bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of N52R Mutation at the SPN-ARR Interface on the Conformational Dynamics of SHANK3
Authors: Almaadani Hiba K. , Mattaparthi Venkata Satish Kumar
Published: August 2024

Background:

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition.
The genetic basis of ASD involves numerous loci converging on neural pathways, particularly
affecting excitatory synapses. SHANK3, an essential protein in the post-synaptic neurons,
has been implicated in ASD, with mutations affecting its N-terminal, including the SPN domain.

Objective:

This study aims to investigate the impact of the N52R mutation on SHANK3 and assess
the dynamics, stability, flexibility, and compactness of the N52R mutant compared to
SHANK3 WT.

Methods:

Molecular dynamics simulations were conducted to investigate the structural dynamics
of SHANK3 WT and the N52R mutant. The simulations involved heating dynamics, density
equilibrium, and production dynamics. The trajectories were analyzed for RMSD, RMSF, Rg, hydrogen
bond analysis, and secondary structure.

Results:

The simulations revealed that the N52R mutant disrupts the stability and folding of
SHANK3, affecting intramolecular contacts between SPN and ARR. This disruption opens up the
distance between SPN and ARR domains, potentially influencing the protein's interactions with
partners, including αCaMKII and α-Fodrin. The altered conformation of the SPN-ARR tandem in
the N52R mutant suggests a potential impact on dendritic spine shape and synaptic plasticity.

Conclusion:

The findings shed light on the structural consequences of the N52R mutation in
SHANK3, emphasizing its role in influencing intramolecular interactions and potential effects on
synaptic function. Understanding these molecular dynamics contributes to unraveling the intricate
relationship between genetic variations in SHANK3 and clinical traits associated with ASD. Further
investigations are warranted to explore the physiological implications of these structural alterations
in vivo.
Design, Synthesis, Biological and in silico Evaluation of Novel Indazole-pyridine Hybrids for the Treatment of Breast Cancer
Authors: Panchal Ishan , Tripathi Rati Kailash Prasad , Yadav Mange Ram , Valera Meet , Parmar Kinjal
Published: August 2024

Introduction:

The prevalence of breast cancer presents a substantial global health
concern, underscoring the ongoing need for the development of inventive therapeutic remedies

Methods:

In this investigation, an array of novel indazole-pyridine hybrids (5a-h) have been
designed and synthesized to assess their potential as candidates for treating breast cancer. Subsequently,
we have conducted biological evaluations to determine their cytotoxic effects on the
human MCF-7 breast cancer cell line. Furthermore, in silico analysis was conducted to estimate
the inhibition potential of the compounds against TrkA (Tropomyosin receptor kinase A), a specific
molecular target associated with breast cancer, through molecular docking. In silico physicochemical
and pharmacokinetic predictions were made to assess the compounds’ drug-like
properties.

Results:

Compound 5a emerged as the most active compound among the others with GI50 < 10
μg/ml. Besides, compound 5a showed high binding energy (BE -10.7 kcal/mol) against TrkA
and was stabilized within the TrkA binding pocket through hydrophobic, H-bonding, and van
der Waals interactions. In silico physicochemical and pharmacokinetic prediction studies indicated
that compound 5a obeyed both Lipinski’s and Veber’s rule and displayed a versatile
pharmacokinetic profile, implying compound 5a to appear as a viable candidate and that it could
be further refined to develop therapeutic agents for potentially treating breast cancer.

Conclusion:

This study offers a promising direction for the advancement of innovative breast
cancer treatments, highlighting the effectiveness of indazole-pyridine hybrids as potential anticancer
agents. Further optimization and preclinical development are necessary to advance these
compounds to clinical trials.
Methimazole-Induced Pancytopenia in a Patient with Graves' Disease:
A Case Report and Literature Review
Authors: Concepción-Zavaleta Marcio José , Quiroz-Aldave Juan Eduardo , Rivera Fabián Katia Eugenia , Ildefonso-Najarro Sofía Pilar , Moscol Chavez Karol Magdalena , Concepción-Urteaga Luis Alberto , Paz-Ibarra José
Published: August 2024

Introduction:

Methimazole is an antithyroid drug known to cause hematological toxicity,
including agranulocytosis and, very rarely, pancytopenia. We herein present a case of a patient
with Graves' Disease (GD) who developed methimazole-induced pancytopenia.

Case Report:

A 53-year-old Peruvian woman with GD, initially treated with methimazole 20 mg
BID, experienced odynophagia, fever, and malaise after 37 days of treatment. The initial diagnosis
was agranulocytosis, leading to the discontinuation of methimazole and initiation of antibiotics.
Due to persistent neutropenia, a Granulocyte Colony-stimulating Factor (G-CSF) was administered.
Eight days later, she developed pancytopenia and was managed with hematopoietic
agents and platelet transfusions. The patient recovered with normalization of the blood count,
eliminating the need for Bone Marrow (BM) examination. Radioiodine therapy was chosen as
the definitive treatment, resulting in hypothyroidism. Currently, the patient is thyroidal and hematologically
stable.

Conclusion:

Methimazole-induced pancytopenia is a rare and serious complication; however,
with appropriate treatment, complete recovery can be achieved.
Vanek's Tumour as a Rare Cause of Dyspeptic Syndrome in a Patient with Primary Biliary Cholangitis: A Case Report
Authors: Gravina Antonietta Gerarda , Pellegrino Raffaele , Romeo Mario , Cipullo Marina , Lucà Stefano , Panarese Iacopo , Federico Alessandro
Published: August 2024

Background:

Inflammatory Fibroid Polyp (IFP), also known as Vanek’s tumour, is a
rare mesenchymal gastrointestinal tumour, potentially causing a wide range of clinical manifestations
(even though it can be completely asymptomatic) primarily related to the location of the formation.
The available evidence suggests a fundamentally non-neoplastic behaviour of IFP.

Case Presentation:

A 67-year-old female was presented with persistent dyspepsia despite symptomatic
therapy. The patient's medical history included primary biliary cholangitis, managed with ursodeoxycholic
acid, non-haemorrhagic uterine fibroids, and right knee arthrosis. Clinical examination
revealed mild epigastric tenderness, and esophagogastroduodenoscopy identified a sessile mucosal
formation. Histological analysis of biopsy samples revealed a gastric hyperplastic polyp,
leading to a subsequent esophagogastroduodenoscopy for polypectomy. The excised specimen
confirmed the diagnosis of gastric IFP. Post-polypectomy, the patient experienced progressive
symptom amelioration, leading to complete resolution within three weeks.

Discussion:

This case thus describes a rare cause of dyspeptic syndrome associated with the presence
of a gastric IFP, promptly managed and resolved after endoscopic removal of the polyp, with
no histological signs of neoplasia within the en bloc resected sample.

Conclusion:

IFP is a possible and rare cause of dyspeptic syndrome. There remain significant challenges
in diagnosing this rare condition, which lacks pathognomonic or specific signs and symptoms
of its presence (especially when it causes symptoms). Endoscopy, when feasible, remains a
cornerstone in the resective management of such lesions.
Research Progress on Compounds with Antioxidant Activity Derived from Microorganisms
Authors: Chen Ning , Chu Junyao , Liu Bing , Zhu Ting , Wang Yuxin , Li Ting
Published: August 2024

Microbial derivatives are a significant source of antioxidants, with varying structures
leading to different activities due to distinct structure-activity relationships. These structures include
polyketones, alkaloids, terpenes, and fatty acids. Microbial-derived antioxidants offer
unique advantages, such as diversity, high yield, customizability, sustainability, and biocompatibility,
making them promising for various applications. This review aims to address the following
objectives: (1) to explore the antioxidant activities of microbial derivatives with these specific
structures, (2) to detail their biosynthesis processes, and (3) to lay the groundwork for their
further utilization and development in diverse fields.
Recent Updates on Novel Carrier Systems for the Delivery of Herbal Bioactives with Poor Bioavailability and their Clinical Trial Status
Authors: Yadav Swati , Harwansh Ranjit K. , Mazumder Rupa
Published: August 2024

Herbal medicine and its active phytochemicals have been used since ancient times to
cure, mitigate, and treat various health issues, such as inflammation, wounds, fever, cough, cold,
diabetes, viral diseases, cancers, etc. Different databases, such as Scopus, Google Scholar,
Pubmed, Pubchem, and ScienceDirect, were searched exhaustively to find potent herbal leads and
their novel carrier systems. Literature was collected from these databases for the last twenty years.
Various research articles, review articles, books, and patents were referred for screening of the herbal
bioactives. In the recent past, herbal medicine-derived bioactives like curcumin, paclitaxel, catechin,
betulinic acid, ferulic acid, gallic acid, rutin, quercetin, resveratrol, glycyrrhizin, silybin,
berberine and many more have been reported for several pharmacological activities, including anticancer,
antidiabetic, hepatoprotective, antioxidant, antiinflammatory, antipyretic, antimicrobial,
etc. However, they have limitations like low aqueous solubility and poor bioavailability, which restrict
their therapeutic efficacy and clinical use. In this context, Novel Carrier Systems (NCSs) are
promising to overcome the problems of herbal bioactives. NCSs, such as liposomes, nanoparticles,
nanocapsules, solid lipid nanoparticles, nanostructured lipid carriers, dendrimers, nanoemulsions,
phytosomes, transfersomes, ethosomes, etc., have been utilized to encapsulate the bioactives
and drugs to enhance their solubility, permeability, elimination half-life, bioavailability, pharmacokinetics,
and therapeutic efficacy. Moreover, they protect the drugs/herbal bioactive from the
gastric environment and minimize the dose-associated toxicity. Recent advances in the various approaches,
including new methodology, analytical techniques, delivery mechanism, materials, loading
capacity, encapsulation efficiency, and in vitro and in vivo models, were considered in the
compilation of this review article. It was found that NCSs are pioneering in drug delivery and targeting.
The present study highlights the importance of herbal bioactives, advanced NCSs, patents,
and their clinical trial status.
Relación no-lineal generalizada altura total-diámetro normal para Pinus greggii y Pinus pseudostrobus en Oaxaca, México
Authors: Guzmán-Santiago Juan Carlos , Vargas-Larreta Benedicto , Nájera-Luna Juan Abel , Cruz-Cobos Francisco , Gómez-Cárdenas Marín , González-Cubas Rigoberto , Hernández-Aguilar José Antonio
Published: August 2024

La altura total de los árboles es una variable importante en la silvicultura y manejo forestal, pero la medición en campo es difícil y costosa, incluso se cometen errores que alteran su dimensión y registro. El objetivo de este estudio fue encontrar la mejor ecuación generalizada no lineal para describir la relación altura-diámetro normal para las plantaciones de Pinus greggii y Pinus pseudostrobus en la Mixteca Oaxaqueña. Se utilizó una muestra de 1180 árboles, midiéndose el diámetro normal (dn) y altura (At), asimismo se determinaron variables de rodal. Se evaluaron seis ecuaciones que se ajustaron sin el intercepto 1.30 m que corresponde al dn; la mejor ecuación se seleccionó mediante un análisis cuantitativo y gráfico. La ecuación de Omule y MacDonald fue ligeramente mejor que el resto en las estimaciones y en los análisis gráficos para describir el comportamiento de la altura de los árboles, cumpliendo con los supuestos de normalidad, homogeneidad de varianza e independencia de residuos. La ecuación seleccionada explicó más de 90% de la variabilidad total de las alturas, con una raíz del error medio cuadrático que osciló entre 0.470 m y 0.600 m y sesgos de -0.051 m a 0.022 m para ambas especies. Esta es la primera ecuación de este tipo que se desarrolla para las especies en la zona, por lo que su aplicación será útil en los inventarios forestales.
Development of national economic systems in the context of transformation of globalization and regionalization processes
Authors: Plotnikov V. A. , Pshenichnikova S. N. , Fedotov V. A.
Published: August 2024

Relevance. In the context of the formation of a multipolar world and the increasing sanctions pressure from unfriendly countries, Russia needs to adjust the models of integration into the system of world economic relations. In this context, an in-depth analysis of the mechanisms of internationalization, globalization and regionalization is required.

The purpose is to consider the peculiarities of the impact of globalization and regionalization processes on national economies, taking into account the transformation of their internationalization models.

Objectives: to consider the concepts of internationalization, regionalization and globalization, to identify their relationship; to identify the advantages and disadvantages of globalization, on the basis of which to describe the directions of transformation of forms of internationalization of economies; based on the analysis of available statistical data, to identify promising areas of integration of the national economy into the system of world economic relations.

Methodology. The methods of quantitative and qualitative analysis, monographic and retrospective analysis, methods of comparing economic phenomena and processes, methods of abstraction, generalization of analyzed economic information are used.

Results. The internationalization of national economies is a long-term sustainable trend. Their development is confirmed by sufficiently convincing quantitative data. Recently, the dynamics of the corresponding time series has become unstable, volatile and turbulent, with a tendency to decrease the level of indicators. There are transformations of the processes of globalization and regionalization, they acquire not only a new quality, but also institutional consolidation.

Conclusions. The traditional model of globalization has exhausted itself. Due to the formation of a multipolar political and economic global space, in addition to the "center" and "periphery", countries of the "semi-periphery" stand out in it. They have sufficient economic sovereignty to refuse to participate in globalization projects, the balance of effects of which for these countries becomes negative. Russia is one of these countries. An additional incentive for reconfiguring the Russian model of internationalization of the economy is the anti-Russian sanctions imposed by the countries of the "center". In this regard, it is necessary to open up new opportunities for the national economy to integrate into the global economic space based on models of regionalization and glocalization.
Factor analysis of innovative activity of the regional economic system
Authors: Kudryakov R. I.
Published: August 2024

Relevance. Innovation activity is one of the fundamental indicators of the effectiveness of innovation activity in the region. In the context of external challenges and economic instability, innovation is a fundamental vector of development of the domestic economy. However, the effectiveness of innovation activity is currently reduced due to the influence of risk factors of various etiologies. Therefore, the assessment of the factors influencing the innovative activity of the region determines the relevance and significance of the study.

The purpose is to determine the influence of factors on the innovative activity of the region and its subjects, taking into account the ranking according to the degree of impact and the possibility of a restraining influence on the innovative potential of the region.

Objectives. The following tasks were set and consistently solved in the study: to conduct a theoretical review of the concept of "innovative activity"; to identify factors; to classify and identify the degree of influence on the innovative activity of the region.

Methodology. The paper uses a theoretical review of domestic and foreign authors dealing with the issues of factorial influence on the innovative activity of the region and its subjects. During the research, special methods were used: regression analysis, statistical analysis, expert approach, etc.

Results. Based on the factor analysis, factors were identified, grouped, classified, and the degree of influence on the innovative activity of the region was determined, which helped to identify the cause of problems in the region (using the example of the Vladimir region).

Conclusions. During the study, it was concluded that factor analysis allows us to examine the current state of innovation activity in the region and find the causes that have the greatest destructive effect on the indicator of innovation activity.
Organizational and economic transformations in the agro-industrial complex of the region as part of the implementation of the federal project
Authors: Tkacheva T. Yu. , Belousova S. N. , Erpuleva D. A.
Published: August 2024

Relevance. The agro-industrial complex is one of the key sectors of the country's economy and includes such areas as: agriculture (livestock and crop production), processing of agricultural raw materials, production of fertilizers, chemicals, and feed. The agro-industrial complex works closely with enterprises involved in the transportation, storage, and processing of agricultural products, as a result, any changes in the agro-industrial complex affect the country's economy.

The purpose of the study is to assess the impact of the implementation of the federal project of the Russian Federation “Development of industries and technical modernization of the agro-industrial complex” (hereinafter referred to as the Federal Project) on structural changes in the agro-industrial complex.

Objectives: consideration of the objectives of the Federal project, its financial support for 2022-2024, analysis and assessment of economic and statistical indicators, identification and consideration of current problems within the framework of the project.

Methodology. The information base of the study consisted of official regulations, works of domestic researchers in the field of agriculture, collections of articles with collective authors, articles from magazines, statistical data, official websites of relevant departments and ministries.

Results. There are many problems in the development of the Russian agro-industrial complex, but there are also many promising areas for its development. These prospects are determined primarily by state policy in the field of supporting agriculture, the goal of which is the development of Russian farmers and increasing their role in the domestic and foreign markets.

Conclusions. A promising direction for the development of the agro-industrial complex is the revision of the entire financing system in order to provide business executives with funds for the purchase of mineral fertilizers, fuels and lubricants, materials, and high-quality feed in the volumes necessary for efficient production. Also requiring attention are such pressing issues as increasing wages for agricultural workers, which will attract young specialists to the village and, thereby, resolve the issue of shortage of qualified personnel.
Optimization of the process of communication with customers when organizing sales on Internet platforms
Authors: Shamina O. V. , Paderina K. S.
Published: August 2024

Relevance. Currently, the field of online trading on Internet platforms is actively developing. Online resources allow customers to familiarize themselves with the assortment, read reviews based on them and personal preferences, make a choice and, in general, make purchases without leaving home. Marketplaces are becoming the main platform for online sales.

The purpose of the research is to develop a model for optimizing the process of communication with customers when organizing sales on Internet platforms.

Objectives: to study the theoretical aspects of the concept of "communication process in the marketplace"; to identify the key problems of the communication process between customers and the seller on the marketplace, to develop a project to optimize the business process of "Communication between customer and seller" in RTK; to form recommendations for optimizing the process of processing information from customers.

Methodology. The research is aimed at implementing the tasks set and is based on a review of scientific research by national and international market participants and a statistical analysis of the functioning of online trading platforms.

Results. During the analysis of the work of the communications department of RTK LLC, a method for automating the communication process between customers and the seller was proposed, namely, optimizing the process of processing customer feedback, while implementing an automated software product.

Conclusions. There are a huge number of technologies that can be implemented into the work of brands engaged in sales on the marketplace, and now this is becoming the most relevant, as the number of sellers in the market increases and competition between them becomes stronger. Mastering new digital technologies will allow trading companies to radically change the business ecosystem, make it faster and more efficient in order to meet the changing needs of customers.

Optimizing the process of communication with customers when organizing sales on Internet platforms will help reduce time costs and increase the efficiency of sales organizations.
Migration agenda of the Kaliningrad region in the context of socio-economic development of Russia
Authors: Abramov A. P. , Gavrikov F. A.
Published: August 2024

Relevance. The socio-economic context of the importance of migration policy is represented by a wide range of areas. First of all, the intensity of migration processes significantly correlates with the state of the labor market, influencing the balance of supply and demand. The relevance of the research topic is due to the importance of migration policy, both for the socio-economic development of the state and for ensuring national security in the strategic management horizon. The importance of building an effective migration policy has a significant level of importance for modern Russia. Taking into account the author’s position, the geopolitical situation and the retrospective history of international communications make Russia the center of gravity of migration flows, which requires the establishment of high-quality control not only over their intensity, but also over their structural content.

The purpose is to determine the most effective tools for improving migration policy, taking into account territorial specifics.

Objectives: to clarify the theoretical and methodological aspects of the implementation of state migration policy in Russia; reveal the features, analytical indicators and organizational mechanisms for implementing migration policy in Russia, taking into account the territorial specifics of the Kaliningrad region.

Methodology. The methodological “portfolio” of the study is built on the basis of the provisions of socioeconomic theories of migration process management using quantitative methods of data collection and analysis.

Results. A targeted analysis was carried out, as a result of which effective tools were identified for improving migration policy in the Kaliningrad region based on the adaptation of the universal migration project in the Kaliningrad city management system, creating the prerequisites for increasing its effectiveness and achieving target indicators.

Conclusion. Improving migration policy is an objective necessity in order to solve a number of socio-economic problems and minimize risks to national security.
Substantiation of theoretical and methodological approaches to the determination of economic efficiency
Authors: Krakhina V. A.
Published: August 2024

Relevance. An analysis of the problems of modern science and practice shows that the process of transition from one model of economic development to another, better one, implies the emergence of a number of phenomena characteristic of a market economy. For example, such a concept as “economic efficiency”. This concept is used by almost all business entities at different levels, since it allows quantitative and qualitative assessment of the condition of the object. Scientists from different times have studied this concept; accordingly, there are different interpretations and methods for determining economic efficiency. The works contain completely different interpretations of the concept under consideration, implying its different properties and elements. The situation is caused by the versatility and multidimensionality of this concept. Therefore, the formation of modern approaches to determining economic efficiency, which will sufficiently correspond to the general theory of performance management and modern requirements of the economy and society, is extremely necessary.

The purpose is to substantiate theoretical and methodological approaches to determining economic efficiency.

Objectives: consider the concept of “efficiency”; establish the relationship between “efficiency” and the concepts of “effect” and “effectiveness”; identify common and distinctive features of these concepts; determine the essence of economic efficiency; consider the main approaches to evaluating effectiveness.

Methodology: comparative analysis, methods of induction and deduction, analysis and synthesis, logical analysis.

Results. The article discusses the concept of “efficiency”, their relationship with the concepts of “effect” and “effectiveness”. The general and distinctive features of these concepts are established, the essence of economic efficiency is determined, and the main approaches to their assessment are considered.

Conclusions. As a result of the work carried out, it was substantiated that economic efficiency consists of such elements as: the ability to assess the degree of achievement of the set goal, both from a quantitative and qualitative point of view; the need to use a systematic approach to calculate economic efficiency; taking into account the time factor and the limitation of all resources necessary to calculate economic efficiency.
Diversification of the concept of foreign economic activity of russian banks in the new economic conditions Yulia S. Polozhentseva1
Authors: Polozhentseva Yu. S. , Logvinova I. O.
Published: August 2024

Relevance. Russian banks actively participate in international trade and economic relations. However, taking into account geopolitical and economic changes, such as sanctions and changes in trade blocs, banks need to develop strategies for effective expansion of their activities at the international level. Business planning for the geographical development of foreign trade will help banks to adapt to new market conditions, determine optimal strategies and resources for the development of export-import operations, as well as minimize risks and increase competitiveness on the world stage..

The purpose is to conduct a comprehensive study of the possibilities of geographical development of the foreign economic activity of Russian banks..

Objectives: analyze regional markets for their potential; to determine the main advantages and disadvantages of the activity of foreign trade of Russian banks; will identify the peculiarities of the bank's exit to the new dawn within the framework of foreign trade, draw up a business plan and determine the criteria for the success of the project.

Methodology. In the process of research, general scientific methods of logical and statistical analysis, field research, as well as qualitative and quantitative analysis were used.

Results. 10 Russian banks, their foreign trade development strategy and future prospects were considered. The regions in which the opening of a bank branch will be the most successful for foreign trade have been identified: Tatarstan, Primorsky Krai, Kaliningrad Oblast, Yekaterinburg. A business plan for entering a new regional market for a bank with a focus on foreign trade has been drawn up, taking into account industry specifics.

Conclusion. The foreign trade development strategy allows banks to expand their client base, increase their global presence and provide their clients with access to international financial services.
The role of artificial intelligence in ensuring the effective functioning of business processes: current state and prospects
Authors: Pyanova N. V. , Stolyarova E. A. , Pyanov R. R. , Kryzhanovskaya O. A.
Published: August 2024

Relevance. Artificial intelligence (AI) has become one of the most discussed and rapidly developing technologies in recent years. Its potential and capabilities have a significant impact on various spheres of life, including business. AI algorithms are used to analyze huge amounts of data and make forecasts, which helps companies make more efficient and rational decisions.

The purpose is to study the main trends in the use of artificial intelligence in business and determine its potential and advantages.

Objectives: to consider various aspects of the use of AI in business, to investigate its impact on the efficiency and effectiveness of business processes, as well as to identify the challenges and limitations associated with the use of this technology.

Methodology.The research methodology includes empirical and analytical methods, statistical analysis is also used, revealing the features of the introduction of artificial intelligence in the business sphere.

Results. It has been revealed that the main areas of application of artificial intelligence in business are sales and communication with customers, marketing, content creation, and personnel management. The important aspects that companies should pay attention to when implementing artificial intelligence are indicated.

Conclusions. The results of the study showed that artificial intelligence (AI) has huge potential to improve business efficiency and productivity. Data security is a key aspect when using AI in business. Companies should pay special attention to the protection of information, ensuring confidentiality and data integrity. It is also important to keep in mind the ethical aspects of using AI in business, such as fairness, transparency and responsibility for decisions.
Using Discrete-Event Simulation to Model Web-Based Crisis Counseling Service Operation: Evaluation Study
Authors: Chiang Byron , Law Yik Wa , Yip Paul Siu Fai
Published: August 2024

Background

According to the Organisation for Economic Co-operation and Development, its member states experienced worsening mental health during the COVID-19 pandemic, leading to an increase of 60% to 1000% in digital counseling access. Hong Kong, too, witnessed a surge in demand for crisis intervention services during the pandemic, attracting both nonrepeat and repeat service users during the process. As a result of the continuing demand, platforms offering short-term emotional support are facing an efficiency challenge in managing caller responses.

Objective

This aim of this paper was to assess the queuing performance of a 24-hour text-based web-based crisis counseling platform using a Python-based discrete-event simulation (DES) model. The model evaluates the staff combinations needed to meet demand and informs service priority decisions. It is able to account for unbalanced and overlapping shifts, unequal simultaneous serving capacities among custom worker types, time-dependent user arrivals, and the influence of user type (nonrepeat users vs repeat users) and suicide risk on service durations.

Methods

Use and queue statistics by user type and staffing conditions were tabulated from past counseling platform database records. After calculating the data distributions, key parameters were incorporated into the DES model to determine the supply-demand equilibrium and identify potential service bottlenecks. An unobserved-components time-series model was fitted to make 30-day forecasts of the arrival rate, with the results piped back to the DES model to estimate the number of workers needed to staff each work shift, as well as the number of repeat service users encountered during a service operation.

Results

The results showed a marked increase (from 3401/9202, 36.96% to 5042/9199, 54.81%) in the overall conversion rate after the strategic deployment of human resources according to the values set in the simulations, with an 85% chance of queuing users receiving counseling service within 10 minutes and releasing an extra 39.57% (3631/9175) capacity to serve nonrepeat users at potential risk.

Conclusions

By exploiting scientifically informed data models with DES, nonprofit web-based counseling platforms, even those with limited resources, can optimize service capacity strategically to manage service bottlenecks and increase service uptake.
Effects of a Digital Care Pathway for Multiple Sclerosis: Observational Study
Authors: Vesinurm Märt , Maunula Anna , Olli Päivi , Lillrank Paul , Ijäs Petra , Torkki Paulus , Mäkitie Laura , Laakso Sini M
Published: August 2024

Background

Helsinki University Hospital has developed a digital care pathway (DCP) for people with multiple sclerosis (MS) to improve the care quality. DCP was designed for especially newly diagnosed patients to support adaptation to a chronic disease.

Objective

This study investigated the MS DCP user behavior and its impact on patient education-mediated changes in health care use, patient-perceived impact of MS on psychological and physical functional health, and patient satisfaction.

Methods

We collected data from the service launch in March 2020 until the end of 2022 (observation period). The number of users, user logins, and their timing and messages sent were collected. The association of the DCP on health care use was studied in a case-control setting in which patients were allowed to freely select whether they wanted to use the service (DCP group n=63) or not (control group n=112). The number of physical and remote appointments either to a doctor, nurse, or other services were considered in addition to emergency department visits and inpatient days. The follow-up time was 1 year (study period). Furthermore, a subgroup of 36 patients was recruited to fill out surveys on net promoter score (NPS) at 3, 6, and 12 months, and their physical and psychological functional health (Multiple Sclerosis Impact Scale) at 0, 3, 6, and 12 months.

Results

During the observation period, a total of 225 patients had the option to use the service, out of whom 79.1% (178/225) logged into the service. On average, a user of the DCP sent 6.8 messages and logged on 7.4 times, with 72.29% (1182/1635) of logins taking place within 1 year of initiating the service. In case-control cohorts, no statistically significant differences between the groups were found for physical doctors’ appointments, remote doctors’ contacts, physical nurse appointments, remote nurse contacts, emergency department visits, or inpatient days. However, the MS DCP was associated with a 2.05 (SD 0.48) visit increase in other services, within 1 year from diagnosis. In the prospective DCP-cohort, no clinically significant change was observed in the physical functional health between the 0 and 12-month marks, but psychological functional health was improved between 3 and 6 months. Patient satisfaction improved from the NPS index of 21 (favorable) at the 3-month mark to the NPS index of 63 (excellent) at the 12-month mark.

Conclusions

The MS DCP has been used by a majority of the people with MS as a complementary service to regular operations, and we find high satisfaction with the service. Psychological health was enhanced during the use of MS DCP. Our results indicate that DCPs hold great promise for managing chronic conditions such as MS. Future studies should explore the potential of DCPs in different health care settings and patient subgroups.
Patients’ Attitudes Toward the Use of Artificial Intelligence as a Diagnostic Tool in Radiology in Saudi Arabia: Cross-Sectional Study
Authors: Baghdadi Leena R , Mobeirek Arwa A , Alhudaithi Dania R , Albenmousa Fatimah A , Alhadlaq Leen S , Alaql Maisa S , Alhamlan Sarah A
Published: August 2024

Background

Artificial intelligence (AI) is widely used in various medical fields, including diagnostic radiology as a tool for greater efficiency, precision, and accuracy. The integration of AI as a radiological diagnostic tool has the potential to mitigate delays in diagnosis, which could, in turn, impact patients’ prognosis and treatment outcomes. The literature shows conflicting results regarding patients’ attitudes to AI as a diagnostic tool. To the best of our knowledge, no similar study has been conducted in Saudi Arabia.

Objective

The objectives of this study are to examine patients’ attitudes toward the use of AI as a tool in diagnostic radiology at King Khalid University Hospital, Saudi Arabia. Additionally, we sought to explore potential associations between patients’ attitudes and various sociodemographic factors.

Methods

This descriptive-analytical cross-sectional study was conducted in a tertiary care hospital. Data were collected from patients scheduled for radiological imaging through a validated self-administered questionnaire. The main outcome was to measure patients’ attitudes to the use of AI in radiology by calculating mean scores of 5 factors, distrust and accountability (factor 1), procedural knowledge (factor 2), personal interaction and communication (factor 3), efficiency (factor 4), and methods of providing information to patients (factor 5). Data were analyzed using the student t test, one-way analysis of variance followed by post hoc and multivariable analysis.

Results

A total of 382 participants (n=273, 71.5% women and n=109, 28.5% men) completed the surveys and were included in the analysis. The mean age of the respondents was 39.51 (SD 13.26) years. Participants favored physicians over AI for procedural knowledge, personal interaction, and being informed. However, the participants demonstrated a neutral attitude for distrust and accountability and for efficiency. Marital status was found to be associated with distrust and accountability, procedural knowledge, and personal interaction. Associations were also found between self-reported health status and being informed and between the field of specialization and distrust and accountability.

Conclusions

Patients were keen to understand the work of AI in radiology but favored personal interaction with a radiologist. Patients were impartial toward AI replacing radiologists and the efficiency of AI, which should be a consideration in future policy development and integration. Future research involving multicenter studies in different regions of Saudi Arabia is required.
Exploring the Experiences of Community-Dwelling Older Adults on Using Wearable Monitoring Devices With Regular Support From Community Health Workers, Nurses, and Social Workers: Qualitative Descriptive Study (Preprint)
Authors: Wong Arkers Kwan Ching , Bayuo Jonathan , Su Jing Jing , Chow Karen Kit Sum , Wong Siu Man , Wong Bonnie Po , Lee Athena Yin Lam , Wong Frances Kam Yuet
Published: August 2024

BACKGROUND

The use of wearable monitoring devices (WMDs), such as smartwatches, is advancing support and care for community-dwelling older adults across the globe. Despite existing evidence of the importance of WMDs in preventing problems and promoting health, significant concerns remain about the decline in use after a period of time, which warrant an understanding of how older adults experience the devices.

OBJECTIVE

This study aims to explore and describe the experiences of community-dwelling older adults after receiving our interventional program, which included the use of a smartwatch with support from a community health workers, nurses, and social workers, including the challenges that they experienced while using the device, the perceived benefits, and strategies to promote their sustained use of the device.

METHODS

We used a qualitative descriptive approach in this study. Older adults who had taken part in an interventional study involving the use of smartwatches and who were receiving regular health and social support were invited to participate in focus group discussions at the end of the trial. Purposive sampling was used to recruit potential participants. Older adults who agreed to participate were assigned to focus groups based on their community. The focus group discussions were facilitated and moderated by 2 members of the research team. All discussions were recorded and transcribed verbatim. We used the constant comparison analytical approach to analyze the focus group data.

RESULTS

A total of 22 participants assigned to 6 focus groups participated in the study. The experiences of community-dwelling older adults emerged as (1) challenges associated with the use of WMDs, (2) the perceived benefits of using the WMDs, and (3) strategies to promote the use of WMDs. In addition, the findings also demonstrate a hierarchical pattern of health-seeking behaviors by older adults: seeking assistance first from older adult volunteers, then from social workers, and finally from nurses.

CONCLUSIONS

Ongoing use of the WMDs is potentially possible, but it is important to ensure the availability of technical support, maintain active professional follow-ups by nurses and social workers, and include older adult volunteers to support other older adults in such programs.
Effects of a Digital Care Pathway for Multiple Sclerosis: Observational Study (Preprint)
Authors: Vesinurm Märt , Maunula Anna , Olli Päivi , Lillrank Paul , Ijäs Petra , Torkki Paulus , Mäkitie Laura , Laakso Sini M
Published: August 2024

BACKGROUND

Helsinki University Hospital has developed a digital care pathway (DCP) for people with multiple sclerosis (MS) to improve the care quality. DCP was designed for especially newly diagnosed patients to support adaptation to a chronic disease.

OBJECTIVE

This study investigated the MS DCP user behavior and its impact on patient education-mediated changes in health care use, patient-perceived impact of MS on psychological and physical functional health, and patient satisfaction.

METHODS

We collected data from the service launch in March 2020 until the end of 2022 (observation period). The number of users, user logins, and their timing and messages sent were collected. The association of the DCP on health care use was studied in a case-control setting in which patients were allowed to freely select whether they wanted to use the service (DCP group n=63) or not (control group n=112). The number of physical and remote appointments either to a doctor, nurse, or other services were considered in addition to emergency department visits and inpatient days. The follow-up time was 1 year (study period). Furthermore, a subgroup of 36 patients was recruited to fill out surveys on net promoter score (NPS) at 3, 6, and 12 months, and their physical and psychological functional health (Multiple Sclerosis Impact Scale) at 0, 3, 6, and 12 months.

RESULTS

During the observation period, a total of 225 patients had the option to use the service, out of whom 79.1% (178/225) logged into the service. On average, a user of the DCP sent 6.8 messages and logged on 7.4 times, with 72.29% (1182/1635) of logins taking place within 1 year of initiating the service. In case-control cohorts, no statistically significant differences between the groups were found for physical doctors’ appointments, remote doctors’ contacts, physical nurse appointments, remote nurse contacts, emergency department visits, or inpatient days. However, the MS DCP was associated with a 2.05 (SD 0.48) visit increase in other services, within 1 year from diagnosis. In the prospective DCP-cohort, no clinically significant change was observed in the physical functional health between the 0 and 12-month marks, but psychological functional health was improved between 3 and 6 months. Patient satisfaction improved from the NPS index of 21 (favorable) at the 3-month mark to the NPS index of 63 (excellent) at the 12-month mark.

CONCLUSIONS

The MS DCP has been used by a majority of the people with MS as a complementary service to regular operations, and we find high satisfaction with the service. Psychological health was enhanced during the use of MS DCP. Our results indicate that DCPs hold great promise for managing chronic conditions such as MS. Future studies should explore the potential of DCPs in different health care settings and patient subgroups.

CLINICALTRIAL
The Potentials of Large Language Models Application in Dermatology Consulting: Starting with Acne Care (Preprint)
Authors: Ji Liyuan , Liu Yanlin , Wang Jiayi , Chen Yifan
Published: August 2024

BACKGROUND

Effective dermatological practices are essential for maintaining healthy skin and addressing health concerns such as acne. Traditional dermatological consultations often face limitations, including accessibility, cost, and variability in expertise. The potential application of Large Language Models (LLMs) in healthcare, particularly for dermatology, is an area of growing interest.

OBJECTIVE

This study aims to evaluate the feasibility of utilizing various mainstream LLMs, including GPT-3.5-turbo, GPT-4, and GPT-4o, as consultants for acne-related health concerns. The primary objective is to determine whether these models can deliver accurate, relevant, and competitive solutions in line with professional dermatological standards. Additionally, the study compares the performance of these models, to identify which offers the best overall performance for acne management consultations.

METHODS

Real human question data were sourced from major social media platforms, health forums, and dermatology clinics. Personally Identifiable Information (PII) filtering was applied when selecting 37 related questions to ensure privacy compliances. Each LLM generated responses three times. An automated evaluation system using GPT-4o assessed the responses based on ten criteria: accuracy of terminology, evidence support, factual correctness, completeness, ethical considerations, practicality, safety advice, tone, personalization, and up-to-date information. Each response was categorized as Pass, Fail, or Ignore.

RESULTS

The evaluation revealed high performance of GPT-3.5-turbo, GPT-4, and GPT-4o in accuracy, with pass rates for correct terminology (95.20%), evidence support (99.10%), and factual correctness (96.10%). Limitations were observed in personalization (24.62%), safety advice (76.88%), and up-to-date information (75.98%). A comparative analysis showed that GPT-4 generally outperformed GPT-3.5-turbo and GPT-4o in most criteria, achieving higher completeness (91.89%) and ethical considerations (97.30%). GPT-4 excelled in tailoring recommendations to individual profiles. In contrast, GPT-4o demonstrated the highest accuracy.

CONCLUSIONS

All models demonstrated strong performance in accuracy, ethical considerations, and providing polite and respectful responses. However, the models showed limitations in personalization and safety advice. Overall, GPT models at the current stage demonstrated the capability in initial dermatological consultations and assist patient as a self-explanatory tool, but ongoing enhancements are necessary to address their current shortcomings and ensure even more reliable and effective performance in the future.

CLINICALTRIAL