bluuebunny/crossref_metadata_2025 huggingface dataset:
Skin Lesion Classification Using Densely Connected Convolutional Networks with Attention Residual Learning
Authors: Wu Jing , Hu Wei , Wen Yuan , Tu Wenli , Liu Xiaoming
Published: December 2020

Skin lesion classification is an effective approach aided by computer vision for the diagnosis of skin cancer. Though deep learning models presented advantages over traditional methods and brought tremendous breakthroughs, a precise diagnosis is still challenging because of the intra-class variation and inter-class similarity caused by the diversity of imaging methods and clinicopathology. In this paper, we propose a densely connected convolutional network with an attention and residual learning (ARDT-DenseNet) method for skin lesion classification. Each ARDT block consists of dense blocks, transition blocks and attention and residual modules. Compared to a residual network with the same number of convolutional layers, the size of the parameters of the densely connected network proposed in this paper has been reduced by half, while the accuracy of skin lesion classification is preserved. Our improved densely connected network adds an attention mechanism and residual learning after each dense block and transition block without introducing additional parameters. We evaluate the ARDT-DenseNet model with the ISIC 2016 and ISIC 2017 datasets. Our method achieves an ACC of 85.7% and an AUC of 83.7% in skin lesion classification with ISIC 2016 and an average AUC of 91.8% in skin lesion classification with ISIC 2017. The experimental results show that the method proposed in this paper has achieved a significant improvement in skin lesion classification, which is superior to that of the state-of-the-art method.
Investigating the Routine Dispatch Tasks Performed by Police Officers
Authors: Orr Robin , Hinton Benjamin , Wilson Andrew , Pope Rodney , Dawes Jay
Published: December 2020

Police officers perform a variety of physical tasks that can range from deskwork to chasing down fleeing suspects on foot. If not sufficiently prepared these tasks can lead to an increased risk of injury or task failure. The aim of this study was to profile the routine dispatch tasks performed by the Australian law enforcement officers of a state police force by frequency and duration. Participants for this study (n = 53: male n = 43, age = 33.5 ± 7.7 years, years of service = 7.2 ± 6.4 years: Female n = 10; age = 31.6 ± 9.1 years, years of service = 7.1 ± 6.1 years) were drawn from ten different police stations. Data reporting the tasks attended, their priorities, and their durations were gathered from a computer-aided dispatch system. Data from 77 shifts (3.8 ± 4.0 tasks/shift) captured 292 tasks attended (29.2 ± 17.5 task per station). ‘Check bona fides’ (checking an individual’s identification; 27%) was the most frequently occurring task followed by attending a domestic incident (14%). The longest task was attending an accident (mean = 43.50 ± 78.85 min, range 2–249 min). The results of this study suggest that police tasks are highly varied in terms of type and duration and these may differ between regions. An understanding of the dispatch tasks police officers are required to attend can inform injury mitigation and return-to-work rehabilitation practices.
Synthesis and Characterization of B/NaF and Silicon Phthalocyanine-Modified TiO2 and an Evaluation of Their Photocatalytic Removal of Carbamazepine
Authors: Anucha Chukwuka B. , Altin IIknur , Fabbri Debora , Degirmencioglu Ismail , Calza Paola , Magnacca Giuliana , Stathopoulos Vassilis N. , Bacaksiz Emin
Published: December 2020

This study investigated the synthesis of two different types of photocatalysts, namely, boron/sodium fluoride co-doped titanium dioxide (B/NaF-TiO2), and its analogue, a dye-sensitized form of silicon-based axial methoxy substituted phthalocyanine (B/NaF-TiO2SiPc). Structural and morphological characterizations were performed via X-ray diffraction (XRD); Fourier transform infra-red (FTIR); N2 adsorption–desorption at 77 K by Brunauer–Emmett–Teller (BET) and Barrett, Joyner, and Halenda (BJH) methods; transmission electron microscopy (TEM); X-ray photoelectron spectroscopy (XPS); and UV–visible absorption spectroscopy. The estimated crystallite size of pure TiO2 and pure B/NaF-TiO2 was 24 nm, and that of B/NaF-TiO2SiPc was 29 nm, whereas particle sizes determined by TEM were 25, 28, and 31 nm for pure TiO2, B/NaF-TiO2 and B/NaF-TiO2SiPc respectively. No significant differences between B/NaF-TiO2 and B/NaF-TiO2SiPc were observed for surface area by (BET) analysis (13 m2/g) or total pore volume by the BJH application model (0.05 cm3/g). Energy band gap values obtained for B/NaF-TiO2 and B/NaF-TiO2SiPc were 3.10 and 2.90 eV respectively, lower than pure TiO2 (3.17 eV). The photocatalytic activity of the synthesized materials was tested using carbamazepine (CBZ) as the model substrate. Carbamazepine removal after 4 h of irradiation was almost 100% for B/NaF-TiO2 and 70% for B/NaF-TiO2SiPc; however, the substrate mineralization proceeded slower, suggesting the presence of organic intermediates after the complete disappearance of the pollutant.
Importance of Government Roles for Market Expansion of Eco-Village Development Plan Establishment Research: Case Study in the City of Suwon, South Korea
Authors: Moon Soo-Young , Jang Daehee , Kim Hyeon Soo , Lee Ji-Young , Kim Jonghoon
Published: December 2020

Korean governmental ministries are promoting strategic projects to support cost-saving and low-carbon technologies in residential complexes and commercial buildings in the City of Suwon, South Korea. Suwon City will build throughout the city focusing on economic feasibility by selecting performance targets and using applied technologies for locations to be continuously expanded. This case study of Suwon shows that the local Korean government has prepared a project to spread eco-friendly residential complexes and is trying to introduce and realize eco-friendly construction standards proposed by the central Korean government. The central government is working to actively establish a system to promote eco-friendly construction technologies and encourages people to use eco-friendly construction methods and products. To build the demo-complex in the city, the role of the government was re-examined considering the universalization of energy and environmental technology through the analysis of case studies where these technologies were applied to residential complexes. The objectives of this research study are: (1) to establish a land use plan for the eco-village site in the City of Suwon, (2) to establish an external space plan, which includes the environmental aspects, and (3) to have alternative designs through a multi-criteria decision-making process. This study also used a cost-benefit analysis (BCA) to evaluate and ensure that there was no waste of the Korean government budget contribution, and to observe the business feasibility based on economic performance.
Perceptions of Future Teachers of Audiovisual Education and Communication. Challenges in Training for a Sustainable Education
Authors: Esteve-Faubel Rosa Pilar , Oller-Benitez Alba , Aparicio-Flores María Pilar
Published: December 2020

The education of future teachers is going through a crisis related to audiovisual education. Following what is known as the 2015–2030 Agenda, the world of education is being confronted with a new learning model that must respond to the proposals of the Sustainable Development Goals—SDGs. In this article, we want to emphasize the need for training future teachers to meet the new needs of media education, taking into account the increasing importance of sustainable development of children in relation to audiovisual media to maintain their welfare, skills and future prospects. For this reason, the objective of the study is to collect the perceptions of 278 future schoolteachers about the significance of audiovisual education and their own training on the subject, the socio-educational objectives of audiovisual tools, their positioning regarding audiovisual methodology and the concept of communication. Two ad-hoc questionnaires with an ex-post-facto design were used. The findings showed that a reduced percentage of students felt they had received full audiovisual training. Nevertheless, over half of the future schoolteachers considered their work in the classroom to be important for social and educational ends, both from a theoretical and a practical viewpoint. We believe it is necessary to provide audiovisual education to future schoolteachers based on students’ interests and needs.
Environmental Sustainability of Digitalization in Manufacturing: A Review
Authors: Chen Xiaoxia , Despeisse Mélanie , Johansson Björn
Published: December 2020

The rapid development and implementation of digitalization in manufacturing has enormous impact on the environment. It is still unclear whether digitalization has positive or negative environmental impact from applications in manufacturing. Therefore, this study aims to discuss the overall implications of digitalization on environmental sustainability through a literature study, within the scope of manufacturing (product design, production, transportation, and customer service). The analysis and categorization of selected articles resulted in two main findings: (1) Digitalization in manufacturing contributes positively to environmental sustainability by increasing resource and information efficiency as a result of applying Industry 4.0 technologies throughout the product lifecycle; (2) the negative environmental burden of digitalization is primarily due to increased resource and energy use, as well as waste and emissions from manufacturing, use, and disposal of the hardware (the technology lifecycle). Based on these findings, a lifecycle perspective is proposed, considering the environmental impacts from both the product and technology lifecycles. This study identified key implications of digitalization on environmental sustainability in manufacturing to increase awareness of both the positive and negative impacts of digitalization and thereby support decision making to invest in new digital technologies.
Sustainability and Educational Technology—A Description of the Teaching Self-Concept
Authors: Baena-Morales Salvador , Martinez-Roig Rosabel , Hernádez-Amorós María J.
Published: December 2020

The work of teaching is fundamental for achieving Agenda 2030, which defends the importance of improving quality in education (Sustainable Development Goal SDG 4), gender equality (SDG 5) and responsible consumption (SDG 12). Thus, the aim of the present study was to analyse teachers’ self-perceived digital competence as regards their eco-responsible use of technology. A total of 259 teachers in Preschool, Primary and Secondary Education in the Valencian Community (Spain) completed the 14-item questionnaire designed and validated by Barragán et al. (2020). Added to this were two open questions. The data collected then underwent quantitative (descriptive and comparative) and qualitative (conventional and summative content) analysis. Notable among the results were the low levels of knowledge and training regarding the environmental impact of technologies and the use of preventive measures. In addition, differences were found as regards gender, with males having a more positive self-perception, especially those teaching in Secondary Education. The information about training they provided in their narratives supported the quantitative findings. Their voices also led to the uncovering of proposals on how to teach eco-responsible practices and attitudes regarding the use of Information and Communication Technology (ICT). Finally, teacher training was identified as the main problem but also the main solution. All efforts should therefore be directed towards training teachers in the eco-responsible use of ICT following a holistic approach to sustainability.
Stakeholders Mapping for Sustainable Biofuels: An Innovative Procedure Based on Computational Text Analysis and Social Network Analysis
Authors: Ludovico Nuccio , Dessi Federica , Bonaiuto Marino
Published: December 2020

The identification and engagement of stakeholders is a challenge whose outcomes have a strong impact on a project’s success. This is even more relevant when the project concerns the introduction of sustainable technologies; these technologies are often less competitive on the market than traditional ones, both in terms of development complexity and production costs. This paper presents a stakeholder identification and mapping procedure, based on an Interest x Influence model, that emphasizes a quantitative methodological approach. The method has been applied on publicly available online data to identify and map potential stakeholders of a European research project aiming at creating a new biomass-derived biofuel. A semi-supervised procedure, built by combining computational text analysis and social network analysis techniques, has been used to calculate Interest and Influence scores for each potential stakeholder toward the project. The results show that stakeholders can be ranked on both dimensions and mapped on a bi-dimensional space according to their level of Interest and Influence. Within projects aiming at developing technologies for sustainability in which a wide range of stakeholders are involved at a transnational level, this stakeholder mapping technique provides a useful tool that can be adopted even with little knowledge on specific fields of application. A further asset of this approach lies in the possibility of profiling stakeholders on the basis of their Interest in the target project: this allows us to know the contents of a stakeholder (or stakeholders category) Interest, and therefore to have useful information for addressing the targeted stakeholder by means of a content design which is based on specific content categories, substantiating the stakeholder(s) Interest in the specific project.
Sustainable Wearable System: Human Behavior Modeling for Life-Logging Activities Using K-Ary Tree Hashing Classifier
Authors: Jalal Ahmad , Batool Mouazma , Kim Kibum
Published: December 2020

Human behavior modeling (HBM) is a challenging classification task for researchers seeking to develop sustainable systems that precisely monitor and record human life-logs. In recent years, several models have been proposed; however, HBM remains an inspiring problem that is only partly solved. This paper proposes a novel framework of human behavior modeling based on wearable inertial sensors; the system framework is composed of data acquisition, feature extraction, optimization and classification stages. First, inertial data is filtered via three different filters, i.e., Chebyshev, Elliptic and Bessel filters. Next, six different features from time and frequency domains are extracted to determine the maximum optimal values. Then, the Probability Based Incremental Learning (PBIL) optimizer and the K-Ary tree hashing classifier are applied to model different human activities. The proposed model is evaluated on two benchmark datasets, namely DALIAC and PAMPA2, and one self-annotated dataset, namely, IM-LifeLog, respectively. For evaluation, we used a leave-one-out cross validation scheme. The experimental results show that our model outperformed existing state-of-the-art methods with accuracy rates of 94.23%, 94.07% and 96.40% over DALIAC, PAMPA2 and IM-LifeLog datasets, respectively. The proposed system can be used in healthcare, physical activity detection, surveillance systems and medical fitness fields.
Examining the morphometric features of bulbus oculi in Van cats by using computed tomography and magnetic resonance imaging
Authors: YILMAZ Osman , DURMAZ Fatma
Published: December 2020

This study was conducted to obtain the morphometric and volumetric measurements of bulbus oculi of Van cats, growing around the city of Van in Turkey and named after here, by using computed tomography (CT) and magnetic resonance imaging (MRI), and to reveal the biometric differences of these measurement values between the sexes. A total of 16 adult Van cats including 8 females and 8 males were used in the study. The animals were anesthetized with the combination of xylazine and ketamine. The anesthetized animals were scanned by using CT and MRI devices and their images were obtained. Then, the morphometric and volumetric measurements of bulbus oculi were calculated from these images using the software (Syngo CT Software) in the workstation and their statistical analysis was performed. Upon the examination of the morphometric and volumetric analysis results, it was determined that while W (bodyweight) and ACL (Left Anterior Chamber) values were higher in male cats, DVLL (Dorsoventral length of the left lens) value was higher in female cats. These differences between the sexes were statistically significant (P<0.05). The volumetric measurement values of bulbus oculi and lens were determined to be averagely 4.60 ± 0.27 cm3 and 0.67 ± 0.09 cm3, respectively. In conclusion, the statistical differences of biometric values of bulbus oculi between male and female Van cats were determined by using CT and MRI. It is thought that the present study would contribute to the ophthalmological applications and the students receiving anatomy education.
Post-bariatric surgery nutritional follow-up in primary care: a population-based cohort study
Authors: Parretti Helen M , Subramanian Anuradhaa , Adderley Nicola J , Abbott Sally , Tahrani Abd A , Nirantharakumar Krishnarajah
Published: December 2020

Background

Bariatric surgery is the most effective treatment for severe obesity. However, without recommended follow-up it has long-term risks.

Aim

To investigate whether nutritional and weight monitoring in primary care meets current clinical guidance, after patients are discharged from specialist bariatric care.

Design and setting

Retrospective cohort study in primary care practices contributing to IQVIA Medical Research Data in the UK (1 January 2000 to 17 January 2018).

Method

Participants were adults who had had bariatric surgery with a minimum of 3 years’ follow-up post-surgery, as this study focused on patients discharged from specialist care (at 2 years post-surgery). Outcomes were the annual proportion of patients from 2 years post-surgery with a record of recommended nutritional screening blood tests, weight measurement, and prescription of nutritional supplements, and the proportions with nutritional deficiencies based on blood tests.

Results

A total of 3137 participants were included in the study, and median follow-up post-surgery was 5.7 (4.2–7.6) years. Between 45% and 59% of these patients had an annual weight measurement. The greatest proportions of patients with a record of annual nutritional blood tests were for tests routinely conducted in primary care, for example, recorded haemoglobin measurement varied between 44.9% (n = 629/1400) and 61.2% (n = 653/1067). Annual proportions of blood tests specific to bariatric surgery were low, for example, recorded copper measurement varied between 1.2% (n = 10/818) and 1.5% (n = 16/1067) where recommended. Results indicated that the most common deficiency was anaemia. Annual proportions of patients with prescriptions for recommended nutritional supplements were low.

Conclusion

This study suggests that patients who have bariatric surgery are not receiving the recommended nutritional monitoring after discharge from specialist care. GPs and patients should be supported to engage with follow-up care. Future research should aim to understand the reasons underpinning these findings.
Integrating Palliative Care by Virtue of Diplomacy; A Cross-sectional Group Interview Study of the Roles and Attitudes of Palliative Care Professionals to Further Integrate Palliative Care in Europe
Authors: van Gurp Jelle , van Wijngaarden Jeroen , Payne Sheila , Radbruch Lukas , van Beek Karen , Csikós Ágnes , Herder-van der Eerden Marlieke , Hasselaa Jeroen
Published: December 2020

Background: Palliative care involves the care for patients with severe and advanced diseases with a focus on quality of life and symptom management. Integration of palliative care with curative and/or chronic care is expected to lead to better results in terms of quality of life and reduced costs. Although initiatives in different countries in Europe choose different structures to integrate care, they face similar challenges when it comes to creating trust and aligning visions, cultures and professional values. This paper sets out to answer the following research question: what roles and attitudes do palliative care professionals need to adopt to further integrate palliative care in Europe? Methods: As part of the European Union (EU)-funded research project InSup-C (Integrated Supportive and Palliative Care). (2012-2016), 19 semi-structured group interviews with 136 (palliative) care professionals in 5 European countries (Germany, the United Kingdom, Belgium, the Netherlands, Hungary) were conducted. A thematic analysis was conducted. Results: Integration of palliative care calls for diplomatic professionals that can bring a cultural shift: to get palliative care, with its particular focus on the four dimensions (physical, psychological, social, spiritual), integrated into historically established medical procedures and guidelines. This requires (a) to find an entrance (for telling a normative story), and (b) to maintain and deepen relationships (in order to build trust). It means using the appropriate words and sending a univocal team message to patients and being grateful, modest, and aiming for a quiet revolution with curation oriented healthcare professionals. Conclusion: Diplomacy appears to be essential to palliative care providers for realizing trust and what can be defined as normative integration between palliative and curative and/or chronic medicine. It requires a practical wisdom about the culture and goals of regular care, as well as keeping a middle road between assimilating with values in regular medicine and standing up for the basic values central to palliative care.
Introducing Voluntary Assisted Dying: Staff Perspectives in an Acute Hospital
Authors: Digby Robin , McDougall Rosalind , Gold Michelle , Ko Danielle , O’Driscoll Lisa , Bucknall Tracey
Published: December 2020

Background: Voluntary assisted dying (VAD) was legalised in Victoria, Australia in June 2019. Physicians can now assist patients to end their lives by providing drugs for self-administration at their voluntary and competent request (or for physician administration in limited circumstances). This study investigates the opinions of clinicians on the implementation of the legislation in one Victorian hospital. Methods: This exploratory survey study was conducted at a 600-bed acute hospital in Melbourne, Australia in Jan 2019. 382 clinicians completed one or more qualitative questions. Participants commented on VAD, potential workplace challenges and staff support required. Free-text responses were analysed using inductive content analysis. Results: Six themes: (1) Polarised views; (2) Fear of conflict; (3) Emotional burden; (4) Vulnerable patients; (5) Organisational challenges; (6) Decision-making. There were diverse views including objections to VAD for religious or ethical reasons, and whole-hearted support based on a compassionate response to suffering and the right of patients to self-determination. Participants feared conflict between colleagues, families and patients, and aggression towards staff. Clinicians called for educational and psychological support. There was concern that vulnerable patients may be coerced to opt for VAD to lessen the burden on families or the health system. Clinicians feared workloads would increase with the introduction of VAD. Patient decision-making capacity in this context must be firmly established before proceeding, and thorough assessments for depression, and optimal symptom management must be implemented before VAD is approved. A dedicated VAD team was suggested to support staff and manage VAD patients. Conclusion: Participants expressed polarised opinions about VAD and showed considerable anxiety about its introduction. Additional education and support are required to ensure that clinicians understand details of the legislation and their professional and personal options. Tolerance and respect for alternative viewpoints must be advocated within the organisation and more broadly.
Exploring Community Mental Health Systems – A Participatory Health Needs and Assets Assessment in the Yamuna Valley, North India
Authors: Mathias Kaaren , Rawat Meenal , Thompson Anna , Gaitonde Rakhal , Jain Sumeet
Published: December 2020

Background: In India and global mental health, a key component of the care gap for people with mental health problems is poor system engagement with the contexts and priorities of community members. This study aimed to explore the nature of community mental health systems by conducting a participatory community assessment of the assets and needs for mental health in Uttarkashi, a remote district in North India. Methods: The data collection and analysis process were emergent, iterative, dialogic and participatory. Transcripts of 28 in-depth interviews (IDIs) with key informants such as traditional healers, people with lived experience and doctors at the government health centres (CHCs), as well as 10 participatory rural appraisal (PRA) meetings with 120 people in community and public health systems, were thematically analysed. The 753 codes were grouped into 93 categories and ultimately nine themes and three meta-themes (place, people, practices), paying attention to equity. Results: Yamuna valley was described as both ‘blessed’ and limited by geography, with bountiful natural resources enhancing mental health, yet remoteness limiting access to care. The people described strong norms of social support, yet hierarchical with entrenched exclusions related to caste and gender, and social conformity that limited social accountability of services. Care practices were porous, pluralist and fragmented, with operational primary care services that acknowledged traditional care providers, and trusted resources for mental health such as traditional healers (malis) and government health workers (accredited social health activists. ASHAs). Yet care was often absent or limited by being experienced as disrespectful or of low quality. Conclusion: Findings support the value of participatory methods, and policy actions that address power relations as well as social determinants within community and public health systems. To improve mental health in this remote setting and other South Asian rural locations, community and public health systems must dialogue with the local context, assets and priorities and be socially accountable.
Partnering to Build Human Resources for Health Capacity in Africa: A Descriptive Review of the Global Health Service Partnership’s Innovative Model for Health Professional Education and Training From 2013-2018
Authors: Kerry Vanessa B. , Ahaisibwe Bonaventure , Malewezi Bridget , Ngoma Deo , Daoust Patricia , Stuart-Shor Eileen , Mannino Clelia Anna , Day Dick , Foradori Laura , Sayeed Sadath A.
Published: December 2020

Several Sustainable Development Goals (SDGs) (3, 16, 17) point to the need to systematically address massive shortages of human resources for health (HRH), build capacity and leverage partnerships to reduce the burden of global illness. Addressing these complex needs remain challenging, as simple increases in absolute numbers of healthcare providers trained is insufficient; substantial investment into long-term high-quality training programs is needed, as are incentives to retain qualified professionals within local systems of care delivery. We describe a novel HRH initiative, the Global Health Service Partnership (GHSP), involving collaboration between the US government (President’s Emergency Plan for AIDS Relief [PEPFAR], Peace Corps), 5 African countries, and a US-based non-profit, Seed Global Health. GHSP was formed to enlist US health professionals to assist in strengthening teaching and training capacity and focused on pre-and in-service medical and nursing education in Malawi, Tanzania, Uganda, Eswatini and Liberia. From 2013-2018, GHSP sent 186 US health professionals to 27 institutions in 5 countries, helping to train 16 280 unique trainees of all levels. Qualitative impacts included cultivating a supportive classroom learning environment, providing a pedagogical bridge to clinical service, and fostering a supportive clinical learning and practice environment through role modeling, mentorship and personalized learning at the bedside. GHSP represented a novel, multilateral, public-private collaboration to help address HRH needs in Africa. It offers a plausible, structured template for engagement and partnership in the field.
Excess Cardiovascular Mortality in Latvia: A Novel Approach Based on Patient-Level Data to Estimate the Separate Contributions of Primary Prevention, Accessibility and Quality of Hospital Care
Authors: Lenzi Jacopo , Reno Chiara , Skrule Jolanta , Lepiksone Jana , Briģis Ģirts , Dūdele Alina , Pia Fantini Maria
Published: December 2020

Background: Because quantifying the relative contributions of prevention and medical care to the decline in cardiovascular mortality is controversial, at present mortality indicators use a fifty-fifty allocation to fraction avoidable cardiovascular deaths as being partly preventable and partly amenable. The aim of this study was to develop a dynamic approach to estimate the contributions of preventable versus amenable mortality, and to estimate the proportion of amenable mortality due to non-utilisation of care versus suboptimal quality of care. Methods: We calculated the contribution of primary prevention, healthcare utilisation and healthcare quality in Latvia by using Emilia-Romagna (ER) (Italy) as the best performer reference standard. In particular, we considered preventable mortality as the number of cardiovascular deaths that could be avoided if Latvia had the same incidence as ER, and then apportioned non-preventable mortality into the two components of non-utilisation versus suboptimal quality of hospital care based on the presence of hospital admissions in the days before death. This calculation was possible thanks to the availability of the unique patient identifier in the administrative databases of Latvia and ER. Results: 41.5 people per 100 000 population died in Latvia in 2016 from cardiovascular causes amenable to healthcare; about half of these (21.4 per 100 000) had had no contact with acute care settings, while the other half (20.1 per 100 000) had accessed the hospital but received suboptimal-quality healthcare. Another estimated 26.8 deaths per 100 000 population were due to lack of primary prevention. Deaths attributable to suboptimal quality or non-utilisation of hospital care constituted 60.7% of all avoidable cardiovascular mortality. Conclusion: If research is undertaken to understand the reasons for differences between territories and their possible relevance to lower performing countries, the dynamic assessment of country-specific contributions to avoidable mortality has considerable potential to stimulate cross-national learning and continuous improvement in population health outcomes.
Reflections on Methodological Congruence in Systems and Complexity-Informed Research Comment on "What Can Policy-Makers Get Out of Systems Thinking? Policy Partners’ Experiences of a Systems-Focused Research Collaboration in Preventive Health"
Authors: Teixeira de Melo Ana
Published: December 2020

In this paper we argue, for an increased congruence between the conceptual frameworks and the research methodology in studies focused on the theory or practice of systems and complexity-informed thinking (SCT). In doing so, we believe we can build more complex forms of knowledge with clearer and more impactful implications for practice. There is scope for both methodological innovations and the adaptation of traditional research methods to enact properties congruent with the systemic complexity of our targeted realities. We organise our reflection around the paper of Haynes et al. We provide examples of how a research methodology more deeply embedded in systems and complexity-thinking may add depth and meaning to the research results and their interpretation. We explore the creative adaptation of the interview techniques to integrate systemic forms of questioning (eg, circular and reflexive questioning) to map the patterns of interaction contributing to the outcomes of interventions.
Examining Governing Board Functions and Health Center Performances During Health System Reform: A Cross-sectional Study in 4 Regional States of Ethiopia
Authors: Argaw Mesele Damte , Desta Binyam Fekadu
Published: December 2020

Background: Since 1995, the Ethiopian health system has been managed through decentralizing functions, resources, and authorities to local levels. As a result, health centers are led and managed by governing boards. In addition, the national health system strives to transform the performance of health centers through the implementation of reforms. Therefore, this study aims to examine the relationship between governing board functions and health center performances within a health reform context in 4 agrarian regions of Ethiopia. Methods: A cross-sectional survey was conducted from August 28, 2018 to September 30, 2018. Primary data were collected from governing board chairpersons or their designees using interviewer-administered structured questionnaires. The performance of each health center was rated out of 100 percentage points against the Ethiopian Health Center Reform Guideline (EHCRIG) standards. Secondary data were abstracted from a routine health information database using customized tools to capture achievements on 69 EHCRIG standards and its 174 validation criteria. Since the data violate the assumptions of the parametric test, the Spearman’s rank (rho) correlation test, (a non-parametric test) was employed to see if any correlation exists among 4 parameters; namely: structure, roles and responsibilities, training and development of governing boards, and performance of health centers against EHCRIGs standards. A statistically significant relationship was claimed at P<.050. Results: All 83 health center governing boards or designees who were approached for this study, participated. The mean health center governing board function score with standard deviation was 56.0% (SD ± 14.5%). The overall performance of health centers against EHCRIGs was 70.4% (SD ± 15.0%). There was a statistically significant and strong correlation (Spearman rho correlation coefficient) between health center performance scores measured against reform standards with governing board scores of (rho=0.866, P<.001) and overall governance scores (rho=0.828, P<.001). Conclusion: Based on the results of this study, we can conclude that well-functioning health center governing boards can improve the performance of health centers against clinical, and management reform standards. Therefore, continuous strengthening of the capacity of governing boards, focusing on improving implementation of their roles and responsibilities, and continuing training on business management is recommended.
KAJI EKSPERIMEN PENGARUH LAPISAN KEKASARAN PERMUKAAN PIPA TERHADAP HEAD LOSS PADA PIPA PVC BERDIAMETER Ø 22 mm PANJANG 80 cm
Authors: Candra Rama , Nuryanti Siti Zahara , Andayani Ratih Diah , Djunaidi Rita
Published: December 2020

Aliran fluida  pada permukaan didalam pipa yang mempunyai lapisan kekasaran  yang berbeda dapat mengalami aliran laminer dan turbulen, yang dapat dilihat dari bilangan Reynold. Kecepatan aliran fluida dapat diketahui dengan mengatur bukaan katub. Setiap pipa diuji dengan air murni pada temperatur 30. Pengujian ini dilakukan dengan alat percobaan yang dipakai adalah pipa PVC silinder yang berdiameter  dengan fluida air menggunakan tujuh jenis  kekasaran dalam pipa yang berbeda yaitu, pipa tanpa lapisan tambahan, pipa dilapisi pasir halus, pipa dilapisi pasir kasar, pipa dibintik lubang, pipa dilapisi daun talas, pipa dilapisi pecahan batu bata, dan pipa dilapisi serat kayu, penelitian ini dilakukan untuk menkaji kekasaran permukaan dalam pipa terhadap perubahan Head Loss. Hasil Pada percobaan bahwa kekasaran permukaan pipa mempengaruhi nilai Bilangan Reynold dan Head Loss, semakin kasar permukaan pipa,  Bilangan Reynold dan head loss cenderung meningkat., Dari ketujuh kekasaran tersebut maka pipa yang dilapisi pecahan batu bata yang memiliki   nilai head loss yang paling tinggi yakni 0,995m dibanding dengan ke enam kekasaran lainya dikarenakan nilai kekasaran pecahan batu bata paling besar yakni              Ꜫ/D= 0,1, dan nilai Head loss yang paling rendah didapat pada pipa yang dilapisi dengan daunt alas yakni ∆h= 0,196m pada Bilangan Reynold 35622,7.

Kata kunci: Aliran turbulen, kekasaran permukaan, bilangan Reynold, Head loss
Capture of two coordinated evaders in a problem with fractional derivatives, phase restrictions and a simple matrix
Authors: Petrov N.N. , Machtakova A.I.
Published: December 2020

In the finite-dimensional Euclidean space, a task of pursuing two evaders by a group of pursuers is considered, described by a system of the form D(α)zij=azij+ui−v, where D(α)f is the Caputo fractional derivative of order α∈(0,1) of the function f, and a is a real number. It is assumed that all evaders use the same control and that the evaders do not leave a convex cone with vertex at the origin. The aim of the group of pursuers is to capture two evaders. The pursuers use program counterstrategies based on information about the initial positions and the control history of the evaders. The set of admissible controls is a unit ball centered at zero, the target sets are the origins. In terms of initial positions and game parameters, sufficient conditions for the capture are obtained. Using the method of resolving functions as a basic research tool, we derive sufficient conditions for the solvability of the approach problem in some guaranteed time
Lyapunov, Perron and upper-limit stability properties of autonomous differential systems
Authors: Sergeev I.N.
Published: December 2020

For a singular point of an autonomous differential system, the natural concepts of its Perron and upper-limit stability are defined, reminiscent of Lyapunov stability. Numerous varieties of them are introduced: from asymptotic and global stability to complete and total instability. Their logical connections with each other are investigated: cases of their coincidence are revealed and examples of their possible differences are given. The invariance of most of these properties with respect to the narrowing of the phase region of the system is established.
Some questions of differential game theory with phase constraints
Authors: Chentsov A.G.
Published: December 2020

Differential game (DG) of guidance-evasion is considered; moreover, its relaxations constructed with due account for priority considerations in the implementation of target set (TS) guidance and phase constraints (PC) validity are considered. We suppose that TS is closed in a natural topology of position space. With respect to the set that defines PC, it is postulated that the sections corresponding to time fixing are closed. For this setting, with the use of program iteration method (PIM), a variant of alternative for some natural (asymmetric) classes of strategies is established. A scheme of relaxation for the game guidance problem with nonclosed (in general case) set defining PC is considered. Under relaxation construction, reasons connected with priority in the implementation of guidance to TS and PC validity are taken into account (the case of asymmetric weakening of conditions of game ending is investigated). A position function is introduced, values of which (with priority correction) play the role of an analogue of least size for neighborhoods of TS and set defining PC under which it is possible to get a guaranteed solution of a relaxed problem of a player interested in approaching with TS while observing PC. It is demonstrated that the value of given function (when fixing the position of the game) is a price of DG for minimax-maximin quality functional which characterizes both the “degree” of approaching with TS and the “degree” of observance of initial PC.
Chapter 1 - Feeding children – a focus of tension in the Algerian city of Oran
Authors: Belghachem Hamdia , Salemi Ouassila , Bouchenak Malika , Nedjadi Karim Bouziane , Chaoui Nabil , Boureghda Imad , Mebtoul Mohamed
Published: December 2020

We looked at the issue of feeding children in the city of Oran from a gender standpoint. The aim was to highlight the tensions that deeply underlie household culinary activities carried out by mothers for the benefit of their children and husbands. An ethnographic survey was conducted in family homes in six socially diverse neighbourhoods of Oran, with 20 mothers from different social backgrounds. The survey involved interviews, monitoring of interactions between parents and children during meals and photos to view products stored in the refrigerator and to document the different meals eaten by the children. Our results showcased women’s heavy physical and mental workload during the different stages of culinary work carried out under time constraints.
Next-generation sequencing-based molecular genetic profiling in adults with acute myeloid leukaemia
Authors: Kashlakova A. I. , Parovichnikova E. N. , Biderman B. V. , Sidorova Y. V. , Chabaeva Y. A. , Troitskaya V. V. , Lukianova I. A. , Kokhno A. V. , Sokolov A. N. , Sudarikov A. B. , Obukhova T. N. , Savchenko V. G.
Published: December 2020

Introduction. Acute myeloid leukaemia (AML) is associated with multiple driver mutations, which prognostic value remains understudied.

Aim. Assessment of the frequency of mutations in various genes and their impact on acute myeloid leukaemia outcome in adults.

Materials and methods. The study included 90 adult patients with newly diagnosed AML; 76 were aged under 60, 14 were 60 and more years old. Patients under 60 had chemotherapy (CT) “7+3” as induction, the elder cohort had variant low-dose CT with hypomethylating agents. The molecular genetic status of patients was determined using next-generation sequencing; the in-house gene panel included ASXL1, BCOR, DNMT3, FLT3, IDH1, IDH2, PIGA, RUNX1, SETBP1, SF3B1, SRSF2, TET2, TP53 and U2AF2.

Results. Nucleotide substitutions were identiﬁed in genes DNMT3, TET2, TP53, SETBP1, BCOR, RUNX1, IDH2, IDH1, FLT3, U2AF2, SF3B1 in 57.8 % of the patients (n = 52), with 17.8 % (n = 16) having compound mutations in two or three genes. Treatment efﬁcacy and long-term outcomes were assessed against age, ELN-2017 risk groups and mutations in genes TP53, RUNX1, IDH1, IDH2 and DNMT3. In the long term, a reliable variation was revealed in the overall survival (OS) rate with respect to mutations in genes TP53 and RUNX1. Patients with mutant TP53 had 30 % OS, those with the intact gene — 53.4 % (p = 0.0037). Similar results were obtained with RUNX1: mutations marked 20 % OS, intact patients had 54% OS (p = 0.0466).

Conclusion. Mutations in genes FLT3-ITD, NPM1 and CEBPA are proxy to AML. However, a more accurate prognosis and optimal choice of therapy require detailed molecular proﬁling due to genetic heterogeneity of AML patients.
Clinical impact of plasma haemostasis disorders and their correction in chronic glomerulonephritis with nephrotic syndrome
Authors: Chebotareva N. V. , Berns A. S. , Lebedeva M. V. , Moiseev S. V.
Published: December 2020

Introduction. Thrombosis and thromboembolism are frequent complications in chronic glomerulonephritis (CGN) with nephrotic syndrome (NS), despite the use of anticoagulant therapy. Therefore, the questions of thrombosis risk assessment and thrombotic complication prevention in NS are still relevant.

Aim. Description of the frequency and localisation of thromboembolic complications in CGN-NS patients and a review of approaches to their risk assessment and prevention.

Main ﬁndings. The main risk predictors of venous thrombosis in NS are considered, including low serum albumin, high plasma D-dimer, age over 60 and hypovolemic conditions. The risk of arterial thrombosis is determined by general population factors: age, gender, smoking, diabetes mellitus and arterial hypertension. Venous thrombosis may be asymptomatic and mainly occurs in deep lower limb veins, renal veins and branches of pulmonary artery. Among the NS-associated CGN morphotypes of high risk are membranous nephropathy and membranoproliferative CGN. Issues in the thrombotic complication risk assessment, prevention and treatment are highlighted.
Coexistence of multiple myeloma and chronic myeloleukosis in one patient
Authors: Rybina O. V. , Shavel J. A. , Petrenko A. A. , Galaiko M. V. , Litvinenko M. S. , Egorkov V. E. , Gubkin A. V.
Published: December 2020

Intoduction. Multiple myeloma (MM) and chronic myelogenous leukaemia (CML) are two haematological malignancies developing through tumour transformation of lymphoid and myeloid progenitor cells, respectively, not sharing a common ancestry. Coexistence of the two diseases is extremely rare.

Aim. Clinical description of a patient diagnosed with CML in a few months after start of MM therapy.

Main ﬁndings. We report a clinical case of MM and CML in a 62 years-old female patient. MM was diagnosed newly and followed by 5 VD chemotherapy cycles. Treatment discontinued due to severe polyneuropathy. The patient was transferred to thalidomide maintenance therapy. CML was diagnosed 12 months after initiation of thalidomide therapy: BCR-ABL (p190), BCR-ABL (p210). Since imatinib produced short-term effect, dasatinib therapy was started. Following 16 months after the onset of dasatinib therapy, MM relapse and CML progression were diagnosed.
Indeks Massa Tubuh dengan Kadar Hb-A1c pada Pasien Diabetes Melitus Tipe II
Authors: Saputra Irman , Esfandiari Firhat , Marhayuni Esteria , Nur M
Published: December 2020

Latar Belakang :Berat badan berlebih adalah keadaan yang hampir mendekati obesitas, di mana seseorang dapat dinyatakan berat badan berlebih apabila orang tersebut memiliki IMT ≥ 23. Timbunan lemak yang berlebihan di dalam tubuh penderita berat badan berlebih atau obesitas dapat mengakibatkan resistensi insulin yang berpengaruh terhadap kadar gula darah dan mempunyai risiko 1,71 kali terkena diabetes melitus. Tanpa adanya penurunan berat badan dan modifikasi gaya hidup, orang dengan sindrom metabolik memiliki resiko bermakna untuk menjadi diabetes melitus tipe 2.Tujuan penelitian : Untuk mengetahui hubungan antara indeks massa tubuh dengan kadar Hb-A1c pada pasien FKTP diabetes melitus tipe 2 di praktik mandiri dokter K. Hakikiyah Lampung Tengah. Metode penelitian :Penelitian ini adalah analitik dengan menggunakan Desain penelitian Cross Sectional, populasi adalah seluruh pasien FKTP diabetes melitus tipe 2 di praktik mandiri dokter K. Hakikiyah Lampung Tengah. Penarikan sampel menggunakan total sampling dengan jumlah sampel 56 orang. Analisa data yang dilakukan adalah univariat dan bivariat dengan uji spearman. Hasil :Distribusi frekuensi Indeks Massa Tubuh IMT terbanyak yaitu kategori berlebih sebanyak 30 orang (53,6 %). Distribusi frekuensi kadar Hb-A1c terbanyak yaitu kategori berlebih  sebanyak 43 orang (76,8 %). Di ketahui ada hubungan antara Indeks Massa Tubuh (IMT) dengan kadar Hb-A1c pada pasien FKTP diabetes melitus tipe 2 di praktik mandiri dokter K. Hakikiyah Lampung Tengah dengan nilai p-value = 0,000, r = 0,600. Kesimpulan:Ada hubungan antara Indeks Massa Tubuh (IMT) dengan kadar Hb-A1c pada pasien FKTP diabetes melitus tipe 2 di praktik mandiri dokter K. Hakikiyah Lampung Tengah.  Kata Kunci : Indeks Masa Tubuh, Kadar Hb-A1c, DMT2.