bluuebunny/crossref_metadata_2025_split huggingface dataset:
Danish Prostate Cancer Consortium Study 1 (DPCC-1) protocol: Multicentre prospective validation of the urine-based three-microRNA biomarker model uCaP
Authors: Fredsøe Jacob , Glud Eske , Boesen Lars , Løgager Vibeke , Poulsen Mads Hvid , Pedersen Bodil Ginnerup , Borre Michael , Sørensen Karina Dalsgaard 
Published: November 2023

IntroductionThe primary objective of the Danish Prostate Cancer Consortium Study 1 (DPCC-1) is to provide validation for a novel urine-based microRNA biomarker, called uCaP, for a diagnosis of prostate cancer.Methods and analysisEligible participants are biopsy naïve men aged ≥18 years with prostate-specific antigen (PSA) levels ≥3 ng/mL, who are referred to prostate MRI due to suspicion of PC at one of the following three major urology/uroradiology centers: Aarhus University Hospital, Herlev & Gentofte University Hospital, or Odense University Hospital, where MRI and targeted biopsy are implemented in clinical use. Exclusion criteria include previous diagnosis of urogenital cancer, contraindication to MRI, gender reassignment treatment or PSA level >20 ng/mL. The participants will be asked to donate a urine sample in connection with their MRI. The study is observational, uses a diagnostic accuracy testing setup and will integrate into the current diagnostic pathway.We will measure the levels of the three microRNAs in the uCaP model (miR-222–3 p, miR-24–3 p and miR-30c-5p) in extracellular vesicle-enriched cell-free urine samples, to assess if uCaP can improve specificity and retain sensitivity for International Society of Urological Pathology Grade Group ≥2 PC, when used as a reflex test to PSA ≥3 ng/mL. We hypothesise that uCaP can improve selection for prostate MRI and reduce the number of unnecessary scans and biopsies.Ethics and disseminationThis study is approved by the Central Denmark Region Committee on Health Research Ethics (reference number: 1-10-72-85-22). All participants will provide written informed consent. Study results will be published in peer-reviewed journals and presented in scientific meetings.Trial registration numberNCT05767307at clinicaltrials.gov.
Improving the impact of pharmacy interventions in hospitals
Authors: Baptista Rafael , Williams Mary , Price Jayne 
Published: November 2023

The clinical and pharmaceutical interventions of pharmacy professionals are considered impactful inputs towards optimised patient care and safety, by rationalising prescriptions, enhancing therapeutic choices and reducing and preventing medication errors and adverse effects. Pharmacy interventions (PIs), related to the identification, prevention and resolution of drug-related problems, should be recorded for optimal clinical governance and potential health outcomes.Between October 2020 and October 2021, the community hospitals at Powys Teaching Health Board recorded 158 PIs, corresponding to 0.4 interventions per staff per week. Only two members of the team were recording these PIs. Poor indicative PIs can result in lost opportunities for medication optimisation and prescribing rationalisation, increased costs and unidentified training potential.The aims of this project were (1) to record 180 interventions between 22 November 2021 and 8 April 2022 (20 weeks), corresponding to an average threefold increase, compared to the interventions recorded between October 2020 and October 2021 (52 weeks); (2) to have all hospital pharmacy staff recording at least one intervention during the same period.The number of interventions recorded and the number of pharmacy staff recording each intervention were two process measures. The project was completed through two Plan-Do-Study-Act cycles and applied theory on managing change in healthcare.The most successful intervention influencing positively the process measures was the implementation of a new Pharmacy Intervention Record Tool (xPIRT) toolkit that included an online recording tool (xPIRT) and an interactive panel with up-to-date results from all interventions recorded (xPIRT Dashboard). Motivating change was proven to be one of the best determinants of user satisfaction and engagement that contributed to meet the project’s targets. xPIRT Dashboard provided staff the capacity to act on possible personal motivators and the possibility to improving care with medicines on their wards. The implementation of xPIRT toolkit was able to increase the representativity and significance of PIs recorded by the hospital pharmacy team, and it is expected to be used for personal professional development, demonstrating team activity and impact, service planning, prescribing practice optimisation and to identify education/training needs. This toolkit can be easily applied and adapted to other health organisations, settings and services.
Challenge of achieving truly individualised informed consent in therapeutic endoscopy
Authors: Berry Philip , Kotha Sreelakshmi 
Published: November 2023

ObjectiveGuidance covering informed consent in endoscopy has been refined in the UK following the obstetric case of Nadine Montgomery, and in light of updated General Medical Council guidance. All risks likely to be material to the patient must be explored, as well as alternatives to the procedure. Despite this, departments and endoscopists still struggle to meet the current standards. In this article, we explore the challenges encountered in achieving individualised consent in therapeutic endoscopy through real-life scenarios.MethodsFive realistic therapeutic endoscopy (hepatobiliary) scenarios are described, followed by presentation of possible or ideal approaches, with references related to existing literature in this field.ResultsThe vignettes allow consideration of how to approach difficult consent challenges, including anxiety and information overload, urgency during acute illness, failure to disclose the risk of death, the role of trainees and intraprocedural distress under conscious sedation.ConclusionsThe authors conclude that a high degree of transparency is required while obtaining consent for therapeutic endoscopy accompanied by full documentation, involvement of relatives in nearly all cases, and clarity around the presence of trainees who may handle the scope. A greater focus on upskilling trainees in the consent process for therapeutic endoscopy is required.
A Deep Time Delay Filter for Cooperative Adaptive Cruise Control
Authors: Hsueh Kuei-Fang , Farnood Ayleen , Al-Darabsah Isam , Al Saaideh Mohammad , Al Janaideh Mohammad , Kundur Deepa 
Published: November 2023

Cooperative adaptive cruise control (CACC) is a smart transportation solution to alleviate traffic congestion and enhance road safety. The performance of CACC systems can be remarkably affected by communication time delays, and traditional control methods often compromise control performance by adjusting control gains to maintain system stability. In this article, we present a study on the stability of a CACC system in the presence of time delays and highlight the tradeoff between control performance and tuning controller gains to address increasing delays. We propose a novel approach incorporating a neural network module called the deep time delay filter (DTDF) to overcome this limitation. The DTDF leverages the assumption that time delays primarily originate from the communication layer of the CACC network, which can be subject to adversarial delays of varying magnitudes. By considering time-delayed versions of the car states and predicting the present (un-delayed) states, the DTDF compensates for the effects of communication delays. The proposed approach combines classical control techniques with machine learning, offering a hybrid control system that excels in explainability and robustness to unknown parameters.
We conduct comprehensive experiments using various deep learning architectures to train and evaluate the DTDF models. Our experiments utilize a robot platform consisting of MATLAB, Simulink, the Optitrack motion capture system, and the Qbot2e robots. Through these experiments, we demonstrate that when appropriately trained, our system can effectively mitigate the adverse effects of constant time delays and outperforms a traditional CACC baseline in control performance. This experimental comparison, to the best of the authors’ knowledge, is the first of its kind in the context of a hybrid machine learning CACC system. We thoroughly explore initial conditions and range policy parameters to evaluate our system under various experimental scenarios. By providing detailed insights and experimental results, we aim to contribute to the advancement of CACC research and highlight the potential of hybrid machine learning approaches in improving the performance and reliability of CACC systems.
Enhancing lung cancer disease diagnosis by employing ensemble deep learning approaches
Authors: Nath Das Manmath , Panda Niranjan , Rautray Rasmita 
Published: November 2023

<span>Cancer is a disease that results from the unnatural proliferation of aberrant cells that infest the body’s healthy cells and spread throughout the body. Lung cancer is characterized by an imbalance in the cells of the affected organs, namely the lungs. The prediction of lung cancer at an early stage is very important, particularly in countries that are densely populated and have lower incomes. Clinically conventional approaches, such as blood tests and other types of treatments, are used by specialists. The age of artificial intelligence (AI) has begun, and today, it is feasible to construct a computer-aided diagnostic mechanism with the assistance of machine learning and deep learning algorithms. In this particular piece of research, one deep learning algorithm, an artificial neural network (ANN), has been investigated to determine whether or not lung cancer could be detected at an earlier stage. In addition to conventional ANN, ensemble ANN with weighted averaging and soft and hard voting ensemble techniques are also considered. In order to achieve this effectiveness, the state-of-the-art parameters for the proposed method using ANN are assessed and evaluated using the lung cancer dataset. The empirical analysis shows that hard voting-enabled ANN shows the highest accuracy at 97.47%.</span>
Anthropogenic Influence on 2022 Extreme January–February Precipitation in Southern China
Authors: Hu Yamin , Dong Buwen , Xie Jiehong , Tan Haobo , Zhou Baiquan , Lin Shuheng , He Jian , Zhao Liang 
Published: November 2023

Abstract
The precipitation in January–February 2022 in southern China was the second-largest amount since 1961. Anthropogenic influence reduced the likelihood of extreme events like 2022 by about 50% (55%) in HadGEM3 (CMIP6).
Balanced Convective Circulations in a Stratified Atmosphere. Part I: A Framework for Assessing Radiation, the Coriolis Force, and Drag
Authors: Marsico David H. , Biello Joseph A. , Igel Matthew R. 
Published: November 2023

Abstract
The so-called traditional approximation, wherein the component of the Coriolis force proportional to the cosine of latitude is ignored, is frequently made in order to simplify the equations of atmospheric circulation. For velocity fields whose vertical component is comparable to their horizontal component (such as convective circulations), and in the tropics where the sine of latitude vanishes, the traditional approximation is not justified. We introduce a framework for studying the effect of diabatic heating on circulations in the presence of both traditional and nontraditional terms in the Coriolis force. The framework is intended to describe steady convective circulations on an f plane in the presence of radiation and momentum damping. We derive a single elliptic equation for the horizontal velocity potential, which is a generalization of the weak temperature gradient (WTG) approximation. The elliptic operator depends on latitude, radiative damping, and momentum damping coefficients. We show how all other dynamical fields can be diagnosed from this velocity potential; the horizontal velocity induced by the Coriolis force has a particularly simple expression in terms of the velocity potential. Limiting examples occur at the equator, where only the nontraditional terms are present, at the poles, where only the traditional terms appear, and in the absence of radiative damping where the WTG approximation is recovered. We discuss how the framework will be used to construct dynamical, nonlinear convective models, in order to diagnose their consequent upscale momentum and temperature fluxes.
Revisiting the Structural (In)Variances of Homicide: Examining the Differential Effects of Context Across Homicide Types
Authors: Fridel Emma E. 
Published: November 2023

Objectives Extend foundational work on the structural covariates of homicide (concentrated disadvantage in particular) by examining the differential effects of context across distinct types of incidents. Methods Using data on 31,513 incidents nested within 4,598 places from the National Violent Death Reporting System (NVDRS) from 2003 to 2018, multilevel latent class analysis (MLCA) classified homicides into types. Two-level negative binomial regression models subsequently examined the place-level correlates of homicide counts disaggregated by type. Results Four empirically distinct types of incidents were identified, including felony, argument, intimate partner violence, and child abuse homicides. While concentrated disadvantage has a positive relationship with all four types, its effect is significantly stronger for felony and argument homicides relative to incidents involving intimate partner violence and child abuse. Conclusions The results indicate that context exhibits differential effects across homicide types, in turn suggesting that their underlying social processes and mechanisms are distinct.
COVID-19 in pediatric palliative care patients: Multicenter, retrospective cohort study
Authors: Korzeniewska-Eksterowicz Aleksandra , Brzezinska Olga , Dryja Urszula , Matczak Dominka , Sopilnyak Andriy , Szuszkiewicz Eugenia , Przysło Łukasz , Szmyd Krzystof , Jabłońska Katarzyna , Krych Piotr , Wojtków-Zielińska Agnieszka , Wąsińska Edyta , Niedźwiecki Maciej 
Published: November 2023

Background: Studies have shown the risk factors for COVID-19 severity in children, including comorbidities, but information on the infection course in children with life-limiting conditions is sparse. Aim: To describe the effect of COVID-19 on pediatric patients receiving palliative care due to life-limiting conditions. Design: We conducted retrospective cohort study. The WHO Clinical Progression Scale was used to measure COVID-19 severity. Setting/participants: Seven of the 24 invited pediatric palliative care centers participated in this study. We analyzed the medical records of children under palliative care with confirmed COVID-19 (January 2020–April 2022) Results: Records of 60 patients with COVID-19 aged 0.24 to 21.6 years (mean (SD); 9.8 (6.6)) were collected. The largest group of patients with COVID-19 was children with congenital malformations and chromosomal abnormalities (42%); the most common manifestation was fever (85%). Bacterial coinfection was confirmed in 17 (28%) children. Fifteen (25%) children required hospitalization, including four admitted to the Intensive Care Unit. Mild COVID-19 was identified in 44 (73%) children, moderate in 11 (18%), severe in 3 (5%), and death in 2 (3%). Six of the 20 eligible children were vaccinated against SARS-CoV-2, followed by 16 mothers and fathers. Conclusion: In the study population initial presentation of COVID-19 was predominantly a mild; however, the small sample size precluded definitive conclusions. For children under palliative care, we should identify if they have an advance care plan for COVID-19, such as desires for intensive care support. Further studies are needed to define the short and long-term effects of COVID-19 in children with life-limiting conditions.
Social Activity Restriction and Psychological Health Among Caregivers of Older Adults With and Without Dementia
Authors: Irani Elliane , Wang Fei , Meyer Kylie , Moore Scott Emory , Ding Kedong 
Published: November 2023

Objectives We examined associations between social activity restriction and psychological distress and well-being for caregivers of older adults with and without dementia, and if the identified associations are different for the two groups. Methods Using data from the 2017 National Study of Caregiving, we identified caregivers of older adults with ( N = 541) and without ( N = 1701) dementia. Linear regression models were estimated, adjusting for caregivers’ age, gender, race, education, relationship to care recipient, and self-rated health. Results Restriction in visiting friends and family and attending religious services were associated with higher distress in dementia caregivers. Restriction in visiting friends and family was associated with higher distress and lower well-being in non-dementia caregivers. Any activity restriction had stronger association with distress for caregivers of older adults with versus without dementia. Discussion Findings highlight the need for tailored interventions based on caregivers’ perceptions of meaningful social activities and dementia-friendly communities to promote social participation.
Considering flexible wheel-rail coupling effects: An analysis of the vibration and transmission characteristics of damped track
Authors: Tang Xueyang , Wang Qihao , Cai Xiaopei , Wang Weihua 
Published: November 2023

The vibration and transmission characteristics of track components during vehicle operation is a complex issue. To address this issue, this paper proposes a flexible wheelset-damped track-tunnel-soil model that considers the interaction between the flexible wheelset and the rail. Using field measurements and the developed model, this study investigates the vibration characteristics of track components and explores the influence of fastener stiffness and damping pad stiffness on track vibration and vibration transfer characteristics between components from an energy perspective, using track spectrum power flow as the evaluation index. The results demonstrate that the model considering wheel-rail coupling can more comprehensively reflect the vibration characteristics of the track during train operation. Compared to fasteners with lower stiffness, damping pads with lower stiffness can reduce track vibration in a wider frequency range. Lower fastener stiffness reduces the transmission of vibration in 50∼2000 Hz, while lower damping pad stiffness reduces the transmission of vibrations in 1∼2000 Hz.
Optimizing antimicrobial prophylaxis strategies in acute leukemia patients: Assessing the efficacy of fluconazole
Authors: Teran Nicholas S. , Park Grace S. 
Published: November 2023

Background Acute myeloid (AML) and promyelocytic (APL) leukemia patients are at high risk for infection and mortality. While guidance for infection prevention is provided by the National Comprehensive Cancer Network (NCCN) and the American Society of Clinical Oncology (ASCO), each institution may vary in antimicrobial prophylaxis prescribing practices. The discrepancy may be explained by medication intolerance, cost, and low incidence of mold infections in leukemia patients. A recent meta-analysis demonstrated mortality benefits with the use of posaconazole, which was adopted by the NCCN. Despite known risks, it is unclear whether universal mold-active coverage is indicated for all AML and APL patients. Objective To assess the incidence of breakthrough infections in AML and APL patients. Methods This was a single-center, retrospective chart review of AML and APL patients receiving induction therapy at Baylor St Luke's Medical Center (BSLMC) between January 2019 and October 2021. The primary outcome assessed the incidence of breakthrough infections. Descriptive statistics were used to summarize the data. Results A total of 55 patients were included and 54 (98%) had prolonged neutropenia with a median duration of 30 days. Five patients (9.3%) experienced breakthrough infections during induction while 21 individuals (38.9%) during the follow-up period. Aspergillus infections occurred in three patients receiving nonmold coverage compared to none on mold-active agents (p = 1.0) with no statistical difference in mortality. Conclusion Despite the majority of patients not receiving mold-active prophylaxis, nonmold-active prophylaxis may be sufficient with consideration of low aspergillosis incidence.
Rapid drug desensitization to taxanes: a descriptive study from Turkey
Authors: Yeşilkaya Selma , Aksu Kurtuluş , Vural Solak Gürgün Tuğçe , Demir Şenay , Topel Musa , Erçelebi Dilek Çuhadar , Koca Kalkan İlkay , Ateş Hale , Köycü Buhari Gözde , Nazik Bahçecioğlu Sakine 
Published: November 2023

Aim To present the characteristics of drug hypersensitivity reactions (DHRs) among taxane recipients with non-small cell lung carcinoma (NSCLC), and to describe the results of rapid drug desensitization (RDD). Methods A retrospective cross-sectional study included 45 patients who were treated with taxane for NSCLC and were found to be hypersensitive to taxane. All patients were administered the standard 3-bag, 12-step RDD protocol following the development of DHR. RDD success was evaluated separately for each cycle, and successful RDD was defined as the completion of the cycle with application of 12 steps of the desensitization protocol and the absence of early and/or late reactions afterwards. Results Among 45 patients hypersensitive to taxane 43 (95.6%) successfully received taxane cycles with desensitization. Failed RDD occurred in only 2 (4.4%) patients. The total number of desensitization cycles was 183, of which 181 (98.9%) were successful. The mean age of patients with successful desensitization was 59.42 ± 10.48 years and 37 (86.0%) of them were male. Conclusion RDD is a reliable procedure that enables effective administration and completion of first-line taxane treatments in taxane-sensitive patients.
Natural Language Processing Enhanced Qualitative Methods: An Opportunity to Improve Health Outcomes
Authors: Parker R. David , Mancini Karen , Abram Marissa D. 
Published: November 2023

Background Electronic health systems contain large amounts of unstructured data (UD) which are often unanalyzed due to the time and costs involved. Unanalyzed data creates missed opportunities to improve health outcomes. Natural language processing (NLP) is the foundation of generative artificial intelligence (GAI), which is the basis for large language models, such as ChatGPT. NLP and GAI are machine learning methods that analyze large amounts of data in a short time at minimal cost. The ability of NLP to conduct qualitative analyses is increasing, yet the results can lack context and nuance in their findings, requiring human intervention. Methods Our study compared outcomes, time, and costs of a previously published qualitative study. Our approach partnered an NLP model and a qualitative researcher (NLP+). UD from behavioral health patients were analyzed using NLP and a Latent Dirichlet allocation to identify the topics using probability of word coherence scores. The topics were then analyzed by a qualitative researcher, translated into themes, and compared with the original findings. Results The NLP + method results aligned with the original, qualitative derived themes. Our model also identified two additional themes which were not originally detected. The NLP + method required 6 hours of labor, 3 minutes for transcription, and a transcription cost of $1.17. The original, qualitative researcher only method required more than 36 hours ($2,250) of time and $1,100 for transcription. Conclusions While natural language processing analyzes voluminous amounts of data in seconds, context and nuance in human language are regularly missed. Combining a qualitative researcher with NLP + could be deployed in many settings, reducing time and costs, and improving context. Until large language models are more prevalent, a human interaction can help translate the patient experience by contextualizing data rich in social determinant indicators which may otherwise go unanalyzed.