bluuebunny/crossref_metadata_2025 huggingface dataset:
Improving the Quality of Service of Fixed WiMAX Networks by Decreasing Application Response Time Using a Distributed Model
Authors: Lawal Ibrahim A. , Ibrahim Adamu A. , Zammarah Nuha A.
Published: November 2022

In the most recent few years, there has been a meteoric rise in the number of different wireless networks, as has the demand for wireless data services and multimedia applications. An improvement in quality of service (QoS) is required in order to meet the ever-increasing demand while also providing a service that is of a higher standard. One of the most cutting-edge technologies, known as World Wide Interoperability for Microwave Access (WIMAX), was developed with the quality of service in mind during its development. Despite utilizing the most recent advancements in technology, the WiMAX network continues to struggle with QoS performance issues. A brand new distributed Client-Server model was designed for the fixed WiMAX Network in order to reduce application response time. This was done in order to improve the quality of service performance. In order to make a comparison with the existing centralized model, the performance of the proposed model was analyzed with OPNET Modeler 16.0. According to the findings, the newly proposed distributed Client-Server system is capable of satisfying the requirements set forth by its users owing to an improvement in QoS performance in terms of application response time when compared to the conventional model. The performance of the network was increased by the deployment of more Base Stations (BSs), Subscriber Stations, and the utilization of client-server Base Stations that were chosen by the Nearest Neighborhood Algorithm that was devised
Une autonomie sous contrainte. Les usages sociaux de l’autosurveillance glycémique par les personnes atteintes de diabète
Authors: Schlegel Vincent
Published: November 2022

À l’instar d’autres maladies chroniques, la gestion médicale du diabète est largement déléguée aux malades eux-mêmes. Les diabétiques sont ainsi amenés à mesurer seuls leur taux de sucre dans le sang, à interpréter le chiffre relevé et à agir en conséquence. En prenant pour objet les transformations induites par la délégation de la surveillance du corps aux malades, cet article propose d’interroger la fabrique du patient autonome lors des programmes éducatifs. Pour ce faire, l’article montre d’abord comment les usages de l’autosurveillance par les malades sont encadrés en amont par l’institution médicale. En adoptant le point de vue des malades, on peut ainsi déceler une profonde incorporation des gestes médicaux. Les pratiques de surveillance du corps donnent à voir comment le contrôle médical se dépersonnalise pour s’incarner dans des raisonnements intériorisés. Paradoxalement, c’est aussi grâce à l’appropriation de gestes et de raisonnements médicaux que certains malades en viennent à s’écarter des prescriptions qui leur sont faites.
« La liberté en toute sécurité ». Analyse d’une tension morale et pratique du care via l’étude des dispositifs techniques de géolocalisation destinés aux résident·e·s dit·es « fugueur·euse·s » des Ehpad : de la séduisante promesse technologique aux difficiles appropriations
Authors: Morey Pearl
Published: November 2022

Cet article propose d’analyser les dispositifs techniques de géolocalisation destinés aux résident·e·s des établissements d’hébergement pour personnes âgées dépendantes (Ehpad). Ces technologies se destinent principalement à des personnes âgées dites « malades d’Alzheimer » et sujettes aux « fugues ». Il s’agit de s’intéresser aux « ambivalences de care » données à voir par ces technologies, et notamment au « dilemme » entre la liberté de circuler et la sécurité des résident·e·s dont se portent garant·e·s les professionnel·le·s. Les dispositifs techniques de géolocalisation sont porteurs de plusieurs promesses, dont une vise spécifiquement la conciliation de ces deux valeurs. Ainsi, je me demande dans quelle mesure les dispositifs de géolocalisation tiennent leur promesse de conciliation de la tension liberté de circuler/sécurité. Pour répondre à cette question, j’analyse d’abord les discours des promesses des industriels, pour m’intéresser ensuite aux appropriations difficiles des dispositifs techniques en institution.
L’apport de l’anglais de spécialité dans la caractérisation sémantico-syntaxique des schémas de complémentation : le cas des énoncés capacitifs
Authors: Marty Caroline
Published: November 2022

Cet article étudie le schéma capacitif (énoncés de type The tent sleeps four), en lien avec ses contextes d’apparition. L’influence mutuelle de la construction verbale et de ces contextes est mise en lumière. La construction capacitive est utilisée pour assigner une capacité d’accueil positive au référent du sujet. Elle est majoritairement employée dans la presse (journaux et magazines), souvent spécialisée (tourisme, restauration, nautisme, loisir, etc.), ainsi que sur des sites internet d’annonces et d’avis (Airbnb, TripAdvisor, etc.). Ces contextes ne peuvent être décrits comme très spécialisés, car ils ne présentent pas de terminologie ou de structures syntaxiques très marquées ; par ailleurs, ils sont compris du grand public. Dès lors, la langue demeure plutôt générale. Cependant, le schéma capacitif peut être perçu comme spécialisé, car il ne dénote qu’une seule idée, celle de la contenance positive. Sa concision formelle et la possibilité qu’il offre de thématiser le constituant de lieu font de lui la construction favorisée dans ces contextes d’apparition, souvent concis et promotionnels.
Pourquoi le grammairien doit-il s’intéresser aux langues de spécialité ?
Authors: Furmaniak Grégory
Published: November 2022

Cet exposé plaide pour la prise en compte des discours spécialisés dans la description grammaticale des langues et dans leur enseignement. Nous commençons par montrer que les programmes de recherche en langues de spécialité et en grammaire ne sont pas incompatibles malgré des orientations opposées. Nous poursuivons en suggérant qu’il est non seulement illégitime mais également méthodologiquement impossible d’exclure des études grammaticales les données spécialisées. La troisième partie défend l’idée que l’étude des discours spécialisés aide le grammairien à mieux appréhender le fonctionnement de la grammaire dans son ensemble. L’article se termine par une réflexion sur les liens entre langue, contexte et culture, et suggère que les approches ethnolinguistiques développées par les chercheurs français en anglais de spécialité pourraient servir de modèle aux grammairiens et permettraient de lever un malentendu sur la dimension culturelle pertinente pour l’étude des langues. Des pistes de réflexion sont ainsi proposées dans le domaine de l’enseignement des langues et de la formation des enseignants.
Une prison pour mémoire
Authors: André Marc
Published: November 2022

Comment des mémoires traumatiques multiples, ancrées dans différentes guerres et devenues concurrentes, peuvent se retrouver dans un récit commun ? Comment réconcilier la mémoire et l’histoire ? Marc André trouve une réponse dans l’histoire de Montluc, une prison marquée par les violences du XXe siècle et les compétitions mémorielles du XXIe siècle.

À rebours des logiques concurrentielles révélées lors de la transformation de la prison en Mémorial en 2010 entre les porte-paroles des détenus sous l’occupation allemande, reconnus, et ceux de la guerre d’Algérie, écartés, le livre explore la manière dont la prison a permis aux expériences passées et présentes d’entrer en résonance, d’une guerre à l’autre. Après 1944, des responsables nazis et des miliciens sont emprisonnés à côté d’anciens résistants hostiles à la colonisation ; un militant communiste est enfermé pour sa critique de la guerre d’Indochine dans la cellule même où il était détenu sous Vichy ; des victimes de Klaus Barbie soutiennent des Algériens raflés, torturés, condamnés à mort et finalement guillotinés ; des cérémonies se tiennent devant les plaques commémoratives de la seconde guerre mondiale et servent à condamner la guerre coloniale. Ces collisions temporelles favorisent le scandale et forgent des solidarités imprévues entre les victimes de différentes répressions.

En nous immergeant dans cet espace où les ombres dialoguent, ce livre nous permet de saisir l’ensemble des événements, des pratiques et tout simplement des vies qui ont convergé et fait de Montluc une prison pour mémoire.
Social Media Influencers as a Sales Tool and Medium for Online-to-Offline Sales
Authors: Seif Sarah
Published: November 2022

According to statistics, customers at around 71% are willing to purchase products based on social media referrals. Also, by searching about products on social media such as Facebook, it shows that 71% of social media users have taken shopping actions because of seeing content posted by content creators. This chapter explores the evolution of influencer marketing as a concept, and discusses social media influencers role in the sales process online and offline as well as influencer marketing as an industry. With such growth of influencer marketing budgets and growth in industry size, and the transformation of influencers from Online third-party word of mouth tools to social commerce catalysts, the industry knows no limits and only knows innovation and finding more creative ways for integrating influencers with brands.
The Security of Global Value Chains (GVC)
Authors: Hong Ziyue , Zahid R. M. Ammar
Published: November 2022

Over the last several decades, as businesses have expanded globally in search of higher profits, value chains have become longer and more intricate. Indicators like inventory levels, on-time-in-full deliveries, and shorter lead times all improved for companies that effectively embraced a lean, global style of manufacturing. Complex production networks were created with the goals of efficiency, closeness to markets, and output, but not always with openness or resilience in mind. This chapter examines how businesses in the value chains of manufactured products must rebalance their operations to better manage the inherent risk in their operations. Indicators of the risk in any given industry's value chain include the industry's susceptibility to various shocks and the inherent weaknesses of companies and the overall chain. Therefore, the authors look at the characteristics in supply chains and operations that might amplify disruption and losses as well as the management of variety of shocks.
Sustainable Belt and Road (OBOR) Development
Authors: Nazir Sajid , Yu Zhang
Published: November 2022

China is the world's second-largest economy after the United States with more than 60% of the value of its trade being transported by sea. Therefore, China looks for short, safe, and inexpensive trade routes (both land and maritime) to reach Europe, Africa, and the Middle East countries. In doing so, China has taken the One Belt-One-Road (OBOR) initiative intending to develop a cost-effective transportation network ensuring timely and secure delivery. The objective of the OBOR strategy is to enhance Pakistan's infrastructure through the construction of the China-Pakistan Economic Corridor (CPEC). Therefore, this chapter aims to examine the implications of CPEC trade routes in terms of cost and delivery between China and other regions (i.e., Saudi Arabia, Iraq, Angola, Oman, Kuwait, and the United Arab Emirates) via Gwadar Port, Pakistan. The results demonstrate a significant reduction in cost and delivery time via the CPEC route in comparison with traditional trade routes.
The geo-spatial perspective of biological, social and environmental determinants of early pregnancy anaemia in rural Sri Lanka: Need for context-specific approaches on prevention
Authors: Amarasinghe Gayani Shashikala , Agampodi Thilini Chanchala , Mendis Vasana , Agampodi Suneth Buddhika
Published: November 2022

We provide a novel approach to understanding the multiple causations of maternal anaemia in a geospatial context, highlighting how genetics, environment and socioeconomic disparities at the micro-geographical level lead to the inequitable distribution of anaemia. All first-trimester pregnant women registered for the antenatal care programme in Anuradhapura District, Sri Lanka from July to September 2019 were invited to the Rajarata Pregnancy Cohort (RaPCo), which assessed the prevalence of anaemia in early pregnancy. The combination of the prevalence of anaemia and minor haemoglobinopathy-related anaemia (MHA) with the poverty headcount index of the 22 health divisions in the district was investigated using GeoDa spatial K-means clustering. Sociodemographic and economic data at the divisional level were compared between identified clusters. Combining the analysis with the geographical and environmental characteristics of the region, further hypotheses regarding anaemia in this community were formulated. The study included data from 3,137 pregnant women in early pregnancy. The anaemia and MHA prevalence varied from 13.6 to 21.7% and from 2.6% to 5%, respectively. We identified four distinct spatial clusters. The cluster with the highest anaemia prevalence also included high poverty and the highest prevalence of MHA. The clusters had significant differences with regard to ethnic distribution, access to water, sanitation and dietary patterns. Areas supplied by major irrigation projects had significantly low levels of anaemia, probably attributable to internal migration and improved livelihood. It was evident that genetic, socioeconomic and environmental risk factors were grouped at the divisional level, and that their complex interactions make controlling anaemia with blanket interventions unsuccessful. Analysis of the distribution of heterogeneous risk factors at the micro-geospatial level helped identify context-specific approaches to tackle anaemia in pregnancy.
Cause-specific mortality in Korea during the first year of the COVID-19 pandemic
Authors: Bahk Jinwook , Jung-Choi Kyunghee
Published: November 2022

OBJECTIVES: This study aimed to examine the trends in total mortality between 1998 and 2020 and to compare the changes in a wide range of detailed causes of death between 2020 (i.e., during the coronavirus disease 2019 [COVID-19] pandemic) and the previous year in Korea.METHODS: We used registered population and mortality data for the years 1998-2020 obtained from Statistics Korea. The age-standardized all-cause mortality rate and the annual percent change between 1998 and 2020 were determined. The rate ratio and rate difference of the age-standardized mortality rate between 2019 and 2020 were calculated.RESULTS: The age-standardized all-cause mortality rate in Korea has been on a downward trend since 1998, and the decline continued in 2020. In 2020, 950 people died from COVID-19, accounting for 0.3% of all deaths. Mortality decreased for most causes of death; however, the number of deaths attributed to sepsis and aspiration pneumonia increased between 2019 and 2020 for both men and women. Age-specific mortality rates decreased or remained stable between 2019 and 2020 for all age groups, except women aged 25-29. This increase was mainly attributed to a higher number of suicide deaths.CONCLUSIONS: This study shed light on the issues of sepsis and aspiration pneumonia despite the successful response to COVID-19 in Korea in 2020. Cases of death from sepsis and aspiration pneumonia should be identified and monitored. In addition, it is necessary to develop a proactive policy to address suicide among young people, especially young women.
Trends in breast cancer screening rates among Korean women: results from the Korean National Cancer Screening Survey, 2005-2020
Authors: Song Soo Yeon , Lee Yun Yeong , Shin Hye Young , Park Bomi , Suh Mina , Choi Kui Son , Jun Jae Kwan
Published: November 2022

OBJECTIVES: Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer.METHODS: Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups.RESULTS: In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas.CONCLUSIONS: Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
Multimorbidity patterns by health-related quality of life status in older adults: an association rules and network analysis utilizing the Korea National Health and Nutrition Examination Survey
Authors: Tran Thi-Ngoc , Lee Sanghee , Oh Chang-Mo , Cho Hyunsoon
Published: November 2022

OBJECTIVES: Improved life expectancy has increased the prevalence of older adults living with multimorbidity which likely deteriorates their health-related quality of life (HRQoL). However, relatively little is known about patterns and the relationships of multimorbidity by HRQoL status in older adults.METHODS: Individuals aged 65 or older from the Korea National Health and Nutrition Examination Survey V-VII (2010-2018) were analyzed. HRQoL was assessed by the EuroQoL-5 dimensions questionnaire and categorized as poor, normal, or good. The impact of multimorbidity on HRQoL was evaluated using logistic regression. The patterns and inter-relationships between multimorbidity, stratified by HRQoL groups, were analyzed using the association rules and network analysis approach.RESULTS: Multimorbidity was significantly associated with poor HRQoL (3 or more diseases vs. none; adjusted odds ratio, 2.70; 95% confidence interval, 2.10 to 3.46). Hypertension, arthritis, hyperlipidemia, and diabetes were the most prevalent diseases across all HRQoL groups. Complex interrelationships of morbidities, higher prevalence, and node strengths in all diseases were observed in the poor HRQoL group, particularly for arthritis, depression, and stroke, compared to other groups (1.5-3.0 times higher, p<0.05 for all). Apart from hypertension, arthritis and hyperlipidemia had a higher prevalence and stronger connections with other diseases in females, whereas this was the case for diabetes and stroke in males with poor HRQoL.CONCLUSIONS: Multimorbidity patterns formed complicatedly inter-correlated disease networks in the poor HRQoL group with differences according to sex. These findings enhance the understanding of multimorbidity connections and provide information on the healthcare needs of older adults, especially those with poor HRQoL.
Transition‐limited pulse‐amplitude modulation technique for high‐speed wireline communication systems
Authors: Song Eunji , Park Seonghyun , Han Jaeduk
Published: November 2022

This paper presents a transition‐limited pulse‐amplitude modulation (TLPAM) signaling method to enable a high data rate and robust wireline communications. TLPAM signaling addresses the impact of high intersymbol interference (ISI) ratios in conventional M‐ary PAM signaling methods by limiting the maximum voltage transition level between adjacent symbols. The implementation of a TLPAM signaling encoder is realized by setting back the most significant bits (MSBs) in the queue. The correlation between TLPAM's maximum transition level, effective data rate, and eye width/height is analyzed with various channel loss parameters, followed by characterization and measurement results with a realistic channel setup. The analysis and experimental results reveal the effectiveness of the proposed TLPAM signaling scheme for achieving a high data rate with minimal interference.
Impacts and implications of Digital Technology use in Supply Chain preparedness and response during the COVID-19 Pandemic
Authors: Akalin Gurkan , Corredor Felipe , Karpak Birsen , Illia Abdou
Published: November 2022

In this study, we examined the effect of digital technologies during COVID-19 pandemic. 104 supply chain managers responded to our survey. Based on their responses we were able to conclude that those firms who invested more in their digital technologies performed better in reducing the severity of COVID-19 pandemic related challenges, felt better prepared in general for the pandemic compared to the competitors, and considers their digital technology investments helped them during COVID-19 on their success which led them to invest further in Technology. We believe our findings will help businesses to consider investing in their digital technologies for better management of uncertainties in their supply chains.
Tendencias de investigación en branding enfocadas al adulto mayor: análisis bibliométrico y revisión sistemática de la literatura
Authors: López Rodríguez Campo Elías , Sandoval-Escobar Marithza
Published: November 2022

El presente artículo tiene como objetivo identificar las tendencias de investigación en branding y construcción de las marcas enfocadas al adulto mayor, considerando la importancia del conocimiento de este segmento de consumo, a partir de los cambios sociodemográficos correspondientes a la estructura poblacional en el mundo. Para esto, se llevó a cabo un análisis bibliométrico a partir de la base de datos Scopus y desarrollado con el software R Core Team 2020 - Bibliometrix y posteriormente se realizó una revisión sistemática cualitativa utilizando el protocolo PRISMA. Los resultados muestran que existe un interés reciente por la investigación en torno al estudio del branding y de temas afines del análisis del consumidor del segmento de adulto mayor, aunque aún posee un bajo nivel de producción científica. Los hallazgos identifican como temas más relevantes aquellos asociados con el valor de marca, la imagen de marca, la orientación al mercado, las estrategias de marketing relacional, la segmentación del mercado y el comportamiento del consumidor mayor. Respecto a la imagen de marca, se aprecia que los aspectos más característicos de los estudios se relacionan con la psicografía de la edad, los procesos cognitivos, la autoconfianza y la audacia. A partir de la revisión previa se reconoce la pertinencia de realizar mayores esfuerzos investigativos para responder a la necesidad de conocimiento acerca del comportamiento del consumidor adulto mayor, dado que son escasos los trabajos que permiten identificar las influencias, procesos y patrones de comportamiento de este segmento de mercado en el mundo.
Criptomonedas y Blockchain en el ámbito financiero: un análisis de correlación
Authors: Patricio Lozano David
Published: November 2022

En este artículo realizamos un estudio acerca de uno de los temas más disruptivos en los últimos tiempos: las criptomonedas. Ya sea como una revolución en los métodos de pago, por ser un activo especulativo o por las particularidades de la tecnología en la que se soporta, las criptomonedas cada vez están generando un mayor impacto en nuestras vidas, especialmente, en el mundo de las finanzas.
El principal objetivo que nos planteamos es adentrarnos en el conocimiento de las criptomonedas y la tecnología que las sostiene, de manera que nos permita tener una idea clara de las consecuencias de su aparición no solo en el ámbito financiero, sino también en la economía en general.
Si realizamos una aproximación a estas criptomonedas y a la tecnología blockchain, podremos conocer las ventajas de su utilización, así como de las desventajas de su existencia, lo que nos permitirá tener conciencia del papel que puede desempeñar esta tecnología en el presente, a corto y largo plazo, especialmente en el ámbito empresarial.
Tras este análisis de los orígenes del Bitcoin y su evolución, estudiamos su correlación con varios activos e índices: Ethereum (segunda criptomoneda con mayor valor), oro (commodity considerada como valor refugio), S&P500 (índice más representativo del mercado estadounidense) y el MSCI World Index (índice más representativo a nivel global), explicando brevemente cada uno de estos activos, para finalmente analizar su correlación con el Bitcoin desde el año del que disponemos datos de cada uno.
"Migrations, Gender and Inclusion in the European Context: An Interdisciplinary Approach". E-Learning Package
Authors: Terrón-Caro María Teresa , Cárdenas-Rodríguez Rocío , Aleksic Kassia , Bajt Veronica , Bergano Sofia , Biligha Patience , Chiappelli Tiziana , Di Grigoli Antonio Raimondo , Fouskas Theodoros , Frelih Mojca , Girón Teresa , Guo Wenjing , Lapov Zoran , Lyberopoulou Lola , Macias Gómez-Esthern Beatriz , Mancaniello Maria Rita , Martins Cristina , Moreira Benilde , Ortega-de-Mora Fabiola , Pajnik Mojca , Rebolledo Gámez Teresa , Rodrigues Maria José , Rodríguez Casado María del Rocío , Selim Monique
Published: November 2022

This publication is the third product of the Erasmus + Project entitled Voices of Immigrant Women (Project Number: 2020-1-ES01-KA203-082364). The e-learning package is aimed at university students from different disciplines, research staff, Higher Education professors and professionals who work in the field to address the social inclusion of migrant women with a gender perspective from Human Rights, an intersectional approach and interdisciplinary. The general objective of this resource is to improve the training of the different social agents who work or will work in the near future in migration and thus help combat discrimination, segregation, racism, harassment and violence, assuming the triple role that universities must carry out both in research, training and in social commitment. The contents are organized in 8 modules and each module has a double dimension: one transnational and one national. Training is based on theory and practice.
Kidney Cancer and Diabetes Mellitus: A Population-Based Case-Control Study in Taiwan
Authors: Lai Shih Wei , Liao Kuan Fu , Lai Hsueh Chou , Tsai Pang Yao , Sung Fung Chang , Chen Pei Chun
Published: November 2022

Introduction: The purpose of this study was to explore whether diabetes mellitus (DM) correlates with the risk of kidney cancer in Taiwan. Materials and Methods: We designed a population-based case-control study from the Taiwan National Health Insurance Database, which consisted of 116 patients with newly diagnosed kidney cancer as cases and 464 subjects without kidney cancer as controls in 2000 to 2009. Both cases and controls were aged ≥20 years. Baseline comorbidities were compared between kidney cancer cases and controls. Results: Multivariable analysis showed no association was detected between DM and kidney cancer (OR 1.06, 95% CI, 0.58 to 1.94). Hypertension (OR 2.05, 95% CI, 1.23 to 3.42), chronic kidney diseases (OR 2.57, 95% CI, 1.23 to 5.37), cystic kidney diseases (OR 18.6, 95% CI, 1.84 to 187.6) and kidney stones (OR 4.02, 95% CI, 2.43 to 6.66) were significant comorbidities associated with increased risk of kidney cancer. Use of alpha-glucosidase inhibitor was associated with increased risk of kidney cancer (OR 4.31, 95% CI, 1.07 to 17.3). Conclusion: DM does not correlate with the risk of kidney cancer. Hypertension, chronic kidney diseases, cystic kidney diseases, kidney stones and use of alpha-glucosidase inhibitors are associated with kidney cancer.

Key words: Chronic kidney disease, Cystic kidney disease, Diabetes mellitus, Hypertension, Kidney cancer, Kidney stone
The Use of Complementary and Alternative Medicine in Chronic Pain Patients in Singapore: A Single-Centre Study
Authors: Tan Michelle GE , Win Ma Thin Mar , Khan Shariq Ali
Published: November 2022

Introduction: The use of complementary and alternative medicine (CAM) in Singapore for a variety of conditions has been reported to be high. However in Asian chronic pain patients, there is no data on their use of CAM and its perceived benefits. Materials and Methods: A cross-sectional survey of 210 patients was carried out in Pain Management Centre. Patients were interviewed directly on their use of CAM. The outcomes were prevalence of CAM use, the types of CAM used, the perceived efficacy and factors influencing its use. Results: The prevalence of CAM users in chronic pain is 84%. The most common class of CAM is traditional Chinese medicine (68%) the subset of which, acupuncture, was most frequently utilised (49% of patients using CAM). In univariate analyses, ethnicity was significantly linked to CAM use but not gender, age, education level and income (P = 0.027). Specifically for neck pain, it was significant that patients were more likely to see a chiropractor, to use massage, to take take vitamins and ginseng to alleviate their symptoms. With upper limb pain, it was the use of Tui na, massage and seeing a TCM practitioner. For abdominal pain, it was the use of herbal medicines. The majority felt that CAM helped with their pain (72%) although less expressed satisfaction with CAM (64%). Reasons for using CAM included: having more control over their pain; fewer side effects; safety and lower costs compared to conventional medicine. Conclusion: The use of CAM in chronic pain patients is higher than the general population. Most felt that it improved their pain. As part of multimodal therapy, CAM may have a role in the management of chronic pain.

Key words: Acupuncture, CAM, Chiropracter, Efficacy
Evidence-Based Guidelines on the Use of Opioids in Chronic Non-Cancer Pain—A Consensus Statement by the Pain Association of Singapore Task Force
Authors: Ho Kok Yuen , Chua Nicholas HL , George Jane M , Yeo Sow Nam , Main Norhisham Bin , Choo Chee Yong , Tan James WT , Tan Kian Hian , Ng Beng Yeong
Published: November 2022

Introduction: While opioids are effective in carefully selected patients with chronic non-cancer pain (CNCP), they are associated with potential risks. Therefore, treatment recommendations for the safe and effective use of opioids in this patient population are needed. Materials and Methods: A multidisciplinary expert panel was convened by the Pain Association of Singapore to develop practical evidence-based recommendations on the use of opioids in the management of CNCP in the local population. This article discusses specific recommendations for various common CNCP conditions. Results: Available data demonstrate weak evidence for the long-term use of opioids. There is moderate evidence for the short-term benefit of opioids in certain CNCP conditions. Patients should be carefully screened and assessed prior to starting opioids. An opioid treatment agreement must be established, and urine drug testing may form part of this agreement. A trial duration of up to 2 months is necessary to determine efficacy, not only in terms of pain relief, but also to document improvement in function and quality of life. Regular reviews are essential with appropriate dose adjustments, if necessary, and routine assessment of analgesic efficacy, aberrant behaviour and adverse effects. The reasons for discontinuation of opioid therapy include side effects, lack of efficacy and aberrant drug behaviour. Conclusion: Due to insufficient evidence, the task force does not recommend the use of opioids as first-line treatment for various CNCP. They can be used as second- or third-line treatment, preferably as part of a multimodal approach. Additional studies conducted over extended periods are required. Key words: Chronic pain, Consensus statement, Guidelines, Non-cancer pain, Opioids
Rates and Predictors for Influenza Vaccine Prescriptions Among HIV-infected Clinic Patients in Singapore
Authors: Lim Poh Lian , Tan Joanne , Yusoff Yusrina , Win Mar Kyaw , Chow Angela
Published: November 2022

Introduction: Although Singapore national guidelines recommend influenza vaccination for individuals with comorbidities, the vaccine uptake remains relatively low. This study examines the rates of influenza vaccine prescriptions in a clinic population, and patient, doctor and clinic factors that could affect the vaccine prescribing rates. Materials and Methods: This retrospective review utilised electronic medical records from HIV-infected patients seen in an infectious disease (ID) specialist clinic. Data from 40 randomly selected patients per physician were analysed for the outcome of influenza vaccine prescriptions from 1 January to 31 December 2007. All 7 consultants and the 6 ID registrars who had spent at least 4 months in the Department during 2007 were included. Data analysed included patient, physician, and clinic characteristics, and clinically relevant outcomes of admission within a year, and the length of hospital stay. Results: Of the 461 HIV-infected patients analysed for this study, only 107 (23%) were prescribed influenza vaccine in 2007. Vaccine prescribing rates by individual physicians ranged from 0% to 77%. The outcome of vaccine prescribing was analysed by patient demographics (age >40 years, gender, race), physician characteristics (doctor grade, gender and training), and clinic volumes (number of patients per clinic session). Multivariate analysis demonstrated that patients with female doctors (OR 1.8, 95% CI, 1.1 to 3.0, P = 0.017), and doctors with overseas medical training (OR 11.6, 95% CI, 6.0 to 22.2, P <0.001) were significantly more likely to have influenza vaccine prescribed. On univariate analysis, patients were more likely to be admitted if they were male (OR 2.1, 95% CI, 1.0 to 5.1, P = 0.041), and over 40 years old (OR 2.1, 95% CI, 1.1 to 4.5, P = 0.024). Patients prescribed influenza vaccine showed a non-significant trend for protection against admission (OR 0.7, P = 0.288), and shorter length of stay (median 5 vs 9 days, P = 0.344). Conclusion: Influenza vaccine prescribing for HIV-infected outpatients in 2007 was only 23%, even in an ID specialist clinic. There was substantial variability in prescribing rates by individual physicians. Neither patient demographics nor patient volumes per clinic session had an impact on the prescribing rates, but significant predictors included physician gender and medical school training. Patients prescribed influenza vaccine had fewer admissions and shorter hospital lengths of stay, although these trends were non-significant. Key words: Asia, Influenza vaccine, HIV, Singapore, Vaccination rates
Revision Total Knee Arthroplasty: Causes and Outcomes
Authors: Tay Kae Sian , Lo Ngai Nung , Yeo Seng Jin , Chia Shi-Lu , Tay Darren KJ , Chin Pak Lin
Published: November 2022

Introduction: Local data on revision total knee arthroplasty (TKA) are limited. This study aims to assess the causes and outcomes of revision TKA in a single institution, with a 2-year follow-up. Materials and Methods: A retrospective review of case records of patients who underwent revision TKA in 2008 and 2009 in the authors’ institution was performed. Outcome was assessed using SF-36, Oxford knee score and Knee Society Clinical Rating System preoperatively, at 6 months and at 2 years’ follow-up. Results: Forty-one patients (41 knees) were included in the study. Indications for revision were aseptic loosening in 13 (31.7%), mechanical wear/component failure in 10 (24.4%), infection in 9 (22.0%), malalignment in 4 (9.8%), instability in 3 (7.3%), periprosthetic fracture in 1 (2.4%) and persistent stiffness in 1 (2.4%). Significant improvements were seen postoperatively in all 3 instruments used to evaluate clinical outcome. These improvements were seen at 6 months after surgery, and were maintained through the 2-year follow-up period. There were no significant changes in all scores between 6 months and 2 years follow-up. There was 100% survivorship of the implants with no postoperative complications requiring surgical intervention. Conclusion: Indications for revision TKA locally are similar to those in other large centres. Revision total knee arthroplasty results in significantly improved function and quality of life for patients, which is maintained over a 2-year follow-up period. In our series, we obtained 100% implant survivorship.

Key words: Failure, Infection, Instability, Loosening, Malalignment
Clinical Characteristics and Outcomes of Patients Undergoing Drug Provocation Tests (DPTs)
Authors: Thalayasingam Meera , Davies Lucy J , Llanora Genevieve V , Gerez Irvin F , Van Bever Hugo P , Shek Lynette P
Published: November 2022

Introduction: Patients who have an adverse drug reaction are frequently labelled drug allergic without undergoing proper evaluation and confirmatory testing. These drug allergy labels may be inaccurate, leading to unnecessary lifelong avoidance. The aim of this study was to review the patients that underwent drug provocation tests (DPTs) in our centre and examine the usefulness of DPTs in confirming or rejecting a diagnosis of drug hypersensitivity. Materials and Methods: The study design was a retrospective chart review of all adult patients who underwent drug provocation in the allergy unit at the National University Hospital, Singapore, for single or multiple suspected drug allergies from the period January 2009 to June 2011. Results: Eighty-seven patients underwent 123 DPTs (median age 41; interquartile range 28 to 50). Twenty-one patients underwent multiple DPTs. The most common culprit drugs reported were antibiotics (43.9%) of which beta-lactams were implicated in 75.9% of the cases. This was followed by non-steroidal anti-inflammatory drugs (NSAIDS) in 15.4%, paracetamol in 7.3% and both NSAIDs and paracetamol in 3.3%. Rash was the most commonly reported symptom (41.5%), followed by angioedema (32.5%), anaphylaxis (9.8%), and other symptoms including respiratory (2.4%), gastrointestinal (0.8%) and others (13.0%). The majority of DPTs were performed to antibiotics (43.9%), NSAIDs (19.5%) and paracetamol (6.5%). DPTs were negative in 93.5% of subjects and positive in 6.5%. Of the 8 positive DPTs, none had a serious reaction, with 5 patients requiring rescue therapy, which comprised solely of oral antihistamines. Conclusion: Suspected drug hypersensitivity is common but true drug allergy is rare. DPTs remain the gold standard and should be included as part of an investigative protocol. DPTs are a safe and valuable diagnostic tool in the hands of the experienced clinician.

Key words: Antibiotics, Drug allergy, Gold standard, NSAIDS
Clinical Outcomes of Esophageal Atresia: Comparison Between the Waterston and the Spitz Classifications
Authors: Niramis Rangsan , Tangkhabuanbut Pitiporn , Anuntkosol Maitree , Buranakitjaroen Veera , Tongsin Achariya , Mahatharadol Varaporn
Published: November 2022

Introduction: Preoperative prognostic predictors are important for surgeons and parents to estimate the survival of patients with esophageal atresia (EA). The aim of this study was to update the clinical outcomes of EA treatment by comparing between the Waterston and the Spitz classification. Materials and Methods: Medical records of the patients with EA treated at Queen Sirikit National Institute of Child Heath from 2003 to 2010 were reviewed. All of the patients were categorised into 3 groups of the Waterston and 3 groups of the Spitz risk factor criteria for comparing of the differences in each group and each classification. Results: One hundred and thirty-two patients (81 males and 61 females) were treated for EA during the study period. Applying the Waterston classification, survival rate was 100% in group A, 91.5% in group B and 48.8% in group C. There was no statistical difference between the survival rate in group A and group B (P = 0.119) but significant difference between group B and group C (P = 0.000). Using the Spitz classification, survival rate was 97.4% in group I, 64.4% in group II and 27.3% in group III. There was obviously statistical difference of the survival rate between each group (group I vs group II, P = 0.000; group II vs group III, P = 0.041). Conclusion: Comparing with the prognostic predictors, the Spitz classification was more valid than the Waterston criteria. The Spitz classification is suitable to use for preoperative predictor to parental counselling and comparing of treatment outcomes of EA among paediatric tertiary care centres.

Key words: Tracheoesophageal fistula, Risk factor, Prognostic predictor, Classification
A Covid Outbreak Prediction using Machine Learning
Authors: Sakshi Saklani  , Ashish Chandak  , Purshottam J Assudani  , Amrusha Rahangdale  , Achal Loya
Published: November 2022

Machine learning (ML] helps with the future prediction of action and take decision. A variety of prediction techniques are used for the future prediction of risks and effectively dealing it. This work shows how ML models can predict death rates of COVID-19 patients so that we can do effective treatment and try to minimize the effect of the causes. Coronavirus 2019, COVID-19 is a member of the Coronaviridae genus. A virus without a cure causes unpredictable devastation to people's lives as well as the financial and economic systems of every nation on earth. We have taken certain features from the COVID-19 dataset to study and comprehend the future circumstance using machine learning algorithms, various prediction models are created, and their performances are calculated and assessed. We have compared machine learning algorithms viz. Random Forest and Linear Regression, Decision Tree to predict a number of cases.
Muscular Adaptations in Drop Set vs. Traditional Training: A meta-analysis
Authors: Coleman Max , Harrison Khalil , Arias Roberto , Johnson Ericka , Grgic Jozo , Orazem John , Schoenfeld Brad
Published: November 2022

The purpose of this paper was to systematically review and meta-analyze the effects of drop set training (DS) vs. traditional training (TRAD) on measures of muscle strength and hypertrophy. We carried out a comprehensive search on PubMed/MEDLINE, Scopus, Web of Science, and CINAHL databases for studies that satisfied the following criteria: (a) had a randomized experimental design (either within- or between-group); (b) directly compared DS versus TRAD; (c) assessed changes in muscular strength and/or hypertrophy; (d) had a training protocol that lasted a minimum of 6 weeks, and; (e) involved apparently healthy participants. We employed a robust variance meta-analysis model, with adjustments for small samples. Study quality was assessed by the Downs and Black checklist. A total of 5 studies met inclusion criteria. Qualitative assessment indicated the included studies were of moderate to good quality. For the strength outcomes results indicated a trivial point estimate of the effect size (ES) with a relatively narrow precision for the confidence interval (CI) estimate (0.07; 95% CI = -0.14, 0.29). Similarly, results for the hypertrophy outcomes indicated a trivial point estimate of the ES with a relatively narrow precision for the CI estimate (0.08; 95% CI = -0.08, 0.24). In conclusion, DS and TRAD appear to have similar effects on muscular strength and hypertrophy. This would seem to indicate that both DS and TRAD are viable options for promoting muscular adaptations; DS may provide a more time-efficient alternative for achieving results.
Zvláštní raně středověké hroby objevené ve Starém Městě – „Na Valách“ a problém jejich interpretace
Authors: Fojtová Martina , Galuška Luděk
Published: November 2022

In 2018, during a rescue archaeological excavation taking place in one of the gardens of Staré Město near Uherské Hradiště, 23 early medieval graves containing skeletal remains of 26 individuals were detected. The site is situated on the northern border of the well-known Great Moravian burial ground ‘Na Valách’. In a large number of the newly excavated graves, greater or lesser deviations from the usual funeral rite were recorded. While the established burial rite in Great Moravian society means the deceased lies on their back in the supine position with extended extremities and head towards the west, here we found skeletons in very different orientations, lying in a prone or crouched position, or, at least, with unusual positions of their upper or lower limbs. Additionally, some of the graves contained incomplete or no skeletons. There is also one double burial and a triple burial, and several graves in superpositions. In nine graves, objects of material culture were found, the most important of them come from the rider’s grave 20/2018. The presented study aims to interpret the burial contexts using the bioarchaeological approach, which is, however, affected by the quality of the preserved finds, especially skeletal remains.
6. SINIF KUVVET VE HAREKET ÜNİTESİNİN LEGO ROBOTİK UYGULAMALARI İLE ÖĞRETİMİNİN ÖĞRENCİLERİN BİLİMSEL SÜREÇ BECERİLERİNE ETKİSİ
Authors: UÇAR Ayhan , SEZEK Fatih
Published: November 2022

Bu çalışmada 6. sınıf fen bilimleri dersi ‘‘Kuvvet ve Hareket’’ ünitesinde Lego Robotik etkinliklerinin uygulanmasının öğrencilerin bilimsel süreç becerilerine etkisini incelemek amaçlanmaktadır. Çalışmada ön test- son test kontrol gruplu yarı deneysel desen kullanılmıştır. Çalışma grubunu; deney grubu (n=24) ve kontrol grubu (n=24) olmak üzere Erzurum ili Palandöken ilçesindeki Barbaros Hayrettin Paşa Ortaokulun altıncı sınıfında öğrenim gören 48 öğrenci oluşturmaktadır. Çalışmada Kuvvet ve Hareket ünitesi; kontrol grubundaki öğrenciler ile Milli Eğitim müfredatında belirtilen şekilde işlenirken, deney grubundaki öğrenciler ile lego robotik uygulama destekli öğretimle gerçekleştirilmiştir. Araştırmanın verilerini elde etmek için Aydoğdu vd. (2012) tarafından geliştirilen ve 27 sorudan oluşan çoktan seçmeli Bilimsel Süreç Beceri Testi (BSBT) kullanılmıştır. Araştırmanın hem başında hem de sonunda her iki gruba da aynı ölçme aracı uygulanmıştır. Ölçme aracıdan elde edilen verilerin analizi için öncelikle, verilerin dağılımı incelenmiştir. Verilerin dağılımını anlamak için normallik testi yapılmış ve normal dağılım gösterdiği görülen verilerin analizinde t testi kullanılmıştır. Yapılan analizler sonucunda ön test puan ortalamalarının istatistiksel olarak denk olduğu, kontrol ve deney gruplarının son test puan ortalamaları arasında ise anlamlı bir fark olduğu tespit edilmiştir. Bu durum fen bilimleri derslerinin mevcut öğretim programına ek olarak lego robotik etkinlikleriyle birlikte işlenmesinin öğrencilerin bilimsel süreç becerilerini artırdığını göstermektedir.