bluuebunny/crossref_metadata_2025 huggingface dataset:
The use of Least Significant Bit (LSB) and Knight Tour Algorithm for image steganography of cover image
Authors: Nie Soo Ann , Sulong Ghazali , Ali Rozniza , Abel Andrew
Published: October 2019

Steganography is one of the method to communicate in a hidden way. In another word, steganography literally means the practice of hiding messages or information within another data. Previous studies have proposed various steganography techniques using different approaches including Least Significant Bit (LSB), Discrete Cosine Transform (DCT) and Discrete Wavelet Transform (DWT). However, different approaches still have its own weaknesses. Therefore image stenography using Knight Tour Algorithm with Least Significant Bit (LSB) technique is presented. The main objective is to improve the security factor in the stego image. Basically, the proposed technique is divided into two parts which are the sender and receiver side. Then, steganalysis which is a type of attack on stenography algorithm is used to detect the secret message in the cover image by the statistical analysis of pixel values. Chi Square Statistical Attach which is one of the type of steganalysis is used to detect these near-equal Po Vs in images and bases the probability of embedding on how close to equal the even pixel values and their corresponding odd pixel values are in the test image. The Knight Tour Algorithm is applied due to the common Least Significant Bit technique that is weak in security and easily decoded by outsider.
Analysis and evaluation of mobile rhythm games : Game structure and playability
Authors: Song Doo Heon , Kim Kwang Baek , Lee Jong Hee
Published: October 2019

The rhythm game is an action simulation game adapted to the presented music. While it is expected to have an educational effect as a functional game, the relationship between the operability and rhythm education under the mobile platform is still questionable. In Korea, it seems that mobile rhythm game is a minority maniac genre that are played mostly among teenagers and early twenties. In this paper, we select three mobile rhythm games that are most played by Korean gamers in analysis. First, we analyze the user interface layout, note control, evaluation style and level of difficulty for three games – Deeno, Cytus, and Lanota. Then, we take a user survey in order to evaluate the playability of those games. All three games obtain high scores but there exust several statistically significant differences among games in analysis.
A new approach for enhancing LSB steganography using bidirectional coding scheme
Authors: Al-Momin Mohammed M. Saeed Abdullah , Abed Issa Ahmed , Leftah Hussein A.
Published: October 2019

This paper proposes a new algorithm for embedding private information within a cover image. Unlike all other already existing algorithms, this one tends to employ the data of the carrier image more efficiently such that the image looks less distorted. As a consequence, the private data is maintained unperceived and the sent information stays unsuspicious.  This task is achieved by dividing the least significant bit plane of the cover image into fixed size blocks, and then embedding the required top-secret message within each block using one of two opposite ways depending on the extent of similarity of each block with the private information needed to be hidden. This technique will contribute to lessen the number of bits needed to be changed in the cover image to accommodate the private data, and hence will substantially reduce the   amount of distortion in the stego-image when compared to the classic LSB image steganography algorithms.
Node activity based trust and reputation estimation approach for secure and QoS routing in MANET
Authors: L Raghavendar Raju , Reddy C R K
Published: October 2019

Achieving safe and secure communication in MANETs is a key challenge due to its dynamic nature. A number of security studies disclose that reputation management systems are able to be effectual with less overhead. The reputation of a node is calculated by using automated assessment algorithms depend on predefined trust scheme. This paper proposes a Node Activity-based Trust and Reputation estimation (NA-TRE) approach for the security and QoS routing in MANET. NA-TRE aims to find trust estimation and reputation of a node. The NA-TRE approach monitors the activity changes, packet forwarding or dropping in a node to find the status of the node. The various activities of a node like Normal State (NS), Resource Limitation State (RS) and Malicious State (MS) are monitored. This status of a node is helpful in computing trust and reputation. In this paper NA-TRE approach compared with existing protocols AODV, FACE and TMS to evaluate the efficiency of MANET. The experiment results show that 20% increasing of throughput, 10% decrease of overhead and end to end delay.
Development metrics measurement level for component reusability evaluation approach (CREA)
Authors: Ismail Suryani , Mohd Fatihah , Jalil Masita Abdul , Wan Kadir Wan M.N.
Published: October 2019

The study of software component reuse is rising in software development field and one of the methods used to reduce the production cost and time. Among the problems faced by software developers in component reuse, is the difficulty to determine which set of components are suitable to use in new software development. Thus, this study was conducted with the purpose; to define the characteristics of software component reusability evaluation approach (CREA) based on experienced software developer’s feedback, and to estimate the measurement level for each of the predefined metric. Three characteristics and sub characteristics, namely understandability (documentation level and observality), adaptability (customizability), and portability (external dependency) were identified that have been used to develop the metrics for CREA. The result for all metrics will be used as an input to the fuzzy inference system (FIS) for measuring the reusability level of the component.
A framework for software requirement ambiguity avoidance
Authors: Gupta Ashok Kumar Gupta , Deraman Aziz
Published: October 2019

This research deals with software requirements ambiguity problems. Among these are incomplete, incorrect, improper, inaccurate and unambiguous requirements. Interestingly, published material related to Software Requirements Specifications (SRS) problems discusses ambiguity as one of the most conversed problems. This paper proposes a Software Requirement Ambiguity Avoidance Framework (SRAAF) to assist and support requirement engineers to write unambiguous requirements, by selecting correct elicitation technique based on the evaluation of various attributes and by applying the W6H technique. We explored existing theories and the outcomes of experimental research to construct the framework. On the basis of existing and inferred knowledge, we tried to justify proposed frameworks components. Our selection process focuses on various situational attributes. We added various situational attributes related to project, stakeholders and requirement engineer for the selection process. Newly devised approach chooses techniques other than traditional techniques or most common techniques and deals with ambiguity to capture the correct requirements information from stakeholders. The framework will be able to address the selection and ambiguity issues in a more effective way and can handle vagueness. New evidence related to attributes and adequacy matrix can be easily added to the framework without any inconvenience.
Frequent itemset mining: technique to improve eclat based algorithm
Authors: Man Mahadi , Jalil Masita Abdul
Published: October 2019

In frequent itemset mining, the main challenge is to discover relationships between data in a transactional database or relational database. Various algorithms have been introduced to process frequent itemset. Eclat based algorithms are one of the prominent algorithm used for frequent itemset mining. Various researches have been conducted based on Eclat based algorithm such as Tidset, dEclat, Sortdiffset and Postdiffset. The algorithm has been improvised along the time. However, the utilization of physical memory and processing time become the main problem in this process. This paper reviews and presents a comparison of various Eclat based algorithms for frequent itemset mining and propose an enhancement technique of Eclat based algorithm to reduce processing time and memory usage. The experimental result shows some improvement in processing time and memory utilization in frequent itemset mining.
The development of an ontology model for early identification of children with specific learning disabilities
Authors: Mohemad Rosmayati , Mamat Nur Fadila Akma , Noor Noor Maizura Mohamad , Alhadi Arifah Che
Published: October 2019

Ontology-based knowledge representation is explored in special education environment as not much attention has been given to the area of specific learning disabilities such as dyslexia, dysgraphia and dyscalculia. Therefore, this paper aims to capture the knowledge in special education domain, represent the knowledge using ontology-based approach and make it efficient for early identification of children who might have specific learning disabilities. In this paper, the step-by-step development process of the ontology is presented by following the five phases of ontological engineering approach, which consists of specification, conceptualization, formalization, implementation, and maintenance. The details of the ontological model’s content and structure is built and the applicability of the ontology for early identification and recommendation is demonstrated.
Knowledge and integrated data management model for personalized intercropping in rubber plantation
Authors: Phoksawat Kornkanok , Mahmuddin Massudi
Published: October 2019

Selection and allocation of space for intercropping in rubber plantations to maximize yield and minimum costs for individual farmers involves Multi-Criteria Decision Making (MCDM) and several conditions.  The problem is that the information is scattered in many related agencies, there are separate stores and some data is redundant. In addition, the format of the data varies depending on the purpose of the data. The knowledge of selecting plants to grow in the rubber plantation is the tacit knowledge acquired from the experience of successful farmers in rubber plantations and from agricultural experts. Therefore, this research involves an Integrated Ontology-based knowledge and Multi-Objective Optimization model for intercropping Decision Support Systems (DSS). This article presents the knowledge and integrated data management model for developing the Intercropping in Rubber Plantations Ontology by using the Triangulation in the method to verify the accuracy of the data and results.  Moreover, propose ways to create recommendation rules that are easy to rule update and maintenance.  Using an ontology for DSS helps to recommended plants according to the appropriate environment of the farmer area by rule-based inference to represent logical reasoning.  It could also be applied to another domain that requires Intelligent DSS for MCDM.
Malaysian Sign Language Mobile Learning Application : A recommendation app to communicate with hearing-impaired communities
Authors: Hafit Hanayanti , Xiang Chiam Wui , Yusof Munirah Mohd , Wahid Norfaradilla , Kassim Shahreen
Published: October 2019

Malaysian Sign Language (MSL) is an important language that is used as the primary communication method for the deaf communities with the others. Currently, the MSL is poorly known by the Malaysians and the existing platform of learning the sign language is inefficient, not to mention the incomplete functionality of the existing mobile learning application in the market. Hence, the purpose of developing this application is aimed to increase the knowledge and recognition of the public towards the MSL and allows them to learn the sign language more effectively. One of the features in this application is sign detection, which could analyze the image captured by phone camera into sign meaning. The application also comprised various categories of the sign for efficient learning and quiz to test user knowledge against their learned sign language. Besides, there is a feedback module for the user to express their opinions and suggestions towards the application to the developer. This application is aimed to help the public to learn MSL efficiently by selecting the category of sign they wish to learn and test themselves by using the quiz module. Besides, the application could also detect the unknown sign by capturing the image and analyze it. The application helped to raise the recognition of MSL among the public and expose the public to the sign language knowledge. It had also become a small help in breaking the barrier of communication between the deaf communities and the public.
Enhanced IPFIX flow monitoring for VXLAN based cloud overlay networks
Authors: Ghazali Osman , Khurram Shahzada
Published: October 2019

The demands for cloud computing services is rapidly growing due to its fast adoption and the migration of workloads from private data centers to cloud data centers. Many companies, small and large, prefer switching their data to the enterprise cloud environment rather than expanding their own data centers. As a result, the network traffic in cloud data centers is increasing rapidly. However, due to the dynamic resource provisioning and high-speed virtualized cloud networks, the traditional flow-monitoring systems is unable to provide detail visibility and information of traffic traversing the cloud overlay network environment. Hence, it does not fulfill the monitoring requirement of cloud overlay traffic. As the growth of cloud network traffic causes difficulties for the service providers and end-users to manage the traffic efficiently, an enhanced IPFIX flow monitoring mechanism for cloud overlay networks was proposed to address this problem. The monitoring mechanism provided detail visibility and information of overlay network traffic that traversed the cloud environment, which is not available in the current network monitoring systems. The experimental results showed that the proposed monitoring system able to capture overlay network traffic and segregated the tenant traffic based on virtual machines as compare to the standard monitoring system.
Assessing completeness of a WEB site from quality perspective
Authors: Jammalamadaka Sasi Bhanu , DBK Kamesh , Sastry Jammalamadaka Kodanda Rama
Published: October 2019

Assessing quality of a web site is most important especially because people world over are dependent on the content hosted on the WEB site for various purposes. May factors are to be considered for assessing the quality. Quality of every factor must be considered individual and also the total quality of the WEB site must be computed. This paper is primarily focused on the factor called “Completeness” which is one of the factors that can be considered for computing the quality of the WEB sites.  There can be much of the disconnected in the content hosted on the web site such as missing href, columns in the tables and forms. The more of the disconnectedness in the content that is hosted on the WEB site, the less the quality, as the information hosted on the WEB site is incomplete and less readable
Design and implementation of smart farming system for fig using connected-argonomics
Authors: Zainal N. , Mohamood N. , Norman M. F. , Sanmutham D.
Published: October 2019

This paper proposes a design and implementation approach of smart farming system using connected-agronomics technique for fig farm application. Nowadays, fig plants having a rapid growth in the current market demand due to its rich in natural health benefiting nutrients, antioxidants and vitamins where some farming systems have been used  in maintaining fig plant’s environmental resources to grow without fail. Smart farming is a system applied to provide user with real time information and plan for desired plant such as time intervals for watering systems. There are two major problems on maintaining the fig fruit quality; watering system fail during emergency blackout and a contagious disease known as leaf rust due to external environments. The system implements two microcontrollers, the Arduino Uno & Raspberry Pi along with smartphone Android application. The system performance is evaluated based on the requirement specification, irrigation soil, surrounding temperature and moisture. It is found that all data collected by the sensors are within the optimal range of values, which are 1500 µS/cm to 1599 µS/cm for the EC reading of the fertilizer while 6.0 to 6.5 for the pH value of the soil. This prototype of smart farming was well developed and can be applied to the fig plantation environment.
Early Discontinuation of P2Y
12
Antagonists and Adverse Clinical Events Post–Percutaneous Coronary Intervention: A Hospital and Primary Care Linked Cohort
Authors: Harris Daniel E. , Lacey Arron , Akbari Ashley , Obaid Daniel R. , Smith Dave A. , Jenkins Geraint H. , Barry James P. , Gravenor Mike B. , Halcox Julian P.
Published: October 2019

Background

Early discontinuation of P2Y
12
antagonists post–percutaneous coronary intervention may increase risk of stent thrombosis or nonstent recurrent myocardial infarction. Our aims were to (1) analyze the early discontinuation rate of P2Y
12
antagonists post–percutaneous coronary intervention, (2) explore factors associated with early discontinuation, and (3) analyze the risk of major adverse cardiovascular events (death, acute coronary syndrome, revascularization, or stroke) associated with discontinuation from a prespecified prescribing instruction of 1 year.

Method and Results

We studied 2090 patients (2011–2015) who were recommended for clopidogrel for 12 months (+aspirin) post–percutaneous coronary intervention within a retrospective observational population cohort. Relationships between clopidogrel discontinuation and major adverse cardiac events were evaluated over 18‐month follow‐up. Discontinuation of clopidogrel in the first 4 quarters was low at 1.1%, 2.6%, 3.7%, and 6.1%, respectively. Previous revascularization, previous ischemic stroke, and age >80 years were independent predictors of early discontinuation. In a time‐dependent multiple regression model, clopidogrel discontinuation and bleeding (hazard ratio=1.82 [1.01–3.30] and hazard ratio=5.30 [3.14–8.94], respectively) were independent predictors of major adverse cardiac events as were age <49 and ≥70 years (versus those aged 50–59 years), hypertension, chronic kidney disease stage 4+, previous revascularization, ischemic stroke, and thromboembolism. Furthermore, in those with both bleeding and clopidogrel discontinuation, hazard ratio for major adverse cardiac events was 9.34 (3.39–25.70).

Conclusions

Discontinuation of clopidogrel is low in the first year post–percutaneous coronary intervention, where a clear discharge instruction to treat for 1 year is provided. Whereas this is reassuring from the population level, at an individual level discontinuation earlier than the intended duration is associated with an increased rate of adverse events, most notably in those with both bleeding and discontinuation.
Movement Behavior Patterns in People With First-Ever Stroke
Authors: Wondergem Roderick , Veenhof Cindy , Wouters Eveline M.J. , de Bie Rob A. , Visser-Meily Johanna M.A. , Pisters Martijn F.
Published: October 2019

Background and Purpose—

Movement behaviors, that is, both physical activity and sedentary behavior, are independently associated with health risks. Although both behaviors have been investigated separately in people after stroke, little is known about the combined movement behavior patterns, differences in these patterns between individuals, or the factors associated with these patterns. Therefore, the objectives of this study are (1) to identify movement behavior patterns in people with first-ever stroke discharged to the home setting and (2) to explore factors associated with the identified patterns.

Methods—

Cross-sectional design using data from 190 people with first-ever stroke discharged to the home setting. Movement, behavior was measured over 2 weeks using an accelerometer. Ten movement behavior outcomes were calculated and compressed using principal component analysis. Movement behavior patterns were identified using a k-means clustering algorithm. Demographics, stroke, care, physical functioning, and psychological, cognitive and social factors were obtained. Differences between and factors associated with the patterns were investigated.

Results—

On average, the accelerometer was worn for 13.7 hours per day. The average movement behavior of the participants showed 9.3 sedentary hours, 3.8 hours of light physical activity, and 0.6 hours of moderate-vigorous physical activity. Three patterns and associated factors were identified: (1) sedentary exercisers (22.6%), with a relatively low age, few pack-years, light drinking, and high levels of physical functioning; (2) sedentary movers (45.8%), with less severe stroke symptoms, low physical functioning and high levels of self-efficacy; and (3) sedentary prolongers (31.6%), with more severe stroke symptoms, more pack-years, and low levels of self-efficacy.

Conclusions—

The majority of people with stroke are inactive and sedentary. Three different movement behavior patterns were identified: sedentary exercisers, sedentary movers, and sedentary prolongers. The identified movement behavior patterns confirm the hypothesis that an individually tailored approach might be warranted with movement behavior coaching by healthcare professionals.
Seeing the Intensity of a Sound-producing Event Modulates the Amplitude of the Initial Auditory Evoked Response
Authors: Libesman Sol , Mannion Damien J. , Whitford Thomas J.
Published: October 2019

An auditory event is often accompanied by characteristic visual information. For example, the sound level produced by a vigorous handclap may be related to the speed of hands as they move toward collision. Here, we tested the hypothesis that visual information about the intensity of auditory signals are capable of altering the subsequent neurophysiological response to auditory stimulation. To do this, we used EEG to measure the response of the human brain (n = 28) to the audiovisual delivery of handclaps. Depictions of a weak handclap were accompanied by auditory handclaps at low (65 dB) and intermediate (72.5 dB) sound levels, whereas depictions of a vigorous handclap were accompanied by auditory handclaps at intermediate (72.5 dB) and high (80 dB) sound levels. The dependent variable was the amplitude of the initial negative component (N1) of the auditory evoked potential. We find that identical clap sounds (intermediate level; 72.5 dB) elicited significantly lower N1 amplitudes when paired with a video of a weak clap, compared with when paired with a video of a vigorous clap. These results demonstrate that intensity predictions can affect the neural responses to auditory stimulation at very early stages (<100 msec) in sensory processing. Furthermore, the established sound-level dependence of auditory N1 amplitude suggests that such effects may serve the functional role of altering auditory responses in accordance with visual inferences. Thus, this study provides evidence that the neurally evoked response to an auditory event results from a combination of a person's beliefs with incoming auditory input.
Diagnostics of new species of Neotropical Tischeriidae (Lepidoptera), with the first record of Coptotriche Walshingham from South America
Authors: STONIS JONAS R. , DIŠKUS ARŪNAS , REMEIKIS ANDRIUS , KATINAS LILIANA , TORRES NIXON CUMBICUS , SCHUSTER JACK , PUPLESYTE-CHAMBERS JULIA
Published: October 2019

We describe seven new Neotropical species of Tischeriidae: Astrotischeria dondavisi Stonis & Diškus, sp. nov., A. bacchariphaga Diškus & Stonis, sp. nov., A. guatemalica Diškus & Stonis, sp. nov., A. sanjosei Stonis & Diškus, sp. nov., A. truncata Diškus & Stonis, sp. nov., Coptotriche parvisacculata Diškus & Stonis, sp. nov. and C. carmencita Stonis & Diškus, sp. nov. We report the discovery of Coptotriche Walsingham in South America and provide the following new host-plant records for the Neotropical Tischeriidae: Terminalia australis Cambess. (Combretaceae), Baccharis latifolia (Ruiz & Pav.) Pers., and B. emarginata (Ruiz & Pav.) Pers. (Asteraceae). We update the biology of Astrotischeria ochrimaculosa Diškus, Stonis & Vargas with the discovery that Wissadula (Malvaceae) is a new, verified host plant. The new species are illustrated with photographs of the adults, male and, if available, female genitalia, and the leaf mines. We expect broader distributions of tisheriid species in South America inferred from known host-plant distributions.
First record of stenogastric Corotoca Schiødte (Staphylinidae, Aleocharinae, Corotocini) with notes on behavior, morphology and its phylogenetic significance
Authors: PIRES-SILVA CARLOS MORENO , ZILBERMAN BRUNO , ELOI IGOR , BEZERRA-GUSMÃO MARIA AVANY
Published: October 2019

Physogastric rove beetles are usually studied in an aspect of the physogastry concept, which is defined as the enlargement of membranous parts of abdomen. This feature along with lack of the secondary sclerotization is used to differentiate physogastric from stenogastric individuals. Charles H. Seevers was the first author to record that the differences between physogastric and stenogastric rove beetles represent more than merely body size difference and that the secondary sclerotization, which occurs during the post-imaginal growth, leads to differences beyond that matter. Herein, we record the first stenogastric Corotoca specimen, and the morphological and behavioral differences of physogastric individuals are discussed. It is concluded that stenogastric individuals have features that may have useful implications for phylogenetic and taxonomic studies.
Hydrometeorological Monitoring Using Opportunistic Sensing Networks in the Amsterdam Metropolitan Area
Authors: de Vos L. W. , Droste A. M. , Zander M. J. , Overeem A. , Leijnse H. , Heusinkveld B. G. , Steeneveld G. J. , Uijlenhoet R.
Published: October 2019

The ongoing urbanization and climate change urges further understanding and monitoring of weather in cities. Two case studies during a 17-day period over the Amsterdam metropolitan area, the Netherlands, are used to illustrate the potential and limitations of hydrometeorological monitoring using nontraditional and opportunistic sensors. We employ three types of opportunistic sensing networks to monitor six important environmental variables: 1) air temperature estimates from smartphone batteries and personal weather stations, 2) rainfall from commercial microwave links and personal weather stations, 3) solar radiation from smartphones, 4) wind speed from personal weather stations, 5) air pressure from smartphones and personal weather stations, and 6) humidity from personal weather stations. These observations are compared to dedicated, traditional observations where possible, although such networks are typically sparse in urban areas. First, we show that the passage of a front can be successfully monitored using data from several types of nontraditional sensors in a complementary fashion. Also, we demonstrate the added value of opportunistic measurements in quantifying the urban heat island (UHI) effect during a hot episode. The UHI can be clearly determined from personal weather stations, though UHI values tend to be high compared to records from a traditional network. Overall, this study illustrates the enormous potential for hydrometeorological monitoring in urban areas using nontraditional and opportunistic sensing networks.
A Score for Probability Forecasts of Binary Events Based on the User’s Cost–Loss Relations
Authors: Ivarsson Karl-Ivar
Published: October 2019

A score for verifying probabilistic forecasts is presented. It is called the continuous specific score (CSS) and is intended for binary events only. The score is based on the user’s cost–loss relations and their relative importance. The relative importance is determined by a continuous function of the user’s density of loss for various cost–loss relations. One may also consider CSS as the result of the expected mean value based on a probability function of the various loss values for all possible cost–loss relations for one single user. The CSS is a negatively oriented score and has the following properties: perfect forecasts yield the score zero, and 100% probability for adverse weather (AW) when AW does not occur leads to the score one. The result of a 0% forecast of AW when AW occurs is the inverted value of the ratio of the average cost to the average loss minus one. Different possible usages of the score are discussed. An effective cost–loss ratio (ECLR) is defined. It measures how important low cost–loss ratios are compared to higher ones.
Body Mass Index Change Between Referral to and Enrollment in Pediatric Weight Management
Authors: White Michelle J. , Hoffman Jessica , Armstrong Sarah , Skinner Asheley C.
Published: October 2019

This study describes changes in body mass index z score (BMI z) and percent of 95th percentile (P95) between referral to pediatric weight management (PWM) and initial PWM visit. We conducted a prospective cohort analysis among subjects (n = 77) aged 5 to 11 years referred to PWM and compared height and weight at time of referral versus initial PWM visit. Mean BMI z decreased by 0.05, and P95 decreased by 1.48 across all age groups (both P < .01) from time of referral to initial visit. Children 5 to 8 years old experienced a greater BMI z change than older children (−0.07 vs −0.02; P < .05). Interval BMI z change was greater for non-Hispanic White and Hispanic children compared with non-Hispanic Blacks (−0.10 vs −0.01; P < .001). There were no subgroup differences in P95. Interval BMI changes between referral and treatment approach half the effect reported by some PWM programs. Referral to PWM may motivate pretreatment lifestyle changes in some patients.
Semi-automated generation of pictures for the Mouse Grimace Scale: A multi-laboratory analysis (Part 2)
Authors: Ernst Lisa , Kopaczka Marcin , Schulz Mareike , Talbot Steven R , Struve Birgitta , Häger Christine , Bleich André , Durst Mattea , Jirkof Paulin , Arras Margarete , van Dijk Roelof Maarten , Miljanovic Nina , Potschka Heidrun , Merhof Dorit , Tolba Rene H
Published: October 2019

The Mouse Grimace Scale (MGS) is an established method for estimating pain in mice during animal studies. Recently, an improved and standardized MGS set-up and an algorithm for automated and blinded output of images for MGS evaluation were introduced. The present study evaluated the application of this standardized set-up and the robustness of the associated algorithm at four facilities in different locations and as part of varied experimental projects. Experiments using the MGS performed at four facilities (F1–F4) were included in the study; 200 pictures per facility (100 pictures each rated as positive and negative by the algorithm) were evaluated by three raters for image quality and reliability of the algorithm. In three of the four facilities, sufficient image quality and consistency were demonstrated. Intraclass correlation coefficient, calculated to demonstrate the correlation among raters at the three facilities (F1–F3), showed excellent correlation. The specificity and sensitivity of the results obtained by different raters and the algorithm were analysed using Fisher's exact test ( p < 0.05). The analysis indicated a sensitivity of 77% and a specificity of 64%. The results of our study showed that the algorithm demonstrated robust performance at facilities in different locations in accordance with the strict application of our MGS setup.
Old-Age Income Security and Tourism Demand: A Quasi-Experimental Study
Authors: Pak Tae-Young
Published: October 2019

A growing number of countries have introduced noncontributory pension to guarantee a minimum income for disadvantaged seniors. The current state of knowledge does not inform us how this change has impacted senior tourism demand and industry. Additional pension income may relax budget constraints and provide an opportunity to fulfill a desired level of tourism. For disadvantaged elderly, however, its impact on tourism choice is not clear because of consumption needs for other necessities and limited mobility. This study examines a recent social pension reform in South Korea to study the impact of old-age income security on tourism demand. We find that a doubling of public pension benefits is associated with an average of 23–59.5% increase in travel frequency and 52–96% rise in travel spending among benefit-eligible seniors. These results suggest that pension reforms aiming to improve old-age income security will have a positive influence on the tourism and hospitality industry.
Borders, Development, and Territory in Argentina: Indigenous Mobilization in the Central Chaco
Authors: Iñigo Carrera Valeria
Published: October 2019

One of the bases for the mobilization of indigenous peoples in Argentina in recent years has been access to, use of, and ownership of the natural resources contained in the territory they occupy or claim. Political mobilization among the Qom of Potae Napocna Navogoh in the central Chaco is a response to the modalities of intervention for development and territory configurations involved in capital accumulation that have threatened the possibility of their reproduction, and it involves conflict with both private capital and the state for territory rather than for land.

Una de las bases para la movilización de los pueblos indígenas en Argentina en los últimos años ha sido el acceso, uso y propiedad de los recursos naturales contenidos en el territorio que ocupan o reclaman. La movilización política entre los Qom de Potae Napocna Navogoh en el Chaco central es una respuesta a las modalidades de intervención para el desarrollo y las configuraciones territoriales involucradas en la acumulación de capital que han amenazado la posibilidad de su reproducción, e involucra conflictos con el capital privado y el estado por el territorio antes que por la tierra.
The Uses of Culture in the Last Argentine Dictatorship (1976–1983): From Studies of Repression to Analyses of the Construction of Consensus
Authors: Schenquer Laura
Published: October 2019

Democratic governments are not the only ones that formulate political strategies to generate consensus. The last Argentine dictatorship (1976–1983) also developed cultural, educational, and communication policies to maintain and increase its support and to curb the opposition. However, these policies have not been studied in the postdictatorship, largely because of the prevalence of the image of the apagón cultural (cultural blackout)—the notion that the dictatorship’s project was simply repression and censorship. Examination of recently discovered official documents reveals the productive and creative character of the dictatorship’s cultural projects, which were used to increase social control and impose a certain “order.”

Los gobiernos democráticos no son los únicos que formulan estrategias políticas para generar consenso. La última dictadura argentina (1976–1983) también desarrolló políticas culturales, educativas y de comunicación para mantener e incrementar su apoyo y frenar a la oposición. Sin embargo, estas políticas no se han estudiado en la postdictadura, en gran parte debido a la prevalencia de la imagen del apagón cultural—la noción de que el proyecto de la dictadura era simplemente represión y censura. El examen de documentos oficiales recientemente descubiertos revela el carácter productivo y creativo de los proyectos culturales de la dictadura, que se utilizaron para aumentar el control social e imponer un cierto “orden”.
Recognizing Persistent Disease in Well‐Differentiated Thyroid Cancer and Association with Lymph Node Yield and Ratio
Authors: Noel Julia E. , Orloff Lisa A.
Published: October 2019

Objective

To establish the association between lymph node yield and ratio in neck dissection for well‐differentiated thyroid cancer and risk for persistent postoperative disease.

Study Design

Retrospective cohort study of patients undergoing lymphadenectomy for thyroid carcinoma.

Setting

Tertiary referral center.

Subjects and Methods

Included patients underwent central and/or lateral neck dissection for papillary thyroid carcinoma at our institution between 1994 and 2015. They were divided into a persistent disease group with biochemical and structural disease (49 patients) and a disease‐free group with no disease after a minimum 2 years of follow‐up (175 patients). Demographic characteristics, adjuvant therapy, tumor, and lymph node features were compared.

Results

There were no significant differences in demographic characteristics between the groups. The mean nodal yield of patients with central and lateral neck persistence was significantly lower than that of patients remaining disease free (4.8 vs. 11.9: odds ratio [OR] 0.69; 95% CI, 0.59 to 0.8; P < .001; 14.8 vs. 31.0: OR, 0.89; 95% CI, 0.84‐0.94; P < .001, respectively). Nodal ratio was higher in patients with persistence in the central and lateral neck (74.2% vs 29.4%: OR, 1.06; 95% CI, 1.04‐1.08; P <. 001; 54.2% vs 19.8%: OR, 1.08; 95% CI, 1.04‐1.12; P <. 001, respectively).

Conclusions

Lower lymph node yield and higher node ratio from cervical lymph node dissections are associated with persistent disease and have potential applications in surgical adequacy.
A randomised controlled trial of perivenous tumescent anaesthesia in addition to general anaesthesia for surgical ligation and stripping of the great saphenous vein
Authors: Nandhra Sandip , Wallace Tom , El-Sheikha Joseph , Carradice Daniel , Chetter Ian
Published: October 2019

Introduction

Open surgical ligation and stripping of the great saphenous vein is a highly cost-effective treatment when compared with conservative management and foam sclerotherapy but has limitations including post-operative morbidity and pain. This study aims to identify if the addition of tumescent anaesthesia could improve patient outcomes following treatment.

Methods

Patients with primary superficial venous incompetence undergoing open surgical ligation and stripping of the great saphenous vein were randomised to either General Anaesthesia (GA) alone (GA) procedure or the addition of tumescent (G + T). The primary outcome was bodily pain (within SF-36) at one week. Additional outcomes included post-procedural pain score (100 mm visual analogue scale), complications and quality of life.

Results

A total of 90 patients were randomised for inclusion. There was no significant difference in primary outcome; bodily pain at one week. Secondary outcome of 4-h post-procedural scores were significantly lower in the G + T group (32 (20–54) mm vs. (GA alone) 56 (24–70) mm (P = 0.016)). Complications were minor and equivalent. Both groups saw a significant increase (worsening) in Aberdeen Varicose Vein Questionnaire scores at week 1 with the G + T group faring worse at six weeks (10.0 (Interquartile Range [IQR] 5.6–17.9) vs. 4.3 (IQR 2.7–7.9) P = 0.004).

Conclusion

The G + T group did not demonstrate a significant difference in the one-week bodily pain domain. The addition of tumescent anaesthesia does improve immediate post-operative pain but appears to negatively impact on six-week quality of life. EudraCT Number: 2011-005574-39
“I’m going to push this door open. You can close it”: A qualitative study of the brokering work of oncology clinic nurses in introducing early palliative care
Authors: Mohammed Shan , Savage Pamela , Kevork Nanor , Swami Nadia , Rodin Gary , Zimmermann Camilla
Published: October 2019

Background:

Early palliative care improves quality of life during life-prolonging treatment for patients with cancer, but the role of nurses in facilitating the early involvement of palliative care is unclear.

Aim:

To conceptualize the psychosocial processes involved in the introduction and provision of palliative care by oncology nurses.

Design:

A constructivist qualitative grounded theory study was conducted.

Setting/participants:

A total of 20 nurses (6 staff nurses, 10 nurse practitioners, and 4 advanced practice nurses) completed semi-structured interviews. Participants were from multiple ambulatory care oncology clinics (i.e. breast, pancreatic, hematology) in a comprehensive cancer center.

Results:

The core category, brokering palliative care, represented the overarching concept of the study that linked other subcategories. The other subcategories were as follows: opening the door—creating the possibility of discussing early palliative care at a time when patients show signs of being receptive to this discussion; building trust—establishing relationships with patients as a starting point for open discussions about palliative care; tackling misconceptions—addressing patients’ assumptions about palliative care as signifying death; and advocating with oncologists—seeding the process of referral by bringing patients’ concerns forward.

Conclusion:

Oncology nurses play a central role in “brokering” the introduction of early palliative care; this process is supported by their relational proximity to patients and their location “in between” the patient and the oncologist. Training all nurses in palliative care and empowering them to have proactive discussions in a collaborative practice context would allow greater access to early palliative care.
Development and Preliminary Validation of the Pedophilic Fantasies, Desires, and Activities Questionnaire
Authors: Stoléru Serge , Moulier Virginie , Fonteille Véronique
Published: October 2019

Although sexual interest in children is a risk factor for recidivism of sexual offenses against children, there is a dearth of measures for assessing its current level in patients with pedophilic disorder. The objective was to develop the Pedophilic Fantasies, Desires, and Activities Questionnaire (PFDAQ) to assess the current level of sexual interest in patients with pedophilic disorder. In total, 57 patients with pedophilic disorder and 53 controls were recruited. In addition to the PFDAQ, participants were presented with other measures of sexual interest. PFDAQ scores were significantly higher in patients than in controls and were correlated with other measures of sexual interest. Three PFDAQ scores were correlated with a phallometric index of preference for children. These results suggest that the PFDAQ may be valid and potentially useful for assessing the current level of pedophilic attraction.
Peer support in anaesthesia: Development and implementation of a peer-support programme within the Royal Brisbane and Women’s Hospital Department of Anaesthesia and Perioperative Medicine
Authors: Slykerman Gemma , Wiemers Melissa J , Wyssusek Kerstin H
Published: October 2019

Recent years have seen a shift in culture surrounding psychological wellbeing in doctors. As suicide continues to devastate medical families, friends and colleagues across the country, and significant rates of mental health issues persist, a greater focus on doctors’ psychological health has emerged. This, coupled with mounting evidence in favour of peer support, has driven the Royal Brisbane and Women’s Hospital Department of Anaesthesia and Perioperative Medicine to implement a unique peer support programme, which has been tailored to the needs of the perioperative environment. The programme provides a peer-driven, confidential, psychological safety net for all Royal Brisbane and Women’s Hospital anaesthetic staff. It focuses on collegial support in times of stress, as well as promoting a workplace culture of understanding for staff suffering psychological strain. The benefit of a formalised programme of this kind is that while staff have the option to obtain support at any time from a responder of their choosing, they do not need to seek it out actively in the event of a critical incident when it is automatically provided to them. Consultant anaesthetists trained in psychological first aid act as responders, offering support as well as resources and psychologist referral as required. It is our hope that its success will prompt other anaesthetic departments to continue the trend towards positive health strategies for doctors and implement similar programmes.
Going It Alone: Advance Directive Discordance in Older Married Couples
Authors: Koss Catheryn S. , Jensen Donna
Published: October 2019

Contrary to expectations of joint decision-making, a substantial minority of older married couples report only one spouse possessing an advance directive. Using Health and Retirement Study data, the authors examined advance directive discordance among heterosexual married couples in which at least one spouse had completed an advance directive. It was predicted that spouses who differed in age, self-rated health, or race/ethnicity would be more apt to adopt individualistic as opposed to relational motivational stances, resulting in higher odds of nonmatching advance directive status. Heterogamy did not account for discordance, but couples in which one or both spouses attended some college were more likely to report advance directive concordance. In contrast, couples in which one or both spouses were non-White were more likely to display advance directive discordance. Study results raise concerns about the effectiveness and reach of advance care planning promotion efforts among low-education and non-White older married adults.
Racial/Ethnic Differences in Diet Quality and Eating Habits Among WIC Pregnant Women: Implications for Policy and Practice
Authors: Hill Alla M. , Nunnery Danielle L. , Ammerman Alice , Dharod Jigna M.
Published: October 2019

Purpose:

One of the major federal food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), serves approximately 1.5 million low-income pregnant women per year; however, limited information is available on their dietary habits. This is critical because low-income women are at higher risk of gaining excess weight during pregnancy. Thus, the study objectives were to (1) determine the overall diet quality of WIC pregnant women and (2) examine diet quality and eating behaviors by race/ethnicity and other sociodemographics.

Design:

This was a cross-sectional study.

Setting:

One of the 3 WIC offices in a north-central county in North Carolina, USA.

Sample:

Pregnant women (n = 198) in the second trimester.

Measures:

Interviews included sociodemographics, food security, diet, and eating behaviors. Diet quality was assessed by the Healthy Eating Index (HEI) 2010 scores.

Analysis:

Descriptives, bivariate analysis, and multivariate analysis.

Results:

Average participant age was 26 years, and the mean HEI-2010 score was 56 of maximum score of 100. Specifically, African American women consumed significantly lower servings of whole grains (β = −1.71; 95% CI: −3.10 to −0.32; P < .05) and dairy (β = −1.42; 95% CI: −2.51 to −0.33; P < .05) compared with non-Hispanic white women. Hispanic women scored higher in daily intake of fruits (β = 0.98; 95% CI: 0.17-1.79; P < .05) and for consuming empty calories in moderation (β = 1.57; 95% CI: 0.06-3.09; P < .05). Frequency of intake of fast foods/outside meals was higher among African American women (57%, P = .025).

Conclusion:

Efforts are warranted to promote optimal nutrition among WIC pregnant women. Specifically, African American women are highly vulnerable to poor dietary habits during pregnancy. Further investigation of barriers/facilitators for healthy eating is necessary to address nutrition disparities among WIC pregnant women.