Present Data Research Articles

Post-Neutron Mass Yield Distribution in the Epi-Cadmium Neutron-Induced Fission of 235U

Cumulative and independent yields of various fission products within the mass ranges of 78 to 117 and 123 to 155 have been measured in the epi-cadmium reactor neutron-induced fission of 235U by using an off-line gamma-ray spectrometric technique. The average neutron energy <En> of the epi-cadmium reactor spectrum is 1.9 MeV. From the cumulative yields, post-neutron mass chain yields were obtained by applying the charge distribution correction. In the mass yield distribution, values of the full-width at tenth-maximum of light and heavy mass wings, average light mass <AL> and heavy mass <AH>, and average number of neutrons <ν> were obtained. The peak-to-valley ratio in the epi-cadmium neutron-induced fission of 235U was obtained for the first time. The present data in the 235U(n,f) reaction were compared with the literature data in the 235U(nth,f) reaction to examine the role of excitation energy on the mass yield distribution parameters and nuclear structure effect. The role of the standard I and standard II asymmetric modes of fission was also discussed.

Saturated/subcooled flow boiling heat transfer characteristics for R134a, HFE-7100 and Deionized water inside micro/mini-channels: Part Ⅱ – New CHF prediction model establishment

A new flow pattern map has been developed and presented in Part Ⅰ of this paper for R134a, HFE-7100 and Deionized water inside micro/mini-channels. To further explain the phenomenon and understand the mechanism of triggering critical heat flux (CHF), the theoretical model to predict the CHF of saturated/subcooled flow boiling inside the micro/mini-channels is proposed based on the liquid layer dry-out and Helmholtz instability (intermittent and continuous vapor blanket) theories. Both the effect of the dry-out flows and the liquid sublayer under the vapor blanket were taken into consideration. For saturated and subcooled boiling, the two mechanisms of triggering the CHF were revealed based on different flow patterns and experimental phenomena, respectively. The boiling heat transfer performance has been experimentally investigated under different liquid subcoolings, mass fluxes and geometry parameters. By analyzing the previous models and establishing a database, the comparison of new model predictions with present experimental data shows good agreement within a standard deviation of ± 10 %. Besides, prior CHF data were used to verify this new model, which also presents varying degrees of success in predicting the CHF.

Metastable water at several compression rates and its freezing kinetics into ice VII

Water can be dynamically over-compressed well into the stability field of ice VII. Whether water then transforms into ice VII, vitreous ice or a metastable novel crystalline phase remained uncertain. We report here the freezing of over-compressed water to ice VII by time-resolved X-ray diffraction. Quasi-isothermal dynamic compression paths are achieved using a dynamic-piezo-Diamond-Anvil-Cell, with programmable pressure rise time from 0.1 ms to 100 ms. By combining the present data set with those obtained on various ns-dynamical platforms, a complete evolution of the solidification pressure of metastable water versus the compression rate is rationalized within the classical nucleation theory framework. Also, when crystallization into ice VII occurs in between 1.6 GPa and 2.0 GPa, that is in the stability field of ice VI, a structural evolution over few ms is then observed into a mixture of ice VI and ice VII that seems to resolve apparent contradictions between previous results.

Pharmacological inhibition of the CB1 cannabinoid receptor restores abnormal brain mitochondrial CB1 receptor expression and rescues bioenergetic and cognitive defects in a female mouse model of Rett syndrome

BackgroundDefective mitochondria and aberrant brain mitochondrial bioenergetics are consistent features in syndromic intellectual disability disorders, such as Rett syndrome (RTT), a rare neurologic disorder that severely affects mainly females carrying mutations in the X-linked MECP2 gene. A pool of CB1 cannabinoid receptors (CB1R), the primary receptor subtype of the endocannabinoid system in the brain, is located on brain mitochondrial membranes (mtCB1R), where it can locally regulate energy production, synaptic transmission and memory abilities through the inhibition of the intra-mitochondrial protein kinase A (mtPKA). In the present study, we asked whether an overactive mtCB1R-mtPKA signaling might underlie the brain mitochondrial alterations in RTT and whether its modulation by systemic administration of the CB1R inverse agonist rimonabant might improve bioenergetics and cognitive defects in mice modeling RTT.MethodsRimonabant (0.3 mg/kg/day, intraperitoneal injections) was administered daily to symptomatic female mice carrying a truncating mutation of the Mecp2 gene and its effects on brain mitochondria functionality, systemic oxidative status, and memory function were assessed.ResultsmtCB1R is overexpressed in the RTT mouse brain. Subchronic treatment with rimonabant normalizes mtCB1R expression in RTT mouse brains, boosts mtPKA signaling, and restores the defective brain mitochondrial bioenergetics, abnormal peripheral redox homeostasis, and impaired cognitive abilities in RTT mice.LimitationsThe lack of selectivity of the rimonabant treatment towards mtCB1R does not allow us to exclude that the beneficial effects exerted by the treatment in the RTT mouse model may be ascribed more broadly to the modulation of CB1R activity and distribution among intracellular compartments, rather than to a selective effect on mtCB1R-mediated signaling. The low sample size of few experiments is a further limitation that has been addressed replicating the main findings under different experimental conditions.ConclusionsThe present data identify mtCB1R overexpression as a novel molecular alteration in the RTT mouse brain that may underlie defective brain mitochondrial bioenergetics and cognitive dysfunction.

Endophytic Bacteria and Fungi Associated with Polygonum cuspidatum in the Russian Far East.

Polygonum cuspidatum, alternatively known as Fallopia japonica or Reynoutria japonica, is a perennial herb belonging to the Polygonaceae family. Commonly called Japanese knotweed or Asian knotweed, this plant is native to East Asia, particularly in regions such as Korea, China, and Japan. It has successfully adapted to a wide range of habitats, resulting in it being listed as a pest and invasive species in several countries in North America and Europe. This study focuses on analysing the composition of the bacterial and fungal endophytic communities associated with Japanese knotweed growing in the Russian Far East, employing next-generation sequencing (NGS) and a cultivation-based method (microbiological sowing). The NGS analysis showed that the dominant classes of endophytic bacteria were Alphaproteobacteria (28%) and Gammaproteobacteria (28%), Actinobacteria (20%), Bacteroidia (15%), and Bacilli (4%), and fungal classes were Agaricomycetes (40%), Dothideomycetes (24%), Leotiomycetes (10%), Tremellomycetes (9%), Pezizomycetes (5%), Sordariomycetes (3%), and Exobasidiomycetes (3%). The most common genera of endophytic bacteria were Burkholderia-Caballeronia-Parabukholderia, Sphingomonas, Hydrotalea, Methylobacterium-Metylorubrum, Cutibacterium, and Comamonadaceae, and genera of fungal endophytes were Marasmius, Tuber, Microcyclosporella, Schizothyrium, Alternaria, Parastagonospora, Vishniacozyma, and Cladosporium. The present data showed that the roots, leaves, and stems of P. cuspidatum have a greater number and diversity of endophytic bacteria and fungi compared to the flowers and seeds. Thus, the biodiversity of endophytic bacteria and fungi of P. cuspidatum was described and analysed for the first time in this study.

Statistical characteristics of large-scale objective tonic-clonic seizure records from medical smartwatches used in daily life.

This study aimed to assess whether population-level patterns in seizure occurrence previously observed in self-reported diaries, medical records, and electroencephalographic recordings were also present in tonic-clonic seizure (TCS) diaries produced via the combined input of a US Food and Drug Administration-cleared wristband with an artificial intelligence detection algorithm and patient self-reports. We also investigated the characteristics of patient interactions with wearable seizure alerts. We analyzed wristband data from patients with TCSs who had at least three reported TCSs over a minimum of 90 days. We quantified TCS frequency and cycles, and the relationship between the mean and variability of monthly TCS counts. We also assessed interaction metrics such as false alarm dismissal and seizure confirmation rates. Applying strict criteria for usable data, we reviewed 137 490 TCSs from 3012 patients, with a median length of TCS alert records of 445 days (range = 90-1806). Analyses showed consistency between prior diary studies and the present data concerning (1) the distribution of monthly TCS frequency (median = 3.1, range = .08-26); (2) the linear relationship (slope = .79, R2 = .83) between the logarithm of the mean and the logarithm of the SD of monthly TCS frequency (L-relationship); and (iii) the prevalence of multiple coexisting seizure cycles, including circadian (84.0%), weekly (24.6%), and long-term cycles (31.1%). Key population-level patterns in seizure occurrence are recapitulated in wrist-worn device recordings, supporting their validity for tracking TCS burden. Compared to other approaches, wearables can provide noninvasive, objective, long-term data, revealing cycles in seizure risk. However, improved patient engagement with wristband alerts and further validation of detection accuracy in ambulatory settings are needed. Together, these findings suggest that data from smart wristbands may be used to derive features of TCS records and, ultimately, facilitate remote monitoring and the development of personalized forecasting tools for TCS management. Our findings may not generalize to other types of seizures.

Discrepancies between treatment preference and effectiveness

AbstractInvolving clients in therapeutic decisions is a crucial component of effective and ethical behavior‐analytic practice. However, discrepancies between client preference for treatment options and treatment effectiveness are possible in the course of treatment. The purpose of this paper is to advance the discussion of discrepancies between client preference for treatment options and treatment effectiveness by (a) reviewing relevant considerations for adapted strategies to involve clients with limited prerequisite skills in therapeutic decisions, (b) presenting clinical data that exemplifies discrepancies between client preference for treatment options and treatment effectiveness, (c) describing nuanced considerations for navigating discrepancies, and (d) providing suggestions for future research on this topic.

Ethical case discussions before compulsory medication in psychiatry

Ethical case discussions in psychiatric hospitals are particularly useful when amoral conflict between respect for the patient's autonomy and well-being becomes apparent when considering the legitimacy of coercive treatment. To date, there is hardly any data on the procedure and the results of such case discussions. We therefore present data from alarge psychiatric clinic. We retrospectively analyzed ethical case discussions prior to compulsory medication in aquantitative and qualitative manner. The study analyzed the protocols of all ethical case discussions over a2-year period. They used the method of principle-based ethical case discussion. The qualitative analysis of selected cases was supplemented by reference to case records. An advance care directive was not available in any of the cases, so that the presumed will was used generally to assess the autonomy perspective. It proved quite complex to address danger to third parties when assessing the beneficence and nonmaleficence perspective. In 5 out of 35 consultations, the compulsory medication was not recommended from an ethical perspective. Ethical case discussions enable aholistic individual examination of moral obligations. They contribute to well-founded decisions and can help to reduce the frequency of coercive medications, suggesting routine use of ethics counselling.

Enterprise supply chain network optimization algorithm based on blockchain-distributed technology under the background of digital economy

Demand forecasting is essential for streamlining supply chain operations in the digital economy and exceeding customer expectations. On the other hand, traditional forecasting techniques cannot frequently present real-time data and respond to dynamic changes in the supply chain network, leading to less-than-ideal decision-making and higher costs. This research aims to create a technique for optimizing the supply chain network based on blockchain-distributed technology (SCN-BT) to overcome these drawbacks and fully utilize the potential of the digital economy. The suggested framework uses the hybridized LSTM network and Grey Wolf Optimization (GWO) algorithm to examine demand forecasting in the supply chain network for inventory planning. The SCN-BT framework develops a safe and productive, enabling precise and flexible demand by combining blockchain with optimization techniques. A thorough case study utilized information collected from an enterprise supply chain that operates in the digital economy to show the efficiency of the suggested framework. Compared to conventional approaches, the results show considerable gains in demand forecasting precision, responsiveness of the supply chain, and cost-effectiveness. In the context of the digital economy, demand sensing and prediction enable firms to react to changes swiftly, shorten turnaround times, optimize inventory levels, and improve overall supply chain performance. The results highlight how blockchain technology has the potential to enhance collaboration, trust, and transparency inside intricate supply chain networks working in the digital economy. The experimental results show the proposed to achieve prediction rate of demand prediction rate of 128.93, demand forecasting accuracy ratio of 92.18%, optimum efficiency of 94.25%, RMSE rate of 1841.25, MAE rate of 260.74, and sMAPE rate of 0.1002 compared to other methods.

Strategies for Differential Diagnosis and Management of Ichthyosis in Newborns

Congenital ichthyosis represents agroup of heterogeneous inherited skin diseases characterized by generalized keratinization disorder in the form of hyperkeratosis, caused by abnormalities in epidermal differentiation. The neonatal period is crucial for patients with ichthyosis due to the risk of developing complications, comorbidities, and fatal outcomes. Most complications arise from impaired skin barrier function. This article discusses the manifestations of ichthyosis in newborns, describes risks and complications, and suggests strategies for monitoring and treating patients. Purpose of the study: to present contemporary data on differential diagnosis and treatment strategies for newborn patients with congenital ichthyosis. Materials and Methods: review of Russian and international sources dedicated to the etiology, diagnosis, and treatment of ichthyosis was conducted. Results: Differential diagnosis of ichthyosis in the neonatal period is acrucial task, hence the most life-threatening subtypes are considered. The most severe progression with ahigh risk of fatal outcomes is characteristic of Harlequin ichthyosis. Collodion baby presents with less pronounced symptoms, is not afinal diagnosis, and may later develop clinical manifestations typical of ichthyosiform erythroderma, lamellar ichthyosis, or self-resolving congenital ichthyosis. Netherton syndrome is characterized by acombination of congenital ichthyosis with structural abnormalities of the hair shaft and apropensity for atopy. Epidermolytic ichthyosis, accompanied by the formation of blisters and erosions on the skin, requires differential diagnosis not only with other forms of ichthyosis but also with bullous epidermolysis, staphylococcal scalded skin syndrome, and toxic epidermal necrolysis. Every newborn with described manifestations requires support from amultidisciplinary team of specialists and timely therapeutic and diagnostic measures aimed at preventing the development of complications and deterioration of the patient’s condition. Conclusion: An analysis of global literature data and the practical experience of the authors indicate the complexities of differential diagnosis of ichthyosis forms in the neonatal period. To improve skin condition, prevent infectious complications, and correct electrolyte and respiratory disturbances, symptomatic treatment should begin before adefinitive diagnosis is established.

PROTEÇÃO JURÍDICA DAS CRIANÇAS VÍTIMAS DE VIOLÊNCIA DOMÉSTICA: A LEI HENRY BOREL (14.344/22) E A EDUCAÇÃO COMO FERRAMENTAS DE PREVENÇÃO E ENFRENTAMENTO.

This article aims to analyze the legal protection of children victims of domestic violence in Brazil, with an emphasis on protective measures and legal protection instruments provided for in legislation. Child domestic violence is presented as a public health problem and a serious threat to social development, recognized by the World Health Organization (WHO). Considering that this issue is closely linked to the pressing need for awareness and confrontation actions and that it is often neglected by society and rarely comes to the attention of the judicial system, child domestic violence tends to perpetuate itself over the years, going through successive generations. The research adopts an exploratory approach, based on a bibliographical review and theoretical-reflective analysis, aiming to conceptualize child domestic violence, present relevant data on available protective measures and highlight the role of education as a tool to raise awareness and combat the problem, with emphasis on in the Henry Borel Law and its prevention and protection mechanisms.

Spatial Analysis at PT ABC

This research aims to describe the influence of existing office layout at PT ABC. The type of research used is qualitative research, with a sample of 36 employees in the company. Data collection methods are literature study, observation, interviews and documentation. The data processing method uses data collection, data reduction and data presentation and drawing data conclusions. The aim of this research is to identify and analyze factors that influence spatial planning at PT ABC As well as to find out obstacles and solutions to obstacles that occur in spatial planning office

A novel membrane-based absorber for sorption heat transformers: A comparative experimental study of a thin-film absorbent and salt-impregnated adsorbents

The present study proposes a novel membrane-based sorber bed with stationary solution film for oscillatory sorption heat transformers. A custom-built gravimetric large pressure jump setup is used to experimentally compare the performance of the novel membrane-based sorber bed with a Lithium Bromide/Silica gel solid composite sorbent synthesized using the salt-impregnation method. It is shown that the current membrane-based sorber bed provides up to about four times the specific cooling power and more than twice the cooling power density of solid sorbents, demonstrating the capability of the present sorber bed as a promising alternative to solid sorbents. The specific cooling power, cooling power density, and energy storage density of about 2.8 kW/kg, 470 kW/m3, and 269 MJ/m3 are experimentally obtained, respectively. According to experimental results, it is observed that the film thickness plays a significant role in sorption dynamics, while the effect of membrane mass transfer resistance on sorption dynamics is less than 10%. In addition, the present membrane-based sorber bed is analytically modeled, and the results are validated with present experimental data. The present analytical model is also used to investigate the effects of design parameters on the performance metrics.

The Economic Burden of Type 2 Diabetes Mellitus in Pakistan: A Cost of Illness Study.

Type 2 Diabetes Mellitus (T2DM) is a highly prevalent disease with a chronic nature and poses a significant health burden worldwide, with no exception in Pakistan. Hence, this study aimed to explore the financial burden of T2DM in Pakistan through cost of illness analysis. A prevalence-based, cross-sectional study was conducted using a structured data collection tool from the patient's perspective. Through structured interviews by trained data collectors, the data regarding direct medical costs, direct non-medical costs, and indirect costs were collected and further verified through prescriptions and bills. After testing the normality of data, mean and median with interquartile range were used to present cost data, while non-parametric tests, i.e., the Mann-Whitney U test and the Kruskal-Wallis test, were used to assess factors associated with costs, as cost data were not normally distributed. The study included 522 participants, with a majority being female (54%) and aged between 41 and 60 years (64%). The mean annual total cost per patient was USD 235.1 (median = USD 162.8), comprising direct medical costs, 93.2% (mean = USD 219.2; median = USD 150.0), direct non-medical costs, 5.3% (mean = USD 12.4; median = USD 7.1), and indirect costs, 1.5% (mean = USD 3.5; median = USD 1.9). Costs were significantly higher for patients with advanced age, high literacy, higher household incomes, duration of diabetes, more than one complication, and using combination therapy. The economic burden of T2DM in Pakistan is substantial, with medication costs being the largest component. Effective management strategies and policy interventions are crucial to mitigate this burden and improve the economic and health outcomes for diabetic patients.

In Pictures We Trust: Evaluating Digital Information and Disinformation with Phenomenon-based Learning in Secondary Schools

Abstract The existence of disinformation in online environments increases the risk that young people will be exposed to manipulated content. It is not surprising, then, researchers and educators are focusing on ways to build pupils’ multiliteracy competencies. In this article, we look at the role visual information plays when students assess the trustworthiness of online information and disinformation. The authors present data from Austrian classroom interventions, where eight teachers used a phenomenon-based learning (PhBL) approach to build their 107 pupils’ multiliteracy competencies. The authors undertook video-based and written classroom observations and conducted interviews (n = 44). They found that visual information plays a significant role in pupils’ decisions on whether to trust online information or not. Other factors that increase trust include human actors (e.g. teachers or other pupils) and easily accessible digital information (e.g. visuals or information provided by algorithms or ai). The phenomenon-based pedagogy approach meant that pupils were working in groups, giving a greater opportunity to engage in reflective dialogue, and being more critical about online information.

Chinese version of the Death Anxiety Beliefs and Behaviours Scale: Psychometric properties based on CTT and IRT

ObjectivesThe Death Anxiety Beliefs and Behaviour Scale (DABBS) is a unique tool designed to assess the detrimental beliefs and avoidant behaviors linked to death anxiety. This study aimed to adapt the DABBS into Chinese and verify its psychometric characteristics within a community-dwelling older adult population. MethodsThis study used a cross-sectional design and translated the DABBS into Chinese. The psychometric properties of 437 community-dwelling older persons were assessed using the Classical Test Theory (CTT) and Item Response Theory (IRT). ResultsThe DABBS consisted of affect, beliefs, and behaviours, with 18 entries in 3 dimensions. The I-CVI of the DABBS ranged from 0.857 to 1.000, and the S-CVI was 0.968; Cronbach's alpha of 0.905. Rasch analysis results showed that the 3 dimensions of the scale possessed good unidimensionality, and the entries were well-fitted to the dimensions in which they were located; each entry Infit MNSQ and Outfit MNSQ were in the range of 0.50 to 1.50; the analysis of the functional differences of items in different characteristic subgroups (gender) showed that the absolute value of DIF Contrast was <0.50. The results of the Wright map showed that the ability of the participants was normally distributed, and the difficulty of the scale's entries was adapted to the average ability level of older adults. ConclusionsThe present data indicate that the revised DABBS is a valid and reliable tool for assessing affect, beliefs, and behaviors associated with death anxiety in community-dwelling older individuals.

Comparative Tissue Identification and Characterization of Long Non-Coding RNAs in the Globally Distributed Blue Shark Prionace glauca.

Long non-coding RNAs (lncRNAs) are involved in numerous biological processes and serve crucial regulatory functions in both animals and plants. Nevertheless, there is limited understanding of lncRNAs and their patterns of expression and roles in sharks. In the current study, we systematically identified and characterized lncRNAs in the blue shark (Prionace glauca) from four tissues (liver, spleen, muscle, and kidney) using high-throughput sequencing and bioinformatics tools. A total of 21,932 high-confidence lncRNAs were identified, with 8984 and 3067 stably and tissue-specific expressed lncRNAs, respectively. In addition, a total of 45,007 differentially expressed (DE) lncRNAs were obtained among tissues, with kidney versus muscle having the largest numbers across tissues. DE lncRNAs trans target protein-coding genes were predicted, and functional gene ontology enrichment of these genes showed GO terms such as muscle system processes, cellular/metabolic processes, and stress and immune responses, all of which correspond with the specific biological functions of each tissue analyzed. These results advance our knowledge of lncRNAs in sharks and present novel data on tissue-specific lncRNAs, providing key information to support future functional shark investigations.

Hypoxia and Foxn1 alter the proteomic signature of dermal fibroblasts to redirect scarless wound healing to scar-forming skin wound healing in Foxn1−/− mice

BackgroundFoxn1−/− deficient mice are a rare model of regenerative skin wound healing among mammals. In wounded skin, the transcription factor Foxn1 interacting with hypoxia-regulated factors affects re-epithelialization, epithelial-mesenchymal transition (EMT) and dermal white adipose tissue (dWAT) reestablishment and is thus a factor regulating scar-forming/reparative healing. Here, we hypothesized that transcriptional crosstalk between Foxn1 and Hif-1α controls the switch from scarless (regenerative) to scar-present (reparative) skin wound healing. To verify this hypothesis, we examined (i) the effect of hypoxia/normoxia and Foxn1 signalling on the proteomic signature of Foxn1−/− (regenerative) dermal fibroblasts (DFs) and then (ii) explored the effect of Hif-1α or Foxn1/Hif-1α introduced by a lentiviral (LV) delivery vector to injured skin of regenerative Foxn1−/− mice with particular attention to the remodelling phase of healing.ResultsWe showed that hypoxic conditions and Foxn1 stimulation modified the proteome of Foxn1−/− DFs. Hypoxic conditions upregulated DF protein profiles, particularly those related to extracellular matrix (ECM) composition: plasminogen activator inhibitor-1 (Pai-1), Sdc4, Plod2, Plod1, Lox, Loxl2, Itga2, Vldlr, Ftl1, Vegfa, Hmox1, Fth1, and F3. We found that Pai-1 was stimulated by hypoxic conditions in regenerative Foxn1−/− DFs but was released by DFs to the culture media exclusively upon hypoxia and Foxn1 stimulation. We also found higher levels of Pai-1 protein in DFs isolated from Foxn1+/+ mice (reparative/scar-forming) than in DFs isolated from Foxn1−/− (regenerative/scarless) mice and triggered by injury increase in Foxn1 and Pai-1 protein in the skin of mice with active Foxn1 (Foxn1+/+ mice). Then, we demonstrated that the introduction of Foxn1 and Hif-1α via lentiviral injection into the wounded skin of regenerative Foxn1−/− mice activates reparative/scar-forming healing by increasing the wounded skin area and decreasing hyaluronic acid deposition and the collagen type III to I ratio. We also identified a stimulatory effect of LV-Foxn1 + LV-Hif-1α injection in the wounded skin of Foxn1−/− mice on Pai-1 protein levels.ConclusionsThe present data highlight the effect of hypoxia and Foxn1 on the protein profile and functionality of regenerative Foxn1−/− DFs and demonstrate that the introduction of Foxn1 and Hif-1α into the wounded skin of regenerative Foxn1−/− mice activates reparative/scar-forming healing.

A Cohort Tree-based Representation and a Multimorbidity Progression Across Pregnancies in Scotland

Pregnancy-related research using routinely collected data is increasing. Electronic Health Records (EHR) are a robust resource because they can provide information on a large population of pregnant women covering prolonged periods at a reasonable cost. Moreover, information is collected prospectively and is thus free from recall bias. However, these data sources also present challenges. Information is gathered for clinical purposes and often recorded in different datasets (prescriptions, hospital admission, demography, birth records, etc.). Therefore, a significant data management effort must be made to convert all the information into structured and meaningful datasets in which identifying the timing of conception, outcomes of interest, multiple pregnancies, and interpregnancy periods can easily be done. In this study, we linked Scottish Maternity Records between 2007 and 2021 (1,575,153 pregnancies, 493,629 women) to demographics data, datasets with International Classification of Diseases (ICD) diagnostic codes for all inpatient stays and day cases in hospitals, and Prescribing Information System (PIS) for data on all medications from primary care. After combining these datasets using R codes, we developed a simple tree-based algorithm that visually represents each woman at each pregnancy and the related health conditions. Presenting data in this way helps identify relevant clinical questions and the temporal relation of different pregnancies. As an example, we identified the progression of multimorbidity through pregnancies and characterised how multimorbidity changes from one pregnancy to another, considering the woman's health conditions and social class.

The Diagnostic Ability of GPT-3.5 and GPT-4.0 in Surgery: Comparative Analysis.

ChatGPT (OpenAI) has shown great potential in clinical diagnosis and could become an excellent auxiliary tool in clinical practice. This study investigates and evaluates ChatGPT in diagnostic capabilities by comparing the performance of GPT-3.5 and GPT-4.0 across model iterations. This study aims to evaluate the precise diagnostic ability of GPT-3.5 and GPT-4.0 for colon cancer and its potential as an auxiliary diagnostic tool for surgeons and compare the diagnostic accuracy rates between GTP-3.5 and GPT-4.0. We precisely assess the accuracy of primary and secondary diagnoses and analyze the causes of misdiagnoses in GPT-3.5 and GPT-4.0 according to 7 categories: patient histories, symptoms, physical signs, laboratory examinations, imaging examinations, pathological examinations, and intraoperative findings. We retrieved 316 case reports for intestinal cancer from the Chinese Medical Association Publishing House database, of which 286 cases were deemed valid after data cleansing. The cases were translated from Mandarin to English and then input into GPT-3.5 and GPT-4.0 using a simple, direct prompt to elicit primary and secondary diagnoses. We conducted a comparative study to evaluate the diagnostic accuracy of GPT-4.0 and GPT-3.5. Three senior surgeons from the General Surgery Department, specializing in Colorectal Surgery, assessed the diagnostic information at the Chinese PLA (People's Liberation Army) General Hospital. The accuracy of primary and secondary diagnoses was scored based on predefined criteria. Additionally, we analyzed and compared the causes of misdiagnoses in both models according to 7 categories: patient histories, symptoms, physical signs, laboratory examinations, imaging examinations, pathological examinations, and intraoperative findings. Out of 286 cases, GPT-4.0 and GPT-3.5 both demonstrated high diagnostic accuracy for primary diagnoses, but the accuracy rates of GPT-4.0 were significantly higher than GPT-3.5 (mean 0.972, SD 0.137 vs mean 0.855, SD 0.335; t285=5.753; P<.001). For secondary diagnoses, the accuracy rates of GPT-4.0 were also significantly higher than GPT-3.5 (mean 0.908, SD 0.159 vs mean 0.617, SD 0.349; t285=-7.727; P<.001). GPT-3.5 showed limitations in processing patient history, symptom presentation, laboratory tests, and imaging data. While GPT-4.0 improved upon GPT-3.5, it still has limitations in identifying symptoms and laboratory test data. For both primary and secondary diagnoses, there was no significant difference in accuracy related to age, gender, or system group between GPT-4.0 and GPT-3.5. This study demonstrates that ChatGPT, particularly GPT-4.0, possesses significant diagnostic potential, with GPT-4.0 exhibiting higher accuracy than GPT-3.5. However, GPT-4.0 still has limitations, particularly in recognizing patient symptoms and laboratory data, indicating a need for more research in real-world clinical settings to enhance its diagnostic capabilities.