Data System Research Articles

Data Pipeline Integrating Apache Kafka and Rabbit MQ

Fast data flow designs for processing volumes of data are crucial in the environment of data-driven technologies of today. This work examines closely how to integrate Apache Kafka with RabbitMQ to produce a powerful data flow architecture. Excellent at managing high speed and flexibility, Apache Kafka is a distributed streaming platform. Considered to be simple to use and capable of handling complicated routing, RabbitMQ is message broker tool. Combining both technologies produces a unique system that makes data, handling, and distribution simpler by using the best aspects of each. The first section of the paper contrasts and evaluates Apache Kafka's and RabbitMQ's inherent capabilities. It then looks at how these platforms may be better used together, with an emphasis on circumstances wherein combining them facilitates real-time data processing and guarantees message delivery even in the event of a disaster. The technical component of the integration—that which relates to settings, system configuration, and methods of enhancing speed and dependability—is covered in further depth in this article Examined are case studies from a variety of companies to demonstrate how and why this integrated approach may be practical in the real world. These examples highlight how adaptable and efficient Kafka-RabbitMQ systems are in handling many kinds of data and demands. This research contributes to the area by providing a whole strategy for combined usage of Apache Kafka and RabbitMQ. This will enable businesses to upgrade their systems of data flow. Particularly with regard to enhancing the flow of data and rendering integrated data systems more valuable, the findings clearly highlight areas that need greater research.

Incidence and clinical impact of coronary artery disease confirmed by coronary CT angiography in patients with interstitial lung disease

BackgroundPatients with interstitial lung disease (ILD) who undergo routine chest computed tomography (CT) often have findings suggestive of coronary artery disease (CAD). However, the incidence and prognostic impact of significant CAD, confirmed by coronary CT angiography (CCTA), are not well established.MethodsFrom January 2013 to February 2024, we evaluated 215 patients from a retrospective ILD registry at our institute, who underwent CCTA as part of ILD management. Using the CAD-Reporting and Data System, we investigated the incidence of significant CAD and evaluated its impact on 5-year mortality and rehospitalization for respiratory or cardiovascular causes through multivariable Cox proportional hazards regression.ResultsDuring a median follow-up of 2.3 years, CCTA was performed at a median of 5 months postdiagnosis of ILD in the cohort. Significant CAD was identified in 92 patients (42.8%), with 27 (12.6%) undergoing coronary revascularization. The presence of significant CAD was significantly associated with an increased risk of mortality (adjusted hazard ratio [HR]: 2.31; 95% confidence interval [CI]: 1.07 − 5.01; P = 0.03) and a higher risk of rehospitalization (adjusted HR: 2.03; 95% CI: 1.23 − 3.34; P = 0.01). Key clinical variables associated with significant CAD included older age (≥ 63 years), hypertension, and coronary calcification observed on non-gated chest CT.ConclusionsCCTA-identified CAD was associated with a worse clinical prognosis in patients with ILD, with significant risk factors including older age, hypertension, and coronary calcification observed on non-gated chest CT. These findings suggest that obtaining CCTA may be beneficial for managing patients with ILD, particularly those with identified risk factors.

A maturity assessment model for data governance in small and medium enterprises in Vietnam

Within digital transformation, data governance is vitally important for business performance improvement. However, small and medium-sized enterprises (SMEs) in Vietnam struggle to achieve this due to their resource and readiness levels, as well as their technological capabilities. The data maturity models that exist, such as DAMA-DMBOK and DCAM, face a similar problem as they are designed for larger enterprises and are not easily applicable to SMEs. This paper seeks to create a model that is more suitable for Vietnamese SMEs. To achieve this, the research is conducted through document analysis, interviewing 20 data governance professionals, and conducting test research within 20 target SMEs across the manufacturing, trade, and service industries. The outcomes reveal that the model assists SMEs in improving data literacy, developing data governance policies, fulfilling security compliance measures, and integrating cloud data systems. Respondents from SMEs claiming to possess the highest level of maturity, on average, reported a 20% relative increase in business performance. In addition to contributing to data governance theory, this model is the first framework that cost-effectively aids Vietnamese SMEs in complying with Decree 13/2023/ND-CP while simultaneously improving their competitive abilities.

Current State of Evidence for Use of MRI in LI-RADS.

The American College of Radiology Liver Imaging Reporting and Data System (LI-RADS) is the preeminent framework for classification and risk stratification of liver observations on imaging in patients at high risk for hepatocellular carcinoma. In this review, the pathogenesis of hepatocellular carcinoma and the use of MRI in LI-RADS is discussed, including specifically the LI-RADS diagnostic algorithm, its components, and its reproducibility with reference to the latest supporting evidence. The LI-RADS treatment response algorithms are reviewed, including the more recent radiation treatment response algorithm. The application of artificial intelligence, points of controversy, LI-RADS relative to other liver imaging systems, and possible future directions are explored. After reading this article, the reader will have an understanding of the foundation and application of LI-RADS as well as possible future directions.

Accommodating Success: Examining the Effects of Accessing Accommodations on Degree Completion Among Community College Students With Non-Apparent Disabilities

This study leverages the Texas Statewide Longitudinal Data System to examine the characteristics of community college students with non-apparent disabilities who access disability accommodations, including students with learning disabilities (LD), other health impairments (OHI), emotional and behavioral disorders (EBD), and autism spectrum disorder (ASD). Additionally, it explores the association between accessing accommodations, the timing of initial access, and the completion of certificates, associate degrees, and vertical transfers. The analysis includes eight cohorts of students who graduated from Texas public high schools between the 2006–2007 and 2013–2014 academic years, representing approximately 28,840 students. Findings reveal that students with LD and OHI consistently show a higher likelihood of degree completion and vertical transfers when they access accommodations, regardless of which semester these supports are initially accessed. Conversely, no significant association exists between accessing accommodations and completion outcomes for students with EBD. For students with ASD, those who delay accessing accommodations until their fourth semester or beyond are less likely to complete a degree or transfer. The findings underscore the need for timely and appropriate accommodations to support academic success and highlight the importance of policies and practices that ensure equitable access to these supports.

Racial and Ethnic Representation Among Complementary and Integrative Health Program Graduates.

Background: Use of complementary and integrative health care (CIH) varies across racial and ethnic groups in the United States. Lack of racial and ethnic diversity among CIH providers may hinder access to CIH for underrepresented groups. This study aimed to (1) document racial and ethnic representation in licensed CIH professions (chiropractic, acupuncture, traditional East Asian medicine, naturopathic medicine, direct-entry midwifery, and massage therapy), non-licensed CIH professions, and conventional health care; (2) compare diversity in these professions with the U.S. population; and (3) examine changes in CIH diversity in recent years. Methods: We conducted a repeated cross-sectional study design with the 2011-2022 Integrated Postsecondary Education Data System to examine race and ethnicity among graduates in licensed CIH professions, compared with non-licensed CIH professions and conventional health care. Our sample included 53,393 programs representing 3,524,494 individuals. We examined the proportion of graduates from each racial and ethnic group, compared results with the U.S. population, and graphically explored changes between 2011 and 2022. Results: Inclusion or exclusion of massage therapy influenced interpretations across all questions. With massage therapy, licensed CIH professions appeared more diverse, with a higher proportion of Latino and Black graduates. Without massage therapy, diversity in licensed CIH professions was similar or slightly reduced compared with non-licensed CIH professions and conventional health care. Notable differences emerged among licensed CIH professions: acupuncture and East Asian medicine had larger proportions of Asian graduates than other CIH programs and the U.S. population. Racial and ethnic diversity in CIH increased modestly between 2011 and 2022. Discussion: While professions such as massage therapy, acupuncture, and traditional East Asian medicine have greater diversity, a disparity persists between the racial and ethnic composition of licensed CIH professions and the diversity of the overall U.S. population.

Ivabradine exposures reported to United States poison centers 2015–2023

Introduction Ivabradine was approved for use in the United States in 2015 for the management of heart failure. It acts through inhibition of sodium channels found in cardiac myocytes (the “funny” pacemaker current, If), which reduces heart rate without significantly affecting inotropy. Methods We queried the National Poison Data System® for reported ivabradine exposures from April 15, 2015–December 31, 2023. Age was stratified into child (0–5 years), adolescent (6–17 years), adult (18–64 years) and geriatric (65+ years). Other descriptive statistics gathered included patient sex, management site, and medical outcome as coded by America’s Poison Centers®. Results There were 240 ivabradine exposures, with 55.0% managed on-site and not transferred to a healthcare facility. The most common reported symptom was bradycardia, reported in 36 patients (15.1%). There were 139 cases that were followed to a known outcome. Within this cohort, 60%, 14%, and 27% of patients suffered no effect, minor effect, or moderate effect, respectively. Exposures in children comprised 18.8% of cases; none required intervention. Intentional self-harm exposures comprised 17.1% of all cases and were more likely to have worse outcomes. Five adult patients received intensive therapy (endotracheal intubation, vasopressors, cardiac pacing, hemodialysis). There were no reported deaths from ivabradine exposure. Discussion This study has limitations. First, our data source was limited by being retrospective and incomplete; we could only study the information that was reported to poison centers, and exposures were not confirmed by laboratory testing. It is possible that cases without further follow-up had other treatments and clinical effects not reported here. Finally, reports to poison centers likely underestimate the true number of ivabradine exposures. Conclusion Adults with unintentional, asymptomatic exposures to ivabradine may be candidates for home monitoring. In ivabradine exposures refractory to medical management, clinicians should consider cardiac pacing or other supportive measures as a temporizing measure.

Combination of CT/MRI LI-RADS With Second-Line Contrast-Enhanced Ultrasound Using Sulfur Hexafluoride or Perfluorobutane for Diagnosing Hepatocellular Carcinoma in High-Risk Patients.

The CT/MRI Liver Imaging Reporting and Data System (LI-RADS) demonstrates high specificity with relatively limited sensitivity for diagnosing hepatocellular carcinoma (HCC) in high-risk patients. This study aimed to explore the possibility of improving sensitivity by combining CT/MRI LI-RADS v2018 with second-line contrast-enhanced ultrasound (CEUS) LI-RADS v2017 using sulfur hexafluoride (SHF) or perfluorobutane (PFB). This retrospective analysis of prospectively collected multicenter data included high-risk patients with treatment-naive hepatic observations. The reference standard was pathological confirmation or a composite reference standard (only for benign lesions). Each participant underwent concurrent CT/MRI, SHF-enhanced US, and PFB-enhanced US examinations. The diagnostic performances for HCC of CT/MRI LI-RADS alone and three combination strategies (combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or a modified algorithm incorporating the Kupffer-phase findings for PFB [modified PFB]) were evaluated. For the three combination strategies, apart from the CT/MRI LR-5 criteria, HCC was diagnosed if CT/MRI LR-3 or LR-4 observations met the LR-5 criteria using LI-RADS SHF, LI-RADS PFB, or modified PFB. In total, 281 participants (237 males; mean age, 55 ± 11 years) with 306 observations (227 HCCs, 40 non-HCC malignancies, and 39 benign lesions) were included. Using LI-RADS SHF, LI-RADS PFB, and modified PFB, 20, 23, and 31 CT/MRI LR-3/4 observations, respectively, were reclassified as LR-5, and all were pathologically confirmed as HCCs. Compared to CT/MRI LI-RADS alone (74%, 95% confidence interval [CI]: 68%-79%), the three combination strategies combining CT/MRI LI-RADS with either LI-RADS SHF, LI-RADS PFB, or modified PFB increased sensitivity (83% [95% CI: 77%-87%], 84% [95% CI: 79%-89%], 88% [95% CI: 83%-92%], respectively; all P < 0.001), while maintaining the specificity at 92% (95% CI: 84%-97%). The combination of CT/MRI LI-RADS with second-line CEUS using SHF or PFB improved the sensitivity of HCC diagnosis without compromising specificity.

Node-RADS category on preoperative CT predicts prognosis in patients with papillary renal cell carcinoma.

This research focused on investigating the relationship between the Node Reporting and Data System (Node-RADS) categories, determined via preoperative CT, and the outcomes of progression-free survival (PFS) and cancer-specific survival (CSS) in individuals diagnosed with papillary renal cell carcinoma (pRCC). A retrospective multicenter study initially enrolled 454 patients, with 218 eligible for analysis following partial nephrectomy or radical resection for pRCC. Prognostic factors related to PFS and CSS in pRCC patients were identified through univariate and multivariate Cox regression analyses. Subsequently, the prognostic value of Node-RADS was assessed and compared with the existing pRCC risk stratification model. In total, 218 patients (mean age, 58 years; men, 164 [75.2%]) with pRCC (186 Node-rads I tumors (85.3%), 10 Node-rads II tumors (4.6%), and 22 Node-rads III tumors (10.1%)) were included. The Node-RADS category emerged as an independent prognostic factor for PFS (III vs II vs I, hazard ratio (HR) 4.250, p < 0.001) and CSS (III vs II vs I, HR 4.466; p < 0.001). When the Node-RADS category was incorporated into Leibovich's model, the resulting combined model demonstrated a significant improvement in predictive accuracy (C-index: 0.865 versus 0.755, p = 0.005 for PFS; and 0.921 versus 0.835, p = 0.01 for CSS). The Node-RADS category has been identified as a more accurate predictor of prognosis for pRCC, regardless of pathologic lymph node involvement. These findings need further confirmation in prospective studies. Question Lymph node status is important for papillary renal cell carcinoma prognosis, and there is a lack of consensus on radiological evaluation. Findings Node-RADS is an independent predictor of progression-free survival and cancer-specific survival in papillary renal cell carcinoma. Clinical relevance The Node Reporting and Data System category improves the accuracy of the Leibovich model for prognosis, which can help clinical practitioners select individualized treatment plans for each patient.

Perilesional Enhancement: AValuable Feature for Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in CEUS LI-RADS M.

Perilesional Enhancement: AValuable Feature for Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma in CEUS LI-RADS M.

Specimen and data sharing to advance research and development on Zika virus.

Specimen and data sharing to advance research and development on Zika virus.

Combining Percentage Prostate-Specific Antigen Reduction and Multiparametric Magnetic Resonance Imaging to Reduce Unnecessary Biopsy After Focal Therapy With High-Intensity Focused Ultrasound for Prostate Cancer.

To test the feasibility of combining percentage prostate-specific antigen (PSA) reduction and multiparametric magnetic resonance imaging (mpMRI) to determine the clinical scenario in which follow-up biopsy could be avoided after focal therapy (FT) with high-intensity focused ultrasound (HIFU) for prostate cancer. We reviewed 90 men treated with FT. Percentage PSA reduction was calculated by PSA nadir within postoperative 6 months. mpMRI was arranged at postoperative 6 months, followed by routine biopsy. Logistic regression analyses were performed to identify predictors for clinically significant prostate cancer (csPC) on follow-up biopsy. Receiver operating characteristic curve analysis was done to assess the area under the curve (AUC). The diagnostic performance of percentage PSA reduction and mpMRI to predict csPC was also calculated. Eight patients had csPC recurrence. Percentage PSA reduction and Prostate Imaging-Reporting and Data System (PI-RADS) ≥ 3 at postoperative 6 months were predictors for csPC (p = 0.033 and p = 0.02, respectively). The AUC of mpMRI, percentage PSA reduction, and their combination were 0.95, 0.816, and 0.982, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of PSA reduction < 70% and PI-RADS ≥ 3 to predict csPC were 87.5%, 69.5%, 21.9%, 98.3%, and 87.5%, 96.3%, 70%, 98.8%, respectively. Using the criteria of PSA reduction < 70% or PI-RADS ≥ 3 to determine biopsy candidates could avoid 60% of biopsies, without missing csPC. For patients whose PSA reduction > 70% and PI-RADS < 3, we suggested avoiding routine biopsy at 6 months after FT with HIFU.

Assessing the Role of Bi- and Multi-Parametric MRI in Prostate Cancer-A Regional Study

Prostate MRI is a key diagnostic tool for prostate cancer (PCa), with current guidelines recommending multi-parametric MRI (mpMRI), which includes T2-weighted (T2W), diffusion-weighted (DWI), and dynamic contrast-enhanced (DCE) imaging. However, biparametric MRI (bpMRI), which omits DCE, is suggested to reduce scan time, cost, and potential contrast-related side effects. Limited research exists comparing bpMRI’s efficacy against mpMRI for detecting clinically significant prostate cancer (CsPCa) using the Prostate Imaging and Reporting Data System (PI-RADS v2.1).To compare the diagnostic performance of bpMRI and mpMRI for prostatic carcinoma and CsPCa detection. This study retrospectively evaluated 115 males over 40 years with elevated prostate-specific antigen (PSA) levels (≥15 ng/ml) who underwent mpMRI and had histopathological results. Two radiologists independently assessed suspected PCa lesions, assigning PI-RADS categories for bpMRI (report one) and mpMRI (report two). The reference standard was histopathological biopsy with Gleason scoring. Among 101 patients with suspected PCa, CsPCa was diagnosed in 45 cases using mpMRI, 39 with bpMRI, and 14 with DCE alone. The PI-RADS grading system showed strong agreement (kappa = 0.82) for bpMRI and near-perfect agreement (kappa = 0.912) for mpMRI. Sensitivity was slightly higher for mpMRI (98.4%) than bpMRI (96.7%) with (P &lt; 0.001), while bpMRI demonstrated higher specificity (75.8% vs. 66.8%, P &lt; 0.001) the detection rates of CsPCa for bpMRI and mpMRI were 51.50% and 53.40% respectively. The study concludes that bpMRI is non-inferior to mpMRI in CsPCa detection, making it a viable alternative while DCE remains valuable for PCa lesion detection.

Threatened fishes of the world: Diptychus maculatus and Aspiorhynchus laticeps

In order to deeply analyze the individual biological characteristics of unique fish in China, lay a solid foundation for the effective protection of its germplasm resources, and further enrich and consolidate the basic biological data system of endemic fish in the world. According to the ethical norms and fishing licenses, 5 samples of Diptychus maculatus and 3 samples of Aspiorhynchus laticeps were collected from the Tarim River system in Baicheng County from 2023 to 2024. The morphological characteristics, age identification and anatomical observation of the two fishes were analyzed by classical biological methods. Both fish belong to Cypriniformes, Cyprinidae, Schizothoracinae. D. maculatus has a long body, a conical head, and a lower mouth with a pair of fish whiskers. The mouth is slightly blunt and arcuate, and the lateral line is complete. A. laticeps has a long, slightly flattened body, a round abdomen, and a large head that is flattened at the front. It also has a pair of fish whiskers located at the corners of the mouth. Age identification materials: D. maculatus lapillus 6+, asteriscus 6+, vertebra 6+, anal scales 6+, opercular bone 5+, A. laticeps lapillus 7+, asteriscus 7+, vertebra 7+, anal scales 7+, opercular bone 7+. The peritoneal wall of D. maculatus is black or brown the tooth type was 3·4-4·3; the external behavior of gill rakers was 8-13; and the internal behavior was 12-16. A. laticeps pharynx teeth 3 lines, tooth type is 2·3·5-5·3·2; the external behavior of gill rakers was 11-13; and the internal behavior was 15-18. D. maculatus and A. laticeps are special species distributed in the Tarim River system. Their evolutionary adaptation is closely related to the uplift of the Qinghai-Tibet Plateau. This study provides important data for better understanding the individual biological characteristics of these two endangered fish species and lays the foundation for their germplasm resource conservation.

Overweight and Obesity and Progression to End-Stage Kidney Disease in Patients with Autosomal Dominant Polycystic Kidney Disease

Background and Objectives: Prior research has linked higher body-mass index (BMI) and greater visceral adiposity with more rapid progression of early-stage autosomal dominant polycystic kidney disease (ADPKD). We now evaluate the association between overweight and obesity in early- and late-stage patients with ADPKD with progression to end-stage kidney disease (ESKD). Design, Setting, Participants, and Measurements: Participants with early-stage ADPKD (Study A; N=556; eGFR: 91±17 mL/min/1.73m2) and late-stage (Study B; N=483; eGFR: 48±12 mL/min/1.73m2) ADPKD who participated in the HALT PKD trials were categorized by BMI as normal weight (18.5-24.9 kg/m2; ref; N=357), overweight (25.0-29.9 kg/m2; N=384), or obese (≥30 kg/m2; N=298). Kaplan Meier survival analysis and multivariate Cox proportional hazard models were used to determine the association of baseline BMI as a continuous and categorical variable with risk of ESKD (according to the US Renal Data System) over median (IQR) follow-up period of 12.2 (7.5, 13.3) [Study A] and 7.3 (5.1, 11.7) [Study B] years (primary outcome). All-cause mortality (National Death Index) was also considered as a competing risk (Fine and Gray method). Results: The number of ESKD events was greater with overweight (N=24) and obesity (N=23) in HALT Study A vs. normal weight (12) but not HALT Study B (normal weight: N=89, overweight: N=102, obese: N=92). In fully adjusted models, higher BMI was associated with risk of progression to ESKD in Study A (Hazard Ratio [HR (95% CI)] 1.09 [1.03, 1.15] per unit higher BMI) but not Study B (HR: 0.98 [0.96, 1.00]). Obesity was associated with increased risk of ESKD (HR: 2.71 [1.22, 6.02] vs. normal weight) in Study A only. Results were similar when considering death as a competing risk. Conclusions: Higher BMI, particularly obesity, increased the risk of progression to ESKD in early- but not late-stage patients with ADPKD.

Proximity of Crisis Pregnancy Centers to Colleges and Universities in the United States, 2021.

Proximity of Crisis Pregnancy Centers to Colleges and Universities in the United States, 2021.

Stroke risk in ADPKD patients treated by dialysis: a retrospective study

Abstract Background and hypothesis The risk of ischaemic or haemorrhagic strokes in patients living with end-stage renal disease (ESRD) and receiving replacement therapy is more than double that of non-dialysed individuals. Autosomal dominant polycystic kidney disease (ADPKD) is an inherited systemic disorder associated with renal and non-renal manifestations, including intracerebral aneurysms (ICA). The role of underlying nephropathy in determining the onset of the stroke is unclear. Methods All patients who started dialysis between January 1st, 2015, and December 31st, 2019, were included in the analysis. Data were retrieved from the REIN registry and the French national Health Data System (SNDS). Cases of stroke were extracted from the SNDS, by using ICD-10 codes. The first stroke observed during the follow-up, irrespective of its nature, was considered as the event of the main analysis, based on semi-parametric survival model. Results 40 980 patients on dialysis were included. Overall, 1 549 patients experienced stroke during the follow-up. The first stroke was ischaemic in 1 148 (74.1%), and haemorrhagic in the remaining 281 patients. The cumulative incidence of stroke on dialysis was 1.58 per 100 person-years (95%CI = 1.51; 1.70). Among 2 182 ADPKD patients, only 44 (2%) experienced stroke. ADPKD was not significantly associated with an increased risk of all type of stroke, after considering major risk factors. Conclusions We found no increase in the risk of stroke in ADPKD patients under dialysis. We believe that the findings of our study support a similar screening strategy in ADPKD patients on dialysis compared to patients not on dialysis.

Evaluating biparametric MRI for diagnosing muscle-invasive bladder cancer with variant urothelial histology: a multicenter study

BackgroundVesical Imaging-Reporting and Data System (VI-RADS) based on multiparametric MRI (mp-MRI) demonstrated excellent performance in diagnosing muscle-invasive bladder cancer (MIBC) in cases of pure urothelial carcinoma. However, the performance of VI-RADS based on mp-MRI and biparametric MRI (bp-MRI) in diagnosing urothelial carcinoma with variant histology (VUC) remains unknown.PurposeTo evaluate the applicability of VI-RADS using mp-MRI and bp-MRI in diagnosing MIBC in patients with VUC.MethodsA retrospective analysis was conducted on 86 patients with VUC from different medical centers. Each patient underwent mp-MRI, with images evaluated using VI-RADS scores. The acquired images were divided into two groups: the mp-MRI group and the bp-MRI group. The mp-MRI group was evaluated according to the VI-RADS protocol. For the bp-MRI group, two VI-RADS scoring criteria were established: bp-DWI, primarily driven by DWI, and bp-T2WI, primarily driven by T2WI. The bp-MRI group was evaluated based on these two criteria. Inter-reader agreement performance was evaluated using Kappa analysis. The evaluation methods were evaluated by receiver operating characteristic curve. Comparison of the area under the curve (AUC) was performed used DeLong’s test. A p-value < 0.05 was considered significant.ResultsInter-reader agreement was high across all evaluation methods, with Kappa values exceeding 0.80. The AUCs for mp-MRI, bp-DWI, and bp-T2WI were 0.934, 0.885, and 0.932, respectively. The diagnostic performance of bp-T2WI was comparable with that of mp-MRI (p = 0.682) and significantly higher than bp-DWI (p = 0.007). Both mp-MRI and bp-T2WI demonstrated high sensitivity and specificity.ConclusionVI-RADS based on mp-MRI demonstrates good diagnostic performance for MIBC in VUC patients. bp-T2WI may provide comparable diagnostic performance to mp-MRI.

Challenges of Educational Management Information System: A Review

This review aims to identify and analyze the challenges faced by educational institutions in implementing and utilizing educational management information system. The study is related to content analysis of relevant documents. Secondary data is used in this study. The EMIS is a system that uses new computer technology to make all the functions work together to give education leaders, decision makers, planners, and managers comprehensive, integrated, relevant, clear and timely data so they can carry out their duties effectively and meet the goals. By giving those needed the right information at the right time to make the best decisions, plan, and monitor in the organization's best interest. According to the study's findings, there are challenges such as disparities in knowledge and skill between those performing various system functions, a weak organizational structure and legal framework, and a lack of hardware, software, internet connectivity, and electrical power, particularly in the most remote and school-level locations in the area. It is found that despite the system's poor data quality, it can be regarded as effective because it provides the information and education data that many stakeholders demand. Officials at various levels are encouraged to prioritize and manage existing problems effectively, as most difficulties can be resolved with proper attention. Additionally, further research is recommended to develop appropriate solutions and strengthen the overall system.

Pulmonary Embolism–Related Mortality in Patients With Cancer

Acute pulmonary embolism (PE) is a major cause of morbidity and mortality in patients with cancer in the US and worldwide. To assess the trends in PE-related mortality from 2011 to 2020 among US patients with cancer across age, sex, ethnic and racial groups, urbanicity, and regionality. This cohort study used the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research data system to determine national trends in age-adjusted mortality rates (AAMRs) due to acute PE among US patients with cancer aged 15 years or older from January 2011 to December 2020. Concomitant trends in cancer mortality and incidence that may have contributed to PE-related mortality were obtained from US Cancer Statistics. Data were analyzed from September to November 2024. PE-related mortality. The primary outcome was PE-related deaths among individuals with cancer. AAMRs and cancer incidence were assessed using joinpoint regression modeling, expressed as an average annual percentage change (AAPC) with relative 95% CIs. From 2011 to 2020, a total of 27 280 194 individuals aged 15 years or older (13 897 519 male [50.9%]; 13 382 675 female [49.1%]) died in the US. The AAMR for PE-related mortality in patients with cancer increased during this time period (AAPC, 2.5%; 95% CI, 1.4% to 3.6%; P = .001), without differences between sexes (P for parallelism = .38). The AAMR increased among those aged 15 to 64 years (AAPC, 3.2%; 95% CI, 1.9% to 4.6%; P = .001), non-Hispanic and non-Latinx White individuals (AAPC, 2.7%; 95% CI, 1.52% to 3.94%; P = .001), non-Hispanic and non-Latinx Black or African American individuals (AAPC, 2.2%; 95% CI, 0.7% to 3.7%; P = .001), Hispanic and Latinx individuals (AAPC, 2.6%; 95% CI, 0.7% to 4.5%; P = .006), and among individuals residing in the Southern US (AAPC, 3.7%; 95% CI, 1.3% to 6.2%; P = .003). During the same period, age-adjusted cancer incidence and cancer-related mortality decreased while the absolute number of new cancer diagnoses and cancer-related deaths increased. This cohort study found that despite decreases in cancer-related mortality rates, age-adjusted PE-related mortality in US patients with cancer increased over the last decade; concerning trends included rising PE-related mortality in younger individuals aged 15 to 64 years, particular ethnic and racial groups, and the Southern region of the US. Recognition of such patterns may inform further research into thromboprophylaxis and treatment of PE as a complication of cancer and cancer-directed therapy.