcomes after FFR-guided PCI and CABG was investigated.

RESULTS:

The FAME 3 trial enrolled 1500 patients and 653 (45.2%) patients had at least 1 true bifurcation lesion. There was no difference in the composite of death, myocardial infarction, or stroke at the 3-year follow-up between patients with or without at least 1 true bifurcation lesion (11.6% versus 10.0%; hazard ratio, 1.17 [95% CI, 0.86–1.61];
P
=0.32), regardless of revascularization strategy. The composite end point was not statistically different between FFR-guided PCI and CABG in patients with at least 1 true bifurcation lesion (hazard ratio, 1.27 [95% CI, 0.80–2.00]) or without a true bifurcation lesion (hazard ratio, 1.36 [95% CI, 0.87–2.12]), with no significant interaction (
P
interaction
=0.81).

CONCLUSIONS:

In patients with 3-vessel coronary artery disease, the presence of a true bifurcation lesion was not associated with a different treatment effect after FFR-guided PCI with contemporary drug-eluting stent versus CABG.
Referral Networks, Racial Inequity, and Hospital Quality for Open Heart Surgery
Authors: Gibson C. Ben , Damberg Cheryl L. , Escarce Jose J. , Zhang Shiyuan , Schuler Megan S. , Matthews Luke J. , Popescu Ioana
Published: December 2024

BACKGROUND:

Differences in the quality of hospitals where Black and White patients receive coronary artery bypass grafting (CABG) surgery have been documented. We examined the contributions of physician networks to the gap.

METHODS:

This was a cross-sectional study of all Medicare fee-for-service Black and White patients undergoing elective CABG during 2017 to 2019; the primary care physicians and cardiologists treating them for 12 months before surgery (the patients’ physician network); and CABG-performing hospitals within 100 miles of each patient. We measured the strength of ties between treating physicians and hospitals as the number of shared prior CABG patients (24 months before surgery). Conditional logit models assessed the relationship between race, prior physician-hospital ties, and receiving CABG at hospitals with minimum versus the median-above-minimum mortality difference, while accounting for home-to-hospital distances.

RESULTS:

The study included 76 376 patients; 5.1% were Blackpatients. Black and White patients were admitted to similar mortality hospitals (3.1% versus 3.1%;
P
=0.07), but Black patients lived closer to lower-mortality hospitals than White patients (mean hospital mortality within median travel distance, 2.5% versus 2.7%;
P
<0.001). Black patients were treated less often at the lowest-mortality hospitals overall and within the median travel distance (10.5% versus 13.9% and 37.4% versus 45.1%;
P
<0.001 for both). In conditional logit models, the Black-White risk ratio of using hospitals with median versus lowest mortality was 1.02 ([95% CI, 0.98–1.06];
P
=0.18) in models including only race and hospital mortality; 1.07 ([95% CI, 1.01–1.13];
P
<0.001) in models adding home-to-hospital distances; and 1.06 ([95% CI, 0.96–1.16];
P
=0.11) in models also accounting for physician-hospital ties.

CONCLUSIONS:

Despite the improvement of previously described disparities in the quality of hospitals treating Black and White patients, Black patients remain less likely to undergo CABG at their lowest available mortality hospitals, possibly due to suboptimal physician referrals.
How to Improve the Security of Password Checkers
Authors: Ngo Tri
Published: December 2024

After years of the attempt to replace password with other alternatives such as biometrics and smart cards, password is still the most pervasive user authentication mechanism. The password checking authentication is widely used for financial services, online social networks, and many other applications. This paper aims to analyze the security of a password checker qualitatively and quantitatively, and show how to improve it. Qualitative security analysis, in which it does not allow any information flow from secret date to public data, considers that the password checker is not a secure process. Therefore, an alternative analysis for the password checker is to analyze quantitatively, i.e., quantifying its information flow and determining how much secret information has been leaked. This method can be used to decide whether we can tolerate small leakages. A quantitative security analysis can be seen as a generalization of a qualitative one. To improve the security of the password checker, we propose a noisy-output policy, i.e., a situation where a system operator is able to add noise to the output: instead of always producing the exact outcomes, the system sometimes reports noisy outcomes. The noisy outcomes reduce the correlation between the output and the input, and thus reduce the leakage.