Specific Requests Research Articles

A Novel Heuristic Algorithm Integrating Battery Digital-Twin-Based State-of-Charge Estimation for Optimized Electric Vehicle Charging

The increasing need for effective electric vehicle (EV) charging solutions in the context of transportation electrification has become a significant challenge. This system introduces an innovative algorithm, named Energy Distribution and Node Allocation using Evolutionary and Resourceful Optimization (ENDEAVOR), designed to elevate the efficiency of EV charging through the integration of a battery’s digital twin. This cutting-edge algorithm offers precise estimations of EV charging time, seamlessly updating both the State of Charge (SOC) via the Unscented Kalman Filter (UKF) and the internal battery resistance using parameterization, while sending this information to the cloud. ENDEAVOR optimizes charging-node allocation and intelligently distributes energy among incoming EVs based on their specific charging requests, all within the context of renewable-energy-sourced charging stations. The incorporation of a digital twin for the battery confers several benefits, including highly accurate SOC and charging-time estimates that ultimately enhance the overall efficiency of the charging process. This algorithm further optimizes energy distribution, resulting in significantly improved charging-time predictions, reduced wait times for users, and an enhanced overall experience for the user. The day-to-day implications of these enhancements are remarkable, culminating in substantial annual energy savings of approximately 180 units. ENDEAVOR has the potential to revolutionize the landscape of EV charging.

The Request of Xiangling: A Controversial Case on Silencing

Dream of the Red Chamber has been one of the well-known novels in China, which has contributed to an area named “redology.” In the realm of redology, there are a lot of controversies about the silencing of Xiangling’s request for Baochai (one main character of the Red Chamber) to teach her poetry. However, few researchers have tried to analyze this conversation through a linguistic angle. This paper will introduce the Austinian approach to silencing to this controversial case in Dream of the Red Chamber, which could make essential distinctions between important concepts, and provide a coherent explanation for the reason why Xiangling insisted on her specific request to learn poetry and why Baochai had such systematic recognition failures. Through the case study, this paper proves that Xiangling suffers illocutionary silencing in her conversation with Baochai by refuting possible counterarguments. It is significant not only to the explanation of this novel, but also to expansion of application of Austin’s speech act theory.

Contrast enhanced mammography (CEM) guided biopsy using a prone table: A retrospective analysis of the preliminary experience in a single CEM referral center

BackgroundThis study evaluates the procedural efficacy and patient experience of Contrast Enhanced Mammography (CEM)-guided biopsies performed in a prone position using the Giotto Class 30,000 system. The emphasis is on the procedural advantages and clinical outcomes for “enhancing-only lesions” (EOLs). MethodsA retrospective analysis of 524 CEM examinations conducted from December 2023 to June 2024 at a tertiary referral center was performed. Patients referred for pre-surgical staging or evaluation of inconclusive findings from conventional imaging were included. The study utilized dual-energy imaging and vacuum-assisted biopsy techniques, focusing on patients with at least one EOL identified in their initial CEM. Exclusions were based on the absence of a primary or follow-up CEM conducted at our facility Endpoints of this work included procedure efficiency which was evaluated in terms of technical success (biopsy completion with adequate sampling), dose distribution and timing and detection of additional lesions and patients’ comfort evaluation, based on the rate of complications (hematomas) and procedure interruption due to patients’ specific request or fainting events. ResultsAmong the evaluated cases, 37 EOLs were biopsied. The average procedure time was 15.8 min. Biopsies were successfully completed in 100% of cases. However, complications occurred in 27% of cases, primarily as hematomas and a significant histological finding rate of 97.3% was recorded. ConclusionsThe use of the Giotto Class 30,000 system for CEM-guided biopsies in a prone position demonstrated high procedural success and was well-tolerated by patients, highlighting its potential to enhance procedural comfort and efficiency. These preliminary results validate the innovative approach, though further studies are required to solidify these findings and explore long-term outcomes.

7870 Exploring The Role Of ChatGPT In Pediatric Endocrinology Education; Exam Preparation And Question Generation

Abstract Disclosure: J. Tarkoff: None. A.G. Martinez Sanchez: None. Large language models (LLMs) hold substantial promise for improving physician knowledge and expertise. Their role in medical education and the generation of diverse diagnoses can be crucial, potentially leading to positive effects on clinical outcomes. The New England Journal of Medicine pediatric case challenges have examined ChatGPT [1]. Yet, its performance in specialized areas like Pediatric Endocrinology remains unexplored. This study assesses the effectiveness of ChatGPT 4 in responding to questions from the Pediatric Endocrine Self-Assessment Program (PESAP). It also examines if the AI is suitable for creating an educational quiz for residents and fellows. Methods: ChatGPT 4 underwent testing with questions from the 2021-2022 version of PESAP, utilizing the prompt: “Can you assist from the perspective of a pediatric endocrinologist with the following patient case”. Responses were evaluated for initial correctness, and performance was analyzed across various competency categories corresponding to the 7 “umbrella sections” of the tool (Adrenal, Bone, Carbohydrate and Lipid Metabolism/Obesity, Growth, Pituitary, Reproductive System, and Thyroid). Subsequently, we personalized the model by incorporating the questions and detailed responses from the PESAP. This customization resulted in a model that was then utilized to create a 10-question proof-of-concept quiz for four board-certified pediatric endocrinologists. The quiz included a scoring system designed to measure the extent and depth of ChatGPT knowledge. Results: ChatGPT 4 accurately answered 52% of PESAP questions, demonstrating varying performance across specific categories, ranging from 30% (Adrenal) to 78% (Reproductive System). In 16 questions, ChatGPT 4 did not provide an initial answer, requiring a specific request for a response. For questions related to thyroid cancer, explicit prompts were necessary to instruct responses based on the American Thyroid Association 2015 guidelines. In the endocrinologist quiz, the average score was 80%, ranging from 60% to 100%. Discussion: Currently, using ChatGPT 4 as the final diagnostic tool, especially in pediatric endocrinology, should be approached with caution, based on our assessment. However, when incorporating distinct Pediatric Endocrinology case studies, ChatGPT 4 successfully generated valuable educational questions, reinforcing fundamental concepts in the field. We anticipate that as LLMs advance and receive direct medical training, the out-of-the-box diagnostic accuracy will improve, leading to a transformative impact on medical education through this technology.

TrojanProbe: Fingerprinting Trojan tunnel implementations by actively probing crafted HTTP requests

Trojan is a well-known hidden tunnel protocol widely used to bypass Internet censorship and thus presents a big challenge to transparent network management and forensics. As claimed by the protocol designer, Trojan maintains its anti-identifiability by proxying real HTTPS/TLS traffic to react to unauthenticated requests, eliminating any subtle differences between the Trojan traffic and the legitimate HTTPS. Despite such a protocol seeming unidentifiable by design, the diverse Trojan implementations adopting very different programming languages will likely have varied coding logic and networking API calls, opening a new door to be identified and fingerprinted from the implementation level. In this paper, we propose TrojanProbe, a new class of active probing methods that can be used to fingerprint Trojan implementations by triggering their identifiable responses. Our basic idea is to audit the source code of the Trojan programs and discover the subtle logic discrepancy compared with the legitimate HTTPS counterparts, to craft specific HTTP requests as probes to trigger these differences for fingerprinting. By this idea, we choose the five most popular open-source Trojan programs off-the-shelf as our targets to audit, covering the majority of Trojan market share and the mainstream programming languages from traditional C++ to the cutting-edge Go and Rust, and design a suite of novel HTTP probes to differentiate them from their web server masquerades. Our probes exploit either the different responding/buffering logic to the malformed HTTP requests and the different HTTP versions, or the varied timeouts set in the different networking APIs by default. To this end, we have conducted extensive experiments to evaluate the TrojanProbe against a comprehensive set of configuration and networking conditions. The experimental results show that our TrojanProbe can effectively fingerprint our selected Trojan targets in most conditions, but leave a single Rust implementation with a minority market occupied that can only be identified in some constraint cases. Despite such an exception, our research sheds light on a new kind of possibility to fingerprint Trojans at their implementation level, even if such a hidden tunnel is widely known as unidentifiable at the protocol level.

Biobanking, digital health and privacy: the choices of 1410 volunteers and neurological patients regarding limitations on use of data and biological samples, return of results and sharing

BackgroundThe growing diffusion of artificial intelligence, data science and digital health has highlighted the role of collection of data and biological samples, thus raising legal and ethical concerns regarding its use and dissemination. Further, the expansion of biobanking, from the basic collection of frozen specimens to the virtual biobanks of specimens and associated data that exist today, has given a revolutionary potential on healthcare systems, particularly in the field of neurological diseases, due to the inaccessibility of central nervous system and the need of non-invasive investigation approaches. Informed Consent (IC) is considered mandatory in all research studies and specimen collections, and must specifically take into account the ethical respect to the individuals to whom the used biological material and data belong.MethodsWe evaluated the attitudes of patients with neurological diseases (NP) and healthy volunteers (HV) towards the donation of biological samples to a biobank for future research studies on neurological diseases, and limitations on the use of data, related to the requirements set by the General Data Protection Regulation (GDPR). The study involved a total of 1454 subjects, including 502 HVs and 952 NPs, recruited at Santa Lucia Foundation IRCCS, Rome, from 2020 to 2024.ResultsWe found that (i) almost all subjects agreed with the participation in biobanking (ii) and authorization to genetic studies (HV = 99.1%; NP = 98.3%); Regarding the return of results, (iii) we found a statistically significant difference between NP and HV, the latter preferring not to be informed of potential results (HV = 43%; NP = 11.3%; p < 0.0001); (iv) a small number limited the sharing inside European Union (EU) (HV = 4.6%; NP = 6.6%), whereas patients were more likely to refuse transfer outside EU (HV = 7.4%; NP = 10.7% p = 0.05); (v) nearly all patients agreed with the use of additional health data from EMR for research purposes (98.9%).ConclusionsConsent for the donation of material for research purposes is crucial for biobanking and biomedical research studies that use biological material of human origin. Here, we have shown that choices regarding participation in a neurological biobank can be different between HVs and NPs, even if the benefit for research and scientific progress is recognized. NP have a strong interest in being informed of possible results but limit sharing of samples, highlighting a perception of greater individual or relative benefit, while HV prefer a wide dissemination and sharing of data but not to have the return of the results, favoring a possible benefit for society and knowledge. The results underline the need to carefully manage biological material and data collected in biobanks, in compliance with the GDPR and the specific requests of donors.

Estimates of the accuracy of identification of a nonlinear dynamic system using step test signals

Machine learning (ML) has become widespread in everyday life. On its basis, programs with artificial intelligence work, on the basis of which many virtual assistants have evolved. ML plays an important role in various spheres of activity of many enterprises. ML helps to automate many processes, simplifying the functioning of the company. Named Entity Recognition (NER) models allow to automatically select and search for information according to certain criteria in mobile data extracted, for example, by the logistic method. Support for NER by Python models makes it possible to flexibly program specific requests that are generated in the forensic examination process. Open source creates a unique opportunity to continuously improve the model by training it on datasets. A powerful NER package is the spaCy framework, which helps to simplify data and extract detailed information from input data, train a model, perform model tuning, and more. spaCy is compatible with 64-bit CPython 3.7+ and runs on Unix/Linux, macOS/OS X and Windows. The latest spaCy releases are available over pip and conda.

Impact of Employee Training Programs on Service Performance in Restaurants

Purpose: The aim of the study was to assess the impact of employee training programs on service performance in restaurants. Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: The study indicated that trained employees are more adept at handling customer complaints and special requests, leading to a more seamless dining experience. Moreover, training fosters a sense of confidence and motivation among staff, reducing turnover rates and promoting a more consistent service quality. Effective training programs also contribute to higher operational standards, ensuring that health, safety, and hygiene regulations are meticulously followed. Consequently, restaurants that invest in comprehensive training programs for their employees often experience increased customer loyalty, positive reviews, and overall better financial performance. Implications to Theory, Practice and Policy: Human capital theory, resource-based view (RBV) and social learning theory may be used to anchor future studies on assessing impact of employee training programs on service performance in restaurants. Restaurants should adopt a culture of continuous training rather than one-time initiatives. Local governments and industry bodies should develop policies that incentivize restaurants to invest in employee training. This could include tax breaks or grants for establishments that demonstrate commitment to staff development.

English Needs by Hotel Receptionists in Sikka: An Analysis of English for Hospitality

The urgency of this research is to improve the quality of hotel services in the Sikka district by identifying hotel receptionist’s needs and challenges in using English. In addition, understanding the English communication needs of hotel receptionists may provide beneficial insight into the industry of hotels and hospitality. This research aims to analyze the English needs of hotel receptionists and identify the importance of using English and the challenges often faced in communicating using English. This research was conducted in several hotels in the Sikka district using qualitative methods. This research employs in-depth interviews with 4 hotel receptionists to gain comprehensive data. The results showed that good English skills are indispensable for receptionists to serve guests more effectively, provide accurate information, handle complaints or special requests from foreign guests, create positive experiences, and support the growth of the hotel business. In addition, this research found that the main challenges faced by receptionists in communicating using English include a lack of technical vocabulary, difficulty understanding different accents and dialects, and constraints in responding quickly and appropriately in emergencies. Solutions to overcome the challenges are continuous and focused English training is essential to overcome these challenges and improve the communication skills of hotel receptionists. In addition, the use of technology such as translator apps can help language obstacles in real-time. In this case, receptionists can be more confident and competent in using English, thus providing better service to international guests.

Capturing anatomy in computed tomography scans for genital pathology.

In this cross-sectional study,we aimed to characterize how frequently the anatomy of interest (AOI) was excluded when evaluating genital pathology using the current CT pelvis protocol recommended by the American College of Radiology and evaluate how AOI exclusion affects patient management. We retrospectively reviewed medical records, using diagnosis and CPT codes, of patients admitted with genital pathology who obtained a CT scan at our institution from July 1, 2020-April 30, 2023. Baseline patient demographics were included. Data about each index CT scan (scan obtained at our institution) were recorded and assessed for exclusion of the AOI. Statistical analysis was performed to determine the rate of AOI exclusion and to compare patient management between patients with AOI excluded versus those without AOI exclusion. 113 presentations for genital pathology included an index CT scan and were included for analysis. Patients were primarily men (98%) with a mean age of 53.1 years (SD 13.9). The most common diagnoses were Fournier's gangrene (35%), scrotal abscess (22%) and unspecified infection (19%). 26/113 scans (23%) did not capture the entire AOI. When the AOI was missed during the index scan, there was a higher rate of obtaining additional scans (38% vs. 21%), but a similar rate of intervention (77% vs. 63%) when compared to index scans that captured the entire AOI.35 scans (31%) had protocol-extending instructions;index scans that captured the entire AOI were more likely to have specific protocol-extending instructions(38% vs. 8% p < 0.01). Creating a specific CT protocol for genital pathology could decrease the amount of inappropriate irradiation and improve AOI capture rates without relying on specific request for protocol deviation.

STRATEGIES OF USING ARTIFICIAL INTELLIGENCE FOR WRITTEN CORRECTIVE FEEDBACK IN LANGUAGE EDUCATION

The article discusses the strategies for using artificial intelligence (AI) in the context of providing written corrective feedback in language education. It provides an overview of the latest research in this area, starting from the most significant publications in the field of Russian neurodidactics and international conferences dedicated to the use of AI in education, to practical examples of using chatbots for feedback in language teaching. The article emphasizes the transformation of the role of language educators through the application of artificial intelligence, highlighting the importance of focusing the teacher on the essential aspects of students’ communicative development while delegating the technical aspects of proofreading written assignments to artificial intelligence. The application of such technologies changes the ways feedback is provided, allowing for a more in-depth linguistic analysis and the creation of more extensive comments on written works. Examples of specific requests made to artificial intelligence when marking assignments and examples of their implementation are provided. In addition, the article summarizes the strengths and weaknesses of using AI technologies for assessment and draws conclusions about its role in providing written corrective feedback. The article also highlights the need for a thoughtful integration of AI into the educational process and calls for further research on the impact of artificial intelligence technologies on the development of students’ written productive language skills.

The Soviet-Chinese cooperation in production of penicillin in the 1950s

The article considers, on the basis of analysis of archival documents, issue of Soviet-Chinese cooperation in field of production of penicillin in the 1950s. The main attention is paid to history of construction of penicillin plant in Shijiazhuang. It is demonstrated that it was carried out on preferential terms for China and it was under special control of the USSR government. The building of plant was bound by great difficulties conditioned by range of project, specifics of production conditions in China, special requests of customer, necessity to manufacture non-standard equipment. The implementation of this project of enormous humanitarian significance was at the same time manifestation of concurrence between the USSR and the USA for geopolitical and ideological influence in East Asia.

Referral Patterns to an Ophthalmic Outpatient Clinic in a Tertiary Eye Care Center in Iraq

Purpose: We aim to conduct a comprehensive review of outpatients at a tertiary ophthalmology clinic to evaluate various aspects including the spectrum of eye disorders, referral patterns, reasons for referral, and patient self-assessment, with a particular focus on self-referrals. Study Design: A cross-sectional study. Place and Duration of Study: Ibn Al-Haitham Teaching Eye Hospital from April to May, 2023. Methods: Referral letters were grouped into the primary health center (PHC), secondary hospital, internal referral and private clinic. Referral letter quality was assessed based on clinical information and particular request. Results: A total of 1367 individuals aged 40.8 ± 22.17 years were eligible for study. There were 19.2% referrals form PHC, 18.4% from secondary hospitals, 10.7% from private clinics, 3.3% were internal referrals, 37.2% were self-referred and 11.3% had medical or surgical follow-up. Blurred vision was the predominant complaint of 677 (51.6%) patients. Out of 659 referral letters, 25% scored two essential information items, 5.2% scored three, and only 0.8% scored four items. The majority (97.2%) of letters provided specific requests. Among all, 26.3% of PHC, 38.2% of hospitals, 34.9% of private clinics, 21.7% self-referred and 51.1% of internally referred patients considered their situations difficult. Conclusion: Majority of cases seen in ophthalmology tertiary centers consist of common conditions that could be effectively managed by PHCs and general hospitals. Improved referral standards for specialized medical institutions may reduce tertiary hospital over population.

Perceptions on Penicillin Allergy Labels among Nurses and Prescribers in Three Pediatric Urgent Care Sites

Background: National guidelines recommend penicillins (PCN) as first-line treatment for many common pediatric infections in the outpatient setting. Although less than 1% of the United States population has a true, IgE-mediated PCN-allergy, approximately 10% of patients are labeled with a PCN-allergy. Accurate adverse drug reaction (ADR) documentation plays an important role in this over-labeling. We have previously shown that nurses feel assessment and documentation of PCN-allergies are critical to their role. However, additional evidence purports nurse hesitancy to interrogate allergy accuracy or reclassify parent’s response to side effect. Our objective was to explore frontline clinicians’ confidence in assessing, documenting, and responding to PCN-allergy labels. Methods: To expose barriers and prioritize improvement ideas for a multidisciplinary quality improvement (QI) project aimed to improve PCN-allergy labeling in our pediatric urgent care clinics, we deployed this investigator-developed survey to prescribers and nurses. It’s comprised of 14-questions scored on a 5-point Likert scale (4 demographic, 4 PCN/safety, 3 allergy types, 4 allergy documentations, 3 treatment options), and 1 optional free-text. We used descriptive statistics to compare survey responses between prescribers and nurses and evaluated free text comments for themes. Results: Eighty-seven clinicians across 3 sites participated, with a response rate of 35%, with variation by sites (25.3% to 41.4%). Forty-one percent of (n=36) responders have been in practice &gt;15 years and 40.2% (n=35) have worked at our hospital &gt; 15 years (Table 1). Overall, perceived knowledge of PCN-allergies and safety was favorable (Table 2). Prescribers reported higher confidence with: 1) perceiving many patients who believe they are allergic to PCN can safety take PCN (prescribers median=5 [IQR: 4, 5] vs. nurses median=4 [4,4], p = 0.003); and 2) perceiving that time pressures influenced their ability to reconcile allergies and side effects (prescribers median=4 [4, 5] vs. nurses median=3 [2, 4], p = 0.001). Both prescribers and nurses reported lower confidence in continuing to administer or prescribe an antibiotic in the setting of a reported ADR. Thirteen respondents (15%) provided comments with specific requests for additional family education and practice guidance, including the referral process to subspecialty clinics for PCN-allergy testing. Conclusions: Our survey results identified barriers to accurate PCN-allergy labels, including knowledge on documentation, time pressures, hesitancy to challenge parent report, and uncertainty on referral process for PCN-allergy testing. This survey will inform future drivers for our QI. Opportunities include electronic medical record refinement, improving referrals to PCN-allergy de-labeling clinics, and the development of scripted education to guide family discussions.Disclosure: Rana El Feghaly: Merck- grant funding. Amanda Nedved: Contracted Research – Merck

Qualitative and quantitative determination of xylazine in oral fluid.

Xylazine has emerged in recent years as a dangerous adulterant in illicit fentanyl use, and methods for the detection of xylazine in toxicology panels are still lagging. We developed methods for the screening and quantitation of xylazine in oral fluid (OF), a popular testing medium due to its ease of collection and reflection of presence in blood for many classes of drugs. Enzyme-linked immunosorbent assays were employed for the rapid screening of xylazine directly from the collection device buffer with a cutoff of 1 ng/mL. Solid-phase extraction coupled with liquid chromatography-tandem mass spectrometry facilitated the confirmation and quantification of xylazine as low as 0.1 ng/mL and a dynamic range of 0.1-25 ng/mL. Selectivity, ionization suppression, processed sample stability, and dilution effect were also assessed. The method was validated through the American National Standards Institute/American Academy of Forensic Sciences Standards Board (ANSI/ASB) Standard 036, first edition from 2019, and found to be accurate, precise, and robust. Living human subject OF samples collected within substance use disorder and therapeutic drug monitoring clinics received between September 2023 and January 2024, with the specific request to test for xylazine (n = 57), were screened. Presumptive positive samples were confirmed using the validated method. Xylazine confirmed living human subject OF sample concentrations ranged from 1.2 to 23.3 ng/mL.

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When and why does customization reduce booking cancellations? Field evidence from two hotels

PurposeThis study employs S-D Logic to examine the hotel booking behaviors of individuals, with a focus on the impact of service customization on service cancellation. Additionally, the moderating role of social co-creation is explored to provide further insight.Design/methodology/approachThe paper draws on booking data from two hotels: a resort hotel with 40,060 recorded bookings, including 11,122 cancellations, and bookings from a city hotel with 79,330 bookings, including 33,102 cancellations.FindingsThe result reveals that bookings with higher levels of initial customization, such as special requests, are more likely to be modified later and less likely to be canceled. Interestingly, while multi-adult bookings were found to have a higher cancellation rate than individual bookings, the effects of customization commitment were more pronounced for multi-adult bookings.Originality/valueThis paper is the first to establish a connection between service customization, the number of adults on a booking and the likelihood of cancellation, thus providing new empirical evidence for the emergence of customization effects in services. Additionally, the study identifies important contingencies based on the number of consumers in a booking.