bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and optimisation of a mobile app (iMPAKT) for improving person-centred practice in healthcare settings: A multi-methods evaluation study
Authors: O’Connor SR , Wilson V , Brown D , Cleland I , McCance TV 
Published: October 2024

Objective To develop and optimise an app (iMPAKT) for improving implementation and measurement of person-centred practice in healthcare settings. Methods Two iterative rounds of testing were carried out based on cognitive task analysis and qualitative interview methods. The System Usability Scale (SUS) was also used to evaluate the app. Quantitative data on task completion and SUS scores were evaluated descriptively, with thematic analysis performed on qualitative data. The MoSCoW prioritisation system was used to identify key modifications to improve the app. Results Twelve participants took part (eight health professionals and four patient and public involvement representatives). Views on design and structure of the app were positive. The majority of the 16 tasks undertaken during the cognitive task analysis were easy to complete. Mean SUS scores were 73.5/100 (SD: 7.9; range = 60–92.5), suggesting good overall usability. For one section of the app that transcribes patients speaking about their experience of care, a non-intuitive user interface and lack of transcription accuracy were identified as key issues influencing usability and acceptability. Conclusions Findings from the evaluation were used to inform iterative modifications to further develop and optimise the iMPAKT App. These included improved navigational flow, and implementation of an updated artificial intelligence (AI) based Speech-To-Text software; allowing for more accurate, real-time transcription. Use of such AI-based software represents an interesting area that requires further evaluation. This is particularly apparent in relation to potential for large-scale collection of data on person-centred measures using the iMPAKT App, and for assessing initiatives designed to improve patient experience.
Developing, delivering, and evaluating an online course on socially assistive robots in culturally competent and compassionate healthcare: A sequential multiphase, mixed-method study
Authors: Papadopoulos Irena , Lazzarino Runa 
Published: October 2024

Objective Artificially intelligent socially assistive robots are a growing technology. There is no evidence-based, theory-informed, open access training targeting health and social care professionals on this advanced technology. This collaborative, international European project – the IENE 10 study – developed, delivered, and evaluated the first Massive Open Online Course on socially assistive robots. Methods A sequential mixed-method design with five phases: (1) literature review; (2) development of the Transcultural Robotic Nursing curriculum model from the care ethics principles of cultural competence and compassion; (3) development of modules, learning units, and assessments; (4) choice of the digital platform, e-facilitators’ training, and definition of the evaluation strategy; (5) recruitment campaign. The methodology was collaborative among the six European partner institutions, who all contributed to each phase, from planning to the outputs. All project outputs and MOOC contents were translated into the four languages of the partners. Results Training needs identified included: knowledge about social robots’ functionality; how to operate them; legal, ethical, and human rights' issues. The course had four modules: Awareness, Knowledge, Sensitivity and Competence, with four learning units each. E-learners ( n = 240) were mostly based in the project partners’ countries and with no previous training on social robots. Graduated e-learners ( n = 185) found their knowledge and skills enhanced, both in relation to social robots and cultural competence. The learning units and the overall quality of the course were rated between good and excellent. Conclusions The IENE 10 project pioneeringly addressed the training needs of health and social care professionals in the era of AI social robots. The collaborative and sequentially phased design proved useful in the integration of a care ethics model. This work reflects the holistic approach needed for preparing professionals for the complexities of contemporary healthcare.
Generative artificial intelligence writing open notes: A mixed methods assessment of the functionality of GPT 3.5 and GPT 4.0
Authors: Kharko Anna , McMillan Brian , Hagström Josefin , Muli Irene , Davidge Gail , Hägglund Maria , Blease Charlotte 
Published: October 2024

Background Worldwide, patients are increasingly being offered access to their full online clinical records including the narrative reports written by clinicians (so-called “open notes”). Against these developments, there is growing interest in the use of generative artificial intelligence (AI) such as OpenAI's ChatGPT to co-assist clinicians with patient-facing documentation. Objective This study aimed to explore the effectiveness of OpenAI's ChatGPT 3.5 and GPT 4.0 in generating three patient-facing clinical notes from fictional general practice narrative reports. Methods On 1 October 2023 and 1 November 2023, we used ChatGPT 3.5 and 4.0 to generate notes for three validated fictional general practice notes, using a prompt in the style of a British primary care note for three commonly presented conditions: (1) type 2 diabetes, (2) major depressive disorder, and (3) a differential diagnosis for suspected bowel cancer. Outputs were analyzed for reading ease, sentiment analysis, empathy, and medical fidelity. Results ChatGPT 3.5 and 4.0 wrote longer notes than the original, and embedded more second person pronouns, with ChatGPT 3.5 scoring higher on both. ChatGPT expanded abbreviations, but readability metrics showed that the notes required a higher reading proficiency, with ChatGPT 3.5 demanding the most advanced level. Across all notes, ChatGPT offered higher signatures of empathy across cognitive, compassion/sympathy, and prosocial cues. Medical fidelity ratings varied across all three cases with ChatGPT 4.0 rated superior. Conclusions While ChatGPT improved sentiment and empathy metrics in the transformed notes, compared to the original they also required higher reading proficiency and omitted details impacting medical fidelity.
Future of knowledge management in investment banking: Role of personal intelligent assistants
Authors: Radhakrishna Vedapradha , Ravi Hariharan , Elango Sudha , Divyashree Venkoba , Jaganathan Ashok , Ponnusamy Muralidharan 
Published: October 2024

Purpose: The study’s objective focuses on investigating the involvement of Personal Intelligent Assistants (PIAs) in the Knowledge Management Process (KMP) in Investment Banking Companies leading to Industrial Revolution 5.0 leading to effective Organizational Knowledge Management. Design/Methodology: A Self-administered Survey Questionnaire was circulated to 695 employees of Investment Banking Companies operating in Bangalore, Mumbai, Delhi, Hyderabad, Chennai, and Pune using the Cluster Sampling method. The Covariance-based Structural Equation Modelling (CB-SEM) and Gradient Boosting Regression technique of Machine Learning were used to validate the hypothesis through JASP V.18 Software. Knowledge Creation, Knowledge Sharing, Knowledge Retrieval, Knowledge Application, and Organizational Knowledge Management are the crucial constructs considered in the study. Findings: The results revealed that Knowledge Application is the most influencing factor in effective organizational Knowledge management among the Investment Banks followed by Knowledge Sharing. It also emphasizes that they have a weak Knowledge retrieval process and minimal efforts taken to create knowledge within these banks. Implications: The PIAs can facilitate effective Data Analysis and research in managing vast data eliminating the repeated tasks in portfolio reconciliation and offering personalized recommendations to manage portfolios. It enables in compliance, risk management, client relationship management, real-time monitoring and leveraged decision-making through predictive analysis.
Board diversity and firm performance in Chinese manufacturing firms: Moderating role of CEO duality
Authors: Zahid Zohaib , Zhang Jijian , Ali Furman , Shahzad Fakhar 
Published: October 2024

This study explores the relationship between board diversity and firm performance, with a focus on the moderating role of CEO duality in Chinese manufacturing firms. This study applies panel fixed-effect regression models for the period 2008–2022, and findings show that board diversity is positively associated with firm performance, and CEO duality negatively moderates the relationship. However, the findings also show that a highly diversified board can minimize the negative effect of CEO duality and increase the firm’s performance. Furthermore, the findings broaden the understanding of board attributes, showing that the education index is more evident among other board attributes for firm performance. This study verifies its results using the two-step system generalized method of moments approach and different board attributes in robust tests. The findings suggest that strategic efforts to promote board diversity may increase the board’s monitoring function and control managerial opportunism, ultimately improving firm performance in the Chinese business landscape. JEL CLASSIFICATIONS: G30; G34; L25
Voices of Thai Patients With Non-Communicable Diseases Towards Healthy and Ready Meal Products: A Mixed-Methods Research
Authors: Sooampon Sireerat , Sooampon Sutti 
Published: October 2024

Introduction Healthy diets reduce the risk of several non-communicable diseases (NCDs) from diabetes to heart disease and hypertension to cancer. Given their busy lifestyles, it is difficult for individuals to routinely prepare healthy food. Therefore, healthy and ready meal products have been developed and commercially launched in Thailand. Objectives Considering ready and healthy meals as an innovative product line in the Thai market, the aim of this study was to identify the factors that influence NCD patients to adopt this product innovation. Methods This study used a mixed-methods approach based on Roger's model of innovation adoption. Two hundred and twenty NCD patients completed a questionnaire regarding their expectations towards healthy meal products. In-depth interviews were conducted with 20 respondents to explore the underlying reasons behind their scoring decisions in the questionnaires. Results The findings revealed that the highest rated items were the expectation that healthy meals reduce the severity of disease, help avoid high-cholesterol food, and comprise a variety of meal choices. Instead of celebrity marketing and corporate branding, the patients preferred healthy meals that are recommended by health professionals and produced by university research teams. The qualitative findings also demonstrated that most patients welcomed healthy menus as a preventive treatment, but still have concerns regarding the availability and quality of the products. Conclusion This study reveals the expectations of prospective consumers, specifically NCD patients, towards healthy and ready meal products. It adds key information for food producers, health professionals, and policymakers to foster healthy food innovation, especially in the context of emerging economies like Thailand where healthy food choices are limited.
Epigenetic features support the diagnosis of B-cell prolymphocytic leukemia and identify 2 clinicobiological subtypes
Authors: Charalampopoulou Stella , Chapiro Elise , Nadeu Ferran , Zenz Thorsten , Beà Sílvia , Martínez-Farran Ares , Aymerich Marta , Rozman Maria , Roos-Weil Damien , Bernard Olivier , Susin Santos A. , Parker Helen , Walewska Renata , Oakes Christopher C. , Strefford Jonathan C. , Campo Elías , Matutes Estela , Duran-Ferrer Martí , Nguyen-Khac Florence , Martín-Subero José I. 
Published: October 2024

Abstract
The recognition of B-cell prolymphocytic leukemia (B-PLL) as a separate entity is controversial based on the current classification systems. Here, we analyzed the DNA methylome of a cohort of 20 B-PLL cases diagnosed according to the guidelines of the International Consensus Classification/Fourth revised edition of the World Health Organization Classification, and compared them with chronic lymphocytic leukemia (CLL), mantle cell lymphoma (MCL), splenic marginal zone lymphoma (SMZL), and normal B-cell subpopulations. Unsupervised principal component analyses suggest that B-PLL is epigenetically distinct from CLL, MCL, and SMZL, which is further supported by robust differential methylation signatures in B-PLL. We also observe that B-PLL can be segregated into 2 epitypes with differential clinicobiological characteristics. B-PLL epitype 1 carries lower immunoglobulin heavy variable somatic hypermutation and a less profound germinal center–related DNA methylation imprint than epitype 2. Furthermore, epitype 1 is significantly enriched in mutations affecting MYC and SF3B1, and displays DNA hypomethylation and gene upregulation signatures enriched in MYC targets. Despite the low sample size, patients from epitype 1 have an inferior overall survival than those of epitype 2. This study provides relevant insights into the biology and differential diagnosis of B-PLL, and potentially identifies 2 subgroups with distinct biological and clinical features.
Detecting complex infections in trypanosomatids using whole genome sequencing
Authors: Reis-Cunha João Luís , Jeffares Daniel Charlton 
Published: October 2024

Abstract
Background
Trypanosomatid parasites are a group of protozoans that cause devastating diseases that disproportionately affect developing countries. These protozoans have developed several mechanisms for adaptation to survive in the mammalian host, such as extensive expansion of multigene families enrolled in host-parasite interaction, adaptation to invade and modulate host cells, and the presence of aneuploidy and polyploidy. Two mechanisms might result in “complex” isolates, with more than two haplotypes being present in a single sample: multiplicity of infections (MOI) and polyploidy. We have developed and validated a methodology to identify multiclonal infections and polyploidy using whole genome sequencing reads, based on fluctuations in allelic read depth in heterozygous positions, which can be easily implemented in experiments sequencing genomes from one sample to larger population surveys.

Results
The methodology estimates the complexity index (CI) of an isolate, and compares real samples with simulated clonal infections at individual and populational level, excluding regions with somy and gene copy number variation. It was primarily validated with simulated MOI and known polyploid isolates respectively from Leishmania and Trypanosoma cruzi. Then, the approach was used to assess the complexity of infection using genome wide SNP data from 497 trypanosomatid samples from four clades, L. donovani/L. infantum, L. braziliensis, T. cruzi and T. brucei providing an overview of multiclonal infection and polyploidy in these cultured parasites. We show that our method robustly detects complex infections in samples with at least 25x coverage, 100 heterozygous SNPs and where 5–10% of the reads correspond to the secondary clone. We find that relatively small proportions (≤ 7%) of cultured trypanosomatid isolates are complex.

Conclusions
The method can accurately identify polyploid isolates, and can identify multiclonal infections in scenarios with sufficient genome read coverage. We pack our method in a single R script that requires only a standard variant call format (VCF) file to run (https://github.com/jaumlrc/Complex-Infections). Our analyses indicate that multiclonality and polyploidy do occur in all clades, but not very frequently in cultured trypanosomatids. We caution that our estimates are lower bounds due to the limitations of current laboratory and bioinformatic methods.
HTS and scRNA-seq revealed that the location and RSS quality of the mammalian TRBV and TRBJ genes impact biased rearrangement
Authors: Wu Yingjie , Wu Fengli , Ma Qingqing , Li Jun , Ma Long , Zhou Hou , Gong Yadong , Yao Xinsheng 
Published: October 2024

AbstractThe quality of Recombination signal sequences (RSSs), location, and genetics of mammalian V, D, and J genes synergistically affect the recombination frequency of genes; however, the specific regulatory mechanism and efficiency have not been elucidated. By taking advantage of single-cell RNA-sequencing (scRNA-seq) and high-throughput sequencing (HTS) to investigate V(D)J rearrangement characteristics in the CDR3 repertoire, we found that the distal and proximal V genes (or J genes) “to D” gene were involved in rearrangement significantly more frequently than the middle V genes (or J genes) in the TRB locus among various species, including Primates (human and rhesus monkey), Rodentia (BALB/c, C57BL/6, and Kunming mice), Artiodactyla (buffalo), and Chiroptera (Rhinolophus affinis). The RSS quality of the V and J genes affected their frequency in rearrangement to varying degrees, especially when the V-RSSs with recombination signal information content (RIC) score < -45 significantly reduced the recombination frequency of the V gene. The V and J genes that were “away from D” had the dual advantages of recombinant structural accessibility and relatively high-quality RSSs, which promoted their preferential utilization in rearrangement. The quality of J-RSSs formed during mammalian evolution was apparently greater than that of V-RSSs, and the D-J distance was obviously shorter than that of V-D, which may be one of the reasons for guaranteeing that the “D-to-J preceding V-to-DJ rule” occurred when rearranged. This study provides a novel perspective on the mechanism and efficiency of V-D-J rearrangement in the mammalian TRB locus, as well as the biased utilization characteristics and application of V and J genes in the initial CDR3 repertoire.
Revisits and frailty in older patients in the emergency department - a prospective observational multicenter study
Authors: Johansson Helena , Fahlander Sara , Hörlin Erika , Henricson Joakim , Munir Ehrlington Samia , Wretborn Jens , Wilhelms Daniel 
Published: October 2024

Abstract
Background
An increased number of revisits may signal that the immediate medical needs of patients seeking care at Emergency Departments (EDs) are not being met. The prevalence and characteristics of revisits to the EDs in Sweden among older patients, and its association to frailty, are unknown. We aimed to investigate the prevalence of ED revisits among patients over 65 years of age, living with or without frailty, and its association with rate of admission, and mortality; in the Swedish ED setting.

Methods
This was a prospective, multicentre study of patients over 65 years of age with an index visit to one of three Swedish EDs during May-Nov 2021. Frailty was assessed in conjunction with standard triage, using the 9-level Clinical Frailty Scale (CFS) with a CFS score of 5 to 8 as cut-off for identifying frailty. For all patients who made a revisit within 90 days of their index visit, we collected information about the revisit, admission, and mortality.

Results
A total of 1835 patients made an index visit which were included, and out of those, 595 patients made a revisit within 90 days of the index visit. Patients living with frailty (CFS 5 to 8) were more likely to make a revisit to the ED at 8 to 30 days (17% vs. 11%, diff 6%, 95% CI 2–10%, p < 0.001) and at 31 to 90 days (19% vs. 12%, diff 7%, 95% CI 3–10%, p < 0.001) and be admitted to in-hospital care during their revisit (57% vs. 47%, diff 10%, 95% CI, 1–18%, p < 0.05), compared to patients living without frailty. Results also show that patients living with frailty had a higher overall mortality rate (17% vs. 5%, diff 12%, 95% CI 7–18%, p < 0.001). However, among patients living without frailty, making a revisit slightly increased the mortality rate compared to those who did not (5% vs. 2%, diff 3%, 95% CI 1–10%, p < 0.05).

Conclusions
Patients living with frailty make more revisits, are more often admitted to in-hospital care, and have a higher overall mortality rate than patients not living with frailty. Frailty, assessed with the CFS may be a simple and useful indicator of increased risk of adverse events, including revisits, in the ED.
Health care utilization at the end of life in Parkinson’s disease: a population-based register study
Authors: Leavy Breiffni , Åkesson Elisabet , Lökk Johan , Schultz Torbjörn , Strang Peter , Franzén Erika 
Published: October 2024

Abstract
Background
Knowledge of health care utilization at the end of life in Parkinson’s disease (PD) is sparse. This study aims to investigate end of life health care utilization, characterized by emergency room (ER) visits, receipt of specialized palliative care (SPC), and acute hospital deaths in a Swedish population-based PD cohort.

Methods
We conducted a retrospective cohort study on deceased patients (≥ 18 years) with a PD diagnosis during their last year of life (n = 922), based on health care-provider data from Region Stockholm´s data warehouse, for the study period 2015–2021. Univariable and multivariable logistic regression analyses tested associations and adjusted Odds ratios (aORs) were calculated.

Results
During the last month of life, approx. half of the cohort had emergency room (ER) visits and risk of frailty (measured by Hospital Frailty Risk Score) significantly predicted these visits (aOR, 3.90 (2.75–5.55)). In total, 120 people (13%) received SPC during their last three months of life, which positively associated with risk for frailty, (aOR, 2.65 (1.43–4.94, p = 0.002). In total, 284 people (31%) died in acute hospital settings. Among community-dwellers, male gender and frailty were strongly associated with acute hospital deaths (aOR, 1.90 (1.15–3.13, p = 0.01) and 3.70 (1.96–6.98, p < 0.0001)).

Conclusions
Rates of ER visits at end of life and hospital deaths were relatively high in this population-based cohort. Considering a high disease burden, referral to SPC at end of life was relatively low. Sex-specific disparities in health care utilization are apparent. Identifying people with high risk for frailty could assist the planning of optimal end-of-life care for people with PD.