Demographic Criteria Research Articles

Technology-Based Interventions for Substance Use Treatment Among People Who Identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native: Scoping Review.

In the United States, racial and ethnic disparities in substance use treatment outcomes are persistent, especially among underrepresented minority (URM) populations. Technology-based interventions (TBIs) for substance use treatment show promise in reducing barriers to evidence-based treatment, yet no studies have described how TBIs may impact racial or ethnic health equity. This study explored whether TBIs in substance use treatment research promote health equity among people who identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native through their inclusion in research. We explored whether research that includes the aforementioned groups consciously considers race and/or ethnicity beyond including these populations as participants. We conducted a scoping review of 5 electronic databases to identify TBIs in substance use treatment studies published in English between January 2000 and March 2021. Studies were included if ≥50% of participants identified as African American or Black, Hispanic or Latino, or American Indian or Alaska Native when combined. Included studies were evaluated for conscious consideration of race and ethnicity in at least one manuscript section. Finally, we conducted a critical appraisal of each study's potential to facilitate insights into the impact of a TBI for members of specific URM groups. Of 6897 titles and abstracts screened and 1158 full-text articles assessed for eligibility, nearly half (532/1158, 45.9%) of the full-text articles were excluded due to the absence of data on race, ethnicity, or not meeting the aforementioned demographic eligibility criteria. Overall, 110 studies met the inclusion criteria. Study designs included 39.1% (43/110) randomized trials, and 35.5% (39/110) feasibility studies. In total, 47.3% (52/110) of studies used computer-based interventions, including electronic screening, brief interventions, and referrals to treatment, whereas 33.6% (37/110) used interactive voice response, ecological momentary assessment or interventions, or SMS text messaging via mobile phones. Studies focused on the following substances: alcohol or drugs (45/110, 40.9%), alcohol alone (26/110, 23.6%), opioids (8/110, 7.3%), cannabis (6/110, 5.5%), cocaine (4/110, 3.6%), and methamphetamines (3/110, 2.7%). Of the studies that consciously considered race or ethnicity (29/110, 26.4%), 6.4% (7/110) explicitly considered race or ethnicity in all manuscript sections. Overall, 28.2% (31/110) of the studies were critically appraised as having a high confidence in the interpretability of the findings for specific URM groups. While the prevalence of TBIs in substance use treatment has increased recently, studies that include and consciously consider URM groups are rare, especially for American Indian or Alaska Native and Hispanic or Latino groups. This review highlights the limited research on TBIs in substance use treatment that promotes racial and ethnic health equity and provides context, insights, and direction for researchers working to develop and evaluate digital technology substance use interventions while promoting health equity.

Comparative Assessment of Suggested Dam Sites Using both Analytic Hierarchy Process and Weighted Sum Method for Rainwater Harvesting in Al-Naft Valley, Eastern Diyala, Iraq

The study compares suggested dam sites for rainwater harvesting in the Al-Naft Valley, east of Diyala Governorate, Iraq, near the Iranian border. The digital elevation model, Operational Land Imager data, ArcGIS 10.8, Global Mapper 24, and Surfer 17 software were employed for this purpose. The watershed, predominantly in Iran 70% with 30% in Iraq, was of the sixth order, covering 1443 km². The total surface runoff volume was estimated at 320,000,000 m³/year using the SCS-CN method, which highlighted challenges due to international border crossings. The evaluation of the suggested dam sites depended on 11encompassed morphometric (stream order), hydrological (annual water income), geometric (reservoir capacity, average depth, surface area of reservoir, and safety factor), demographic (number of capita benefiting), economic (relative cost/ storage, road submerging by the lake, distance to roads) and geopolitical criteria (area of lake crossed international borders). Analytic Hierarchy Process and Weighted Sum Method were used for comparison, with input from 35 experts to weight criteria to evaluate six proposed sites (alternatives). The second, third, and fourth proposed dams are classified as large-sized, while the others are medium-sized. The third proposed dam emerged as the most suitable, offering a storage capacity of 165,000,000 m³, representing 51.5% of annual input water. To align storage with annual water input, multiple dams are preferred. The first, third, and sixth proposed reservoirs, with a total capacity of 237,000,000 m³, constitute 74% of the expected annual water input to the watershed.

Stratification of Hand Bone Fractures in the Kyrgyz Republic

The study aimed to stratify hand bone fractures in the Kyrgyz Republic based on patient data, including age, gender, and other clinical characteristics. Data from patients treated in 2019 were analyzed, with assessments made using key medical parameters such as fracture type, age, gender, blood group, and other laboratory indicators. A retrospective analysis of 200 hand fracture cases was conducted, classified by various clinical and demographic criteria. Conclusions were drawn based on statistical analysis of the data. Results: Significant differences in fracture incidence were observed between males and females, as well as across different age groups. The highest incidence was found in the working-age population, indicating a need for enhanced preventive measures in this demographic.

Trends and Patterns in Bicycle Injuries: The Significance of Protective Equipment.

Introduction This research presents a five-year comprehensive analysis of trends and efficacy related to helmetand protective equipment use in bicycle-related incidents. Our areas of comparison included injury severity, hospital stay, theGlasgow Coma Scale(GCS) scores, and demographic data. In light of the current increasein bicycle use popularity, this study aimed to provide clear information regarding the significance of protective equipment to combat the surge in bicycle-related incidents in recent years. Methods A retrospective analysis was performed using the National Trauma Data Standard (NTDS) as a data source. Our inclusion criteria considered the mechanism of injury involving bicycle incidents, narrowing our pool of patients to 135,605. These cases were screened based on the following parameters: use of helmet/protective equipment, demographic criteria, and several other injury markers. Statistical analyses, including two sample t-tests, were performed using SAS. Results A total of 5.7 million patients were screened for inclusion criteria, yielding 135,605 cases involving bicycle-related injuries between 2018 and 2022. Of the patients who met the inclusion criteria, patients wearing helmets had an overall high GCS score (p<0.001) and decreased hospital stay (p<0.001) compared to those without helmet use. Similar findings were drawn related to protective equipment use and GCS (p<0.001). The Injury Severity Score (ISS) on average was higher for those wearing helmets (p<0.001). Overall, an increase in helmet use was noted for the years in question (R2=0.467). Additional observations made include large variations in helmet use in different age groups. Patients aged <17 yearswore helmets in just 6,514 (22%) cases while those aged +65 years wore helmets in 10,925 (51%)cases. Conclusions This study observed a statistically significant difference between GCS values in helmet/non-helmet-wearing groups. Similar findings were found regarding other protective equipment use as well. A statistically significant difference was also found regarding increased ISS with helmet use. This challenges our current assumptions aboutimproved injury severity with the use of protective equipment. In line withother studies, we determined that helmet use tends to decrease the level of injuries on the head. Overall, helmet use has increased in the past five years, but several demographic groups were found towear protective equipment less often. We recommend future research that focuseson understanding the trends in protective equipment use among bicycle-riding individuals under the age of 25 years, Native Americans, and African Americans. Continued research regarding injury reduction interventions is of utmost importance, especially given the widespread increase in the popularity of bicycle use.

Effect of the WHEY protein on pregnancyneonatal outcomes and prophylactic effect on fetal growth restriction cases: A randomized clinical trial

Background: WHEY protein is a high-quality protein source that is easily absorbed and utilized by the body. It has a beneficial effect on pregnancy and neonatal outcomes. Aim: To evaluate the impact of WHEY protein on pregnancy-neonatal outcomes and its prophylactic effect on Fetal growth restriction (FGR) cases. Patients and methods: This study was a prospective randomized, controlled clinical trial conducted on 300 pregnant females from attendees of obstetrics and gynecology clinics of Al Azhar University Hospitals. They were randomly divided into two groups: Case group: The intervention group (150 cases) received a daily WHEY protein supplement containing 25 grams of protein, and the Control Group: 150 cases received a placebo supplement. Results: There was no statistically significant difference between the studied groups regarding demographic criteria (P&gt;0.01), and the prevalence of FGR was (20% vs 18.75) in the studied groups. According to fetal biometry at birth, there was no statistically significant difference regarding sonographic parameters between the appropriate gestational age (AGA) in the studied groups (P&gt;0.01). There was no statistically significant difference between the two groups regarding complete blood parameters, platelets, or PTT (P&gt;0.01). There was a highly statistically significant difference regarding PT between the studied groups (P&lt;0.001). There was no statistically significant difference between the two groups regarding liver and kidney function tests (P&gt;0.01). There was a highly statistically significant difference regarding total proteins and serum calcium between the studied groups (P&lt;0.001). Conclusion: WHEY protein supplementation did not affect fetal growth, but it improved some maternal parameters, such as total protein and PT.

Study the Effect of Polycystic Ovarian Syndrome on the Ferriman-Gallwey Score and Some Anthropometric and Demographic Criteria on Women in Al-Ramadi City

Introduction: Polycystic ovarian syndrome (PCOS) is one of the most common complex endocrine disorders that affect females at the reproductive age, can cause obesity, the appearance of excess hair on the body, acne, menstrual irregularities and infertility. Aim: This study aimed to identify the extent to which some anthropometric and demographic criteria are affected by PCOS compared to healthy women Method: The study included 50 volunteer women divided into two groups, the first group included 25 women with polycystic ovarian syndrome, and 25 healthy women were considered as a control group, women treated with medication and those with other diseases were excluded. Result: The current study found that there was a significant increase in body mass index BMI for women with PCOS compared with the control group. It also found that there was a significant increase in Ferriman-Gallwey score as a measure of hirsutism, in the patient group compared to the control group of . The study also found that the rate of infertility was closely associated with polycystic ovarian syndrome, also confirmed that there was a significant increase in women suffering from menstrual irregularities compared with control group, while the family history of the disease had no influence on the development of the disease in the study sample. Conclusion: We observed that obesity and hirsutism are associated with a polycystic ovarian syndrom, and polycystic ovarian syndrome can lead to menstrual irregularities, which usually ends with infertility.

Holistic shape variation of the rib cage in an adult population.

Traumatic injuries to the thorax are a common occurrence, and given the disparity in outcomes, injury risk is non-uniformly distributed within the population. Rib cage geometry, in conjunction with well-established biomechanical characteristics, is thought to influence injury tolerance, but quantifiable descriptions of adult rib cage shape as a whole are lacking. Here, we develop an automated pipeline to extract whole rib cage measurements from a large population and produce distributions of these measurements to assess variability in rib cage shape. Ten measurements of whole rib cage shape were collected from 1,719 individuals aged 25-45years old including angular, linear, areal, and volumetric measures. The resulting pipeline produced measurements with a mean percent difference to manually collected measurements of 1.7% ± 1.6%, and the whole process takes 30s per scan. Each measurement followed a normal distribution with a maximum absolute skew value of 0.43 and a maximum absolute excess kurtosis value of 0.6. Significant differences were found between the sexes (p < 0.001) in all except angular measures. Multivariate regression revealed that demographic predictors explain 29%-68% of the variance in the data. The angular measurements had the three lowest R2 values and were also the only three to have little correlation with subject stature. Unlike other measures, rib cage height had a negative correlation with BMI. Stature was the dominant demographic factor in predicting rib cage height, coronal area, sagittal area, and volume. Subject weight was the dominant demographic factor for rib cage width, depth, axial area, and angular measurements. Age was minimally important in this cohort of adults from a narrow age range. Individuals of similar height and weight had average rib cage measurements near the regression predictions, but the range of values across all subjects encompassed a large portion of their respective distributions. Our findings characterize the variability in adult rib cage geometry, including the variation within narrow demographic criteria. In future work, these can be integrated into computer aided engineering workflows to assess the influence of whole rib cage shape on the biomechanics of the adult human thorax.

Social assessment of the population for the transition to Value- based healthcare model

Background: The advanced experience of implementing a value-based model in the practice of Moscow healthcare allowed us to identify a number of the most significant practices of its effectiveness, among which support for making an informed decision by the patient, as well as measuring satisfaction and analyzing the needs of patients were noted. In this regard, the transition of the entire national healthcare system to a value-based model requires the development of approaches to assessing the population’s compliance with such a transformation, taking into account socio-economic, demographic and psychological criteria. Aim: To consider possible predictors of the readiness of a social group of the population older than working age to transition to a value-based model of national health care. Materials and methods: A review of fundamental and modern works in the problem field was carried out. The empirical basis of the work was made up of data from the official website of the Federal Statistics Service with geographic coverage of the entire Russian Federation. Results: Analysis of data from a subjective assessment of the population's health on a national sample of the Russian Federation demonstrates the internal readiness of the population for a value-based healthcare model, despite the negative trends of aging. In the age groups 55-59, 60-64, 65-69, 70-74, 75-79, 80 and older, there is a general trend in assessing their health - the majority of respondents rated it as “satisfactory,” while the number of ratings was “very bad” is minimal. The positive dynamics of the formation of information and technical competence of the population 65+, who are experiencing difficulties in integrating into digital health services, is shown. Conclusion: The transition of national healthcare to a value-based model involves the active involvement of the patient and the formation of patient experience in assessing the outcome of medical care. In this regard, it is necessary to take into account the patient’s personal socio-psychological compliance profile, the elements of which determine the horizons of promising research in the problem field under consideration. As a possible patient profile module, a subjective assessment of health and an assessment of information technology competencies in a social group older than working age, whose work growth is determined by demographic realities, are used.

Sociodemographic Factors and Students’ Attitudes towards Integrated Instruction

The primary objective of the study was to ascertain the attitudes of final-year students in undergraduate academic and master’s academic studies at the University of Nis Faculty of Sport and Physical Education and the University of Pristina - Kosovska Mitrovica Teacher Education Faculty in Prizren - Leposavic toward the possibilities of integrating the learning contents of the subjects Serbian Language and Physical Education. The study aims to investigate views about integrated instruction and the incorporation of Serbian Language and Physical Education in the integrative curriculum based on several demographic criteria such as gender, age, faculty major, overall grade point average, and socioeconomic status. The research was conducted on a sample of 179 students. Descriptive techniques were used to determine the level of expression of basic variables, while a Linear Regression Model was employed for statistical inference testing of established hypothesis. The results obtained indicate a statistically significant correlation between attitudes towards integrated instruction and the incorporation of the Serbian Language in the integrative curriculum in relation to sociodemographic characteristics (Hypothesis 1 and 2). However, no statistically significant associations were found for attitudes towards the incorporation of Physical Education in the integrative curriculum concerning sociodemographic variables (Hypothesis 3).

Treatment Outcomes and Patterns of Disease Recurrence of Patients with Carcinoma of the Buccal Mucosa.

Locally advanced buccal mucosa cancer is typically treated with surgery and adjuvant postoperative radiation therapy, which includes concurrent Cisplatin 100mg/m2 on Day 1, plus 5-Fluorouracil 1000mg/m2 from Day 1 to 4 every three weeks. Ipsilateral face radiotherapy is a de-escalated treatment that spares the opposite side of the face, enhancing post-treatment chewing function. The availability of electron beam radiotherapy for treating recurrences on the opposite side has increased the use of ipsilateral face radiotherapy. This retrospective study aimed to assess treatment outcomes and patterns of disease recurrence in patients with carcinoma of the buccal mucosa treated with different schedules. We retrospectively reviewed records of 54 patients with a pathological diagnosis of buccal mucosa cancers treated between 2018 and 2023. We extracted patients' demographic, disease, and treatment criteria. Indications for postoperative radiotherapy included a close margin of less than 3mm and lymph node positivity. The primary tumor (face) and neck were considered separately for radiotherapy treatment. One patient who refused surgery, radiotherapy, and chemotherapy but regularly came for follow-up after receiving Ayurvedic treatment died of the disease after 2 years and 1 month. Fifty-three patients received concurrent chemoradiotherapy with Cisplatin 100mg/m2 on Day 1, plus 5-Fluorouracil 1000mg/m2 from Day 1 to 4 every three weeks for three cycles. Postoperative patients were treated with radiotherapy fields covering the face (bilateral or ipsilateral wedged fields) and the whole neck field with central shielding for the initial 44Gy in 22 fractions over 4.5 weeks followed by a boost dose of 16Gy to the primary tumor and involved neck. For radical radiotherapy, patients received a similar radiation field but the boost dose delivered was 26Gy in 13 fractions over 2.5 weeks. For ipsilateral radiotherapy fields, the average face anterior field size was 6W x 8cm; the thick edge of the wedge laterally; depth 4cm and lateral 8W x 8cm radiation field with a thick edge of the wedge anteriorly; depth 3cm. The median dose to high-risk clinical target volume was 60Gy/30 fractions in postoperative cases. Forty-eight patients received radical radiotherapy with a higher dose (66Gy/33 fractions to 70Gy/35 fractions); twenty-eight patients received radiotherapy fields of bilateral face and neck with a central spinal shield of 2cm. Statistical analysis was conducted at the Community Medicine Department using SPSS software version 21.0. The Chi-square test and Fisher Exact test were applied to compare various groups. Fifty-four patients were analyzed. The median follow-up was 9 months. Surgery consisted of Composite Resection (Commando operation) plus Radical Neck dissection in three (5.5%) patients and non-composite resection surgeries (Wide excision of the lesion plus supra-omohyoid dissection) in nine (16.6%) cases, of which six (50%) cases had lymph node involvement but no patient with positive dissection had extracapsular extension. Tumor thickness by histopathology was found to be between 5 and 15mm. Sixteen (28.1%) patients failed locally and 11 (20.3%) had lymph node recurrences. One patient (1.8%) with mucoepidermoid cancer had bony metastases at D9, L1, and the pelvis after 4 months of treatment. Death occurred in 12 (20.3%; one due to a non-oncologic cause) out of 54 patients during our study. The majority (88%) of patients in our study are male, aged less than 50 (55%). A KPS of 70/>70 was present in 83.3% of patients. The majority of patients in this study are T3 (37%) and T4a (29.6%). Nodal status of patients included 29.6% N0; 27.7% N1, and 35.1% N2. The majority of patients (57.4%) have well-differentiated carcinoma followed by moderately differentiated carcinoma in 38.8% of patients. The difference in death is non-significant when ipsilateral face + neck radiotherapy is compared to bilateral face + neck radiotherapy by Fisher Exact test (statistical value = 0.1246; p > 0.05, statistically not significant), and in other groups, it could not be compared due to the small number of patients. Our results show the non-inferiority of non-composite resection surgery + bilateral face + neck radiotherapy to non-operative radical radiotherapy (bilateral or ipsilateral face wedged radiotherapy + neck radiotherapy), so the majority of patients can be treated by these modalities of treatment. De-escalation of radiotherapy by the use of ipsilateral face wedged + neck radiotherapy is possible as there is no statistically significant difference in local and nodal relapse when compared to bilateral face + neck radiotherapy, and it results in sparing of the opposite side of the face. Buccal mucosa carcinoma in eastern Uttar Pradesh is a very aggressive disease, with 12 (20.3%; one due to a non-oncologic cause) out of 54 patients dying. Our results are different compared to historical data, possibly due to the use of concurrent Cisplatin + 5-Fluorouracil chemotherapy and the lower number of patients in the composite resection group as the majority of patients were frail and did not consent to composite resection.

Suitable Site Selection of Public Charging Stations: A Fuzzy TOPSIS MCDA Framework on Capacity Substation Assessment

The number of electric vehicles (EVs) continues to increase in the automobile market, driven by public policies since they contribute to the global decarbonization of the transportation sector. Still, the main challenge to increasing EV adoption is charging infrastructure. Therefore, the site selection of public EV charging stations should be made very carefully to maximize EV usage and address the population’s range anxiety. Since electricity demand for charging EVs introduces new load shapes, the interrelationship between the location of charging stations and long-term electrical grid planning must be addressed. The selection of the most suitable site involves conflicting criteria, requiring the application of multi-criteria analysis. Thus, a geographic information system-based Multicriteria Decision Analysis (MCDA) approach is applied in this work to address the charging station site selection, where the demographic criteria and energy density are taken into account to formulate an EV increase model. Several methods, including Fuzzy TOPSIS, are applied to validate the selection of suitable sites. In this evaluation, the impact of the EV charging station on the substation capacity is assessed through a high EV penetration scenario. The proposed method is applied in Cuenca, Ecuador. Results show the effectiveness of MCDA in assessing the impact of charging stations on power distribution systems ensuring suitable system operation under substation capacity reserves.

Selected demographic determinants of CSR, financial &amp; environmental management and business ethics in SMEs

Research background: Small and medium-sized enterprises are at the heart of the business environment in every country. At the same time, emphasis is placed on the environmental aspect and, in many cases, corporate social responsibility. In this context, business ethics is also a widely discussed topic. At the same time, financial management is one of the critical areas of business management. These aspects can be influenced by various demographic factors related to the company, as well as by the business owners or managers. Purpose of the article: The objective of this paper is to examine the influence of selected demographic factors on Corporate Social Responsibility (CSR), financial management, environmental practices, and business ethics in small and medium-sized enterprises (SMEs) in Slovakia and the Czech Republic. Methods: The empirical research was carried out as part of a broad-based research that aimed to ascertain the attitudes of small and medium-sized firms. It was conducted in June 2022 in Slovakia and the Czech Republic using the CAWI Research Method. The questionnaire could be completed by the owner or the top manager of the SME. The questionnaire was secured against automatic computer completion. Descriptive statistical analysis was used to analyse the characteristics of the variable, and regression (LRM) and correlation analysis methods were applied to find statistically significant differences in the influence of each independent factor. Findings &amp; Value added: The analysis suggests interesting differences in how demographic factors influence ethics, CSR, environment and financial management in the Czech and Slovak Republics. In general, the impacts of these factors on these areas are very weak. The results showed that firm size influences SMEs' attitudes towards the environment, financial management and CSR in all countries combined. The other independent variables of the sector, such as length of business and age, do not affect attitudes towards ethics, environment, CSR, or financial management. We can generalise that in the conditions of Slovakia and the Czech Republic, among demographic criteria, only firm size plays a significant role in determining the attitudes of SME managers.

Physician Attire - Does it Matter? A Study Evaluating Patient Preferences for Attire for Family Medicine

Introduction: Historically, white coats have been the distinctive and respected dress code worn by physicians. With the onset of the Covid-19 pandemic, many physicians exchanged white coats and professional attire for scrubs and personal protective equipment to feel safer and reduce the spread of infectious pathogens in clinical settings. Our aim was to investigate patient preferences in attire for family physicians in an outpatient setting following the Covid-19 pandemic. Methods: Patients from two family medicine clinics were recruited to participate in the study from June 2023 to December 2023. Surveys were distributed to volunteers who met demographic criteria: age ≥ 18 years, ability to read and speak English and not legally blind. Patients completed an anonymous survey consisting of six questions that would assess physician attire based on level of knowledge, trustworthiness, caring, approachability, comfortability, and professionalism on a 10-point scale (1=somewhat to 10=extremely). Each photo set included a male and female in one of the following attire: white coat with either business casual attire (#1) or scrubs (#2), or fleece with either business casual attire (#3) or scrubs (#4). A one-way analysis of variance was performed to compare photos sets on variable scores; means ± standard deviations were calculated. P&lt;.05 was considered significant. Results: A total of 288 patients participated in the study. Photo sets #1 (8.2±2.1) and #3 (7.7±2.4) were significantly different for approachability compared to #2 (7.6±2.5) and #4 (7.6±2.5) (p=.007). Otherwise, photo set #1 was significantly different from all other photo sets in regards to knowledge (p=.0001), trustworthiness (p=.0005), caringness (p=.0003), comfortableness (p=.002), and professionalism (p=&lt;.0001). Conclusions: Patients prefer physicians to wear a white coat with business casual attire, based on all six of our study’s domains. Continuation of this study could look at variables of gender and race and the roles they play in patient preference for physician attire.

IMPACT OF CASHLESS PAYMENTS ON IMPULSE BUYING BEHAVIOUR OF GEN Z

This study investigates the effect of cashless payments on Generation Z's impulse buying behavior in Mumbai. With the growing ubiquity of digital payment methods, companies and governments must understand their impact on customer behaviour, particularly among young adults. The goal was to look at how the use of cashless payments influences impulse buying among Generation Z customers. The study included 122 individuals aged 16 to 26 years old, chosen using a stratified random selection procedure to guarantee representation across key demographic criteria such as gender and socioeconomic status. Data was gathered using structured surveys that focused on participants' use of digital payment methods and their proclivity for impulsive purchases. According to the findings, the ease and accessibility of cashless transactions have a substantial impact on Generation Z's willingness to make impulsive purchases. This study adds to the current literature by shedding light on the behavioral dynamics of young consumers in metropolitan settings in terms of digital payments and impulsive purchasing. The consequences include that firms and marketers should modify their tactics to fit Generation Z customers' tastes and behaviors affected by the proliferation of cashless payment technology in cities such as Mumbai.

Demographic Features of Ulcerative Gastroduodenal Bleeding

Background. Gastroduodenal bleeding (GDB) is a common cause of endoscopic examinations. This study aims to study demographic criteria in patients with ulcerative genesis GDB during primary endoscopic examinations in a single center. Materials and Methods. The diagnostic esophagogastroduodenoscopy (EGDS) of 231 patients with GDB of ulcerative etiology from January 2020 to December 2021 was analyzed, all patients were with primary EGDS. The study compared the activity of ulcerative bleeding, depending on gender and age groups. Results. The majority of patients with ulcerative GDCS were women – 57.7%. In both groups, duodenal ulcer was the predominant cause of GDB, 61.5% in women, and 54.2% in men. Active bleeding was observed in 8 (3.4%) patients. Among all women and men, Forrest-II bleeding was detected in 126 (93.4%) and 86 (89.6%) patients, respectively. In women and men, GDB is most common over the age of 50 (83.7% and 59.3%). Significant differences were observed, such as GDB occurs more often in men at the age of 41–50 years, whereas in women it occurs more often at the age of 51–60 years (p &lt; 0.05). Bleeding activity according to Forrest did not depend on gender (p &gt; 0.05). Conclusion. The risk of bleeding among both women and men is higher over the age of 50. At the same time, the activity of GDK does not depend on the gender and age of the patient.

Zero-shot learning to extract assessment criteria and medical services from the preventive healthcare guidelines using large language models.

The integration of these preventive guidelines with Electronic Health Records (EHRs) systems, coupled with the generation of personalized preventive care recommendations, holds significant potential for improving healthcare outcomes. Our study investigates the feasibility of using Large Language Models (LLMs) to automate the assessment criteria and risk factors from the guidelines for future analysis against medical records in EHR. We annotated the criteria, risk factors, and preventive medical services described in the adult guidelines published by United States Preventive Services Taskforce and evaluated 3 state-of-the-art LLMs on extracting information in these categories from the guidelines automatically. We included 24 guidelines in this study. The LLMs can automate the extraction of all criteria, risk factors, and medical services from 9 guidelines. All 3 LLMs perform well on extracting information regarding the demographic criteria or risk factors. Some LLMs perform better on extracting the social determinants of health, family history, and preventive counseling services than the others. While LLMs demonstrate the capability to handle lengthy preventive care guidelines, several challenges persist, including constraints related to the maximum length of input tokens and the tendency to generate content rather than adhering strictly to the original input. Moreover, the utilization of LLMs in real-world clinical settings necessitates careful ethical consideration. It is imperative that healthcare professionals meticulously validate the extracted information to mitigate biases, ensure completeness, and maintain accuracy. We developed a data structure to store the annotated preventive guidelines and make it publicly available. Employing state-of-the-art LLMs to extract preventive care criteria, risk factors, and preventive care services paves the way for the future integration of these guidelines into the EHR.

Public Attitudes, Interests, and Concerns Regarding Polygenic Embryo Screening

Polygenic embryo screening (PES) is a novel technology that estimates the likelihood of developing future conditions (eg, diabetes or depression) and traits (eg, height or cognitive ability) in human embryos, with the goal of selecting which embryos to use. Given its commercial availability and concerns raised by researchers, clinicians, bioethicists, and professional organizations, it is essential to inform key stakeholders and relevant policymakers about the public's perspectives on this technology. To survey US adults to examine general attitudes, interests, and concerns regarding PES use. For this survey study, data were collected from 1 stratified sample and 1 nonprobability sample (samples 1 and 2, respectively) between March and July 2023. The surveys measured approval, interest, and concerns regarding various applications of PES. In the second sample, presentation of a list of potential concerns was randomized (presented at survey onset vs survey end). The survey was designed using Qualtrics and distributed to participants through Prolific, an online sampling firm. Sample 1 was nationally representative with respect to gender, age, and race and ethnicity; sample 2 was recruited without specific demographic criteria. Analyses were conducted between March 2023 and February 2024. Participants reported their approval, interest, and concerns regarding various applications of PES and outcomes screened (eg, traits and conditions). Statistical analysis was conducted using independent samples t tests and repeated-measures analyses of variance. Of the 1435 respondents in sample 1, demographic data were available for 1427 (mean [SD] age, 45.8 [16.0] years; 724 women [50.7%]). Among these 1427 sample 1 respondents, 1027 (72.0%) expressed approval for PES and 1169 (81.9%) expressed some interest in using PES if already undergoing in vitro fertilization (IVF). Approval among these respondents for using PES for embryo selection was notably high for physical health conditions (1109 [77.7%]) and psychiatric health conditions (1028 [72.0%]). In contrast, there was minority approval for embryo selection based on PES for behavioral traits (514 [36.0%]) and physical traits (432 [30.3%]). Nevertheless, concerns about PES leading to false expectations and promoting eugenic practices were pronounced, with 787 of 1422 (55.3%) and 780 of 1423 (54.8%) respondents finding them very to extremely concerning, respectively. Sample 2 included 192 respondents (mean [SD] age 37.7 [12.2] years; 110 men [57.3%]). These respondents were presented concerns at survey onset (n = 95) vs survey end (n = 97), which was associated with less approval (28-percentage point decrease) and more uncertainty (24 percentage-point increase) but with only slightly higher disapproval (4 percentage-point increase). These findings suggest that it is critical for health care professionals and medical societies to consider and understand the perspectives of diverse stakeholders (eg, patients undergoing IVF, clinicians, and the general public), given the absence of regulation and the recent commercial availability of PES.

English proficiency of Japanese third-age learners: A Quantitative Inquiry

The EFL (English as a Foreign Language) participation and engagement of third-age learners, whose ages range from 50 up to 70 and above has received global attention. Japanese third-age learners' pursuit of English competence exhibits broader societal trends and personal desires for lifelong learning. Utilizing a descriptive-correlational approach, the study assessed the level of English language proficiency (ELP) of 59 Japanese third-age learners registered in the 2023-2024 EFL program in five cities of Aichi prefecture, Japan, when they were taken as a whole and when they were demographically grouped by sex, age, educational background, and weekly average study time. The results show that on average, third-age learners in Japan achieve an intermediate level of English proficiency or B1, with variances observed attributed to demographic criteria such as sex, age, educational background, and weekly English study time. The study found a significant relationship between ELP and the respondents’ demographic, indicating that ELP levels are influenced by sex, age, educational attainment, and the number of hours spent learning English per week, with males showing higher proficiency and older learners generally showing higher levels. The study underscores the need for tailored English language instruction for third-age learners, taking into account their specific demographics. It also considers the policy implications of institutionalizing programs for third-age learners in Japan, aiming to promote active aging, social integration, and overall well-being. Researchers, teachers, and curriculum designers may use this study as one of the bases for developing tailored curricula and instructional materials for third-age learners.

P097 Launching the Juvenile Idiopathic Arthritis VIP Research Panel - an innovative and unique way to engage with the Juvenile Idiopathic Arthritis community

Abstract Background/Aims The volume of survey-based research targeting families affected by Juvenile Idiopathic Arthritis (JIA) has been increasing, leading to respondent fatigue, reduced response rates, repetitive data collection, and consequential reduced robustness of data. In addition, poor quality surveys with no anticipated research outcomes of benefit to the community have further added to the burden on families. There is also increased interest in recruiting patient representatives to help shape and steer research through appropriate Patient and Public Engagement and Involvement (PPIE), but without a robust structure in place the numbers of families involved has been small and their representativeness questioned. This project improves research quality, accessibility for researchers to access motivated survey respondents, reduces the burden on participants, and provides a central solution for accessing JIA research participants. Methods Juvenile Arthritis Research is a charity in the UK, with considerable experience of developing research projects and engaging in PPIE activities, and a highly-engaged network of families affected by JIA. The charity launched the JIA VIP Research Panel in September 2023, inviting members of their network to join. Participants give fully informed consent upon sign-up, and provide demographic details. These are held securely and anonymously. New research, developed in-house or with academic, clinical or industry partners, is shared with the JIA VIP Research Panel. Participants are invited to complete surveys, knowing they have been quality assured and verified, and without the need to re-submit the same demographic data repeatedly over time. The Panel is also available for PPIE activities, with researchers able to access members of the Panel based on diagnosis, demographic or other criteria. Results Within 3 days of launch, over 100 families joined the JIA VIP Research Panel, with a representative spread of participants; recruitment is an ongoing and continuous process. Conclusion The JIA VIP Research Panel (www.jarproject.org/vip) is an innovative resource enabling faster, more flexible, and more efficient access to families with JIA in the UK both for survey-based research and involvement in PPIE. The Panel has begun to improve the quality of research, building upon previous success and continuing to develop high levels of engagement with participants. Disclosure R.P. Beesley: None. R.M. Beesley: None.

Earthquake Risk Assessment Using GIS-Based Analytical Hierarchy Process (AHP): The Case of Bitlis Province (Türkiye)

The risk level of natural disasters such as earthquakes depends on many factors. Some of these are direct hazards, while others are vulnerability factors that increase the risk. In this regard, risk assessment should be performed by evaluating the hazard and vulnerability factors together. The Analytical Hierarchy Process (AHP) is a powerful tool for co-evaluating such multiple decision criteria. The spatial visualization of the results facilitates the direct assessment of risks as well. In the present study, the seismic risk assessment of the Bitlis province in Eastern Anatolia, which has a high seismic risk, was performed by using the GIS-based AHP method. Among many criteria, six effective criteria on earthquake risk such as seismicity, demographic and topographic criteria were taken into consideration based on expert decision makers. It is concluded that the results obtained from the study were quite successful in terms of determining the seismic risks of the study area. Accordingly, while the risks are high in densely populated settlements with high peak ground acceleration (PGA), the risk decreases according to soil and land use.