bluuebunny/crossref_metadata_2025 huggingface dataset:
From Multiple Myeloma to Acute Myeloid Leukemia: A Case Report of a
61-year-old Woman after 8 Years of Chemotherapy and Immunotherapy
Authors: Fu Xue-Hang , Guan Rong-Yan , Huang Zoufang , Li Yun , Lu Guang , Mou Wei-Wei , Du Jun
Published: June 2023

Background:

As the second most prevalent hematologic malignancy, multiple myeloma
(MM) affects plasma cells and is characterized by chromosomal abnormalities, particularly
involving the immunoglobulin heavy chain switch region. MM represents a biologically and clinically
heterogeneous hematological malignancy that serves as a clonal evolution model, exhibiting
clonal heterogeneity throughout all stages from monoclonal gammopathy undetermined significance
(MGUS) and smoldering multiple myeloma (SMM) to MM. Although significant progress
has been made in the treatment of MM, leading to improved patient outcomes, concerns are arising
regarding disease relapse due to the presence and selection of pre-existing resistant clones or
selective pressure during therapy.

Case Presentation:

We present a case of multiple myeloma (MM) in a female patient, who underwent
an 8-year course of treatment, including chemotherapy, immunomodulators, hematopoietic
stem cell transplantation, CD38 monoclonal antibody, and chimeric antigen receptor T-cell
(CAR-T), and was recently diagnosed with concurrent progressive MM and acute myeloid leukemia
(AML). This patient has witnessed the evolution of MM treatment paradigms.

Conclusion:

In this course, disease relapses occurred twice, one of which was manifested by a
light chain escape (LCE). Moreover, through the course of the disease in this patient, we review
the process of clonal evolution that may be relevant.
Navigated Transcranial Magnetic Stimulation (nTMS) based Preoperative
Planning for Brain Tumor Treatment
Authors: Riaz Hammad , Uzair Mohammad , Arshad Muhammad , Hamza Ali , Bukhari Nedal , Azam Faisal , Bashir Shahid
Published: June 2023

Transcranial Magnetic Stimulation (TMS) is a non-invasive technique for analyzing the
central and peripheral nervous system. TMS could be a powerful therapeutic technique for neurological
disorders. TMS has also shown potential in treating various neurophysiological complications,
such as depression, anxiety, and obsessive-compulsive disorders, without pain and analgesics. Despite
advancements in diagnosis and treatment, there has been an increase in the prevalence of brain cancer
globally. For surgical planning, mapping brain tumors has proven challenging, particularly those localized
in expressive regions. Preoperative brain tumor mapping may lower the possibility of postoperative
morbidity in surrounding areas. A navigated TMS (nTMS) uses magnetic resonance imaging
(MRI) to enable precise mapping during navigated brain stimulation. The resulting magnetic impulses
can be precisely applied to the target spot in the cortical region by employing nTMS. This review focuses
on nTMS for preoperative planning for brain cancer. This study reviews several studies on TMS
and its subtypes in treating cancer and surgical planning. nTMS gives wider and improved dimensions
of preoperative planning of the motor-eloquent areas in brain tumor patients. nTMS also predicts postoperative
neurological deficits, which might be helpful in counseling patients. nTMS have the potential
for finding possible abnormalities in the motor cortex areas.
Genetic Diversity of Salvia Officinalis L. (Lamiaceae) and its Related Species using TU-DAMD Analysis
Authors: Saleh Basel
Published: June 2023

Background:

Salvia tomentosa Mill., Salvia fruticosa Mill., and Salvia officinalis L. are Mediterranean species with different pharmaceutical and medicinal applications. However, genetic relationships among these species are still unclear.

Objective:

The study aimed to investigate the genetic polymorphism among S. officinalis L. (SO) and its related species S. tomentosa Mill. (ST) and S. fruticosa Mill. (SF) collected from different geographical regions in Syria.

Methods:

Touch-up directed amplification of minisatellite DNA (TU-DAMD) assay has been employed to assess genetic relationships among the studied Salvia species based on the estimated percent disagreement values (PDV).

Results:

Seventeen DAMD primers highlighted a mean of 90.419, 0.254, and 2.398% for polymorphism level (P%), polymorphic information content (PIC), and marker index (MI) values, respectively, across the three studied Salvia species. Unweighted Pair Group Mean Arithmetic average (UPGMA) analysis revealed that the studied Salvia samples were clustered into three main clusters; each species was split into one cluster. Overall, moderate P% of 72.662 and 70.374% was recorded for SO and ST species, respectively. Whereas, low P% of 51.429% was recorded for SF species.

Conclusion:

TU-DAMD marker is a potential tool for studying genetic relationships among the three studied Salvia species.
Strategies to Improve Access to Mental Health and Psychosocial
Support Among Displaced Populations in Ethiopia
Authors: Greene M. Claire , Getz Mara , Streicker Eleanor , Thind Priyam , Tayama Eri , Lafto Kinfu Manzura , Ayele Noah Wubishet , Worku Tinsae Abera , Carson Ryan , d'Andon Cécile Fanton , Yilma Tesfahun , Wainberg Milton , Fufa Yaregal , Firew Tsion
Published: June 2023

Background:

In 2021, more than 23 million people were in need of humanitarian
assistance in Ethiopia, including four million internally displaced persons and returnees. Displaced
populations face an elevated risk of mental health and psychosocial problems, yet they
often have limited access to mental health and psychosocial support.

Objective:

This study aimed to assess: 1) the mental health and psychosocial needs and resources
among displaced persons in Ethiopia; and 2) examine barriers, and facilitators, and
identify strategies to improve access to culturally appropriate mental health and psychosocial
support in this population and context.

Methods:

We conducted a sequential mixed-methods assessment of mental health and psychosocial
needs and resources. First, we conducted 16 key informant interviews with those who
had experience and knowledge regarding the mental health situation of displaced persons in
Ethiopia, including mental health providers and humanitarian practitioners. Second, we conducted
an assessment of available mental health services in 15 internally displaced persons
(IDP) sites in Ethiopia along with 28 key informant interviews in this context to explore some
of the challenges and strategies to improving access to mental health and psychosocial support.

Results:

Access to mental health services was limited in IDP sites. Participants identified numerous
barriers to accessing services that ranged from limited supply and fragmentation of
existing mental health services to an incongruence between formal mental health services and
explanatory models of mental illness. Strategies to address these barriers included engagement
of community members and key stakeholders (e.g., traditional and religious healers), improving
mental health literacy, strengthening referral systems and mental health capacity, and improving
coordination and integration of mental health within the national health system.

Conclusion:

This study highlights several challenges and opportunities for improving access to
mental health and psychosocial support among displaced persons in Ethiopia. Efforts to bridge
gaps in access to mental health and psychosocial support must consider both systems-level
factors that influence availability as well as community factors influencing perceptions and
acceptability of services within this context.
Accumulation of Microplastics in the Digestive Tract and Gonads and its Effects on Gonad Quality of Sea urchins Tripnesutes gratilla
Authors: Lekatompessy Vanela Chatrin , Warih Marhendra Agung Pramana , Kurniawan Nia
Published: June 2023

Marine plastic debris that is transported will move with the flow of water and float and then be degraded into smaller particles, namely microplastics, sink and settle on the substrate. Sea urchins as deposit feeders have the potential to ingest microplastic particles, where these particles can influence changes in behavior, growth, enzyme production, reproduction, and tissue structure. This study used a purposive sampling method with descriptive analysis for data related to the recording of morphometrics and gonadal quality as well as follow-up tests of the Tukey test and Pearson test. This study aims to analyze how the accumulation of microplastics in organs (digestive tract and gonads) affects the gonadal quality of sea urchins Tripneustes gratilla. The results showed that the number of microplastic particles found in the digestive tract of sea urchins was 233 particles/individual and in the gonads were 205 particles/individual with the color variants transparent, multicolor, blue, yellow, red, green, and purple. Gonadal quality assessment indicators are color, firmness, and gonadal index. Gonads with good quality were shown by sea urchins from Laha beach (site 1) with a composition of 40% bright orange, 40% yellow/pale yellow, 20% bright orange, very firm 80% and not firm20%, and a gonadal index value of 7.57 %. In contrast, gonads with poor quality were shown by sea urchins from Erie beach (site 4) with a composition of 80% brown and 20% gray, a very firm of 60% and 40% firm, and a gonadal index value of 3.08%. This difference in quality is thought to be the result of microplastic accumulation in the sea urchin organs which causes the satiated delusion.
Diversidad y abundancia de mamíferos del bosque mesófilo de montaña del noreste de México
Authors: Ochoa-Espinoza Juan Martin , Soria-Díaz Leroy , Astudillo-Sánchez Claudia C. , Treviño-Carreón Jacinto , Barriga-Vallejo Carlos , Maldonado-Camacho Eder
Published: June 2023

El bosque mesófilo de montaña (BMM) es uno de los ecosistemas vegetales con una gran diversidad biológica, sin embargo, también es uno de los más reducidos en superficie territorial y su distribución es fragmentada, lo que incrementa su probabilidad de sufrir perturbaciones humanas y pérdida de la biodiversidad. El objetivo de esta investigación fue estimar la diversidad alfa y la abundancia relativa de los mamíferos medianos y grandes presentes en el BMM de la reserva de la biosfera El Cielo (RBEC), Tamaulipas, México. El estudio se realizó de enero del 2018 a diciembre del 2020. En este periodo se colocaron 20 estaciones de muestreo con una cámara-trampa. Se estimó la diversidad de los mamíferos durante la temporada de lluvia y seca con los números de la serie Hill. La diversidad se comparó entre temporadas con las curvas de rarefacción y la abundancia se estimó con el índice de abundancia relativa (IAR) para cada especie. Se lograron identificar 18 especies de mamíferos y el orden mejor representado fue Carnivora. La riqueza fue de 16 y 18 especies, para la temporada de lluvia y seca, respectivamente. La especie con mayor abundancia relativa en la temporada de lluvia fue Mazama temama y la de menor Odocoileus virginianus. En la seca, Didelphis sp. fue la que presentó mayor IAR, y la menor fue O. virginianus. Se registraron cinco especies que se encuentran en peligro de extinción y una considerada como amenazada. El número de especies que se describen muestra que se trata de uno de los sitios con mayor riqueza de mamíferos medianos y grandes en BMM de México y destacan abundancias relativas altas de M. temama, Ursus americanus y Leopardus wiedii. A demás, la presencia de especies como Panthera onca y Puma concolor, muestran que este tipo de vegetación tiene un buen estado de conservación.
Evaluation of the use of e-learning in the implementation of the "Stake's countenance" model in the era of the Covid 19 pandemic
Authors: Retnowati Trie Hartiti , Kuswarsantyo Kuswarsantyo , Prihadi Bambang , Wulandari Aldia , Alya Winny Chrisan , Rafika Tria
Published: June 2023

The learning process in the Master of Arts Education Study Program during the Covid-19 pandemic experienced problems not being able to hold meetings offline. The purpose of the study was to evaluate the use of e-learning with a countenance stake model. This research uses a qualitative evaluation method with a countenance evaluation model by Stake. Matters evaluated include (1) Antecedent (context, input); (2) Transactions (processes) and (3) Outcomes (results) of curriculum implementation. The results showed that learning in the Master of Arts Education Study Program during the Covid-19 pandemic went smoothly. A total of 21.57% of the smooth learning process has the category of mostly smooth meetings. The suitability of student learning outcomes with CPL was 88.46%. CPL Based on the results of the questionnaire, data was obtained that the achievement of appropriate student learning outcomes (80-100%) was 83.33%. These results illustrate that student learning outcomes are fulfilling the aspect of achievement. Keywords: Art learning, evaluation, countenance stake Evaluasi pemanfaatan e-learning dalam pelaksanaan pembelajaran dengan model “countenance stake” di era pandemi Covid 19AbstrakProses pembelajaran di Program Studi Magister Pendidikan Seni masa pandemi covid-19 mengalami kendala tidak bisa melakukan pertemuan secara luring. Tujuan penelitian untuk mengevaluasi penggunaan e-learning dengan model countenance stake. Penelitian ini menggunakan metode evaluasi kualitatif dengan model countenance evaluation oleh Stake. Hal-hal yang di evaluasi meliputi (1) Antecedent (konteks, input); (2) Transaction (proses) dan (3) Outcomes (hasil) pelaksanaan kurikulum. Hasil penelitian menunjukkan bahwa pembelajaran di Program Studi Magister Pendidikan Seni masa pandemi covid-19 berjalan lancar. Sejumlah 21,57% kelancaran proses pembelajaran memiliki kategori sebagian besar pertemuan lancar. Kesesuaian hasil belajar mahasiswa dengan CPL sebesar 88,46%. CPL Berdasarkan hasil angket diperoleh data bahwa ketercapaian hasil belajar mahasiswa yang sesuai (80-100%) sejumlah 83,33%. Hasil tersebut menggambarkan hasil belajar mahasiswa terlah memenuhi aspek ketercapaian. Kata Kunci: Pembelajaran Seni, evaluasi, countenance stake
Tinjauan performance measurement pada pengelolaan produksi pementasan teater
Authors: Alfianti Dewi
Published: June 2023

Tulisan ini bertujuan untuk menguraikan proses produksi pementasan teater oleh mahasiswa peserta mata kuliah Apresiasi Drama tahun 2021 dan Apresiasi Sastra tahun 2022 di Program Studi Pendidikan Bahasa dan Sastra Indonesia, Fakultas Keguruan dan Ilmu Pendidikan, Universitas Lambung Mangkurat (PS PBSI FKIP ULM), dan penilaian kinerja berdasarkan model Integrated performance Measurement System. Tulisan ini menggunakan pendekatan kualitatif dengan metode deskriptif. Hasil yang didapatkan menunjukkan bahwa pengelolaan badan produksi yang dilakukan mahasiswa dikategorikan baik dengan kisaran nilai 7,5-8. Hasil ini diharapkan dapat menjadi bahan evaluasi dan peningkatan pembelajaran bagi dosen pengampu.Kata kunci: performance measurement, badan produksi, pementasan teater, penilaian kinerja, evaluasi pembelajaran,ABSTRACTThis paper aims to describe the production process of theatrical performances by students participating in the 2021 Drama Appreciation and Literary Appreciation courses in 2022 at the Indonesian Language and Literature Education Study Program, Faculty of Teacher Training and Education, Lambung Mangkurat University (PS PBSI FKIP ULM), and an assessment performance based on the Integrated performance Measurement System model. This paper uses a qualitative approach with a descriptive method. The results obtained indicate that the management of production bodies carried out by students is categorized as good with a range of 7.5-8. These results are expected to be used as material for evaluation and improvement of learning for supporting lecturersKeyword: performance measurement, production group, theatrical performance, performance assesment, learning evaluation
The development of assessment instrument for the Gambyong Pareanom dance practice
Authors: Rumiwiharsih Rumiwiharsih
Published: June 2023

This study aims to develop an assessment instrument for the Gambyong Pareanom dance for students of the Dance Arts Education Study Program, Faculty of Languages and Arts of Yogyakarta State University, to find out the effectiveness of the Surakarta style Gambyong Pareanom dance assessment instrument. This was a research and development study with the DDD-E model by Borg Gall consisting of several development stages, including planning, design, and development, initial product trial, initial product revision, final product revision, operational product revision, and operational product trial. This research and development study involved 30 students of the Dance Arts Education Study Program, Faculty of Languages and Arts of Yogyakarta State University. The planning stage includes a needs analysis study and formulating these needs in a development plan. The planning involved several Javanese dance lecturers in Surakarta. This planning stage was carried out by determining the scope, identifying the characteristics of learning/students, determining product limitations, and making planning documents. The second stage, namely the design stage, includes making the design of the Gambyong Dance practice assessment model, which consists of aspects of assessment (attitudes, knowledge, and skills) in accordance with the learning outcomes of the Surakarta Female Dance course. The third stage, which is development, includes initial product trial, initial product revision, final product trial, and operational product trial. The effectiveness of the model was assessed based on the percentage of lecturers’ satisfaction on the Surakarta dance course, with the Gambyong Pareanom dance material based on the results of product trial. The results of the study show that the product is an assessment sheet which includes aspects of: 1) pacak, 2) pancat, 3) ulat, 4) lulut, 5) wiled, 6) luwes, 7) wirama, and 8) gendhing, all of which referred to as Hasta Sawanda. Two other aspects (wiraga and wirasa) are added, resulting in a total of ten assessment aspects. The effectiveness of the product shows that this assessment sheet is good for assessing the Gambyong Pareanom dance. Keywords: development, instrument, assessment, dance
The effect of storage conditions on the characteristics of various types of biomass
Authors: Nimitpaitoon Tassanapoom , Sajjakulnukit Boonrod , Prangbang Punyaporn
Published: June 2023

In order to determine optimal conditions for maintaining biomass quality during storage, an analysis was conducted to investigate the changes in biomass characteristics in Bangkok, Thailand. The study focused on three types of biomass: corncob, woodchip, and bagasse, which are valuable renewable energy resources in the region. Each type of biomass was divided into two separate piles: one covered with a plastic sheet and the other left uncovered. Over a storage period of seven months (February-September), various characteristics of the biomass piles were evaluated, including pile temperature, moisture content, ash content, heating value, and dry matter loss. The findings indicate that the utilization of plastic sheets significantly enhanced the quality of corncob and woodchip biomass. This improvement was attributed to reduced moisture content, leading to higher heating values, lower ash content, and decreased dry matter loss in the covered piles compared to the uncovered ones. However, such improvements were not observed in the case of bagasse, as its quality exhibited fluctuations throughout the study period.
Cutaneous Manifestations of Anabolic-Androgenic Steroid Use in Bodybuilders and the Dermatologist’s Role in Patient Care
Authors: Furth Garrett , Marroquin Nathaniel A , Kirk Jessica , Ajmal Hamza , Szeto Mindy D , Zueger Morgan , Quinn Alyssa P , Carboni Alexa , Dellavalle Robert P
Published: June 2023

Young adults have been increasingly facing pressure to achieve an appealing athletic physique, often influenced by social media influencers on platforms like Instagram. This viewpoint highlights the association between image-centric social media, dissatisfied body image, the use of anabolic-androgenic steroids (AAS) to achieve desired results, and the overlooked dermatological side effects of AAS, including acne and acne fulminans. We underscore the importance of recognizing acne fulminans as an indicator of possible AAS abuse and encourage dermatologists to actively identify and address AAS use to improve their patients’ well-being.
Patient Satisfaction With a Multisite, Multiregional Remote Patient Monitoring Program for Acute and Chronic Condition Management: Survey-Based Analysis
Authors: Haddad Tufia C , Maita Karla C , Inselman Jonathan W , Avila Francisco R , Torres-Guzman Ricardo A , Coffey Jordan D , Christopherson Laura A , Leuenberger Angela M , Bell Sarah J , Pahl Dominick F , Garcia John P , Manka Lukas , Forte Antonio J , Maniaci Michael J
Published: June 2023

Background

Remote patient monitoring (RPM) is an option for continuously managing the care of patients in the comfort of their homes or locations outside hospitals and clinics. Patient engagement with RPM programs is essential for achieving successful outcomes and high quality of care. When relying on technology to facilitate monitoring and shifting disease management to the home environment, it is important to understand the patients’ experiences to enable quality improvement.

Objective

This study aimed to describe patients’ experiences and overall satisfaction with an RPM program for acute and chronic conditions in a multisite, multiregional health care system.

Methods

Between January 1, 2021, and August 31, 2022, a patient experience survey was delivered via email to all patients enrolled in the RPM program. The survey encompassed 19 questions across 4 categories regarding comfort, equipment, communication, and overall experience, as well as 2 open-ended questions. Descriptive analysis of the survey response data was performed using frequency distribution and percentages.

Results

Surveys were sent to 8535 patients. The survey response rate was 37.16% (3172/8535) and the completion rate was 95.23% (3172/3331). Survey results indicated that 88.97% (2783/3128) of participants agreed or strongly agreed that the program helped them feel comfortable managing their health from home. Furthermore, 93.58% (2873/3070) were satisfied with the RPM program and ready to graduate when meeting the program goals. In addition, patient confidence in this model of care was confirmed by 92.76% (2846/3068) of the participants who would recommend RPM to people with similar conditions. There were no differences in ease of technology use according to age. Those with high school or less education were more likely to agree that the equipment and educational materials helped them feel more informed about their care plans than those with higher education levels.

Conclusions

This multisite, multiregional RPM program has become a reliable health care delivery model for the management of acute and chronic conditions outside hospitals and clinics. Program participants reported an excellent overall experience and a high level of satisfaction in managing their health from the comfort of their home environment.
Mindfulness-Based Mobile Apps and Their Impact on Well-Being in Nonclinical Populations: Systematic Review of Randomized Controlled Trials
Authors: Schwartz Katrin , Ganster Fabienne Marie , Tran Ulrich S
Published: June 2023

Background

Mindfulness-based mobile apps have become popular tools for enhancing well-being in today’s fast-paced world. Their ability to reduce geographical, financial, and social barriers makes them a promising alternative to traditional interventions.

Objective

As most available apps lack a theoretical framework, this review aimed to evaluate their effectiveness and assess their quality. We expected to find small sample sizes, high dropout rates, and small effect sizes in the included studies.

Methods

A systematic literature search was conducted using PsycInfo, PsycNet, PubMed, an institutional search engine (u:search), and Google Scholar. Randomized controlled trials assessing the impact of mobile mindfulness apps on well-being in nonclinical samples were included. Study selection, risk of bias (using the version 2 of the Cochrane risk-of-bias tool for randomized trials), and reporting quality (using selected CONSORT [Consolidated Standards of Reporting Trials] statement criteria) assessments were performed by 2 authors independently and discussed until a consensus was reached.

Results

The 28 included randomized controlled trials differed in well-being measures, apps, and intervention duration (7 to 56 days; median duration 28 days). A wide range of sample sizes (12 to 2282; median 161) and attrition rates (0% to 84.7%; median rate 23.4%) were observed. Most studies (19/28, 68%) reported positive effects on at least one aspect of well-being. The effects were presented using different metrics but were primarily small or small to medium in size. Overall risk of bias was mostly high.

Conclusions

The wide range of sample sizes, attrition rates, and intervention periods and the variation in well-being measures and mobile apps contributed to the limited comparability of the studies. Although most studies (16/28, 57%) reported small or small to medium effects for at least one well-being outcome, this review demonstrates that the generalizability of the results is limited. Further research is needed to obtain more consistent conclusions regarding the impact of mindfulness-based mobile apps on well-being in nonclinical populations.
Perceived Use Cases, Barriers, and Requirements for a Smart Health-Tracking Toilet Seat: Qualitative Focus Group Study
Authors: Hermsen Sander , Verbiest Vera , Buijs Marije , Wentink Eva
Published: June 2023

Background

Smart bathroom technology offers unrivaled opportunities for the automated measurement of a range of biomarkers and other data. Unfortunately, efforts in this area are mostly driven by a technology push rather than market pull approach, which decreases the chances of successful adoption. As yet, little is known about the use cases, barriers, and desires that potential users of smart bathrooms perceive.

Objective

This study aimed to investigate how participants from the general population experience using a smart sensor-equipped toilet seat installed in their home. The study contributes to answering the following questions: What use cases do citizens see for this innovation? and What are the limitations and barriers to its everyday use that they see, including concerns regarding privacy, the lack of fit with everyday practices, and unmet expectations for user experience?

Methods

Overall, 31 participants from 30 households participated in a study consisting of 3 (partially overlapping) stages: sensitizing, in which participants filled out questionnaires to trigger their thoughts about smart bathroom use and personal health; provotyping, in which participants received a gentle provocation in the form of a smart toilet seat, which they used for 2 weeks; and discussion, in which participants took part in a web-based focus group session to discuss their experiences.

Results

Participants mostly found the everyday use of the toilet, including installation and dismantling when necessary, to be relatively easy and free of complications. Where complications occurred, participants mentioned issues related to the design of the prototype, technology, or mismatches with normal practices in using toilets and hygiene. A broad range of use cases were mentioned, ranging from signaling potentially detrimental health conditions or exacerbations of existing conditions to documenting physical data to measuring biomarkers to inform a diagnosis and behavioral change. Participants differed greatly in whether they let others use, or even know about, the seat. Ownership and control over their own data were essential for most participants.

Conclusions

This study showed that participants felt that a smart toilet seat could be acceptable and effective, as long as it fits everyday practices concerning toilet use and hygiene. The range of potential uses for a smart toilet seat is broad, as long as privacy and control over disclosure and data are warranted.
A Web-Based Sexual Violence, Alcohol Misuse, and Bystander Intervention Program for College Women (RealConsent): Randomized Controlled Trial (Preprint)
Authors: Salazar Laura Francisca , Schipani-McLaughlin Anne Marie , Sebeh Yesser , Nizam Zainab , Hayat Matt
Published: June 2023

BACKGROUND

Sexual violence (SV) incidence among college women has been invariant for the past 20 years. Innovative prevention strategies that are low resource and technology driven but demonstrate efficacy are greatly needed.

OBJECTIVE

The aim of this study was to determine the efficacy of a novel theoretically driven internet-based intervention for first-year college students who identify as women (RealConsent) in reducing their risk of exposure to SV and alcohol misuse as well as increasing alcohol protective and bystander behaviors.

METHODS

This randomized controlled trial involved first-year college students who identified as women (n=881) attending 1 of 3 universities in the southeastern United States. Participants aged 18 to 20 years were randomized to RealConsent (444/881, 50.4%) or to an attention-matched placebo control (437/881, 49.6%). RealConsent is fully automated and consists of four 45-minute modules that incorporate entertainment-education media and proven behavior change techniques. The primary outcome was exposure to SV; the secondary outcomes were alcohol protective behaviors, dating risk behaviors, alcohol misuse, and bystander behavior. Study outcomes were assessed at baseline and 6-month follow-up.

RESULTS

Among participants with some exposure to SV, those in the RealConsent group experienced less exposure to SV than the placebo group (adjusted incidence rate ratio 0.48, 95% CI 0.33-0.69; P=.002). Furthermore, participants in the RealConsent group engaged in more alcohol protective behaviors (adjusted odds ratio 1.17, 95% CI 0.12-2.22; P=.03) and were less likely to binge drink (adjusted incidence rate ratio 0.81, 95% CI 0.67-0.97; P=.003). Finally, participants in the RealConsent group who had 100% dosage were more likely to engage in bystander behavior than those with <100% dosage plus placebo group (adjusted odds ratio 1.72, 95% CI 1.17-2.55; P=.006).

CONCLUSIONS

A comprehensive exposure to SV, alcohol use, and bystander educational program was successful in decreasing the occurrence of exposure to SV among those most at risk and in increasing alcohol protective behaviors. Because of its web-based and mobile technologies, RealConsent can be easily disseminated and holds potential for reducing campus SV.

CLINICALTRIAL

ClinicalTrials.gov NCT03726437; https://clinicaltrials.gov/ct2/show/NCT03726437
Improvement of Cancer Prevention and Control: Reflection on the Role of Emerging Information Technologies (Preprint)
Authors: Dong Pei , Mao Ayan , Qiu Wuqi , Li Guanglin
Published: June 2023

UNSTRUCTURED

Cancer has become an important public health problem affecting the health of Chinese residents, as well as residents all over the world. With the improvement of cancer prevention and treatment, the growth of the mortality rate of cancers has slowed down gradually, but the incidence rate is still increasing rapidly, and cancers still impose heavy disease and economic burdens. Cancer screening and early cancer diagnosis and treatment are important ways to reduce the burden of cancer-related diseases. At present, various projects for early cancer diagnosis and treatment have been implemented in China. With the expansion of the coverage of these projects, the problems related to project implementation, operation, and management have emerged gradually. In recent years, emerging information technologies have been applied in the field of health and have facilitated health management and clinical decision-making. Meanwhile, China announced multiple policies to encourage and promote the application of information technologies in the field of health. Therefore, combined with the analysis of major problems in cancer prevention and control projects, this paper probes into how to apply information technologies such as biological information mining, artificial intelligence, and electronic information collection technology to various stages of cancer prevention and control. Information technologies realize the integrated management of prevention and control processes, for example, mobilization and preliminary identification, high-risk assessment, clinical screening, clinical diagnosis and treatment, tracking and follow-up, and biological sample management of high-risk groups, and promote the efficient implementation of cancer prevention and control projects in China.
True Mitotic Count Prediction in Gastrointestinal Stromal Tumors: Bayesian Network Model and PROMETheus (Preoperative Mitosis Estimator Tool) Application Development (Preprint)
Authors: Renne Salvatore Lorenzo , Cammelli Manuela , Santori Ilaria , Tassan-Mangina Marta , Samà Laura , Ruspi Laura , Sicoli Federico , Colombo Piergiuseppe , Terracciano Luigi Maria , Quagliuolo Vittorio , Cananzi Ferdinando Carlo Maria
Published: June 2023

BACKGROUND

Gastrointestinal stromal tumors (GISTs) present a complex clinical landscape, where precise preoperative risk assessment plays a pivotal role in guiding therapeutic decisions. Conventional methods for evaluating mitotic count, such as biopsy-based assessments, encounter challenges stemming from tumor heterogeneity and sampling biases, thereby underscoring the urgent need for innovative approaches to enhance prognostic accuracy.

OBJECTIVE

The primary objective of this study was to develop a robust and reliable computational tool, PROMETheus (Preoperative Mitosis Estimator Tool), aimed at refining patient stratification through the precise estimation of mitotic count in GISTs.

METHODS

Using advanced Bayesian network methodologies, we constructed a directed acyclic graph (DAG) integrating pertinent clinicopathological variables essential for accurate mitotic count prediction on the surgical specimen. Key parameters identified and incorporated into the model encompassed tumor size, location, mitotic count from biopsy specimens, surface area evaluated during biopsy, and tumor response to therapy, when applicable. Rigorous testing procedures, including prior predictive simulations, validation utilizing synthetic data sets were employed. Finally, the model was trained on a comprehensive cohort of real-world GIST cases (n=80), drawn from the repository of the Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Humanitas Research Hospital, with a total of 160 cases analyzed.

RESULTS

Our computational model exhibited excellent diagnostic performance on synthetic data. Different model architecture were selected based on lower deviance and robust out-of-sample predictive capabilities. Posterior predictive checks (retrodiction) further corroborated the model’s accuracy. Subsequently, PROMETheus was developed. This is an intuitive tool that dynamically computes predicted mitotic count and risk assessment on surgical specimens based on tumor-specific attributes, including size, location, surface area, and biopsy-derived mitotic count, using posterior probabilities derived from the model.

CONCLUSIONS

The deployment of PROMETheus represents a potential advancement in preoperative risk stratification for GISTs, offering clinicians a precise and reliable means to anticipate mitotic counts on surgical specimens and a solid base to stratify patients for clinical studies. By facilitating tailored therapeutic strategies, this innovative tool is poised to revolutionize clinical decision-making paradigms, ultimately translating into improved patient outcomes and enhanced prognostic precision in the management of GISTs.
Requirements for and Barriers to Rehabilitation Services for Children With Disabilities in Middle- and High-Income Countries: Scoping Review (Preprint)
Authors: Xie Yijun , Wu Jing , Li Yao , Liu Hui , Peng Yanyan , Zhou Ping , Sun Yizhou , Kang Luyan , Jiang Chenghua , Wu Hengjing
Published: June 2023

BACKGROUND

The rehabilitation of children with disabilities has received considerable attention from the United Nations. However, the state of rehabilitation services for children with disabilities worldwide remains far from optimistic, even in economically affluent middle- and high-income countries.

OBJECTIVE

This scoping review aimed to identify the rehabilitation needs of children with disabilities and their barriers to rehabilitation services in middle- and high-income countries.

METHODS

A systematic search was conducted using MEDLINE and Web of Science for papers published from January 2013 to December 2023. Studies were included if they were peer-reviewed, full-text articles related to children with disabilities, reporting on their access to rehabilitation services, and conducted in countries classified by the World Bank 2023 as middle- and high-income economies. Exclusion criteria included duplicates, unavailable full texts, and studies without distinct outcomes. A total of 27 studies were selected following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, focusing on children, their families, or service providers.

RESULTS

The suitability, availability, and affordability of rehabilitation services were identified as the major needs and barriers for children with disabilities in middle- and high-income countries. This included communication barriers, a need for more personnel and facilities, and the stagnation and inadequacy of economic subsidies.

CONCLUSIONS

Middle- and high-income countries have relatively well-established rehabilitation infrastructure and support systems. They are nevertheless insufficient for meeting the needs of children with disabilities. More attention should be paid to these issues to improve the well-being of children with disabilities. The data provided by this review can help raise awareness of rehabilitation needs and barriers at the policy level.
Factors Associated With Worsened Mental Health of Health Care Workers in Canada During the COVID-19 Pandemic: Cross-Sectional Survey Study (Preprint)
Authors: AbdulHussein Ali , Butt Zahid Ahmad , Dimitrov Stanko , Cozzarin Brian
Published: June 2023

BACKGROUND

Health care workers (HCWs) in Canada have endured difficult conditions during the COVID-19 pandemic. Many worked long hours while attending to patients in a contagious environment. This introduced an additional burden that may have contributed to worsened mental health conditions.

OBJECTIVE

In this study, we examine the factors associated with worsened mental health conditions of HCWs as compared to before the start of the pandemic.

METHODS

We use data from a survey of HCWs by Statistics Canada. A regression model is used to estimate the odds ratios (ORs) of worsened mental health after the start of the pandemic. The estimated odds ratio (OR) is associated with different independent variables that include demographics (age, sex, immigration status, and geographic area), occupational factors (work status, occupational group, and exposure category), and different access levels to personal protective equipment (PPE).

RESULTS

Of 18,139 eligible participants surveyed, 13,990 (77.1%) provided valid responses. We found that HCWs younger than 35 years old were more likely (OR 1.14, 95% CI 1.03-1.27; P=.01) to exhibit worsened mental health as compared to the reference group (35-44 years old). As for sex, male HCWs were less likely (OR 0.76, 95% CI 0.67-0.86; P<.001) to exhibit worsened mental health as compared to female HCWs. Immigrant HCWs were also less likely (OR 0.57, 95% CI 0.51-0.64; P<.001) to exhibit worsened mental health as compared to nonimmigrant HCWs. Further, HCWs working in Alberta had the highest likelihood of exhibiting worsened mental health as compared to HCWs working elsewhere (Atlantic provinces, Quebec, Manitoba, Saskatchewan, Ontario, British Columbia, and Northern Territories). Frontline workers were more likely (OR 1.26, 95% CI 1.16-1.38; P<.001) to exhibit worsened mental health than nonfrontline HCWs. Part-time HCWs were less likely (OR 0.85, 95% CI 0.76-0.93; P<.001) to exhibit worsened mental health than full-time HCWs. HCWs who reported encountering COVID-19 cases were more likely (OR 1.55, 95% CI 1.41-1.70; P<.001) to exhibit worsened mental health as compared to HCWs who reported no contact with the disease. As for PPE, HCWs who never had access to respirators, eye protection, and face shields are more likely to exhibit worsened mental health by 1.31 (95% CI 1.07-1.62; P<.001), 1.51 (95% CI 1.17-1.96; P<.001), and 1.41 (95% CI 1.05-1.92; P=.02) than those who always had access to the same PPE, respectively.

CONCLUSIONS

Different HCW groups experienced the pandemic differently based on their demographic and occupational backgrounds as well as access to PPE. Such findings are important to stakeholders involved in the planning of personalized support programs and aid mental health mitigation in future crises. Certain groups require more attention.

CLINICALTRIAL
Human-AI Teaming in Critical Care: A Comparative Analysis of Data Scientists’ and Clinicians’ Perspectives on AI Augmentation and Automation (Preprint)
Authors: Bienefeld Nadine , Keller Emanuela , Grote Gudela
Published: June 2023

BACKGROUND

Artificial intelligence (AI) holds immense potential for enhancing clinical and administrative health care tasks. However, slow adoption and implementation challenges highlight the need to consider how humans can effectively collaborate with AI within broader socio-technical systems in health care.

OBJECTIVE

In the example of intensive care units (ICUs), we compare data scientists’ and clinicians’ assessments of the optimal utilization of human and AI capabilities by determining suitable levels of human-AI teaming for safely and meaningfully augmenting or automating 6 core tasks. The goal is to provide actionable recommendations for policy makers and health care practitioners regarding AI design and implementation.

METHODS

In this multimethod study, we combine a systematic task analysis across 6 ICUs with an international Delphi survey involving 19 health data scientists from the industry and academia and 61 ICU clinicians (25 physicians and 36 nurses) to define and assess optimal levels of human-AI teaming (level 1=no performance benefits; level 2=AI augments human performance; level 3=humans augment AI performance; level 4=AI performs without human input). Stakeholder groups also considered ethical and social implications.

RESULTS

Both stakeholder groups chose level 2 and 3 human-AI teaming for 4 out of 6 core tasks in the ICU. For one task (monitoring), level 4 was the preferred design choice. For the task of patient interactions, both data scientists and clinicians agreed that AI should not be used regardless of technological feasibility due to the importance of the physician-patient and nurse-patient relationship and ethical concerns. Human-AI design choices rely on interpretability, predictability, and control over AI systems. If these conditions are not met and AI performs below human-level reliability, a reduction to level 1 or shifting accountability away from human end users is advised. If AI performs at or beyond human-level reliability and these conditions are not met, shifting to level 4 automation should be considered to ensure safe and efficient human-AI teaming.

CONCLUSIONS

By considering the sociotechnical system and determining appropriate levels of human-AI teaming, our study showcases the potential for improving the safety and effectiveness of AI usage in ICUs and broader health care settings. Regulatory measures should prioritize interpretability, predictability, and control if clinicians hold full accountability. Ethical and social implications must be carefully evaluated to ensure effective collaboration between humans and AI, particularly considering the most recent advancements in generative AI.
Kekuatan kompresi semen alpha tricalcium phosphate dengan komposisi larutan sodium yang berbeda
Authors: Ruslin Ruslin , Larnani Sri , Nursalim Priztika Widya , Rachmawati Mayu Winnie , Dewi Anne Handrini
Published: June 2023

Calcium phosphate cement (CPC) merupakan campuran dari cairan dan serbuk yang mengandung calcium phosphate. Kelebihan CPC dibandingkan dengan bone graft lain adalah dapat menyesuaikan defek tulang, mengeras pada in vivo, dan biokompatibel. Kekurangan dari CPC adalah kekuatan mekanik yang rendah. Reaksi setting dan mengerasnya CPC dikarenakan adanya ikatan antar kristal apatite yang berpresipitasi. Cairan yang mengandung ion fosfat biasanya digunakan sebagai campuran untuk mempercepat reaksi setting. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan kekuatan kompresi semen alpha tricalcium phosphate (α-TCP) dengan penggunaan larutan disodium hydrogen phosphate (Na2HPO4) dan sodium dihydrogen phosphate (NaH2PO4). Sebanyak 12 sampel semen α-TCP dibuat dengan ukuran diameter 3 mm dan tinggi 6 mm. Sampel penelitian dibagi menjadi 2 kelompok perlakuan, kelompok pertama campuran serbuk dan larutan Na2HPO4 dan kelompok kedua campuran serbuk α-TCP dan larutan NaH2PO4. Sampel kemudian direndam dalam larutan saline selama 24 jam pada suhu 37 °C. Setelah perendaman selesai, sampel diuji dengan menggunakan universal testing machine (UTM). Data yang diperoleh dimasukkan ke dalam rumus untuk mengetahui kekuatan kompresinya. Data kemudian dianalisis dengan menggunakan independent sample t-test dengan tingkat signifikansi 95%. Rerata kekuatan kompresi semen α-TCP dengan penggunaan larutan Na2HPO4 dan NaH2PO4 adalah 44,51 ± 4,22 MPa dan 21,52 ± 1,85 MPa. Hasil analisis statistik menunjukkan adanya perbedaan yang signifikan pada penggunaan kedua larutan (p < 0,05). Kesimpulan penelitian ini adalah terdapat perbedaan kekuatan kompresi yang signifikaan antara semen α- TCP dengan penggunaan larutan Na2HPO4 NaH2PO44. Kekuatan kompresi semen α-TCP dengan penggunaan larutan Na2HPO4 lebih tinggi daripada semen α-TCP dengan penggunaan larutan NaH2PO4.
Replantasi intensional fraktur gigi vertikal menggunakan mineral trioxide aggregate dan self adhesive resin cement terhadap pembentukan kolagen tipe I
Authors: Untara Tri Endra , Kristanti Yulita , Widyastuti Andina
Published: June 2023

Replantasi intensional merupakan salah satu cara untuk mempertahankan gigi yang mengalami fraktur vertikal. Replantasi gigi dengan fraktur vertikal memerlukan kerapatan pada sisi fraktur dengan baik. Hal ini dapat dicapai dengan cara penempatan perekat fragmen fraktur yang tepat yang dapat diterima tubuh agar dicapai penyembuhan yang baik. Tujuan penelitian ini adalah untuk mengetahui reaksi regenerasi jaringan periradikuler dengan indikator pembentukan kolagen tipe I pada penggunaan self-adhesive resin cement dan mineral trioxide aggregate (MTA) sebagai bahan penutup garis fraktur. Penelitian menggunakan 27 ekor kelinci New Zealand jantan yang dibagi menjadi 3 kelompok perlakuan. Kelompok I tanpa aplikasi bahan (kontrol), kelompok II dengan aplikasi MTA dan kelompok III dengan aplikasi self-adhesive resin cement. Pengamatan pembentukan kolagen tipe I dilakukan pada hari ke-7 (minggu I), hari ke-14 (minggu II) dan hari ke-21 (minggu III). Serum diambil dari darah kelinci melalui vena auricularis. Kadar kolagen tipe I diamati dengan rabbit collagen type I kit menggunakan teknik ELISA. Data dianalisis dengan analisis variansi dan post hoc LSD dengan tingkat kepercayaan 95%. Hasil uji statistik dengan analisis variansi menunjukkan bahwa terdapat pengaruh yang signifikan (p < 0,05) penggunaan self-adhesive resin cement dan MTA sebagai penutup garis fraktur pada replantasi intensional fraktur gigi vertikal terhadap pembentukan kolagen tipe I. Pembentukan kolagen tipe I kelompok dengan aplikasi MTA lebih tinggi dari kelompok kontrol maupun kelompok self-adhesive resin cement pada pengamatan minggu II dan minggu III (p < 0,05). Berdasarkan penelitian yang telah dilakukan dapat diambil kesimpulan bahwa pembentukan kolagen tipe I pada aplikasi MTA lebih tinggi daripada self-adhesive resin cement.