bluuebunny/crossref_metadata_2025 huggingface dataset:
DAMPAK KEMAMPUAN KERJA, DISIPLIN, DAN MOTIVASI TERHADAP KINERJA PEGAWAI SEKRETARIAT DAERAH KOTA PADANG
Authors: Sumiati Sumiati , Sumarta Riozi
Published: May 2023

Penelitian ini bertujuan untuk menganalisis dampak kemampuan kerja, disiplin, dan motivasi terhadap kinerja pegawai sekretariat daerah kota Padang . Penelitian ini menggunakan metode kuantitatif. Populasi adalah seluruh Pegawai Negri Sipil sekretariat daerah kota Padang, sebanyak 164 responden dan sampelnya sebanyak 164 responden, teknik pengambilan sampel adalah teknik total sampling dimana semua populasi dijadikan sampel. Analisis data menggunakan analisis regresi linear berganda dengan menggunakan aplikasi SPSS. Hasil penelitian menunjukan bahwa kemanpuan kerja berpengaruh positif dan signifikan terhadap kinerja pegawai sekretariat daerah kota Padang, disiplin kerja berpengaruh positif dan signifikan terhadap kinerja pegawai sekretariat daerah kota Padang, motivasi kerja berpengaruh positif dan signifikan terhadap kinerja pegawai sekretariat daerah kota Padang dan keampuan kerja, disiplin kerja dan motivasi kerja secara simultan berpengaruh positif dan signifikan terhadap kinerja pegawai sekretariat daerah kota Padang.Kata kunci: Kemampuan Kerja, Disiplin, Motivasi dan Kinerja Pegawai
PENERAPAN FAILOVER NETWORK MENGGUNAKAN JARINGAN VPN DAN JARINGAN WIRELESS POINT-TO-POINT PADA DISTANCE BUILDING DI PT. TITIPAN KILAT RIAU
Authors: Hafid Afdhil , Mukhtar Harun , Harlian Dani
Published: May 2023

This research is intended to build a network that that can connect branch offices with main office buildings in a company. This is done in order to create all performance connected to a company network that can improve and run well, so as to be able to support the company's business processes. At the stage of meeting company needs and in an effort to overcome problems in the network used technology that can always be online with the expectation of quality of services (QoS) approaching 100%.. The technology applied uses two communication lines, the first connection line is point-to-point wireless and the second connection line applies a Virtual Private Network (VPN) with the use of the internet. Handles failover on both network communication connections used by the mikrotik router. This allows if one connection is lost, the other connection line will automatically become a backup line. In this failed network simulation, it shows satisfactory results, as can be seen from the communication performance that runs without feeling tired of traffic. The application of this method can also operate without involving humans. In addition, the results of the measurement of the time lag required for switching connection lines have an average delay value of not more than 4.97 seconds.
İÇ MOĞOLİSTAN ÖRNEĞİNDE MEKÂNSAL DİNAMİKLER VE MOĞOL MİLLÎ BİRLİĞİ
Authors: TEZİÇ Mustafa Can
Published: May 2023

İç Moğolistan’daki idari yapılanma siyasetleri üzerinden yapılan bu tekrardan okuma mekânsal yapıların etnik bilinç ve grup aidiyetleri üzerinde belirleyici etkisi olduğunu göstermektedir. Mekânsal bir yapı olan etnografik sınırların parçalanması etnik bilinç ve grup aidiyetinin örtüşmesi üzerinde bir engel oluşturabildiği gibi bu karşıtlık İç Moğolistan örneğinde olduğu gibi millî bütünleşmenin de önüne geçebilmektedir. Araştırmalar Mançuların da içerisine dahil olduğu geleneksel Çin politikasının kuzey sınırlarının güvenliğinin bu bölgedeki konar göçer grupların sosyolojik dinamiklerini bozmak üzerine kurulu olduğunu göstermektedir. Konar göçer gruplar arasındaki çatışmalar üzerine kurulu olan bu dinamik yapı güçlü liderlerin çıkıp büyük siyasi birliklerin kurulmasına yol vermektedir. Bu noktada bölgede uygulanan idari yapılanma siyasetleri bu sosyolojik yapının önüne geçilmesi için kullanılan araçlardan bir olmuştur. Konar göçer gruplar arasında yüzyıllardır süren bu sosyolojik döngünün önüne geçilmesi beraberinde kendi çıkarlarını tehlikeye atmak istemeyen bu yüzden de gruplar arasındaki çatışmalardan uzak duran bölgesel yöneticilerin ve yönetimlerin ortaya çıkmasına neden olmuştur. Bu noktada mekânsal bağlılıklar ve etnik bilinç düzeyindeki karşıtlıklar siyasi yapı üzerinde kendisini hissettirmiştir. Bu karşıtlık sonucunda bugün İç Moğolistan olarak bilinen bölgede Mançu Çin politikaları karşısında bir Moğol birliği kurulamamış, farklı grupların kendi bölgesel politikaları Moğolların bir bütün olarak hareket etmelerinin önüne geçmiştir.

İlerleyen dönemde ise bölgede yükselen Moğol milliyetçiliği karşısında Mançu Çin idaresi bu idari yapıları Moğolların aleyhlerine olacak şekilde daha da geliştirmiştir. Bu çerçevede kurulan nüfusça kalabalık Çinli idari birimler içerisine Moğol yerleşim birimlerinin eklenmesi sureti ile Moğol nüfus zayıflatılmak istenmiştir. Bu parçalı yapılanma aynı dönem içerisinde Moğol milliyetçi hareket içerinde de Moğolların bir bütün olarak hareket etmelerine engel olmuştur. Farklı idari yapılara bölünmüş Moğol gruplar Çin içerisinde bir bütün olarak hareket edememişlerdir.

Diğer taraftan Büyük Asya politikası ile bölgede etkin bir politika izleyen Japonya ise idari yapılar üzerinden benzer politikalar izlemiştir. Böylelikle bir yandan Çin üzerinde baskı kurarken aynı zamanda da Moğollar üzerinde de etkin bir siyaset izleme olanağı bulmuştur.
The Rights of the Indigenous People and the Amazon: A Road Ahead+
Authors: Antunes Paulo de Bessa
Published: May 2023

The Amazon is one of the most complex and important biomes in the world. Its role in global climate stability is recognized worldwide. The political changes that took place in Brazil in 2022 brought a new hope for the protection of the forest and the different peoples that inhabit it. The dissemination of correct information about the current stage of the Amazon is essential for the forest to be preserved. One cannot imagine the future without analyzing past successes and mistakes so as to avoid the repetition of failed policies. It is essential both for the protection of the rights of the indigenous peoples as well as preservation of thier habitat of Amazonia.
Perspective study on identification of high-impact processes for advancing Diversity, Equity and Inclusion (DEI) in Indian organizations
Authors: Sreedhar Volety Naga , Nayak Parameswar
Published: May 2023

BACKGROUND: Inequality in India is quite a common phenomenon, the same is intertwined with social stratification and cultural influences. In a classical Indian setup, occupations are driven by social structure. Discrimination in the workplace in India is primarily also the result of structural inequalities. Organizations today are facing challenges in blending different cultures. This study gathered the views of Diversity, Equity and Inclusion (DEI) implementors and identified the high-impact processes that helped them to advance their work. OBJECTIVE: The primary objective of this study is to understand the high-impact practices which are being followed by employees implementing DEI in Indian organizations and how the leadership is helping them in driving DEI in their organizations. METHOD: To achieve the stated objective, this study used a semi-structured interview technique that involves asking participants a set of questions and following them up with probe questions to further explore their responses. This interview’s target group involves executives currently engaged in DEI implementation activities. The interview questions are based on the research instrument, a modified version of the Museus Context Culturally Engaging Campus Environment (CECE) model. A purposeful snowball sampling technique with predefined criteria was used for sample selection. The semi-structured interview transcripts were open-coded to derive code lists which then were axially coded for the identification of various themes. RESULTS: The study found that employee hiring & retention, engaging and supporting relationships, culturally relevant and responsive programs. and transformation framework are the four dominant high-impact practices which have significantly helped Indian organizations in implementing and advancing DEI initiatives in their organizations. CONCLUSIONS: By identifying the high-impact practices that helped Indian organizations in implementing DEI initiatives this study adds to the current body of knowledge in workplace diversity research. This study helps policymakers and other stakeholders in promoting, supporting and sustaining DEI initiatives, which now form a part of mandatory ESG (Environmental, Social, and Corporate Governance) reporting to be done by the top 1000 listed companies, Furthermore, entrepreneurs and practitioners can utilize the finding of the study as a guide.
Psychometric assessment of organizational readiness scale for digital innovations and antecedents of organizational readiness
Authors: Taganoviq Besarta , Kurutkan Mehmet Nurullah , Bagis Mehmet , Hoxha Adnan , Kryeziu Blerta , Hysenaj Arben , Haxhijakupi Erza , Bimbashi Altina , Dalipi Arta , Hyseni Blerte , Harris Linda Ukimeraj
Published: May 2023

BACKGROUND: This article aims to perform a psychometric assessment of the scale of organizational readiness for digital innovations in a transition economy and to examine the antecedents of organizational readiness for digital innovations. METHODOLOGY: The study employed a quantitative research method to analyze data collected from a sample of 1236 health professionals. The scale secondary confirmatory factor and linear regression analysis were employed to verify organizational readiness and test the respective hypotheses about organizational readiness for digital innovation, respectively. RESULTS/CONCLUSIONS: The research findings show that the organizational readiness scale for digital innovations is valid and reliable in transition economies. Findings show that the relationship between variables such as adaptation of human resources (AHR), cognitive readiness (COR), planning for new telehealth and e-health (PNTH), IT readiness (ITR), resource readiness (RR), partnership readiness (PR), and cultural readiness (CUR) are correlated with the innovations implementation effectiveness (IIE), and organizational readiness for digital innovation is positive statistically significant. Findings also suggest that Integration of old technologies (IoT) and organizational readiness for digital innovation is statistically significant and have negative relationship.
The effect of reliability and empathy on customer satisfaction: A survey of PT Telkom Indonesia’s IndiHome customers
Authors: Widagdo Suwignyo , Handayani Yuniorita Indah , Prastyowati Agustin Hari , Rachmawati Lia , Dimyati Muhaimin , Amalia Sofi
Published: May 2023

BACKGROUND: Many customers often complain about Indihome facilities, causing dissatisfaction with the service of Indihome products at PT. Telkom. OBJECTIVE: This study examines physical evidence, reliability, responsiveness, assurance, and empathy on customer satisfaction at PT. Telkom. METHODS: This study uses quantitative research with a population of all Indihome customers who make complaints or make payment transactions at PT. Telkom. RESULTS: Based on the study results, service quality, as seen from the variables of physical evidence, reliability, responsiveness, assurance, and empathy, significantly influences customer satisfaction in Indihome PT. Telkom. This study found that reliability and empathy affect Indihome customer satisfaction. Meanwhile, physical evidence, responsiveness, and guarantees do not affect Indihome customer satisfaction. Reliability and empathy are the five service quality variables with the most dominant influence. CONCLUSIONS: The results of this study can be used as input for PT. Telkom retains and attracts new customers by maintaining quality, reliability, and empathy. Customers feel that Telkom employees deliver products clearly and in detail and do not discriminate between customers, even though sometimes service completion could be more timely.
Midlife Neuropsychological Profiles and Associated Vascular Risk: The Bogalusa Heart Study
Authors: De Anda-Duran Ileana , Kolachalama Vijaya B. , Carmichael Owen T. , Hwang Phillip H. , Fernandez Camilo , Au Rhoda , Bazzano Lydia A. , Libon David J.
Published: May 2023

Background:

Individuals with Alzheimer’s disease (AD) often present with coexisting vascular pathology that is expressed to different degrees and can lead to clinical heterogeneity.

Objective:

To examine the utility of unsupervised statistical clustering approaches in identifying neuropsychological (NP) test performance subtypes that closely correlate with carotid intima-media thickness (cIMT) in midlife.

Methods:

A hierarchical agglomerative and k-means clustering analysis based on NP scores (standardized for age, sex, and race) was conducted among 1,203 participants (age 48±5.3 years) from the Bogalusa Heart Study. Regression models assessed the association between cIMT ≥50th percentile and NP profiles, and global cognitive score (GCS) tertiles for sensitivity analysis.

Results:

Three NP profiles were identified: Mixed-low performance [16%, n = 192], scores ≥1 SD below the mean on immediate, delayed free recall, recognition verbal memory, and information processing; Average [59%, n = 704]; and Optimal [26%, n = 307] NP performance. Participants with greater cIMT were more likely to have a Mixed-low profile [OR = 3.10, 95% CI (2.13, 4.53), p < 0.001] compared to Optimal. After adjusting for education and cardiovascular (CV) risks, results remained. The association with GCS tertiles was more attenuated [lowest (34%, n = 407) versus highest (33%, n = 403) tertile: adjusted OR = 1.66, 95% CI (1.07, 2.60), p = 0.024].

Conclusion:

As early as midlife, individuals with higher subclinical atherosclerosis were more likely to be in the Mixed-low profile, underscoring the potential malignancy of CV risk as related to NP test performance, suggesting that classification approaches may aid in identifying those at risk for AD/vascular dementia spectrum illness.
Elecsys Cerebrospinal Fluid Immunoassays Accurately Detect Alzheimer’s Disease Regardless of Concomitant Small Vessel Disease
Authors: Ortner Marion , Lanz Korbinian , Goldhardt Oliver , Müller-Sarnowski Felix , Diehl-Schmid Janine , Förstl Hans , Hedderich Dennis M. , Yakushev Igor , Logan Chad A. , Weinberger Jan-Philipp , Simon Maryline , Grimmer Timo
Published: May 2023

Background:

Differentiating dementia due to small vessel disease (SVD) from dementia due to Alzheimer’s disease (AD) with concomitant SVD is challenging in clinical practice. Accurate and early diagnosis of AD is critical to delivering stratified patient care.

Objective:

We characterized the results of Elecsys® cerebrospinal fluid (CSF) immunoassays (Roche Diagnostics International Ltd) in patients with early AD, diagnosed using core clinical criteria, with varying extent of SVD.

Methods:

Frozen CSF samples ( n = 84) were measured using Elecsys β-Amyloid(1–42) (Aβ42), Phospho-Tau (181P) (pTau181), and Total-Tau (tTau) CSF immunoassays, adapted for use on the cobas® e 411 analyzer (Roche Diagnostics International Ltd), and a robust prototype β-Amyloid(1–40) (Aβ40) CSF immunoassay. SVD was assessed by extent of white matter hyperintensities (WMH) using the lesion segmentation tool. Interrelations between WMH, biomarkers, fluorodeoxyglucose F18-positron emission tomography (FDG-PET), and other parameters (including age and Mini-Mental State examinations [MMSE]) were assessed using Spearman’s correlation, sensitivity/specificity, and logistic/linear regression analyses.

Results:

The extent of WMH showed significant correlation with Aβ42/Aβ40 ratio (Rho=-0.250; p = 0.040), tTau (Rho = 0.292; p = 0.016), tTau/Aβ42 ratio (Rho = 0.247; p = 0.042), age (Rho = 0.373; p = 0.002), and MMSE (Rho=-0.410; p = 0.001). Sensitivity/specificity point estimates for Elecsys CSF immunoassays versus FDG-PET positivity for underlying AD pathophysiology were mostly comparable or greater in patients with high versus low WMH. WMH were not a significant predictor and did not interact with CSF biomarker positivity but modified the association between pTau181 and tTau.

Conclusion:

Elecsys CSF immunoassays detect AD pathophysiology regardless of concomitant SVD and may help to identify patients with early dementia with underlying AD pathophysiology.
The Prevalence and Agreement of Sarcopenic Obesity Using Different Definitions and Its Association with Mild Cognitive Impairment
Authors: Fu Yu , Li Xiaolong , Wang Ting , Yan Shuhua , Zhang Xisheng , Hu Geng , Zhou Jin , Wang Yan , Liu ChangShu , Wang Sai , Cong Yang , Chen Liangkai , Li Tingting , Rong Shuang
Published: May 2023

Background:

The consistent definition of sarcopenic obesity (SO) is limited, its association with mild cognitive impairment (MCI) has not been clarified.

Objective:

This study aimed to evaluate the prevalence and agreement of SO using different definitions and the association between SO and MCI.

Methods:

SO was diagnosed by the co-existence of sarcopenia defined by the Asia Working Group for Sarcopenia (AWGS) and obesity by body mass index (BMI), visceral fat area (VFA), waist circumference (WC), or body fat percentage (BF%). Cohen’s kappa was used to assess the agreement between the different definitions. The association between SO and MCI was assessed using multivariable logistic regression.

Results:

Among 2,451 participants, the prevalence of SO ranged from 1.7% to 8.0% under different definitions. SO defined by AWGS and BMI (AWGS+BMI) showed fair agreements with the other three criteria ( κ ranged from 0.334 to 0.359). The other criteria showed good agreements with each other. The κ statistics were 0.882 for AWGS+VFA and AWGS+BF%, 0.852 for AWGS+VFA and AWGS+WC, and 0.804 for AWGS+BF% and AWGS+WC, respectively. When using different diagnoses of SO, compared with the health group, the adjusted ORs of MCI for SO were 1.96 (95% CI: 1.29-2.99, SO: AWGS+WC), 1.75 (95% CI: 1.14-2.68, SO: AWGS+VFA), 1.94 (95% CI: 1.29-2.93, SO: AWGS+BF%), and 1.45 (95% CI: 0.67-3.12, SO: AWGS+BMI), respectively.

Conclusion:

Using different obesity indicators combined with AWGS to diagnose SO, BMI had lower prevalence and agreement compared with other three indicators. SO was associated with MCI under different methods (WC, VFA, or BF%).
miRNAs and Stem Cells as Promising Diagnostic and Therapeutic Targets for Alzheimer’s Disease
Authors: Elzayat Emad M. , Shahien Sherif A. , El-Sherif Ahmed A. , Hosney Mohamed
Published: May 2023

Alzheimer’s disease (AD) is a cumulative progressive neurodegenerative disease characterized mainly by impairment in cognitive functions accompanied by memory loss, disturbance in behavior and personality, and difficulties in learning. Although the main causes of AD pathogenesis are not fully understood yet, amyloid-β peptides and tau proteins are supposed to be responsible for AD onset and pathogenesis. Various demographic, genetic, and environmental risk factors are involved in AD onset and pathogenesis such as age, gender, several genes, lipids, malnutrition, and poor diet. Significant changes were observed in microRNA (miRNA) levels between normal and AD cases giving hope for a diagnostic procedure for AD through a simple blood test. As yet, only two classes of AD therapeutic drugs are approved by FDA. They are classified as acetylcholinesterase inhibitors and N-methyl-D-aspartate antagonists (NMDA). Unfortunately, they can only treat the symptoms but cannot cure AD or stop its progression. New therapeutic approaches were developed for AD treatment including acitretin due to its ability to cross blood-brain barrier in the brain of rats and mice and induce the expression of ADAM 10 gene, the α-secretase of human amyloid-β protein precursor, stimulating the non-amyloidogenic pathway for amyloid-β protein precursor processing resulting in amyloid-β reduction. Also stem cells may have a crucial role in AD treatment as they can improve cognitive functions and memory in AD rats through regeneration of damaged neurons. This review spotlights on promising diagnostic techniques such as miRNAs and therapeutic approaches such as acitretin and/or stem cells keeping in consideration AD pathogenesis, stages, symptoms, and risk factors.
Pilot Study of Second-Generation DNA Methylation Epigenetic Markers in Relation to Cognitive and Neuropsychiatric Symptoms in Older Adults
Authors: Vyas Chirag M. , Sadreyev Ruslan I. , Gatchel Jennifer R. , Kang Jae H. , Reynolds Charles F. , Mischoulon David , Chang Grace , Hazra Aditi , Manson JoAnn E. , Blacker Deborah , De Vivo Immaculata , Okereke Olivia I.
Published: May 2023

Background:

Associations between epigenetic aging with cognitive aging and neuropsychiatric measures are not well-understood.

Objective:

1) To assess cross-sectional correlations between second-generation DNA methylation (DNAm)-based clocks of healthspan and lifespan (i.e., GrimAge, PhenoAge, and DNAm-based estimator of telomere length [DNAmTL]) and cognitive and neuropsychiatric measures; 2) To examine longitudinal associations between change in DNAm markers and change in cognition over 2 years.

Methods:

Participants were members of VITAL-DEP (VITamin D and OmegA-3 TriaL- Depression Endpoint Prevention) study. From previously ascertained cognitive groups (i.e., cognitively normal and mild cognitive impairment), we randomly selected 45 participants, aged≥60 years, who completed in-person neuropsychiatric assessments at baseline and 2 years. The primary outcome was global cognitive score (averaging z-scores of 9 tests). Neuropsychiatric Inventory severity scores were mapped from neuropsychiatric symptoms (NPS) from psychological scales and structured diagnostic interviews. DNAm was assayed using Illumina MethylationEPIC 850K BeadChip at baseline and 2 years. We calculated baseline partial Spearman correlations between DNAm markers and cognitive and NPS measures. We constructed multivariable linear regression models to examine longitudinal relations between DNAm markers and cognition.

Results:

At baseline, we observed a suggestive negative correlation between GrimAge clock markers and global cognition but no signal between DNAm markers and NPS measures. Over 2 years: each 1-year increase in DNAmGrimAge was significantly associated with faster declines in global cognition; each 100-base pair increase in DNAmTL was significantly associated with better global cognition.

Conclusion:

We found preliminary evidence of cross-sectional and longitudinal associations between DNAm markers and global cognition.
Age Related Burden of Swallowing in Adult Patients Affected by Duchenne Muscular Dystrophy
Authors: Crescimanno Grazia , Greco Francesca , Bertini Manuela , Maltese Giacomo , Marrone Oreste
Published: May 2023

Background: In Duchenne muscular dystrophy (DMD), dysphagia is a common but often overlooked symptom, which may affect quality of life (QoL). Its possible causes are progressive deterioration of muscle groups involved in swallowing function (oropharyngeal, inspiratory muscles) or impairment of autonomic function. Objectives: In adult patients with DMD, we aimed to identify predictors of swallowing-related QoL and to compare swallowing-related QoL at different ages. Methods: Forty-eight patients aged 30.0±6.6 years were enrolled. Questionnaires were administered: the Swallowing Quality of Life questionnaire (SWAL-QOL) for swallowing-related QoL assessment, and the Compass 31 for autonomic symptoms assessment. The Brooke Upper Extremity Scale was used for upper limbs muscular function assessment. Respiratory and muscle function tests were performed, including spirometry, arterial blood gases, polysomnography, maximal inspiratory pressure (MIP), maximal expiratory pressure and sniff nasal inspiratory pressure. Results: An abnormal composite SWAL-QOL score (≤86) was found in 33 patients. Autonomic symptoms were mild, while a severe impairment was shown by the Brooke Upper Extremity Scale. Spirometry and muscle strength tests demonstrated severe alterations, while diurnal and nocturnal blood gases were normal, due to effective use of noninvasive ventilation. Independent predictors of the composite SWAL-QOL score were age, MIP and Compass 31. A MIP < 22 had an accuracy of 92% in predicting altered swallowing-related QoL. The composite SWAL-QOL score was worse in subjects > 30 years old than in younger patients (64.5±19.2 vs 76.6±16.3, p < 0.02), due to worse scores in items pertinent to mental and social functioning; scores in domains pertinent to the physical function were similar in both groups. Conclusions: In adult DMD, swallowing-related QoL, which is altered in most patients, can be predicted by age, inspiratory muscles strength and autonomic dysfunction symptoms. While swallowing function is already altered in young patients, swallowing-related QoL can progressively worsen with advancing age due to psychological and social factors.
Nomogram for Early Prediction of Parkinson’s Disease Based on microRNA Profiles and Clinical Variables
Authors: Hou Xiangqing , Wong Garry
Published: May 2023

Background:

Few efficient and simple models for the early prediction of Parkinson’s disease (PD) exists.

Objective:

To develop and validate a novel nomogram for early identification of PD by incorporating microRNA (miRNA) expression profiles and clinical indicators.

Methods:

Expression levels of blood-based miRNAs and clinical variables from 1,284 individuals were downloaded from the Parkinson’s Progression Marker Initiative database on June 1, 2022. Initially, the generalized estimating equation was used to screen candidate biomarkers of PD progression in the discovery phase. Then, the elastic net model was utilized for variable selection and a logistics regression model was constructed to establish a nomogram. Additionally, the receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves were utilized to evaluate the performance of the nomogram.

Results:

An accurate and externally validated nomogram was constructed for predicting prodromal and early PD. The nomogram is easy to utilize in a clinical setting since it consists of age, gender, education level, and transcriptional score (calculated by 10 miRNA profiles). Compared with the independent clinical model or 10 miRNA panel separately, the nomogram was reliable and satisfactory because the area under the ROC curve achieved 0.72 (95% confidence interval, 0.68-0.77) and obtained a superior clinical net benefit in DCA based on external datasets. Moreover, calibration curves also revealed its excellent prediction power.

Conclusion:

The constructed nomogram has potential for large-scale early screening of PD based upon its utility and precision.
IgA-Biome Profiles Correlate with Clinical Parkinson’s Disease Subtypes
Authors: Brown Eric L. , Essigmann Heather T. , Hoffman Kristi L. , Alexander Ashley S. , Newmark Michael , Jiang Zhi-Dong , Suescun Jessika , Schiess Mya C. , Hanis Craig L. , DuPont Herbert L.
Published: May 2023

Background:

Parkinson’s disease is a heterogeneous neurodegenerative disorder with distinctive gut microbiome patterns suggesting that interventions targeting the gut microbiota may prevent, slow, or reverse disease progression and severity.

Objective:

Because secretory IgA (SIgA) plays a key role in shaping the gut microbiota, characterization of the IgA-Biome of individuals classified into either the akinetic rigid (AR) or tremor dominant (TD) Parkinson’s disease clinical subtypes was used to further define taxa unique to these distinct clinical phenotypes.

Methods:

Flow cytometry was used to separate IgA-coated and -uncoated bacteria from stool samples obtained from AR and TD patients followed by amplification and sequencing of the V4 region of the 16 S rDNA gene on the MiSeq platform (Illumina).

Results:

IgA-Biome analyses identified significant alpha and beta diversity differences between the Parkinson’s disease phenotypes and the Firmicutes/Bacteroides ratio was significantly higher in those with TD compared to those with AR. In addition, discriminant taxa analyses identified a more pro-inflammatory bacterial profile in the IgA+ fraction of those with the AR clinical subclass compared to IgA-Biome analyses of those with the TD subclass and with the taxa identified in the unsorted control samples.

Conclusion:

IgA-Biome analyses underscores the importance of the host immune response in shaping the gut microbiome potentially affecting disease progression and presentation. In the present study, IgA-Biome analyses identified a unique proinflammatory microbial signature in the IgA+ fraction of those with AR that would have otherwise been undetected using conventional microbiome analysis approaches.
Impact of long-term high dietary fat intake and regular exercise on serum TMAO and microbiome composition in female rats
Authors: Almer Gunter , Semeraro Maria Donatella , Meinitzer Andreas , Enko Dietmar , Rodriguez Blanco Giovanny , Gallé Birgit , Horvath Angela , Moissl-Eichinger Christine , Till Holger , Gruber Hans-Jürgen , Herrmann Markus
Published: May 2023

BACKGROUD:

Trimethylamine oxide (TMAO) represents a gut metabolite and it's physiological concentration is proposed to be influenced by the abundance of precursor trimethylamine (TMA)-producing microbiota in the gut.

OBJECTIVE:

Lifestyle factors, such as diet and exercise, modify the microbiome, but their long-term impact on plasma TMAO and TMA production in the gut is poorly understood.

METHODS:

Fecal microbiome composition was analyzed and correlated with TMAO serum concentrations in female Sprague-Dawley rats that received either a healthy normal or a high-fat diet (HFD) for 10 months. Half of the animals performed regular running exercise, the other half served as sedentary controls.

RESULTS:

HFD consumption induced an alteration of the fecal microbiome with increased alpha diversity on ASV levels. More importantly, HFD reduced the abundance of genera containing potential TMA producers, such as certain members of Clostridia and Lachnospiraceae. In line with this observation, serum TMAO concentrations were found to be lower with HFD and to correlate with the abundance of these genera. Regular exercise also induced changes in microbiome beta diversity but had no effect on serum TMAO in female rats.

CONCLUSION:

A diet containing high amounts of dietary fat reduced serum TMAO, probably through a reduced intestinal abundance of TMA-producing bacteria. In contrast, regular exercise altered beta diversity of the microbiome composition, but without significant effects on serum TMAO concentrations.
Participatory Study to Explore Healthcare Professionals’ Perceptions of a Connected Digital Solution for Adherence Monitoring of Recombinant Human Growth Hormone Treatment: Study Protocol and First Findings
Authors: Rivera-Romero Octavio , Felicia Faienza Maria , Vergani Edoardo , Zucchiatti Chantal , Koledova Ekaterina
Published: May 2023

Adherence to recombinant human growth hormone (r-hGH; somatropin, [Saizen®], Merck Healthcare KGaA, Darmstadt, Germany) treatment is fundamental to achieve positive growth outcomes in children with growth disorders and to improve quality of life and cardiometabolic risk in adult patients affected by GH deficiency. Pen injector devices are commonly used to deliver r-hGH but, to the authors’ knowledge, none is currently digitally connected. Since digital health solutions are rapidly becoming valuable tools to support patients to adhere to treatment, the combination of a pen injector connected to a digital ecosystem to monitor treatment adherence is an important advance. Here, we present the methodology and first results of a participatory workshop that assessed clinicians’ perceptions on such a digital solution – the aluetta™ smartdot™ (Merck Healthcare KGaA, Darmstadt, Germany) – combining the aluetta™ pen injector and a connected device, components of a comprehensive digital health ecosystem to support pediatric patients receiving r-hGH treatment. The aim being to highlight the importance of collecting clinically meaningful and accurate real-world adherence data to support data-driven healthcare.
Implementation Status of the Proposal for a Regulation of the European Health Data Space in Portugal: Are We Ready for It?
Authors: Mateus Margarida , Loureiro Maria , Fernandes A. Raquel , Oliveira Miguel , Cruz-Correia Ricardo
Published: May 2023

The European Health Data Space (EHDS) proposal aims to establish a set of rules and governance frameworks to promote the use of electronic health data for both primary and secondary purposes. This study aims at analysing the implementation status of the EHDS proposal in Portugal, particularly the points concerning the primary use of health data. The proposal was scanned for the points that gave member states a direct responsibility to implement actions, and a literature review and interviews were conducted to assess the implementation status of these policies in Portugal This study found that Portugal is well advanced in the implementation of policies concerning the rights of natural persons in relation to the primary use of their personal health data, but also identified challenges, which include the lack of a common interoperability framework for the exchange of electronic health data.
Assessing the FAIRness of Deep Learning Models in Cardiovascular Disease Using Computed Tomography Images: Data and Code Perspective
Authors: Shiferaw Kirubel Biruk , Zeleke Atinkut , Waltemath Dagmar
Published: May 2023

The interest in the application of AI in medicine has intensely increased over the past decade with most of the changes in the past five years. Most recently, the application of deep learning algorithms in prediction and classification of cardiovascular diseases (CVD) using computed tomography (CT) images showed promising results. The notable and exciting advancement in this area of study is, however, associated with different challenges related to the findability (F), accessibility(A), interoperability(I), reusability(R) of both data and source code. The aim of this work is to identify reoccurring missing FAIR-related features and to assess the level of FAIRness of data and models used to predict/diagnose cardiovascular diseases from CT images. We evaluated the FAIRness of data and models in published studies using the RDA (Research Data Alliance) FAIR Data maturity model and FAIRshake toolkit. The finding showed that although AI is anticipated to bring ground breaking solutions for complex medical problems, the findability, accessibility, interoperability and reusability of data/metadata/code is still a prominent challenge.
Predicting Family Implementation of Complementary and Alternative Medicine in Autism Online Communities
Authors: Ni Zhenni , Qian Yuxing , Li Hao , Yao Zhizhen
Published: May 2023

Complementary and alternative medicine (CAM) is widely adopted by families with autistic children. This study aims to predict family caregivers’ CAM implementation in Autism online communities. Dietary interventions were reported as a case study. We extracted behavioral (degree and betweenness), environmental (positive feedback and social persuasion), and personal features (language style) of family caregivers in online communities. The results of the experiment showed that random forests performed well in predicting families’ tendency to implement CAM (AUC=0.887). It is promising to use machine learning to predict and intervene in the CAM implementation by family caregivers.
Classification of Parkinson’s Disease from Voice – Analysis of Data Selection Bias
Authors: Brenner Alexander , Van Alen Catharina Marie , Plagwitz Lucas , Varghese Julian
Published: May 2023

A growing number of studies have been researching biomarkers of Parkinson’s disease (PD) using mobile technology. Many have shown high accuracy in PD classification using machine learning (ML) and voice records from the mPower study, a large database of PD patients and healthy controls. Since the dataset has unbalanced class, gender and age distribution, it is important to consider appropriate sampling when assessing classification scores. We analyse biases, such as identity confounding and implicit learning of non-disease-specific characteristics and present a sampling strategy to highlight and prevent these problems.
A Toolchain for Big Data Analyses in the Intelligent Cognitive Operating Room
Authors: Kirsch Elena , Junger Denise , Kücherer Christian , Burgert Oliver
Published: May 2023

This project aims to evaluate existing big data infrastructures for their applicability in the operating room to support medical staff with context-sensitive systems. Requirements for the system design were generated. The project compares different data mining technologies, interfaces, and software system infrastructures with a focus on their usefulness in the peri-operative setting. The lambda architecture was chosen for the proposed system design, which will provide data for both postoperative analysis and real-time support during surgery.
Cross-Registry Benchmarking of Data Quality: Lessons Learned
Authors: Stausberg Jürgen , Harkener Sonja , Engel Christoph , Finger Robert , Heinz Carsten , Jenetzky Ekkehart , Jersch Patrick , Martin David , Rupp Rüdiger , Schoenthaler Martin , Suwelack Barbara , Wegner Jeannine
Published: May 2023

Feedback of data quality measures to study sites is an established procedure in the management of registries. Comparisons of data quality between registries as a whole are missing. We implemented a cross-registry benchmarking of data quality within the field of health services research for six projects. Five (2020) and six (2021) quality indicators were selected from a national recommendation. The calculation of the indicators was adjusted to the registries’ specific settings. Nineteen (2020) and 29 results (2021) could be included in the yearly quality report. Seventy-four per cent (2020) and 79% (2021) of the results did not include the threshold in their 95%-confidence-limits. The benchmarking revealed several starting points for a weak-point analysis through a comparison of results with a predefined threshold as well as through comparisons among each other. In the future, a cross-registry benchmarking might be part of services provided through a health services research infrastructure.
‘Quer N0 AVC’ for Monitoring Stroke Patients’ Healthcare Using a Mobile App
Authors: Leandro Gabrielle Dos Santos , Bittencourt Ivonei , Nagel Vivian , Moro Carla Heloisa Cabral , Moro Claudia
Published: May 2023

Stroke is one of the leading causes of death and impairments worldwide. After hospital discharge, it is necessary to monitor these patients during their recovery. This research addresses the implementation of a mobile app, entitled ‘Quer N0 AVC’, to improve the quality of stroke patient care in Joinville, Brazil. The study method was divided into two parts. The adaptation phase included all the necessary information in the app for monitoring stroke patients. The implementation phase aimed to prepare a routine for the Quer mobile app installation. One of the questionnaires collected data from 42 patients and identified that before hospital admission 29% of them did not have medical appointments, 36% had one or two appointments, 11% had three appointments, and 24% had four or more appointments. This research portrayed adaptation feasibility and the implementation of a cell phone app for following up on stroke patients.
User Satisfaction with Recently Deployed Electronic Health Records
Authors: Lintvedt Ove , Marco-Ruiz Luis , Pedersen Rune
Published: May 2023

The high investments in deploying a new Electronic Health Record (EHR) make it necessary to understand its effect on usability (effectiveness, efficiency, and user satisfaction). This paper describes the evaluation process related to user satisfaction over data gathered from three Northern Norway Health Trust hospitals. A questionnaire gathered responses about user satisfaction regarding the newly adopted EHR. A regression model reduces the number of satisfaction items from 15 to nine, where the result represents user EHR Features Satisfaction. The results show positive satisfaction with the newly introduced EHR, a result of proper EHR transition planning and the previous experience of the vendor with the hospitals involved.
Implementation, Adoption and Use of the Kanta Services in Finland 2010–2022
Authors: Jormanainen Vesa , Vehko Tuulikki , Lindgren Marina , Keskimäki Ilmo , Kaila Minna
Published: May 2023

Nationwide implementation and adoption of the Prescription Centre and the Patient Data Repository services required 5.5 years since May 2010 in Finland. The Clinical Adoption Meta-Model (CAMM) was applied in the post-deployment assessment of the Kanta Services in its four dimensions (availability, use, behavior, clinical outcomes) over time. The CAMM results on the national level in this study suggest ‘Adoption with Benefits’ as the most appropriate CAMM archetype.
The Smart Data Extractor, a Clinician Friendly Solution to Accelerate and Improve the Data Collection During Clinical Trials
Authors: Quennelle Sophie , Douillet Maxime , Friedlander Lisa , Boyer Olivia , Neuraz Antoine , Burgun Anita , Garcelon Nicolas
Published: May 2023

In medical research, the traditional way to collect data, i.e. browsing patient files, has been proven to induce bias, errors, human labor and costs. We propose a semi-automated system able to extract every type of data, including notes. The Smart Data Extractor pre-populates clinic research forms by following rules. We performed a cross-testing experiment to compare semi-automated to manual data collection. 20 target items had to be collected for 79 patients. The average time to complete one form was 6’81” for manual data collection and 3’22” with the Smart Data Extractor. There were also more mistakes during manual data collection (163 for the whole cohort) than with the Smart Data Extractor (46 for the whole cohort). We present an easy to use, understandable and agile solution to fill out clinical research forms. It reduces human effort and provides higher quality data, avoiding data re-entry and fatigue induced errors.
Automating Structured Results Communication to Expedite Imaging-Directed Care in Spine Oncology
Authors: Hassankhani Alvand , Mattay Raghav R. , Freeman Colbey W. , Kahn Jr. Charles E.
Published: May 2023

Cancers frequently metastasize to the spine, where they can cause severe morbidity, including pain, vertebral collapse, and paralysis. Accurate assessment and timely communication of actionable imaging findings are critical. We developed a scoring mechanism to capture the key imaging features of examinations performed to detect and characterize spinal metastases in patients with cancer. An automated system was developed to relay those findings to the institution’s spine oncology team to expedite treatment. This report describes the scoring scheme, the automated results communication platform, and initial clinical experience with the system. The scoring system and communication platform enable prompt, imaging-directed care of patients with spinal metastases.
Agent Based Modelling for Simulating the Interregional Patient Mobility in Italy
Authors: Pecoraro Fabrizio , Accordino Filippo , Cecconi Federico , Paolucci Mario
Published: May 2023

Patient mobility is considered one of the main concerns for policy-makers as it impacts financial sustainability of regional health systems due to the high percentage of patients accessing care services in other regions. For a better understanding of this phenomenon, it is necessary to define a behavioral model able to represent the patient-system interaction. In this paper we adopted the Agent-Based Modelling (ABM) approach with the aim of simulating patient flow across regions and determining which are the main factors influencing it. This may provide a new insight for policy makers to capture which are the main factors influencing mobility and actions that may contribute to contain this phenomenon.
Timeline of and Expectations for the National Medication List in Sweden
Authors: Hoffmann Mikael
Published: May 2023

It is important to separate the continuous chains of medications orders (or decisions by the prescriber) in modern electronic health records from the one-way communication of prescriptions from healthcare to pharmacies. To support the self-administration of prescribed drugs the patient needs a continuously updated list of medication orders. For the NLL to function as a safe resource for the patient, it is necessary to have the information updated, curated, and documented by prescribers in a one-step process within the electronic health record. Four of the Nordic countries have chosen separate ways trying to achieve this. The experiences and obstacles during the introduction of the mandatory National Medication List (NLL) in Sweden and the resulting delays are described. The planned integration for 2022 is now delayed to 2025 and will probably only be achieved in 2028 or even 2030 in some regions.
MedSecurance Project: Advanced Security-for-Safety Assurance for Medical Device IoT (IoMT)
Authors: Gallos Parisis , DeLong Rance , Matragkas Nicholas , Blanchard Allan , Mraidha Chokri , Epiphaniou Gregory , Maple Carsten , Katzis Konstantinos , Delgado Jaime , Llorente Silvia , Maló Pedro , Almeida Bruno , Menychtas Andreas , Panagopoulos Christos , Maglogiannis Ilias , Papachristou Petros , Soares Mariana , Breia Paula , Vidal Ana Cristina , Ratz Martin , Williamson Ross , Erwee Eduard , Stasiak Lukasz , Flores Orfeu , Clemente Carla , Mantas John , Weber Patrick , Arvanitis Theodoros N. , Hansen Scott
Published: May 2023

The MedSecurance project focus on identifying new challenges in cyber security with focus on hardware and software medical devices in the context of emerging healthcare architectures. In addition, the project will review best practice and identify gaps in the guidance, particularly the guidance stipulated by the medical device regulation and directives. Finally, the project will develop comprehensive methodology and tooling for the engineering of trustworthy networks of inter-operating medical devices, that shall have security-for-safety by design, with a strategy for device certification and certifiable dynamic network composition, ensuring that patient safety is safeguarded from malicious cyber actors and technology “accidents”.
Electronic Health Records as Information Source in Assessment of the Effectiveness of Delivered Care – A Pilot Study
Authors: Von Gerich Hanna , Moen Hans , Peltonen Laura-Maria
Published: May 2023

Effectiveness is a key element of high quality health services. The aim of this pilot study was to explore the potential of electronic health records (EHR) as an information source for assessing the effectiveness of nursing care by investigating the appearance of nursing processes in the documentation of care. Deductive and inductive content analysis were used in a manual annotation of ten patients’ EHRs. The analysis resulted in the identification of 229 documented nursing processes. The results indicate that EHRs can be used in decision support systems for assessing effectiveness of nursing care, however, future work is needed to verify these findings in a larger data set and extend to other dimensions related to care quality.
Improving Pressure Ulcers Prediction in Nursing Homes with ML Algorithm
Authors: Charon Clara , Wuillemin Pierre-Henri , Belmin Joël
Published: May 2023

An automated ML classifier predicting pressure ulcers one-month before performs better than the reference methods currently used in nursing homes.
Pharmacists’ Experiences of Using Knowledge Bases on Medicines in Pregnancy and Breastfeeding
Authors: Karlsson Lind Linnéa , Dreher Sköld Patrik , Nörby Ulrika
Published: May 2023

Knowledge bases on medicines during pregnancy and breastfeeding integrated into a clinical decision support system are valuable tools for pharmacists. The information facilitates counseling, is time-saving and improves patient safety.
Local Approval Processes in a Federated and Distributed Research Infrastructure – Lessons Learned from the AKTIN-Project
Authors: Kombeiz Alexander ,   Aktin Research Group, Bienzeisler Jonas , Ehrentreich Saskia , Röhrig Rainer , Majeed Raphael W.
Published: May 2023

The AKTIN-Emergency Department Registry is a federated and distributed health data network which uses a two-step process for local approval of received data queries and result transmission. For currently establishing distributed research infrastructures, we present our lessons learned from 5 years of established operations.