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The use of routinely collected electronic healthcare records (EHR) for outcome assessment in clinical trials has been described as a 'disruptive' new technique more than a decade ago. Despite this potential, significant methodological issues and regulatory barriers have hampered the progress in this area. This article discusses the key considerations that trialists should take into account when incorporating EHR into their trials. These include considerations of the clinical relevance of the outcome, data timeliness and quality, ethical and regulatory issues, and some practical considerations for clinical trials units. In addition, this article describes the benefits of using EHR which include cost, reduced trial burden for participants and staff, follow up efficiencies, and improved health economic evaluation procedures. We also describe the major regulatory and start up costs of using EHR in clinical trials. This article focuses on the UK specific EHR landscape in clinical trials and would help researchers and trials units considering the use of this method of outcome data collection in their next trial. If the issues described are mitigated, this method will be a formidable tool for conducting pragmatic clinical trials. [ABSTRACT FROM AUTHOR]

Brazilian electronic invoices (Nota Fiscal eletrônica, NFe) are digital documents that register the purchase and sale operations of goods and services. In this work, we developed and used data‐cleaning procedures, clustering methods, and outlier detection algorithms to investigate the presence of two main risk patterns in the electronic invoices data of public entities, such as states or municipalities: abnormal product quantities and anomalous prices paid with public funds. As a case study, we analyzed nearly 3.5 million electronic invoices containing more than 11 million items from purchases made by public entities of the Brazilian state of Mato Grosso (MT) in 2016–2019. The results indicate that the total value of invoice items categorized as high‐intensity price alerts amounted to more than R$ 560 million, i.e., approximately US$ 139 million at the rate of December 31, 2019. Several cases of high‐risk patterns are presented to illustrate these practical results. [ABSTRACT FROM AUTHOR]

Background: To describe the 3‐ and 5‐year outcomes of an inception cohort of Australian children with JIA for whom 1‐year outcomes have previously been published. Methods: Data regarding clinical outcomes of the original cohort of 134 patients at 3 and 5 years were sought. Relevant clinical features and medication exposures entered prospectively into an electronic record were collected and analyzed using descriptive statistics. Results: Data were available for 110 and 98 patients at 3 and 5 years, respectively. The proportion of patients with active joints progressively decreased from 34% at 12 months to 21% at 3 years and 16% at 5 years. Cumulative exposure to methotrexate increased between 3 and 5 years (75%–80%), however, point prevalence use decreased (45%–41%). Cumulative exposure and point prevalence use of bDMARDS both increased between 3 and 5 years; 30%–42% and 29%–33%, respectively. Thirty‐five percent of patients had inactive joint disease off medications at 5 years, which occurred most frequently in patients with sJIA and oligoarthritis. Conclusion: Five‐year outcomes of Australian children with JIA are good, with only a small minority having ongoing active joint disease at 5 years. bDMARDS play an increasing role in management over time; however, methotrexate use remains significant. A majority of children remain on medications at 5 years. [ABSTRACT FROM AUTHOR]

Understanding the factors driving SARS-CoV-2 infection progression and severity is complex due to the dynamic nature of human physiology. Therefore, we aimed to explore the severity risk indicators of SARS-CoV-2 through demographic data, clinical manifestations, and the profile of laboratory parameters. The study included 175 patients either hospitalized at King Abdulaziz Medical City–Riyadh or placed in quarantine at designated hotels in Riyadh, Saudi Arabia, from June 2020 to April 2021. Hospitalized patients were followed up through the first week of admission. Demographic data, clinical presentations, and laboratory results were retrieved from electronic patient records. Our results revealed that older age (OR: 1.1, CI: [1.1–1.12]; p < 0.0001), male gender (OR: 2.26, CI: [1.0–5.1]; p = 0.047), and blood urea nitrogen level (OR: 2.56, CI: [1.07–6.12]; p = 0.034) were potential predictors of severity level. In conclusion, the study showed that apart from laboratory parameters, age and gender could potentially predict the severity of SARS-CoV-2 infection in the early stages. To our knowledge, this study is the first in Saudi Arabia to explore the longitudinal profile of laboratory parameters among risk factors, shedding light on SARS-CoV-2 infection progression parameters. [ABSTRACT FROM AUTHOR]

In the context of world education digitalization, the Chinese government has formulated China's education digitalization strategy. The education digitalization policy tools of provincial governments are an important factor affecting the effectiveness of education digitalization policies. In this study, a text quantification and content analysis is conducted on educational digital policy documents released by eight provinces of China during the 14th Five-Year Plan period in China. This is based on a two-dimensional analysis framework of "instruments-value" using instrument types and policy principles, and NVivo software. The research outcomes reveal the following: (1) The distribution of educational digital policy instrument types is uneven, with an excess of supply-side instruments and a noticeable shortage of demand-side instruments. (2) Different policy instruments exhibit varying degrees of preference in implementing policy principles. There is a stronger emphasis on technology application and balanced development, while the emphasis on service principles promoting diverse participation is relatively weaker. (3) The policy instruments that facilitate interaction between policymakers and educational entities require further strengthening. In light of these findings, local governments in China should strengthen the use of demand-side policy instruments to achieve comprehensiveness and sustainability in educational digitalization. Policymakers should pay more attention to the demands of educational entities to shift educational digitalization from being technology driven to being demand driven. Furthermore, policy instrument selection should adhere to the value of serving and supporting individuals and reinforce the concept of multi-participation in their development, ultimately improving the precision and coordination of policies, and achieving a harmonious integration of technological and value aspects of policy instruments. [ABSTRACT FROM AUTHOR]

This research proposes a novel high-capacity-based reversible data embedding strategy for e-healthcare applications. The proposed reversible embedding scheme for electronic patient records (EPR) replaced the conventional embedding and interpolation techniques with a simple pixel-to-block-level transformation, repeated pixel differencing (RPD) and conditional pixel permutation (CPP) strategies. A fragile watermark image combined with EPR is employed to identify tamper detection in medical stego-images. In the proposed pixel-to-block conversion, a pixel is replicated to a 2 × 2 pixel block to facilitate the reversibility of EPR data. For embedding, RPD determines and adjusts the 2 × 2 pixel differences based on EPR and watermark data. Further, to ensure high imperceptibility for the human visual system proposed scheme computes the average value of pixels that must similar to the seed pixel. To maintain a histogram invariant stego-images, a permutation of 2 × 2 pixels is employed to embed additional secret data bits while exploiting the CPP strategy. The proposed scheme is extensively evaluated on + 2000 images regarding embedding capacity, perceptual imperceptibility, and tamper detection while employing different image processing attacks. Experimental results show that the proposed scheme achieved an average of 2.24 bpp with 41.27 dB PNSR on medical images and 2.49 bpp with 40.68 PSNR with general images. The proposed strategy outperformed existing approaches in terms of high embedding capacity, acceptable visual imperceptibility, and tamper detection while ensuring the 100% reversibility of EPR data in medical images. [ABSTRACT FROM AUTHOR]

Copyright of Revista del Museo de Antropología is the property of Museo de Antropologia - IDACOR and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The prevalence of fungal bloodstream infections (BSI), especially candidaemia, has been increasing globally during the last decades. Fungal diagnosis is still challenging due to the slow growth of fungal microorganisms and need for special expertise. Fungal polymicrobial infections further complicate the diagnosis and extend the time required. Epidemiological data are vital to generate effective empirical treatment strategies. Objectives: The overall aim of this project is to describe the epidemiology of monomicrobial candidaemia and polymicrobial BSI, both with mixed fungaemia and with mixed Candida/bacterial BSIs. Methods: We conducted a single‐centre retrospective epidemiological study that encompasses 950,161 blood cultures during the years 2010 to 2020. The epidemiology of monomicrobial and polymicrobial candidaemia episodes were investigated from the electronic records. Results: We found that 1334 candidaemia episodes were identified belonging to 1144 individual patients during 2010 to 2020. Candida albicans was the most prevalent species detected in candidaemia patients, representing 57.7% of these episodes. Nakaseomyces (Candida) glabrata and Candida parapsilosis complex showed an increasing trend compared to previous studies, whereas Candida albicans demonstrated a decrease. 19.8% of these episodes were polymicrobial and 17% presented with mixed Candida/bacterial BSIs while 2.8% were mixed fungaemia. C. albicans and N. glabrata were the most common combination (51.4%) in mixed fungaemia episodes. Enterococcus and Lactobacillus spp. were the most common bacteria isolated in mixed Candida/bacterial BSIs. Conclusions: Polymicrobial growth with candidaemia is common, mostly being mixed Candida/bacterial BSIs. C. albicans was detected in more than half of all the candidaemia patients however showed a decreasing trend in time, whereas an increase is noteworthy in C. parapsilosis complex and N. glabrata. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prevalence of DD and AI with POP symptoms in females attending a urogynecology clinic, and to identify factors associated with DD and AI in POP symptoms patients. Methods: Computer-based medical records of women with POP symptoms attending a urogynecology clinic in a referral tertiary center between January 2016 and December 2020 were reviewed. Demographic data were collected. Selected defecatory dysfunction (DD) and anal incontinence (AI) were recorded. The associations between patient characteristics, site and severity of prolapse, and DD and AI symptoms in POP patients were investigated for identified associated factors. Results: The mean age of the 754 participants was 65.77 ± 9.44 years. Seven hundred and fifteen (94.83%) were menopause. The prevalence of DD and AI in patients with POP symptoms was 44.03% (332/754) and 42.04% (317/754) according to the PFBQ and medical history records, respectively. Advanced posterior wall prolapse (OR 1.59, 95% CI 1.10–2.30) and wider GH (OR1.23, 95% CI 1.05–1.43) were identified as risk factors for DD by multivariate analysis. Additionally, single-compartment prolapse (OR 0.4, 95% CI 0.21–0.76) and a stronger pelvic floor muscle assessed with brink score (OR 0.94, 95% CI 0.88–0.98) are protective factors for AI. Conclusion: DD and AI are prevalent among women with POP symptoms who visit a urogynecology clinic. DD should be evaluated in women with POP symptoms especially in women with increased genital hiatus and point Ap beyond the hymen. To prevent AI, women with POP should be encouraged to perform pelvic floor muscle training in order to increase pelvic floor muscle strength. [ABSTRACT FROM AUTHOR]

In this work, we study the polarization properties of diffraction gratings recorded in thin films of the azopolymer PAZO (poly[1-[4-(3-carboxy-4-hydroxyphenylazo)benzene sulfonamido]-1,2-ethanediyl, sodium salt]) using digital polarization holography. Using two quarter-wave plates, the phase retardation of each pixel of the SLM is converted into the azimuth rotation of linearly polarized light. When recording from the azopolymer side of the sample, significant surface relief amplitude is observed with atomic force microscopy. In contrast, recording from the substrate side of the sample allows the reduction of the surface relief modulation and the obtaining of polarization gratings with characteristics close to an ideal grating, recorded with two orthogonal circular polarizations. This can be achieved even with a four-pixel period of grating, as demonstrated by our results. [ABSTRACT FROM AUTHOR]

Simple Summary: Coleomegilla maculata lengi is an important insect predator in North American agroecosystems. Collection records reveal that the reputed range for C. maculata lengi has been substantially underestimated. New records indicate an expanded geographic range, including the recent expansion of C. maculata lengi in central North America and a new state record for Wyoming, USA. The expanding geographic range of C. maculata lengi contrasts with that of several species of lady beetles native to North America. Several species of lady beetle native to North America have declined in abundance in the last few decades, often accompanied by contractions in their geographic ranges. Coleomegilla maculata lengi is a lady beetle native to North America that is an important predator of pests in various agroecosystems. Its reported range spans the eastern half of the USA, with no sustained decline in abundance or contraction of its range reported. Indeed, we recently collected several individuals of this lady beetle in central USA roughly 500 km beyond the western edge of its reputed range. We hypothesized that new records could indicate either that previous range characterization failed to include pre-existing collection records further west or that C. maculata lengi has recently expanded its geographic range. To test these hypotheses, we searched several institutional insect collections and digital databases for records and found many earlier records of C. maculata lengi beyond its reputed geographic range, clearly showing that the previous characterization of its geographic distribution in North America was substantially underestimated. In addition, we report a new state record of C. maculata lengi from Wyoming, USA, that further indicates its geographic range expansion in North America. We discuss new records of C. maculata lengi in light of declines in native coccinelline lady beetle species in North America. [ABSTRACT FROM AUTHOR]

Background: The collection of data on 'infant feeding at hospital discharge' is used to monitor breastfeeding outcomes, health service benchmarking, and research. While some Australian states have clear definitions of this data collection point, there is no operational definition of 'infant feeding at hospital discharge' in the Australian state of New South Wales. Little is known about how midwives interpret the term 'infant feeding at hospital discharge', in particular, the timeframe used to calculate these important indicators. The purpose of this study was to explore midwives' and nurses' practices of reporting 'infant feeding at hospital discharge' in the Australian state of New South Wales. Methods: An online survey was distributed across public and private maternity hospitals in New South Wales, Australia. The survey asked midwives and nurses their practice of reporting 'infant feeding at discharge' from categories offered by the state Mothers and Babies report of either "full breastfeeding", "any breastfeeding", and "infant formula only". The Qualtrics survey was available from December 2021 to May 2022. Results: There were 319 completed surveys for analysis and all 15 NSW Health Districts were represented. Some participants reported using the timeframe 'since birth' as a reference (39%), however, the majority (54%, n = 173) referenced one of the feeding timeframes within the previous 24 h. Most midwives and nurses (83%, n = 265) recommended 24 h before discharge as the most relevant reference timeframe, and 65% (n = 207) were in favour of recording data on 'exclusive breastfeeding' since birth. Conclusion: This study identified multiple practice inconsistencies within New South Wales reporting of 'infant feeding at hospital discharge'. This has ramifications for key health statistics, state reporting, and national benchmarking. While the Baby Friendly Hospital Initiative accreditation requires hospitals to demonstrate and continuously monitor at least a 75% exclusive breastfeeding rate on discharge, only 11 New South Wales facilities have achieved this accreditation. We recommend introducing an option to collect 'exclusive breastfeeding' on discharge' which is in line with participant recommendations and the Baby Friendly Hospital accreditation. Other important considerations are the updated World Health Organization indicators such as, "Ever breastfed"; "Early initiation of breastfeeding" (first hour); "Exclusively breastfed for the first two days after birth". [ABSTRACT FROM AUTHOR]

Background: Chronic kidney disease (CKD) affects more than 38 million people in the United States, predominantly those over 65 years of age. While CKD etiology is complex, recent research suggests associations with environmental exposures. Methods: Our primary objective is to examine creatinine-based estimated glomerular filtration rate (eGFRcr) and diagnosis of CKD and potential associations with fine particulate matter (PM2.5), ozone (O3), and nitrogen dioxide (NO2) using a random sample of North Carolina electronic healthcare records (EHRs) from 2004 to 2016. We estimated eGFRcr using the serum creatinine-based 2021 CKD-EPI equation. PM2.5 and NO2 data come from a hybrid model using 1 km2 grids and O3 data from 12 km2 CMAQ grids. Exposure concentrations were 1-year averages. We used linear mixed models to estimate eGFRcr per IQR increase of pollutants. We used multiple logistic regression to estimate associations between pollutants and first appearance of CKD. We adjusted for patient sex, race, age, comorbidities, temporality, and 2010 census block group variables. Results: We found 44,872 serum creatinine measurements among 7,722 patients. An IQR increase in PM2.5 was associated with a 1.63 mL/min/1.73m2 (95% CI: -1.96, -1.31) reduction in eGFRcr, with O3 and NO2 showing positive associations. There were 1,015 patients identified with CKD through e-phenotyping and ICD codes. None of the environmental exposures were positively associated with a first-time measure of eGFRcr < 60 mL/min/1.73m2. NO2 was inversely associated with a first-time diagnosis of CKD with aOR of 0.77 (95% CI: 0.66, 0.90). Conclusions: One-year average PM2.5 was associated with reduced eGFRcr, while O3 and NO2 were inversely associated. Neither PM2.5 or O3 were associated with a first-time identification of CKD, NO2 was inversely associated. We recommend future research examining the relationship between air pollution and impaired renal function. [ABSTRACT FROM AUTHOR]

Conventional techniques for sharing paper documents in teleconferencing tend to introduce two inconsistencies: 1) media inconsistency: a paper document is converted into a digital image on the remote site; 2) space inconsistency: a workspace deliberately inverts the partner's handwriting to make a document easy to read. In this paper, we present a novel system that eliminates these inconsistencies. The media and space inconsistencies are resolved by reproducing a real paper document on a remote site and allowing a user to handover the paper document to a remote partner across a videoconferencing display. From a series of experiments, we found that reproducing a real paper document contributes to a higher sense of information sharing. We also found that handing over a document enhances a sense of space sharing, regardless of whether the document is digital or paper-based. These findings provide insights into designing systems for sharing paper documents across distances. [ABSTRACT FROM AUTHOR]

Records and archives are the footprints of any organisation due to the value of their information. In South Africa, the records and archives are governed by the National Archives and Record Service of South Africa Act No. 43 of 1996, as amended under the auspices of the National Archives and Record Services of South Africa. The current archival holding is compatible with paper, film, and audio formats as provided in the Act. This study sought to explore the strategies for developing digital infrastructure that would rescue records and archives from a stagnant state in the Government of South Africa. This being an interpretive study, qualitative data were collected through semi-structured interviews and augmented with content analysis. In view that this was a case study, the population comprised 10 chief information officers and records practitioners from national government departments of South Africa. The collected data were thematically analysed. This study established that the current infrastructure of record-keeping contributes heavily to the stagnant situation of records because only those in the proximity of the archival holdings can access the records by visiting the premises. This study also argues that if the current infrastructure prevails, records and archives will continue to be stagnant. In view of the emerging Fourth Industrial Revolution, the study recommends that records and archives can be saved from the stagnant state by developing the infrastructure for cloud storage within the borders of South Africa. [ABSTRACT FROM AUTHOR]

Aim: To conduct a service evaluation of patients who had functional appliance treatment to correct Class II malocclusions in a public orthodontic clinic. To evaluate the effect of prioritisation and earlier treatment of these patients on treatment duration and patient compliance. Methodology: The prioritised treatment group (PTG) had twin block appliances fitted when they were 11 or 12 years old. In comparison, the routine treatment group (RTG) had twin block appliances fitted when they were 13 or 14. Electronic patient records were screened to find a sample of 100 patients from each cohort. The number of compliance issues, functional appliance treatment duration, fixed appliance treatment duration, and total treatment duration were recorded retrospectively from patient charts. Results: While mean total treatment time was similar across the two cohorts, the PTG did have significantly shorter fixed appliance treatment durations than the RTG. The PTG was also found to have better compliance than the RTG. Conclusions: Prioritising patients who require functional appliance treatment does not reduce total treatment duration. A correlation between earlier treatment, improved patient compliance, and a shorter course of fixed appliance therapy can be seen, which may prove clinically beneficial. Further research in this area would be valuab [ABSTRACT FROM AUTHOR]

Copyright of Revista Española de Documentación Científica is the property of Consejo Superior de Investigaciones Cientificas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Currently, telehealth services in rural regions of Peru primarily rely on telephone and text message communication between rural physicians and specialists based in cities, leading to delays in accessing specialized healthcare services. To overcome this limitation, we propose an information and communication technology (ICT) model for asynchronous teleconsultation in rural areas of Peru. This model, implemented through a system called SITEA, coordinates city-based specialists with treating physicians in rural areas and integrates care phases along with electronic clinical records. A case study conducted in a rural Peruvian healthcare facility, which had limited Internet connectivity and lacked teleconsultation services, revealed significant outcomes. Within 23 days of implementing SITEA, the facility began offering specialized care services, leading to a 60% reduction in patient transfers to specialized urban healthcare facilities. Furthermore, a satisfaction survey conducted with 50 patients resulted in overwhelmingly positive feedback regarding the quality of medical care and future expectations for healthcare services. These positive outcomes can be attributed to the implementation of specialized services, the shift from physical to electronic records, and improved diagnostic accuracy. Importantly, healthcare personnel found the system easy to navigate and highly beneficial, despite the area's connectivity limitations. [ABSTRACT FROM AUTHOR]

Multi-label text classification (MLTC) is a popular method for organizing electronic documents, which is crucial for accessing and processing data. As the number of classes increases, learning multi-label data will be challenging. The number of possible states for various labels increases exponentially, and learning algorithms in single-label data cannot be used to solve these problems. In the meantime, using single-label data algorithms could be very time-consuming. In MLTC, complexity costs should be reduced. Deep-learning neural networks that can learn intricate patterns are used in many real-world problems because of their high power and accuracy. This paper proposed a hybridization of the long short-term memory (LSTM) neural network and the convolutional neural network (CNN) method for MLTC. The proposed model uses LSTM to enhance CNN to improve the proposed model's accuracy. Also, the competitive search algorithm (CSA) is used to improve the LSTM hyperparameters. The LSTM hyperparameters play an important role in increasing the detection accuracy. The CSA algorithm finds the best values for the hyperparameters by searching the problem space. It was tested on four different datasets of multi-label texts: Reuters-21578, RCV1-v2, EUR-Lex, and Bookmarks. The result showed that the proposed model performed better than CNN and LSTM-CSA in terms of accuracy percentage and that it has improved by an average of more than 10%. Also, the results show that the LSTM-CSA model has higher detection accuracy compared to LSTM—Gradient-based optimizer (GBO) and LSTM—whale optimization algorithm (WOA). [ABSTRACT FROM AUTHOR]

Background Decolonization treatment of MRSA carriers is recommended in Denmark, except in households with MRSA-positive children <2 years old (wait-and-see approach). Objectives To investigate a wait-and-see approach in children 2–5 years old, and the effect of decolonization treatment of MRSA carriage in all children <6 years old. Patients and methods In this retrospective follow-up study, we included MRSA carriers <6 years old in the Capital Region of Denmark from 2007 to 2021. Data were collected from laboratory information systems and electronic patient records. We divided children into age groups of <2 years or 2–5 years and decolonization treatment versus no treatment. Treatment was chlorhexidine body washes and nasal mupirocin, sometimes supplemented with systemic antibiotics. Children were followed until becoming MRSA free, or censoring. The probability of becoming MRSA free was investigated with Cox regression (higher HRs indicate faster decolonization). Results Of 348 included children, 226 were <2 years old [56/226 (25%) received treatment] and 122 were 2–5 years old [90/122 (74%) received treatment]. Multivariable analyses did not show a larger effect of decolonization treatment versus no treatment in <2-year-olds (HR 0.92, 95% CI 0.52–1.65) or 2–5-year-olds (HR 0.54, 95% CI 0.26–1.12). Without treatment, 2–5-year-olds tended to clear MRSA faster than <2-year-olds (HR 1.81, 95% CI 0.98–3.37). Conclusions We did not find a larger effect of decolonization treatment versus no treatment in children <6 years old, and 2–5-year-olds tended to become MRSA free faster than <2-year-olds. These results support a wait-and-see approach for all children <6 years old, but further studies are needed. [ABSTRACT FROM AUTHOR]

Building information modeling (BIM) has been attracting increasing attention in the architecture, engineering, and construction (AEC) industry in recent years. The wide spread of BIM marks the transition from 2D and paper-based archiving to 3D and digital archiving of project information. However, the commonly used centralized managing approaches for BIM data have high risks of data loss and data tampering. With cryptographic algorithms and distributed databases, blockchain has the potential to address the limitations of data loss and trust in conventional BIM management methods. Therefore, this paper proposes a blockchain-based framework for digital archiving of BIM data. In this paper, the axiomatic design approach is utilized to design the archiving framework in order to systematically map the design parameters with the functional requirements and minimize the information contents. The proposed framework contains five modules, including the BIM module, building plan approval (BPA) module, building data simplification (BDS) module, distributed data storage (DDS) module, and digital document verification (DDV) module. Hyperledger Fabric is utilized to develop the blockchain system based on the proposed framework. In the end, a simple BIM model with 240 components and around 11,000 lines of content in the Industry Foundation Classes (IFC) file is taken as an illustrative example to validate the proposed blockchain approach. By storing the BIM model on to the developed blockchain, it is found that each transaction of a blockchain can store over 5000 lines of IFC contents with 0.09 s of uploading latency. The results show that the proposed blockchain-based approach can effectively and securely archive BIM data. [ABSTRACT FROM AUTHOR]

Background Chronic urinary retention (CUR) occurs when urine accumulates in the bladder secondary to incomplete voiding. The aim of this audit was to assess compliance to the Mater Dei Hospital Urinary Retention Management Guidelines in a cohort of patients admitted between August 2019 and February 2020. Methodology Patients admitted because of CUR were included. Data was acquired from medical files, discharge letters, hospital electronic record systems and urology outreach records. Standard used The Urinary Retention Management Guidelines, published in 2018, were considered standard for outcome comparison. Results The quantitative results included data on clinical presentation, inpatient management and medium-term outcomes. 55% had a successful TWOC after CUR. 45% were treated pharmacologically, 35% had a trans-urethral resection of the prostate, 10% started a self-intermittent catheterisation (SIC) programme, 5% remained with a long-term catheter and 5% required a re-trial without catheter (TWOC). Conclusion Compliance to MDH guidelines was suboptimal in some cases. This audit highlights CUR management issues which can be optimised and also current outcomes of patients presenting in CUR. 55% of patients presented with a degree of acute kidney injury. Nephrology specialists were rarely involved in the management of these patients. [ABSTRACT FROM AUTHOR]

The ease of creating digital documents due to today's technological advancements has led to a surge in whitecollar crimes involving forgery and manipulation. Detecting these digital document alterations presents a unique set of challenges to forensic investigators. The present study aims to uncover a forgery in a digitally manipulated document and demonstrate the successful detection of digital document alterations. This study examines a reallife case to explore the methods utilized by forensic experts in detecting and evaluating document forgery. It highlights the crucial role of digital forensic analysis in contemporary investigative procedures. This research emphasises the significance of understanding document forgery and the need for robust forensic techniques in detecting digital manipulation. Ensuring the integrity of digital documents is crucial in maintaining trust and reliability in today's information-driven era. [ABSTRACT FROM AUTHOR]

Introduction: Partial nephrectomy is currently the preferred treatment option for T1a renal cell carcinomas (RCC), with nephron-sparing techniques, including microwave ablation, becoming more common in select patients. Primary aims are to document outcomes of microwave ablation for T1a RCCs in an Australian tertiary centre to add to the evidence for its safety and efficacy. Methods: The prospectively maintained Sir Charles Gairdner Hospital Interventional Radiology database was retrospectively searched for all Renal Microwave ablations completed between June 2012 and February 2022. This database and a combination of hospital programmes including Agfa Impax PACS, Bossnet digital medical record and iSoft Clinical Manager were used to extract the relevant data which was anonymized and entered into an Excel spreadsheet for analysis. Results: Forty-eight patients underwent microwave ablation for 50 tumours. Of these, there were two local and two distant recurrences. A fifth patient had metastases on presentation. Higher local recurrence rates were associated with larger tumour size (P = 0.043). Tumour proximity to the collecting system <4 mm was associated with higher rates of complications (P = 0.020). RENAL scores did not show statistically significant correlation with complications (P = 0.092) or local or distant recurrence. Notably, the study follow-up time was longer than many comparative studies (mean = 2796, ~7.66 years censoring for death and mean = 832 days, ~2.28 years not censoring for death). Conclusion: Consistent with the literature, this study further demonstrates that microwave ablation is a safe and efficacious option for treatment of T1a RCC. [ABSTRACT FROM AUTHOR]

Background: This research aims to assess the treatment outcomes and chemotherapy duration required for the normalization of Human chorionic gonadotropin (HCG) levels in patients diagnosed with Gestational Trophoblastic Neoplasia (GTN), encompassing both benign and malignant forms of the condition. Methods: This retrospective study included GTD patients treated with chemotherapy in a single oncology clinic from January 2016 to May 2022. Clinical data were gathered from electronic records of the patients. Results: During the study period, a total of 24 patients diagnosed with GTD underwent chemotherapy, with a median age of 32 years (range: 18- 51). Intramuscular Methotrexate was the primary single-agent chemotherapy utilized in 20 cases (83%) for low-risk disease, while the EMA-CO regimen was the predominant combination chemotherapy employed in 3 cases (13%) for high-risk disease. The median number of chemotherapy cycles administered was 2 (range: 1-16), with a median duration of 4 weeks (range: 1-16) required for Human chorionic gonadotropin (HCG) normalization. Approximately half of the patients (n=10, 47.5%) transitioned to second-line combination chemotherapy, with a median normalization duration of 4 months. Four patients (40%) subsequently received third-line combination chemotherapy using the EMA-CO regimen. Initial complete response was achieved in 11 patients (47%) with first-line treatment, while 10 patients (43%) required second-line chemotherapy and 4 patients (17%) necessitated third-line EMACO chemotherapy. Of the 24 patients, 22 achieved complete response, while 2 patients are currently undergoing treatment. Conclusion: All patients successfully attained complete response with chemotherapy. The median duration of chemotherapy for achieving normalization of HCG was 4 weeks, equivalent to 2 cycles. Notably, only 4 patients necessitated third-line chemotherapy following single-agent chemotherapy in the first and second lines. [ABSTRACT FROM AUTHOR]

Using a common protocol across seven countries in the European Union/European Economic Area, we estimated XBB.1.5 monovalent vaccine effectiveness (VE) against COVID‐19 hospitalisation and death in booster‐eligible ≥ 65‐year‐olds, during October–November 2023. We linked electronic records to construct retrospective cohorts and used Cox models to estimate adjusted hazard ratios and derive VE. VE for COVID‐19 hospitalisation and death was, respectively, 67% (95%CI: 58–74) and 67% (95%CI: 42–81) in 65‐ to 79‐year‐olds and 66% (95%CI: 57–73) and 72% (95%CI: 51–85) in ≥ 80‐year‐olds. Results indicate that periodic vaccination of individuals ≥ 65 years has an ongoing benefit and support current vaccination strategies in the EU/EEA. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19, in combination with steroid treatment, is known to propagate hyperglycemia in diabetic patients. The purpose of this study was to establish a new insulin protocol for diabetic patients with COVID-19 on the dexamethasone protocol for better glycemic control. Research Design and Methods: This was a retrospective cohort study conducted at NYU Langone Long Island Hospital from 1 July 2020 to 1 July 2021. Eligible cases had to meet the following inclusion criteria: age of 18 years or greater, history of or new-onset diabetes, diagnosis of COVID-19 and receiving the 10 day dexamethasone treatment, length of stay of at least 3 days with a minimum of 48 h of glucose monitoring, and requiring basal and prandial insulin with correction during hospital stay. Data were collected using the hospital's electronic record system. The total basal, prandial, and daily doses of insulin on the day at which glycemic control was achieved, or if glycemic control was not achieved by the discharge date, then on the completion date of the dexamethasone treatment, were collected and assessed. Results: A total of 145 patient cases were analyzed. About 46% of patients achieved glycemic control. The average insulin dose required was 0.67 (0.61–0.74) unit/kg. The mean total dose of insulin was 59 units. The mean total basal dose was 21 units. The mean total prandial dose was 38 units. The average prandial doses were higher than the basal doses for all participants. Conclusions: Diabetic patients with COVID-19 on dexamethasone should be initiated on at least 0.6–0.7 u/kg of insulin to achieve glycemic control. [ABSTRACT FROM AUTHOR]

An introduction to articles published within the issue is presented including the digitization of land records in India, the bureaucratic tools of documentation, and green stormwater management.

Background: Electronic health records (EHRs) are digital records of individual health information. However, their adoption and utilization remain low. This study explores the factors influencing the implementation of EHRs through a questionnaire survey to enhance individual awareness and adoption of EHRs. Methods: A questionnaire and an expert rating scale were developed sequentially, and the consistency of the scores from five experts was calculated using Kendall's W to generate a final questionnaire. A non-parametric test was utilized to analyze differences in continuous data that did not follow a normal distribution. Categorical variables were expressed as percentages (%), the chi-square test was employed for group comparisons, and multiple logistic regression was implemented to assess individuals' awareness and adoption of EHRs. Results: In total, 1,341 survey questionnaires were distributed between January and December 2022, with 1,337 valid responses (99.7%). The results indicated that the proportion of participants who were aware of EHRs and had a bachelor's degree or higher education, an income of ≥$700 per month, residence in urban areas, possessed self-care abilities, and underwent annual physical examinations was significantly higher than that without awareness of EHRs (P < 0.05), while in hearing problems and walking abilities was markedly lower than that of participants without awareness of EHRs (P < 0.05). Additionally, the proportion of individuals willing to self-manage EHRs was significantly higher than those reluctant to do so (P < 0.05) among participants with a bachelor's degree or higher education, an income of ≥$700 per month, residence in urban areas, possession of self-care abilities, annual physical examinations, hearing problems, and poor walking abilities. Age (Odds Ratio [OR] = 1.104, 95% Confidence Interval [CI] 1.001–1.028, P = 0.033), hearing problems (OR = 0.604, 95% CI 0.377–0.967, P = 0.036), self-care ability (OR = 5.881, 95% CI 1.867–18.529, P = 0.002), and annual physical examinations (OR = 3.167, 95% CI 2.31–4.34, P < 0.001) were independently associated with willingness to self-manage EHRs. Annual physical examination (OR = 2.507, 95%CI 1.585–2.669, P < 0.001) also independently made a difference to the awareness of EHRs. Conclusions: Our findings suggest that annual physical examinations, age, hearing problems, and self-care abilities are significant factors in assessing individuals' awareness and adoption of EHRs. Understanding the characteristics of individuals who are aware of or are willing to take advantage of EHRs plays a positive role in promoting their popularization and application. [ABSTRACT FROM AUTHOR]

Introduction: Early-onset (EOMG) and late-onset (LOMG) are distinct groups of MG patients. It is unclear if treatment strategies and treatment-related adverse events may differ according to the age of MG onset. Methods: This single-center retrospective study includes all MG patients followed at a tertiary center since 2007. We reviewed the electronic clinical records. Results: In total, 212 patients were identified, 142 (67.0%) females, with a median disease duration of 10years. The median age of symptom onset was 42.0 (26.0– 64.5) years, with 130 (61.3%) EOMG cases and 82 (38.7%) LOMG. EOMG were more frequently female, had longer disease duration and often more generalized MG (p < 0.001). Comorbidities were significantly more frequent in LOMG (67.1%) compared to EOMG (53.1%) (p = 0.002). Steroid-related adverse effects motivating the switch to steroid-sparing agents (82.0%) were different between groups, with hypertension, hypercholesterolemia, diabetes mellitus and malignancies being more common in LOMG. At the same time, osteoporosis and dyspepsia were more frequent in EOMG (p < 0.001). The most common first-line choice was azathioprine (45.8%), and rituximab was used in 4 patients (1.9%). Conclusion: Our study shows that treatment modalities are similar between EOMG and LOMG, while steroid-related adverse events appear to be distinct. [ABSTRACT FROM AUTHOR]

This research proposes a system to store transaction records from a payment gateway based on digital payments by utilizing blockchain technology and Interplanetary File System (IPFS) as distributed storage. In digital payments, the possibility of online fraud or theft of customer data is a problem that needs to be solved. Although the solution is to use a Payment Gateway with security standards to prevent these problems, the system is still centralized and vulnerable to the possibility of system failure or data changes by irresponsible people. Blockchain furnishes a secure and unalterable record for documenting payment transactions. Conversely, IPFS presents a decentralized and immune-to-censorship approach for storing and accessing data. The usage of these technologies guarantees the secure storage of payment transaction data and related documents (such as invoices and receipts) while effectively thwarting data manipulation or censorship attempts. Therefore, this research aims to build a blockchain technology system to increase security and maintain the integrity of the data generated from the Payment Gateway. This research using distributed data storage using IPFS to save transaction from the payment gateway data. Based on the evaluation and security analysis results, implementing a blockchain technology system to store transaction records from digital-based payment gateways can improve data security and integrity. In the gas fee increase analysis, the gas fee will increase according to the total number of bytes generated when the transaction is made, where each byte will cost 12 gwei to pay the gas fee. [ABSTRACT FROM AUTHOR]

This paper discusses a Multiagent System architecture and its supporting concepts and technical implementation for food-producing systems. The Food and Beverages industry is in dire need of embracing more advanced industrial digitization practices to be able to meet immediate sustainability requirements. One such challenge is improving and optimizing resource utilization. A more rationalized use of raw materials, production processes and machinery is a key aspect of the latter. At the same time, food is still produced, in many instances, in a very traditional way, particularly when it comes to ingredient selection. The architecture introduced in this paper has the ambition of articulating the supply and demand of food products based in the technical characteristics of food (e.g., composition, nutritional content and value, processing efficiency, and taste profiles) instead of the more traditional characteristics. To that end, the paper introduces, among other key concepts, the notion of the Digital Food Identity Card as an active digital document that stores such technical information and the notion of Dynamic Recipe as an active software entity with the dynamic capability of adjusting production parameters in a recipe to market conditions, as well as coordinating the resources included in the execution of a industrial food recipe. Both concepts are modeled as agents and part of the proposed architecture. Finally, the paper provides a formal grammar for a domain specific language, that can be used by human specialists to define a dynamic recipe and be simultaneously interpreted by Dynamic Recipe Agents to enact the behaviours previously described. The domain specific language is an integral part of the architecture, together with the agent-based formulation, and an important link in creating an effectively data-oriented way of articulating different stake-holder concerns. The proposed solution is informed by requirements elicited within domain experts and sustainability targets that food-producing companies currently must adhere to. [ABSTRACT FROM AUTHOR]

Objective. To analyze the clinical characteristics of patients taking Factor Xa inhibitors (FXai), either direct FXai or enoxaparin (only in active cancer patients), and to estimate the incidence of and risk factors for major bleeding during FXai use. Methods. A retrospective cohort study, which included secondary data from computerized health records of primary care centers and hospitals in seven Spanish Autonomous Communities. Results. 9374 patients were analyzed, with 8972 taking direct FXai and 402 enoxaparin. At baseline, the mean age (SD) was 71.8 (9.4) years, 56.0% were women, 76.3% had hypertension, 33.6% had type 2 diabetes, and 25.5% had heart failure. The most common indication for FXai use was atrial fibrillation (72.3%), followed by venous thromboembolism (22.2%) and non-mechanical cardiac–valve replacement (5.6%). At the end of the follow-up period, the incidence rates of major bleeding overall, gastrointestinal, and intracranial were 10.2, 9.0, and 0.8 per 100 person-years, respectively. The total incidence of fatal major bleeding was 0.5 per 100 person-years. Incidence rates of all bleedings progressively decreased over time, with 62.5% of the first events occurring in the initial three months and reaching 76.8% within six months following initiation of treatment. Only 4.8% of the 1st major bleedings led to death, 2.3% in the case of major gastrointestinal bleeding, and 30.8% after an intracranial bleeding. 65.9% of patients discontinued anticoagulation after experiencing major bleeding. Conclusions. In Spain, patients taking FXai were old and had many comorbidities. Despite incidence rates of major bleeding were high, incidence rates of intracranial and fatal bleedings were low, but more efforts are required due to their relevant clinical impact. [ABSTRACT FROM AUTHOR]

Background: The mosquito-borne zoonotic parasite Dirofilaria immitis continues to spread northwards in Europe. This parasite can cause potentially life-threatening heartworm disease in dogs and pulmonary dirofilariasis in humans and is, therefore, a major health concern in both the veterinary medicine and human medical fields. This is the first report of D. immitis infections and heartworm disease in the Baltic country Estonia. Methods: Data on canine D. immitis infections and heartworm disease were collected from the electronic patient records database of the Small Animal Clinic of Estonian University of Life Sciences, the only university clinic in Estonia. The patient records of dogs with confirmed diagnosis of D. immitis infection or heartworm disease were reviewed and summarised. Results: Six dogs had been diagnosed with confirmed D. immitis infection or heartworm disease at the university clinic in 2021–2022. The confirmed diagnoses had been reached following international guidelines, based on a combination of different tests. Molecular confirmation of the parasite species had not been performed. Two of the dogs had been imported while four had no travel history outside of the country. Conclusions: Four of the dogs with a confirmed D. immitis infection or heartworm disease had no history of being imported or travelling outside of the country, indicating autochthonous infections and, consequently, local circulation of the parasite in Estonia. These findings represent the new northernmost autochthonous cases of D. immitis infection and canine heartworm disease reported in the European Union. [ABSTRACT FROM AUTHOR]

Using medical data to improve diagnosis accuracy has recently become common practice in hospitals. A modern computing environment has enabled real-time diagnosis of medical data using Convolutional Neural Networks (CNNs). To extract and evaluate skin melanoma recorded with digital dermatoscopy images (DDI), we developed a CNN segmentation framework. In this proposal, four phases are proposed: (i) DDI collection and resizing, (ii) DDI enhancement using pre-processing techniques, (iii) CNN segmentation for lesion extraction, (v) Comparing the extracted sections to the ground truth images, and (v) Verifying whether the framework is valid. Using DDI pre-processed with (i) Traditional procedures, (ii) Otsu's thresholding, (iii) Kapur's thresholding, and (iv) Fuzzy-Tsallis thresholding, this proposal examines the different CNN segmentation schemes presented in the literature. For mining skin lesions, the Moth-Flame Algorithm (MFA) combined with tri-level thresholding achieves an optimal threshold for the DDI. With Fuzzy-Tsallis thresholding images, the VGG-UNet performs better than the alternatives. This framework helps to achieve better values of Jaccard (88.47±2.13%), Dice (93.08±1.17%), and Accuracy (98.64±0.71%) on the chosen DDI database. [ABSTRACT FROM AUTHOR]

Securing Electronic Medical Records for Healthcare 4.0 is one of the prime requirements in the medical care service domains. Healthcare 4.0 refers to the evolution process of healthcare systems that leverage digital technologies, connectivity, and data-driven insights to provide more personalized and efficient care. With the increasing adoption of electronic healthcare records and the growing importance of data in the healthcare sector, ensuring the privacy of patient data becomes paramount. To ensuring the security for healthcare 4.0 in the current work a voice authentication-based system is devised. This enables the protection of electronic healthcare records (EHRs) in the association of healthcare 4.0. More precisely here the voice authentication is used as an additional layer of security for accessing and managing EHRs. The Voice authentication can also be categorized as the voice biometric. This is a technology that uses unique voice characteristics and patterns to verify the identity of individuals. The result establishes the innovative smart security arrangement for the Healthcare 4.0 using the voice authentication-based identity management infrastructure; and a modified version of asymmetric cryptosystem has been used inside the blockchain. The simulation outcome indicates better performance in the form of block generation time, block number, ensure the transaction, and minimize the latency of the transaction. [ABSTRACT FROM AUTHOR]

This longitudinal content analysis examines 128 articles containing the words hemp, hashish or marijuana appearing in the New York Times from 1851-1939, which starts at the publication's inception and concludes with the decade of the Marijuana Tax Act's passage. The research locates master framing of contentious issues by adapting previous computerized content analysis research to address historical documents unavailable for digital analysis. This study paints a more complete picture of one plant. [ABSTRACT FROM AUTHOR]

Document management is the process of organizing, storing, managing, and accessing documents and information in an organization. The main purpose of document management is to ensure efficient file management and their availability whenever it is necessary to quickly access information in documents safely. The purpose of this research is to present and explain what the Alfresco platform consists of, and what are its advantages for efficient document management in an organization. The stages and phases of change management are presented, in general, and those specific to the design and implementation of the Alfresco platform for modern and efficient document management in an organization. The main beneficiaries of the research are managers from public and private organizations, who aim to reduce document costs, increase accessibility to electronic documents, and improve ICT infrastructure to streamline internal communication and decision-making using integrated, durable, and sustainable IT platforms. [ABSTRACT FROM AUTHOR]

Digital document helps as the lifeblood of present communication, yet their vulnerability to tampering poses major safety anxieties. Digital text watermarking is an effective mechanism to protect the reliability of text-based data in the digital. Introducing a hidden layer of accountability and safety, allows individuals and organizations to trust the written word and make sure the truth behind all the files. Watermarking model identifies the tampering attack by inspecting the embedded signature for distortions or alterations. Watermarks can able to mechanically classify and repair themselves once tampered with, improving document resilience. Watermarking acts as a powerful tool to detect tampering attacks in digital document. By embedding strong and imperceptible watermarks in document distribution or creation, alterations are recognized by specialized procedure. This study introduces an Evolutionary Optimizer-powered Watermarking for Tampering Attack Detection in Digital Document (EO-WTAD3) model. The main intention of EO-WTAD3 approach is to support textual integrity using the applications of metaheuristic optimizer algorithm based watermarking technique for detecting tampering attacks in digital document. In the EO-WTAD3 method, a digital watermarking method has been proposed for the ownership verification and document copyright protection using data mining concept. Moreover, the EO-WTAD3 technique utilizes the concepts of data mining to define appropriate characteristics from the document for embedding watermarks. Moreover, fractional gorilla troops optimization (FGTO) algorithm can be applied for the assortment of optimal situation of watermarks in the content, ensuring both imperceptibility and strong to tamper. The performance validation of the EO-WTAD3 methodology takes place employing multiple datasets. The extensive result analysis portrayed that the EO-WTAD3 system accomplishes improve solution with other existing approaches with respect distinct aspects. [ABSTRACT FROM AUTHOR]