bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moving Biosurveillance Beyond Coded Data Using AI for Symptom Detection From Physician Notes: Retrospective Cohort Study
Authors: McMurry Andrew J , Zipursky Amy R , Geva Alon , Olson Karen L , Jones James R , Ignatov Vladimir , Miller Timothy A , Mandl Kenneth D 
Published: April 2024

Background
Real-time surveillance of emerging infectious diseases necessitates a dynamically evolving, computable case definition, which frequently incorporates symptom-related criteria. For symptom detection, both population health monitoring platforms and research initiatives primarily depend on structured data extracted from electronic health records.

Objective
This study sought to validate and test an artificial intelligence (AI)–based natural language processing (NLP) pipeline for detecting COVID-19 symptoms from physician notes in pediatric patients. We specifically study patients presenting to the emergency department (ED) who can be sentinel cases in an outbreak.

Methods
Subjects in this retrospective cohort study are patients who are 21 years of age and younger, who presented to a pediatric ED at a large academic children’s hospital between March 1, 2020, and May 31, 2022. The ED notes for all patients were processed with an NLP pipeline tuned to detect the mention of 11 COVID-19 symptoms based on Centers for Disease Control and Prevention (CDC) criteria. For a gold standard, 3 subject matter experts labeled 226 ED notes and had strong agreement (F1-score=0.986; positive predictive value [PPV]=0.972; and sensitivity=1.0). F1-score, PPV, and sensitivity were used to compare the performance of both NLP and the International Classification of Diseases, 10th Revision (ICD-10) coding to the gold standard chart review. As a formative use case, variations in symptom patterns were measured across SARS-CoV-2 variant eras.

Results
There were 85,678 ED encounters during the study period, including 4% (n=3420) with patients with COVID-19. NLP was more accurate at identifying encounters with patients that had any of the COVID-19 symptoms (F1-score=0.796) than ICD-10 codes (F1-score =0.451). NLP accuracy was higher for positive symptoms (sensitivity=0.930) than ICD-10 (sensitivity=0.300). However, ICD-10 accuracy was higher for negative symptoms (specificity=0.994) than NLP (specificity=0.917). Congestion or runny nose showed the highest accuracy difference (NLP: F1-score=0.828 and ICD-10: F1-score=0.042). For encounters with patients with COVID-19, prevalence estimates of each NLP symptom differed across variant eras. Patients with COVID-19 were more likely to have each NLP symptom detected than patients without this disease. Effect sizes (odds ratios) varied across pandemic eras.

Conclusions
This study establishes the value of AI-based NLP as a highly effective tool for real-time COVID-19 symptom detection in pediatric patients, outperforming traditional ICD-10 methods. It also reveals the evolving nature of symptom prevalence across different virus variants, underscoring the need for dynamic, technology-driven approaches in infectious disease surveillance.
Development and Evaluation of a Clinician-Vetted Dementia Caregiver Resources Website: Mixed Methods Approach
Authors: McLaren Jaye E , Hoang-Gia Dat , Dorisca Eugenia , Hartz Stephanie , Dang Stuti , Moo Lauren 
Published: April 2024

Background
About 11 million Americans are caregivers for the 6.7 million Americans currently living with dementia. They provide over 18 billion hours of unpaid care per year, yet most have no formal dementia education or support. It is extremely difficult for clinicians to keep up with the demand for caregiver education, especially as dementia is neurodegenerative in nature, requiring different information at different stages of the disease process. In this digital age, caregivers often seek dementia information on the internet, but clinicians lack a single, reliable compendium of expert-approved digital resources to provide to dementia caregivers.

Objective
Our aim was to create a dementia caregiver resources website to serve as a hub for user-friendly, high-quality, and expert-reviewed dementia educational resources that clinicians can easily supply to family caregivers of people with dementia.

Methods
An interdisciplinary website development team (representing dementia experts from occupational therapy, nursing, social work, geriatrics, and neurology) went through 6 iterative steps of website development to ensure resource selection quality and eligibility rigor. Steps included (1) resource collection, (2) creation of eligibility criteria, (3) resource organization by topic, (4) additional content identification, (5) finalize resource selection, and (6) website testing and launch. Website visits were tracked, and a 20-item survey about website usability and utility was sent to Veterans Affairs tele-geriatrics interdisciplinary specialty care groups.

Results
Following website development, the dementia caregiver resource website was launched in February 2022. Over the first 9 months, the site averaged 1100 visits per month. The 3 subcategories with the highest number of visits were “general dementia information,” “activities of daily living,” and “self-care and support.” Most (44/45, 98%) respondents agreed or strongly agreed that the website was easy to navigate, and all respondents agreed or strongly agreed that the resources were useful.

Conclusions
The iterative process of creating the dementia caregiver resources website included continuous identification, categorization, and prioritization of resources, followed by clinician feedback on website usability, accessibility, and suggestions for improvement. The website received thousands of visits and positive clinician reviews in its first 9 months. Results demonstrate that an expert-vetted, nationally, and remotely available resource website allows for easy access to dementia education for clinicians to provide for their patients and caregivers. This process of website development can serve as a model for other clinical subspecialty groups seeking to create a comprehensive educational resource for populations who lack easy access to specialty care.
Insulin resistance and stroke: mechanisms and therapeutic approaches
Authors: Pashkovska N.V. , Pashkovskyy V.M. 
Published: April 2024

The review analyzed literature data on the epidemio­logy, risk factors, and mechanisms of acute cerebrovascular accident (ACVA) in patients with diabetes mellitus. The role of insulin resistance and the effectiveness of therapeutic approaches to its correction in cerebral stroke are considered. Diabetes mellitus is recognized as an independent modifiable risk factor for ACVA. In people with diabetes of different age, the risk of stroke is increased by 2–6 times, and the indicators are especially high in patients of young working age. The presence of diabetes mellitus is associated with more severe symptoms, increased risk of complications, longer hospitalization, and higher mortality. Research results show that insulin resistance is one of the main triggers for the development of ischemic stroke due to embolism caused by oxidative stress, endothelial dysfunction and platelet hyperactivation, as well as due to atherosclerotic changes caused by inflammation, proliferation of smooth muscle cells of the vascular wall, dyslipidemia and hypertension on the background of hyperglycemia and hyperinsulinemia. It has been proven that insulin resistance not only provokes ACVA, but also negatively affects their prognosis. Metformin is a key drug for improving insulin sensitivity and is recognized as one of the most important first-line therapeutic agents to achieve and maintain treatment goals in patients with type 2 diabetes. The results of expe­rimental and clinical studies proved that this agent has a whole range of neuroprotective properties, which generally prevent the development of cerebral ischemia and reduce the negative consequences in case of its occurrence. Animals with experimental acute cerebral ischemia who have been treated with metformin had a better overall neurological score, significantly smaller infarct size, better coordination scores, and higher numbers of neurons and microglia. The neuroprotective effect of metformin in stroke is realized through the AMPK (5’AMP-activated protein kinase) signaling pathway with reduction of oxidative stress, neuroinflammation, stimulation of angiogenesis and neurogenesis, autophagy, and inhibition of apoptosis. According to data from cohort and randomized clinical trials, the use of metformin is associated with a significantly lower risk of developing ACVA. Long-term use of this drug in type 2 diabetes contributes to a milder course of stroke, is associated with better functional recovery, and a decrease in disability and mortality rates.
Reverse Engineering a Multiple-Choice Test Blueprint to Improve Course Alignment
Authors: Petrovic-Dzerdz Maristela 
Published: April 2024

Large introductory classes typically reflect courses that cover a broad landscape of learning and necessitate assessment formats that are efficient and reliable, making multiple-choice (MC) tests a good option. Designing a good quality MC test requires reflection on the appropriateness of the assessment format, designing a test blueprint, and writing MC questions following item-writing guidelines that align with course learning objectives and teaching/learning strategies. It is a time-consuming endeavour that often requires a group of question writers who are experts in the domain—both of which can be challenging considering the demands of teaching in higher education. Sometimes we want to adopt or adapt existing MC tests that we have access to. I suggest a five-step “reverse engineering” analytical process for selecting questions from existing MC tests to utilize in our course assessment, emphasizing the alignment process. In one of the steps, we will refer to the Taxonomy Table, a practical two-dimensional aid proposed by Anderson and Krathwohl (2001), to select the questions that cover a cognitive dimension landscape. The outcome of this process provides an effective visual representation of the alignment and enables us to decide on the utility of questions for the context of our unit and assessment objectives.
Keywords: course alignment, assessment, multiple-choice test, taxonomy table.
User Acceptance for Multitask IoT Monitoring and Controlling System for Salt Ponds
Authors: Yudantoro Tri Raharjo , Hamida Busra Nur , Febriyanti Eka , Wiktasari Wiktasari , Pernanda Suko Tyas , Prabuwono Anton Satria 
Published: April 2024

The process of making salt is still done manually by filling water into reservoirs and plots which require salt farmers to visit their farms periodically. This is mainly because the speed of the salt crystalization process is always inconsistent due to salt concentration in seawater and the weather. This study aims to build a new prototype of a water level monitoring system in reservoirs and plots in salt ponds then measure the water's salinity value, which will be reported to the farmers. The method used in this research is prototyping, which includes system requirement analysis, rapid design, prototype building, system evaluation, and system improvement. The system was tested using the black box method, namely testing all system functionality and determining user satisfaction with questionnaires. The functionality test results, including monitoring the water level and the pump control, show that the prototype functions correctly. The designed system can send information in the form of water level values in reservoirs, water levels in plots, and salinity values with linear sensor accuracy with measurement results with conventional measuring instruments with standard error values of 0.485, 0.44, and 0.72, respectively. Applying this system will ease farmers’ monitoring of water levels and controlling irrigation in reservoirs and plots.
A competency-bazed approach in the environmental education of the students - future biology teachers
Authors: Doychinova Klaida 
Published: April 2024

Abstract
The contemporary trends of globalization and enhanced international cooperation, as well as the aim at building a knowledge-based society, have put higher education institutions in an ever-increasing public interest. The fast-developing digitalization, the implementation of artificial intelligence and especially the generational characteristics of the learners determine the need for new approaches in teaching and learning tailored to individual needs. One of them is the competence approach, which represents one of the leading pedagogical concepts of the 21st century and is the basis for the formation of ecological competence. Its application in pedagogical practice is a serious challenge for both teachers and students – future Biology teachers. The article analyses on a structural and functional basis the components of environmental competence. A theoretical model for the formation of ecological competence in the discipline “Forms and methods of ecological education and upbringing in Biology education”, included in the curriculum of Master degree students is presented. The model is aimed at updating the vision of the learning process in the relevant discipline, the main part of which is environmental education.
Lecanemab: A Second in Class Therapy for the Management of Early Alzheimer’s Disease
Authors: Yoon Connie , Groff Corey , Criss Olivia 
Published: April 2024

The Food and Drug Administration granted traditional approval of lecanemab for the treatment of Alzheimer’s disease (AD). Lecanemab is a humanized anti-amyloid monoclonal antibody directed towards Aβ protofibrils. Lecanemab is the only drug that targets Aβ soluble protofils and has shown statistical differences in mild AD or mild cognitive impairment. In its landmark phase III trial, lecanemab was shown to slow the progression of clinical decline, and a reduction in amyloid protein accumulation. The difference in mean CDR-SOB score improvement between the treatment and placebo groups was -0.45, of which the clinical significance could be argued. Amyloid burden was also considerably reduced as well, but the true clinical consequence of this reduction remains to be seen. This beneficial impact on daily living is offset by rare but serious side effects including amyloid-related imaging abnormalities (ARIA) causing cerebral edema (ARIA-E) or cerebral microhemorrhages or hemosiderin deposits (ARIA-H). Benefits of therapy must be considered against the risk of cerebral microhemorrhages and edema. Affordability must also be taken into consideration. The current estimated yearly cost for twice monthly lecanemab infusion is $26,500. In addition to the significant cost challenges, the frequent infusions may pose concerns related to access. Additional agents within this class are in the pipelines with possibly increased efficacy or decreased adverse events.
Development and Evaluation of a Reliable Medication Management Self-Assessment Checklist
Authors: Isetts Brian , Talley Kristine , Brearley Ann 
Published: April 2024

An ability to effectively self-manage medications is the result of several factors influencing a person’s decision to take medications. The need for new approaches to medication self-management are evident in the persistent trends of ineffective and unfortunate medication use consequences, referred to as drug-related morbidity and mortality. Fortunately, pioneering initiatives have emerged to reshape our approach for developing a rational organizational paradigm so that patients can confidently self-manage medications.
Favorable outcomes of studies pertaining to the delivery of comprehensive medication therapy management services within the practice of pharmaceutical care prompts the question, ‘Can patients and family members apply the 4-step pharmacotherapy workup process to better organize their decision-making and confidence in medication self-management?’ To answer this question an Effective Medication Self-Management Toolkit based on this 4-step process, and a Medication Management Self-efficacy Checklist, were created and evaluated for feasibility, acceptability, and internal consistency reliability.
The first evaluation established the preliminary acceptability and feasibility of the toolkit using a convenience sample of 39 residents of independent living facilities in focus group sessions. All participants indicated they perceive that the 4-step process can help individuals successfully self-manage medications. At the conclusion of the focus group sessions, all 39 participants completed the 7-item post-session checklist. This paper presents the second evaluation to establish the internal consistency reliability of the toolkit’s Medication Management Self-efficacy Checklist using Cronbach’s alpha. There was good internal consistency of the self-efficacy checklist with a Cronbach’s alpha value of 0.82.
This investigation of a novel approach for applying the 4-step pharmacotherapy assessment process by patients suggests that it is feasible and acceptable to use, and that the medication self-efficacy checklist provides a reliable and useful measure of a patient’s confidence in self-managing medications.
PENGARUH KEPEMILIKAN INSTITUSIONAL, KOMITE AUDIT DAN KOMISARIS INDEPENDEN TERHADAP INTEGRITAS LAPORAN KEUANGAN
Authors: Abidatus Suroya Naela , Darmayanti Novi , Shoimah Siti 
Published: April 2024

ABSTRACT

This study aims to determine the effect of Institutional Ownership, Audit Committee and Independent Commissioners on the Integrity of Financial Statements, partially or simultaneously. The population of this study were all manufacturing companies in the chemical sub-sector which were listed on the Indonesia Stock Exchange (IDX), totaling 93 companies. This study used the 2018-2022 observation period, using the purposive sampling method to obtain a sample of 70. The data analysis method used in this study was a multiple linear regression test. The variables used are Institutional Ownership, Audit Committee and Independent Commissioners as independent variables, while the Integrity of Financial Statements as the dependent variable. The results of this study resulted in the finding that partially Institutional Ownership, Audit Committees, Independent Commissioners have a significant effect on the Integrity of Financial Statements. Simultaneously, institutional ownership, audit committee and independent commissioners have a significant effect on the integrity of financial statement.
Telang Flower Extract (Clitoria Ternatea) as Antioxidant in Snack Sticks
Authors: Fangohoi Latarus , Aimanah Ummu , Munira Munira , L Andi Besse Sumpala 
Published: April 2024

Telang flower (Clitoria ternatea) is a flower that can be grown as an ornamental plant or as a wild plant. It has long been used in traditional medicine and as a food coloring because it contains a number of active ingredients with pharmacological potential. Snack sticks can improve organoleptic quality and antioxidant activity content, this study aims to determine the organoleptic quality, and antioxidant activity content and to find out how to make snack sticks against the addition of telang flower extract as an antioxidant on snack sticks. The study method used was an experimental method of Completely Randomized Design (CRD) with 5 treatments and 3 replications resulting in 15 experimental units with each experiment, namely P0 = no treatment, P1 = 10g telang flower extract + 100ml water, P2 = 20g extract telang flower + 100ml water, P3 = 30g telang flower extract + 100ml water, P4 = 40g telang flower extract + 100ml water. The results showed that the P4 treatment (40g telang flower extract + 100ml water) gave the best results on organoleptic quality with an average score of 11.6, and the best content of antioxidant activity was found in P4 treatment with an amount of 103.52 ppm.
Keywords: extract, Telang flower, stick, organoleptic, and antioxidant
The Different Time Administration of Cherry Leaf Teabag (Muntingia calabura L.) to Broiler Immunity
Authors: Mawarni I , Putri D D , Candra A A , Noviadi R , Maradon G G 
Published: April 2024

This study purpose was to analyze the different time administration of cherry leaf teabag (Muntingia calabura L.) to broiler immunity. This study used 2 treatment groups. The first group (T1) was given cherry leaf teabag (Muntingia calabura L.) every day in drinking water (T1), and the second group (T2) was given cherry leaf teabag (Muntingia calabura L.) every two days. The dosage of cherry leaf used in this study 420 mg/kg BW. Paired samples t-test was used to compare the results of the two treatment groups. To determine the effect of different time administration of cherry leaf teabag on the broiler immunity, the parameter observed was the antibody titer in response to Newcastle Disease vaccination, another parameter observed is the weight percentage of the lymphoid organs (Bursa of Fabricius and Spleen) to find out that the herbs with immunostimulatory activity do not cause lymphoid organs to work excessively does not cause the lymphoid organs to work excessively. Based on the results of this study, it was concluded that giving Cherry leaf teabag (Muntingia calabura L) every two days had almost the same effect in increasing broiler immunity as giving every day, and giving Cherry leaf teabag (Muntingia calabura L) every day also does not have a negative effect on the lymphoid organs which are responsible for immunity
Exploring Midline Asymmetry: A Comprehensive Study Among Adolescents in the North Bihar Population
Authors: Shankar Daya , Anjan Ravi , Choudhary Anuj Kumar , Shankar Rahul , Nanda Medha , Bharti Gayatri 
Published: April 2024

Objectives
In the contemporary era, achieving a sense of equilibrium is a paramount concern, and a visually pleasing smile is intricately linked to both professional success and social acceptance. Esthetics, with a specific focus on Oro-facial aesthetics, emerges as a primary motivation for individuals seeking dental treatment. Nevertheless, there exists an optimal and aesthetically pleasing range of dental midline deviation.
The current study aimed to ascertain the prevalence of dental midline shifting and the average extent of midline discrepancy among adolescents (aged 13-17) from North Bihar population.

Material & Methods
Two hundred subjects participated in the study, with 100 males and 100 females selected based on predetermined inclusion criteria. Intraoral frontal occlusion photographs were captured for each participant, and subsequent analysis was done utilizing Digimizer software. Statistical analysis was applied to the linear measurement data obtained through photographic evaluation.

Results
The study’s findings revealed a noteworthy proportion of subjects displaying deviations between upper and lower midlines and anterior teeth midlines, falling within the range of 0.03-3.80 mm.

Conclusion
The prevalence of these deviations was observed to be higher in males compared to females, and this difference was statistically significant.