Real Evidence Research Articles

Shaping Clinical Policy for Salvage Radiotherapy After Radical Prostatectomy in Prostate Cancer: Bridging the Gap Between Clinical Trials and Daily Practice.

Salvage radiotherapy (sRT) can have similar outcomes to adjuvant radiotherapy (aRT) if administered at the earliest evidence of biochemical recurrence. RADICALS-RT was the first trial to support this hypothesis and a policy of observation after radical prostatectomy (RP) with early sRT has become the new standard of care since then. This study assessed the impact of RADICALS-RT in the clinical practice regarding the timing of sRT for prostate cancer initially treated with RP. Data from 297 patients who underwent sRT after radical RP were retrospectively collected. Two groups were created and analyzed on the basis of the date of RADICALS-RT presentation at ESMO. After these results were released in October 2021, our institutional postoperative radiotherapy policy was revisited, and a third group was created and analyzed separately. Median PSA for Groups 1, 2, and 3 were 0.33, 0.27, and 0.2, respectively. Less than one-third of patients in Groups 1 and 2 had a postoperative PSA of 0.2 ng/mL or less at the time of sRT. Group 3 showed statistically significant differences in median PSA at the time of sRT compared with Groups 1 and 2. RADICALS-RT demonstrated a significant impact on clinical practice only after being complemented with real local evidence.

Perdagangan Orang: Ancaman Nyata, Upaya Hukum dan Pencegahannya di Desa Tirtayasa Serang Banten

Human Trafficking is a transnational crime, this is because human trafficking involves many countries in terms of planning, real actions and the consequences. The countries targeted are not only developed countries but developing countries such as Indonesia are not immune to this crime. Real evidence can be found in one of the areas in Banten province, namely Tirtayasa Village located in Serang Regency. Many residents think that by going abroad they can change their fate in the village, without thinking about the legal or illegal process. As a result, there are several residents who experience physical violence and not being paid their wages. Therefore, it is necessary to hold comprehensive socialization activities related to human trafficking which include real actions, legal efforts and prevention efforts. The results of this socialization show that the knowledge of village communities who assume that if they can work abroad it will change their fate is a misguided perception. Because in this socialization, the legal and illegal processes related to the departure of migrant workers from Indonesia abroad are conveyed. With this socialization, village communities know that the law will protect them wherever they go as long as they are law-abiding citizens. Furthermore, it is hoped that this activity can be continued by village officials so that it can be a filter for its residents before they dare to work abroad.

Legal implications of oral agreements prior to the making of grant deeds

The significance of this study lies in recognizing the crucial role grants play within the social fabric of Indonesian communities. Despite their importance, grants, particularly in the context of land inheritance, often pose challenges, leading to complications such as the potential for withdrawal or annulment. This research aimed to dissect and comprehend the legal ramifications of verbal agreements made prior to the formulation of a grant deed, especially focusing on how such agreements influence the withdrawal of land ownership rights, as illustrated by the decision of the Kupang High Court (Case No. 23/Pdt/2017/PT.KPG). Employing a normative legal research approach, this investigation delves into secondary data and legal literature to interpret the law both as it is written and as it governs societal behavior. A comparative analysis of similar cases provides additional insights, revealing how varying interpretations of verbal agreements can impact the enforceability of grant deeds across different jurisdictions. This study proposed a detailed analysis, asserting the necessity for clearly defining real evidence in the form of authentic deeds. These deeds serve not only as conclusive proof of land ownership but also as a foundational element for any modifications to such ownership, premised on the mutual consent and responsibilities undertaken by both the grantor and grantee during the deedʼs creation. The grant deed emerges as a pivotal document, ensuring the granteeʼs rights over the land, predicated on the lawful acts executed by both parties involved in the transaction. By exploring these aspects, the research offers insights into enhancing the legal framework surrounding grants, aiming to mitigate the issues arising from oral agreements in land transactions

Assessing the accuracy of self-reported health expenditure data: Evidence from two public surveys in China

This paper utilizes Benford's law, the distribution that the first significant digit of numbers in certain datasets should follow, to assess the accuracy of self-reported health expenditure data known for measurement errors. We provide both simulation and real data evidence supporting the validity assumption that genuine health expenditure data conform to Benford's law. We then conduct a Benford analysis of health expenditure variables from two widely utilized public datasets, the China Health and Nutrition Survey and the China Family Panel Studies. Our findings show that health expenditure data in both datasets exhibit inconsistencies with Benford's law, with the former dataset tending to be less prone to reporting errors. These results remain robust while accounting for variations in survey design, recall periods, and sample sizes. Moreover, we demonstrate that data accuracy improves with a shorter time interval between hospitalization and interviews, when the data is self-reported as opposed to proxy responses, and at the household level. We find no compelling evidence that enumerators' assessments of respondents' credibility or urgency to end interviews are indicative of data accuracy. This paper contributes to literature by introducing an easy-to-implement analytical framework for scrutinizing and comparing the reporting accuracy of health expenditure data.

294P Intrahepatic cholangiocarcinoma (iCCA) trends and treatment lines: Real life evidence from the French National Hospital discharge database

294P Intrahepatic cholangiocarcinoma (iCCA) trends and treatment lines: Real life evidence from the French National Hospital discharge database

Rethinking rectal cancer management through COVID: Real word evidence in a public hospital in the south of Brazil.

e15620 Background: Treatment of locally advanced rectal cancer is based on a combination of radiotherapy and chemotherapy, either as adjuvant, neoadjuvant or total strategies. Short course radiotherapy followed by neoadjuvant chemotherapy, as described in the RAPIDO trial, was chosen by our Oncology, Radiotherapy and Coloproctological tumor board at Hospital de Clínicas de Porto Alegre during the COVID19 pandemic as a measure to reduce hospital visits and thus the possibility of transmission and infection by the SARS-COV-2 virus. Methods: We performed an observational analysis, including all patients treated with short course radiotherapy for locally advanced rectal cancer, at the Hospital de Clínicas de Porto Alegre in the period between January 2020 and March 2023. Metastatic patients were included, either treated with curative or palliative intent. Demographic characteristics, clinical staging, timing of chemotherapy, radiotherapy and surgery were analyzed. Clinical response was evaluated through sigmoidoscopy and clinical rectal exam. Patients with complete clinical response were offered the watch and wait strategy or surgery, after careful discussion of the possible benefits and risks. Results: Ninety-six patients were submitted to short course radiotherapy in the period described. Seven (7) patients were excluded; 89 patients were included in the final analysis. Fifty-five percent were male; mean age was 62 ±12.5 years; 52.8% were ECOG 1 at the diagnosis. Median CEA value at diagnosis was 7 ng/mL (CI 95%:4.4 - 9.8). Sixty-four percent were stage III, 31.4% stage IV, 3.3% stage II. Ninety-eight percent completed the programmed radiotherapy treatment. Only two patients received less than 25Gy. Forty-nine percent of patients completed the whole planned chemotherapy treatment; 15.7% were treated with palliative intent chemotherapy and 5.6% couldn’t receive chemotherapy for other reasons. Clinical response data were available in 62 patients: the main reason for unavailable clinical response was metastatic disease. Disease control was achieved in 98.4% of the cases, with only 1 patient having progressive disease during treatment (1.6%). The overall clinical response rate was 72.6%, 25.8% had stable disease and 24.2% complete clinical response. Fifteen of the 16 patients that presented with complete clinical response opted into a watch and wait strategy, achieving a 1-year disease free survival of 86.6%. Conclusions: Adopting the RAPIDO approach had a positive outcome in our advanced rectal cancer population. Short course radiotherapy followed by chemotherapy achieved excellent rates of disease control. Almost 25% of the non-metastatic patients undergoing RAPIDO treatment achieved complete clinical response opting into a watch and wait program.

From a Piece of Paper to Court Evidence: The Means Of Collection and Examination of Physical Documents in Ukrainian Criminal Justice

The purpose of this article is to outline criminal procedural and forensic means of collection and examination of physical documents in Ukrainian criminal justice. The linguistic analysis, formal-legal, formal-logical, modeling, forecasting methods, as well as the praxeological approach in forensic science are used. The authors argue that a document, as a material object, must be obtained in a manner permitted by law and examined using the necessary forensic means in order to acquire evidentiary status and be suitable for use in criminal proceedings. It was established that the procedural status of a document depends on its internal and external features. If the content of the document carries evidentiary information, it is considered written evidence; if such information is carried by its external (material) features, it is physical (real) evidence. Procedural means of collecting documents are defined by Art. 93 of the Criminal Procedure Code of Ukraine and differ for the parties to the proceedings. Preliminary, judicial and expert examination of documents is distinguished. The main stages of the preliminary examination of documents and the necessary technical means are described. It is emphasized that Ukrainian judges avoid using their own special knowledge when examining documents. Some features of the appointment of forensic examinations of documents and evaluation of their conclusions are highlighted. The perspective of the study of methods of using documents as evidence has been established.

SINGLE-PILL, TRIPLE ANTIHYPERTENSIVE THERAPY IN RURAL SUB-SAHARAN AFRICA: PRELIMINARY EXPERIENCE

Objective: Arterial hypertension is worldwide the leading modifiable cardiovascular risk factor. Beside life-style changes, strong evidence supports the efficacy of pharmacological treatment in reducing the complications of hypertension. International guidelines have recommended single-pill, low-dose combinations as initial treatment strategy. We investigated whether management of hypertension through this approach is feasible and effective in a rural sub-Saharan Africa setting. Design and method: Diagnosis of hypertension was established over three sets of blood pressure measurements: during a community-based, house-to-house screening in 2020 and in 2022, and at the hypertension outpatient clinic. Blood pressure measurements were performed according to the ESH recommendations by trained personnel, using a validated, oscillometric device OMRON M7 IT-HEM-7322-E. In 98 individuals diagnosed to have arterial hypertension, once-daily, single-pill combination of olmesartan, amlodipine, and hydrochlorothiazide was prescribed at a dose suitable to their blood pressure values and clinical characteristics. They were instructed on its administration and potential side effects and encouraged towards lifestyle modifications. Treatment regimen was adjusted, if needed, at each outpatient clinic visit scheduled after 4, 8, 12, and 16 weeks Results: 79 patients (aged 61 [53-70] years; median and interquartile range) strictly adhered to the treatment schedule, while overall 19 individuals dropped-out (aged 70 [65-80] years) because of different reasons. About 20% were tobacco smokers and nearly all consumed alcohol. Blood pressure was <140/90 mm Hg after 4 weeks in 44 (56%), after 8 weeks in 62 (78%), after 12 weeks in 69 (87%), and after 16 weeks in 74 (94%) participants. Excellent tolerance was widely reported. Conclusions: Management of hypertension with once-daily, single-pill combination of olmesartan, amlodipine, and hydrochlorothiazide as initial treatment was feasible and effective also in a rural sub-Saharan setting, with very high rate of hypertension control in patients adherent to treatment. Our results provide real life evidence in favor of extensive implementation of single-pill combination therapy also in low- and middle-income countries where local Health Care Systems should include recommendation on their usage in national guidelines and should make them available also in rural and remote areas at low or no cost as reliable first-line treatment strategy

STRATEGI INTERNALISASI NILAI-NILAI KARAKTER DI MTs NEGERI 1 HULU SUNGAI SELATAN

AbstractThe phenomenon that is often seen related to character is the real evidence that there is a contradiction between the behavior of educated people and the behavior that should be displayed. The actions of educated people even show bad morals. The morals they display are not by the basic objectives of national education. This means that there is a contradiction between the results and the goals that national education aims to achieve. This type of research uses field research, located at MTs Negeri 1 Hulu Sungai Selatan, the subjects in this study were the head of the madrasah and educators, instruments and data collection techniques using observation, interviews, and documentation techniques, and data analysis techniques in this study using qualitative descriptive analysis. The three strategies carried out by schools are caring attitudes that are developed not limited to the classroom, familiarizing good morals in the school environment, and synergizing with parents and the community. The strategies carried out by educators are educators as role models, creating moral communities in the classroom, implementing moral discipline, and encouraging moral reflection. The character values instilled are the characteristics of environmental care, hard work, religion, creativity, national spirit, respect for achievement, and honest character.So, it can be concluded that there are four character internalization strategies carried out by educators, and three strategies carried out by schools. The internalized character values are the characteristics of environment Awareness, hard work, religious, creative, patriotic, appreciate to the achievement, and honest.

The Food Instagrammer Effect in the Study of Advertising Literature

Food Instagrammer became a new trend of society. Proven by many food photo posts by users of Instagram social media accounts. Food is no longer an object of hunger busting, but it has become a worthy object to exploit in order to gain existence on social media. Food Instagrammer become the determining trend of food photo trends on Instagram, because the food is presented with the technique of food. The more full Instagram timeline with food photos is the real evidence of a new phase in the advertising world, advertising is no longer a corporate communication tool created by the advertising agency, the presence of social media makes everyone able to Produce advertising content. In this study, tried to reveal the world of advertising that is entering a new phase due to the presence of social media by Food Instagrammer. Based on the analysis results of 80 respondents, it was obtained that almost 80% more interested in food advertising by Food Instagrammer primarily on Instagram, rather than conventional advertising by companies that appear on social media. After thorough analysis, researchers get surprising data. For respondents, the advertising of companies on social media is considered to be disturbing, and is often avoided. Unlike the advertising by Food Instagrammer, more often sought as a reference source, because more natural in the presentation of persuasive information.

Heat management system design and implementation in a PEM water electrolyser

Green hydrogen has emerged as a real alternative for the decarbonization of industry, mainly Oil&Gas, ammonia and the transport sector. In addition, in situations of global crisis like the current one, it is a key tool to avoid being dependent on natural gas exported from other countries. That is why the European Union has set a production target of 10 million tons of green hydrogen per year by 2030. As recently as May 2022 the European Union signed a pact with European electrolyser manufacturers in order to reach this target as rapidly as possible. There are many ways of producing hydrogen, natural gas/coal reforming, biomass pyrolysis, but all of them involve the production or capture of carbon dioxide, in some way, water electrolysis being the most efficient way to obtain hydrogen without greenhouse gas emissions, in addition, water electrolysis has great synergies with renewable energies. This article is based on the study of the different parameters that affect the efficiency of the electrolysis process, focusing on the operating temperature control. A temperature management system has been proposed to maintain the stack at the desired operating point. The real electrical consumption data during the operation of an electrolyser under different ambient temperatures have been studied. Real evidence has been found regarding the relationship between external temperature and the efficiency of the electrolyser, leading to a more in-depth analysis to obtain efficiency correction curves based on the ambient operating temperature.

PS2MS: A Deep Learning-Based Prediction System for Identifying New Psychoactive Substances Using Mass Spectrometry.

The rapid proliferation of new psychoactive substances (NPS) poses significant challenges to conventional mass-spectrometry-based identification methods due to the absence of reference spectra for these emerging substances. This paper introduces PS2MS, an AI-powered predictive system designed specifically to address the limitations of identifying the emergence of unidentified novel illicit drugs. PS2MS builds a synthetic NPS database by enumerating feasible derivatives of known substances and uses deep learning to generate mass spectra and chemical fingerprints. When the mass spectrum of an analyte does not match any known reference, PS2MS simultaneously examines the chemical fingerprint and mass spectrum against the putative NPS database using integrated metrics to deduce possible identities. Experimental results affirm the effectiveness of PS2MS in identifying cathinone derivatives within real evidence specimens, signifying its potential for practical use in identifying emerging drugs of abuse for researchers and forensic experts.

MANAJEMEN LABA PERSPEKTIF TEORITIS DAN EMPIRIS

Earnings management is managing income (cash inflow) and expenses (cash outflow) to ensure that the business generates a net operating profit. There are parties who define earnings management as a situation carried out by a manager to deceive other people, while other parties define it as a normal activity carried out by managers in preparing financial reports. The perspective approach is intended to understand that studying organizational theory is not just enough to use a single and unrecorded model of an organization's structure. Theoretical is the stage of research testing based on theory with research hypotheses so that this can always help when we try to imagine something or solve problems based on theory which must always be tested practically. Empirical is a research approach that prioritizes the use of real evidence and direct observation in generating knowledge. This research aims to identify earnings management perspectives, theoretical and empirical. In this research, the author used a qualitative descriptive approach. Qualitative descriptive research, namely a problem formulation that guides research to explore or photograph the social situation that will be researched thoroughly, broadly and in depth

THE IMPACT OF FINANCIAL AND NON-FINANCIAL COMPENSATION ON THE JOB SATISFACTION OF PT. DEMPO ANDALAS SAMUDERA PADANG EMPLOYEES

Purpose: This research aims to obtain real evidence of the influence of financial and non-financial compensation on job satisfaction PT. Dempo Andalas Samudera Padang employees. Desain/Methodology/Approach: A sample of 67 employees who received financial and non-financial compensation was used for the test. Sample selection was carried out using the survey method. Hypothesis testing uses inferential analysis through multiple linear regression models and t-statistical tests. Findings: The test results showed that the first hypothesis was accepted, namely that financial compensation had a significant effect on job satisfaction, and the second hypothesis was also accepted, namely that non-financial compensation had a significant effect on job satisfaction. Research Implications: This research proves that good compensation can increase employee satisfaction. Therefore, companies need to formulate financial and non-financial compensation for their employees.

Digital forensic of Maze ransomware: A case of electricity distributor enterprise in ASEAN

Due to the Coronavirus pandemic (COVID-19) throughout 2020–22, remote working has played an important part in organizations, businesses, and agencies worldwide. This situation makes the various cybersecurity threats the Internet poses, especially ransomware. Ransomware will remain the top cybersecurity threat, and the energy sector is the prime target. Previously, research papers only focused on the analytical and protection frameworks. These papers rarely provide real evidence and detailed digital forensics. Interestingly, the ransomware gangs developed new methods but still used similar attack patterns. The authors envisage that a precise understanding of the ransomware attack characteristics is a starting point for the correct detection process. This paper presents a true case study demonstrating the actual occurrence of digital forensics and in-depth technical details of the attacks within the energy sector. The significant attack patterns, which have never been emphasized in research papers, can be proposed for the two loops. The results led to a novel ransomware attack matrix with two loop patterns (dwell time factor) applicable to other ransomware gangs for the detection stage of the NIST.

A Real Evidence of Community: Poll Worker Portraits in the North Carolina Piedmont

Abstract: Georgia poll workers came under fire for alleged election fraud in the 2020 presidential election, but the accusations stood in stark contrast to the author's own experiences as a poll worker in North Carolina during the same election. The author, a photographer, visited a few precincts in central North Carolina to ask volunteers why they became poll workers and to discuss their duty to ensure all voters who showed up were able to cast a ballot and have it counted. Some poll workers talked about voting rights; many described their own voting history and the changes they've witnessed. Others talked about misinformation and the news media. All mentioned integrity, asking themselves: As a citizen and as a poll worker, what can I do to help ensure that each person in my community has the opportunity to vote on Election Day and have that vote counted?

Data and Evidence of Real Clinical Practice: A Comparative Legal Study

The development of technologies collecting and processing large amounts of data for medical purposes, as well as the development of digital tools and the growth of medical information collected by both private and public medical institutions, determine the scientific interest in the problems discussed in this paper. One of the effective tools for collecting such data is data from real clinical practice and evidence of real clinical practice, which make it possible to collect information about the individuals’ health status, safety and effectiveness of medicines and medical devices, as well as other data. At the same time, the conceptual and categorical apparatus necessary for the formation and implementation of regulatory policy in this area started its development relatively recently. An analysis of Russian and foreign legislation and the practice of their application allows us to conclude that this element of sectoral legal regulation is in the initial stage of its formation and is characterized by the use of inconsistent terminology and different approaches to understanding the source and subject matter of such data.

Evaluation and comparison of different methods for determining the contribution of climatic factors and direct human interventions in reducing watershed discharge

Planning for reducing climate changes impacts and human interventions on river discharge relies on determining the extent to which factor has contributed to the observed changes. However, the diversity of approaches and methods proposed for assessing the impact of human and climatic factors, coupled with limitations in data and time, necessitate the careful selection of suitable methods. This study aims to address these challenges by providing a reliable framework to reduce uncertainty and select appropriate methods for quantifying the contribution of human and climatic factors to runoff changes using available information. To achieve this goal, a comparative analysis of different approaches and methods was conducted in three stages: trend determination, assessment of homogeneity and breakpoints of the meteorological and hydrological watershed, and quantification of the contribution of climatic and human factors, followed by validation against real evidence. Subsequently, these methods were employed to evaluate the contribution of climatic and human factors in the Boukan watershed, enabling a quantitative comparison of the results. The findings revealed an upward trend in temperature, a downward trend in precipitation and runoff, and significant changes in annual runoff in 1997. The results obtained from various methods exhibited a range of variations, attributing human factors to 35% to 85% of the reduction in runoff, while climatic factors accounted for 15% to 64%. In general, the box plot analysis indicated that human factors contributed approximately 57% on average, whereas climatic factors contributed around an average of 47%. Additionally, the examination of land use changes, resource utilization, and consumption patterns further supported the notion of human factors playing a more substantial role in the regional runoff reduction. Based on the available evidence, the double-mass curve methods, the water balance model, and the SWAT are identified as the most suitable approaches for this watershed, displaying a better fit to reality. Therefore, given the wide range of results, adopting multiple methods with different methodologies becomes crucial to reduce uncertainty. In this context, the proposed framework can serve as a valuable guide for selecting appropriate methods and decision-making processes.

СУБПІКСЕЛЬНЕ СКАНУВАННЯ ДЛЯ АНАЛІЗУ ЗОБРАЖЕНЬ СПЕКТРА

Subject and Purpose. In this paper, an algorithm is developed to improve the spectrum image resolution in the atomic emission spectrum registration using multi-element detectors and taking multiple exposures with image shifting by a fractional part of a pixel. Methods and Methodology. Mathematical modeling techniques are employed in the coordinate representation dictated by the prior information. The modeling results are checked by experiment. Results. The importance of the resolution value of spectral image registration systems and its impact on the quality of the obtained results have been highlighted. The spectral informativeness of the regularly (matrix- or linearly) structured multi-element detectors has been evaluated against the irregular-structure sensors, such as photographic emulsions. As it has been found that the process of pixel size reduction is demanding, an alternative approach through subpixel image shifting has been proposed. Unlike the case of the corresponding instruments implemented as a rule in the frequency domain, here the relevant theoretical problem reduces to the over- determined system of linear equations. The proposed solution algorithm employs the least squares method having regard to the prior data specificity posed by the isolation of the spectral lines and a smooth flow of the background between them. The digital simulation results and the real experimental evidence from the atomic emission spectral analysis have been presented, illustrating the algorithm operation. The experimental research was carried out for one-dimensional spectrum images registered with linear charge-coupling photodetectors. The so gained resolution was twice the spatial resolution of the photodetector. Conclusions. It has been demonstrated that controlled image shifting not only improves the photometry accuracy but also significantly enhances the detector resolution. The general comparisons of the theory with the experiment have proved the feasibility of bringing the proposed methodology into atomic emission analysis.

External urology consultation quality at a third-level public hospital in Mexico

IntroductionPatient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. ObjectiveTo identify the quality of care in the Urology outpatient department of a third-level hospital. Materials and methodsThe NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. ResultsAccording to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11−20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. ConclusionsThe use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.