bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancing Performance of the National Field Triage Guidelines Using Machine Learning: Development of a Prehospital Triage Model to Predict Severe Trauma (Preprint)
Authors: Chen Qi , Qin Yuchen , Jin Zhichao , Zhao Xinxin , He Jia , Wu Cheng , Tang Bihan
Published: April 2024

BACKGROUND

Prehospital trauma triage is essential to get the right patient to the right hospital. However, the national field triage guidelines proposed by the American College of Surgeons have proven to be relatively insensitive when identifying severe traumas.

OBJECTIVE

This study aimed to build a prehospital triage model to predict severe trauma and enhance the performance of the national field triage guidelines.

METHODS

This was a multisite prediction study, and the data were extracted from the National Trauma Data Bank between 2017 and 2019. All patients with injury, aged 16 years of age or older, and transported by ambulance from the injury scene to any trauma center were potentially eligible. The data were divided into training, internal, and external validation sets of 672,309; 288,134; and 508,703 patients, respectively. As the national field triage guidelines recommended, age, 7 vital signs, and 8 injury patterns at the prehospital stage were included as candidate variables for model development. Outcomes were severe trauma with an Injured Severity Score ≥16 (primary) and critical resource use within 24 hours of emergency department arrival (secondary). The triage model was developed using an extreme gradient boosting model and Shapley additive explanation analysis. The model’s accuracy regarding discrimination, calibration, and clinical benefit was assessed.

RESULTS

At a fixed specificity of 0.5, the model showed a sensitivity of 0.799 (95% CI 0.797-0.801), an undertriage rate of 0.080 (95% CI 0.079-0.081), and an overtriage rate of 0.743 (95% CI 0.742-0.743) for predicting severe trauma. The model showed a sensitivity of 0.774 (95% CI 0.772-0.776), an undertriage rate of 0.158 (95% CI 0.157-0.159), and an overtriage rate of 0.609 (95% CI 0.608-0.609) when predicting critical resource use, fixed at 0.5 specificity. The triage model’s areas under the curve were 0.755 (95% CI 0.753-0.757) for severe trauma prediction and 0.736 (95% CI 0.734-0.737) for critical resource use prediction. The triage model’s performance was better than those of the Glasgow Coma Score, Prehospital Index, revised trauma score, and the 2011 national field triage guidelines RED criteria. The model’s performance was consistent in the 2 validation sets.

CONCLUSIONS

The prehospital triage model is promising for predicting severe trauma and achieving an undertriage rate of <10%. Moreover, machine learning enhances the performance of field triage guidelines.
Dropout in a Longitudinal Survey of Amazon Mechanical Turk Workers With Low Back Pain: Observational Study (Preprint)
Authors: Qureshi Nabeel , Hays Ron D , Herman Patricia M
Published: April 2024

BACKGROUND

Surveys of internet panels such as Amazon’s Mechanical Turk (MTurk) are common in health research. Nonresponse in longitudinal studies can limit inferences about change over time.

OBJECTIVE

This study aimed to (1) describe the patterns of survey responses and nonresponse among MTurk members with back pain, (2) identify factors associated with survey response over time, (3) assess the impact of nonresponse on sample characteristics, and (4) assess how well inverse probability weighting can account for differences in sample composition.

METHODS

We surveyed adult MTurk workers who identified as having back pain. We report participation trends over 3 survey waves and use stepwise logistic regression to identify factors related to survey participation in successive waves.

RESULTS

A total of 1678 adults participated in wave 1. Of those, 983 (59%) participated in wave 2 and 703 (42%) in wave 3. Participants who did not drop out took less time to complete previous surveys (30 min vs 35 min in wave 1, P<.001; 24 min vs 26 min in wave 2, P=.02) and reported having fewer health conditions (5.88 vs 6.6, P<.001). In multivariate models predicting responding at wave 2, lower odds of participation were associated with more time to complete the baseline survey (odds ratio [OR] 0.98, 95% CI 0.97-0.99), being Hispanic (compared with non-Hispanic, OR 0.69, 95% CI 0.49-0.96), having a bachelor’s degree as their terminal degree (compared with all other levels of education, OR 0.58, 95% CI 0.46-0.73), having more pain interference and intensity (OR 0.75, 95% CI 0.64-0.89), and having more health conditions. In contrast, older respondents (older than 45 years age compared with 18-24 years age) were more likely to respond to the wave 2 survey (OR 2.63 and 3.79, respectively) and those whose marital status was divorced (OR 1.81) and separated (OR 1.77) were also more likely to respond to the wave 2 survey. Weighted analysis showed slight differences in sample demographics and conditions and larger differences in pain assessments, particularly for those who responded to wave 2.

CONCLUSIONS

Longitudinal studies on MTurk have large, differential dropouts between waves. This study provided information about the individuals more likely to drop out over time, which can help researchers prepare for future surveys.
Digital nursing quality management: an evolutionary concept analysis (Preprint)
Authors: Han Lin , Bai Xinrui , Zhang Hongyan , An Ning
Published: April 2024

BACKGROUND

Rapid advances in digital technology and its increasing integration into healthcare create an opportunity to leverage these innovations to improve nursing quality management.

OBJECTIVE

This paper aims to report the results of an evolutionary concept analysis of Digital Nursing Quality Management (DNQM).

METHODS

The Rodgers evolutionary method of concept analysis was used to examine the attributes, antecedents, consequences, and related concepts of DNQM.

RESULTS

DNQM is a strategic management approach that systematically uses evolving digital technology to achieve optimal nursing quality, guided by the timeless principle of humanistic care. The defining attributes are human-machine collaboration, interactive empowerment, and a digital ecosystem.

CONCLUSIONS

DNQM is not a mere amalgamation of separate components but a dynamic ecosystem shaped by individual, organizational, and technological factors.

CLINICALTRIAL

Not applicable.

INTERNATIONAL REGISTERED REPORT

RR2-DOI: 10.1101/2023.07.16.23292725
Factors Associated with Accuracy of Large Language Models Artificial Intelligence in Basic Medical Science Examinations: Cross-Sectional Study (Preprint)
Authors: Kaewboonlert Naritsaret , Poontananggul Jiraphon , Pongsuwan Natthipong , Bhakdisongkhram Gun
Published: April 2024

BACKGROUND

Artificial intelligence (AI) is widely applied across several industries, including medical education. The content validation and its answers are based on training datasets and the optimization of each model. The accuracy of large language models (LLMs) AI in basic medical examinations and the factors related to its accuracy have been explored.

OBJECTIVE

Aimed at evaluating factors associated with the accuracy of large language models (ChatGPT, GPT-4, Google Bard, and Microsoft Bing) in answering multiple-choice questions from basic medical science examinations.

METHODS

We employed questions that were closely aligned with the content and topic distribution of Thailand's Step 1 National Medical Licensing Examination. Variables such as the difficulty index, discrimination index, and question characteristics were collected. These questions were then simultaneously input into ChatGPT, GPT-4, Microsoft Bing, and Google Bard, and their responses were recorded. The accuracy of these LLMs and their association factors were analyzed using multivariable logistic regression. This analysis aimed to assess the effect of various factors on model accuracy, with results reported as Odds ratio (OR).

RESULTS

The study revealed GPT-4 as the top-performing model with an overall accuracy of 89.07% (95% CI 84.76 - 92.41), significantly outperforming the others (p < 0.001). Microsoft Bing followed with an accuracy of 83.69% (95% CI 78.85 - 87.80), ChatGPT at 67.02% (95% 61.20 - 72.48), and Google Bard at 63.83% (95% CI 57.92 - 69.44). The multivariable logistic regression showed a correlation between question difficulty and model performance, with GPT-4 demonstrating the strongest association. Interestingly, no significant correlation was found between model accuracy and question length, negative wording, clinical scenarios, or the discrimination index for most models, except for Google Bard, which showed varying correlations.

CONCLUSIONS

The GPT-4 and Microsoft Bing models demonstrated equal and superior accuracy compared to ChatGPT and Google Bard in the domain of basic medical science. The accuracy of these models is significantly influenced by the item's difficulty index (p). Indicating that the LLMs have more accuracy on easier questions. This suggests that the more accurate models, such as GPT-4 and Bing, can be valuable tools for understanding and learning basic medical science concepts.
Mapping Indonesia's South-South Cooperation Initiatives & Potential: Climate Adaptation and Sustainable Development
Authors: Adjani Wulan Kencana
Published: April 2024

Indonesia has committed to the ASEAN Outlook on the Indo-Pacific (AOIP), and one of the commitments includes its efforts to enhance South-South Cooperation (SSC). Within those SSC sectors, one of the most promising sectors are the Climate change aspects such as Agriculture, disaster risk reduction, renewable energy and energy efficiency, forestry, transport, water resources, and waste management. Notably, countries' recognition is growing to utilize SSC as a strategic tool in addressing climate change and achieving their National Development Contributions (NDC). This paper employs qualitative research methods, drawing insights from existing literature and data, to analyse Indonesia's SSC efforts as part of its AOIP commitment. The study sheds light on Indonesia's endeavours to provide SSC within the Indo-Pacific region, considering the political, economic, and strategic benefits of assisting countries in this area. Additionally, it underscores the significance of technological exchange, particularly with countries sharing similar geo-climatic, cultural, and socio-economic conditions, in fostering effective cooperation, particularly within the Climate Change agenda. The study proposes a potential framework for cooperation by aligning each host country's specific needs with an analysis of their NDCs, complemented by the expertise of contributing nations.
Three Concepts of Internationalism in the Global South: Solidarism, Pluralism, and Developmentalism
Authors: Wu Wenbo
Published: April 2024

Throughout modern history, internationalism has been one of the most powerful forces that drives global political changes. While existing research focuses exceptionally on liberal internationalism, studies devoted to internationalism beyond its liberal and Western forms remain relatively scant. Building on a conception that perceives internationalism as a form of human practices, this article explores the evolution of the concept of internationalism in the Global South through a series of political practices from the drafting of the Universal Declaration of Human Rights in 1948 and the 1955 Asian-African Conference in Bandung to the proposal of the New International Economic Order in 1974 and the BRICS’s contestation over NATO’s Libyan intervention in 2011. It is argued that the normative core of internationalism in the Global South is constituted of three major components – pluralism, solidarism, and developmentalism, each in its particular form. Taken together, it envisions an international order rooted in the solidarity of the post-colonial peoples based on their shared colonial past, underpinned by a pluralistic outlook of political life, and places emphasis on redistributive justice in structuring the international economic order. Though some argue that with the rise of the BRICS countries, there will be a revival of Global South internationalism, this article concludes that this is not likely to happen at present.
Extraction of trans-Anethole from Star Anise (Illicium verum) Using Combination of Microwave, Ultrasonic, and Enzyme Assisted Methods and Evaluation of Their Antibacterial Activity
Authors: Iftitah Elvina Dhiaul , Warsito Warsito , Nurhadianty Vivi , Miranda Fitri Ariadna Sodi , Hafidah Rafika Nur
Published: April 2024

This study examines the efficiency of non-conventional extraction methods to obtain trans-anethole from Illicium verum using single and combination extraction techniques: microwave assisted extraction (MAE), ultrasound-assisted extraction (UAE), and enzyme assisted extraction (EAE) employing lipase from Aspergillus oryzae. All extraction methods were conducted using 96% ethanol (1:5 w/v) with varying time durations. The resulting product was an oleoresin, subsequently analyzed and separated using thin liquid chromatography (TLC) and column chromatography employing a solvent mixture of toluene and ethyl acetate in a 9:1 ratio and identified via gas chromatography-mass spectra (GC-MS). The results revealed that trans-anethole yields from a single extraction method were 30.76% (MAE), 41.05% (UAE), and 40.90% (EAE). The combination of extraction methods, such as MAE-UAE, MAE-EAE, and UAE-EAE, produced trans-anethole yields of approximately 42.73%, 52.80%, and 45.02% respectively, surpassing the yields of the single extraction method. Notably, the triple extraction method of MAE-UAE-EAE yielded the highest trans-anethole content at 56.00%. Antibacterial testing against Staphylococcus aureus was performed on all samples. The trans-anethole demonstrating the highest inhibitory effect was obtained from the double extraction method, particularly the combination of UAE-EAE. These results underscore the synergistic efficiency of combining microwave, ultrasound, and enzymatic extraction methods, highlighting their superior efficacy in obtaining trans-anethole.
Preparation, Characterization, and Biological Activity of La(III), Nd(III), Er(III), Gd(III), and Dy(III) Complexes with Schiff Base Resulted from Reaction of 4-Antipyrinecarboxaldehyde and 2-Aminobenzothiazole
Authors: Hussein Kawther Adeeb , Shaalan Naser , Lafta Aliaa Khauon , Al Akeedi Janan Majeed
Published: April 2024

The research includes the preparation of several complexes of the internal transition elements lanthanide (Ln = La, Nd, Er, Gd, and Dy) containing the 4f shell, with Schiff bases resulting from condensation reactions between 4-antipyrinecarboxaldehyde and 2-aminobenzothiazoles. Schiff's base was identified using FTIR spectra, UV-vis spectroscopy, elemental microanalysis CHNSO, nuclear magnetic resonance, mass spectrometry, and TGA thermal analysis. The complexes were studied and identified with elemental microanalysis CHNSO, FTIR spectroscopy, UV-vis spectroscopy, TGA thermal analysis, conductivity measurement, and magnetic sensitivity. The result showed that these complexes were classified as homogeneous bidentate complexes with the general formula of [Ln2(L)2(NO3)6]·6H2O. The physical measurements indicated that the prepared complexes are non-electrolyte and paramagnetic. Some compounds prepared in vitro were evaluated for their antibacterial activity against four types of pathogenic strains Staphylococcus aureus, Bacillus subtilis, Escherichia coli, and Klebsiella pneumonia, and using the agar disc spreading method for the evaluation. The results showed that some of these complexes have good antibacterial activity compared to the biological activity of the ligand. Also, the biological activity of Schiff's base and the prepared complexes were evaluated against three types of fungi (Candida albicans, Tropical fungi, and Scandal fungi), and they showed great activity against the prepared complexes.
Modification of Natural Zeolite from Klaten, Indonesia Using Ammonium Chloride by Ion-Exchange and Its Application as Catalyst in Ethanol Dehydration to Produce Diethyl Ether
Authors: Adila Zaira , Trisunaryanti Wega , Triyono Triyono
Published: April 2024

Modification of a natural zeolite from Klaten, Indonesia, as a catalyst in the dehydration of ethanol to produce diethyl ether (DEE) has been conducted. Raw Klaten natural zeolite (ZA) was modified using 1 and 2 M of an ammonium chloride solution for 24 h while stirring for 18 h, then calcined at 500 °C for 5 h under N2 gas flow produced HZA1 and HZA2 catalyst, respectively. The catalysts were characterized using XRD, BET surface area, SEM-EDX, XRF, FTIR and gravimetric acidity test using ammonia-based vapor. The dehydration process was conducted under variations of temperature (200, 250, and 300 °C) and catalyst mass of 0.1, 0.2, and 0.4 g for 20 mL of 96% ethanol. The HZA1 catalyst produced the highest yield of DEE (2.41%) at 250 °C and 0.1 g catalyst. This catalyst showed needle-like of 66.22 nm crystal size, consisting of 32.57% mordenite, the highest surface area (48.32 m2/g), crystallinity (32.93%) and Brønsted acid sites (2.75 mmol/g), the lowest pore diameter (1.77 nm) and Si/Al mol ratio (4.03). The HZA1 catalyst can be used repetitively and produced DEE yield at the second and third runs (2.40 and 2.61%).
Modification of Petroleum Bitumen with Secondary Polyethylene in the Presence of Vermiculite
Authors: Kulash Syrmanova , Zhanat Kaldybekova , Aktolkyn Agabekova , Sholpan Baizhanova , Rassul Tuleuov , Al Azzam Khaldun , Negim El-Sayed , Nadia Bounoua
Published: April 2024

This article presents studies on the modification of petroleum bitumen with polymer waste in the presence of vermiculite. An increase in temperature leads to an increase in the interaction of components, partial breakage of polyethylene and bitumen macromolecules, and the formation of radical-free valences. As a result, fragments of polyethylene and bitumen molecules react with each other, and the formation of qualitatively new structural formations occurs via the strong connection of polar and amorphous bitumen with nonpolar structurally viscous polyethylene. Domestically produced Kulantau vermiculite was used to ensure stable adhesion over a wide temperature range and increase the specific surface area, which acquired additional energy, resulting in an increase in the degree of adhesion to bitumen and increased durability of the binder with improved rheological characteristics. Because of the increased service life of road asphalt pavements, the use of the latter results in a considerable decrease in the cost of polymer-bitumen binders. Based on improved binder formulations, asphalt concrete exhibits excellent water resistance and strength at 50 °C (4.7 to 5.0 MPa). In summary, the modification of bitumen with polymer waste and vermiculite offers a promising avenue for improving the performance and longevity of asphalt pavements.
Readiness of Interprofessional Education on Maternal Health of Medical and Dental Students: A Mixed-Methods Study
Authors: Faizin Chamim , Fahreza Erwin Ulinnuha
Published: April 2024

Background: The high mortality rate and various health problems for maternal are of great concern in Indonesia. Oral and dental health of maternal receives less attention from both patients and health workers. The need for collaborative practices between doctors and dentists to optimize the health care of maternal. Interprofessional education is prepared to form medical and dental practitioners who are ready to interprofessional collaboration practice. Therefore, careful preparation is needed so that the learning process goes well and produces the desired results.This study aims to analyze the readiness of interprofessional education on maternal health among medical and dental students.Methods: This study was used mix methods. The cross-sectional quantitative method uses the questionnaire of readiness interprofessional learning scale (RIPLS) which has been modified and validated by Tyastuti (2014), containing 3 sub-scales. The qualitative method uses case studies with focus group discussions of student representatives.Results: There were 139 medical students and 49 dentistry students, both of whom had good readiness respectively 65,51 and 66,45 with a p value of 0,175. There was no significant difference in IPE readiness between the two. Good IPE readiness shows the development of teamwork, a good impression of IPE. However, there are problems that must be corrected such as bad attitudes and perceptions as well as problems in the field during home visits.Conclusion: Medical students and dental students have good readiness for maternal health of IPE, proven to give a good impression and establish teamwork. However, it still needs improvement to be even better.
Research on the Integration of Blockchain and Innovation Chain: Organizational Patterns and Governance Mechanisms
Authors: Han Zhong
Published: April 2024

This study explores the integration of blockchain technology with innovation chain theory and its impact on organizational patterns and governance mechanisms. Firstly, the concepts of blockchain technology and innovation chain are introduced, along with an explanation of the motivation and significance of their integration. Subsequently, the characteristics of blockchain technology and the importance of innovation chain as a mechanism for driving innovation are analyzed. The possibility of combining these two aspects is discussed, followed by an analysis of the impact of integration on organizational patterns and governance mechanisms. The advantages that integration may bring, such as enhancing innovation efficiency and improving transparency, are discussed, along with an analysis of potential challenges, such as technological limitations and privacy concerns. Finally, the significance and impact of the integration of blockchain and innovation chain are summarized, and future research directions or suggestions are proposed.
Boosting Innovation in India: A Policy Framework
Authors: - Monika , Narayanan Badri
Published: April 2024

Innovation and entrepreneurship are becoming increasingly important in the global economy, as emerging technologies like artificial intelligence and machine learning drive the production landscape. This paper proposes a policy framework to expand India's innovation and entrepreneurship horizons, with the goal of establishing the nation as a global research and development (R&D) powerhouse. India has made significant progress in recent years, ranking in the top 40 innovative countries for the first time in 2022. However, there are still significant impediments to innovation and entrepreneurship in India, including deficiencies in education and research, inadequate research infrastructure, burdensome regulations, and a lack of synergized approach. This paper presents a comprehensive approach encompassing improvements in research infrastructure development, regulatory reforms, fostering collaboration between industry and academia, and strong support for startups and small businesses to promote innovation and entrepreneurship in India. By implementing these measures, India can unlock its latent potential, address local challenges, pioneer cutting-edge technologies, and actively contribute to the global knowledge economy.
"ИНДУСТРИЯ 5.0" – НОВЫЙ ВЕКТОР ПРОМЫШЛЕННОГО РАЗВИТИЯ
Authors: Пронин А.Ю.
Published: April 2024

Рассматриваются основные причины перехода к новому этапу развития промышленности и экономики, приведен сравнительный анализ основных концептуальных положений "Индустрии 4.0" и "Индустрии 5.0". Сформулированы основные принципы развития промышленности в условиях перехода к "Индустрии 5.0".
КВАРЦЕВАЯ ЭТАЛОННАЯ МЕРА ДЛЯ СКАНИРУЮЩЕЙ ЗОНДОВОЙ МИКРОСКОПИИ
Authors: Ахметова А.И. , Советников Т.О. , Логинов Б.А. , Яминский Д.И. , Яминский И.В.
Published: April 2024

Повышение точности и достоверности измерений в наномасштабе становится все более
актуальной задачей для различных приложений, особенно в таких областях, как полупроводниковая электроника, оптические метаматериалы, сенсоры и биологические измерения. С появлением методов визуализации высокого разрешения закономерно возникла и потребность в метрологической поверке
этих приборов. Появилась задача измерить наноразмерную морфологию в конкретном местоположении, что требует точности позиционирования как в вертикальном, так и в латеральном направлении. Стабильность и надежность измерений требуют регулярно отлаживать микроскоп с помощью калибровочных средств. Одним из таких эталонов могут быть кварцевые калибровочные меры.
An Efficient Deep Neural Network Based Image Enhancement with Improved Filtering Technics
Authors: Begum Jariya
Published: April 2024

Abstract: Paper explores the challenging problem of text-to-image synthesis within the domain of generative modeling. The task involves generating coherent and realistic images from textual descriptions, a critical aspect of automatic learning for applications such as image creation, modification, analysis, and optimization. In response to existing limitations in scene understanding, especially in synthesizing coherent structures in complex scenes, we introduce a novel model called CapGAN. CapGAN utilizes skip-thought vectors to encode given text statements into vector representations, serving as inputs for image synthesis through an adversarial process involving a generator (G) and discriminator (D). The distinguishing feature of CapGAN lies in the integration of capsules at the discriminator level, enriching the model's comprehension of orientational and relative spatial relationships within different entities of an object in an image.
Investment Portfolio Management System Using Machine Learning
Authors: Narale Payal
Published: April 2024

Abstract: Portfolio management is the concept of determining the proportions of various assets to be held in a portfolio in order to maximize return while minimizing risk exposure. Investment banking and financial management both depend heavily on portfolio optimization. Choosing the greatest feasible combinations of several portfolios to construct an optimal portfolio is an exponentially complex challenge in terms of computation. It's commonly believed that public opinion and financial markets are intertwined. Recently, a variety of machine learning algorithms have been employed to anticipate short-term financial markets with positive outcomes. On the other hand, historical returns don't seem to fit the normal distribution theory. But sentiment analysis performs better when combined with long short-term memory networks and historical data. In this project, we want to use AI/ML to predict portfolio risk and provide insights into how stocks will perform. We will train our model using datasets obtained from the Yahoo Financial API that include historical data from the top 100 companies (NIFTY 100) in the NSE and BSE from 2010 to 2021.
Understanding Work Experiences of Type-A Behavior Pattern (TABP) Individuals and Their
Authors: K B Darshini
Published: April 2024

Abstract: Type-A Behavior Pattern (TABP) individuals are often characterized by their competitive drive, time urgency, and ambitious nature, which significantly influence their work experiences and contributions within organizations. Drawing upon qualitative research methods, including in-depth interviews and thematic analysis, this study explores the lived experiences of TABP individuals in various organizational contexts. Through interviews with a diverse sample of TABP professionals across different industries and hierarchical levels, this research investigates how their inherent traits manifest in their work behavior, interactions with colleagues, perceived contribution and approaches to task completion. Findings reveal that participants were noted for fostering a culture of healthy competition in the workplace, effectively handling interruptions without succumbing to irritability, and actively engaging in team-based work dynamics. Additionally, it was discovered that participants expressed concerns about both their personal development and their contributions to the welfare of the organization in which they are currently employed. By understanding the unique work experiences of TABP individuals and their perceived contributions to the organization, organizations can better leverage their talents and foster a conducive work environment for all employees.
Optimizing Healthcare Finance: A Predictive Modeling Approach to Medical Insurance Premium
Authors: Chandran Kavya
Published: April 2024

Abstract: This research delves into optimizing healthcare finance through predictive modeling to forecast medical insurance premiums accurately. By harnessing a robust dataset and integrating advanced analytics, this study meticulously constructs models that allow insurance companies to price their policies competitively, ensuring both profitability and fairness. Employing a variety of machine learning algorithms, including linear regression, decision trees, random forests, and gradient boosting, we thoroughly assess the influence of critical factors such as age, BMI, gender, and regional healthcare costs on premium costs. Our analysis not only showcases the precision of predictive modeling in refining insurance pricing strategies and risk management but also illuminates its broader implications for the healthcare insurance sector. By systematically exploring the factors affecting premiums, identifying the most efficacious modeling techniques, and delineating the potential benefits for insurers and policyholders, this paper significantly contributes to the ongoing discourse on leveraging data-driven approaches to enhance the insurance industry's operational efficiency and promote equitable access to healthcare coverage.
Pengaruh dukungan sosial dan parenting self-efficacy terhadap parental burnout pada ibu bekerja
Authors: Muliasari Ainun , Amalia Sofa
Published: April 2024

Nowadays becoming parents is not a simple thing, especially as a mother. In this era, there are many demands that make mothers carry out a dual role, a housewife and a working mother. Therefore, the multiple roles chosen by the mother will cause burnout and have an impact for childcare. The purpose of this study is to determine the effect of social support and parenting self-efficacy on parental burnout in working mothers. This research uses a quantitative approach and a non-experimental quantitative research design with a causal relationship. The study encompassed a cohort of one hundred and twelve (112) employed mothers within governmental or private organizations, chosen through the application of accidental sampling methodology. The data analysis with a simple linear regression test to measure the effect of social support on parental burnout (r= 0,403, p < 0,05) and parenting self-efficacy on parental burnout (r=0,471, p <0,05) and multiple linear regression test to measure the effect of social support and parenting self-efficacy on parental burnout (p < 0,05). Social support makes an effective contribution to parental burnout of seven point seven percent (7,7%) and parenting self-efficacy of seventeen point six percent (17,6%).
Peran iklim keselamatan terhadap perilaku aman karyawan
Authors: Yeni Ariska Wulandari  , Djudiyah Djudiyah
Published: April 2024

Safety behavior describes the actions of employees to protect themselves with the aim of avoiding hazards in the workplace. A positive safety climate indicates that the organization values a job and helps the health and well-being of workers. A supportive workplace safety climate will make employees feel safe at work. The purpose of this study is to determine the role of work safety climate on the safe behavior of employees in a company. This study uses a quantitative approach to study the relationship between two variables. Respondents in this study amounted to 150 employees of the mining company's production department which was taken using incident sampling techniques. The instruments in this study used the Nordic Safety Climate Questionnaire (NOSACQ 50) and safety behavior scale. The data analysis method used is simple regression analysis with the help of SPSS program version 25. The results showed that the safety climate had a significant effect on employee safe behavior (F = 47,093 with p = 0,000).
Regulatory requirement for Medical Devices
Authors: Umapathi Uthanthi Thamizhselvi , Vijayakumar Vijay , Muthusamy Sivakumar , Ramamurthy Vijayakumar Arumugam , Natarajan Deepa
Published: April 2024

The safety and regulatory compliance of a widely used medical device have become a growing concern among a significant population. This has raised questions about the assessment of risks, monitoring of adverse drug reactions (ADR), and overall product safety. The efficacy and safety of such medical devices heavily rely on the regulations and guidelines set forth by regulatory agencies (RAs).

In the pharmaceutical industry, regulatory affairs (RA) professionals play a crucial role in overseeing the lifecycle of healthcare products. They provide strategic, tactical, and operational guidance to ensure compliance with regulations, facilitating the efficient development and delivery of safe and effective healthcare products worldwide. Evaluating adherence to regulations requires a combination of expertise from the business, legal, and pharmaceutical domains.

Regulatory authorities must thoroughly monitor medical device design, development, and manufacturing processes to guarantee that the products reaching the market are safe and effective. The certification process is intricate, involving multiple steps and the assessment of materials by competent authorities. In the United States, manufacturers must seek marketing authorization from the United States Food and Drug Administration (USFDA) through two primary application types: 510(k) and Pre-Market Application (PMA). In the European Union (EU), national authorities grant permission for the sale of medical devices, employing a third-party compliance system where notified bodies ensure quality assurance pre- and post-approval. In India, the Central Drug Standard Control Organization (CDSCO) licenses devices for sale and import under the CLAA framework.

Conclusion

Pharmaceutical regulatory affairs experts play a critical role in ensuring compliance with industry requirements for all pharmaceutical products. This review provides an overview of how medical devices are regulated and monitored in the EU, India, and the USA, emphasizing the importance of regulatory affairs in maintaining the safety and efficacy of healthcare products.
Regulatory requirements for approval and Registration Procedure of Biosimilar in US and European Union (EU)
Authors: Patel Nishi , Prajapati Hardik , Joshi Navin , Movaliya Vinit , Kanaki Niranjan , Deshpande Shrikalp , Zaveri Maitreyi
Published: April 2024

The market for biotechnology-derived medicinal products is evolving rapidly with the imminent entry of biosimilars. The development and approval of biosimilars represent a critical pathway to expanding access to biological therapies while maintaining high standards of safety, efficacy and immunogenicity profile because biosimilars are made in living organisms there may be some minor differences from the reference medicines.

In the US, biosimilars are regulated under the Biologics Price Competition and Innovation Act (BPCIA), which is part of the Affordable Care Act. The regulatory pathway emphasizes a stepwise approach, involving analytical studies, preclinical assessments, and comparative clinical trials to establish biosimilarity with a reference product. The FDA assesses the totality of evidence provided by the biosimilar applicant to make a determination on safety, purity, and potency.

In the EU, the approval process for biosimilars is governed by the European Medicines Agency (EMA). The regulatory framework relies on a robust comparability exercise, emphasizing extensive analytical studies and well-designed clinical trials to establish biosimilarity. The EMA assesses the comprehensive data package submitted by the biosimilar applicant, considering the totality of evidence before granting marketing authorization.

While the overall approach is similar, there are nuanced differences in the regulatory processes. The US typically requires a more prescriptive approach to clinical trials, with the expectation of conducting at least one confirmatory comparative clinical trial. In contrast, the EU may allow for a more tailored approach to clinical development, recognizing that the need for extensive clinical trials may vary depending on the nature of the biosimilar and the reference product.

As the biosimilar landscape continues to evolve, ongoing collaboration and harmonization efforts between regulatory authorities aim to streamline global access to high-quality ,cost-effective biologic therapies.
Operations and Similarity Measures Between (m,n)-Fuzzy Sets
Authors: Thakur Samajh Singh , Banafar Anita Singh , Thakur Mahima , Pandey Bajpai Jyoti , Prasad Archana Kumari
Published: April 2024

Recently Jun and Hur proposed (m, n)-fuzzy sets which can handle vagueness and uncertainty in information very efficiently in the process of solving complex problems. They defined basic operations over (m, n)-fuzzy sets. The present paper created some new operations over this super class of fuzzy sets and established many theorems related to the their properties. Further some distance and similarity measures of (m, n)-fuzzy sets are proposed and their properties are examined. Moreover, the proposed similarity measures are applied to the problem of pattern recognition.
Síndrome de la arteria de Percheron, a propósito de un caso
Authors: Guevara Rodríguez Marbelys , Bosch Rodríguez Bettsy Bell , Medina Hernández Larry , Bordón Hernández Mercedes , Luna Capote Amalia Inés
Published: April 2024

Introducción: el síndrome de Percheron es una entidad infrecuente de difícil determinación clínica y que es causada por la oclusión de la arteria de Percheron.
Presentación del caso: paciente masculino de 71 años que llega obnubilado al servicio de urgencias, con disartria, hemiparesia izquierda, signo de Babinski bilateral, ptosis palpebral derecha, con exotropía, limitación total de la aducción del ojo derecho y abducción parcial del izquierdo, con imposibilidad de supraducción e infraducción de ambos ojos. Además, tenía reflejo oculocefálico vertical ausente bilateralmente y horizontal derecho ausente, pupilas anisocóricas y reflejo fotomotor ausente en ambos ojos. La imágenes obtenidas por resonancia magnética nuclear (RMN) (T1W, T2, T2-FLAIR y técnicas de difusión) demostraron que hubo un infarto de la arteria de Percheron. El paciente se mantuvo por 10 días hospitalizado y evolucionó favorablemente.
Discusión: el síndrome de Percheron cursa con una triada clásica caracterizada por alteración de la conciencia, deterioro cognitivo y parálisis de la mirada vertical, a lo que se le añade hemiplejía, ataxia cerebelosa y déficit oculomotor y,  si se acompaña de lesiones mesencefálicas, se produce un síndrome tálamo-peduncular. La sospecha clínica de esta patología constituye un desafío en la práctica médica, debido a la infrecuencia de presentación, variabilidad de alteraciones neurológicas y la dificultad que ofrecen los estudios imagenológicos de urgencia.
Conclusiones: hemos descrito una entidad infrecuente y de difícil determinación clínica, en la cual, los criterios para el diagnóstico son fundamentalmente imagenológicos, siendo de elección la RMN. La evolución y el pronóstico dependerán de la extensión del proceso, las estructuras involucradas, el diagnóstico y su tratamiento oportuno.
Policiais e bolsonarismo: a expressão de discursos discriminatórios em redes sociais abertas e fechadas
Authors: Sinhoretto Jacqueline , Cedro André , Macedo Henrique
Published: April 2024

Qual é o alcance dos riscos que as instituições democráticas correm com a politização da polícia produzida pelo bolsonarismo no Brasil? O artigo visa a apresentar alguns elementos de resposta ao analisar a evolução da interação entre policiais militares de São Paulo em redes sociais digitais. Os dados coletados e as observações realizadas em redes sociais de policiais militares demonstram escolhas individuais e institucionais de práticas e políticas que podem opor grupos de policiais ao regime democrático. Os resultados apontam que a adesão bolsonarista de policiais produziu um deslocamento do eixo do debate público sobre segurança, com recuo das propostas reformistas e reforço da militarização do controle do crime.
O papel dos desembargadores do estado do Rio Grande do Sul nas incriminações por tráfico privilegiado
Authors: Hypolito Laura Girardi
Published: April 2024

Este trabalho pretende compreender a maneira como os desembargadores do estado do Rio Grande do Sul aplicam o benefício representado no art. 33, §4ª, da Lei nº 11.343/06, que constitui a conduta do tráfico privilegiado e prevê uma possibilidade de redução de um sexto a dois terços do apenamento. Para isso, foi realizada a análise de 420 acórdãos referentes a recursos de apelação protocolados no Tribunal de Justiça do Estado do Rio Grande do Sul, interpostos com o fim de aplicar a privilegiadora e julgados pelas três primeiras câmaras criminais durante o ano de 2019. A metodologia adotada para a apreciação dos dados foi quantitativa, a partir da análise de diversas variáveis. Acerca do problema de pesquisa, questiona-se se estariam os julgadores de segundo grau atuando de forma punitivista e negando o direito ao benefício da privilegiadora, como fazem os juízes de primeiro grau, ou se, em segundo grau, existe uma ruptura dessas atuações dos magistrados. Como resultado é apurado que embora a legislação determine quatro condicionantes para o reconhecimento do tráfico privilegiado – ser réu primário, com bons antecedentes, não dedicado a atividades criminosas nem integrante de organização criminal – os desembargadores da primeira e segunda câmaras fizeram uso de 21 motivos extralegais para indeferir o benefício à privilegiadora, enquanto a Terceira utilizou apenas dois. Isso demonstra a distinção entre o entendimento das câmaras de como a lei deve ser aplicada, evidenciando as disputas internas no campo do Judiciário e a insegurança jurídica na qual recaem os acusados por tráfico privilegiado.
Reconfigurando a noção de tradição na Europa: uma introdução ao tema
Authors: Isnart Cyril , Testa Alessando , Bartel Bruno Ferraz
Published: April 2024

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Apresentação: Dinâmicas, fluxos e representações do crime e da justiça penal: uma agenda de pesquisa
Authors: Sinhoretto Jacqueline , Mello Kátia Sento Sé , Azevedo Rodrigo Ghiringhelli de
Published: April 2024

Este dossiê é resultado de anos de trabalho coletivo, apresentado em fóruns de debate sobre o tema, tais como a Reunião Brasileira de Antropologia, a Reunião de Antropologia do Mercosul, os Congressos da Sociedade Brasileira de Sociologia e os Seminários do Instituto Nacional de Estudos Comparados em Administração Institucional de Conflitos (INCT-IEEAC/UFF). Nesses fóruns, reunimos pesquisas empíricas nacionais e internacionais, fruto de produções acadêmicas que abordam institucionalidades, práticas, atores sociais e dimensões do controle do crime, da Justiça Penal e da seletividade penal. Os trabalhos abordam as instituições e os atores da Justiça Penal a partir da interpretação de práticas e concepções gerencialistas/punitivistas/garantistas, nas diferentes etapas do controle do crime, incluindo o uso, a legitimação e o controle de práticas de violência institucional. Além disso, os trabalhos tratam das narrativas morais a respeito dos infratores, do perfil sociodemográfico dos sujeitos encarcerados e de marcadores sociais de gênero, raça e classe social na seletividade penal. As formas de gestão dos policiamentos e da prisão são aspectos que revelam tipos de controle social e lógicas de administração de conflitos que permitem uma análise compreensiva da natureza dos modelos de controle social nas sociedades estudadas. Neste dossiê estão publicados alguns dos trabalhos apresentados e debatidos nesses espaços de debate, o que imaginamos ser uma contribuição para a sua divulgação e a consolidação do campo de estudos no qual estão inseridos.
YA ES UN NUEVO TIEMPO EL PRESENTE. AMÉRICA LATINA EN LA TERCERA DÉCADA DEL SIGLO XXI
Authors: Ortega Reyna Jaime
Published: April 2024

Este ensayo busca captar las principales tendencias y contra-tendencias alrededor de la lucha política y social que se desarrolla de manera destacada en latino-américa. Se trata de un ejercicio interpretativo que da cuenta de las grandes líneas de desarrollo, ubicando momentos específicos y cruciales de la forma de comprensión. Todo ello desde un mirador marxista que busca hacer dialogar concepciones tanto de la crítica de la economía política como de la crítica de la coyuntura.
Palabras clave: Transición, Estado, Progresismo.
Palavras-chave: transição, estado, progressivismo
“NÃO PENSE EM CRISE, TRABALHE”: O EMPRESARIAMENTO DA EDUCAÇÃO DE NOVO TIPO E A CRISE ORGÂNICA DO CAPITALISMO BRASILEIRO
Authors: Pires de Andrade Maria Carolina , Cardoso da Motta Vânia
Published: April 2024

“Não pense em crise, trabalhe” foi a frase espalhada pela cidade de Florianópolis em 2016 pelo então presidente golpista Michel Temer, que traduzia muito bem o projeto de sociedade em curso. Argumentamos que a crise orgânica instalada no Brasil em 2013 fez imperioso ajustes estruturais e superestruturais, expressos em um conjunto de contrarreformas que operaram, concretamente, uma nova etapa da reforma neoliberal. Demonstramos que o conjunto de ataques à educação, com foco no Novo Ensino Médio, inauguraram uma nova fase do empresariamento da educação de novo tipo cujos desdobramentos são inaceitáveis.
Palavras-chave: Novo Ensino Médio; Empresariamento da educação de novo tipo; crise orgânica.
NEOLIBERALISMO, GERENCIALISMO E EDUCAÇÃO: O PROJETO DO EMPRESARIADO PARA A AMÉRICA LATINA
Authors: Caetano Maria Raquel
Published: April 2024

Neste artigo, problematizaremos as transformações do neoliberalismo em sua versão no século XXI, o papel do Estado e o gerencialismo a partir da incorporação de novas matrizes teóricas. As ações empresariais, no campo da educação, desenvolvem práticas que promovem a síntese entre interesse individual e interesse geral. Metodologicamente, usamos a análise de documentos produzidos pela Reduca e suas instituições membros. Nas considerações, o que se destaca, é o interesse dos empresários que financiam e atuam na educação, por intermédio de redes, alinhando-se à doutrina do mercado na América Latina.
Palavras-chave: Neoliberalismo; Gerencialismo; Educação.
PL 1.603/1996: O JOGO IDEOLÓGICO E ECONÔMICO DA EDUCAÇÃO DOS MAIS POBRES NO BRASIL NEOLIBERAL
Authors: Kuenzer Acácia
Published: April 2024

O estudo das políticas públicas para o ensino médio e educação profissional tem sido um dos objetos privilegiados pelo GT 9 da Anped, ao longo da sua história. Nesse momento histórico que estamos vivendo, em que políticas de ensino médio e educação profissional e tecnológica têm sido formuladas sem o necessário debate com as entidades representativas dos trabalhadores, professores, pesquisadores e estudantes, o resgate de outros momentos em que essa mesma estratégia foi utilizada para impor diretrizes curriculares que aprofundam a desigualdade da oferta em prejuízo da classe trabalhadora, é um movimento necessário. Isso porque o passado nos ajuda a compreender o presente, que por sua vez traz anúncios do futuro, reforçando a necessidade do enfrentamento das políticas estabelecidas de forma autoritária que desqualificam a educação disponibilizada para os que vivem do trabalho, com o que se aprofundam as diferenças de classe.