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INTRODUCTION AND OBJECTIVES: Autoimmune liver diseases (AILDs) are rare and require precise evaluation, which is often challenging for medical providers. Chatbots are innovative solutions to assist healthcare professionals in clinical management. In our study, ten liver specialists systematically evaluated four chatbots to determine their utility as clinical decision support tools in the field of AILDs. MATERIALS AND METHODS: We constructed a 56-question questionnaire focusing on AILD evaluation, diagnosis, and management of Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), and Primary Sclerosing Cholangitis (PSC). Four chatbots -ChatGPT 3.5, Claude, Microsoft Copilot, and Google Bard- were presented with the questions in their free tiers in December 2023. Responses underwent critical evaluation by ten liver specialists using a standardized 1 to 10 Likert scale. The analysis included mean scores, the number of highest-rated replies, and the identification of common shortcomings in chatbots performance. RESULTS: Among the assessed chatbots, specialists rated Claude highest with a mean score of 7.37 (SD = 1.91), followed by ChatGPT (7.17, SD = 1.89), Microsoft Copilot (6.63, SD = 2.10), and Google Bard (6.52, SD = 2.27). Claude also excelled with 27 best-rated replies, outperforming ChatGPT (20), while Microsoft Copilot and Google Bard lagged with only 6 and 9, respectively. Common deficiencies included listing details over specific advice, limited dosing options, inaccuracies for pregnant patients, insufficient recent data, over-reliance on CT and MRI imaging, and inadequate discussion regarding off-label use and fibrates in PBC treatment. Notably, internet access for Microsoft Copilot and Google Bard did not enhance precision compared to pre-trained models. CONCLUSIONS: Chatbots hold promise in AILD support, but our study underscores key areas for improvement. Refinement is needed in providing specific advice, accuracy, and focused up-to-date information. Addressing these shortcomings is essential for enhancing the utility of chatbots in AILD management, guiding future development, and ensuring their effectiveness as clinical decision-support tools.
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The study of sustainability challenges requires the consideration of multiple coupled systems that are often complex and deeply uncertain. As a result, traditional analytical methods offer limited insights with respect to how to best address such challenges. By analyzing the case of global climate change mitigation, this paper shows that the combination of high-performance computing, mathematical modeling, and computational intelligence tools, such as optimization and clustering algorithms, leads to richer analytical insights. The paper concludes by proposing an analytical hierarchy of computational tools that can be applied to other sustainability challenges.
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AbstractIntroduction: This paper aims to develop a data warehouse (AD-SISCOLO) in order to support the management of the cervical cancer screening program in the municipality of Rio de Janeiro/Brazil. As a part of the management process, the program managers of the municipality perform tedious manual work in order to calculate a series of performance indicators and then take decisions based on them. Methods AD-SISCOLO was implemented using the Pentaho BI Suite Business Intelligence Platform and the MySQL database management system. The indicators to be calculated and visualized in the tool were based on the municipal data of the cytopathology and histopathology tests from January 2012 until December 2014, which was obtained from the Information System of Cervical Cancer (SISCOLO) after a record linkage process. The follow-up indicators were based on a simplified version of the Brazilian guidelines for the cervical cancer screening. Results AD-SISCOLO allows the visualization of a set of test-based and follow-up indicators from different views and dimensions, which enable managers to monitor all the phases of the screening process and to identify the process' failures. Conclusions Compared with the current available environments in Brazil, AD-SISCOLO is unique in its visualization of the follow-up indicators of groups of women, according to their test results and age. Thereby it provides presentation flexibility to suit the program manager's needs.
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RESUMO A disposição final de Resíduos Sólidos Urbanos (RSU) em aterros sanitários é discutida, neste artigo, sob o contexto de conflitos ambientais. Nessa perspectiva, foi analisado o conflito ambiental no âmbito do Aterro Sanitário de Puxinanã (ASP), na Paraíba, no período compreendido entre julho de 2009 a agosto de 2014. Foram abordadas e aplicadas técnicas que contribuíram para a análise e o entendimento do conflito ambiental em pauta, em nível macro, auxiliando com informações necessárias à tomada de decisão. A localização do ASP, dentro da bacia hidrográfica do principal manancial que abastece toda a população urbana do município de Puxinanã (PB), somada à disposição dos RSU do município de Campina Grande (PB) nesse aterro, acentuou o conflito. Pela modelagem do conflito por meio do Modelo Grafo para Resolução de Conflitos (GMCR), foram apontadas alternativas de solução, em função dos jogadores envolvidos e dos interesses de cada um. Nos três cenários simulados, a construção de um novo aterro para Puxinanã, além da disposição dos RSU de Campina Grande em aterro próprio, foi indicada como equilíbrio do conflito.
ABSTRACT The final disposal of Municipal Solid Waste (MSW) landfill is discussed in this article in the context of environmental conflicts. From this perspective, the environmental conflict was analysed under the Puxinanã Landfill (ASP), in Paraiba, in the period from July 2009 to August 2014. Techniques were addressed and implemented, and they contributed to the analysis and understanding of environmental conflict in question, at the macro level, assisting with necessary information for decision making. The location of the ASP within hydrographic basin of the main spring that supplies the entire urban population of the municipality of Puxinanã (PB), plus the disposal of MSW of Campina Grande (PB) municipality in this landfill, aggravated the conflict. Through modeling the conflict using the Graph Model for Conflict Resolution (GMCR), some alternative solutions were identified according to the players involved and the interests of each part. In the three simulated scenarios, the construction of a new landfill for Puxinanã, as well as disposal of MSW Campina Grande in the landfill, was identified as an equilibrium for the conflict.