Managing uncertainty

PURPOSE: To compare ChatGPT-4 and ChatGPT-3.5's performance on Taiwan urology board examination (TUBE), focusing on answer accuracy, explanation consistency, and uncertainty management tactics to minimize score penalties from incorrect responses across 12 urology domains. METHODS: 450 multiple-choice questions from TUBE(2020-2022) were presented to two models. Three urologists assessed correctness and consistency of each response. Accuracy quantifies correct answers; consistency assesses logic and coherence in explanations out of total responses, alongside a penalty reduction experiment with prompt variations...

Climate change requires major mitigation efforts, mainly emission reduction. Carbon sequestration and avoided deforestation are complementary mitigation strategies that can promote nature conservation and local development but may also have undesirable impacts. We reviewed 246 articles citing impacts, risks, or concerns from carbon projects, and 78 others related to this topic. Most of the impacts cited focus on biodiversity, especially in afforestation projects, and on social effects related to avoided deforestation projects...

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by hypothalamic dysfunction, hypotonia, cognitive deficits, and hyperphagia, primarily resulting from genetic abnormalities on chromosome 15. Among its varied manifestations, musculoskeletal issues, notably scoliosis, pose important challenges in management. This study aims to investigate differences in postural-motor development and spinal range of movement between preadolescents and adolescents with PWS, with and without scoliosis, while also exploring the potential impact of scoliosis on caregiving burden, an aspect yet to be thoroughly explored in existing literature...

There is increasing interest in using extended genetic sequencing (EGS) in newborn screening (NBS) for cystic fibrosis (CF). How this is implemented will change the number of children being given an uncertain outcome of CRMS/CFSPID (cystic fibrosis transmembrane conductance regulator (CFTR)-related metabolic syndrome/CF Screen Positive Inconclusive Diagnosis), probable carrier results, and the number of missed CF diagnoses. An international survey of CF health professionals was used to gather views on two approaches to EGS-specific (may reduce detection of CRMS/CFSID but miss some CF cases) versus sensitive (may increase detection of CRMS/CFSPID but avoid missing more CF cases)...

Elevated skull fracture (ESF) is a rare but potentially life-threatening type of skull fracture. The literature on this topic is relatively sparse. Herein, we conducted a meta-analysis of all the patients reported in the literature with ESFs with respect to their clinical management to better inform practice. On 20th of January 2023, we conducted a systematic search of literature to find all published cases of ESF. We also conducted a retrospective review of ESF cases from our institution. The data collection and analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...

Wastewater treatment plants have been recognized as important sinks for per- and polyfluoroalkyl substances (PFAS) because of their ineffectiveness in removing them reflecting both water and sewage sludge discharge routes. Hydrothermal treatment represents an alternative technology for treating sludge to recover energy and other valuable products. In this study, 15 PFAS were determined in sludge and hydrochar substrates using sonication-solid phase extraction procedure and analyzed using LC-Orbitrap-High Resolution-MS/MS...

The collapse of the Soviet Union triggered an escalation of the tuberculosis (TB) epidemic in many post-Soviet countries, including Ukraine. The main reasons for this situation include both the approach to TB care and the concentration of TB cases in prisons. The neoliberal approach to TB care system reform promises the optimization of treatment terms, "dehospitalization" and "despecialization" of the system of care, and a different type of control, established through digital technologies. One such technology is the "e-TB Manager", which was designated as a national TB registry, including in the prison system in 2012...

BACKGROUND: During COVID-19 pandemic, health professionals have been working in an extreme uncertainty context. Affected patients needed to be cared at home as long as possible to avoid virus spreading and hospital resources saturation. The Veneto Regional Administration (North-east of Italy) released Regional guidelines about it. The Western Healthcare District of the Local Health Authority of the city of Vicenza (180,000 inhabitants) implemented a healthcare pathway following them. Aim of the study is to describe the results and outcomes of such implementation...

Many questions are raised, and challenges faced in the new era of (intranasal) bovine respiratory disease complex vaccination. An increase in vaccination rate is expected, due to its positive impact on cattle health, reduction of antimicrobial use and economic factors. However, engagement of farmers and veterinarians with regard to vaccination is often affected by limitations, resulting in the development of barriers to vaccination, but also opportunities to overcome these. The objective of the report is to provide practical recommendations and a consensus on best practises for BRDC vaccination, addressing barriers faced by veterinarians and farmers...

Melanoma of the dog and cat poses a clinical challenge to veterinary practitioners across the globe. As knowledge evolves, so too do clinical practices. However, there remain uncertainties and controversies. There is value for the veterinary community at large in the generation of a contemporary wide-ranging guideline document. The aim of this project was therefore to assimilate the available published knowledge into a single accessible referenced resource and to provide expert clinical guidance to support professional colleagues as they navigate current melanoma challenges and controversies...

Background: Clinical trial is a crucial step in the development of a new therapy (e.g., medication) and is remarkably expensive and time-consuming. Forecasting the approval of clinical trials accurately would enable us to circumvent trials destined to fail, thereby allowing us to allocate more resources to therapies with better chances. However, existing approval prediction algorithms did not quantify the uncertainty and provide interpretability, limiting their usage in real-world clinical trial management...

PURPOSE: Negotiable fate as a belief in coping with the difficulties and uncertainties of life has an impact on people's mental health. This study aims to understand the influence of negotiate fate on college students' life satisfaction and its underlying mechanism. METHODS: A cross-sectional study was conducted with the participation of 1523 students from six universities across China. The study aimed to measure the variables of negotiable fate, self-esteem, positive psychological capital, and life satisfaction of all participants...

Landfills play a key role as greenhouse gas (GHGs) emitters, and urgently need assessment and management plans development to swiftly reduce their climate impact. In this context, accurate emission measurements from landfills under different climate and management would reduce the uncertainty in emission accounting. In this study, more than one year of long-term high-frequency data of CO2 and CH4 fluxes were collected in two Italian landfills (Giugliano and Case Passerini) with contrasting management (gas recovery VS no management) using eddy covariance (EC), with the aim to i) investigate the relation between climate drivers and CO2 and CH4 fluxes at different time intervals and ii) to assess the overall GHG balances including the biogas extraction and energy recovery components...

BACKGROUND: The highest priority uncertainty for people with symptomatic cerebral cavernous malformation is whether to have medical management and surgery or medical management alone. We conducted a pilot phase randomised controlled trial to assess the feasibility of addressing this uncertainty in a definitive trial. METHODS: The CARE pilot trial was a prospective, randomised, open-label, assessor-blinded, parallel-group trial at neuroscience centres in the UK and Ireland...

Land is the foundation of human life and development, which is also the most important part of a country. The study of land carrying capacity is one of the important contents of land management, wherein the evaluation of land resource carrying capacity (LRCC) is an important reference for land resource planning. Aiming at the information fuzziness and uncertainty in the evaluation of LRCC, firstly, a comprehensive evaluation model based on entropy weight and normal cloud similarity was proposed, which is based on cloud model theory and combined with normal cloud similarity measurement method and entropy weight method...

Epistemic uncertainty in data-driven landslide susceptibility assessment often tends to be increased by the limited accuracy of an individual model, as well as uncertainties associated with the selection of non-landslide samples. To address these issues, this paper centers on the landslide disaster in Ji'an City, China, and proposes a heterogeneous ensemble learning method incorporating frequency ratio (FR) and semi-supervised sample expansion. Based on the superimposed results of 12 environmental factor frequency ratios (FFR), non-landslide samples were selected and input into light gradient boosting machine (LightGBM), random forest (RF), and convolutional neural network (CNN) models for prediction along with historical landslide samples...

No-till and mulching are typical management operations in conservation agriculture (CA). To model pesticide degradation and leaching under a CA scenario, as compared to a conventional-tillage scenario (CT), the mulch module of the agro-hydrological model Daisy was extended. A Daisy soil column was parameterized with measurements of topsoil, mulch, and a realistic subsoil, and tested against published experimental data of pesticide fate in laboratory soil columns covered by mulch. Uncertainty and sensitivity analyses of the new Daisy version were conducted for a series of weather, soil, pesticide, and mulch parameters, using 4939 Monte Carlo simulations under each scenario...

BACKGROUND: Despite a global epidemiological transition towards increased burden of non-communicable diseases, communicable diseases continue to cause substantial morbidity and mortality worldwide. Understanding the burden of a wide range of infectious diseases, and its variation by geography and age, is pivotal to research priority setting and resource mobilisation globally. METHODS: We estimated disability-adjusted life-years (DALYs) associated with 85 pathogens in 2019, globally, regionally, and for 204 countries and territories...

BACKGROUND: Hospitals can be challenging environments for nurses when providing palliative and end-of-life care. Understanding hospital nurses' experiences of their application of palliative and end-of-life knowledge could help direct future education to support such challenging care. AIM: To understand how hospital nurses use knowledge in palliative and end-of-life care situations. METHOD: Interpretive phenomenology was used to understand 10 hospital nurses' experiences and ability to apply palliative and end-of-life knowledge...

In the context of colorectal cancer, splenic and ovarian metastases are rare outside of widely disseminated disease. Growing evidence suggests that 'oligometastatic' or limited metastatic disease can be treated surgically with good oncological outcomes. Splenic and ovarian metastases are not well represented in studies of oligometastatic colorectal cancer, resulting in uncertainty in the best management for these patients. We present the case of a 78-year-old woman diagnosed with oligometastatic colorectal cancer to bilateral ovaries and spleen, 5 years after resection of a primary colon cancer...