bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived effect of financial risk protection by the Urban–Rural Resident Basic Medical Insurance Scheme: a mixed-methods study of rural residents in China
Authors: Jiang Huan , Zhao Miaomiao , Tian Guomei , Zhao Zihua , Ding Ding , Yin Mei
Published: October 2021

Objectives

It is to explore the perceived financial risk protection effect of the Urban–Rural Resident Basic Medical Insurance Scheme (URRBMI) and its influencing factors to provide evidence to further improve the URRBMI.

Design

It is a cross-sectional survey.

Participants

This mixed-methods study is conducted in five provinces in rural China. Through stratified cluster random sampling, 1681 rural residents participate in a cross-sectional questionnaire survey (1657 valid questionnaires are retrieved). Thirty rural residents participate in in-depth interviews.

Primary and secondary outcome measures

A multivariate logistic regression analysis is adopted to identify factors influencing respondents’ perceptions. Semistructured interviews are used to identify the reasons why some respondents believed the URRBMI to be ineffective.

Results

Overall, 77.5% of respondents believe that the URRBMI is effective. Respondents, who are older, have a higher household income, prefer primary health facilities and provide a higher rating for critical illness compensation and maximum compensatory payouts. They are more likely to give the URRBMI a higher effectiveness rating than their counterparts. Qualitatively, participants who believe the URRBMI to be ineffective list the following reasons: low outpatient service coverage, insufficient or undersupplied drugs and services in the insurance list, problems in the arrangement of deductibles and maximum compensatory payouts, provider-induced behaviour and increased healthcare service price.

Conclusions

This exploration focuses on the reasons why rural residents think the scheme is invalid, which are vital for policy reform. Policies should focus on benefits design and coverage, the assumption of a supervisory role, avoiding financial risk stemming from critical illness and cross-sectoral actions to strengthen the primary healthcare system and comprehensive social security wealth.
Behaviours of older adults and caregivers preparing for elective surgery: a virtually conducted mixed-methods research protocol to improve surgical outcomes
Authors: Norcott Alexandra , Chan Chiao-Li , Nyquist Linda , Bynum Julie P , Min Lillian , Fetters Michael D , DeJonckheere Melissa
Published: October 2021

Introduction

Older adults (age ≥65 years) are pursuing increasingly complex, elective surgeries; and, are at higher risk for intraoperative and postoperative complications. Patients and their caregivers frequently struggle with the postoperative recovery process at home, which may contribute to complications. We aim to identify opportunities to intervene during the preoperative period to improve postoperative outcomes by understanding the preparatory behaviours of older adults and their caregivers before a complex, elective surgery.

Methods and analysis

As a result of the COVID-19 pandemic, we will conduct this study via telephone and videoconferencing. Using a multiphase mixed-methods research design, we will collect data on 10–15 patient–caregiver dyads from a pool of older adults (across a spectrum of cognitive abilities) scheduled for an elective colorectal surgery between 1 July 2020 and 30 May 2021. We will collect quantitative and qualitative data before (T1, T2) and after (T3, T4) surgery. Preoperatively, participants will each complete a cognitive assessment and a semi-structured qualitative interview that focuses on their preparatory behaviours (T1). They will then answer questionnaires about mood, self-efficacy and home environment (T2). Three weeks following hospital discharge, participants will complete another qualitative interview focusing on a comparison of preoperative and postoperative preparedness (T3). Researchers will also collect information about the patient’s medical conditions, the postoperative complications and healthcare utilisation from the patient’s chart 30 days following discharge (T4). We will code and conduct thematic analysis of the qualitative data to identify salient themes. Quantitative data will be analysed using basic descriptive statistics to characterise the participants. We will integrate the qualitative and quantitative findings using results from the quantitative scales to group participants and with use of joint display analysis.

Ethics and dissemination

Ethics approval was obtained from the University of Michigan IRB. Study findings will be disseminated through peer-reviewed journals and presentations at conferences.
Protocol to test the efficacy and safety of frequent applications of skin electrical stimulation for Leber hereditary optic neuropathy: a single-arm, open-label, non-randomised prospective study
Authors: Ueda Kaori , Kurimoto Takuji , Takano Fumio , Murai Yusuke , Mori Sotaro , Sakamoto Mari , Nagai Takayuki , Yamada-Nakanishi Yuko , Nakamura Makoto
Published: October 2021

Introduction

Leber hereditary optic neuropathy (LHON) is an acute or subacute inherited optic neuropathy caused by mitochondrial mutations. More than 90% of patients with LHON have one of three point mutations (ie, G3460A, G11778A and T14484C). We previously reported that a 12-week session of skin electrical stimulation (SES) with a 2-week interval significantly improved visual acuity and field tests 1 week after the last stimulation and without adverse effects in 10 cases of LHON carrying the mt DNA G11778A mutation. In the present study, we will examine the magnitude and persistence of the efficacy and presence or absence of adverse events using SES with a more frequent stimulation protocol.

Methods and analysis

This study will be a single-arm, open-labelled, non-randomised clinical study that analyses 15 cases of LHON with G11778A mutation. All participants will take a portable SES device home and perform SES by themselves every other day for 12 weeks. The logarithm for the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at 1 week after the last SES will be measured as the primary outcome. LogMAR BCVA will be measured at four and 8 weeks after the last SES treatment. The Humphrey visual field sensitivity test using size V stimulation and critical fusion frequency at 1, 4 and 8 weeks after the last SES session will be secondary outcome measurements. Slit-lamp examination, optical coherence tomography and specular microscopy will also be performed to verify the safety of SES.

Ethics and dissemination

The protocol was approved by the Institutional Review Board at Kobe University, Japan (Approval No.C190030). This study is in progress and deserves Pre-result. All documents communicating with the ethics committee will be reposited by the researcher. Modifications to the protocol will be reviewed by the ethics committee and implemented after approval. Data monitoring will be performed by a researcher who is not involved in the study every 6 months after approval. The research summary results will be registered in the Japan Registry of Clinical Trials (jRCTs) and made available to participants in accordance with the terms described in the documents. In addition, the results of this study will be presented at domestic and international meetings and published in peer-reviewed journals within a year after data is fixed.

Trial registration number

jRCTs052200033.
Buteyko method for people with asthma: a protocol for a systematic review and meta-analysis
Authors: Mendonça Karla Morganna Pereira Pinto de , Collins Sean , Santos Tácito ZM , Chaves Gabriela , Leite Sarah , Santino Thayla Amorim , Monteiro Karolinne Souza
Published: October 2021

Introduction

Buteyko method is recommended as a non-pharmacological treatment for people with asthma. Although the worldwide interest in the Buteyko method, there is a paucity of studies gathering evidence to support its use. Therefore, we aim to conduct a systematic review and meta-analysis to assess the effects of the Buteyko method in children and adults with asthma.

Methods and analysis

We will search on Cochrane Central Register of Controlled Trials, MEDLINE, Embase, US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov and WHO International Clinical Trials Registry Platform for studies focusing on the Buteyko method for children and adults with asthma. The searches will be carried out in September 2021 from database’s inception to the present. We will include randomised controlled trials comparing Buteyko method alone with asthma education or inactive control intervention. There will be no restriction on language. Primary outcomes include quality of life, asthma symptoms and adverse events/side effects. Two review authors will independently screen the studies for inclusion and extract data. We will assess the quality of the included studies using the ‘Risk of Bias’ tool. The certainty of the evidence will be assessed using the GRADE approach. Data synthesis will be conducted using Review Manager software. Reporting of the review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance and the Cochrane Handbook for Systematic Reviews of Interventions.

Ethics and dissemination

This study will assess and provide evidence for the use of the Buteyko method in people with asthma. We will analyse secondary data and this does not require ethics approval. The findings will be published in peer-reviewed journals, at relevant conferences and will be shared in plain language in social media. Moreover, the findings of this review could guide the direction of healthcare practice and research.

PROSPERO registration number

CRD42020193132.
Impact of COVID-19 restrictions on preschool children’s eating, activity and sleep behaviours: a qualitative study
Authors: Clarke Joanne , Kipping Ruth , Chambers Stephanie , Willis Kate , Taylor Hilary , Brophy Rachel , Hannam Kimberly , Simpson Sharon Anne , Langford Rebecca
Published: October 2021

Objectives

In spring 2020, the first COVID-19 national lockdown placed unprecedented restrictions on the behaviour and movements of the UK population. Citizens were ordered to ‘stay at home’, only allowed to leave their houses to buy essential supplies, attend medical appointments or exercise once a day. We explored how lockdown and its subsequent easing changed young children’s everyday activities, eating and sleep habits to gain insight into the impact for health and well-being.

Design

In-depth qualitative interviews; data analysed using thematic analysis.

Setting

South West and West Midlands of England.

Participants

Twenty parents (16 mothers; 4 fathers) of preschool-age children (3–5 years) due to start school in September 2020. Forty per cent of the sample were from Black, Asian or minority ethnic backgrounds and half lived in the most deprived areas.

Results

Children’s activity, screen time, eating and sleep routines had been disrupted. Parents reported children ate more snacks, but families also spent more time preparing meals and eating together. Most parents reported a reduction in their children’s physical activity and an increase in screen time, which some linked to difficulties in getting their child to sleep. Parents sometimes expressed guilt about changes in activity, screen time and snacking over lockdown. Most felt these changes would be temporary, though others worried about re-establishing healthy routines.

Conclusions

Parents reported that lockdown negatively impacted on preschool children’s eating, activity and sleep routines. While some positive changes were identified, many participants described lack of routines, habits and boundaries which may have been detrimental for child health and development. Guidance and support for families during COVID-19 restrictions could be valuable to help maintain healthy activity, eating, screen time and sleeping routines to protect child health and ensure unhealthy habits are not adopted.
Study protocol for a randomised controlled clinical trial comparing desflurane-based versus propofol-based anaesthesia on postanaesthesia respiratory depression in patients with obstructive sleep apnoea after major abdominal surgery
Authors: Wu Huanghui , Yang Fei , Zhang Ran , Xue Haiyan , Yang Yongyong , Liao Ruizhe , Li Min , Wu Xiaozhi , Chen Dongsheng , Chen Guozhong , Gong Yi , Hou Lichao
Published: October 2021

Introduction

Patients with obstructive sleep apnoea (OSA) are more sensitive to postanaesthesia respiratory depression. Whether different anaesthetic regimens (intravenous-based or inhalational-based general anaesthesia) affect the postanaesthesia respiratory depression is controversial. Although desflurane has been reported that presents favourable rapid recovery profile in special patients including whom with OSA, the strong clinical evidence of the benefit on postanaesthesia respiratory depression is far from being revealed. This study aims to fill this knowledge gap by investigating the postanaesthesia respiratory depression in postanaesthesia care unit (PACU) in patients with OSA after major abdominal surgery, followed by desflurane-based anaesthesia compared with propofol-based anaesthesia.

Methods and analysis

Eight hundred and fifty-four patients with OSA scheduled for elective major abdominal surgery will be randomly 1:1 assigned to desflurane-based (n=427) or propofol-based anaesthesia (n=427) using a computer-generated randomisation scheme with permuted block size maintained by a centralised randomisation centre. Patients will be assessed before and a consecutive 3 days after their surgery according to the standardised tasks. Demographic data as well as surgical and anaesthesia information will be collected for the duration of the procedure. Incidence of postanaesthesia respiratory depression in PACU as well as anaesthesia recovery, emergence delirium, postoperative nausea and vomiting, rescue analgesia, duration of PACU and hospital stay, and any other adverse events will be assessed at the given study time point. Investigators performing postoperative follow-up are not involved in both anaesthesia implementation and postoperative care.

Ethics and dissemination

This study protocol has been approved by the ethics board at Xiang’an Hospital of Xiamen University (XAHLL2019003). The results of this study will be published in a peer-review journal and presented at national conferences as poster or oral presentations. Participants wishing to know the results of this study will be contacted directly on data publication.

Trial registration number

ChiCTR2000031087.
Longitudinal trajectory of depression symptom severity and the influence of concussion history and physical function over a 19-year period among former National Football League (NFL) players: an NFL-LONG Study
Authors: Brett Benjamin L , Kerr Zachary Y , Walton Samuel R , Chandran Avinash , Defreese J D , Mannix Rebekah , Echemendia Ruben J , Meehan William P , Guskiewicz Kevin M , McCrea Michael
Published: October 2021

Objective

This study investigated the longitudinal course of depressive symptom severity over 19 years in former American football players and the influence of concussion history, contact sport participation and physical function on observed trajectories.

Methods

Former American football players completed a general health questionnaire involving demographic information, medical/psychiatric history, concussion/football history and validated measures of depression and physical function at three time points (2001, 2010 and 2019). Parallel process latent growth curve modelling tested associations between concussion history, years of football participation, and overall and change in physical function on the overall level and trajectory of depressive symptoms.

Results

Among the 333 participants (mean(SD) age, 48.95 (9.37) at enrolment), there was a statistically significant, but small increase in depressive symptom severity from 2001 (48.34 (7.75)) to 2019 (49.77 (9.52)), slope=0.079 (SE=0.11), p=0.007. Those with greater concussion history endorsed greater overall depressive symptom severity, B=1.38 (SE=0.33), p<0.001. Concussion history, B<0.001 (SE=0.02), p=0.997 and years of participation, B<0.001 (SE=0.01), p=0.980, were not associated with rate of change (slope factor) over 19 years. Greater decline in physical function, B=−0.71 (SE=0.16), p<0.001, was predictive of a faster growth rate (ie, steeper increase) of depression symptom endorsement over time.

Conclusions

Concussion history, not years of participation, was associated with greater depressive symptom severity. Neither factor was predictive of changes over a 19-year period. Decline in physical function was a significant predictor of a steeper trajectory of increased depressive symptoms, independent of concussion effects. This represents one viable target for preventative intervention to mitigate long-term neuropsychiatric difficulties associated with concussion across subsequent decades of life.
Dementia Early-Stage Cognitive Aids New Trial (DESCANT) of memory aids and guidance for people with dementia: randomised controlled trial
Authors: Clarkson Paul , Pitts Rosa , Islam Saiful , Peconi Julie , Russell Ian , Fegan Greg , Beresford Rebecca , Entwistle Charlotte , Gillan Vincent , Orrell Martin , Challis David , Chester Helen , Hughes Jane , Kapur Narinder , Roe Brenda , Malik Baber , Robinson Catherine
Published: October 2021

Background

Common memory aids for people with dementia at home are recommended. However, rigorous evaluation is lacking, particularly what guidance or support is valued.

Objective

To investigate effects of memory aids and guidance by dementia support practitioners (DSPs) for people in early-stage dementia through a pragmatic, randomised controlled trial.

Methods

Of 469 people with mild-to-moderate dementia and their informal carers, 468 were randomised to a DSP with memory aids or to usual care plus existing dementia guide. Allocation was stratified by Trust/Health Board; time since first attendance at memory service; gender; age; and living with primary carer or not. Primary outcome was Bristol Activities of Daily Living Scale (BADLS) Score at 3 and 6 months (primary end-point). Secondary outcomes for people with dementia: quality of life (CASP-19; DEMQOL); cognition and functioning (Clinical Dementia Rating Scale; S-MMSE); capability (ICECAP-O); social networks (LSNS-R); and instrumental daily living activities (R-IDDD). Secondary outcomes for carers: psychological health (GHQ-12); sense of competence (SSCQ).

Results

DSPs were successfully trained, compliance was good and welcomed by participants. Mean 6 months BADLS Score increased to 14.6 (SD: 10.4) in intervention and 12.6 (SD: 8.1) in comparator, indicative of greater dependence in the activities of daily living. Adjusted between-group difference was 0.38 (95% CI: −0.89 to 1.65, p=0.56). Though this suggests greater dependency in the intervention group the difference was not significant. No differences were found in secondary outcomes.

Conclusions

This intervention did not maintain independence in the activities of daily living with no improvement in other outcomes for people with dementia or carers.

Trial registration number

Current Controlled TrialsISRCTN12591717.
Measurement of the effects of lateral release
Authors: Quaile A.
Published: October 2021

In a prospective trial of 37 knees with anterior knee pain, 12 improved with conservative treatment. Twenty five knees in 23 patients required arthroscopy and lateral release. It was found that the clinical examination combined with skyline X-Rays gave a good assessment of these patients. The medial angle and the congruence angle were rarely abnormal but often showed improved centring after lateral release. It seems unlikely, however, that this is responsible for improved symptoms especially as the asymptomatic side frequently showed similar X-Ray changes.
The Royal Naval Medical Stores for Service Afloat: a prospective quantitative study
Authors: Dewar E. P. , Mitchell K. A. W. , Hett D. A. , Taylor R. B.
Published: October 2021

The contents of the scale of Medical Stores for Service Afloat must provide adequate quantities of drugs to allow proper patient care in a variety of situations often remote from specialist support. The overall make up of the scale is difficult to envisage outside the context for which it was conceived. This study was designed to assess the accuracy of the make up of the scale in three RN ships over a six-month period during a detached deployment. During this time the usage of all consumable items was specifically recorded and the outcome subjected to rigorous analysis in relation to the present scale. The results of the study indicate that in the case of both HMS Ark Royal (AR) and the two smaller ships HMS Edinburgh and HMS Sirius (ES) the quantities of drugs in the majority of cases are in excess of requirements. Of the 290 (AR) and 266 (ES) individual drugs 68% and 40% respectively could safely be reduced by varying amounts, whereas only 7.6% and 4.9% respectively needed to be increased. Furthermore, when these changes are costed the savings that result are £7806 for the AR scale and £1532 for the ES scale. Extrapolation of these figures across the surface fleet produces an overall saving on the costs of drugs of over £87,000.
Malignant Ameloblastoma? A case report and review of literature outlining problems in diagnosis and treatment
Authors: Matear D. W. , Crewe T. C.
Published: October 2021

This paper reviews the literature on the clinical and histological diagnosis of both malignant ameloblastoma and ameloblastic carcinoma. The problems of existing classifications are emphasised and guidelines as to clearer, simpler classification are suggested. The case history emphasises the need for a clear classification between malignant ameloblastoma and ameloblastic carcinoma.
Intensive Stress?? Caring under pressure
Authors: Watkinson G. E.
Published: October 2021

This article is based on a survey of the intensive care nursing staff at RNH Haslar and RNH Stonehouse. It examines individuals response to external stressors and was undertaken as part of a project for the Health Education Certificate Course. The survey took place during December 1989 and January 1990.

The prime purpose of this research was to explore whether high levels of stress existed among nurses on the Intensive Care Unit (ICU) at RNH Haslar. If so, to discover the main causes of work-related stress, and in addition to examine how best to implement a nursing management strategy to enable those affected to cope with stress. However, the pilot study carried out at RNH Stonehouse allowed a change in tack, enabling not only a comparison between external stressors on similar units but providing a much broader insight.
Is perianal sepsis adequately managed? The results of a five year audit at Royal Naval Hospital Haslar
Authors: Parker S. J. , Dale R. F.
Published: October 2021

A retrospective audit and postal questionnaire of 148 patients presenting with perianal sepsis confirms that the isolation of gut-related organisms remains a sensitive indicator of a perianal fistula. It did not confirm that the use of microbiological results affects the long term outcome for these patients. It suggests that early examination under anaesthetic and laying open of a fistula may not be necessary in all patients in which gut-related organisms are identified. There was no statistical difference in recurrence rates of perianal sepsis between those operated on by senior or junior surgeons, though there may have been selection bias in these patients.
Diagnosis, progression, prognostic indication and classification of periodontal disease (Part 2)
Authors: Priestland C. R.
Published: October 2021

In the second part of this review the various forms of Gingivitis will be described outlining their aetiological and modifying factors. This group of inflammatory lesions of the gingivae is grouped according to the classification accepted by the World Workshop on Periodontics (1989). In view of the relationship between gingivitis and systemic modifying factors, it is important that all general dental practitioners have a sound knowledge of oral medicine and oral pathology in order that patients exhibiting exaggerated oral symptoms or signs of disease, may be referred to the appropriate dental or medical practitioner/specialist. Furthermore it is highly desirable that general medical practitioners have adequate experience in oral examination and are able to recognise deviations from the normal oral appearance.
INM investigations into drugs for seasickness prophylaxis
Authors: Pingree B. J. W.
Published: October 2021

A summary is presented of a programme of work investigating the comparative efficacy of the two drugs most commonly used for seasickness prophylaxis in the Royal Navy, hyoscine and cinnarizine. The programme had both laboratory and sea-trial components. It was shown that hyoscine was a more effective drug than cinnarizine, but cinnarizine had less marked side effects. This comparative superior tolerability of cinnarizine decreased as motion sickness increased. Guidance is given as to the optimum indications for each drug, together with prophylactic regimens.
Radio Medical Advice – the Danish experience
Authors: Strange-Vognsen H. H. , Knudstorp N.
Published: October 2021

From 1980 to 1993, the Danish Radio Medical Advice Service (RMAS) had 1136 contacts from overseas Danish merchant ships and 213 contacts from Danish territorial waters. The diagnoses were almost always of acute conditions. The distribution of the diagnoses in the overseas contacts were; diseases in the digestive and genitourinary system 30%, traumatic lesions 23%, infectious diseases 14% and diseases in the cardiovascular and respiratory system 9%. The only trend over the years was a significant (P=0.01) decrease in psychiatric diagnosis. Evacuation from the ship was recommended in 53% and medicine was prescribed in 61% of the contacts. The medicine was antibiotics in 40% and analgesics in 29% of the contacts. Intravenous infusion was evaluated as relevant in 5% of the cases and this procedure will be included in the new education of officers on the ships.

In the contacts from Danish territorial waters, where many ships are recreational yachts, evacuation was recommended in 79% and medicine was prescribed in 28% of the contacts. This was probably due to the short distance to the nearest harbour and the variation in medical equipment and knowledge. The medical speciality for doctors participating in RMAS should be general surgery or orthopaedic surgery but access to advice from all other medical specialities should be available. Experience as a naval medical officer would be beneficial. The education of the officers on the ships should be more comprehensive including e.g. intravenous infusion. Communication should be by telephone and television would be an advantage.
The follow up of Acute Otitis Media in general practice
Authors: Newton A. P.
Published: October 2021

Acute Otitis Media is a common condition of childhood which potentially has a number of significant sequelae including the development of Otitis Media with Effusion (‘Glue Ear’). A general practice based study is described which assesses the implementation of a protocol for the follow up of Acute Otitis Media by the primary care team. The results of this study show that following the introduction of a follow up protocol a significantly improved rate of follow up was achieved with resultant improvements in the identification of ‘Glue Ear’ and hence more appropriate referral for ENT care.
Orthopaedic implant removal at Royal Naval Hospital Stonehouse: A three-year review
Authors: Howell G. E. D. , Hand C. J. , Dodenhoff R.
Published: October 2021

A recent study stated that 11% of all elective orthopaedic procedures performed at a Regional Orthopaedic Unit involved removal of orthopaedic implants. Indications for certain orthopaedic implant removal remain unclear.

As budgets are squeezed even tighter throughout all branches of the Royal Navy, we looked at each operation performed for orthopaedic implant removal at Royal Naval Hospital Stonehouse and questioned their effectiveness with respect to finance and working days lost for serving personnel.
A pragmatic approach to risk assessment in pulmonary arterial hypertension using the 2015 European Society of Cardiology/European Respiratory Society guidelines
Authors: Dardi Fabio , Manes Alessandra , Guarino Daniele , Zuffa Elisa , De Lorenzis Alessandro , Magnani Ilenia , Rotunno Mariangela , Ballerini Alberto , Lo Russo Gerardo Vito , Nardi Elena , Galiè Nazzareno , Palazzini Massimiliano
Published: October 2021

Objective

To optimise treatment of patients with pulmonary arterial hypertension (PAH), the 2015 European Society of Cardiology/European Respiratory Society guidelines recommend using risk stratification, with the aim of patients achieving low-risk status. Previous analyses of registries made progress in using risk stratification approaches, however, the focus is often on patients with a low-risk prognosis, whereas most PAH patients are in intermediate-risk or high-risk categories. Using only six parameters with high prognostic relevance, we aimed to demonstrate a pragmatic approach to individual patient risk assessment to discriminate between patients at low risk, intermediate risk and high risk of death.

Methods

Risk assessment was performed combining six parameters in four criteria: (1) WHO functional class, (2) 6 min walk distance, (3) N-terminal pro-brain natriuretic peptide (BNP)/BNP plasma levels or right atrial pressure and (4) cardiac index or mixed venous oxygen saturation. Assessments were made at baseline and at first follow-up after 3–4 months.

Results

725 PAH treatment-naive patients were analysed. Survival estimates between risk groups were statistically significant at baseline and first follow-up (p<0.001), even when the analysis was performed within PAH etiological subgroups. Similar results were observed in 208 previously treated PAH patients. Furthermore, patients who remained at or improved to low risk had a significantly better estimated survival compared with patients who remained at or worsened to intermediate risk or high risk (p≤0.005).

Conclusion

The simplified risk-assessment method can discriminate idiopathic, connective-tissue-disease-associated and congenital-heart-disease-associated PAH patients into meaningful high-risk, intermediate-risk and low-risk groups at baseline and first follow-up. This pragmatic approach reinforces targeting a low-risk profile for PAH patients.
Impact of a mass media campaign on presentations and ambulance use for acute coronary syndrome
Authors: Eastwood Kathryn , Howell Stuart , Nehme Ziad , Finn Judith , Smith Karen , Cameron Peter , Stub Dion , Bray Janet E
Published: October 2021

Objective

Between 2009 and 2013, the National Heart Foundation of Australia ran mass media campaigns to improve Australian’s awareness of acute coronary syndrome (ACS) symptoms and the need to call emergency medical services (EMS). This study examined the impact of this campaign on emergency department (ED) presentations and EMS use in Victoria, Australia.

Methods

The Victorian Department of Health and Human Services provided data for adult Victorian patients presenting to public hospitals with an ED diagnosis of ACS or unspecified chest pain (U-CP). We modelled changes in the incidence of ED presentations, and the association between the campaign period and (1) EMS arrival and (2) referred to ED by a general practitioner (GP). Models were adjusted for increasing population size, ACS subtype and demographics.

Results

Between 2003 and 2015, there were 124 632 eligible ED presentations with ACS and 536 148 with U-CP. In patients with ACS, the campaign period was associated with an increase in ED presentations (incidence rate ratio: 1.11; 95% CI 1.07 to 1.15), a decrease in presentations via a GP (adjusted OR (AOR): 0.77; 95% CI 0.70 to 0.86) and an increase in EMS use (AOR: 1.10; 95% CI 1.05 to 1.17). Similar, but smaller associations were seen in U-CP.

Conclusions

The Warning Signs Campaign was associated with improvements in treatment seeking in patients with ACS—including increased EMS use. The increase in ACS ED presentations corresponds with a decrease in out-of-hospital cardiac arrest over this time. Future education needs to focus on improving EMS use in ACS patient groups where use remains low.
Differences in social activity increase efficiency of contact tracing
Authors: Nielsen Bjarke Frost , Sneppen Kim , Simonsen Lone , Mathiesen Joachim
Published: October 2021

Digital contact tracing has been suggested as an effective strategy for controlling an epidemic without severely limiting personal mobility. Here, we use smartphone proximity data to explore how social structure affects contact tracing of COVID-19. We model the spread of COVID-19 and find that the effectiveness of contact tracing depends strongly on social network structure and heterogeneous social activity. Contact tracing is shown to be remarkably effective in a workplace environment and the effectiveness depends strongly on the minimum duration of contact required to initiate quarantine. In a realistic social network, we find that forward contact tracing with immediate isolation can reduce an epidemic by more than 70%. In perspective, our findings highlight the necessity of incorporating social heterogeneity into models of mitigation strategies.

Graphic abstract
Gravitating Cho–Maison monopole
Authors: Wong Khai-Ming , Zhu Dan , Wong Guo-Quan
Published: October 2021

We study numerical solutions corresponding to spherically symmetric gravitating electroweak monopole and magnetically charged black holes of the Einstein–Weinberg–Salam theory. The gravitating electroweak monopole solutions are quite identical to the gravitating monopole solution in SU(2) Einstein–Yang–Mills–Higgs theory, but with distinctive characteristics. We also found solutions representing radially excited monopole, which has no counterpart in flat space. Both of these solutions exist up to a maximal gravitational coupling before they cease to exist. Lastly we also report on magnetically charged non-Abelian black holes solutions that is closely related to the regular monopole solutions, which represents counterexample to the ‘no-hair’ conjecture.
Rigorous treatment of pairwise and many-body electrostatic interactions among dielectric spheres at the Debye–Hückel level
Authors: Obolensky O. I. , Doerr T. P. , Yu Yi-Kuo
Published: October 2021

Electrostatic interactions among colloidal particles are often described using the venerable (two-particle) Derjaguin–Landau–Verwey–Overbeek (DLVO) approximation and its various modifications. However, until the recent development of a many-body theory exact at the Debye–Hückel level (Yu in Phys Rev E 102:052404, 2020), it was difficult to assess the errors of such approximations and impossible to assess the role of many-body effects. By applying the exact Debye–Hückel level theory, we quantify the errors inherent to DLVO and the additional errors associated with replacing many-particle interactions by the sum of pairwise interactions (even when the latter are calculated exactly). In particular, we show that: (1) the DLVO approximation does not provide sufficient accuracy at shorter distances, especially when there is an asymmetry in charges and/or sizes of interacting dielectric spheres; (2) the pairwise approximation leads to significant errors at shorter distances and at large and moderate Debye lengths and also gets worse with increasing asymmetry in the size of the spheres or magnitude or placement of the charges. We also demonstrate that asymmetric dielectric screening, i.e., the enhanced repulsion between charged dielectric bodies immersed in media with high dielectric constant, is preserved in the presence of free ions in the medium.

Graphic abstract
Quantum groups and polymer quantum mechanics
Authors: Acquaviva G. , Iorio A. , Smaldone L.
Published: October 2021

In Polymer Quantum Mechanics, a quantization scheme that naturally emerges from Loop Quantum Gravity, position and momentum operators cannot be both well defined on the Hilbert space [Formula: see text]. It is henceforth deemed impossible to define standard creation and annihilation operators. In this paper, we show that a [Formula: see text]-oscillator structure, and hence [Formula: see text]-deformed creation/annihilation operators, can be naturally defined on [Formula: see text], which is then mapped into the sum of many copies of the [Formula: see text]-oscillator Hilbert space. This shows that the [Formula: see text]-calculus is a natural calculus for Polymer Quantum Mechanics. Moreover, we show that the inequivalence of different superselected sectors of [Formula: see text] is of topological nature.
Interlaced Attitude Estimation for Spacecraft Using Vector Observations
Authors: Chang Lubin
Published: October 2021

This paper proposes an interlaced attitude estimation method for spacecraft using vector observations, which can simultaneously estimate the constant attitude at the very start and the attitude of the body frame relative to its initial state. The arbitrary initial attitude, described by constant attitude at the very start, is determined using quaternion estimator which requires no prior information. The multiplicative extended Kalman filter (EKF) is competent for estimating the attitude of the body frame relative to its initial state since the initial value of this attitude is exactly known. The simulation results show that the proposed algorithms could achieve better performance compared with the state-of-the-art algorithms even with extreme large initial errors. Meanwhile, the computational burden is also much less than that of the advanced nonlinear attitude estimators.
Study Behavior in Computing Education—A Systematic Literature Review
Authors: Lorås Madeleine , Sindre Guttorm , Trætteberg Hallvard , Aalberg Trond
Published: October 2021

As the field of computing education grows and matures, it has become essential to unite computing education and higher education research. Educational research has highlighted that how students study is crucial to their learning progress, and study behaviors have been found to play an important role in students’ academic success. This article presents the main results of a systematic literature review intended to determine what we know about the study behaviors of computing students and the role of educational design in shaping them. A taxonomy of study behaviors was developed and used to clarify and classify the definitions of study behavior, process, strategies, habits, and tactics as well as to identify their relationship to the educational context. The literature search resulted in 107 included papers, which were analyzed according to defined criteria and variables. The review of study behavior terminology found that the same terms are used to describe substantially different study behaviors, and the lack of standard terminology makes it difficult to compare findings from different papers. Furthermore, it was more common for papers to use study behaviors to explain other aspects of students rather than exploring and understanding them. Additionally, the results revealed a tendency to focus on specific educational contexts, predominantly introductory programming courses. Although computing education as a field is well equipped to expand the knowledge about both study behaviors and their connection to the educational context, the lack of common terminology and theories limits the impact. The taxonomy of study behaviors in computing education proposed in this article can contribute to contextualizing the research in such a way that researchers and educators across institutional borders can compare and utilize results. Last, the article outlines some areas for future research and recommendations for practice.
How to Evaluate Trust in AI-Assisted Decision Making? A Survey of Empirical Methodologies
Authors: Vereschak Oleksandra , Bailly Gilles , Caramiaux Baptiste
Published: October 2021

The spread of AI-embedded systems involved in human decision making makes studying human trust in these systems critical. However, empirically investigating trust is challenging. One reason is the lack of standard protocols to design trust experiments. In this paper, we present a survey of existing methods to empirically investigate trust in AI-assisted decision making and analyse the corpus along the constitutive elements of an experimental protocol. We find that the definition of trust is not commonly integrated in experimental protocols, which can lead to findings that are overclaimed or are hard to interpret and compare across studies. Drawing from empirical practices in social and cognitive studies on human-human trust, we provide practical guidelines to improve the methodology of studying Human-AI trust in decision-making contexts. In addition, we bring forward research opportunities of two types: one focusing on further investigation regarding trust methodologies and the other on factors that impact Human-AI trust.
Shared Realities: Avatar Identification and Privacy Concerns in Reconstructed Experiences
Authors: Wang Cheng Yao , Sriram Sandhya , Won Andrea Stevenson
Published: October 2021

Recent advances in 3D reconstruction technology allow people to capture and share their experiences in 3D. However, little is known about people's sharing preferences and privacy concerns for these reconstructed experiences. To fill this gap, we first present ReliveReality, an experience-sharing method utilizing deep learning-based computer vision techniques to reconstruct clothed humans and 3D environments and estimate 3D pose with only a RGB camera. ReliveReality can be integrated into social virtual environments, allowing others to socially relive a shared experience by moving around the experience from different perspectives, on desktop or in VR. We conducted a 44-participant within-subject study to compare ReliveReality to viewing recorded videos, and to a ReliveReality version with blurring obfuscation. Our results shed light on how people identify with reconstructed avatars, how obfuscation affects reliving experiences, and sharing preferences and privacy concerns for reconstructed experiences. We propose design implications for addressing these issues.
A Case Study of Phishing Incident Response in an Educational Organization
Authors: Althobaiti Kholoud , Jenkins Adam D G , Vaniea Kami
Published: October 2021

Malicious communications aimed at tricking employees are a serious threat for organizations, necessitating the creation of procedures and policies for quickly respond to ongoing attacks. While automated measures provide some protection, they cannot completely protect an organization. In this case study, we use interviews and observations to explore the processes staff at a large University use when handling reports of malicious communication, including how the help desk processes reports, whom they escalate them to, and how teams who manage protections such as the firewalls and mail relays use these reports to improve defenses. We found that the process and work patterns are a distributed cognitive process requiring multiple distinct teams with narrow system access and tactic knowledge. Sudden large campaigns were found to overwhelm the help desk with reports, greatly impacting staff's workflow and hindering the effective application of mitigations and the potential for reflection. We detail potential improvements to ticketing systems and reflect on ITIL, a common framework of best practice in IT management.
Mapping Computations in Heterogeneous Multicore Systems with Statistical Regression on Program Inputs
Authors: Da Silva Junio Cezar Ribeiro , Leão Lorena , Petrucci Vinicius , Gamatié Abdoulaye , Pereira Fernando Magno Quintão
Published: October 2021

A hardware configuration is a set of processors and their frequency levels in a multicore heterogeneous system. This article presents a compiler-based technique to match functions with hardware configurations. Such a technique consists of using multivariate linear regression to associate function arguments with particular hardware configurations. By showing that this classification space tends to be convex in practice, this article demonstrates that linear regression is not only an efficient tool to map computations to heterogeneous hardware, but also an effective one. To demonstrate the viability of multivariate linear regression as a way to perform adaptive compilation for heterogeneous architectures, we have implemented our ideas onto the Soot Java bytecode analyzer. Code that we produce can predict the best configuration for a large class of Java and Scala benchmarks running on an Odroid XU4 big.LITTLE board; hence, outperforming prior techniques such as ARM’s GTS and CHOAMP, a recently released static program scheduler.
Latexify Math: Mathematical Formula Markup Revision to Assist Collaborative Editing in Math Q&A Sites
Authors: Ma Suyu , Chen Chunyang , Khalajzadeh Hourieh , Grundy John
Published: October 2021

Collaborative editing questions and answers plays an important role in quality control of Mathematics StackExchange which is a math Q&A Site. Our study of post edits in Mathematics Stack Exchange shows that there is a large number of math-related edits about latexifying formulas, revising LaTeX and converting the blurred math formula screenshots to LaTeX sequence. Despite its importance, manually editing one math-related post especially those with complex mathematical formulas is time-consuming and error-prone even for experienced users. To assist post owners and editors to do this editing, we have developed an edit-assistance tool, MathLatexEdit for formula latexification, LaTeX revision and screenshot transcription. We formulate this formula editing task as a translation problem, in which an original post is translated to a revised post. MathLatexEdit implements a deep learning based approach including two encoder-decoder models for textual and visual LaTeX edit recommendation with math-specific inference. The two models are trained on large-scale historical original-edited post pairs and synthesized screenshot-formula pairs. Our evaluation of MathLatexEdit not only demonstrates the accuracy of our model, but also the usefulness of MathLatexEdit in editing real-world posts which are accepted in Mathematics Stack Exchange.
Every Cloud Has a Silver Lining: Exploring Experiential Knowledge and Assets of Family Caregivers
Authors: Shin Ji Youn , Chaar Dima , Davis Catherine , Choi Sung Won , Lee Hee Rin
Published: October 2021

Family caregivers of patients with chronic conditions often subject themselves to drastic life changes. The quality of life of the caregivers often decreases noticeably at the beginning of the caregiving trajectory, because they typically reorient their lives to focus on the patient's health status. As a result, previous studies viewed caregivers primarily as people who need help and focused on how technologies can support them. However, in our study, we found that caregivers are also capable of developing their own experiential knowledge and strategies, which have been invisible in previous caregiver studies. By conducting in-home interviews with fourteen family caregivers, we present the types of new knowledge and coping strategies family caregivers have developed from their lived experiences during everyday caregiving tasks. These include 1) establishing new mindsets, 2) developing mindful activities, 3) building relationship management strategies, and 4) sharing experiences with people in their own networks. Based on our findings, we call for an asset-based approach that will help researchers notice the capabilities of caregivers. This approach could enable researchers to be more reflexive in the incorporation of caregivers' devalued knowledge within their system designs.