bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human-centered Design of a Health Recommender System for Orthopaedic Shoulder Treatment
Authors: Singh Akanksha , Schooley Benjamin , Mobley Jack , Mobley Patrick , Lindros Sydney , Brooks John M. , Floyd Sarah B. 
Published: May 2024

Abstract

Background
Rich data on diverse patients and their treatments and outcomes within Electronic Health Record (EHR) systems can be used to generate real world evidence. A health recommender system (HRS) framework can be applied to a decision support system application to generate data summaries for similar patients during the clinical encounter to assist physicians and patients in making evidence-based shared treatment decisions.
Objective
A human-centered design (HCD) process was used to develop a HRS for treatment decision support in orthopaedic medicine, the Informatics Consult for Individualized Treatment (I-C-IT). We also evaluate the usability and utility of the system from the physician’s perspective, focusing on elements of utility and shared decision-making in orthopaedic medicine.
Methods
The HCD process for I-C-IT included 6 steps across three phases of analysis, design, and evaluation. A team of informaticians and comparative effectiveness researchers directly engaged with orthopaedic surgeon subject matter experts in a collaborative I-C-IT prototype design process. Ten orthopaedic surgeons participated in a mixed methods evaluation of the I-C-IT prototype that was produced.
Results
The HCD process resulted in a prototype system, I-C-IT, with 14 data visualization elements and a set of design principles crucial for HRS for decision support. The overall standard system usability scale (SUS) score for the I-C-IT Webapp prototype was 88.75 indicating high usability. In addition, utility questions addressing shared decision-making found that 90% of orthopaedic surgeon respondents either strongly agreed or agreed that I-C-IT would help them make data informed decisions with their patients.
Conclusion
The HCD process produced an HRS prototype that is capable of supporting orthopaedic surgeons and patients in their information needs during clinical encounters. Future research should focus on refining I-C-IT by incorporating patient feedback in future iterative cycles of system design and evaluation.
Prescribed fires effects on actual and modeled fuel loads and forest structure in southern coast redwood (Sequoia sempervirens) forests
Authors: Katuna Taj A , Collins Brandon M , Stephens Scott L 
Published: May 2024

Abstract

Background: Fire suppression, timber harvesting, and the forced removal of Indigenous burning have fundamentally changed conditions in coast redwood forests. The contemporary approach of forest preservation and fire exclusion has produced high densities of small trees, elevated fuel loads, sparse understories with limited herbaceous plant diversity and cover, and increased vulnerability to wildfire and climate change. Prescribed broadcast burning presents a viable treatment option to meet forest restoration goals, especially where mechanical treatments are not feasible. Forest and fire managers utilizing fire modeling software such as the Fire and Fuels Extension of Forest Vegetation Simulator (FFE) to predict prescribed fire effects in coast redwoods are limited by model accuracy due to a lack of empirical research and model verification across a breadth of site and weather conditions.
Results: We compared the difference between pre- and post-treatment conditions for two fall-season prescribed burns in Sonoma and Santa Cruz counties in California to quantify changes to forest structure, fuel loads, and treatment effectiveness in mitigating future wildfire behavior. This observed data was used to analyze the accuracy of FFE modeled prescribed fire treatment outputs for post-treatment forest and fuels conditions. Observed burn treatments were low intensity and resulted in no significant change to forest structure and composition, but there was a reduction in seedling and sapling densities and an increase in resprout density. There was a reduction in duff and litter fuels, and we found litter and fine woody debris reduction was driven by pre-treatment total fuel loads. The modeled probability of torching was very low pre- and post-treatment. FFE underpredicted scorch height, duff fuel reduction, and redwood regeneration, but slightly overpredicted tree mortality and significantly overpredicted reduction of litter and fine woody debris.
Conclusion: Our results highlight a need for model refinement in regards to species-specific mortality, tree regeneration dynamics, and moisture-dependent fuel consumption. In order to achieve desired forest restoration goals, fire practitioners may need to burn at moderate to higher intensities than those typically implemented in these forests, and potentially pair burning with mechanical thinning. Long-term health of coast redwood forests also relies on the restoration of cultural fire and stewardship partnerships that equally share decision making power between western science and Indigenous knowledge bearers.
Defining the transition from new to normal: a qualitative investigation of the clinical change process
Authors: Silver Santana R. , Jones Kayla Christine , Hook Kimberly , Crable Erika L. , George Emily R. , Serwint Janet R. , Austad Kirsten , Walkey Allan , Drainoni Mari-Lynn 
Published: May 2024

Abstract

Background Understanding how and when a new evidence-based clinical intervention becomes standard practice is crucial to ensure that healthcare is delivered in alignment with the most up-to-date knowledge. However, rigorous methods are needed to determine when a new clinical practice becomes normalized to the standard of care. To address this gap, this study qualitatively explores how, when, and why a clinical practice change becomes normalized within healthcare organizations.Methods We used purposive sampling to recruit clinical leaders who worked in implementation science across diverse health contexts. Enrolled participants completed semi-structured interviews. Qualitative data analysis was guided by a modified version of the Normalization Process Theory (NPT) framework to identify salient themes. Identified normalization strategies were mapped to the Expert Recommendations for Implementation Change (ERIC) project.Results A total of 17 individuals were interviewed. Participants described four key signals for identifying when a novel clinical practice becomes the new normal: 1) integration into existing workflows; 2) scaling across the entire organizational unit; 3) staff buy-in and ownership; and 4) sustainment without ongoing monitoring. Participants identified salient strategies to normalize new clinical interventions: 1) taking a patient approach; 2) gaining staff buy-in and ownership; and 3) conducting ongoing measurement of progress towards normalization.Conclusions The results offer valuable insight into the indicators that signify when a novel clinical practice becomes normalized, and the strategies employed to facilitate this transition. These findings can inform future research to develop instruments that implementation leaders can use to systematically measure the clinical change process.
The effects of decentralized financing and funding levels on the breadth and quality of services provided in primary health facilities in Nigeria
Authors: Hagedorn Brittany , Cooper Jeremy , Loevinsohn Benjamin , Martufi Valentina 
Published: May 2024

Abstract

Background To improve service delivery of Nigeria’s primary health care (PHC) system, the government tested two approaches for facility-level financing: performance-based financing (PBF) and decentralized facility financing (DFF). Facilities also had increased autonomy, supervision, and community oversight. We examine how the approach, funding level, and state context affected breadth of services and structural quality.Methods We use health facility surveys previously collected in 2014 and 2017, covering three years of implementation, in which districts were randomly assigned PBF or DFF and compared to matched districts in control states. We use log-linear regressions and non-parametric statistics to estimate the effect size of the financing approach and level of funding per capita.Results Service availability was highest in PBF facilities, while DFF also outperformed control on most measures. Results showed that structural readiness and service offerings both increased with more funding, especially under DFF. DFF and PBF facilities were better equipped to provide services that they claimed to offer, which was not the case for controls. Overall, PBF outperformed DFF, partially explained by funding levels. The rate of offering complimentary services followed a pattern of easiest-to-hardest to deliver.Conclusion PBF and DFF both improved the breadth and structural quality of services, although DFF performance was more sensitive to funding levels. Improvements were observed at relatively low levels of funding, but larger investments were associated with better performance. Most DFF facilities exceeded the performance of higher-funded controls, implying that funding was more valuable in the context of autonomy, increased supervision, and community oversight.
Application of Luminex-xTAG multiplex SNP detection in genetic quality control of outbred and inbred rats
Authors: li huan , Wang Hong , Zhou Jiaqi , Zhao Lan , Zhu Wanyue , Wei Jie , Yue Bingfei 
Published: May 2024

Abstract

Laboratory rats are widely used in the biological and medical research.The genetic quality of laboratory rats is essential for the reproducibility of experimental results.Traditional genetic monitoring methods of rats require a lot of work and time, and have limitations on the number and quality of genetic markers. To overcome these limitations,we developed a Luminex-Based Multiplex Assay for the simultaneous detection of 38 SNP markers to monitor the genetic quality of inbred strains and outbred rats. 38 SNP loci in 4 samples were detected by Luminex-based multiplexing, and genotype assignment results were consistent with first-generation sequencing, demonstrating good robustness of this methods. Finally,we used Luminex-Based Multiplex Assay to detect 38 SNP genetic markers in 12 inbred rats and 2 outbred groups of rats in China. The results showed that 38 SNPs were abundant in 12 inbred rat strains, and could be used to identify 12 rat strains. 23 SNP loci with good polymorphism were selected to analyse the genetic diversity of Wistar and SD rat populations. The average PIC values of these loci were 0.3 and 0.31, respectively, indicating that the polymorphic information content of these loci was high. The average Fis of the two populations were − 0.072 and − 0.086 respectively, indicating that the two populations were randomly mated and had good genetic diversity. In short, the method based on Luminex detection of SNP markers is a reliable, economical and rapid method for monitoring the genetic quality of rats, which can ensure the genetic quality of rats and support the standardisation of rat quality.
Aligning CEO Compensation with Sustainability Performance: The Role of CEO Duality, Board Size, and Compensation Committees
Authors: Nee Elain Oon Yen , Shabbir Muhammad Farooq , Asif Muhammad 
Published: May 2024

Abstract

This study uses agency theory as a framework to examine how board size, compensation committee, and CEO duality align the relationship between CEO compensation and firm sustainability performance. We examined 100 non-financial Asian companies with highest sustainability scores between 2010 and 2019. The findings support the pay-performance relationship proposed by agency theory by demonstrating a positive association between CEO compensation and firm sustainability performance. Our study claimed that, the compensation committee has a major impact on how closely CEO compensation is correlated with company sustainability performance, but board size has no discernible impact. This alignment is negatively impacted by CEO duality since improved performance offers a more realistic picture of the company. Furthermore, CEO compensation is significantly impacted by firm size which is justified by the complexity and the increased responsibilities associated with managing larger firms. Conclusively this investigation suggest that CEO compensation can be utilized effectively in the presence of effective governance practices. This study advances knowledge of agency theory and the connection between sustainability performance and compensation.
Risk factors associated with Acute Myocardial Infarction (MI) in patients reporting at tertiary care hospitals in Karachi
Authors: Ali Syed Rohan , Buriro Gulzar Ali , Moti Fatima Amin , Guzdar Tanzeel , Farooq Fawad , Khan Sawera , Sikander Faraz , Muhammad Ghulam 
Published: May 2024

Abstract

Background:
Cardiovascular diseases have a multi-factorial etiology, that includes hypertension, diabetes, stress, smoking, dyslipidemia and positive family history. Of them Acute myocardial infarction remains one of the most life threatening condition that can lead to post MI complications or death.
Objective:
To determine the risk factors associated with Acute Myocardial infarction in patients presenting in tertiary care hospitals in Karachi.
Method:
A cross sectional study was conducted on a sample size of 377 Acute Myocardial Infarcted patients .The sample was taken through non probability purposive sampling from Dr. Ruth K. M. Pfau Civil Hospital Karachi and National institute of Cardiovascular Diseases (NICVD) Karachi.. Data was then analyzed using SPSS version 22 with 95% confidence interval, margin of error was taken 5% and P-value 0.05 was significant.
Results:
A study was conducted to characterize patient demographics and assess the prevalence of various health factors among individuals presenting with Acute Myocardial Infarction (MI) at a tertiary care hospital in Karachi. Among the 377 patients analyzed, 40.3% fell within the age range of 56-65 years, totaling 152 individuals. The male representation was higher, constituting 57.8% (218 out of 377), compared to females at 42.2%. A considerable proportion, totaling 77.7%, had hypertension, while approximately 52.5% were smokers. Diabetes was present in only 36.3% of participants, whereas 38.2% reported dyslipidemia. Additionally, 67.4% had a positive family history of MI, and a mere 9.5% engaged in regular exercise. Consumption of whisky was reported by 19.6% of participants, and 60.5% had undergone surgical procedures.
Significantly, male participants exhibited a higher prevalence of smoking (83%) compared to females at 10.69% (p-value = 0.000). Alcohol consumption was also notably higher in males, reported at 30.7%, in contrast to females at 4.40% (p-value = 0.000). Surgical procedures were more prevalent among female participants, with 77.35% having undergone them, compared to 48.16% of males (p-value = 0.000).Furthermore, there was a significant association between age groups and the presence of hypertension, diabetes, and dyslipidemia (p-values = 0.000, 0.001, and 0.000, respectively), suggesting variations in prevalence across different age brackets.
Conclusion:
The study highlights the prevalence of various health factors among the sampled population, with significant gender disparities observed in smoking, alcohol consumption, and surgical procedures. Understanding these factors is crucial for implementing targeted interventions and public health initiatives to address prevalent health issues within the community. Further research may delve into the underlying factors contributing to these disparities and explore effective strategies for health promotion and disease prevention.
Toxin Data Quality: A Critical Examination of Bacterial Exotoxins and Animal Toxins
Authors: Krüger Tanja , Koludarov Ivan , Littmann Maria , Rost Burkhard , Jimenez-Soto Luisa F. 
Published: May 2024

Abstract

Objective
Existing toxins data sets include a mixture of proteins and toxin peptides. In this study we present two curated data sets of toxic proteins free of associated proteins: bacterial exotoxins and animal toxins. Our stringent selection criteria resulted in two data sets with only toxins that directly target or disrupt vital molecular mechanisms of their target organism. To gain insight in their properties and differences, we compared both sets of toxins to controls, and used simple biophysical features such as protein length, and amino acid composition distinguishing between evolutionary kingdoms (phyla). This approach should reveal if there is a need to consider differences present in toxin sets depending on their origin.
Results
Our analysis revealed biophysical differences between animal and bacterial toxins that should not be ignored. Both toxin groups exhibited preference amino acid usage depending on their origin, together with higher cysteine content compared to their respective controls. The animal toxins set contains, on average, significantly shorter sequences than bacterial toxins, and had their isoelectric point shifted towards acidic pH values. We show that animal toxins and bacterial toxins possess intrinsic differences in general biophysical properties, which reinforce the necessity of segregating these datasets to ensure reliability of bioinformatics models aimed at understanding and predicting toxin characteristics.
Barriers to dermatologic care for geriatric patients who received extensive Mohs surgery - an in-depth qualitative analysis
Authors: Prajapati Stuti , Zaino Mallory , Kontzias Christina , Siddiqui Fahad , Feldman Steven R. , Doerfler Laura B. 
Published: May 2024

Abstract

Two to three million new cases of skin cancer are diagnosed annually in patients over the age of 65. Evaluation, diagnosis, and treatment of skin cancer in the geriatric population may be impeded due to various barriers. Diagnostic delay can frequently lead to larger and more complex skin cancers that require treatment with Mohs micrographic surgery (MMS). Our objective was to identify barriers for skin cancer intervention in patients ³65 years of age who have undergone MMS.
We performed a qualitative analysis using open-ended, semi-structured interview questions with patients ³65 years of age from Atrium Health Wake Forest Baptist dermatology clinics who underwent non-extensive and extensive MMS. Non-extensive MMS was defined as having two or fewer skin layers removed, while extensive MMS was defined as having three or more skin layers removed.
Twelve patients (ages 68-91, 42% female, 100% White, with one to 13 skin layers removed) described barriers to early skin cancer identification and intervention, including poor skin cancer knowledge, individual and systemic factors, and patient-provider relationships. Early education, direct and consistent communication, and personal provider-patient relationships may be beneficial in preventing the progression of skin cancers in the geriatric patient population and subsequent extensive MMS.
Effects of land use change on runoff depth in the Songnen Plain, China
Authors: Lu Zhong , Zhang Jinliang , Li Chaoqun , Dong Zhiqiang , Lei Guoping , Yu Ziyang 
Published: May 2024

Abstract

Climate change and human activities both have a considerable impact on runoff depth, which are important parts of a changing ecosystem. Nevertheless, the main focus of hydrological response research has been on investigating the impact of climate change on the depth of runoff. In contrast, there has been limited emphasis on comprehending the precise mechanisms through which changes in land use, in relation to human activities, influence runoff depth. This paper utilized the MIKE SHE/MIKE 11 model to simulate the runoff depth process in the study area from 1980 to 2020. It estimated the influence of climate change and land use change on runoff depth using the runoff reduction method. Additionally, it quantified the impact of different land use changes on runoff depth by employing the spatio-temporal geographically weighted regression model. The study demonstrates that the MIKE SHE/MIKE 11 model is capable of accurately reproducing the runoff depth of the Songnen Plain. Both the R and NSE values for both the base and validation periods exceed 0.75. Moreover, from a geographical standpoint, climate change has a greater influence on runoff depth than human activity. Nevertheless, the impact of human activity is more evident in small, specific areas. As human activities intensify, their impact on runoff depth also increases, with the average contribution rising from 20% to over 30%. Changes in various land types within the watershed can be used to observe the influence of human activities on runoff depth. More precisely, a 10% rise in the rate of change of construction land, dry land, and unoccupied land results in an increase in runoff depth of 6.21 mm, 2.45 mm, and 1.14 mm, respectively. Conversely, a 10% rise in the rate of alteration of marsh, paddy, and forest land leads to a reduction in the depth of runoff by 9.49 mm, 6.46 mm, and 3.07 mm, respectively. This research can contribute to improving the efficiency of water and land resource utilization and optimizing land resource governance.
Herpes Zoster Ophthalmicus with Oculomotor Nerve Palsy：A Case report and Literature Review
Authors: Hu Xinru , He Jia , Chen Meng , Chen Xing , Du Shuang , Duan Xi 
Published: May 2024

Abstract

Background
Oculomotor nerve palsy in herpes zoster ophthalmicus(HZO) is rare. HZO can manifest with delayed complications such as Oculomotor Nerve Complications (OMCN) or other significant neurological consequences.
Case presentation:
We report a 77-year-old woman with right ptosis while receiving treatment for herpes zoster. Physical examination showed crusted vesicles on the right V1 dermatome, complete right ptosis, and limited right eye movement in all directions. The symptoms of oculomotor nerve palsy have not yet improved although the lesion healing after anti-inflammatory and antiviral treatment.
Conclusions
Prompt initiation of antiviral therapy and steroidal anti-inflammatory treatment are advocated in Herpes Zoster(HZ) to mitigate severe outcomes. Moreover, diligent monitoring and routine follow-ups for HZO patients are imperative. While therapeutic strategies for HZO-induced OMCN remain underdeveloped due to its scarcity, the prognosis for recovery is generally optimistic.This case report details a cases of HZO with oculomotor nerve palsy and summarizes relevant cases.
Novel classification algorithms inspired by firing rate stochastic resonance
Authors: Xu Ziheng , Fu Yuxuan , Mei Ruofeng , Zhai Yajie , Kang Yanmei 
Published: May 2024

Abstract

The aim of this paper is to present a category of novel pattern classification algorithms inspired by the phenomenon of the firing rate based stochastic resonance (SR) in a noisy leaky integrate-and-fire neuron. To this end, the firing rate-based SR phenomenon in the noisy leaky integrate-and-fire neuron model is displayed by means of the approximation of adiabatic elimination. And then, a multi-layer neural network with back-propagation learning is constructed by using the stationary firing rare for activation function. Since the intensity of the involving Gaussian white noise is taken as an independent trainable parameter, the benefit of noise can be maximally utilized. The algorithm and its improvements have been verified with binary classification and handwritten digit recognition. By further simplifying calculation of the firing rate activation, this algorithm is embedded into the network architecture of PreAct-ResNet-18 for more complex tasks. It is shown that the improved version based on the stochastic gradient descent (SGD) optimizer outperforms several typical artificial neural network algorithms and brain-inspired spiking neural network (SNN) algorithms on the CIFAR-10 dataset, and it achieves a good accuracy on CIFAR-100, surpassing the accuracy based on the ReLU activation. Since the trained intensity of Gaussian white noise is nonzero in all the applications, stochastic resonance like effect has been observed. Hence it is disclosed from this study that noise can really be designed as an optimizable factor into the brain-inspired machine learning algorithms.