Standard Format Research Articles

Supporting the CIF file format of proteins in molecular dynamics simulations

Molecular dynamics (MD) simulations can capture the dynamic behavior of proteins in full atomic detail and at very fine temporal resolution, so they have become an important tool in the study of protein dynamics. To date, several MD packages are widely used. An MD simulation starts from an initial structure that is generally taken from the Protein Data Bank (PDB). Until 2014, the PDB format was the standard file format for protein structures. However, there are certain intrinsic limitations in the PDB format, such as the storage of structural information in a fixed-width format, which is an issue for very large protein complexes. Therefore, the CIF (crystallographic information framework) format has been proposed, which is characterized by its superior expansibility. To our knowledge, the current mainstream MD packages support only the PDB format but do not support the CIF format directly. In this study, we modified the source code of one of the MD packages, GROMACS, which enables it to support CIF-formatted structure files as input and subsequently generate molecular topology files. This work simplifies the preprocessing of large protein complexes for MD simulations.

Exploration the use of digital technology in the revitalisation design of Ming Dynasty’s Yingluo jewellery

Buddhist art originated with the emergence of Buddhism and has experienced continual innovation and development throughout history. Yingluo jewellery was introduced to China from India, with its form continuously incorporating ancient Chinese aesthetics in its inheritance and development. The designs of Ming Dynasty’s Yingluo jewellery exhibited a more secular and everyday trend. This article centres on the design of Ming Dynasty necklaces, using the Fahai Temple mural and the Yongxuan court statues as representative examples. The article summarises the distinct artistic features of Ming Dynasty necklaces and explores their aesthetics, focusing on three aspects: shape structure, colour matching, and pattern design. Additionally, 3D digital modelling is employed to revitalise and restore the necklaces’ beauty. Technical abbreviations will be explained upon first usage, and the text adheres to standard academic formatting and language conventions. The objective is to enhance national cultural confidence, bridge the gap between cultural heritage, appreciate the allure of traditional art treasures, and revive cultural artifacts. The infusion of rich cultural nuances into contemporary jewellery design, integration of traditional artistic components into modern aesthetics, and merging exceptional Ming Dynasty necklace works with contemporary aesthetic context, facilitates the seamless integration of outstanding culture into contemporary society.

A DIDACTICAL APPROACH TO FOSTERING LANGUAGE SENSITIVITY IN MULTILINGUAL CLASSROOM SETTINGS: THE COMMON EUROPEAN FRAMEWORK OF REFERENCE FOR LANGUAGES (CEFR) AS A TOOL TO UNITE NATIONS

The article emphasizes the crucial role of language proficiency as well as language sensitivity, especially within multilingual classroom environments, underlining the significance of adhering to the Common European Reference of Languages (CEFR) as a means of fostering global cohesion. It underscores the importance of aligning Ukraine’s educational strategies with international standards, particularly emphasizing the value of foreign language education. Furthermore, the paper stresses the necessity for foreign language teachers to acquire adequate didactical and methodological competencies, an awareness for language sensitivity, and intercultural understanding. It describes Austria’s successful implementation of the CEFR in language assessment, illustrating its pivotal role in standardized examinations and its broad international recognition. Specifically, the article outlines the structure of Austria’s Matura exam for foreign languages, which evaluates reading, listening, language in use, and writing, with a mandatory requirement to achieve a B2 level of CEFR proficiency. It suggests that standardized assessment formats, based on CEFR levels, mitigate stigmatization and ensure fairness in evaluation. Consequently, the paper recommends integrating the CEFR into Ukraine’s educational system to foster language proficiency and enhance language sensitivity in multilingual classrooms. It advocates training programs for language teachers on CEFR implementation and assessment, with the aim of fostering European unity through language education. The article suggests incorporating CEFR principles into Ukraine’s educational reform «New Ukrainian School», and underscores the importance of collaboration between Austrian and Ukrainian educators and researchers in achieving this goal.

Enhancing IoT systems through Cloud-Fog-Edge architectures challenges and opportunities

This article examines the deployment and implications of Cloud- Fog-Edge architectures in Internet of Things (IoT) systems, highlighting their significance in enhancing data management and system security across diverse sectors. As IoT ecosystems expand, the necessity for architectures that efficiently handle large volumes of data and ensure real-time processing capabilities becomes paramount. The Cloud-Fog-Edge architecture addresses these needs by distributing computing resources across three layers—cloud, fog, and edge—each optimized for specific tasks within the IoT workflow. We discuss the challenges and solutions associated with interoperability in such multi-layered systems, emphasizing the need for standardized communication protocols and data formats to facilitate seamless interactions between heterogeneous devices and platforms. Furthermore, the article delves into the critical aspects of security within these architectures, outlining strategies for robust data encryption, access management, regular security updates, and comprehensive network activity monitoring to safeguard against unauthorized access and cyber threats. The integration of Cloud-Fog-Edge architectures not only promises enhanced operational efficiency and scalability but also significantly boosts the adaptability of IoT systems to meet evolving technological and operational demands. By providing a detailed analysis of the functionalities, integration challenges, and security practices associated with each architectural layer, this article contributes to a deeper understanding of how Cloud-Fog-Edge frameworks can be optimized to bolster the reliability, efficiency, and security of modern IoT environments.

Fabrication of sports mouthguards using a semi-digital workflow with 4D-printing technology.

Purpose This technical procedure report explains the fabrication protocol for a newly developed 4D-printed sports mouthguard (MG) based on 4D-printing technology.Methods An intraoral scanner was used to scan a maxillary arch model. A two-layer sports MG was designed based on the scanned model using computer-aided design software and output in a standard tessellation language file format. Two types of filament materials were used for the MG material: a thermoplastic shape memory polyurethane elastomer with a unique glass transition temperature for the external layer and a thermoplastic elastomer for the internal layer. Both MGs were printed using a fused deposition modeling 3D printer and assembled using adhesives after trimming the support material. To confirm the shape-memory performance of the fabricated 4D-printed MG, a deviation analysis was performed by superimposing the internal surface data of the fabricated MG and the MG whose shape was recovered. The distance between the data obtained by deviation analysis was calculated, and the root mean square error value (mm) was determined.Conclusions The 4D-printing technology simplifies the complex processes required with conventional methods. It also overcomes the issues of conventional and 3D-printed MGs, such as the reduced fitting accuracy caused by deformation, because this technology employs shape memory materials.

«…Не Шекспир главное, а примечания к нему»: комментарий академический и учебный, комментарий как автобиография, исследование и расследование

The paper deals with the history of academic commentary in the Soviet era, particularly the formation of standards for a description of the sources of the text, its creative history, and clarification of the encountered realities incomprehensible to the reader. A separate part of the paper is devoted to the critical editions of Russian “classics” designed for high school institutions, among them, e. g., the five-volume collection of works by A.S. Pushkin, issued by Lev I. Polivanov. The main specificity of these comments is that they precede the literary text and answer questions that students may have in advance. The next object of our analysis is N.L. Brodsky’s commentary on Pushkin’s novel “Eugene Onegin,” intended for secondary school teachers. It became a subject of sharp criticism by V.V. Nabokov, like a commentary on the same novel released by Yu.M. Lotman. A new stage in the genre of commentary has become the Russian version of Nabokov’s “A Novel in Verse by Alexandr Pushkin,” growing into an autobiography and a self-discovery tool for the editor (Nabokov). We are also considering the question of how fair was Nabokov’s criticism of the commentaries of Brodsky and Chizhevsky. Another type of commentary should be that of Odessa researcher S.Z. Lushchik, published as an appendix to Kataev’s novel “Werther has already been written” (1980) and entitled “A real commentary on the novel.” This type of commentary grows into a full-fledged study that discovers unknown and carefully hidden details of the famous Soviet writer’s biography.

The use of artificial intelligence technology in Chinese show business

: The object of the study is artificial intelligence technology in Chinese show business. The subject of the study is the following technologies of Chinese show business, at the basis of which we can find an artificial intelligence: virtual idols, digital avatars, virtual influencers. The following aspects of these technologies are considered in detail: making a profit, strengthening national identity. Special attention is focused on the fact that the development of artificial intelligence technology is part of the state policy of the People's Republic of China, which is reflected in the country's regulatory legal acts. The theoretical basis of the study is the work of the following authors: A.M. Gridnev, G. A. Ioakimidi, M. D. Pysin, K. F. Lee, H. Khan and others. The following methods are used in the article: analysis of special literature, publications of mass media, normative legal acts, synthesis, deduction. The study showed that virtual idols and influencers such as "Xiangwan Big Devil", digital copies of celebrities (B. Sa, S. Zhu, B. Gao, Ya. Long) and presenter Xiao Xi bring additional profits and attract an audience, as well as strengthen the national image and unity of China. The scientific novelty of this study lies in the detailed systematization of information and cultural analysis of the phenomenon of "virtual influencer", which is gaining popularity in the modern digital world. The results of the study provide valuable data for the development and implementation of artificial intelligence strategies in China, especially in such areas as industry, defense, social sphere and show business. These findings contribute to the formation of standards and ethical principles for artificial intelligence, which is critically important for the successful digital transformation of the country. The study highlights China's strategic goals of using AI as a driver of modernization of the national economy by 2030. The document identifies key stages of development and goals, including the development of standards and the widespread introduction of AI in various sectors. China views AI as an important tool to strengthen its position on the world stage, striving to become a leader in high technology, which will undoubtedly have a significant impact on the global economy and the development of technological innovations.

基于超宽带冲激雷达的人体动作识别和心率估计数据集

Human action recognition and heart rate estimation for indoor human targets carry significant applications in many fields such as smart homes, health care, sports analysis, etc., and have attracted increasing attention in recent years. Impulse-Radio Ultra-Wideband (IR-UWB) radar, with its advantages in privacy protection, environmental requirements and performance, has found extensive applications in indoor human target monitoring. In view of the data demand for indoor human perception related research based on IR-UWB radar, and the issues with a lack of relevant public data and inadequacy in the authenticity of simulation data, this paper presents a dataset of human action recognition and heart rate estimation based on IR-UWB radar through typical indoor scene measurement experiments and data processing and annotation. The dataset collects 1,629 groups of action recognition data (i.e. unmanned scene data and 10 common actions such as walking, waving, squatting, etc.) from 10 human targets as well as 4,670 groups of heart rate estimation data. All data are presented in a standardized format with precise labeling, making it a valuable resource for research in relevant fields.

Future of Digital Commerce with Online Network for Digital Commerce

Open Network for Digital Commerce (ONDC) is a revolutionizing and ground-breaking initiative first announced in 2020 that is aimed to forever change the world of digital commerce by using new concepts like openness and inclusivity. It is designed to provide safe and secure interoperable digital transactions that go beyond geographical boundaries, enabling users to participate in businesses of all sizes and economies. It also provides standard formats and APIs to ensure cross-compatibility between different platforms, marketplaces, and logistics support. ONDC also puts a great amount of care and emphasis on data privacy, security, robust transactions, and encryption and also encourages user empowerment and allows an individual to manage their data and information to produce maximum trust and transparency between participants. This platform also aims to bring new opportunities by supporting merchants of all levels despite their scale and size and helping them get on online platforms. It will allow both consumers and sellers to engage and trade online regardless of the platform they are using. It is an initiative provided by the Department for Promotion of Industry and Internal Trade (DPIIT) under the Ministry of Commerce and Industry. It was implemented and registered as a non-profit company on December 31, 2021.

A Systematic Review on the Cost-Effectiveness of Intra-Articular Injections for Pain Relief in Symptomatic Patients with Osteoarthritis

Background: This systematic review aimed to assess the quality of published economic evaluations of ultrasound-guided intra-articular injections for symptomatic management of osteoarthritis, explore their scope and diversity, and determine their cost-effectiveness.
 Methods: Relevant electronic databases were systematically searched for studies published from January 2009 to June 2019. Keyword searches and Boolean operators were used to retrieve relevant literature. The PICOTS framework was utilized to define key research questions and guide the literature search. Duplicate removal, title and abstract screening were conducted to exclude irrelevant articles. Data from each study were extracted using a standardized form and summarized in an Excel spreadsheet. The SIGN quality appraisal tool for economic evaluations was employed to assess the quality of each study.
 Results: The initial database search yielded 238 articles, with 35 duplicates removed. Following title and abstract screening, an additional 198 articles were excluded due to not meeting the inclusion criteria. Full-text manuscripts of the remaining 5 articles were reviewed. Based on the quality appraisal, 4 out of the 5 studies were excluded. One study was not a primary study, one was still ongoing, and two were not economic evaluations. Due to the limited number of included studies, no subgroups were identified.
 Conclusions: This study provides evidence that ultrasound-guided intra-articular injections significantly improve clinical outcomes and enhance cost-effectiveness in the management of osteoarthritic joints. However, the scarcity of relevant studies highlights the need for further research to strengthen this finding.

Considering the Factor of Ignorance in Linguo-Criminal Texts

The article considers the problem of ignorance and resulting misunderstanding in texts that are the objects of forensic linguistic expertise. The authors of linguo-criminal texts may use set phrases that have become memes, but it can be difficult to determine whether they are real citations. Misunderstanding of words and phraseological units is often explained by the fact that the speakers are detached from Soviet reality, including Soviet cultural realia. Soviet people understood them, either from their own experience or from works of literature and art (performances or films). The author may be aware of a quote, but not know its origin and real meaning. In such cases, careful contextual analysis of the utterance is necessary. In addition, the expert must take into account linguistic factors: firstly, a certain quotation is reproduced in a standardized or free form, and secondly, this phrase is rigidly or freely specified according to the rules of syntax. The semantics of some words can be understood only after reference to dictionaries, but there can be no certainty that the author of the text meant this. Many words are polysemantic, and their true meaning is not always shown in the context.

INVESTIGATION OF EARLY PERMANENT TOOTH LOSS IN PATIENTS BETWEEN 10-25 YEARS OF AGE IN ELAZIĞ REGION

Objective: To determine the prevalence and distribution of permanent missing teeth accor-ding to gender and location, to investigate the causes of early tooth loss and to emphasize the importance of early diagnosis. 
 Material and method: Panoramic radiographs of 1879 patients (1037 women, 842 men) aged between 10-25 years who applied to Fırat University Faculty of Dentistry were evalua-ted retrospectively. A standardized research form was used in the study. The patients were evaluated in terms of gender, location and number of missing teeth. The obtained data were anaylzed statistically by chi-square and one-sided chi-square tests.
 Results: In the total of 1879 panoramic radiographs, 569 missing permanent teeth were identified in 299 patients (175 women, 124 men). The prevalence of permanent missing te-eth was found to be 15.9% (16.9% female, 14.7% male). The most commonly missing teeth were determined as: lower first molar, lower second premolar and upper lateral incisor, res-pectively. Permanent tooth loss was more common in the mandibula than in the maxilla and a statistically significant difference was obtained. Among patients with missing teeth, the prevalance of patients with only one missing tooth was found to be 48.2%.
 Conclusion: Detailed radiological and clinical examination is the key in the diagnosis of missing teeth and early diagnosis is of great importance for treatment planning.
 Keywords: Hypodontia; Congenital missing teeth; Permanent missing teeth

Improving access to chronic pain care with central referral and triage: The 6-year findings from a single-entry model

ABSTRACT Background Despite the established efficacy of multidisciplinary chronic pain care, barriers such as inflated referral wait times and uncoordinated care further hinder patient health care access. Aims Here we describe the evolution of a single-entry model (SEM) for coordinating access to chronic pain care across seven hospitals in Toronto and explore the impact on patient care 6 years after implementation. Methods In 2017, an innovative SEM was implemented for chronic pain referrals in Toronto and surrounding areas. Referrals are received centrally, triaged by a clinical team, and assigned an appointment according to the level of urgency and the most appropriate care setting/provider. To evaluate the impact of the SEM, a retrospective analysis was undertaken to determine referral patterns, patient characteristics, and referral wait times over the past 6 years. Results Implementation of an SEM streamlined the number of steps in the referral process and led to a standardized referral form with common inclusion and exclusion criteria across sites. Over the 6-year period, referrals increased by 93% and the number of unique providers increased by 91%. Chronic pain service wait times were reduced from 299 (±158) days to 176 (±103) days. However, certain pain diagnoses such as chronic pelvic pain and fibromyalgia far exceed the average. Conclusions The results indicate that the SEM helped reduce wait times for pain conditions and standardized the referral pathway. Continued data capture efforts can help identify gaps in care to enable further health care refinement and improvement.

Extending 3D geometric file formats for geospatial applications

This study addresses the representation and exchange of geospatial geometric 3D models, which is a common requirement in various applications like outdoor mixed reality, urban planning, and disaster risk management. Over the years, multiple file formats have been developed to cater to diverse needs, offering a wide range of supported features and target areas of application. However, classic exchange formats like the JavaScript Object Notation and the Extensible Markup Language have been predominantly favored as a basis for exchanging geospatial information, leaving out common geometric information exchange formats such as Wavefront’s OBJ, Stanford’s PLY, and OFF. To bridge this gap, our research proposes three novel extensions for the mentioned geometric file formats, with a primary focus on minimizing storage requirements while effectively representing geospatial data and also allowing to store semantic meta-information. The extensions, named GeoOBJ, GeoOFF, and GeoPLY, offer significant reductions in storage needs, ranging from 14 to 823% less compared to standard file formats, while retaining support for an adequate number of semantic features. Through extensive evaluations, we demonstrate the suitability of these proposed extensions for geospatial information representation, showcasing their efficacy in delivering low storage overheads and seamless incorporation of critical semantic features. The findings underscore the potential of GeoOBJ, GeoOFF, and GeoPLY as viable solutions for efficient geospatial data representation, empowering various applications to operate optimally with minimal storage constraints.

Employing word-embedding for schema matching in standard lifecycle management

Today, businesses rely on numerous information systems to achieve their production goals and improve their global competitiveness. Semantically integrating those systems is essential for businesses to achieve both. To do so, businesses must rely on standards, the most important of which are data exchange standards (DES). DES focus on technical and business semantics that are needed to deliver quality and timely products and services. Consequently, the ability for businesses to quickly use and adapt DES to their innovations and processes is crucial.Traditionally, information standards are managed and used 1) in a platform-specific form and 2) usually with standalone and file-based applications. These traditional approaches no longer meet today's business and information agility needs. For example, businesses now must deal with companies and suppliers that use heterogeneous syntaxes for their information. Syntaxes that are optimized for individual but have different objectives. Moreover, file-based standards and the usage specifications derived from the standards cause inconsistencies since there is neither a single standard format for each usage specification nor a single source of truth for all of them.As the number and types of information systems grow, developing, maintaining, reviewing, and approving standards and their derived usage specifications are becoming more difficult and time consuming. Each file-based usage specification is typically based on a different syntax than the standard syntax. As a result, each usage specification must be manually updated as the standard evolves; this can cause significant delays and costs in adopting the new and better standard versions. National Institute of Standards and Technology (NIST) in collaboration with the Open Application Groups Inc. (OAGi) has developed a web-based standard lifecycle management tool called SCORE to address these problems. The objective of this paper is to introduce the SCORE tool and discuss its particular functionality where a word-embedding technique has been employed along with other schema-matching approaches. Together they can assist standard users in updating the usage specification due to the release of new version of a standard leading to faster adaptations of DES to new processes.

PENGEMBANGAN SUMBER DAYA MANUSIA UNTUK MENINGKATKAN KUALITAS PENDIDIKAN DI AL WAFI ISLAMIC BOARDING SCHOOL DEPOK, JAWA BARAT

The purpose of this study is to explain: (1) Pesantren Al Wafi Islamic Boarding School strategy to improve human resource competence in accordance with Education Quality Standards; (2) The effect of HR Organization development on work culture at Pesantren Al Wafi Islamic Boarding School; and (3) Future perspectives for HR Organization development. This study used qualitative phenomenological methodology. Data collection methods through observation, documentation, and interviews. Research results: (1) The HR competency development strategy of Pesantren Al Wafi includes the HR development planning process, competency development programs and activities, factors that support and hinder competency development. (2) The influence of HR organization development on work culture at Pesantren Al Wafi has shown the results of knowledge, which is in the form of increasing employee understanding of what is meant by "work" (3) Perspective of organizational development HR Pesantren Al Wafi is committed to improving the quality of its human resources through organizational development. This is achieved in various ways, such as having a program of HR development activities, using a clear standard format to identify real needs for corporate development programs, and encouraging employees to self-assess their abilities and skills.

Risk Factors and Prevention of Needlestick Instruments in the Medical Field: Systematic Review

Introduction: Needlestick and sharp object injuries represent a significant occupational hazard faced by healthcare workers worldwide. A systematic review focusing on needlestick and sharp object injuries among healthcare workers is essential due to the heterogeneous nature of existing research. The aim of this systematic review is to comprehensively synthesize existing literature to provide a comprehensive understanding of the prevalence, risk factors, and prevention strategies related to needlestick and sharp object injuries among healthcare workers. Methods: This thorough examination adheres to PRISMA principles and implements a pre-planned research plan to promote transparency and minimize partiality. It encompasses investigations involving medical personnel (such as nurses and physicians) centered on puncture wounds and sharp instrument mishaps, exploring contributing factors, occurrence rate, aftermaths, and preventative measures. A thorough exploration is conducted through various databases, with two separate evaluators examining and evaluating the studies. Suitable studies encompass both observational and intervention-based studies without constraints on publication dates. Information is extracted using a standardized format, and ethical clearance is not required as the review solely relies on already published data. Results: In our systematic review, we initially identified 1,523 articles through a database search, which underwent a stepwise screening process, resulting in 198 articles after assessing titles and abstracts. Subsequently, these 198 articles underwent a rigorous full-text evaluation. After this thorough assessment, 14 studies were included that met our predefined eligibility criteria. Our synthesis of the observational studies revealed recurring risk factors for needlestick and sharp object injuries among healthcare workers, including inadequate training, the impact of fatigue and extended working hours, and insufficient personal protective equipment (PPE). Additional factors like job category, experience level, and compliance with safety protocols were also highlighted in specific studies. Conclusions: This systematic review highlights the importance of standardized approaches to enhance healthcare worker safety, particularly in addressing risk factors like inadequate training, fatigue, and inadequate personal protective equipment (PPE). The effectiveness of prevention strategies, as demonstrated in our meta-analysis, underscores the value of comprehensive programs in reducing injury rates, emphasizing the need for more standardized and multifaceted safety measures across healthcare settings.

How a nursing navigation role enhances patient recovery across Orthopedic Integrated Pathways

Introduction: Our academic urban institution developed an integrated care pathway that has significantly improved patient transitions to outpatient rehabilitation after total joint replacement (TJR) and as patients requested, supports their earlier discharge from a hospital to home to recover. Early recovery at home has identified a need for care navigation, particularly for patients with a higher complexity of medical and social issues. Implementation of a nursing role for care navigation into our existing integrated pathways would provide support for patients receiving TJR surgery ensuring better coordination of services in their community. 
 Aims, Objectives and Methodology: Our objective was to evaluate an IC nursing lead (ICL) role embedded in our existing orthopedic TJR integrated pathway to support “extended” care patients to safely discharge home. Process mapping sessions conducted in 2019-20, that included key stakeholders and patient partners, identified gaps in communication and care coordination before and after surgery affecting overall patient experience and surgical recovery.
 “Extended” care patients were identified by the orthopedic care team using a standardized referral form developed in conjunction with the ICL. Patients were contacted 1-2 weeks pre-surgery and supported at various pre-operative time points with care coordination. An in-person visit with the patient occurred on the day of surgery and prior to discharge from hospital. A standard 24-hr post-op phone call was completed once the patient returned home. The ICL could be engaged by the patient or care team at any point across the TJR journey (between consent and day of surgery, acute inpatient stay, and up to 90 days post-surgery.
 Key Findings: The ICL role, piloted in March 2022, started with gradual enrolment of patients across 2 arthroplasty surgeons. By August 2022, all 6 arthroplasty care teams (surgeons, physiotherapist practitioners, fellows, physician assistants and admins) were committed to this model of care. ICL patients were 41% male and 59% female ranging in age from 50-92 (mean age of 78). Inpatient pts represented 94% (ALOS 1-2 days). Discharge (DC) disposition patterns aligned with existing best practice guidelines. Discharge coordination made up the bulk of support (82%) provided by the ICL. Other key themes and interventions included emotional reassurance (32%), education/expectation setting (30%), information on community resources and services (18%), arrangement of homecare (6%), other miscellaneous questions (5%). The average time spent for care coordination was 90 mins per patient over the 90 day period.
 Qualitative report from ICL patients revealed improved patient experience with the degree of detail and support provided. "I'm so glad I can call you. I don't always know who to talk to when I have questions". "It's so good to have someone pick up the phone when I need an answer when everything is closed".
 Conclusions: Early findings highlight the benefits of an ICL in improving care quality of patients undergoing TJR and enabling coordinated transitions post discharge from hospital through to their recovery at home. As hospital stays for TJR becoming exceedingly shorter this type of role becomes even more critical, especially with increased patient needs in the aftermath of COVID-19.
 

Home-Based Double-Blind, Placebo-Controlled Challenges for Diagnosis of Delayed Gluten/Milk Hypersensitivity in Children

Delayed hypersensitivity to gluten and milk protein is frequently reported but may be difficult to diagnose. We aimed to explore if a method of home-based double-blind placebo-controlled food challenges (H-FC) can identify and reduce unnecessary elimination diets in children. We included 73 of 92 children aged 1 to 17 years referred to a tertiary allergy clinic from 2011 to 2021 due to self-reported, delayed symptoms to gluten or milk. The children were randomized to H-FC, receiving gluten/milk protein or placebo for 5 to 7 days in a double-blind crossover manner, separated by 3 washout weeks. Patients/parents recorded symptoms using standardized forms. Two crossover periods were used from 2011 to 2016 and 3 periods from 2017 to 2021. A positive challenge required significantly more symptoms during the active period versus the placebo period. After the challenge, reintroduction of milk/gluten was assessed by a follow-up interview. The primary outcome was the proportion of children with a positive challenge. The children, with a mean age of 11 years, had followed a strict gluten-free or milk-protein-free diet for a median duration of 24 months (range: 3-180 months). A positive challenge was observed in 18 of 73 children (25%), more often using 2 (35%) compared with 3 challenge periods (12%). At follow-up, 44 of 55 (80%) children with a negative challenge had successfully reintroduced milk/gluten. H-FC may be an effective method in avoiding unnecessary elimination diets in children. Only 25% of the challenges were positive, and 80% of the children with negative challenges succeeded in reintroducing the food. Three challenge periods may be necessary to reduce false-positive outcomes.

Can we increase the value of data from bladder diaries? International Consultation on Incontinence-Research Society 2023.

Bladder diaries represent a fundamental component in the assessment of patients presenting with lower urinary tract symptoms. Nevertheless, their importance often remains underappreciated and undervalued within clinical practice. This paper aims to conduct a comprehensive review of the existing literature concerning the utility of bladder diaries, underscore the criticality of their precision, elucidate the factors contributing to noncompliance with bladder diary completion, and investigate potential strategies for enhancing patient compliance. A review of the English-language scientific literature available in the domains of Medline, Embase, Emcare, Midirs, and Cinahl was conducted. This was supplemented by discussion at the International Consultation on Incontinence Research Society Proposal session to define knowledge and identify gaps in knowledge surrounding the utility of bladder diaries. The existing evidence and outcome of the relevant discussion held in the meeting are presented. Bladder diaries (BD) serve to characterize the nature and severity of storage lower urinary tract symptoms (LUTS) and provide an objective record of an individual's urination patterns. They aid in the refinement and customization of treatment strategies based on the clinical responses documented in the diary, optimizing treatment outcomes. Notably, both BD and urodynamic studies (UDS) play complementary yet distinct roles in LUTS evaluation. BD offers a more comprehensive and accessible approach to assessing specific storage LUTS, particularly due to their affordability and widespread availability, especially in resource-limited settings. Nevertheless, the absence of a standardized BD format across global healthcare systems presents a significant challenge. Despite being recognized as reliable, noninvasive, validated, and cost-effective tools for evaluating patients with LUTS, the implementation and completion of BD have proven to be complex. The introduction of automated bladder diaries heralds an era of precise, real-time data collection, potentially enhancing the patient-clinician relationship. Completion of bladder diaries depends on an array of individual, social, and healthcare-specific factors. Compliance with bladder diary completion could be enhanced with clear instructions, patient education, regular follow-ups and positive re-enforcement. This study has identified four critical areas for future research: Addressing healthcare disparities between affluent and developing nations, enhancing the current functionality and effectiveness of bladder diaries, exploring the feasibility of incorporating bladder diaries into the treatment and education process and improving the quality and functionality of existing bladder diaries. Bladder diaries play a pivotal role in the evaluation and management of patients with LUTS, providing a holistic perspective. When their complete potential is harnessed, they have the capacity to revolutionize the paradigm of LUTS management, ushering in a patient-centered era of care.