Inform Decision Makers Research Articles

Validation of the P-POSSUM score in predicting outcomes in emergency craniotomy: A prospective observational study

Background: The Portsmouth physiological and operative severity score for the enumeration of mortality and morbidity (P-POSSUM) is an established tool for predicting surgical outcomes. However, its applicability and accuracy in predicting post-operative mortality in patients undergoing emergency craniotomy require further validation. Aims and Objectives: This study aims to validate the accuracy of the P-POSSUM score in predicting post-operative mortality in patients undergoing emergency craniotomy. Materials and Methods: A prospective observational study was conducted over 2 years (June 2022–May 2024) at Maharani Laxmi Bai Medical College, Jhansi. Patients undergoing emergency craniotomy were included in the study. Data were collected on pre-operative physiological parameters and intraoperative variables to calculate the P-POSSUM score. The primary outcome was post-operative mortality within 30 days. Statistical analysis involved receiver operating characteristic curve analysis and the Hosmer-Lemeshow test to assess the predictive accuracy and calibration of the P-POSSUM score. Results: A total of 200 patients were included in the study. The mean age was 53±17 years; 113 were male and 87 were female. The P-POSSUM score demonstrated good predictive accuracy for post-operative mortality with an area under the ROC curve of 0.85 (95% CI: 0.79–0.91). Calibration analysis using the Hosmer–Lemeshow test showed good calibration (P=0.23). Observed mortality was 56 (28%) compared to an expected 61, resulting in an observed-to-expected mortality ratio of 0.92. Conclusion: The P-POSSUM score is a reliable and accurate tool for predicting post-operative mortality in patients undergoing emergency craniotomy. Its integration into clinical practice can enhance risk stratification and inform clinical decision-making. Further studies with larger cohorts and diverse populations are warranted to generalize these findings.

NO2 mapping of Perth bushfire utilizing Sentinel-5P TROPOMI

Abstract In the face of escalating environmental concerns, effective management of air quality remains critical. This study focuses on Perth, Australia, a region impacted by frequent bushfires and industrial emissions, necessitating precise monitoring of atmospheric pollutants like NO2. Leveraging advanced remote sensing technologies, including Sentinel-2 and Sentinel-5P satellites, this research assesses the spatial and temporal dynamics of NO2 before, during, and after the 2021 Wooroloo bushfire. A key objective was to convert satellite-derived NO2 data from mol/m2 to μg/m3 to enable accurate environmental assessment. This conversion utilized a unit conversion method, improving accuracy metrics substantially, with a correlation coefficient (r) increasing from 0.59 to 0.82 and root mean square error (RMSE) decreasing from 7.58 μg/m3 to 3.20 μg/m3. A regression model, validated with ground-level measurements, demonstrates robust predictive capability (R2 = 0.76, RMSE = 2.58 μg/m3), aiding in the creation of NO2 distribution maps across Greater Perth. Comparison with six ground stations revealed varying accuracy (RMSE: 2.9249 to 7.2705 μg/m3), likely influenced by proximity to the fire and prevailing wind directions. Spatiotemporal analysis depicted distinct NO2 patterns: stable levels pre-fire, dramatic increases during, and gradual post-fire recovery. Maximum NO2 concentrations peaked during the fire (up to 79.227 μg/m3), exceeding air quality guidelines. Post-fire, concentrations normalized, yet sporadic peaks persisted, indicating an ongoing environmental impact. Furthermore, analysis of environmental parameters such as Land Surface Temperature (LST), precipitation, and Normalized Difference Vegetation Index (NDVI) during the study period revealed significant correlations with NO2 levels. LST showed a positive correlation (r = 0.64) with NO2 concentrations during the fire, suggesting temperature influences on atmospheric stability and pollutant dispersion. Precipitation exhibited a negative correlation (r = −0.52), indicating its role in scavenging NO2 from the atmosphere post-fire. NDVI displayed a weak negative correlation (r = −0.30), reflecting vegetation recovery trends post-fire. This comprehensive study integrates advanced remote sensing with statistical modelling to enhance air quality monitoring and inform decision-making in bushfire-prone regions. By elucidating NO2 dynamics and their environmental implications, this research contributes essential insights for mitigating air pollution and safeguarding public health amidst climate-induced challenges.

Empowering Palliative Wound Care in Long-Term Care Facilities: A Comprehensive Nursing Competency for Palliative Wound Care

Purpose: The importance of wound care as a part of end-of-life care is rising due to aging populations and increased chronic disease prevalence. This study developed a comprehensive competency framework on palliative wound care for nursing staff within long-term care facilities (LTCFs). Methods: The study utilized a three-phased exploratory methods approach involving topic modeling, expert interviews, and a Delphi survey. Results: Four key competencies emerged regarding nursing competency for palliative wound care in LTCFs: (1) building partnerships with patients and caregivers, (2) an individual approach to wound treatment based on understanding the patient's situation, (3) a holistic approach through shared information and cooperative decision-making, and (4) integration of wound management knowledge within end-of-life care. Conclusion: This framework supports developing targeted training programs for nurses to improve the quality of life for terminally ill patients in LTCFs.

Service quality management under risk prioritization and imprecise information: a hybrid fuzzy approach

PurposeConventional risk prioritization methods rely on crisp inputs but struggle with imprecise data and hesitancy, resulting in inaccurate assessments that affect service and information quality and performance monitoring. This study proposes a fuzzy data-driven risk prioritization model for service quality under imprecise information.Design/methodology/approachEnterprise risk management is crucial for service quality management, ensuring effective identification, assessment and mitigation of risks impacting service delivery and customer satisfaction. This paper proposes a fuzzy data-driven multi-criteria model for risk prioritization involving multiple decision-makers. It introduces a hybrid method combining intuitionistic and hesitant fuzzy group decision-making to assess better and prioritize risks based on decision-maker preferences.FindingsThe proposed hybrid fuzzy model improves service quality in business operations by efficiently representing uncertain information in traditional frameworks. It helps identify potential risks in advance and enhances control over business operations, enabling organizations to benchmark service quality and identify best practices. Accordingly, organizations acquire information and background knowledge to benchmark their service quality. This, in turn, improves service quality under performance management.Research limitations/implicationsDespite the advantages of fuzzy models in risk prioritization, such as mimicking human reasoning more accurately, their complexity can hinder adoption. The intricate computational steps may deter shop-floor managers who prefer the more straightforward conventional crisp RPN approach, which is easier to understand and implement. However, while developing a hybrid fuzzy risk prioritization model may require more effort, its benefits become apparent over time. Once developed, the model can be integrated into software applications, allowing decision-makers to use it easily. This integration simplifies fuzzy computations and enhances risk prioritization, leading to more informed decision-making and improved risk management in the long term.Practical implicationsThe proposed robust fuzzy framework improves risk management by integrating uncertain information and multiple decision-makers expertise, leading to more reliable outputs that enhance strategic decisions and operational efficiency.Originality/valueWe validate the proposed approach at an integrated steel plant’s risk management process, covering broad areas of the service quality domain. To the best of our knowledge, no study exists in existing literature attempting to explore the efficacy of the proposed hybrid fuzzy approach in risk management practices at prime sectors like steel. The study’s novelty is backed by this validation experiment, which indicates that the effectiveness of the results obtained from the proposed multi-attribute hybrid fuzzy methodology is more practical. The model’s outcome substantially adds value to the current risk assessment and prioritization literature that significantly affects service quality.

Preoperative anorectal manometry as a predictor of function after ileal pouch anal anastomosis: a systematic review and meta-analysis.

Since the ileal pouch anal anastomosis (IPAA) was first described, anorectal manometry (ARM) has been used to study its physiology and function. Few studies have investigated if preoperative ARM can predict pouch function. Pubmed, EMBASE, and the Cochrane Library databases were systematically searched. Papers detailing preoperative ARM results and postoperative functional outcomes of patients with IPAA were included. Meta-analysis with meta-regression was performed, assessing the relationship between preoperative manometric results and objective postoperative functional outcomes including frequency, seepage, pad usage and medications, and functional scoring systems including Wexner Incontinence and Oresland Scores. Results from 31 studies were analysed. Mean resting pressure (MRP) decreased significantly (- 23.16mmHg, 95%CI - 27.98 to - 18.35, p < 0.01) after pouch formation but before ileostomy reversal, with subsequent minor increase (3.51mmHg, 95%CI 0.93 to 6.09, p = 0.01) by 6months after reversal of ileostomy. Pooled bowel frequency was 5.4 per 24h (4.90-5.91), day and night-time soiling, incontinence, and pad usage rates were 16% (9-24%), 26% (19-33%), 12% (4-20%), and 21% (13-30%) respectively. Pooled Oresland and Wexner Scores were 3.81 (2.92-4.70) and 3.45 (2.71-4.19). A significant association between preoperative MRP and Wexner Score was observed (p < 0.001). As a result of risk of bias, study heterogeneity, and variation in manometry systems, certainty of evidence was low or very low. Preoperative predictors of function inform patient and clinician decision-making. Further investigations into the association between preoperative MRP and Wexner Score using modern ARM techniques are warranted.

Economic Values for Coral Reef Conservation and Restoration in Florida

Florida’s coral reef is the third-largest barrier reef system in the world and provides valuable ecosystem services, such as recreation and tourism, erosion protection, and other services. Florida’s reefs have been declining due to impacts from climate change, pollution, and other pressures. In response, various conservation strategies have been implemented, including education and outreach, growing corals in nurseries and transplanting them to degraded reef sites, and deploying artificial reefs. However, few studies have estimated an explicit value for different strategies to attain conservation goals. Understanding economic values for reef restoration and enhancement is needed to help inform decision-making and support marine policy. This study conducted a stated preference choice experiment survey to examine the way U.S. residents make economic trade-offs among different restoration strategies, including increasing coral cover, deploying artificial reefs, and limiting visitor access to reef sites. The results suggest that, on average, the economic value of increasing coral cover is about twice as high as the value of increasing the number of artificial reef sites. Economic values for reducing visitation were similar to values for increasing the number of artificial reefs. These results provide essential information to policy analysts concerning reef use, reef importance, and economic values for reef restoration.

The Influence of Realism on the Sense of Presence in Virtual Reality: Neurophysiological Insights Using EEG

One of the most crucial aspects of the user experience in virtual reality (VR) is the sense of presence. To evaluate this, both subjective and objective methods can be employed. While subjective methods are easy to implement and interpret, they may not fully capture user feedback, and the results can sometimes lack consistency. In contrast, using objective methods, such as electroencephalography (EEG), can provide more reliable insights. To investigate the influence of realism on the sense of presence, we conducted an EEG study with 21 participants who experienced two VR environments—one realistic and one non-realistic. During the study, we continuously measured their brain activity using an EEG device. Our findings showed that alteration in the level of realism in an environment can be detected through changes in brain activity. Notably, we observed that users take longer to adapt to a non-realistic environment when transitioning from a realistic scene, compared to the reverse. Although our study has limitations, such as the total number of participants, we gained valuable initial insights into how realism may influence brain activity. These findings suggest that higher realism may lead to reduced cognitive load, increased attention, improved decision-making, and suppression of irrelevant information.

Exploring outsourcing dynamics: a comprehensive bibliometric analysis of emerging markets

PurposeThis research aims to enhance understanding of outsourcing dynamics from emerging markets by employing a bibliometric analysis of relevant scholarly articles. The study explores publication patterns, citation networks, author collaborations and contributions by different countries, offering insights for researchers and practitioners investigating outsourcing in these markets.Design/methodology/approachA comprehensive bibliometric analysis was conducted using 197 articles from the SCOPUS database, spanning January 1999 to June 2023. Established bibliometric techniques were utilized to analyze publication patterns, citation networks, author collaborations and country contributions, identifying key research themes and influential authors and institutions.FindingsThe study identified eight distinct research clusters, highlighting interdisciplinary collaborations, influential authors like Thomas Frisanco and Erdener Kaynak, and significant contributions from the United States and the UK. Notable organizational collaborations include the Hong Kong Polytechnic University and the University of Miami. These findings provide valuable insights into outsourcing practices and research trends in emerging markets.Research limitations/implicationsThe study acknowledges limitations such as sampling bias, language bias and publication bias, which may affect the generalizability of the findings. Future research should strive for more diverse and representative samples, including non-English publications and studies with non-significant results, to provide a more comprehensive understanding of outsourcing dynamics.Practical implicationsThe findings offer practical insights for organizations considering outsourcing from emerging markets, guiding strategic decision-making and policy development. Understanding publication patterns and research themes can help organizations navigate location selection, vendor management, risk mitigation and performance evaluation in these markets.Social implicationsOutsourcing can significantly impact employment, income generation, skill development and overall economic development in emerging markets. Policymakers can use these insights to foster business growth, infrastructure development and investment incentives, contributing to economic growth and employment opportunities.Originality/valueThis study provides a comprehensive bibliometric analysis of outsourcing from emerging markets, filling a gap in the existing literature. The insights gained can guide future research, inform strategic decision-making and enhance the understanding of outsourcing dynamics in these rapidly evolving markets.

Perceptions of Relationships with Kinship Caregivers Among Parents Following State-Detected Psychoactive Substance Use

SYNOPSIS Objective. This study sought to better understand parent relationships with kinship caregivers, with an eye toward parents’ perceptions of how kinship caregiver mindsets and behaviors surrounding substance use may have impacted parents. Design. Data came from transcripts of in-depth, semi-structured interviews with 16 parents in the United States, who had substantiated child welfare cases related to substance use. Transcripts were dual-coded, and analysis was guided by the reflexive thematic analysis framework. Results. Parents described two different experiences with kinship caregivers. For some families, parents reported fragmentation of their support system; parents described caregivers as undermining their parental authority, disrupting attachment bonds, and communicating with children in ways that perpetuated stigma around substance use. Other parents reported increased cohesion among family members; parents described caregivers as supportive and empowering, particularly as they navigated mandated “recovery.” Conclusions. Findings offer insights to help inform decision-making by both practitioners and policymakers by giving a voice to parents as they navigate the complex systems of child welfare services and drug court programming.

Abstract B036: Pathway repression in progression on osimertinib therapy in NSCLC via a comprehensive genomic and epigenomic circulating tumor DNA (ctDNA) assay

Abstract Background: Osimertinib is currently the most common precision therapy for patients with non- small cell lung cancer (NSCLC) with EGFR mutations. While it prolongs progression-free survival, resistance eventually develops in many, leading to disease progression. Somatic NGS has identified resistance mutations in the EGFR pathway and other oncogenes, but these account for only 40-45% of cases, suggesting non-genetic factors, such as epigenetic changes, may be involved. This study investigates the epigenetic landscape at diagnosis and progression on first- line osimertinib, focusing on cases with and without canonical resistance mutations. Methods: We defined two cohorts from GuardantINFORM, a clinico-genomics database, restricting to only patients with a test on the Guardant Infinity platform, a comprehensive blood-based NGS assay, that analyzes DNA sequence variants and performs extensive methylation profiling (∼15Mb) in &amp;gt;20,000 differentially methylated regions (DMRs) assessed for sample-specific methylation patterns. (A) Diagnosis Cohort: Comprised of 34 NSCLC patients with blood samples collected within six days prior to the initiation of first-line osimertinib therapy. (B) Progression Cohort: Comprised of 36 patients who were on first-line osimertinib therapy, with blood samples collected within 60 days of discontinuation. The progression cohort was further stratified based on the presence or absence of known resistance mutations identified through somatic variant analysis by Guardant360. Gene set enrichment analysis was conducted on these methylation profiles using the Reactome database to define pathway-level differences between the cohorts. Results: Pathway enrichment analysis in the diagnosis and progression cohorts found expected biological processes in NSCLC such as extracellular matrix organization, G- protein coupled receptor (GPCR) signaling, and FGFR pathways. Additionally, the progression cohort lacking canonical resistance mutations (n=23) exhibited unique enrichment in two specific pathways: Glucose-dependent Insulinotropic Polypeptide and Physiological Factors. These pathways include genes such as GATA4, which has been implicated in the epithelial- mesenchymal transition (EMT)—a process associated with transforming to a small cell phenotype, a known mechanism of resistance to EGFR inhibition, including osimertinib. Conclusion: This study demonstrates the utility of epigenetic profiling via liquid biopsies in uncovering non-genetic mechanisms underlying osimertinib resistance in advanced NSCLC. Identification of unique epigenetic pathways in progressing patients without canonical resistance mutations highlights the potential for discovering novel biomarkers of resistance. Further investigation into these findings may advance our understanding of resistance mechanisms across various cancer therapies, particularly for patients without identified genomic resistance, and inform clinical decision-making and trial design. Citation Format: Aaron Hardin, Leslie Bucheit, Amar Das, Craig Eagel, Helmy Eltoukhy. Pathway repression in progression on osimertinib therapy in NSCLC via a comprehensive genomic and epigenomic circulating tumor DNA (ctDNA) assay [abstract]. In: Proceedings of the AACR Special Conference: Liquid Biopsy: From Discovery to Clinical Implementation; 2024 Nov 13-16; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2024;30(21_Suppl):Abstract nr B036.

2018-2019 human seasonal H3N2 influenza A virus spillovers into swine with demonstrated virus transmission in pigs were not sustained in the pig population.

Human seasonal H3 clade 3C3a influenza A viruses (IAV) were detected four times in U.S. pigs from commercial swine farms in Michigan, Illinois, and Virginia in 2019. To evaluate the relative risk of this spillover to the pig population, whole genome sequencing and phylogenetic characterization were conducted, and the results revealed that all eight viral gene segments were closely related to 2018-2019 H3N2 human seasonal IAV. Next, a series of in vitro viral kinetics, receptor binding, and antigenic characterization studies were performed using a representative A/swine/Virginia/A02478738/2018(H3N2) (SW/VA/19) isolate. Viral replication kinetic studies of SW/VA/19 demonstrated less efficient replication curves than all 10 swine H3N2 viruses tested but higher than three human H3N2 strains. Serial passaging experiments of SW/VA/19 in swine cells did not increase virus replication, but changes at HA amino acid positions 9 and 159 occurred. In swine transmission studies, wild-type SW/VA/19 was shed in nasal secretions and transmitted to all indirect contact pigs, whereas the human seasonal strain A/Switzerland/9715293/2013(H3N2) from the same 3C3a clade failed to transmit. SW/VA/19 induced minimal macroscopic and microscopic lung lesions. Collectively, these findings demonstrate that these human seasonal H3N2 3C3a-like viruses did not require reassortment with endemic swine IAV gene segments for virus shedding and transmission in pigs. Limited detections in the U.S. pig population in the subsequent period of time suggest a yet-unknown restriction factor likely limiting the spread of these viruses in the U.S. pig population.IMPORTANCEInterspecies human-to-swine IAV transmission occurs globally and contributes to increased IAV diversity in pig populations. We present data that a swine isolate from a 2018-2019 human-to-swine transmission event was shed for multiple days in challenged and contact pigs. By characterizing this introduction through bioinformatic, molecular, and animal experimental approaches, these findings better inform animal health practices and vaccine decision-making. Since wholly human seasonal H3N2 viruses in the United States were not previously identified as being transmissible in pigs (i.e., reverse zoonosis), these findings reveal that the interspecies barriers for transmission to pigs may not require significant changes to all human seasonal H3N2, although additional changes may be required for sustained transmission in swine populations.

Medical and Engineering Applications for Estimation and Prediction of a New Competing Risks Model: A Bayesian Approach

The Bayesian approach offers a flexible, interpretable and powerful framework for statistical analysis, making it a valuable tool to help in making optimal decisions under uncertainty. It incorporates prior knowledge or beliefs about the parameters, which can lead to more accurate and informative results. Also, it offers credible intervals as a measure of uncertainty, which are often more interpretable than confidence intervals. Hence, the Bayesian approach is utilized to estimate the parameters, reliability function, hazard rate function and reversed hazard rate function of a new competing risks model. A squared error loss function as a symmetric loss function and a linear exponential loss function as an asymmetric loss function are employed to derive the Bayesian estimators. Credible intervals of the parameters, reliability function, hazard rate function and reversed hazard rate function are obtained. Predicting future observations is important in many fields, from finance and weather forecasting to healthcare and engineering. Thus, two-sample prediction (as a special case of the multi-sample prediction) for future observation is considered. An adaptive Metropolis algorithm is applied to conduct a simulation study to evaluate the performance of the Bayes estimates and predictors. Moreover, two applications of medical and engineering data sets are used to test and validate the theoretical results, ensuring that they are accurate, applicable to real-world scenarios and contribute to the understanding of the world and inform decision-making.

Sleep Management: The Use of Continuous Physiological Monitoring to Support Patient Self-Care

Circadian misalignment (CM) is a sleep disruption where an individual’s circadian rhythm and actual sleep-wake cycle are unsynchronized. CM is frequently misdiagnosed and difficult to treat but can adversely impact short-term and long-term health outcomes. CM often interacts bidirectionally with chronic conditions affecting cognitive and physical functionality. Continuous physiological monitoring (CPM) of the hormone melatonin would support real-time, patient-driven interventions to address CM. However, patient-driven self-care tasks involve complex information processing and decision-making. Effective CPM use requires situation awareness regarding current circadian health and projected future status, sufficient background knowledge to identify circadian intervention alternatives, and selection of appropriate alternatives given their current state. Melatonin data has characteristics distinct from biomarkers previously subject to CPM, introducing further challenges around data presentation. Task analysis efforts can identify the cognitive processes involved in five different tasks associated with a continuous melatonin monitor to identify necessary informational elements to include in interface design.

The global health and economic burden of chikungunya from 2011 to 2020: a model-driven analysis on the impact of an emerging vector-borne disease

IntroductionChikungunya is a mosquito-borne arboviral disease posing an emerging global public health threat. Understanding the global burden of chikungunya is critical for designing effective prevention and control strategies. However, current...

Patient-reported outcome and preference after craniotomy and laser interstitial thermal therapy ablation: a pilot study.

Laser interstitial thermal therapy (LITT) is a minimally invasive procedure that allows cytoreduction of brain tumors and can be considered as an alternative to craniotomy. The authors surveyed 27 patients who underwent both craniotomy and LITT during distinct stages of their oncology journey to assess patient-reported outcomes comparing both procedures. A 9-question survey was developed and validated to assess patient-reported postoperative recovery, pain level, narcotic use, and procedure preference. The survey was administered to patients with WHO grade II-IV gliomas who underwent both craniotomy and LITT. The survey was reviewed by independent surgeons, patient advocates, and patients for face validity and showed > 90% intrarater agreement over time. The cohort had a mean age of 57 ± 12 years, and 78% had glioblastoma. There was no significant difference in symptomatic improvement postcraniotomy or post-LITT (30% vs 4%, p = 0.17). Similarly, no significance was detected in patient-reported recovery time from craniotomy (time required to return to preoperative state: mean 4.3 ± 9.1 weeks, median 2 weeks) or LITT (mean 2 ± 2.3 weeks, median 1 week; p = 0.21). Notably, postsurgical pain (0-10 on the visual analog scale) and need for narcotic use in the first week (yes/no) after the procedure were significantly lower post-LITT (average visual analog scale score 1.7 vs 5 points, narcotic use 4% vs 81%; p < 0.0001 for both comparisons). When asked which procedure they would choose-having experienced both craniotomy and LITT-surveyed patients overwhelmingly chose LITT over craniotomy (89% vs 11%, p < 0.0001). Of note, the patients who preferred craniotomy experienced improved neurological function postcraniotomy or suffered new deficits post-LITT. In this pilot study, patients reported less pain and narcotic use post-LITT relative to craniotomy and generally preferred the former procedure if given the choice. Validation of these results in future studies can help inform decision-making in clinical scenarios where there is equipoise between LITT and craniotomy.

Ancient Indian epistemology and modern cognitive science: Exploring vedic insights in contemporary thought processes

Background: This article explores the connections between the concept of anviksiki in Hindu philosophy and theories in cognitive science, and how these principles can be applied in modern education. Anviksiki, which focuses on critical thinking and deep reflection, is considered to have strong relevance to cognitive science concepts such as information processing, perception, and decision-making. Methods: The method used in this research is literature study and comparative analysis, by reviewing various literatures that discuss Hindu philosophy and cognitive science in depth. The analysis shows that anviksiki can provide an additional perspective in understanding how humans think and process information, especially in the context of moral and ethical reflection. Finding: In education, the principle of anviksiki that emphasises self-reflection and critical thinking can enrich students' learning process. This concept supports active learning methods that allow students to construct their own understanding, in a way that is in line with Piaget's theory of constructivism. In addition, cognitive science provides practical insights into information processing and memory, which can be used to design more effective teaching strategies. Conclusion: The conclusion of this study confirms that anviksiki can be integrated with cognitive science to create a holistic approach to education, which enriches intellectual, ethical and reflective aspects. By combining Hindu wisdom and cognitive science insights, education can support the development of balanced individuals, who are able to think critically and understand the moral consequences of their decisions. This research reveals that Anviksiki, as a philosophy of critical thinking in the Hindu tradition, has strong relevance to concepts in modern cognitive science, particularly in analytic approaches, logic, and deductive methods. Thus, the heritage of Hindu thought not only demonstrates traditional wisdom but also presents a philosophical foundation that supports contemporary cognitive exploration. Novelty/Originality of this article: This research offers a new perspective by bridging the ancient philosophy of Anviksiki with modern cognitive science, demonstrating the continuity of concepts in the critical thinking process involving logical analysis and deductive methods. It provides new insights in understanding the contribution of the Hindu tradition of thought to the development of cognitive theory today.

Особенности когнитивных процессов поколений: X, Y, Z, Alpha

The article focuses on the changes in cognitive processes among different generations – X, Y, Z, and Alpha – taking into account sociocultural and technological transformations. Key traits of each generation are examined, including technological literacy, cognitive flexibility, multitasking abilities, and preferences in learning and communication. The article emphasizes the importance of understanding these features for adapting educational and social practices, as well as for developing more effective strategies for interacting with different generations in society. The investigation of cognitive processes across generations represents a significant aspect of understanding the evolution of human thought and interaction in the modern world. This study analyzes the differences in cognitive processes among generations, including information perception, memory, attention, and decision-making. Particular attention is given to the influence of digital technologies on thinking and communication. The article discusses the challenges of adapting educational programs to meet the needs of new generations and offers recommendations to enhance the effectiveness of learning. Additionally, the prospects for further research in the context of technological progress and sociocultural changes are outlined.

Development of Internet of Things and Artificial Intelligence for intelligent sanitation systems: A literature review

Adequate sanitation is crucial for human health and well-being, yet billions worldwide lack access to basic facilities. This comprehensive review examines the emerging field of intelligent sanitation systems, which leverage Internet of Things (IoT) and advanced Artificial Intelligence (AI) technologies to address global sanitation challenges. The existing intelligent sanitation systems and applications is still in their early stages, marked by inconsistencies and gaps. The paper consolidates fragmented research from both academic and industrial perspectives based on PRISMA protocol, exploring the historical development, current state, and future potential of intelligent sanitation solutions. The assessment of existing intelligent sanitation systems focuses on system detection, health monitoring, and AI enhancement. The paper examines how IoT-enabled data collection and AI-driven analytics can optimize sanitation facility performance, predict system failures, detect health risks, and inform decision-making for sanitation improvements. By synthesizing existing research, identifying knowledge gaps, and discussing opportunities and challenges, this review provides valuable insights for practitioners, academics, engineers, policymakers, and other stakeholders. It offers a foundation for understanding how advanced IoT and AI techniques can enhance the efficiency, sustainability, and safety of the sanitation industry.

Modelling Of The Weed Invasion And Control Strategies For Mesquite Plants

The new study presents an innovative model for examining the spread of the mesquite species, which is well-known for its extensive presence around the world thanks to water dispersion in various areas. The goal is to assess the stability of the system locally and globally using epidemiological modeling techniques. The approach involved analyzing the basic reproduction number (R₀) using the next-generation matrix to find the coefficients for the Lyapunov function. The results indicated that, the absence of mesquite remains stable on both local and global scale when R₀ is less than 1, but when R₀ exceeds 1, an endemic equilibrium is observed. Numerical simulations using Runge Kutta ode45 algorithm implemented in MATLAB. The study demonstrated that, an increase in the number of water bodies flowing on land, leads to a faster spread and invasion of mesquite. The study suggests the use of this model in areas where the mesquite species is native to raise awareness, inform decision-making, and educate communities, ultimately aiding efforts to manage and eliminate the species.

Torsemide versus furosemide in patients with heart failure: a systematic review and meta-analysis

Abstract Introduction Loop diuretics are essential agents in the management of fluid overload conditions, heart failure and renal dysfunction. Despite their widespread use, there is ongoing debate regarding the relative efficacy, safety, and clinical outcomes associated with furosemide and torsemide. By systematically analyzing existing literature, this study seeks to provide a comprehensive evaluation of the comparative effectiveness and safety profiles of these two medications , Helping to inform clinical decision-making and contribute to the optimization of diuretic therapy in patients with heart and kidney diseases. Methods We searched PubMed, Scopus, WOS, and Cochrane until February 2024 for relevant studies comparing the torsemide and furosemide in Heart failure patients. Outcomes of interest were all-cause mortality, cardiovascular mortality, all-cause hospitalization, hospitalization for HF, and improvement of ≥ 1 in NYHA functional class. Results 16 studies were included in this meta-analysis with a total of 12545 patients, There were no significant results between the two drugs in all-cause mortality, cardiovascular mortality or all-cause hospitalization, torsemide showed a reduction in hospitalization from heart failure (RR 0.85, 95% CI [0.71 to 1.02]), torsemide showed a significant improvement of ≥ 1 in NYHA functional class (OR 1.60, 95% CI [1.18, 2.17]). Conclusion There was no difference between torsemide and furosemide when it comes to all-cause and cardiovascular mortality, but torsemide showed better results in reducing hospitalization rates and and improving quality of life.Hospitalization from heart failureImprovement ≥ 1 in NYHA class