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Degrees are presumably the most important institution in education markets. However, despite their high relevance, degrees and their design features remain poorly understood within the economics of education. This study addresses this gap. We provide an accurate formal definition of what constitutes a degree and formulate the first theory of degree design. This theory is based on a technological platform view that interprets degrees as modules within a hierarchical structure resembling that of software architectures. This approach provides new opportunities to address questions of degree optimization. Furthermore, a novel strategy to optimize the design of school degrees is proposed. This strategy is expected to improve the learning environment of weaker students across all school types, leaving higher-performing students rather unaffected. The implications and limitations of our approach are also discussed.
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Background: Within the rapidly evolving healthcare landscape in Japan, digital marketing innovations are transforming pharmaceutical and medical device marketing. This study explores the emergence of new business models in the digital marketing, highlighting a transition from traditional methods to more dynamic, data-driven strategies. Methods: InsighTCROSS® is a business model that qualitatively and quantitatively examines three steps based on stratified persona images: (1) verifying the effectiveness of product marketing promotions, (2) identifying competitors from the users' perspective, and (3) developing marketing strategies to counter competition. To demonstrate the effectiveness of this model, a case study was conducted focusing on the current anticoagulant drugs, including apixaban, dabigatran, edoxaban, rivaroxaban, and warfarin. Results: Rivaroxaban, the only drug prescribed for the prevention of thrombus and embolism formation in patients with peripheral artery disease after lower limb revascularization, garnered the most interest from interventional cardiologists performing peripheral vascular interventions, as determined by InsighTCROSS® factor analysis, confirming that the manufacturer's marketing activities have effectively penetrated the market. A survey conducted between 20 September 2023 and 3 October 2023, among members of a cardiology website, identified edoxaban as the market leader with a 39.1% share, followed by apixaban (32.7%) and rivaroxaban (16.8%). The main competitor of edoxaban was warfarin, whereas that of rivaroxaban was apixaban. Decision tree analysis was conducted using InsighTCROSS®, highlighting the strengths and weaknesses of each anticoagulant, providing strategic approaches to exploit competitive weaknesses. For edoxaban, increased use was driven by elderly and poorly adherent patients; for apixaban, high-volume percutaneous coronary intervention centers; and for rivaroxaban, the influence of medical representative detailing. It is recommended to avoid markets where these drugs have a strong presence and to focus marketing activities on leveraging their specific strengths. Conclusion: The findings suggest that digital marketing enhances product visibility and patient engagement, providing valuable insights into market behavior and consumer preferences.
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BACKGROUND: Coronary heart disease (CHD) is a leading cause of death worldwide and imposes a significant economic burden. TikTok has risen as a favored platform within the social media sphere for disseminating CHD-related information and stands as a pivotal resource for patients seeking knowledge about CHD. However, the quality of such content on TikTok remains largely unexplored. OBJECTIVE: This study aims to assess the quality of information conveyed in TikTok CHD-related videos. METHODS: A comprehensive cross-sectional study was undertaken on TikTok videos related to CHD. The sources of the videos were identified and analyzed. The comprehensiveness of content was assessed through 6 questions addressing the definition, signs and symptoms, risk factors, evaluation, management, and outcomes. The quality of the videos was assessed using 3 standardized evaluative instruments: DISCERN, the Journal of the American Medical Association (JAMA) benchmarks, and the Global Quality Scale (GQS). Furthermore, correlative analyses between video quality and characteristics of the uploaders and the videos themselves were conducted. RESULTS: The search yielded 145 CHD-related videos from TikTok, predominantly uploaded by health professionals (n=128, 88.3%), followed by news agencies (n=6, 4.1%), nonprofit organizations (n=10, 6.9%), and for-profit organizations (n=1, 0.7%). Content comprehensiveness achieved a median score of 3 (IQR 2-4). Median values for the DISCERN, JAMA, and GQS evaluations across all videos stood at 27 (IQR 24-32), 2 (IQR 2-2), and 2 (IQR 2-3), respectively. Videos from health professionals and nonprofit organizations attained significantly superior JAMA scores in comparison to those of news agencies (P<.001 and P=.02, respectively), whereas GQS scores for videos from health professionals were also notably higher than those from news agencies (P=.048). Within health professionals, cardiologists demonstrated discernibly enhanced performance over noncardiologists in both DISCERN and GQS assessments (P=.02). Correlative analyses unveiled positive correlations between video quality and uploader metrics, encompassing the positive correlations between the number of followers; total likes; average likes per video; and established quality indices such as DISCERN, JAMA, or GQS scores. Similar investigations relating to video attributes showed correlations between user engagement factors-likes, comments, collections, shares-and the aforementioned quality indicators. In contrast, a negative correlation emerged between the number of days since upload and quality indices, while a longer video duration corresponded positively with higher DISCERN and GQS scores. CONCLUSIONS: The quality of the videos was generally poor, with significant disparities based on source category. The content comprehensiveness coverage proved insufficient, casting doubts on the reliability and quality of the information relayed through these videos. Among health professionals, video contributions from cardiologists exhibited superior quality compared to noncardiologists. As TikTok's role in health information dissemination expands, ensuring accurate and reliable content is crucial to better meet patients' needs for CHD information that conventional health education fails to fulfill.
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Maladie coronarienne , Médias sociaux , Enregistrement sur magnétoscope , Études transversales , Humains , Diffusion de l'information/méthodesRÉSUMÉ
Decentralized clinical trials (DCTs) are becoming increasingly popular. Digital clinical trial platforms are software environments where users complete designated clinical trial tasks, providing investigators and trial participants with efficient tools to support trial activities and streamline trial processes. In particular, digital platforms with a modular architecture lend themselves to DCTs, where individual trial activities can correspond to specific platform modules. While design features can allow users to customize their platform experience, the real strengths of digital platforms for DCTs are enabling centralized data capture and remote monitoring of trial participants and in using digital technologies to streamline workflows and improve trial management. When selecting a platform for use in a DCT, sponsors and investigators must consider the specific trial requirements. All digital platforms are limited in their functionality and technical capabilities. Integrating additional functional modules into a central platform may solve these challenges, but few commercial platforms are open to integrating third-party components. The lack of common data standardization protocols for clinical trials will likely limit the development of one-size-fits-all digital platforms for DCTs. This viewpoint summarizes the current role of digital platforms in supporting decentralized trial activities, including a discussion of the potential benefits and challenges of digital platforms for investigators and participants. We will highlight the role of the digital platform in the development of DCTs and emphasize where existing technology is functionally limiting. Finally, we will discuss the concept of the ideal fully integrated and unified DCT and the obstacles developers must address before it can be realized.
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Essais cliniques comme sujet , Essais cliniques comme sujet/méthodes , Humains , Logiciel , Technologie numériqueRÉSUMÉ
The highly sensitive detection method for porcine epidemic diarrhea virus (PEDV) is crucial for promptly identify infected pigs and effectively control the spread of the virus. In this study, the sensitization enhancement of organic photoactive material was combined with near zero background noise strategy for PEDV sensitive detection. A novel sensitized signal probe CdS quantum dots-doxycycline complex (CdS QDs-Dox) was prepared serving as a photoelectrochemical (PEC) probe embedded in dsDNA. Subsequently, a thiol-modified upstream inner primer (SH-FIP) was immobilized on the surface of electrode modified with gold nanoparticles (Au NPs) via Au-S bonding, enabling the loop-mediated isothermal amplification (LAMP) of PEDV on the electrode surface. The PEC probe (CdS QDs-Dox) embedded in the amplified dsDNA groove showed an increasing photocurrent signal with the rise of PEDV concentration, establishing a near-zero background LAMP-PEC sensing platform for PEDV detection. Under optimized conditions, the photocurrent intensity of this platform exhibited a good linear relationship with PEDV concentrations ranging from 0.0005 pg/µL to 10 pg/µL, achieving a detection limit as low as 0.17 fg/µL. This platform demonstrates outstanding specificity and sensitivity, thereby enabling precise quantitative detection of diverse pathogens.
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Discussions about the Future of Work have become ubiquitous both in academic and international organizations' discourse. As part of these developments, the platform economy has revolutionized work practices and relationships. Despite the emergence of a burgeoning literature on platform studies, little is known about whether and to what extent platform work exacerbates the risk of gender-based violence among workers. This review article examines 39 academic articles, book chapters, reports, and conference papers published between 2016 and 2023 using qualitative content analysis to provide a preliminary understanding of empirical data on this issue. The reviewed studies were selected using relevant keywords on the basis of a database of 175 studies examining the platform economy with gender perspective, complemented with additional sources identified during the review. The main findings are: platform workers across sectors are vulnerable to gender-based violence, especially those at the intersection of several axes of subordination; platforms' socio-technological features exacerbate the risk of gender-based violence; (fear of) gender-based violence limits women's access to platform work and the economic benefits derived from it; most platforms lack effective preventative and redressal mechanisms against violence; and, faced with platforms' inaction, workers adopt individual and collective measures to address (the risk of) gender-based violence in platform work. The analysis also evidences the need for more research on intersectional vulnerabilities, particularly with regard to sexual orientation and gender expression and identity, as well as on the physical and psychological impact of gender-based violence on platform workers, which provides avenues for future research.
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The efficient removal of organic pollutants from water is crucial for protecting human health and the ecosystem. While adsorbent-based approaches offer advantages over traditional chemical and thermal methods, they still suffer from slow adsorption kinetics, high energy demand, and limited material lifespan. Herein, an efficient decontamination platform is introduced, using magnetic hydrogel microbots (MHMs) made from picolitre-sized hydrogel droplets coated with multifunctional magnetic nanoparticles. This approach includes 1) dividing a droplet into smaller microbots to enhance their interaction with sample solution and 2) dynamically spinning these MHMs to generate hydrodynamic flows that actively draw pollutants toward the embedded hydrogel for capture. The MHMs show high decontamination effectiveness in both bulk and continuous flow setups, achieving ≈95% removal efficiency within 3 min. Further integrating MHMs with a non-pressurized fluidic platform enables energy-efficient continuous flow decontamination, removing ≥95% total organic carbon from a complex pollutant mixture at a flow rate surpassing other recent designs. Additionally, the MHMs facilitate self-catalyzed regeneration using an environmentally friendly H2O2 precursor, allowing for long-term and repeated usage. By enabling the unique divide-and-arrest decontamination of toxic pollutants, the multifunctional design holds tremendous promise for on-site wastewater treatment to ensure safe water access for everyone, even in resource-limited environments.
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BACKGROUND: The COVID-19 pandemic underscored the challenge of swiftly disseminating research findings to a global audience. Language barriers further exacerbated disparities in access to timely scientific information, particularly for non-English speaking communities. The majority of COVID-19 research was published in English, limiting accessibility for Spanish-speaking populations. OBJECTIVE: This paper aims to assess the reach and effectiveness of AccesoCovid.com, a platform designed to disseminate up-to-date COVID-19 research in both English and Spanish, addressing the language gap in scientific communication. METHODS: AccesoCovid.com was developed through a partnership between the University of California, San Francisco (UCSF) and Universidad Nacional Autónoma de México (UNAM). The website's performance and user engagement were evaluated using Google Analytics over a span of 2 years. Key metrics included user language preference, geographical distribution, and site traffic. The website summarized and translated 1032 articles on various COVID-19 topics, such as "Pharmaceutical Interventions and Vaccines." RESULTS: From February 2021 to February 2023, the platform attracted 57,000 users. Of the 43,000 unique new visitors, 84.2% (n=36,219) hailed from Spanish-speaking regions. The majority accessed the site organically through search engines, with 88.4% (n=38,000) of users arriving this way, while 5000 (11.6%) users accessed the site directly. Most users (n=30,894, 72.1%) preferred the Spanish version of the site. The website's most accessed category was "Pharmaceutical Interventions and Vaccines," followed by "Clinical Presentation and Management" and "Mental Health." Regarding language distribution, 72.1% (n=30,894) of users primarily used Spanish; 21.4% (n=9215) used English; and 6.7% (n=2891) spoke other languages, including Portuguese, Chinese, and German. Geographically, the website attracted visitors from 179 countries, with the highest visitor counts from Mexico (n=12,342, 28.7%), Spain (n=6405, 14.9%), the United States (n=4416, 10.3%), and Peru (n=3821, 8.9%). CONCLUSIONS: AccesoCovid.com successfully bridged a critical language gap in the dissemination of COVID-19 research. Its success underscores the pressing need for multilingual scientific resources. The platform demonstrated significant user engagement and reach, particularly in Spanish-speaking countries. This highlights the potential for similar platforms to ensure equitable access to scientific knowledge across diverse linguistic communities. Future efforts should focus on expanding to other languages and conducting formal evaluations to enhance user satisfaction and impact.
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COVID-19 , Barrières de communication , Diffusion de l'information , Humains , COVID-19/épidémiologie , Diffusion de l'information/méthodes , Langage , Recherche biomédicaleRÉSUMÉ
Background and objectives: Clinical data are essential for developing cloud platforms for intelligent diagnosis and treatment decision of diseases. However, cloud platforms for data sharing and exchange with clinicians are poorly suited. We aim to establish Eyecare-cloud, a platform which provide a novel method for clinical data and medical image sharing, to provide a convenient tool for clinicians. Methods: In this study, we displayed the main functions of Eyecare-cloud that we established. Based on clinical data from the cloud platform, we analyzed the incidence trend of the most common infantile retinal diseases, such as retinopathy of prematurity (ROP), over the past 20 years, as well as the associated risk factors for ROP occurrence. Statistical analyses were performed using GraphPad Prism (V.8.0) and SPSS software (V.26.0). Results: The Eyecare-cloud offers numerous advantages, including systematic archiving of patient information, one-click export data, simplifying data collection and management, eliminating the need for manual input of clinical information, reducing clinical data migration time, and lowering data management costs significantly. A total of 22,913 premature infants from Eyecare-cloud were included in the data analysis. Based on 20 years of premature infant screening data analysis, we found that the ROP incidence began to slowly decline starting in 2003 but showed a gradual increase trend again in 2016. The incidence of severe ROP remained relatively stable at a low level since 2010. The number of premature infants increased steadily before 2016 but decreased since then. ROP occurrence was significantly associated with male sex, lower gestational age, and lower birth weight (P < 0.001). Conclusion: Eyecare-cloud provides clinicians and researchers with convenient tools for big data analysis, which helps alleviate clinical workloads and integrate research data. This cloud platform supports the principles of predictive, preventive, and personalized medicine (PPPM/3PM), empowering clinicians and researchers to deliver more precise, proactive, and patient-centered eye care.
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An understanding of the complexity of the surgical anatomy of the upper eyelid and the surrounding structures is mandatory when trying to minimize complications and achieve excellent cosmetic results during eyelid surgery. Postoperative upper eyelid asymmetry is one of the most common causes of patients' dissatisfaction, and several parameters should be taken into consideration when performing cosmetic blepharoplasties and ptosis surgery. Tarsal platform show and brow fat span are two of the most important variables pertaining to the perception of beauty and youthfulness that every oculoplastic and facial plastic surgeon should address when performing such surgery. The aim of this review paper is to provide a detailed anatomy of the upper eyelid and the surrounding structures, to highlight all the relevant factors that contribute to the perception of beauty and the changes that occur to the aging face and to address the preoperative factors that need to be carefully examined before performing upper eyelid surgery.
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Interactions between photosynthetic and heterotrophic microbes play a key role in global primary production. Understanding phototroph-heterotroph interactions remains challenging because these microbes reside in chemically complex environments. Here, we leverage a massively parallel droplet microfluidic platform that enables us to interrogate interactions between photosynthetic algae and heterotrophic bacteria in >100,000 communities across â¼525 environmental conditions with varying pH, carbon availability, and phosphorus availability. By developing a statistical framework to dissect interactions in this complex dataset, we reveal that the dependence of algae-bacteria interactions on nutrient availability is strongly modulated by pH and buffering capacity. Furthermore, we show that the chemical identity of the available organic carbon source controls how pH, buffering capacity, and nutrient availability modulate algae-bacteria interactions. Our study reveals the previously underappreciated role of pH in modulating phototroph-heterotroph interactions and provides a framework for thinking about interactions between phototrophs and heterotrophs in more natural contexts.
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Background: The acceptance of telemedicine in the German health care system is growing. This also extends to gynecological applications such as the prescription of contraceptives. This study investigates the contraceptive use and adherence of patients using a direct-to-consumer (DTC) prescription platform for oral contraception. Methods: A retrospective cross-sectional study was conducted using anonymized data obtained from a DTC prescription platform between May 2021 and March 2023. The patient-reported outcome was evaluated after 3 months through a follow-up questionnaire. Results: In total, 8,065 patient records were available and 1,008 patients responded to the follow-up questionnaire. Patients were mostly taking combined oral contraceptives (COCs) and only 6% were taking a progestin-only pill (POP). Even in patient populations at higher risk, such as smokers and obese women, the proportion of POP users was less than 20%. Over 90% of users reported that they took the pill without any intake errors, with the main intake error being forgotten intake. Overall, 23% of patients reported adverse events while taking the pill, with POP users reporting more adverse events than COC users (36.7% vs. 22.2%). Over 70% of patients regularly attended cervical screening. Conclusions: Users of a DTC prescribing platform exhibit strong adherence, with over 90% successfully taking oral contraceptive pills. The platform effectively identifies absolute contraindications but could enhance recommendations for contraceptives in the presence of relative contraindications. For healthy women familiar with pill usage, DTC platforms offer a viable and convenient alternative to traditional doctor's office prescriptions.
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PURPOSE: The innate immune response, particularly the reaction of polymorphonuclear neutrophils (PMNs), is crucial in shaping the outcomes of chronic inflammation, fibrosis, or osseointegration following biomaterial implantation. Peri-implantitis or peri-mucositis, inflammatory conditions linked to dental implants, pose a significant threat to implant success. We developed a single-cell analysis approach using a murine model to assess the immune response to implant materials, offering a practical screening tool for potential dental implants. METHODS: We performed bioinformatics analysis and established a peri-implant inflammation model by inserting two titanium implants into the maxillary region, to examine the immune response. RESULTS: Bioinformatics analysis revealed that titanium implants triggered a host immune response, primarily mediated by PMNs. In the in vivo experiments, we observed a rapid PMN-mediated response, with increased infiltration around the implants and on the implant surface by day 3. Remarkably, PMN attachment to the implants persisted for 7 days, resembling the immune profiles seen in human implant-mediated inflammation. CONCLUSIONS: Our findings indicate that persistent attachment of the short-living PMNs to titanium implants can serve as an indicator or traits of peri-implant inflammation. Therefore, analyzing gingival tissue at the single-cell level could be a useful tool for evaluating the biocompatibility of candidate dental implants.
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BACKGROUND: Decentralising medical school training enhances curriculum relevance, exposing students to generalist patient care in diverse contexts. AIM: The aim of the study was to understand the student experiences of learning during their 7-week Family Medicine rural rotation. SETTING: Final year medical students who had completed their Family Medicine rotation in November 2022. METHODS: A qualitative study involving 24 final year students (four semi- structured interviews and four focus group discussions [4 x 5 students]). All interviews were recorded, transcribed verbatim and analysed thematically. RESULTS: Analysis revealed positive learning experiences and identified the following themes: taking responsibility for learning, the generalist context, teaching and learning in context and managing the learning environment. CONCLUSION: Active participation in hospital activities, exposure to disorientating dilemmas that challenged assumptions and reflection on these experiences led to transformative learning and knowledge co-construction.Contribution: The study contributes to the discussion and reinforces the advantages of distributed, experiential training, highlighting the positive impact of meaningful participation and transformative learning opportunities.
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Médecine de famille , Groupes de discussion , Hôpitaux de district (USA) , Hôpitaux ruraux , Recherche qualitative , Étudiant médecine , Humains , Étudiant médecine/psychologie , Médecine de famille/enseignement et éducation , Enseignement médical premier cycle/méthodes , Femelle , Mâle , Programme d'études , Entretiens comme sujet , Apprentissage , Apprentissage par problèmes/méthodesRÉSUMÉ
Purpose: The present study aimed to develop a lipid nanoplatform, denoted as "BAL-PTX-LN", co-loaded with chiral baicalin derivatives (BAL) and paclitaxel (PTX) to promote the anti-lung cancer efficacy of paclitaxel and reduce the toxicity of chemotherapeutic drugs. Methods: BAL-PTX-LN was optimized through central composite design based on a single-factor experiments. BAL-PTX-LN was evaluated by TEM, particle size, encapsulation efficiency, hemolysis rate, release kinetics and stability. And was evaluated by pharmacokinetics and the antitumor efficacy studied both in vitro and in vivo. The in vivo safety profile of the formulation was assessed using hematoxylin and eosin (HE) staining. Results: BAL-PTX-LN exhibited spherical morphology with a particle size of 134.36 ± 3.18 nm, PDI of 0.24 ± 0.02, and with an encapsulation efficiency exceeding 90%, BAL-PTX-LN remained stable after 180 days storage. In vitro release studies revealed a zero-order kinetic model of PTX from the liposomal formulation. No hemolysis was observed in the preparation group. Pharmacokinetic analysis of PTX in the BAL-PTX-LN group revealed an approximately three-fold higher bioavailability and twice longer t1/2 compared to the bulk drug group. Furthermore, the IC50 of BAL-PTX-LN decreased by 2.35 times (13.48 µg/mL vs 31.722 µg/mL) and the apoptosis rate increased by 1.82 times (29.38% vs 16.13%) at 24 h compared to the PTX group. In tumor-bearing nude mice, the BAL-PTX-LN formulation exhibited a two-fold higher tumor inhibition rate compared to the PTX group (62.83% vs 29.95%), accompanied by a ten-fold decrease in Ki67 expression (4.26% vs 45.88%). Interestingly, HE staining revealed no pathological changes in tissues from the BAL-PTX-LN group, whereas tissues from the PTX group exhibited pathological changes and tumor cell infiltration. Conclusion: BAL-PTX-LN improves the therapeutic effect of poorly soluble chemotherapeutic drugs on lung cancer, which is anticipated to emerge as a viable therapeutic agent for lung cancer in clinical applications.
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Tumeurs du poumon , Paclitaxel , Paclitaxel/composition chimique , Paclitaxel/pharmacocinétique , Paclitaxel/pharmacologie , Paclitaxel/administration et posologie , Animaux , Tumeurs du poumon/traitement médicamenteux , Tumeurs du poumon/anatomopathologie , Humains , Flavonoïdes/composition chimique , Flavonoïdes/pharmacologie , Flavonoïdes/pharmacocinétique , Flavonoïdes/administration et posologie , Taille de particule , Nanoparticules/composition chimique , Souris , Liposomes/composition chimique , Liposomes/pharmacocinétique , Cellules A549 , Lipides/composition chimique , Mâle , Souris de lignée BALB C , Lignée cellulaire tumorale , Libération de médicament , Antinéoplasiques d'origine végétale/pharmacologie , Antinéoplasiques d'origine végétale/administration et posologie , Antinéoplasiques d'origine végétale/composition chimique , Antinéoplasiques d'origine végétale/pharmacocinétique , Souris nude , Hémolyse/effets des médicaments et des substances chimiques , Antinéoplasiques/composition chimique , Antinéoplasiques/pharmacologie , Antinéoplasiques/pharmacocinétique , Antinéoplasiques/administration et posologieRÉSUMÉ
Adaptive platform trials allow treatments to be added or dropped during the study, meaning that the control arm may be active for longer than the experimental arms. This leads to nonconcurrent controls, which provide nonrandomized information that may increase efficiency but may introduce bias from temporal confounding and other factors. Various methods have been proposed to control confounding from nonconcurrent controls, based on adjusting for time period. We demonstrate that time adjustment is insufficient to prevent bias in some circumstances where nonconcurrent controls are present in adaptive platform trials, and we propose a more general analytical framework that accounts for nonconcurrent controls in such circumstances. We begin by defining nonconcurrent controls using the concept of a concurrently randomized cohort, which is a subgroup of participants all subject to the same randomized design. We then use cohort adjustment rather than time adjustment. Due to flexibilities in platform trials, more than one randomized design may be in force at any time, meaning that cohort-adjusted and time-adjusted analyses may be quite different. Using simulation studies, we demonstrate that time-adjusted analyses may be biased while cohort-adjusted analyses remove this bias. We also demonstrate that the cohort-adjusted analysis may be interpreted as a synthesis of randomized and indirect comparisons analogous to mixed treatment comparisons in network meta-analysis. This allows the use of network meta-analysis methodology to separate the randomized and nonrandomized components and to assess their consistency. Whenever nonconcurrent controls are used in platform trials, the separate randomized and indirect contributions to the treatment effect should be presented.
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Biométrie , Humains , Biométrie/méthodes , Essais contrôlés randomisés comme sujetRÉSUMÉ
For over a century, the neuro- and pathophysiological, behavioral, and cognitive correlates of consciousness have been an active field of theoretical considerations and empirical research in a wide range of modern disciplines. Conscious cognitive processing of information cannot be observed directly, but might be inferred from step-like discontinuities in learning performance or sudden insight-based improvements in problem solving behavior. It is assumed that a sudden step of knowledge associated with insight requires a creative reorganization of mental representations of task- or problem-relevant information and the restructuration of the task, respectively problem to overcome an cognitive dead-end or impasse. Discontinuities in learning performance or problem solving after an insight event can be used as time-tags to capture the time window in which conscious cognitive information processing must have taken place. According to the platform theory of conscious cognitive information processing, the reorganization and restructuration processes, require the maintenance of task- or problem-relevant information in working memory for the operation of executive functions on these mental representations. Electrophysiological evidence suggests that the reorganization and restructuration processes in working memory, that precede insight-based problem solutions are accompanied by an increase in the power of gamma oscillations in cortical areas including the prefrontal cortex. Empirical evidence and theoretical assumptions argue for an involvement of gap junction channels and connexin hemichannels in cortical gamma-oscillations and working memory processes. Discontinuities in learning or problem solving performance might be used as time-tags to investigate the implication of gap junction channels and hemichannels in conscious cognitive processing.
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Ungulates are terrestrial herbivores, basically adapted to running fast on the ground; tree-climbing behavior has been reported only in seven species, and five of them live in open habitats (Capra hircus, C. aegagrus, C. falconeri, C. cylindricornis, Oreotragus oreotragus). Tree-climbing behavior may also be evolved in ungulates inhabiting dense forests with abundant trees; however, this has rarely been reported in such species (Moschus leucogaster, M. moschiferus), probably due to the difficulty of observing in the wild. The numerous publicly available records in social networks hold potentially valuable information on the atypical behaviors of wild ungulates. Here, we explored the tree-climbing behavior of a forest-dwelling ungulate, the Formosan serow in Taiwan, a subtropical island, by extracting information from online social media platforms. We researched images and videos of Formosan serows through Facebook and YouTube and collected a total of 15 tree-climbing events. In these materials, Formosan serows climbed 10 tree species, including evergreen coniferous and broad-leaved trees, and a variety of parts, ranging in height from 0.6 to 4 m, and from branches of shrubs to trunks of tall trees. Tree-climbing behavior was recorded throughout Taiwan and from lowlands to subalpine zones, suggesting that tree climbing may be a common behavior in this species. Foraging while climbing trees was frequently observed (53.3%), suggesting that the purpose or benefit for climbing is to obtain additional food other than plants growing near the ground surface. In contrast to other tree-climbing ungulates, Formosan serows climbed trees not only in winter, but also in other seasons, when food is relatively abundant. This is the first scientific report of tree-climbing behavior in the Formosan serow that is typically a forest dweller.
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This article presents an ingestion procedure towards an interoperable repository called ALPACS (Anonymized Local Picture Archiving and Communication System). ALPACS provides services to clinical and hospital users, who can access the repository data through an Artificial Intelligence (AI) application called PROXIMITY. This article shows the automated procedure for data ingestion from the medical imaging provider to the ALPACS repository. The data ingestion procedure was successfully applied by the data provider (Hospital Clínico de la Universidad de Chile, HCUCH) using a pseudo-anonymization algorithm at the source, thereby ensuring that the privacy of patients' sensitive data is respected. Data transfer was carried out using international communication standards for health systems, which allows for replication of the procedure by other institutions that provide medical images. OBJECTIVES: This article aims to create a repository of 33,000 medical CT images and 33,000 diagnostic reports with international standards (HL7 HAPI FHIR, DICOM, SNOMED). This goal requires devising a data ingestion procedure that can be replicated by other provider institutions, guaranteeing data privacy by implementing a pseudo-anonymization algorithm at the source, and generating labels from annotations via NLP. METHODOLOGY: Our approach involves hybrid on-premise/cloud deployment of PACS and FHIR services, including transfer services for anonymized data to populate the repository through a structured ingestion procedure. We used NLP over the diagnostic reports to generate annotations, which were then used to train ML algorithms for content-based similar exam recovery. OUTCOMES: We successfully implemented ALPACS and PROXIMITY 2.0, ingesting almost 19,000 thorax CT exams to date along with their corresponding reports.
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Algorithmes , Systèmes d'information de radiologie , Humains , Intelligence artificielle , Tomodensitométrie/méthodes , Imagerie diagnostique , Bases de données factuellesRÉSUMÉ
Bloodstream HSV-1 and HSV-2 infections can cause devastating outcomes with high morbidity and mortality, especially in neonates or immunocompromised individuals. Proper patient management for herpes simplex virus (HSV) bloodstream infections is time-sensitive and requires a rapid, accurate, and definitive diagnosis. The absence of the U.S. Food and Drug Administration (FDA)-approved molecular assays for HSV detection in blood, coupled with a lack of consensus on the optimal sample type, underscores the unmet need for improved diagnostics. We prospectively compared the cycle threshold values in paired samples including whole blood (WB), plasma, serum, and peripheral blood mononuclear cells (PBMCs) from patients with bloodstream HSV infections. This analysis employed a modified use of the FDA-cleared Simplexa HSV-1 & 2 Direct assay. The clinical performance in serum was assessed by comparing the results of 247 remnant specimens on this sample-to-answer platform to established laboratory-developed tests in a blinded fashion. Serum samples exhibited significantly lower cycle thresholds than whole blood samples [2.6 cycle threshold (Ct) bias, P < 0.001]. The modified Simplexa assay demonstrated 100% positive percent agreement for the detection of HSV-1 and HSV-2 DNA in serum samples and yielded an overall agreement of 95% (95% CI, 0.92 to 0.97), with a κ statistic of 0.75 (95% CI, 0.62 to 0.86) compared to the composite reference method. Discordance rates were 5.20% for HSV-1 and 0.81% for HSV-2. This investigation demonstrates that serum is an optimal specimen type for HSV detection when compared to several blood compartments. Serum offers a promising sample type for rapid and accurate diagnosis of HSV bloodstream infections using the modified Simplexa assay. IMPORTANCE: Rapid, accurate, and definitive diagnosis of herpes simplex virus (HSV) infections is crucial in clinical settings for patient management. The absence of FDA-authorized molecular assays for HSV-1/2 detection in blood, coupled with a lack of consensus on the optimal sample type, underscores the need for improved diagnostic methods. Furthermore, rapid diagnosis of HSV bloodstream infections enables timely administration of antiviral treatment, influences patient management decisions for those at high risk, and can contribute to shorter hospital stays, thereby reducing healthcare costs.