bluuebunny/crossref_metadata_2025 huggingface dataset:
Checkpoint Inhibitors and Classical Hodgkin’s Lymphoma: Efficacy and Safety of Pembrolizumab in Relapsed/Refractory Tumor (Experience at the NI Pirogov Russian National Medical Center of Surgery)
Authors: Sarzhevskii Vladislav Olegovich , Demina E.A. , Mochkin N.E. , Spornik A.A. , Mamedova A.A. , Smirnova E.G. , Bannikova A.E. , Samoilova A.A. , Bogatyrev V.S. , Melnichenko V.Ya.
Published: April 2021

Background. Checkpoint inhibitors contribute to improving the treatment outcomes in patients with relapsed/refractory classical Hodgkin's lymphoma (cHL). The paper describes the first generalized experience with pembrolizumab-induc-ing cHL immunotherapy in Russia. The hallmark of the study is a long follow-up period. Aim. To retrospectively assess efficacy and safety of pem-brolizumab-inducing immunotherapy of relapsed/refractory cHL. Materials & Methods. The study enrolled 14 cHL patients: 3 men and 11 women aged 24-57 years (median 33 years). Pembrolizumab 200 mg or 2 mg/kg was intravenously administered every 3 weeks. Median pembrolizumab administration number was 27 (max. 52 administrations), median follow-up after immunotherapy onset was 31 months. Results. Complete response (as best response) was achieved in 8 (57 %) patients, 3 (21 %) patients showed partial response (as best response). Overall objective response was 78 %. Median number of pembrolizumab administrations resulting in better responses to immunotherapy was 4, which corresponded to 3 months of treatment. Maximum number of pembrolizumab administrations before achieving best response was 32. Best response duration (the period from achieving it to disease progression/relapse or to the end-point of data collection in case of sustained response) varied from 3 to 56 months (median 15 months). Most common severe adverse events of grade 3-4 were pulmonary complications. Overall survival for 12, 24, and 36 months was 92.9 %, 85.7 %, and 85.7 %, respectively, and progression-free survival was 76.9 %, 59.3 %, and 37.1 %, respectively; median time before progression was 27.7 months. Conclusion. The experience with pembrolizumab-inducing immunotherapy of relapsed/refractory cHL in Russia proves the efficacy and relative safety of this treatment approach. Due to long follow-up period a series of crucial practical immunotherapy-related issues were raised, which will need to be dealt with in future studies.
Chronic Lymphocytic Leukemia in Blood Relatives: Two Case Reports of Male Siblings
Authors: Kurkina Nadezhda Viktorovna , Repina E.A.
Published: April 2021

In recent years there are more and more evidences for a hereditary factor in malignant lymphoproliferative disorders. Various lymphoid tumors are diagnosed in blood relatives. This is most frequently observed in chronic lymphocytic leukemia: 13.3 % vs. 8.8 % in non-Hodgkin’s lymphoma and 5.9 % in Hodgkin’s lymphoma. This paper presents two case reports of chronic lymphocytic leukemia in blood relatives (male siblings). Besides, in one of them the efficacy of targeted therapy with ibrutinib is estimated.
Retrospective Survival Analysis of Multiple Myeloma Patients after Autologous Hematopoietic Stem Cell Transplantation
Authors: Kostroma Ivan Ivanovich , Zhernyakova A.A. , Zapreeva I.M. , Sidorova Zh.Yu. , Semenova N.Yu. , Karyagina E.V. , Stepchenkova E.I. , Bessmeltsev S.S. , Chechetkin A.V. , Gritsaev S.V.
Published: April 2021

Background. Autologous hematopoietic stem cell transplantation (auto-HSCT) is an indispensable treatment stage in patients with newly diagnosed multiple myeloma (MM) who are, based on age and health status, eligible for high-dose chemotherapy with subsequent auto-HSCT. However, the issue of double (tandem) auto-HSCT feasibility remains unresolved. Aim. To compare overall survival (OS) and progression-free survival (PFS) in MM patients after single and double (tandem) auto-HSCTs in clinical practice. Materials & Methods. Retrospective analysis enrolled 83 MM patients divided into two groups: with single (n = 41) and double (n = 42) auto-HSCTs. Median age in groups 1 and 2 was 58 years (range 42-68) and 54 years (range 40-65), respectively. In these groups there were 16 (39 %) and 11 (26.2 %) patients > 60 years old. The reference point of survival curve was the date of first (in group 1) and 2nd (in group 2) auto-HSCTs. In PFS assessment, completed event was the date of disease progression or relapse detection, including the biochemical one in case of specific therapy onset. Results. Total number of patients with > very good partial response before receiving auto-HSCT in group 1 was 23 (56.1 %), and in group 2 before receiving 2nd auto-HSCT it was 30 (71.4 %). Mel200 conditioning was administered to 53.7 % of patients in group 1. In group 2 this conditioning regimen was a priority in performing first auto-HSCT (83.3 % of patients) and was more rarely used in case of repeated transplantation (40.5 %). With median follow-up of 11 and 40.5 months in groups 1 and 2 no significant differences were identified either in median PFS (21 and 40 months; p = 0.154) or in median OS (not reached in both groups; p = 0.882). No differences between groups with respect to the time before relapse/progression or early relapse rate were observed. Conclusion. Repeated auto-HSCT showed no additional antitumor effect. It can be accounted for by the lack of data on chromosome aberrations at the disease onset in most patients and by a small number of patients in the groups. Nevertheless, it was decided to limit the number of tandem auto-HSCTs and to perform 2nd transplantation mostly in case of late relapse/progression. New studies were initiated which will focus on the search of predictors associated with survival improvement in MM patients while performing double (tandem) auto-HSCTs.
Comparative Pathomorphology of Lymph Node Changes in Kikuchi-Fujimoto and Autoimmune Diseases with Lymphadenopathy: Own Experience
Authors: Kovrigina Alla Mikhailovna
Published: April 2021

Background. Pathomorphological analysis of lymph node tissues in immune-mediated lymphadenopathies commonly presupposes differential diagnosis with tumors of lymphoid and myeloid tissues with partial lesions in lymph nodes. Besides, further study is required on pathogenetic relationship between autoimmune diseases with lymphadenopathy and Kikuchi-Fujimoto disease (KFD) with morphological substrate characterized by histiocytic necrotizing lymphadenitis. Aim. To compare, based on biopsy material, morpho-immunohistochemical characteristics of changes in lymph node tissues in patients with pathomorphological diagnosis of KFD and in patients with autoimmune diseases with lymphadenopathy, i.e. systemic lupus erythematosus (SLE) and adult Still's disease (ASD). Materials & Methods. Morphological and immunohistochemical analyses were carried out on lymph node biopsies of 20 patients, 16 out of them with KFD (men/women 15:1, median age 26.5 years, range 18-47 years; in 44 % of cases lesions were only in cervical lymph nodes). In 2 female patients (aged 19 and 33 years) SLE was diagnosed based on clinical and laboratory data, and 2 patients (a woman aged 43 years and a man aged 25 years) were diagnosed with ASD. Results. Morphological and immunohistochemical analyses detected three major cell populations similar in KFD and SLE and probably reflecting pathogenetic relationship of these diseases: histiocytes expressing myeloperoxidase (MPO+), CD123+ plasmacytoid dendritic cells, cytotoxic CD8+ T-cells, and granzyme B+. In 55 % of KFD cases and 2 SLE cases there were many activated CD30+ lymphoid cells clustered and scattered in the areas of cytotoxic T-cells. Conclusion. To exclude SLE during subsequent additional examination of patients with morphological substrate characterized by histiocytic necrotizing lymphadenitis it is reasonable to use the term “Kikuchi-like changes” instead of KFD. When the data of immunohistochemical analysis in KFD, SLE, and ASD patients are compared, MPO+ histiocytes in lymph node tissue can serve as diagnostic immunohistochemical marker of immunoinflammatory process. If they are detected, differential diagnosis with myeloid sarcoma is required. CD30 expression by activated cytotoxic lymphoid cells was identified in SLE and in 55 % of KFD cases, which is another important common diagnostic characteristic of the substrate of two diseases (KFD and SLE) and requires differential diagnosis with anaplastic large-cell lymphoma and Hodgkin's lymphoma. Within the analyzed group of 20 patients morphological substrate of lymph nodes in 2 ASD patients differed in its morphological and immunohistochemical parameters from that in KFD and SLE patients and was characterized by expanded paracortex and morpho-immunohistochemical characteristics of extrafollicular B-cell activation.
Erken Çocukluk Özel Eğitimi: Kuramsal ve Yasal Temeller, Dünya’daki ve Türkiye’deki Son Eğilimler
Authors: TOMRİS Gözde , ÇELİK Seçil
Published: April 2021

Giriş: Erken Çocukluk Özel Eğitimi (EÇÖE); 0-6/8 yaş döneminde gelişimsel yetersizliğe sahip veya gelişimi risk altında olan özel gereksinimli çocuklara ve ailelerine sunulan hizmetler bütünüdür. Kendine özgü çalışma alanı, felsefesi, değerleri, amaçları ve ortaya çıkış nedenleriyle profesyonel alanyazını ve araştırmaları olan bir disiplin alanıdır. Bu çalışmada, EÇÖE’nin temel özelliklerine ve kuramsal temellerine, tarihsel süreç içerisindeki gelişimine, alandaki yasal düzenlemelere, Dünya’da ve Türkiye’de EÇÖE uygulamalarına yönelik güncel gelişmelere, ülkemizdeki çözüm bekleyen sorunlara ve hizmetlerin niteliğini artırabilecek birtakım önerilere yer verilmesi amaçlanmıştır.Tartışma: Ülkemizdeki yasal düzenlemelerin gelişmiş ülkelerle paralellik gösterdiği ve alandaki çalışmaların giderek hız kazandığı gözlense de ülkemize özgü EÇÖE sistem modelinin olmaması, alandaki uzman personel eksikliği, uzmanlar ve kurumlar arası iş birliği, kanıt temelli müdahalelerin uygulamalara yansıması gibi konular halen çözüm beklemektedir. Çalışmanın özellikle ülkemizdeki özel gereksinimli çocuklara ve ailelerine, EÇÖE hizmetleri sunan uzmanlara ve eğitimcilere, bu alanda araştırma yapan araştırmacılara ve yasa geliştiricilere katkılar sunması beklenmektedir.
Türkiye’de Özel Eğitim Alanında Korunmaya İhtiyacı Olan Çocuklar
Authors: ELMACI Davut
Published: April 2021

Giriş: Tarihsel olarak bakıldığında korunmaya ihtiyacı olan çocukların ve özel eğitime ihtiyacı olan çocukların toplumca desteklenmeleri gerekli olan gruplardan olduğu söylenebilir. Bu kapsamda korunmaya ihtiyacı olan çocuk hizmetleriyle özel eğitim hizmetleri arasında da bir benzerlik bulunmaktadır. Ancak özel eğitim alanında korunmaya ihtiyacı olan çocuklara yeterince önem verilmediği dikkati çekmektedir.Yöntem: Derleme türü bu çalışmada, Türkiye’de korunmaya ihtiyacı olan çocukların özel eğitim alanındaki yerinin ne olduğunun belirlenmesi amaçlanmıştır. Bu amaç doğrultusunda doküman incelemesi yöntemi ile korunmaya ihtiyacı olan çocuklara yönelik hizmetlerin gelişimi ile özel eğitime ihtiyacı olan çocuklara yönelik hizmetlerin gelişimi yasal düzenlemeleri yansıtan belgeler temel alınarak incelenmiştir. İncelenen belgelerin temelini, Korunmaya Muhtaç Çocuklar Hakkında Kanunlar ve bu kanunlara ilişkin tasarılar ile Çocuk Koruma Kanunu oluşturmaktadır.Bulgular: Türkiye’de özel eğitimin gelişimi ile korunmaya ihtiyacı olan çocuk hizmetlerinin gelişimi arasında çok yakın ilişki bulunmaktadır. Özellikle 1949-1983 yılları arasında bu hizmetlerin bir arada şekillendiği görülmektedir. Özel eğitime ihtiyacı olan çocuk tanımı ile korunmaya ihtiyacı olan çocuk tanımı arasında benzerlikler bulunmaktadır.Tartışma: Özel eğitimin ne olduğu ile ilgili tartışmalar, özel eğitim ile çocuk koruma hizmetleri arasındaki ilişkiyi de etkilemektedir. Farklı koşulları ve gereksinimleri olan korunmaya ihtiyacı olan çocukların eğitimsel açıdan normal olarak aileleri yanında kalan akranları gibi değerlendirilmeleri hatalı olabilir. Gerek uygulama açısından gerekse kuramsal ve felsefi açıdan korunmaya ihtiyacı olan çocukların özel eğitim alanında ele alınması gerekli görülmektedir.
Countering Extremist Violence (CEV)
Authors: McCauley Clark
Published: April 2021

On November 24, 2020, Dr. Clark McCauley presented Countering Extremist Violence (CEV) at the 2020 CASIS West Coast Security Conference. The presentation was followed by a group panel for questions and answers. Main discussion topics included the distinction between terrorists and extremists; extremist violence; the role of Islam in extremism; and deradicalization.
Team Science in Precision Medicine: Study of Coleadership and Coauthorship Across Health Organizations
Authors: An Ning , Mattison John , Chen Xinyu , Alterovitz Gil
Published: April 2021

Background

Interdisciplinary collaborations bring lots of benefits to researchers in multiple areas, including precision medicine.

Objective

This viewpoint aims at studying how cross-institution team science would affect the development of precision medicine.

Methods

Publications of organizations on the eHealth Catalogue of Activities were collected in 2015 and 2017. The significance of the correlation between coleadership and coauthorship among different organizations was calculated using the Pearson chi-square test of independence. Other nonparametric tests examined whether organizations with coleaders publish more and better papers than organizations without coleaders.

Results

A total of 374 publications from 69 organizations were analyzed in 2015, and 7064 papers from 87 organizations were analyzed in 2017. Organizations with coleadership published more papers (P<.001, 2015 and 2017), which received higher citations (Z=–13.547, P<.001, 2017), compared to those without coleadership. Organizations with coleaders tended to publish papers together (P<.001, 2015 and 2017).

Conclusions

Our findings suggest that organizations in the field of precision medicine could greatly benefit from institutional-level team science. As a result, stronger collaboration is recommended.
The Uncounted Casualties of a Hidden COVID-19 Epidemic in China: Cross-sectional Study on Deaths Related to Overwork
Authors: Wang Zhicheng , Lin Leesa , Guo Yan , Xiong Huayi , Tang Kun
Published: April 2021

Background

During the COVID-19 response, nonclinical essential workers usually worked overtime and experienced significant work stress, which subsequently increased their risk of mortality due to cardiovascular diseases, stroke, and pre-existing conditions. Deaths on duty, including deaths due to overwork, during the COVID-19 response were usually reported on web-based platforms for public recognition and solidarity. Although no official statistics are available for these casualties, a list of on-duty deaths has been made publicly available on the web by crowdsourcing.

Objective

This study aims to understand the trends and characteristics of deaths related to overwork among the frontline nonclinical essential workers participating in nonpharmaceutical interventions during the first wave of COVID-19 in China.

Methods

Based on a web-based crowdsourced list of deaths on duty during the first wave of the COVID-19 response in China, we manually verified all overwork-related death records against the full-text web reports from credible sources. After excluding deaths caused by COVID-19 infection and accidents, a total of 340 deaths related to overwork among nonclinical essential workers were attributed to combatting the COVID-19 crisis. We coded the key characteristics of the deceased workers, including sex, age at death, location, causes of death, date of incidence, date of death, containment duties, working area, and occupation. The temporal and spatial correlations between deaths from overwork and COVID-19 cases in China were also examined using Pearson correlation coefficient.

Results

From January 20 to April 26, 2020, at least 340 nonclinical frontline workers in China were reported to have died as a result of overwork while combatting COVID-19. The weekly overwork mortality was positively correlated with weekly COVID-19 cases (r=0.79, P<.001). Two-thirds of deceased workers (230/340, 67.6%) were under 55 years old, and two major causes of deaths related to overwork were cardiovascular diseases (138/340, 40.6%) and cerebrovascular diseases (73/340, 21.5%). Outside of Hubei province, there were almost 2.5 times as many deaths caused by COVID-19–related overwork (308/340, 90.6%) than by COVID-19 itself (n=120).

Conclusions

The high number of deaths related to overwork among nonclinical essential workers at the frontline of the COVID-19 epidemic is alarming. Policies for occupational health protection against work hazards should therefore be prioritized and enforced.
Information Quality Frameworks for Digital Health Technologies: Systematic Review
Authors: Fadahunsi Kayode Philip , O'Connor Siobhan , Akinlua James Tosin , Wark Petra A , Gallagher Joseph , Carroll Christopher , Car Josip , Majeed Azeem , O'Donoghue John
Published: April 2021

Background

Digital health technologies (DHTs) generate a large volume of information used in health care for administrative, educational, research, and clinical purposes. The clinical use of digital information for diagnostic, therapeutic, and prognostic purposes has multiple patient safety problems, some of which result from poor information quality (IQ).

Objective

This systematic review aims to synthesize an IQ framework that could be used to evaluate the extent to which digital health information is fit for clinical purposes.

Methods

The review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. We searched Embase, MEDLINE, PubMed, CINAHL, Maternity and Infant Care, PsycINFO, Global Health, ProQuest Dissertations and Theses Global, Scopus, and HMIC (the Health Management Information Consortium) from inception until October 2019. Multidimensional IQ frameworks for assessing DHTs used in the clinical context by health care professionals were included. A thematic synthesis approach was used to synthesize the Clinical Information Quality (CLIQ) framework for digital health.

Results

We identified 10 existing IQ frameworks from which we developed the CLIQ framework for digital health with 13 unique dimensions: accessibility, completeness, portability, security, timeliness, accuracy, interpretability, plausibility, provenance, relevance, conformance, consistency, and maintainability, which were categorized into 3 meaningful categories: availability, informativeness, and usability.

Conclusions

This systematic review highlights the importance of the IQ of DHTs and its relevance to patient safety. The CLIQ framework for digital health will be useful in evaluating and conceptualizing IQ issues associated with digital health, thus forestalling potential patient safety problems.

Trial Registration

PROSPERO International Prospective Register of Systematic Reviews CRD42018097142; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=97142

International Registered Report Identifier (IRRID)

RR2-10.1136/bmjopen-2018-024722
“Ask a Doctor About Coronavirus”: How Physicians on Social Media Can Provide Valid Health Information During a Pandemic
Authors: Furstrand Dorthe , Pihl Andreas , Orbe Elif Bayram , Kingod Natasja , Søndergaard Jens
Published: April 2021

In the wake of the COVID-19 pandemic, the information stream has overflowed with accurate information, misinformation, and constantly changing guidelines. There is a great need for guidance on the identification of trustworthy health information, and official channels are struggling to keep pace with this infodemic. Consequently, a Facebook group was created where volunteer medical physicians would answer laypeople’s questions about the 2019 novel coronavirus. There is not much precedence in health care professional–driven Facebook groups, and the framework was thus developed continuously. We ended up with an approach without room for debate, which fostered a sense of calmness, trust, and safety among the questioners. Substantial moderator effort was needed to ensure high quality and consistency through collaboration among the presently >200 physicians participating in this group. At the time of writing, the group provides a much-needed service to >58,000 people in Denmark during this crisis.
Associations Between Health Literacy, eHealth Literacy, and COVID-19–Related Health Behaviors Among Chinese College Students: Cross-sectional Online Study
Authors: Li Shaojie , Cui Guanghui , Kaminga Atipatsa Chiwanda , Cheng Sixiang , Xu Huilan
Published: April 2021

Background

During the COVID-19 pandemic, the internet has significantly spread information, providing people with knowledge and advice about health protection regarding COVID-19. While a previous study demonstrated that health and eHealth literacy are related to COVID-19 prevention behaviors, few studies have focused on the relationship between health literacy, eHealth literacy, and COVID-19–related health behaviors. The latter includes not only preventative behaviors but also conventional health behaviors.

Objective

The objective of this study was to develop and verify a COVID-19–related health behavior questionnaire, explore its status and structure, and examine the associations between these behaviors and participants’ health literacy and eHealth literacy.

Methods

A snowball sampling method was adopted to recruit participants to complete anonymous cross-sectional questionnaire surveys online that assessed sociodemographic information, self-reported coronavirus knowledge, health literacy, eHealth literacy, and COVID-19–related health behaviors.

Results

Of 1873 college students who were recruited, 781 (41.7%) had adequate health literacy; the mean eHealth literacy score was 30.16 (SD 6.31). The COVID-19–related health behavior questionnaire presented a two-factor structure—COVID-19–specific precautionary behaviors and conventional health behaviors—with satisfactory fit indices and internal consistency (Cronbach α=.79). The mean score of COVID-19–related health behaviors was 53.77 (SD 8.03), and scores differed significantly (P<.05) with respect to residence, college year, academic major, family economic level, self-reported health status, having a family member or friend infected with coronavirus, and health literacy level. Linear regression analysis showed that health literacy and eHealth literacy were positively associated with COVID-19–specific precautionary behaviors (βhealth literacy=.149, βeHealth literacy=.368; P<.001) and conventional health behaviors (βhealth literacy=.219, βeHealth literacy=.277; P<.001).

Conclusions

The COVID-19–related health behavior questionnaire was a valid and reliable measure for assessing health behaviors during the pandemic. College students with higher health literacy and eHealth literacy can more actively adopt COVID-19–related health behaviors. Additionally, compared to health literacy, eHealth literacy is more closely related to COVID-19–related health behaviors. Public intervention measures based on health and eHealth literacy are required to promote COVID-19–related health behaviors during the pandemic, which may be helpful to reduce the risk of COVID-19 infection among college students.
Smart Decentralization of Personal Health Records with Physician Apps and Helper Agents on Blockchain: Platform Design and Implementation Study
Authors: Kim Hyeong-Joon , Kim Hye Hyeon , Ku Hosuk , Yoo Kyung Don , Lee Suehyun , Park Ji In , Kim Hyo Jin , Kim Kyeongmin , Chung Moon Kyung , Lee Kye Hwa , Kim Ju Han
Published: April 2021

Background

The Health Avatar Platform provides a mobile health environment with interconnected patient Avatars, physician apps, and intelligent agents (termed IoA3) for data privacy and participatory medicine; however, its fully decentralized architecture has come at the expense of decentralized data management and data provenance.

Objective

The introduction of blockchain and smart contract technologies to the legacy Health Avatar Platform with a clinical metadata registry remarkably strengthens decentralized health data integrity and immutable transaction traceability at the corresponding data-element level in a privacy-preserving fashion. A crypto-economy ecosystem was built to facilitate secure and traceable exchanges of sensitive health data.

Methods

The Health Avatar Platform decentralizes patient data in appropriate locations (ie, on patients’ smartphones and on physicians’ smart devices). We implemented an Ethereum-based hash chain for all transactions and smart contract–based processes to guarantee decentralized data integrity and to generate block data containing transaction metadata on-chain. Parameters of all types of data communications were enumerated and incorporated into 3 smart contracts, in this case, a health data transaction manager, a transaction status manager, and an application programming interface transaction manager. The actual decentralized health data are managed in an off-chain manner on appropriate smart devices and authenticated by hashed metadata on-chain.

Results

Metadata of each data transaction are captured in a Health Avatar Platform blockchain node by the smart contracts. We provide workflow diagrams each of the 3 use cases of data push (from a physician app or an intelligent agents to a patient Avatar), data pull (request to a patient Avatar by other entities), and data backup transactions. Each transaction can be finely managed at the corresponding data-element level rather than at the resource or document levels. Hash-chained metadata support data element–level verification of data integrity in subsequent transactions. Smart contracts can incentivize transactions for data sharing and intelligent digital health care services.

Conclusions

Health Avatar Platform and interconnected patient Avatars, physician apps, and intelligent agents provide a decentralized blockchain ecosystem for health data that enables trusted and finely tuned data sharing and facilitates health value-creating transactions with smart contracts.
A Wearable Ballistocardiography Device for Estimating Heart Rate During Positive Airway Pressure Therapy: Investigational Study Among the General Population
Authors: Gardner Mark , Randhawa Sharmil , Malouf Gordon , Reynolds Karen
Published: April 2021

Background

Obstructive sleep apnea (OSA) is a condition in which a person’s airway is obstructed during sleep, thus disturbing their sleep. People with OSA are at a higher risk of developing heart problems. OSA is commonly treated with a positive airway pressure (PAP) therapy device, which is used during sleep. The PAP therapy setup provides a good opportunity to monitor the heart health of people with OSA, but no simple, low-cost method is available for the PAP therapy device to monitor heart rate (HR).

Objective

This study aims to develop a simple, low-cost device to monitor the HR of people with OSA during PAP therapy. This device was then tested on a small group of participants to investigate the feasibility of the device.

Methods

A low-cost and simple device to monitor HR was created by attaching a gyroscope to a PAP mask, thus integrating HR monitoring into PAP therapy. The gyroscope signals were then analyzed to detect heartbeats, and a Kalman filter was used to produce a more accurate and consistent HR signal. In this study, 19 participants wore the modified PAP mask while the mask was connected to a PAP device. Participants lay in 3 common sleeping positions and then underwent 2 different PAP therapy modes to determine if these affected the accuracy of the HR estimation.

Results

Before the PAP device was turned on, the median HR error was <5 beats per minute, although the HR estimation error increased when participants lay on their side compared with when participants lay on their back. Using the different PAP therapy modes did not significantly increase the HR error.

Conclusions

These results show that monitoring HR from gyroscope signals in a PAP mask is possible during PAP therapy for different sleeping positions and PAP therapy modes, suggesting that long-term HR monitoring of OSA during PAP therapy may be possible.
Fast Healthcare Interoperability Resources (FHIR)–Based Quality Information Exchange for Clinical Next-Generation Sequencing Genomic Testing: Implementation Study
Authors: Seong Donghyeong , Jung Sungwon , Bae Sungchul , Chung Jongsuk , Son Dae-Soon , Yi Byoung-Kee
Published: April 2021

Background

Next-generation sequencing (NGS) technology has been rapidly adopted in clinical practice, with the scope extended to early diagnosis, disease classification, and treatment planning. As the number of requests for NGS genomic testing increases, substantial efforts have been made to deliver the testing results clearly and unambiguously. For the legitimacy of clinical NGS genomic testing, quality information from the process of producing genomic data should be included within the results. However, most reports provide insufficient quality information to confirm the reliability of genomic testing owing to the complexity of the NGS process.

Objective

The goal of this study was to develop a Fast Healthcare Interoperability Resources (FHIR)–based web app, NGS Quality Reporting (NGS-QR), to report and manage the quality of the information obtained from clinical NGS genomic tests.

Methods

We defined data elements for the exchange of quality information from clinical NGS genomic tests, and profiled a FHIR genomic resource to enable information exchange in a standardized format. We then developed the FHIR-based web app and FHIR server to exchange quality information, along with statistical analysis tools implemented with the R Shiny server.

Results

Approximately 1000 experimental data entries collected from the targeted sequencing pipeline CancerSCAN designed by Samsung Medical Center were used to validate implementation of the NGS-QR app using real-world data. The user can share the quality information of NGS genomic testing and verify the quality status of individual samples in the overall distribution.

Conclusions

This study successfully demonstrated how quality information of clinical NGS genomic testing can be exchanged in a standardized format. As the demand for NGS genomic testing in clinical settings increases and genomic data accumulate, quality information can be used as reference material to improve the quality of testing. This app could also motivate laboratories to perform diagnostic tests to provide high-quality genomic data.
Deep Convolutional Neural Network–Based Computer-Aided Detection System for COVID-19 Using Multiple Lung Scans: Design and Implementation Study
Authors: Ghaderzadeh Mustafa , Asadi Farkhondeh , Jafari Ramezan , Bashash Davood , Abolghasemi Hassan , Aria Mehrad
Published: April 2021

Background

Owing to the COVID-19 pandemic and the imminent collapse of health care systems following the exhaustion of financial, hospital, and medicinal resources, the World Health Organization changed the alert level of the COVID-19 pandemic from high to very high. Meanwhile, more cost-effective and precise COVID-19 detection methods are being preferred worldwide.

Objective

Machine vision–based COVID-19 detection methods, especially deep learning as a diagnostic method in the early stages of the pandemic, have been assigned great importance during the pandemic. This study aimed to design a highly efficient computer-aided detection (CAD) system for COVID-19 by using a neural search architecture network (NASNet)–based algorithm.

Methods

NASNet, a state-of-the-art pretrained convolutional neural network for image feature extraction, was adopted to identify patients with COVID-19 in their early stages of the disease. A local data set, comprising 10,153 computed tomography scans of 190 patients with and 59 without COVID-19 was used.

Results

After fitting on the training data set, hyperparameter tuning, and topological alterations of the classifier block, the proposed NASNet-based model was evaluated on the test data set and yielded remarkable results. The proposed model's performance achieved a detection sensitivity, specificity, and accuracy of 0.999, 0.986, and 0.996, respectively.

Conclusions

The proposed model achieved acceptable results in the categorization of 2 data classes. Therefore, a CAD system was designed on the basis of this model for COVID-19 detection using multiple lung computed tomography scans. The system differentiated all COVID-19 cases from non–COVID-19 ones without any error in the application phase. Overall, the proposed deep learning–based CAD system can greatly help radiologists detect COVID-19 in its early stages. During the COVID-19 pandemic, the use of a CAD system as a screening tool would accelerate disease detection and prevent the loss of health care resources.
Feasibility, Acceptability, and Efficacy of Virtual Reality Training for Older Adults and People With Disabilities: Single-Arm Pre-Post Study
Authors: Chau Pui Hing , Kwok Yan Yan Jojo , Chan Mee Kie Maggie , Kwan Ka Yu Daniel , Wong Kam Lun , Tang Ying Ho , Chau Kan Lung Peter , Lau Sheung Wa Matthew , Yiu Yan Yan Yannex , Kwong Mei Yan Fanny , Lai Wai Ting Thomas , Leung Mun Kit
Published: April 2021

Background

Unlike most virtual reality (VR) training programs that are targeted at homogenous populations, a set of VR games for rehabilitation purposes targeted at a heterogeneous group of users was developed. The VR games covered physical training, cognitive training (classification and reality orientation), community-living skills training, and relaxing scenery experiences. Special considerations for local older adults and people with disabilities were made in terms of hardware choice and software design.

Objective

This study aimed to evaluate the feasibility, acceptance, and efficacy of VR training among users with varying abilities.

Methods

A single-arm pretest-posttest evaluation study was conducted. The participants of the evaluation study were encouraged to undergo 30-minute VR training three times a week for 6 weeks. The 30-minute session consisted of 10 minutes of upper-limb motion games, 10 minutes of lower-limb motion games, and 10 minutes of cognitive games/community-living skills training/relaxing scenery experiences, as appropriate. On completion of each session, usage statistics were documented via the built-in VR software, whereas feedback on the experience of the VR games and adverse events was collected via self-reports and staff observations. Feasibility was reflected by usage statistics, and acceptance was reflected by positive feedback. In addition, health outcomes, including upper-limb dexterity, functional mobility, cognitive function, and happiness, were assessed at baseline, as well as 6 weeks and 3 months after baseline. The primary outcomes were upper-limb dexterity and acceptance of playing VR games.

Results

A total of 135 participants with a mean age of 62.7 years (SD 21.5) were recruited from May 2019 to January 2020, and 124 (91.9%) completed at least one follow-up. Additionally, 76.3% (103/135) of the participants could attend at least 70% of the proposed 18 sessions, and 72.5% (1382/1906) of the sessions had a training time of at least 20 minutes. Linear mixed effect models showed statistically significant effects in terms of upper-limb dexterity (small effect) and cognitive function (moderate effect). Among the 135 participants, 88 provided positive comments. Additionally, 10.4% (14/135) reported mild discomfort, such as dizziness, and none reported severe discomfort.

Conclusions

A set of VR training games for rehabilitation could be applied to users with heterogeneous abilities. Our VR games were acceptable to local older adults and those with different disabilities. Benefits in upper-limb dexterity and cognitive function were observed despite partial compliance to the training protocol. Service providers could refer to our experiences when developing VR training systems for their clients.
L´hospitalité aux immigrants et les frontières urbaines : du régime des échanges conditionnels de Mauss à l’hospitalité inconditionnelle de Derrida
Authors: Brusadin Leandro Benedini
Published: April 2021

La sociologie et la philosophie sont comprises dans cette étude comme des prémisses fondamentales pour la recherche en hospitalité sous les attributs et les pensées de l’École française. À contre-sens du processus d’accueil social, la modernité se caractérise par une société d’individus qui extrait d’elle-même les actions collectives et les obligations envers l’autre. La méthodologie part d’une discussion épistémologique qui cherche à connecter les études classiques axées sur la théorie du don de Marcel Mauss aux écrits d’hospitalité de Jacques Derrida par l’entremise de penseurs français contemporains comme Anne Gotman. L’aspiration inconditionnelle aux immigrants dans la ville et les échanges de dons asymétriques entre membres et non-membres forment notre concept humain d’hospitalité.
Entre encontros e desencontros: representação, debate público e participação política da comunidade libanesa de São Paulo e Foz do Iguaçu
Authors: Somma de Castro Isabelle Christine
Published: April 2021

Esse artigo aborda os diferentes aspectos da percepção sobre e dos imigrantes sírio-libaneses em duas cidades brasileiras, São Paulo e Foz do Iguaçu. Foram observados três eixos específicos: o debate público, envolvendo as representações e as controvérsias, a participação e mobilização de membros da comunidade no cenário político local e a questão da etnicidade, com ênfase nas comunidades muçulmanas. Além de basear-nos em fontes secundárias, acrescentaremos relatos colhidos em pesquisa de campo realizadas em ambas as cidades entre 2018 e 2020, além de documentos oficiais, também disponibilizados pela Lei de Acesso à Informação. Concluímos que as tensões entre as fidelidades étnica, nacional e político-sectária conduzem a comunidade libanesa em sua dimensão mais ampla. Entre os descendentes dos pioneiros, essas tensões foram superadas pela total assimilação, facilitada pela adesão confessional. Por outro lado, novos desafios se colocam especialmente aos libaneses e descendentes da comunidade muçulmana, que têm de lidar com a crescente adesão dos brasileiros revertidos e a pouca inserção no cenário político-partidário do país.
Experiências vivenciadas por refugiados sírios em seu processo de integração cultural na cidade de São Paulo
Authors: Costa Eric Junior , Fernandes Duval Magalhães
Published: April 2021

Este artigo, após descrever brevemente o histórico das migrações sírio-libanesas para o Brasil, analisa narrativas de refugiados sírios, cujos temas são experiências linguísticas vividas na cidade de São Paulo. Os resultados destacam traumas ocasionados devido à guerra na Síria como obstáculos para a aprendizagem do novo idioma e para a integração desses migrantes, principalmente no comércio. Esses discursos apontam diferentes trajetórias e formas de integração dessa comunidade no Brasil.
O conceito da Turãh e a produção intelectual da imigração árabe no Brasil
Authors: Curi Guilherme Oliveira
Published: April 2021

Este artigo analisa a produção intelectual árabe no Brasil ao longo do século XX e a influência do conceito de turãh na trajetória destes intelectuais. Em um primeiro momento, analisamos as formas pelas quais os primeiros imigrantes árabes transformaram e representaram discursivamente a experiência migratória. Em seguida, abordamos a produção intelectual da segunda geração de imigrantes árabes no Brasil através de seis autores escolhidos.
Um retrato da migração de falantes de árabe para Foz do Iguaçu: história e integração à sociedade local
Authors: Jalil Samira Abdel
Published: April 2021

O presente artigo tem como objetivo apresentar um recorte sócio-histórico da migração de falantes de árabe para a cidade de Foz do Iguaçu a partir das representações sobre o movimento diaspórico construídas por quatro brasileiros natos, residentes na cidade, e que pelo menos um de seus progenitores era oriundo de país de língua árabe. Para atingir esse objetivo, intercalou-se a descrição de fatos históricos com trechos das narrativas dos participantes, que ilustraram suas percepções acerca do movimento migratório e do processo de reterritorialização de suas famílias.
As origens aldeãs das comunidades teuto-brasileiras no sul do Brasil: os Commons
Authors: Relly Eduardo
Published: April 2021

A historiografia da imigração alemã ao Brasil pouco conhece sobre as estruturas que animavam a vida social dos teuto-brasileiros no período pré-imigratório. Através de pesquisa empírica realizada na Alemanha, percebe-se que, em grande parte, a origem social das comunidades germano-brasileiras estava ligada à vivência de um contexto institucionalizado de aldeia comunal. Denominadas pela literatura como commons, este sistema sugere continuidades em relação à ocupação territorial do sul do Brasil pelos imigrantes alemães.
O Museu Municipal Ângelo Rosa de Moura (Porangatu-GO) e as reivindicações pelo patrimônio cultural
Authors: Campos Yussef Salomão de , Pina Max Lanio Martins
Published: April 2021

Este artigo faz levantamento histórico do Museu Municipal Ângelo Rosa de Moura de Porangatu, situado em um antigo prédio que foi uma importante casa de comércio de “secos e molhados". Recebeu o nome de Casa Jaguatirica e foi a residência do primeiro prefeito eleito desse município, o qual conferiu ao Museu a sua nomenclatura atual. Nossa intenção é perceber o perfil do público que frequentou o Museu, as nuances sobre a valorização patrimonial que ele recebe e a potencialidade como espaço científico, cultural e propício ao ensino e aprendizagem.
Brug dog kataloget!
Authors: Redaktionen Revy-
Published: April 2021

I Aarhus Amtstidende lørdag den 23. januar 1900 kunne man blandt andet læse om drøftelser om bygning af ”en videnskabelig højskole i Aarhus”, telegrammer fra Boerkrigen i Sydafrika og et friskt interview med den russiske forfatter, grev Leo Tolstoj. Men dagens avis indeholder også et fint læserbrev fra en trofast bruger af det daværende Landbohøjskolens Bibliotek, som i 1898 havde svimlende 2.633 udlån! Og så får vi slået fast, hvordan man bedrev litteratursøgning før internettet: Man brugte da kataloget!

Aarhus Amtstidende udkom for sidste gang i 1965.
Ny digital publikumsplatform hos Videnskabernes Selskab
Authors: Redaktionen Revy-
Published: April 2021

Hvad enten du er på udkig efter forskellige blækspruttearter, puniske gudebilleder, optegnelser over Knud den Helliges møntsamling eller de astronomiske observationer af Venus’ passage forbi solen i 1769 – eller bare et af tusindvis af andre emner – så er du kommet til det helt rette sted, når du går ind på publ.royalacademy.dk.
INVESTIGATION OF THE RELATIONSHIP BETWEEN UPSTREAM AND ON-RAMP FLOWS AT DOWNSTREAM CAPACITY LEVEL ON ISTANBUL FREEWAY MERGES
Authors: AKSOY Göker , ÖĞÜT Kemal Selçuk
Published: April 2021

Traffic congestion usually occurs at freeway merges due to the inequality of lane numbers at upstream and downstream. The freeway entry, defined as on-ramp, is the main cause of this irregularity and in order to clarify its effect, three freeway merges are investigated in this study with macroscopic flow parameters where a variety of geometric properties are present. In each merge, when the capacity flow is achieved at downstream, the on-ramp and upstream flows are determined and the relationship between upstream flow rate and ‘on-ramp ratio’, which is calculated by dividing the on ramp flow rate to the sum of on-ramp and upstream flow rates, is investigated. An inverse relationship is determined between total upstream flows (upstream flow plus on-ramp flow) with respect to on-ramp ratio. As a result, the merge with one lane drop and three-lanes at downstream seems to be least influenced type while the merge with two lanes drop and four lanes at downstream is the highest. For the former, 1% increase in on-ramp ratio causes a reduction of 20 pcu/h/lane on sum of total upstream flows while for the latter 26 pcu/h/lane. It is seen that the term on ramp ratio, can be quite useful variable for establishing capacities of freeway merges with the help of upstream and on-ramp traffic demands.
MULTI-STEP FORECASTING OF COVID-19 CASES IN EUROPEAN COUNTRIES USING TEMPORAL CONVOLUTIONAL NETWORKS
Authors: BİŞKİN Osman Tayfun
Published: April 2021

The novel Coronavirus (COVID-19) has significantly affected millions of people around the world since the first notification until nowadays. The rapid spread of the virus has dramatically increased the workload of healthcare systems in many countries. Therefore, the need for efficient use of the healthcare system leads researchers to forecast the trend of virus spread. For this purpose, Machine Learning (ML) and Artificial Intelligence (AI) applications have intensively used to struggle against the coronavirus outbreak. In this study, Temporal Convolutional Network (TCN) is applied for modeling the cumulative confirmed COVID-19 cases and forecasting the spread of it in various European countries using time series data. It is also presented that numerical examples for comparing performances of TCN against Long-Short Term Memory (LSTM) and Gates Recurrent Units(GRU) in terms of computation time, root-mean-square error (RMSE), normalized root-mean-square error (NRMSE), root mean squared log error (RMSLE), mean absolute percentage error (MAPE), and symmetric mean absolute percentage error (SMAPE). Simulation results indicate that the Temporal Convolutional Networks used in this manuscript performs better than other models for forecasting the cumulative confirmed COVID-19 cases.
Predictive value of d-dimer/albumin ratio and fibrinogen/albumin ratio for in-hospital mortality in patients with COVID-19
Authors: Küçükceran Kadir , Ayrancı Mustafa Kürşat , Girisgin Sadik , Koçak Sedat
Published: April 2021

Introduction: Due to the high mortality of coronavirus disease
2019 (COVID-19), there are difficulties in the managing emergency
department. We investigated whether the d-dimer/albumin ratio (DAR) and
fibrinogen/albumin ratio (FAR) predicts mortality in the COVID-19
patients.

Methods: A total of 717 COVID-19 patients who were brought to
the emergency department from March to October 2020 were included in the
study. Levels of d-dimer, fibrinogen, and albumin, as well as DAR, FAR,
age, gender, and in-hospital mortality status of the patients were
recorded. The patients were grouped by in-hospital mortality.
Statistical comparison was conducted between the groups.

Results: Of the patients included in the study, 371(51.7%)
were male, and their median age was 64 years (50–74). There was
in-hospital mortality in 126 (17.6%) patients. The area-under-the-curve
(AUC) and odds ratio values obtained by DAR to predict in-hospital
mortality were higher than the values obtained by the all other
parameters (AUC of DAR, albumin, d-dimer, FAR, and fibrinogen: 0.773,
0.766, 0.757, 0.703, and 0.637, respectively; odds ratio of
DAR>56.36, albumin<4.015,
d-dimer>292.5, FAR>112.33, and
fibrinogen>423: 7.898, 6.216, 6.058, 4.437, and 2.794,
respectively). In addition; patients with concurrent
DAR>56.36 and FAR>112.33 had an odds ratio of
21.879 with respect to patients with concurrent DAR<56.36 and
FAR<112.33.

Conclusion: DAR may be used as a new marker to predict
mortality in COVID-19 patients. In addition the concurrent high DARs and
FARs were found to be more valuable in predicting in-hospital mortality
than either separately.

Keywords: Covid-19, D-dimer, Fibrinogen, Serum Albumin,
in-Hospital Mortality
New Lump Solutions for Spatio-Temporal Dispersion (1+1)-Dimensional Ito-Equation
Authors: Shehata Maha , Zahran Emad , Bekir Ahmet
Published: April 2021

From point of view of two different schemas several new impressive lump
solutions to (1+1)-dimensional Ito equation have been established. The
first schema is the Paul-Painleve approach method (PPAM) which will be
applied perfectly to extract multiple lump solutions of this model,
while the second schema is the famous one of the ansatze method and has
personal profile named the Ricatti-Bernolli Sub-ODE method. In related
subject the numerical solutions corresponding to all lump solutions
achieved via each method have been demonstrated individually in the
framework of the variational iteration method (VIM).