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The subject of predicting global crude oil prices is well recognized in academic circles. The notion of hybrid modeling suggests that the integration of several methodologies has the potential to optimize advantages while reducing limitations. Consequently, hybrid techniques are extensively used in contemporary research. In this paper, a novel decompose-ensemble prediction approach is proposed by integrating various optimization algorithms, namely biography-based optimization (BBO), backtracking search algorithm (BSA), teaching-learning-based algorithm (TLBO), cuckoo optimization algorithm (COA), multi-verse optimization (MVO), and multilayer perceptron (MLP). Furthermore, the aforementioned approaches, namely BBO-MLP, BSA-MLP, and TLBO-MLP, include the de-compose-ensemble technique into the individual artificial intelligence model in order to enhance the accuracy of predictions. In order to validate the findings, the forecast is conducted using the authoritative data on oil prices. This study will use three primary indicators, including EMA 20, EMA 60, EMA 100, ROC, and AUC assessments, to assess and evaluate the efficacy of the five methodologies under investigation. The below findings are derived from the conducted research: Based on the achieved AUC values of 0.9567 and 0.9429, it can be concluded that using a multi-verse optimization technique is considered the most suitable strategy for effectively handling the dataset pertaining to crude oil revenue. The next four approaches likewise have a significant AUC value, surpassing 0.8. The AUC values for the BBO- MLP, BSA-MLP, TLBO-MLP, and COA-MLP approaches were obtained as follows: (0.874 and 0.792) for training and testing stages, (0.809 and 0.792) for training and testing stages, (0.9353 and 0.9237) for training and testing stages, and (0.9092 and 0.8927) for training and testing stages, respectively. This model has the potential to contribute to the resolution of default probability and is very valuable to the credit card industry. Broadly speaking, this novel forecasting approach serves as a notable predictor of crude oil prices. [ABSTRACT FROM AUTHOR]

In this article, we introduce the multifractal conditional diffusion entropy method for analyzing the volatility of financial time series. This method utilizes a q-order diffusion entropy based on a q-weighted time lag scale. The technique of conditional diffusion entropy proves valuable for examining bull and bear behaviors in stock markets across various time scales. Empirical findings from analyzing the Dow Jones Industrial Average (DJI) indicate that employing multi-time lag scales offers greater insight into the complex dynamics of highly fluctuating time series, often characterized by multifractal behavior. A smaller time scale like t = 2 to t = 256 coincides more with the state of the DJI index than larger time scales like t = 256 to t = 1024 . We observe extreme fluctuations in the conditional diffusion entropy for DJI for a short time lag, while smoother or averaged fluctuations occur over larger time lags. [ABSTRACT FROM AUTHOR]

Background: An electronic consultation (e-consult) platform was implemented to support pediatric primary care providers (PCPs) in providing gender-affirming care to transgender and nonbinary (TNB) adolescents. Following implementation, a study was conducted to (1) explore how access to this e-consult platform impacts PCP confidence and referral patterns, (2) describe the content of questions, and (3) evaluate PCP's perspectives regarding platform usability. Methods: Following each submission, providers completed a 17-item survey. A total of 20 providers submitted 38 e-consults and 26 follow-up surveys between October 2021 and December 2022. Results: All PCPs reported a high overall value and increased confidence caring for TNB adolescents. Nearly one in five (19%) felt it allowed them to avoid submitting a specialty referral. Mean System Usability Scale score was 78.2 indicating good usability. Conclusion: This e-consult platform shows great promise in increasing PCP confidence providing gender-affirming care adolescents. More widespread utilization could help improve access to care and decrease specialty care referrals. [ABSTRACT FROM AUTHOR]

Transgender and gender diverse (TGD) youth have high rates of health disparities and face significant barriers to accessing medical care. Primary care providers (PCPs) are often the first health care providers that TGD youth seek out to discuss gender identity and find support. Thus, it is crucial for PCPs to have an understanding of gender diversity and knowledge to support TGD youth with gender-affirming care. The purpose of this article is to offer strategies PCPs can implement to increase their comfort and capacity in providing care for TGD people. Key steps to support TGD youth in the primary care setting include creating affirming clinical environments, discussing gender identity at routine visits, supporting parents and families, supporting social transition, and providing menstrual suppression for those who desire it. Multidisciplinary gender clinics can partner with PCPs to support adolescents in accessing gender-affirming medical care and to provide additional education and support. [Pediatr Ann. 2023;52(12):e442–e449.] [ABSTRACT FROM AUTHOR]

Purpose: To explore transgender and nonbinary (TNB) young adults' (1) interest in receiving gender-affirming medications through telemedicine before age 18 years and (2) willingness to initiate this care with primary care providers (PCPs). Methods: Data were from a survey of TNB young adults who had not received gender-affirming medications before age 18 years. Chi-square and Wald tests identified demographic differences in telemedicine interest and willingness to initiate medications with their PCP as minors. Results: Among 280 respondents, 82.5% indicated interest in telemedicine and 42.0% were willing to initiate medications with their PCP. Black/African American respondents were more likely to indicate interest in telemedicine than White and multiracial respondents. Respondents from rural areas were more likely to indicate willingness to initiate medications with their PCP than those from urban areas. Conclusions: Telemedicine expansion and further support for PCPs may represent critical opportunities to promote equitable access to adolescent gender-affirming care.

Telemedicine may help improve access to gender-affirming care for transgender and gender diverse (TGD) adolescents. Parents or guardians (i.e., caregivers) of TGD adolescents play a critical role in supporting TGD adolescents in accessing this care. The purpose of this study was to explore caregivers' perspectives regarding their adolescent receiving pediatric gender-affirming care via telemedicine to help providers and health systems optimize this modality for future care delivery. Caregivers (n=18) of TGD adolescents ages 14-17 participated in semi-structured, individual interviews that were transcribed and analyzed qualitatively. Caregivers cited participating in visits from their home environment, decreased anxiety, COVID safety, ability to have more family members attend, no transportation demands, and effective delivery of care as advantages of telemedicine. Disadvantages included dysphoria or discomfort with self-image, impersonal provider-patient interactions, video teleconferencing fatigue, difficulty with portal navigation, connectivity issues, and lack of privacy. Caregivers largely deferred to their child's preference regarding the choice of visit modality, but many reported a preference for the first to be conducted in-person, and follow-up and less complex visits via telemedicine. Health systems should consider these perspectives as they adapt telemedicine infrastructure to better meet the needs of patients and their families., Competing Interests: Declaration of Interests Statement Dr. Sequeira is a consultant for Pivotal Ventures and the Fenway Institute. The authors have no other interests to disclose.