bluuebunny/crossref_metadata_2025 huggingface dataset:
KOMUNIKASI INSTRUKSIONAL GURU DALAM MENUMBUHKAN MOTIVASI BELAJAR SISWA (STUDI KOMUNIKATOR PADA SMPN 5 KENDARI)
Authors: Joko Joko
Published: October 2020

Permasalahan yang dikemukakan adalah bagaimana komunikasi instruksional guru dalammenumbuhkan motivasi belajar siswa dan bagaimana tingkat perubahan siswa terhadapkomunikasi instruksional guru dalam menumbuhkan motivasi belajar siswa pada SMPN 5Kendari. Penelitian ini bertujuan untuk mengetahui komunikasi instruksional guru dalammenumbuhkan motivasi belajar siswa dan bagaimana tingkat perubahan siswa terhadapkomunikasi instruksional guru dalam menumbuhkan motivasi belajar siswa pada SMPN 5Kendari. Jumlah informan dalam penelitian ini sebanyak 10 orang guru SMPN 5 Kendari.Pengumpulan data dilakukan melalui observasi, wawancara dan dokumentasi kemudian dianalisissecara kualitatif yaitu dengan mendeskripsikan data hasil observasi di lapangan serta jawabaninforman yang telah diolah dan dianalisis sebelumnya. Hasil penelitian ini menunjukkan bahwakomunikasi instruksional yang dilakukan oleh guru baik di dalam maupun di luar kelas dapatmemberikan pengaruh positif dalam menumbuhkan motivasi belajar siswa serta merubah sikapdan tingkah laku siswa menjadi lebih baik. Hal ini dapat hasil wawancara yang dilakukanberdasarkan penerapan proses komunikasi instruksional oleh guru SMPN 5 Kendari terhadapsiswanya bisa mencapai target yang diharapkan, berdasarkan hasil wawancara dan pengamatanpeneliti dimana evaluasi akhir yang dilakukan menunjukkan tingkat perubahan pengetahuanterhadap penguasaan materi dan praktik mata pelajaran yang diajarkan oleh guru meningkat daritahun ke tahun, hal ini jelas dilihat pada kualitas nilai akhir ujian yang rata-rata mendekati tagetyang diharapkan.
KAMPANYE WALK TO SCHOOL DINAS PERHUBUNGAN KOTA BANDUNG
Authors: Sulistyawan Yoga Wiratama , Novianti Evi , Budiana Heru Ryanto
Published: October 2020

Penelitian ini bertujuan untuk mengetahui tahap perencanaan, pelaksanaan dan evaluasi dariKampanye Walk To School yang dilakukan oleh Dinas Perhubungan Kota Bandung. Metode yangdigunakan adalah metode penelitian deskriptif. Teknik pengumpulan daya yang digunakan adalahmelalui wawancara mendalam semi terstruktur, observasi, dan studi pustaka. Teknik penentuankey informant menggunakan teknik purposive sampling. Teknik analisis data menggunakan tigatahap yakni reduksi data, penyajian data, serta penarikan kesimpulan. Teknik validitas datamenggunakan triangulasi sumber. Hasil penelitian menjelaskan bahwa Dishub Kota Bandungtidak melakukan riset formatif pada tahap perencanaan kampanye, pelaksanaan kampanye sudahsesuai dengan apa yang sudah direncanakan, evaluasi menunjukkan adanya pengurangan tingkatkemacetan di Jalan Merdeka, namun Dishub Kota Bandung tidak mengetahui bagaimanapengetahuan, sikap, dan perilaku khalayak sasaran setelah selesai kegiatan kampanye. Melaluipenelitian ini, peneliti menyarankan agar Dishub Kota Bandung melakukan riset formatif padatahap perenncanaan kampanyenya, sehingga dapat diketahui bagaimana tingkat pengetahuan,sikap, dan perilaku khalayak yang disasar. Memperpanjang masa kampanye, atau menambahintensitas kegiatan dalam sepekan. Pada pelaksanaan, sebaiknya melaksanakan sosialisasi disekolah dilakukan beberapa kali untuk pemerataan informasi pada orang tua murid. Sertamelakukan kerja sama dengan media massa. Pada tahap evaluasi sebaiknya Dishub KotaBandung melakukan kembali pengukuran kepada khalayak, apakah ada perubahan pengetahuan,sikap, dan perilaku setelah dilaksanakan kampanye.
The Influence of Seasonal Climate Variability on Vehicle Exhaust PM2.5 in the State of California: A Hybrid Approach based on Artificial Neural Network and Spatial Analysis
Authors: Yu Fan , Mohebbi Amin , Cai Shiqing , Akbariyeh Simin , Russo Brendan , Smaglik Edward
Published: October 2020

This study aims to develop a hybrid approach based on backpropagation Artificial Neural Network (ANN) and spatial analysis techniques to predict particulate matter of size 2.5 µm (PM2.5) from vehicle exhaust emissions in the State of California using Aerosol Optical Depth (AOD) and several climatic indicators (relative humidity, temperature, precipitation, and wind speed). The PM2.5 data were generated using Motor Vehicle Emission Simulator (MOVES), the measured climatic variables and AOD were obtained from the California Irrigation Management Information System (CIMIS), and NASA’s Moderate Resolution Spectroradiometer (MODIS). The data were resampled to a seasonal format and downscaled over grids of 10 by 10 to 150 by 150, and precipitation was determined to be the most important independent variable. Coefficient of determination ( ), Mean Absolute Percentage Error (MAPE), and Root Mean Square Error (RMSE) were used to assess the quality of the ANN prediction model. The model peaked at winter seasons with = 0.984, RMSE = 0.027, and MAPE = 25.311, whereas it had the lowest performance in summer with = 0.920, RMSE = 0.057, and MAPE = 65.214. These results indicate that the ANN model can accurately predict the PM2.5 concentration and can be used to forecast future trends.
Investigating Anti-Evasion Malware Triggers Using Automated Sandbox Reconfiguration Techniques
Authors: Mills Alan , Legg Phil
Published: October 2020

Malware analysis is fundamental for defending against prevalent cyber security threats, and requires a means to deploy and study behavioural software traits as more sophisticated malware is developed. Traditionally, virtual machines are used to provide an environment that is isolated from production systems so as to not cause any adverse impact on existing infrastructure. Malware developers are fully aware of this and so will often develop evasion techniques to avoid detection within sandbox environments. In this paper, we conduct an investigation into anti-evasion malware triggers for uncovering malware behaviours that may act benign when they detect a traditional sandbox environment. To facilitate our investigation, we developed a dynamic sandbox reconfiguration tool called MORRIGU that couples together both automated and human-driven analysis for anti-evasion configuration testing, along with a visual analytics view for examining system behaviours and performing comparative analysis. Our study reveals a variety of anti-evasion traits that are shared amongst different malware families, such as sandbox `wear-and-tear’, and Reverse Turing Tests (RTT), as well as more sophisticated malware samples that require multiple anti-evasion checks to be deployed. Using a systematic testing approach such as MORRIGU enables test coverage of anti-evasion methods, whilst also offering flexibility for further human-driven analysis of additional evasion methods. We also perform a comparative study against automated analysis using Cuckoo sandbox to show that automated scoring alone can not reliably inform on the presence of evasive malware, hence requiring a more sophisticated anti-evasive testing approach. With a greater understanding of anti-evasion malware triggers and with appropriate tools to explore these in an effective and efficient manner, this study helps to advance research on how evasive malware is being utilised to evade analysis so that we can better defend against future attacks.
An Fusion of Whale and Sine Cosine Algorithms for solving optimization Functions
Authors: Singh Walia Gurjeet , Singh Narinder , Singh Sharandeep
Published: October 2020

We developed a novel hybrid approach for solving global optimization, computer science, bio-medical and engineering real life applications that is based on the coupling of the Whale Optimizer and Sine Cosine Algorithms via a surrogate model. We relate the whale optimizer algorithm to balance between the exploitation and the exploration process in the proposed method. There exist confirmed techniques for searching approximate best optimal solutions, but our algorithm will further guarantee that such numerical and statistical solutions satisfy physical bounds of the standard and real life functions. Our experiments with the benchmark, bio-medical, computer science and engineering real life problems have illustrated the advantages of using a newly hybrid approach based on mixing Whale Optimizer and Sine Cosine algorithms. It holds considerable potential for reducing execution time for solving standard and real life problems and at the same time improving the quality of the solution.
A Systematic Review and Meta-analysis for Effects of Exercise Interventions on Accumulation of Subcutaneous, Visceral, and Ectopic Fat in Overweight and Obese Adults: A Randomized Controlled Trial
Authors: Lee Junga
Published: October 2020

Background: Overweight and obese adults seek effective exercise interventions to reduce accumulated fat, but the effectiveness of these interventions vary across studies. The purpose of this meta-analysis was to investigate the effectiveness of exercise interventions in overweight and obese adults based on measurement of accumulated fat distributions. (2) Methods: Databases were used to select eligible studies for this meta-analysis. Randomized controlled trials with a control and experimental group were included. Degrees of effectiveness of exercise interventions were computed to assess the benefits on reducing weight and subcutaneous, visceral, and ectopic fat accumulation. (3) Results: A total of twenty-one studies were included in this meta-analysis. Participation in exercise interventions showed beneficial effects in reducing weight and subcutaneous and visceral fat. The effectiveness of exercise interventions on ectopic fat accumulation could not be assessed due to the limited number of studies measuring ectopic fat. Additionally, effectiveness of exercise interventions that depended on measurements of accumulated fat varied. The average exercise intervention for overweight and obese individuals was moderate to vigorous intensity, 4 times per week, 50 minutes per session, and 22 weeks duration. (4) Conclusions: Participating in exercise interventions has favorable effects on reducing weight and accumulation of subcutaneous and visceral fat.
Ionized or Total Magnesium Levels, What Should We Measure?
Authors: Scarpati Giuliana , Baldassarre Daniela , Oliva Filomena , Pascale Gabriele , Piazza Ornella
Published: October 2020

Monitoring and measuring magnesium (Mg) values are essential to prevent the development of numerous complications in perioperative medicine and critically ill patients. Although previous studies suggest that measuring free ionized magnesium (iMg) is more useful for estimating Mg status, clinicians currently rely on measurement of total serum magnesium to determine if supplemental magnesium is needed. In this review, we analyzed the recent literature to decide whether it is better to measure ionized serum Mg or total serum Mg when assessing magnesium status, whether iMg predicts clinical outcome, and what are the difficulties in measuring serum iMg levels in intensive care patients and perioperative medicine.
THE EFFECT OF LEARNING TECHNIQUE AND LOCUS OF CONTROL ON STUDENTS COMPETENCE IN TRANSLATING FROM GERMAN TEXT INTO INDONESIAN ( AN EXPERIMENT AT GERMAN STUDY PROGRAM OF MAKASSAR STATE UNIVERSITY
Authors: Mannahali Misnah , Rasyid Yumna
Published: October 2020

The aim of this research was to find out the effect of learning technique and Locus of Control on students competence in translating from German Text into Indonesian. The research was conducted at the fourth semester on German Study Program in the academic years 2013/2014. It was an eksprimental study with 2 x 2 factorial design. The sample was 40 students. It was divided into two groups, each group experiment consisting of 20 students where 10 students had Internal Locus of Control and 10 others had external Locus of Control. The data was collected by using two kinds of test : Locus of Control test and test of translating from German Text into Indonesian. ANAVA and Tukey test were used to analyse the data. The results of this research concludes that generally Jigsaw learning technique was more effective than STAD learning technique, that is : 18,65 > 17,35. The result of this research also conclude that, the students who have internal Locus of Control when following lectures with STAD learning technique is higher ( 20,2 ) than Jigsaw learning technique ( 17,1 ). On the contrary students with external Locus of Control showing that Jigsaw learning technique (20,2) is better than STAD learning technique ( 14,5 ).The finding that Jigsaw and STAD learning technique can be used in teaching translation, however in choosing the teaching technique studentsâ€™ Locus of Control should be considered.
Immediate and Long-Term Implications of the COVID-19 Pandemic for People With Disabilities
Authors: Kendall Elizabeth , Ehrlich Carolyn , Chapman Kelsey , Shirota Camila , Allen Gary , Gall Andrew , Kek-Pamenter Joe-Anne , Cocks Kevin , Palipana Dinesh
Published: October 2020

Some people with disabilities may have greater risk of contracting COVID-19 or experiencing worse outcomes if infected. Although COVID-19 is a genuine threat for people with disabilities, they also fear decisions that might limit lifesaving treatment should they contract the virus.

During a pandemic, health systems must manage excess demand for treatment, and governments must enact heavy restrictions on their citizens to prevent transmission. Both actions can have a negative impact on people with disabilities.

Ironically, the sociotechnical advances prompted by this pandemic could also revolutionize quality of life and participation for people with disabilities. Preparation for future disasters requires careful consideration.
COVID-19 and Overall Mortality Inequities in the Surge in Death Rates by Zip Code Characteristics: Massachusetts, January 1 to May 19, 2020
Authors: Krieger Nancy , Waterman Pamela D. , Chen Jarvis T.
Published: October 2020

Objectives. To address evidence gaps in COVID-19 mortality inequities resulting from inadequate race/ethnicity data and no socioeconomic data.

Methods. We analyzed age-standardized death rates in Massachusetts by weekly time intervals, comparing rates for January 1 to May 19, 2020, with the corresponding historical average for 2015 to 2019 stratified by zip code social metrics.

Results. At the surge peak (week 16, April 15–21), mortality rate ratios (comparing 2020 vs 2015–2019) were 2.2 (95% confidence interval [CI] = 1.4, 3.5) and 2.7 (95% CI = 1.4, 5.5) for the lowest and highest zip code tabulation area (ZCTA) poverty categories, respectively, with the 2020 peak mortality rate 1.1 (95% CI = 1.0, 1.3) times higher in the highest than the lowest poverty ZCTA. Similarly, rate ratios were significantly elevated for the highest versus lowest quintiles with respect to household crowding (1.7; 95% CI = 1.0, 2.9), racialized economic segregation (3.1; 95% CI = 1.8, 5.3), and percentage population of color (1.8; 95% CI = 1.6, 2.0).

Conclusions. The COVID-19 mortality surge exhibited large inequities.

Public Health Implications. Using zip code social metrics can guide equity-oriented COVID-19 prevention and mitigation efforts.
Dental Radiographs for Age Estimation in US Asylum Seekers: Methodological, Ethical, and Health Issues
Authors: Kapadia Farzana , Stevens Jacqueline , Silver Diana
Published: October 2020

Unaccompanied migrant children seeking asylum status in the United States are often forced to undergo dental radiographs, or x-rays, to verify that they are younger than 18 years.

The application of third molar dental radiographs is methodologically flawed and should not be employed as a determinant of chronological age. Furthermore, the use of such tests without obtaining informed consent from either the youth or an objective advocate is unethical.

Finally, the legal and health consequences of these inappropriately applied tests are severe and jeopardize the safety and security of these vulnerable minors.
Development of Calculation Theory for Hinged-Connected Beams on Elastic Base
Authors: Kozunova O. V.
Published: October 2020

The paper provides a brief review of the literature on the theory and methods of calculating hinged-connected or articulated structures on an elastic base. The author refers to the works of B. G. Korenev, G. Ya. Popov, I. A. Simvulidi, R. V. Serebryany, A. G. Yuriev, in which, using various approaches, studies have been carried out to calculate hinged-connected beams and slabs on an elastic base. From the analysis of  scientific literature on the topic under consideration, it can be concluded that there is no general approach to solving this problem, which is valid for any hinged-connected beams and plates lying on any model of an elastic base under the action of an arbitrary external load.  In addition, a similar problem for this type of engineering calculations is observed in the normative documents. In the Republic of Belarus, a number of industry documents have been used to calculate pavement bearing elements for various highways and track transverse structures, in which road pavements with a load-bearing element and the connection of elements between themselves (hinged or rigid) are considered in an incoherent formulation. The paper proposes a universal approach for calculating hinged-connected beams on an elastic foundation, based on the mixed method of structural mechanics, taking into account the Zhemochkin ratios for functions of the elastic medium effects. The following hypotheses and assumptions are taken into account: only normal stresses act on  the  contact  of  the  beam  with the base, hypotheses  of  the bending  theory are valid  for beams,  hinges  between  the beams are cylindrical, and the distribution of contact stresses along the width of the beams is uniform. As a result of the proposed calculation, the stress-strain state of a system of hinged-connected beams on an elastic foundation has been investigated, namely: distribution of contact stresses under beams, internal forces in the beams and hinged joints, as well as settlements of the elastic foundation under them. The numerical implementation of this approach has been performed using the mathematical package Mathematica 10.4. Examples of calculation are given for different versions of hinged-connected beams and an elastic base: for three hinged-connected beams based on Winkler and seven – on an elastic half-space.
Application Flexibility of Jet Pump – Unconventional Method for Offloading a Sidetracked Well and Reactivation of Inactive Well using Jet Pump
Authors: Abbasi Haris Shakeel , Khan Zubair , Junaid Ahmad Hafiz , Cristea Robert Constantin
Published: October 2020

This paper presents the analysis and results of the Jet Pump (JP) applications in the two oil fields: Well -A, for customer in U.A.E, and Well-B for customer in Oman. Well-A was a deviated well with 3-1/2-inch single string completion. The tubing-string was equipped with three Side Pocket Mandrels (SPM). Based on preliminary screening for Artificial Lift Systems (ALS) against the provided well data, the jet pump system was found the most suitable ALS method. Jet pump was evaluated for its efficiency in reviving a dead well with rig less installation using Jet Evaluation and Modeling Software (JEMS). Thus, a reverse circulation JP was straddled across the last SPM in the tubing using two tubing packers. The power fluid was then injected through casing which entered the JP to create the drawdown required to bring the formation fluid through tubing to the surface. The dead well was produced successfully at different injection pressures and rates for four months. The production results were compared to the theoretical model of JEMS to assess the JP performance.

The Well-B was a newly side tracked well where customer intended to use a jet pump for offloading the kill fluid of well from its last zone. A 2-7/8-inch bottom hole assembly of JP was run at 9,348 ft depth during the well completion. Jet pump was freely dropped in the well to offload the kill fluid and revive the production. Rig pump was used to inject power fluid at high pressure in the tubing and returned fluids were taken from the annulus. Constant samples of produced liquid were taken to ensure the kill fluid has been offloaded and the reservoir started contributing its fluid. Jet pump was retrieved with the help of slick line once satisfactory results were received at the surface. The well was successfully offloaded at around 900 bbl. of gross fluid using JP technology.
Drill Bit Damage Assessment Using Image Analysis and Deep Learning as an Alternative to Traditional IADC Dull Grading
Authors: Ashok Pradeepkumar , Vashisht Prabal , Kong Hyeok , Witt-Doerring Ysabel , Chu Jian , Yan Zeyu , van Oort Eric , Behounek Michael
Published: October 2020

IADC dull bit grading is the current industry standard to assess the condition of a drill bit when it comes out of the hole. It is intended to capture the impact of drilling issues (e.g. drilling abrasive hard rock, drilling dysfunctions) on the bit and to improve future bit selection. However, the grading process is manual and subjective, making the bit grading outcome an inconsistent and unreliable metric. Recent advances in image processing and deep learning allow for bit grading to become more consistent and automated. Such a process is described in this paper.

The dataset used in this project consisted of multiple images (taken from different perspectives in a random manner) of used drill bits from 13 bit runs across multiple wells. As a preliminary step in developing the approach, only PDC bits were considered in this project. The first task was to identify all the cutters on a drill bit image using Convolutional Neural Networks (CNN). The CNN approach was chosen since it has shown remarkable success in solving the problem of object detection and classification in other fields. Next, the amount of damage to each cutter was quantified using image processing techniques. Finally, from information gathered in the previous steps, a holistic damage assessment of the drill bit was made.

The trained CNN was able to detect the cutters in an image to a high degree of accuracy. The accuracy of cutter detection was further improved through the use of heuristics that predict potential locations of cutters based on blade location and shape. The identification of unique cutters from a group of images of the same bit proved more challenging. Since the images could not be appropriately stitched together, each image was graded independently, and a holistic assessment of the bit was made by aggregation of the individual assessments. Additionally, not all of the cutters identified could be positively identified as damaged or not. For example, if the perspective that was available was at a right angle to the cutter's face, it is inherently not possible to quantify the damage. The computer-generated assessment of the bit was validated with collaborative assessments made by multiple human operators.

This paper presents a novel approach to bit damage classification that removes the subjective bias that comes with human evaluations. The application of deep learning techniques to cutter identification, damage detection and quantification is unique and has the potential to significantly improve bit design, selection, and thus, drilling efficiency.
Routine colonoscopy may be needed for uncomplicated acute right colonic diverticulitis
Authors: Lee Kil-yong , Lee Jaeim , Park Youn Young , Oh Seong Taek
Published: October 2020

BACKGROUND: Routine colonoscopy is recommended to determine the coexistence of colon cancer after medical treatment for colon diverticulitis. However, in the case of uncomplicated diverticulitis diagnosed by computed tomography imaging, the clinical relevance of routine follow-up colonoscopy has recently been debated. Yet, the role of follow-up colonoscopy for right colon diverticulitis, which tends to develop at a younger age than left colon diverticulitis, has not been specifically evaluated. Therefore, our aim in this study was to evaluate the incidence of right colon cancer or colonic adenomatous polyps, detected by routine colonoscopy, after conservative management of acute uncomplicated right colon diverticulitis. METHODS: Included were patients with uncomplicated right colon diverticulitis diagnosed by computed tomography imaging, between 2011 and 2017, and who underwent follow-up colonoscopy surveillance after treatment. The primary outcome was the incidence of colon cancer, with the detection rate of adenoma being the secondary outcome. Information for analysis was retrieved, retrospectively, from patients’ medical records. RESULTS: The study group included 330 consecutive patients, with a mean age of 41.9 years, and 51.9% being men. For the primary outcome, the rate of colon cancer on follow-up colonoscopy was 0.3% (1/330 cases). The rate of adenoma detection was 20.9% (69/330 cases), with advanced adenoma, including colon cancer, observed in 9 patients (2.7%). CONCLUSION: In patients with acute uncomplicated right colonic diverticulitis, routine colonoscopy after conservative treatment may be necessary because although the colon cancer detection rate is low, it is possible to detect advanced colon adenoma.
Classification and morphology of middle mesial canals of mandibular first molars in a Southern Chinese subpopulation: a cone-beam computed tomographic study
Authors: Yang Yeqing , Wu Buling , Zeng Junkai , Chen Ming
Published: October 2020

Background: Cone-beam computed tomography (CBCT) was employed to study the morphology and curvature of middle mesial canals (MMCs) of mandibular first molars (MFMs).Methods: CBCT scanning was performed on MFMs of 1100 patients. Patients' images that met the inclusion criteria were divided into group A (<40 years old) and group B (≥40 years old) for further study. The images were used to study the incidence of MMCs at different ages, measure the curvature of MMCs in the mesiodistal and buccolingual directions using the Schneider method, and observe the anatomical morphology of the mesial root canal system. All statistical analyses were performed by using SPSS 21.0 software. Quantitative data were presented as mean ± standard deviation. Student’s t-test was used to calculate the statistical significance. P<0.05 was considered statistically significant.Results: In 875 patients, 1750 MFM images met the inclusion criteria. Among these cases, 158 MFMs contained an MMC, yielding an incidence rate of 9.03%. The incidence rate of MMCs was 11.22% in group A and 6.61% in group B, and this difference was statistically significant (P<0.05). The curvature in the mesiodistal direction was 29.39±8.53º in group A and 26.06±8.50º in group B, and this difference was also significant (P<0.05). The curved regions in groups A and B were often located in the middle 1/3 of canal. No significant difference in the distance between MMC orifices and mesiobuccal canal orifices or mesiolingual canal orifices was noted (P>0.05). The most common mesial root canal morphological type was type II (3-2) (53.80%). Conclusion: The incidence of MMCs in MFMs declined as age increased. The canal systems of MMCs were varied and complex, mainly exhibiting an obvious mesiodistal curve. CBCT is an outstanding method to help guide root canal therapy.
Parkinson's disease: Current assessment methods and wearable devices for evaluation of movement disorder motor symptoms - A patient and healthcare professional perspective
Authors: AlMahadin Ghayth , Lotfi Ahmad , Zysk Eva , Siena Francesco Luke , Carthy Marie Mc , Breedon Philip
Published: October 2020

Background Parkinson's disease is the second most common long-term chronic, progressive, neurodegenerative disease, affecting more than 10 million people worldwide. There has been a rising interest in wearable devices for evaluation of movement disorder diseases such as Parkinson's disease due to the limitations in current clinic assessment methods such as Unified Parkinson's Disease Rating Scale. However, there are only a few commercial wearable devices available, which, in addition, have had very limited adoption and implementation. This inconsistency may be due to a lack of users’ perspectives in terms of device design and implementation. Objectives This study aims to identify the perspectives of healthcare professionals and patients linked to current assessment methods and to identify preferences, needs, and requirements of wearable devices. Methods This was a qualitative study using semi-structured interviews followed by focus groups. Transcripts from sessions were analysed using a thematic approach. Results It was noted that the well-known assessment and monitoring process such as Unified Parkinson's Disease Rating Scale was not used routinely in clinics since it is time consuming, subjective, inaccurate, infrequent and dependent on patients’ memories. Participants suggested that objective diagnosis and assessment methods are needed to increase the chance of effective treatment. The participants’ perspectives were positive toward using wearable devices, particularly if they were involved in early design stages. Patients emphasized that the devices should be comfortable, but they did not have any concerns regarding device visibility or data privacy transmitted over the internet when it comes to their health. In terms of wearing a monitor, the preferable part of the body for all participants was the wrist. Healthcare professionals stated a need for an economical solution that is easy to interpret. Some design aspects identified by patients included clasps, material choice, and form factor. Conclusion The study concluded that current diagnosis and assessment methods are limited. Patients’ and healthcare professionals’ involvement in wearable devices design process has a pivotal role in terms of ultimate user acceptance. This includes the provision of additional functions to the wearable device, such as fall detection and medication reminders, which could be attractive features for patients.
Determinants of Anxiety and Depression in Patients with Cubital Tunnel Syndrome
Authors: jia siming , Shi Xiaoying , Liu Guanglian , Wang Li , Zhang Xiaoran , Ma Xuelin , li jia , shao xinzhong
Published: October 2020

Background: This aim of the cross-sectional study were to assess the proportions of anxiety and depression in patients with cubital tunnel syndrome, and to explore the associated demographic and clinical features. Methods: From May 2011 to January 2017, 246 patients diagnosed with CuTS were recruited. The Hospital Anxiety and Depression Scale was used to assess the proportions of depression and anxiety. Patient demographic and clinical data were collected. Univariate analysis and multivariate regression were carried out to identify the variables that were independently associated with anxiety and depression. Results: The proportions of depression and anxiety were 18% (n=44) and 14% (n=35), respectively. Five patients had both possible/probable anxiety and depression. Logistic regression analysis revealed that diabetes mellitus was independently associated with depression; and the modified McGowan grade was independently associated with anxiety. Conclusions: In patients with CuTS, the proportions of depression and anxiety were 18% and 14%, respectively. Early screening for anxiety and depression is beneficial for patients with CuTS.
Estimated glomerular filtration rate and postoperative mortality in patients undergoing non-cardiac and non-neuron surgery: a single-center retrospective study
Authors: Luo Xueying , Zheng Sujing , Liu Baoer , Yang Liping , Li Ya , Li Feng , Gao Rui , Hu Haofei , He Jinsong
Published: October 2020

Background：There is limited evidence to clarify the specific relationship between preoperative estimated glomerular filtration rate (preop-eGFR) and postoperative thirty-day mortality in Asian patients undergoing non-cardiac and non-neuron surgery. We aimed to investigate details of this relationship.Methods：We reanalyzed a retrospective analysis of the clinical records of 90,785 surgical patients at the Singapore General Hospital from January 1, 2012 to October 31, 2016. The main outcome was postoperative thirty-day mortality.Results：The average age of these recruited patients was 53.96 ± 16.88 years, of which approximately 51.64% were female. The mean of preop-eGFR distribution was 84.45 ± 38.56mL/min/1.73m2. Multivariate logistic regression analysis indicated that preop-eGFR was independently associated with thirty-day mortality (adjusted odds ratio: 0.992; 95% confidence interval [CI]: 0.990-0.995; P < 0.001). A U-shaped relationship was detected between preop-eGFR and thirty-day mortality with an inflection point of 98.688(P for log likelihood ratio test <0.001). The effect sizes and confidence intervals on the right and left sides of the inflection point were 1.013 (1.007 to 1.019) [P < 0.0001] and 0.984 (0.981 to 0.987) [P < 0.0001], respectively. Preoperative comorbidities such as congestive heart failure (CHF), type 1 diabetes, ischemic heart disease (IHD),and anemia were associated with the odds ratio of preop-eGFR to thirty-day mortality (interaction P < 0.05).Discussion：The relationship between preop-eGFR and thirty-day mortality is U-shaped. The recommended preop-eGFR at which the rate of the thirty-day mortality was lowest was 98.688mL/min/1.73m2.
Effect of gut microbiota modulation on feeding tolerance of enterally-fed critically ill adult patients: a systematic review
Authors: Seifi Najmeh , Esfahani Ali Jafarzadeh , Sedaghat Alireza , Rezvani Reza , Khadem-Rezaiyan Majid , Nematy Mohsen , Safarian Mohammad
Published: October 2020

Purpose: The objective of this systematic review was to evaluate the effect of pre-, pro-, and synbiotics on feeding tolerance of enterally-fed critically ill adult patients. Methods: Medline, Science Direct, Web of Knowledge, and the Cochrane Central Register of Controlled Trials were searched up to November 2019. English language randomized controlled trials reporting the effect of pre, pro or synbiotics on the feeding tolerance of enterally-fed critically ill adult patients were included. Results: Overall, 15 papers were selected for review. Among six studies reporting the energy intake, only two studies showed significantly higher energy intake in the prebiotic-receiving groups. Among four RCTs reporting frequency or time to achieve the target calorie, only one found a significant effect of probiotics to reduce the time to achieve a target dose of calorie. About the prevalence or duration of diarrhea, 7 out of 12 RCTs reported a beneficial effect. All but one study found no beneficial effects for gut microbiota manipulation on clinical endpoints including length of stay (LOS) in hospital and intensive care unit (ICU). Conclusion: It should be noticed that the heterogeneity in study designs, product format, and ICU patient populations makes it difficult to draw any general conclusion. Overall, it seems that pre, pro or synbiotics have not significant beneficial effect on feeding tolerance and clinical endpoints in critically ill adults, but they may reduce the prevalence or duration of diarrhea.
Evaluation of sensitivity and specificity of CanPatrolTM technology for detection of circulating tumor cells in patients with non-small cell lung cancer
Authors: Li Jingyao , Liao Yi , Ran Yaling , Wang Guiyu , Wu Wei , Qiu Yang , Liu Jie , Wen Ningyu , Jing Tao , Wang Haidong , Zhang Shixin
Published: October 2020

Background: The early diagnosis of non-small cell lung cancer is of great significance to the prognosis of patients. However, traditional histopathology and imaging screening have certain limitations. Therefore, new diagnostical methods are urgently needed for the current clinical diagnosis. In this study we evaluated the sensitivity and specificity of CanPatrolTM technology for the detection of circulating tumor cells in patients with non-small cell lung cancer (NSCLC). Methods: CTCs in the peripheral blood of 98 patients with NSCLC and 38 patients with benign pulmonary diseases were collected by the latest typing of CanPatrolTM detection technology. A 3-year follow-up was performed to observe their recurrence and metastasis. Kruskal-Wallis test was used to compare multiple groups of data, Mann-Whitney U test was used to compare data between the two groups, and ROC curve analysis was used to obtain the critical value. The COX risk regression and Kaplan-Meier survival analysis were performed in the 63 NSCLC patients who were effectively followed up. Results: The epithelial, epithelial-mesenchymal, and total CTCs were significantly higher in NSCLC patients than that in patients with benign lung disease (P < 0.001). The mesenchymal CTCs of NSCLC patients was slightly higher than that of benign lung diseases (P = 0.013). The AUC of the ROC curve of the total CTCs was 0.837 (95% CI: 0.76-0.914), and the cut-off value corresponding to the most approximate index was 0.5 CTCs/5 ml, at which point the sensitivity was 81.6% and the specificity was 86.8%. COX regression analysis revealed that the clinical stage was correlated with patient survival (P = 0.006), while gender, age, and smoking were not (P > 0.05). After excluding the confounders of staging, surgery, and chemotherapy, Kaplan-Meier survival analysis showed that patients in stage IIIA with CTCs ≥ 0.5 had significantly lower DFS than those with CTCs < 0.5 (P = 0.022). Conclusions: CTC positive can well predict the recurrence of NSCLC patients. CanPatrolTM technology has good sensitivity and specificity in detecting CTCs in peripheral blood of NSCLC patients and has a certain value for clinical prognosis evaluation.
The Effect of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction (A Case Study of Private Hospitals in Mashhad)
Authors: Kaffashpoor Azar , Sadeghian Samaneh
Published: October 2020

Background: The emerging ethical leadership, a novel approach in leadership perspective, has provided the ground for building and promoting individual and organizational effectiveness through prioritizing ethics in organization. The purpose of the study is survey of effect of Ethical Leadership on Subjective Wellbeing, Given the Moderator Job Satisfaction in Private Hospitals in MashhadMethods: This research, employing a descriptive-correlational survey design, was conducted in 2015-2016 to examine the probable effect of ethical leadership on subjective wellbeing and job satisfaction (both as the outcome variable and the mediator) among the nurses of private hospitals in Mashhad, Iran. The statistical population included all nurses of private hospitals in Mashhad city (730 nurses, in total). 166 nurses were eventually selected as a sample of respondents by following a simple randomized method. The data were collected with the adapted version of the questionnaire designed by Yang (2014). The validity and reliability of the survey were tested and confirmed. For data analysis, structural equation modeling (SEM) was used. Results: The results indicated a positive significant relationship between ethical leadership and job satisfaction. Ethical leadership both directly and indirectly affected the subjective wellbeing of nurses through job satisfaction.Conclusions: The finding suggests that an emphasis on ethics and ethically-oriented leaders in hospitals, enhanced by job satisfaction, can provide a positive climate which can lead to the subjective wellbeing of nurses.
Cloning and Expression Analysis of GATA1 gene in Carassius auratus red var.
Authors: Tian Yusu , Sun Yuandong , Ou Mi , Cui Xiaojuan , Zhou Dinggang , Che Wen’an
Published: October 2020

Background: GATA1 is a key transcription factor in the GATA family, and promotes the differentiation and maturation of red blood cell, which is essential for normal hematopoiesis.Results: Our results showed that the cDNA sequence of GATA1 was 2730 bp long encoding 443 amino acids. qRT-PCR analysis demonstrated that GATA1 had the highest expression in testis(T), followed by pituitary(P) and spleen(S). GATA1 gene expression in C. auratus red var. embryo from the neuroblast stage (N) to the embryo hatching(H) changes continuously; and the gene expression levels of nonylphenol (NP)-treated and those of control embryos were significantly different. Moreover, Methylation levels of GATA1 gene in NP-treated embryos were higher than those in control embryos, indicating that NP affected GATA1 methylation.Conclusions: Our study provides cues for further studying the roles of GATA1 gene in fish development, and suggested a potential molecular mechanism by which NP leads to abnormal development of fish embryos.
The Feasibility and Efficacy of Emotion-Focused Therapy for Binge-Eating Disorder: A Pilot Randomised Waitlist Control Trial
Authors: Glisenti Kevin , Strodl Esben , King Robert , Greenberg Leslie
Published: October 2020

Background: Research into psychotherapy for binge-eating disorder (BED) has focused mainly on cognitive behavioural therapies, but efficacy, failure to abstain, and dropout rates continue to be problematic. The experience of negative emotions is among the most accurate predictors for the occurrence of binge eating episodes in BED, suggesting benefits to exploring psychological treatments with a more specific focus on the role of emotion. The present study aimed to explore the feasibility and efficacy of individual emotion-focused therapy (EFT) as a treatment for BED by examining the outcomes of a pilot randomised waitlist-controlled trial.
Methods: Twenty-one participants were assessed using measures of feasibility (recruitment, credibility and expectancy, and therapy retention), and efficacy (objective binge episodes and days, and binge eating psychopathology). The treatment consisted of 12 weekly one-hour sessions of EFT for maladaptive emotions over three months. A mixed model approach was utilised with one between effect (group) using a one-way analysis of variance (ANOVA) to test the hypothesis that participants immediately receiving the EFT treatment would demonstrate a greater degree of improvement on outcomes relating to objective binge episodes and days, and binge eating psychopathology, compared to participants on the EFT waitlist; and one within effect (time) using a repeated-measures ANOVA to test the hypothesis that participation in the EFT intervention would result in significant improvements in outcome measures from pre to post-therapy and then maintained at follow-up.
Results: Recruitment, credibility and expectancy, and therapy retention outcomes indicated EFT is a feasible treatment for BED. Participants receiving EFT demonstrated a greater degree of improvement in objective binge episodes and days, and binge eating psychopathology compared to EFT waitlist control group participants. When participants in the EFT waitlist control group then received treatment and outcomes data were combined with participants who initially received the treatment, EFT demonstrated significant improvement in objective binge episodes and days, and binge eating psychopathology for the entire sample.
Conclusions: These findings provide further preliminary evidence for the feasibility and efficacy of individual EFT for BED and support more extensive randomised control trials.
Clinical Impact of Estradiol/Testosterone Ratio in Patients with Acute Ischemic Stroke
Authors: Choi Jung-Won , Ryoo In Woo , Hong Jun Yeong , Lee Kyung-Yul , Nam Hyo Suk , Kim Won Chan , Oh Seung-Hun , Kang Jaeku , Lee Hoi Young , Na Sang-Jun , Heo Ji Hoe , Lee Kee Ook
Published: October 2020

Background: Sex hormones may be associated with a higher incidence of ischemic stroke or stroke-related events. In observational studies, lower testosterone concentrations are associated with infirmity, vascular disease, and adverse cardiovascular risk factors. Currently, female sexual hormones are considered neuroprotective agents. The purpose of this study was to assess the role of sex hormones and the ratio of estradiol/testosterone (E/T) in patients with acute ischemic stroke (AIS).Methods: Between January 2011 and December 2016, 146 male patients with AIS and 152 age- and sex-matched control subjects were included in this study. Sex hormones, including estradiol, progesterone, and testosterone, were evaluated in the AIS patient and control groups. We analyzed the clinical and physiological levels of sex hormones and hormone ratios in these patients.Results: The E/T ratio was significantly elevated among patients in the stroke group compared to those in the control group (P = 0.001). Categorization of data into tertiles revealed that patients with the highest E/T ratio were more likely to have AIS [odds ratio (OR) 3.084; 95% Confidence interval (CI): 1.616-5.886; P < 0.001) compared with those in the first tertile. The E/T ratio was also an independent unfavorable outcome predictor with an adjusted OR of 1.167 (95% CI: 1.053-1.294; P = 0.003).Conclusions: These findings support the hypothesis that increased estradiol and reduced testosterone levels are associated with AIS in men.
“Standing on common ground” - a qualitative study of self-management support for patients with multimorbidity in primary health care
Authors: Freilich Joel , Nilsson Gunnar , Ekstedt Mirjam , Flink Maria
Published: October 2020

Background: Multimorbidity, the co-existence of two or more chronic conditions in an individual, is present in most patients over 65 years. Primary health care (PHC) is uniquely positioned to provide the holistic and continual care recommended for this group of patients, including support for self-management. The aim of this study was to explore professionals’, patients’, and family caregivers’ perspectives on how PHC professionals should support self-management in patients with multimorbidity. This study also includes experiences of using telemedicine to support self-management.Methods: A mixed qualitative method was used to explore regular self-management support and telemedicine as a tool to support self-management. A total of 42 participants (20 physicians, 3 registered nurses, 12 patients, and 7 family caregivers) were interviewed using focus group interviews (PHC professionals), pair interviews (patients and family caregivers), and individual interviews (registered nurses, patients, and family caregivers). The study was performed in urban areas in central Sweden and rural areas in southern Sweden between April 2018 and October 2019. Data were analyzed using content analysis.Results: The main theme that emerged was “Standing on common ground enables individualized support.” To achieve such support, professionals needed to understand their own views on who bears the primary responsibility for patients’ self-management, as well as patients’ self-management abilities, needs, and perspectives. Personal continuity and trustful relationships facilitated this understanding. The findings also indicated that professionals should be accessible for patients with multimorbidity, function as knowledge translators (help patients understand their symptoms and how the symptoms correlated with diseases), and coordinate between levels of care. Telemedicine supported continual monitoring and facilitated patient access to PHC professionals.Conclusion: Through personal continuity and patient-centered consultations, professionals could collaborate with patients to individualize self-management support. For some patients, this means that PHC professionals are in control and monitor symptoms. For others, PHC professionals play a less controlling role, empowering patients’ self-management. Development and improvement of eHealth tools for patients with multimorbidity should focus on improving the ability to set mutual goals, strengthening patients’ inner motivation, and including multiple caregivers to enhance information-sharing and care coordination.