bluuebunny/crossref_metadata_2025 huggingface dataset:
New Insights in Adherence and Survival in Myotonic Dystrophy Patients Using Home Mechanical Ventilation
Authors: Seijger Charlotte , Raaphorst Joost , Vonk Judith , van Engelen Baziel , Heijerman Harry , Stigter Nadine , Wijkstra Peter
Published: January 2021

Background: Non-invasive home mechanical ventilation (HMV) is a complex treatment in myotonic dystrophy type 1 (DM1) patients, due to a presumed poor adherence, variable symptom improvement, and uncertainty regarding survival benefits. Objectives: We aimed to investigate indications, adherence to HMV and its effects on mortality in a large cohort of DM1 patients. Methods: In this retrospective cohort study, we evaluated 224 DM1 patients. Different groups based on hypercapnia and HMV treatment were compared. Cox regression analyses were performed to compare mortality between different defined groups. Results: 224 patients were analysed of whom 111 started non-invasive HMV. Indications were daytime hypercapnia (n = 75), only nocturnal hypercapnia (n = 33), or other reasons (n = 3). Adequate adherence (≥4 h/night) was found in 84.9% of patients. Adequate ventilation was reached in 86.5% of patients. In 33 patients (29.7%), HMV was stopped prematurely due to not reaching patients’ expectations on symptom relief or treatment burden (n = 22), or intolerance (n = 8), or other reasons (n = 3). HMV did not improve survival in daytime hypercapnic patients (p = 0.61) nor in nocturnal hypercapnia patients compared to daytime hypercapnia (p = 0.21). Significant survival benefits after starting HMV were found for patients with HMV adherence ≥5 h/24 h compared to patients who used HMV less. Conclusion: In this large cohort, daytime hypercapnia is the main reason for starting HMV, which is well tolerated and used. Mortality is not associated with the reason why HMV was started, but once started, patients with ≥5 h/24 h adherence have significantly better survival compared to patients who use it less.
meio ambiente urbano como questão
Authors: Martins Maria Lúcia Refinetti , Oliveira Paula Custódio
Published: January 2021

No amplo quadro de significados e abrangência da questão ambiental contemporânea, o presente artigo procura evidenciar particularidades de sua dimensão no âmbito das cidades, observando a tensão entre assentamento urbano e meio ambiente em suas diversas dimensões. A partir da Região Metropolitana de São Paulo, o texto recorre a resultados e conclusões de duas pesquisas recentemente concluídas, uma na área do saneamento ambiental e habitação, outra no campo do desenho urbano e conforto ambiental. Busca, nesse contexto, articular as relações entre dinâmicas e processos naturais com as dinâmicas e processos sociais.
Role of Blood-Based Biomarkers in Ischemic Stroke Prognosis
Authors: Montellano Felipe A. , Ungethüm Kathrin , Ramiro Laura , Nacu Aliona , Hellwig Simon , Fluri Felix , Whiteley William N. , Bustamante Alejandro , Montaner Joan , Heuschmann Peter U.
Published: January 2021

Background and Purpose:

Outcome prognostication in ischemic stroke patients remains challenging due to limited predictive properties of existing models. Blood-based biomarkers might provide additional information to established prognostic factors. We intended to identify the most promising prognostic biomarkers in ischemic stroke, their incremental prognostic value, and whether their predictive value differs among etiologies.

Methods:

We searched MEDLINE (Ovid) and Institute for Scientific Information Web of Knowledge for articles reporting the predictive performance of blood-based biomarkers measured up to 7 days after ischemic stroke and reporting functional outcome or death at least 7 days after stroke. This work updates a previous systematic review (up to January 2007), follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and was registered (International Prospective Register of Systematic Reviews PROSPERO 2018;
https://www.crd.york.ac.uk/PROSPERO
/; Unique identifier: CRD42018094671).

Results:

Two hundred ninety-one articles published between January 2007 and August 2018 comprising 257 different biomarkers met inclusion criteria. Median sample size was 232 (interquartile range, 110–455); 260 (89%) articles reported regression analyses with 78% adjusting for stroke severity, 82% for age, 67% for both, and 9% for none of them; 37% investigated discrimination, 5% calibration, and 11% reclassification. Including publications from a previous systematic review (1960–January 2007), natriuretic peptides, copeptin, procalcitonin, mannose-binding lectin, adipocyte fatty acid–binding protein, and cortisol were the biomarkers most consistently associated with poor outcome in higher-quality studies showing an incremental value over established prognostic factors. Other biomarkers were less consistently associated with poor outcome or were reported in lower quality studies. High heterogeneity among studies precluded the performance of a meta-analysis.

Conclusions:

The number of reports on prognostic blood-based biomarkers in ischemic stroke increased 3.5-fold in the period January 2007 to August 2018. Although sample size increased, methodological flaws are still common. Natriuretic peptides and markers of inflammation, atherogenesis, and stress response are the most promising prognostic biomarkers among identified studies.
THE SCALE INSECTS OF IRAN Part 1 THE ARMOURED SCALES (HEMIPTERA: COCCOMORPHA: DIASPIDIDAE)
Authors: MOGHADDAM MASUMEH , WATSON GILLIAN W.
Published: January 2021

Iran is situated at the junctions of the Palaearctic and Oriental zoogeographical regions, and the Caspian, Baluchi and Irano-Tiranian floral zones, so it has a very diverse scale insect fauna. Scale insects (Hemiptera: Coccomorpha) are economically important in forestry, agriculture and horticulture. This taxonomic account of the armoured scales (Diaspididae) of Iran is the first of three works planned to cover all the scale insects in the country. It provides a resource for accurate laboratory identification of all the species known to occur in Iran or that are likely to be found there. Keys to the families of scale insects found in Iran, and to the 49 genera and 144 species of Diaspididae found there, are provided. Detailed line drawings of all the species known to occur in Iran are provided to facilitate identification. These are accompanied by detailed descriptions, distribution data, information on natural enemies, economic importance and host-plants recorded in Iran. The main purpose of the work is to provide agricultural entomologists concerned with pest control and quarantine inspection worldwide with a reliable means of species identification.
Composite Life Cycle of West Pacific Jet-Superposition Events and the Large-Scale Environmental Response over Western North America
Authors: Handlos Zachary J. , Martin Jonathan E.
Published: January 2021

Vertical alignment of the polar and subtropical jet streams in the west Pacific basin occurs most often during the boreal cold season. Recent work has revealed that the large-scale environment conducive to producing such superpositions involves interaction between East Asian winter monsoon cold-surge events, lower-latitude convection, and internal jet dynamics. The evolution of the large-scale environments associated with these events post-superposition as well as the significance of that evolution on aspects of the wintertime Northern Hemisphere general circulation is examined through construction of a 44-case composite. The post-superposition west Pacific jet extends eastward associated with an anomalous positive–negative geopotential height couplet straddling the jet’s exit region. This jet extension results in ridge building over Alaska and northwestern Canada. The large-scale evolutions associated with the composite post-superposition environment occur consistently among the majority of cases considered within this analysis. The positive–negative geopotential height anomaly couplet, enhanced jet entrance circulation, low-latitude convection, and internal jet dynamics present in the pre-superposition environment weaken post-superposition. As a result, the characteristic vertical PV “wall” associated with the composite vertically superposed jet weakens. Last, investigation of the value of using the two most dominant modes of west Pacific jet variability in observing the evolution of the superposed west Pacific jet post-superposition reveals that, while the extension of the jet is exhibited, significant variability exists when analyzing each of the 44 cases of interest individually.
Error Growth Dynamics within Convection-Allowing Ensemble Forecasts over Central U.S. Regions for Days of Active Convection
Authors: Zhuang Xiaoran , Xue Ming , Min Jinzhong , Kang Zhiming , Wu Naigeng , Kong Fanyou
Published: January 2021

Error growth is investigated based on convection-allowing ensemble forecasts starting from 0000 UTC for 13 active convection events over central to eastern U.S. regions from spring 2018. The analysis domain is divided into the northwest (NW), northeast (NE), southeast (SE), and southwest (SW) quadrants (subregions). Total difference energy and its decompositions are used to measure and analyze error growth at and across scales. Special attention is paid to the dominant types of convection with respect to their forcing mechanisms in the four subregions and the associated difference in precipitation diurnal cycles. The discussions on the average behaviors of error growth in each region are supplemented by four representative cases. Results show that the meso-γ-scale error growth is directly linked to precipitation diurnal cycle while meso-α-scale error growth has a strong link to large-scale forcing. Upscale error growth is evident in all regions/cases but up-amplitude growth within its own scale plays different roles in different regions/cases. When large-scale flow is important (as in the NE region), precipitation is strongly modulated by the large-scale forcing and becomes more organized with time, and upscale transfer of forecast error is stronger. On the other hand, when local instability plays more dominant roles (as in the SE region), precipitation is overall less organized and has the weakest diurnal variations. Its associated errors at the γ and β scale can reach their peaks sooner and meso-α-scale error tends to rely more on growth of error with its own scale. Small-scale forecast errors are directly impacted by convective activities and have a short response time to convection while increasingly larger-scale errors have longer response times and delayed phase within the diurnal cycle.
Intergovernmental veto points in crisis management: Italy and Spain facing the COVID-19 pandemic
Authors: Parrado Salvador , Galli Davide
Published: January 2021

Italy and Spain were the first countries affected by the shift of the pandemic epicentre from east to west. The rapid spread of the virus in allegedly similar social settings, the relatively high numbers of cases and casualties, and the adoption of drastic containment measures were similar in the two countries during the first wave of the pandemic. Both countries are enmeshed in an unstable political equilibrium at the centre, governed by recently established national political coalitions that have continuously been called into question and exposed to significant public debt. The two countries differ in the role of the executive vis-a-vis the legislative, and the tensions between central coordination and regional centrifugal forces. To improve the understanding of how the pandemic has influenced decision-making and crisis management, this article explains the relevance of institutional veto points, as well as differences between the two countries. There is room to match coordination, policy capacity and shared accountability through more collaborative governance.

Points for practitioners

Governing a transboundary crisis that involves different governmental levels is about creating an effective coordination mechanism that clarifies responsibilities, avoiding those who may block decision-making processes (veto players) through being incentivized to do so due to the absence of adequate shared accountability systems. National and regional managers should realize that the separation of territorial powers not accompanied by political coordination jeopardizes policy capacity in both the short and long term.
Vehicle lateral motion control via robust delay-dependent Takagi-Sugeno strategy
Authors: Coskun Serdar , Li Lin
Published: January 2021

Presented in this research paper is an integrated direct yaw moment control (DYC) and active front steering (AFS) for an uncertain vehicle lateral dynamics model considering network-induced communication delay, which is a time-varying continuous function with a known upper bound. Firstly, we consider tire cornering stiffness as a non-linear norm-bounded uncertain system that is modeled by fuzzy membership functions, and then vehicle lateral dynamics model is expressed by a set of linear Takagi-Sugeno (T-S) uncertain fuzzy models. Secondly, since the network-induced communication delay in vehicle control system is an inherent reason for stability and performance degradation, we derive a robust delay-dependent [Formula: see text] control methodology via the Lyapunov-Krasovskii functional for stability and performance conditions of the closed-loop system. For the synthesis, the robust control method is employed within the T-S fuzzy-model-based analysis framework and formulations are performed based on the solution of delay-dependent linear matrix inequalities (LMIs). The simulation study is presented using MATLAB/Simulink to show the achieved improvements in tracking variables via the designed robust fuzzy [Formula: see text] state-feedback controller. The proposed fuzzy robust delay-dependent controller is compared with a linear robust delay-dependent controller to clearly show the tracking improvements for different road conditions. Moreover, a performance-based analysis is carried out to demonstrate the advantage of the design with respect to different delay values. It is confirmed from the analysis results that the proposed fuzzy controller can successfully stabilize and possess improved tracking performance for vehicle lateral motion control.
3D Printing of a BAHA Protective Cap
Authors: Siu Alice K. Y. , Lee Lilian P. Y. , Leung Samantha M. L.
Published: January 2021

Mechanical feedback is one of the most common difficulties encountered when fitting hearing aids for toddlers and young children. We described the use of 3D printing to tailor a protective cap for a toddler with bilateral microtia/canal atresia to facilitate bone-anchoring hearing aid use.
The fundamentals of health economics and its application in the provision of vascular surgery in the UK
Authors: Osman Fatima , Ravendren Andrew , Mohammed Idhrees , Bashir Mohamad
Published: January 2021

Health economics offers a lifeline to policymakers as a way of improving health outcomes in the face of increased monetary constraints. Doctors are uniquely placed in healthcare delivery where they have a pertinent influence on both supply and demand for healthcare provisions. Every clinical decision made by doctors is also an economic decision, and the true cost of offering a scarce healthcare resource includes not being able to fund alternative therapies and hence, foregoing its benefit. Technology and innovation in medicine is seeing an increase in potential therapies; however, how well do they perform against the current gold standard and are they worth the additional cost? A personalized and patient-centered approach to medicine has paved the way for a holistic health outcome measure, quality-adjusted life years, which is predominately used by United Kingdom resource allocators. Aortic surgical interventions are resource-intensive, and recent trends have shown the growing economic burden as yearly costs continue to climb. Health economic models are not without their weaknesses and it is important that future analyses assess the impact on society, distributional consequences, and the value of collecting more information to reduce the uncertainty of the economic result.
Assessment of eye movements and selected vision function tests in three pupils with albinism: A case study in Tanzania
Authors: Wilhelmsen Gunvor B , Eide Mads Gjerstad , Felder Marion
Published: January 2021

Albinism is a huge challenge both socially and educationally in Tanzania and many other countries. Pupils with albinism are normally encouraged to read with a fixed gaze due to their nystagmus, and there are doubts about whether refraction improves their reading.

The aim is to get more knowledge about their functional vision as a fundament for educating pupils with albinism.

The article presents a case study with three pupils from a primary school in Tanzania who went through a functional assessment of vision using standardized methods and a new eye-tracker software measuring smooth pursuits.

The assessment reveals large individual differences not only in visual acuity but also in ocular motor functions.

There is a need for better understanding of the vision challenges these pupils face so that professionals can develop more suitable methods in school for securing their education.
Self-Directed Learning Online: An Opportunity to Binge
Authors: LaTour Kathryn A. , Noel Hayden N.
Published: January 2021

The online classroom is self-directed, where students decide when and how often they access their course material. Even in the traditional classroom, students have shown a propensity to shift their time allocation to the last minute, so it is not clear what happens when they have full control over their learning schedules. Our interest is whether this self-directed learning environment produces similar harmful binge behavior as observed with online television, where memory and satisfaction with the experience decrease over time. With access to clickstream data from an online e-educator, we found 62% of the sample binged their learning by concentrating their studies within the semester rather than distributing their online activity throughout. Two types of binge learning emerged as significant: Front-bingers, who accessed the majority of their education early, performed more similarly over time to those who spaced their learning activities. Back-bingers, who accessed the majority of their material late in the semester, did not perform as well. To help us better understand these findings, we used a relatively new measure of behavior called “clumpiness” to summarize their overall online activity. We discuss our findings and their implications for online education and marketing course design.
Medical Communications in an Agency Setting: A Career Option for Pharmacists
Authors: Miernicki Samantha , Anagnostos Gregory , Nathan Joseph P. , Grossman Sara
Published: January 2021

Medical communications (MedComms) agencies serve the varied needs of the pharmaceutical industry and other healthcare-related organizations. These agencies present a unique practice opportunity for pharmacists who possess the requisite knowledge and skillset to flourish and grow professionally in this environment. Published information about this sector of the industry is limited. To this end, this article provides an overview of the MedComms agency setting and describes the services provided by such agencies. These include the development of branded and/or unbranded communications materials in the form of publications, oral and video presentations, slide decks, and other materials. MedComms professionals also facilitate and support professional meetings and presentations, such as congresses, symposia, and advisory boards. Other services that MedComms agencies provide include engaging key opinion leaders, providing clinical trial services, and brand identification or positioning. The article describes the opportunities for pharmacists in this field, key characteristics and skills needed to succeed in this industry, and the pathway for pharmacists to enter this field.
Emotional Labour and the Autonomy of Dependent Self-Employed Workers: The Limitations of Digital Managerial Control in the Home Credit Sector
Authors: Terry Esme , Marks Abigail , Dakessian Arek , Christopoulos Dimitris
Published: January 2021

Changes to the labour process in the home credit sector have exposed the industry’s agency workforce to increased levels of digital managerial control through the introduction of lending applications and algorithmic decision-making techniques. This article highlights the heterogeneous nature of the impact of digitalisation on the labour process and worker autonomy – specifically, in terms of workers’ engagement in unquantified emotional labour. By considering the limitations of digital control in relation to qualitative elements of the labour process, it becomes evident that emotional labour has the scope to be a source of autonomy for dependent self-employed workers when set against a backdrop of heightened digital control. This article therefore contributes to ongoing labour process debates surrounding digitalisation, quantified workers and digital managerial control.
Climatic and anthropogenic influences on vegetation changes during the last 5000 years in a seasonal dry tropical forest at the northern limits of the Neotropics
Authors: Lozano-García Socorro , Figueroa-Rangel Blanca , Sosa-Nájera Susana , Caballero Margarita , Noren Anders J , Metcalfe Sarah E , Tellez-Valdés Oswaldo , Ortega-Guerrero Beatriz
Published: January 2021

Seasonal dry tropical forest (STDF) is a widespread vegetation type in western Mexico. Generally, this type of forest develops in semihumid habitats where lacustrine basins are scarce, preventing documentation of the vegetation history and forest dynamics using a paleoecological approach. Here, we present a palynological record from the Santa Maria del Oro crater lake, located within the distribution area of the STDF and the adjacent dry oak forest which gives insight into the changes in diversity and human impact at this tropical site. Pollen data, in combination with geochemical analysis and microcharcoal data from a lacustrine sequence, are used to discuss vegetation change and diversity in the plant assemblages related to drought or anthropogenic activity over the last 5000 years. Our results show three distinct periods of drought in the basin, from 4200 to 3850, 3100 to 2300, 1570 to 1100 and 300 cal year BP, with changes in vegetation composition mainly related to a decrease in taxa diversity during these periods. Based on the presence of maize pollen, two periods of human activity (3790–2160 and 280 cal year BP to present) were detected with an increase in herbaceous pollen used as a surrogate for deforestation. These two disturbance periods, pre-Columbian and postcolonial, occurred during wet conditions in the basin. Our results highlight the correlation between El Niño events, drought and fire with changes in the composition and diversity of STDF.
Rituximab – The first twenty years
Authors: Leandro Maria , Isenberg David A
Published: January 2021

It is now two decades since Rituximab was first used in the treatment of patients with systemic lupus erythematosus. There have been many challenges but in spite of failing to meet its primary endpoints in two clinical trials it is widely used for many aspects of lupus, its side-effects and the possibility that combining it with Benlysta may be of value. We also consider the proposal that it may provide a useful initial therapy. In this review, we consider the place of Rituximab in the treatment of lupus and anticipate how developments in fully-humanized anti-CD20 monoclonals may well extend the “therapeutic life” of B-cell depletion as a viable treatment option.
The Impact of Interest Rate on Exchange Rate Within ASEAN Countries: Evidence from Linear and Nonlinear ARDL Frameworks
Authors: Ahmed H. F. Tareq , Mazlan Nur Syazwani
Published: January 2021

This study examines the symmetric and/or asymmetric effects of changes in the interest rate on exchange rate of the ASEAN countries. It further aims to compare these linkages by using a dataset consisting of 48–68 quarterly data items, ranging over the period 2002–2017, of the ASEAN countries. Using both the linear autoregressive distributed lag (ARDL) and nonlinear ARDL (NARDL) approaches, the findings indicate that these effects vary from one country to another. We observe that changes in interest rates have short-run symmetric effects on the exchange rates, which also hold in the long run for five ASEAN countries, namely, Cambodia, Malaysia, Thailand, Vietnam, and Singapore. On the other hand, changes in interest rates have asymmetric (negative) effects on the exchange rates, which also hold in the long run for seven ASEAN countries, namely, Cambodia, Indonesia, Malaysia, the Philippines, Singapore, Thailand, and Vietnam.
An online monitoring method for creep-fatigue life consumption with real-time damage accumulation
Authors: Hong Hui , Cai Zhenwei , Wang Weizhe , Liu Yingzheng
Published: January 2021

Online damage evaluation based on monitored complex cyclic loadings has become an important technique for reliability assessment, especially in high-temperature environments where creep occurs in addition to fatigue. Accuracy and rapidity of calculation are basic requirements for online damage evaluation methods. However, current creep damage evaluation methods seldom consider the fluctuation in stress, which leads to inaccuracy in life-consumption estimates. In addition, traditional cycle-counting methods are not applicable to online use. In this study, an online creep-fatigue damage evaluation method is proposed that accounts for the creep behavior that occurs under fluctuating loads. The cycle-counting method is modified from a rainflow-counting algorithm; it broadens the counting of half-cycles and adopts a new equivalent temperature in the stress-strain response calculation. The proposed method is explained in detail and demonstrated with a case study. The application of this method to a high-temperature, high-pressure pipe demonstrates its online applicability and accuracy. A time-matching algorithm is developed to display the damage evolution in real time, thus revealing the link between the incremental damage and the current load conditions, and yielding an intuitive demonstration of a given component’s state of health.
Time-dependent behavior of rock-like specimen containing multiple discontinuous joints under uniaxial step-loading compression
Authors: Yang Wendong , Bo Chunjie , Chen Xuguang , Huang Chenchen , Li Guizhi
Published: January 2021

Rock with multiple discontinuous joints widely exists in rock engineering, and its mechanical properties are complex, which greatly increases the difficulty of engineering design and construction. Time-dependent deformation characteristics and long-term strength evaluation of jointed rock masses remain poorly understood. In this work, the creep experiments of rock-like specimens with multiple discontinuous joints under uniaxial step-loading compression are carried out to explore the influence of joint geometry (rock bridge length, joint length, joint angle, and joint spacing) on creep strain, long-term strength, and failure pattern of specimens with multiple discontinuous joints. The following conclusions are drawn from the test results: 1) The deformation of jointed rock specimens has evident time-dependent effect, and the cumulative creep deformation increases as creep load increases; 2) The strength of jointed rock specimens under loading changes with time, and the ratio of long-term strength and creep peak strength ( σ∞/ σc) of the tested specimens ranges from 41% to 96%; 3) The distribution of initial joints affects the creep fracture modes of rock-like specimens. The rupture of rock-like specimens with different joints distribution is mainly caused by the growth of wing cracks and quasi-coplanar secondary cracks. Three different failure modes are observed from these specimens: i) tensile failure with cracks across the joint plane; ii) shear failure with cracks along the joint plane; and iii) tensile failure with cracks along the joint plane. Based on the principles of damage mechanics and fracture mechanics, a theoretical mechanistic model considering both the closure stage of pre-existing open joints and time-dependent propagation stage of new cracks is established. Considering the influence of joint length, joint angle and joint density, the evolution of creep strain of rock-like specimen with multiple discontinuous joints is analyzed. The theoretical model results agree well with the experimental results, which indicates that the established model can replicate the creep failure process of jointed rock mass. These theoretical and test results help us better understand the effect of multiple joints on the long-term behavior of rock mass.
The Global Ruling of Local Crisis Intervention: An Institutional Ethnography of Anti-Violence Work in Kyrgyzstan
Authors: Kim Elena
Published: January 2021

This article analyzes contradictory practices carried out in Kyrgyzstani crisis centers for victims of gender violence resulting in women-clients failing to obtain the protection they seek. These problematic dynamics are shaped by a global apparatus on women’s human rights protection and international standards of practice. Crisis center professionals perform the final activation of this ruling apparatus through textual work driven not by the women’s needs but by the goal of bringing local actions into accord with the “legal framework” organized and expressed by the national anti-violence law and the government’s need to report on it to international treaty bodies.
The influence of eWOM on intentions for booking luxury hotels by Generation Y
Authors: Lee Harold , Min Jihye , Yuan Jessica
Published: January 2021

Electronic word-of-mouth on social networking sites is one of the most effective marketing resources in the lodging industry. Furthermore, Generation Y is becoming an important customer base for the luxury hotel industry and relies heavily on eWOM on social networking sties. By adopting and using four selected constructs (perceived usefulness, enjoyment, subjective norm, and perceived behavioral control) from the extended Technology Acceptance Model and the Theory of Planned Behavior, this study reveals how eWOM on social networking sites influences Generation Y’s purchase intentions when booking luxury hotels. The current study suggests that the usage of eWOM on social networking sites not only helps potential Generation Y customers select suitable luxury hotels but also allows luxury hoteliers to better cater to this growing market segment.
Healthcare utilization and telemedicine: An evaluation using linked administrative data from Manitoba
Authors: Llorian Elisabet Rodriguez , Mason Gregory
Published: January 2021

Introduction

This research examines utilization patterns for patients using telemedicine compared to those receiving treatment conventionally. Administrative data from 2007–2016 is linked to records from the Manitoba Telehealth programme to conduct a population-level study.

Methods

Using a high dimensional propensity-weighted regression model, the study compares four utilization measures between telemedicine users and non-users. These include: ambulatory visits (number of visits to any physician), visits to primary care physicians, visits to specialists and the number of hospitalizations.

Results

Compared to non-users, telemedicine patients showed a higher number of in-person visits. Specifically, using incidence-rate ratios, telemedicine users had 1.32 more ambulatory visits ( p < 0.001; 95% confidence interval, 1.23–1.41), 1.26 more visits to primary care practitioners ( p<0.001; 95% confidence interval, 1.17–1.35), 1.38 more visits to specialists ( p < 0.001; 95% confidence interval, 1.19–1.61) and 1.14 more hospitalizations ( p>0.1; 95% confidence interval, 0.91–1.43). These results were robust to restricted analyses for distance, regions, and chronic conditions. Those patients with frequent virtual encounters with a specialist showed a decrease of the frequency of in-person visits of the same type of care (incidence-rate ratio=0.48, p < 0.001; 95% confidence interval, 0.44–0.54).

Discussion

Patterns in utilization vary between telemedicine users and non-users, with users showing a higher number of in-person visits than non-users, and only frequent users of telemedicine showing reduced in-person visits. Future investigation linking utilization patterns with patient care outcomes and costs will inform healthcare policy and clinical treatment plans.
The possibility of democratic socialism in Habermas
Authors: Teixeira Pedro A.
Published: January 2021

In keeping with the radical openness of his theory of democracy, Habermas avoided pre-determining the ideal mode of economic organization for his favoured model of deliberative democracy. Instead of attempting a full-blown derivation, in this article, I propose adapting the Rawlsian method of comparing different political–economic regimes as candidate applications of his theory of justice to Habermas’s theory of deliberative democracy. Although both theorists are seen as endorsing liberal democratic world views, from the perspective of political economy, the corollary of their conceptions of democracy would arguably veer elsewhere: in Rawls’s case, into the territory of property-owning democracy or democratic socialism, and in Habermas’s, into any political–economic regime which guarantees the real exercise of full political and discursive liberties against the background of legitimate lawmaking. The ultimate aim of this article is to discuss whether a concrete conception of democratic socialism, if any, is compatible with Habermas’s theory of deliberative democracy.
Using Social Marketing to Tackle Compulsive Buying
Authors: Sârghie Monica M. Popa
Published: January 2021

Background:

The present paper focuses on compulsive buying, outlining the need to tackle this phenomenon using a social marketing approach, for the wellbeing of the affected individuals, their families and contacts, and for the health of our society at large.

Focus of the Article:

This conceptual development article is centered on behavior change and social marketing strategies that can address compulsive buying.

Research Questions:

How can social marketers help in curbing compulsive buying? What conceptual components and practical guidelines can be used in marketing programs for addressing compulsive shopping?

Program Design/Approach:

The platform developed herein outlines segmentation, targeting, product, price, place and promotional strategies recommended based on theoretical elements across disciplines.

Importance to the Social Marketing Field:

To date, compulsive buying has largely been ignored in the social marketing field, despite its relevance and prevalence. This paper provides a framework that can be employed in developing social marketing programs.

Method:

The proposed platform was created by bridging the literatures on compulsive buying and social marketing, identifying useful theoretical elements (e.g., the potential of the Thranstheoretical model), adapting and customizing these elements to provide actionable insights for intervention programs. The toolkit used for tackling other addictions was taken into account and integrated into the current development.

Future Research:

This paper offers an initial framework for social marketing efforts aimed at compulsive buying. It hopes to inspire significantly more work in this area to explore the potential of other theories and approaches to foster behavioral change for the better.
Improved fatigue failure model for reliability analysis of mechanical parts inducing stress spectrum
Authors: Wang Yuhan , Liu Xintian , Wang Haijie , Wang Xu , Wang Xiaolan
Published: January 2021

To study the influence of random parameter on the reliability of the vehicle front stabilizer bar, the fatigue strength is analyzed according to the random fatigue strength prediction method, then the fatigue limit of the actual parts are estimated, a new fatigue failure model is improved by using the fatigue limit [Formula: see text] of actual parts. Through this model, the stress spectrum collected by real vehicle is introduced, Monte-Carlo simulation method is adopted to analyze the reliability and sensitivities of stabilizer bar under driving conditions. In addition, the influence of each basic random parameter on the failure probability is obtained. The results show that stabilizer bar diameter has a great influence on the failure probability, which provides certain reference for improving the reliability of the front stabilizer bar.
Value of information of in situ inspections of mooring lines
Authors: Mendoza Jorge , Paglia Jacopo , Eidsvik Jo , Köhler Jochen
Published: January 2021

Mooring systems that are used to secure position keeping of floating offshore oil and gas facilities are subject to deterioration processes, such as pitting corrosion and fatigue crack growth. Past investigations show that pitting corrosion has a significant effect on reducing the fatigue resistance of mooring chain links. In situ inspections are essential to monitor the development of the corrosion condition of the components of mooring systems and ensure sufficient structural safety. Unfortunately, offshore inspection campaigns require large financial commitments. As a consequence, inspecting all structural components is unfeasible. This article proposes to use value of information analysis to rank identified inspection alternatives. A Bayesian Network is proposed to model the statistical dependence of the corrosion deterioration among chain links at different locations of the mooring system. This is used to efficiently update the estimation of the corrosion condition of the complete mooring system given evidence from local observations and to reassess the structural reliability of the system. A case study is presented to illustrate the application of the framework.
An improved object tracking algorithm based on adaptive weighted strategy and occlusion detection mechanism
Authors: Tian Xiuyan , Li Haifang , Deng Hongxia
Published: January 2021

Due to complex background and volatile object shape-appearance in image, the stability and accuracy of tracking algorithm is often disturbed and reduced. So how to accurately and robustly track object in object tracking application is a challenge topic at home and abroad. Built upon the methodologies of compressive tracking and spatio-temporal context, a simple yet robust object tracking method is proposed for solving the drift and occlusion problems in paper. It combines two existing classical ideas into a single framework: adaptive weighted idea and occlusion detection mechanism. In order to weaken interference problems of object background, object area is firstly partitioned into equal-sized sub-patches and the different weight related with location information is assigned for each patch; Then, for improving its robustness, Bhattacharyya distance is adopted to find out these samples with maximum discrimination; In addition, our proposed occlusion detection mechanism is for recapturing the tracked object when occlusion occurs. Many simulation experiments show that our proposed algorithm achieves more favorable performance than these existing state-of-the-art algorithms in handing various challenging infrared videos, especially occlusion and shape deformation.
Anatomic study of fibrous structures attached to the volar ulnar corner of the radius: implications in the volar rim fracture
Authors: Saka Natsumi , Nimura Akimoto , Tsutsumi Masahiro , Nozaki Taiki , Watanabe Yoshinobu , Akita Keiichi
Published: January 2021

This study aimed to clarify the bone and soft tissue morphological features at the volar ulnar corner of the radius. Micro-computed tomography, macroscopic and histological analyses were conducted using 12 cadaveric wrists, and in vivo MRI studies of the wrist were evaluated in five healthy volunteers. The volar ulnar corner of the distal radius has a protrusion volar to the sigmoid notch. The capsule elements of the radiolunate and radioulnar joints merge and this conjoined capsule attaches to the radius at the ulnar protrusion. Histologically, this capsule attaches to the radius via fibrocartilage, with fibres running in the radioulnar direction. In-vivo MRI studies showed that the capsule attaching to the volar ulnar corner could be traced to the dorsal side of the ulnar styloid. Our findings indicate that, given the direction of the fibres, an avulsion force in the radioulnar direction could be a cause for volar rim fractures.
Intersession reliability of GPS-based and accelerometer-based physical variables in small-sided games with and without the offside rule
Authors: Custódio Igor Junio de Oliveira , Praça Gibson Moreira , Paula Leandro Vinhas de , Bredt Sarah da Glória Teles , Nakamura Fabio Yuzo , Chagas Mauro Heleno
Published: January 2021

This study aimed to analyze the intersession reliability of global positioning system (GPS-based) distances and accelerometer-based (acceleration) variables in small-sided soccer games (SSG) with and without the offside rule, as well as compare variables between the tasks. Twenty-four high-level U-17 soccer athletes played 3 versus 3 (plus goalkeepers) SSG in two formats (with and without the offside rule). SSG were performed on eight consecutive weeks (4 weeks for each group), twice a week. The physical demands were recorded using a GPS with an embedded triaxial accelerometer. GPS-based variables (total distance, average speed, and distances covered at different speeds) and accelerometer-based variables (Player Load™, root mean square of the acceleration recorded in each movement axis, and the root mean square of resultant acceleration) were calculated. Results showed that the inclusion of the offside rule reduced the total distance covered (large effect) and the distances covered at moderate speed zones (7–12.9 km/h – moderate effect; 13–17.9 km/h – large effect). In both SSG formats, GPS-based variables presented good to excellent reliability (intraclass correlation coefficients – ICC > 0.62) and accelerometer-based variables presented excellent reliability (ICC values > 0.89). Based on the results of this study, the offside rule decreases the physical demand of 3 versus 3 SSG and the physical demands required in these SSG present high intersession reliability.
Compressed sensing time-of-flight magnetic resonance angiography with high spatial resolution for evaluating intracranial aneurysms: comparison with digital subtraction angiography
Authors: Kim Donghyun , Heo Young Jin , Jeong Hae Woong , Baek Jin Wook , Shin Gi Won , Jin Sung-Chul , Baek Hye Jin , Ryu Kyeong Hwa , Kim Kang Soo , Kim InSeong
Published: January 2021

Background and purpose

Compressed sensing is used for accelerated acquisitions with incoherently under-sampled k-space data, and intracranial time-of-flight magnetic resonance angiography is suitable for compressed sensing. Compressed sensing time-of-flight is beneficial in decreasing acquisition time and increasing spatial resolution while maintaining acquisition time. In this retrospective study, we aimed to evaluate the image quality and diagnostic performance of compressed sensing time-of-flight with high spatial resolution and compare with parallel imaging time-of-flight using digital subtraction angiography as a reference.

Material and methods

In total, 39 patients with 46 intracranial aneurysms underwent parallel imaging and compressed sensing time-of-flight in the same imaging session and digital subtraction angiography before or after magnetic resonance angiography. The overall image quality, artefacts and diagnostic confidence were assessed by two observers. The contrast ratio, maximal aneurysm diameters and diagnostic performance were evaluated.

Results

Compressed sensing time-of-flight showed significantly better overall image quality, degree of artefacts and diagnostic confidence in both observers, with better inter-observer agreement. The contrast ratio was significantly higher for compressed sensing time-of-flight than for parallel imaging time-of-flight in both observers (source images, P < 0.001; maximum intensity projection images, P < 0.05 for both observers); however, the measured maximal diameters of aneurysms were not significantly different. Compressed sensing time-of-flight showed higher sensitivity, specificity, accuracy and positive and negative predictive values for detecting aneurysms than parallel imaging time-of-flight in both observers, with better inter-observer agreement. Compressed sensing time-of-flight was preferred over parallel imaging time-of-flight by both observers; however, parallel imaging time-of-flight was preferred in cases of giant and large aneurysms.

Conclusions

Compressed sensing-time-of-flight provides better image quality and diagnostic performance than parallel imaging time-of-flight. However, neuroradiologists should be aware of under-sampling artefacts caused by compressed sensing.
The effect of monoamine oxidase-B inhibitors on the alleviation of depressive symptoms in Parkinson’s disease: meta-analysis of randomized controlled trials
Authors: Huang Yao Hsien , Chen Jia Hung , Loh El Wui , Chan Lung , Hong Chien Tai
Published: January 2021

Background:

Depression is a major nonmotor symptom of Parkinson’s disease (PD). However, few treatments exist for PD depression. Monoamine oxidase-B inhibitors (MAOB-Is) provide symptomatic relief for the motor symptoms of PD and exert antidepressive effects. The present meta-analysis of randomized controlled trials (RCTs) investigated the effects of MAOB-Is on depressive symptoms in patients with PD.

Methods:

Articles on PD-management-related RCTs using one of three MAOB-Is approved by the US Food and Drug Administration, that is, selegiline, rasagiline, and safinamide, were identified. The primary outcomes were the benefits of MAOB-Is for depressive symptoms. Subgroup analysis included the effects of MAOB-Is on patients in the early versus middle-to-late stages of PD and the effect of short-term versus long-term treatment.

Results:

Overall, six studies were included, four of which were conducted on patients with early stage PD. Overall, MAOB-Is significantly reduced the severity of depressive symptoms [standardized mean difference (SMD): −0.14, 95% confidence interval (CI): −0.21 to −0.06, p < 0.001]. Subgroup analysis indicated that the positive effect of MAOB-Is was significant in patients with early stage PD (SMD: −0.20, 95% CI: −0.31 to −0.09, p < 0.001), but not in those with middle-to-late-stage PD (SMD: −0.07, 95% CI: −0.17 to 0.03, p = 0.18). The antidepressive effect was significant for short-term treatment, that is, 90–120 days (SMD: −0.23, 95% CI: −0.35 to −0.10, p < 0.001), but not long-term treatment, that is, 24 weeks to 18 months (SMD: −0.08, 95% CI: −0.18 to 0.01, p = 0.09).

Conclusion:

In addition to the treatment of PD motor symptoms, MAOB-Is may help reduce the severity of depressive symptoms in PD, especially in patients with early stage PD. Considering the tolerability and simultaneous benefits of MAOB-Is, further RCTs are warranted to confirm their therapeutic effects in moderate-to-severe PD depression.