bluuebunny/crossref_metadata_2025 huggingface dataset:
Η πορεία ένταξης των Επτανησίων πατριωτών στην ελληνική εθνική ιδέα (1797- 1827)
Authors: Λαβράνος Αθανάσιος
Published: May 2024

Κεφαλληνία, Ζάκυνθος, Λευκάδα: Τρία από τα Ιόνια Νησιά με ιδιαιτερότητα, ζωηρότητα και άφθονη επαναστατικότητα, των οποίων η συμβολή στον Αγώνα της Ανεξαρτησίας υπήρξε αξιόλογη σε ποσότητα και ποιότητα. Η Κεφαλληνία ανέδειξε τους Κεφαλλονίτες της Διασποράς, οι οποίοι χαρακτηρίστηκαν στο κατάλογο των Φιλικών ως «οι πολλοί» στο κίνημα του Υψηλάντη στις Παραδουνάβιες Ηγεμονίες. Καραβοκύρηδες με όνομα και παράδοση αποδύθηκαν σε Αγώνα μετατρέποντας τον εμπορικό τους στόλο σε πολεμικό. Επίσης η Φιλική Εταιρία εξαπλώθηκε σε όλα τα κοινωνικά στρώματα και σε αρκετές οικογένειες, που συνέχισαν τον Αγώνα στην κυρίως Ελλάδα. Στη Ζάκυνθο υπήρξε μαζική και ενσυνείδητη ένταξη στη Φιλική Εταιρία. Η συμμετοχή Ζακυνθίων κυρίως αριστοκρατών ξένης και ελληνικής προέλευσης υπήρξε πλούσια στην επανάσταση του 1821 Αναδείχθηκαν σε αξιόλογους πατριώτες και κάποιοι από αυτούς όπως ο Κόμης Διονύσιος Ρώμας υπήρξαν σπουδαίες εθνικές φυσιογνωμίες και διανοητικά κέντρα του Αγώνα. Σημαντική ήταν η δράση της Επιτροπής Ζακύνθου, που έδρασε κατά τα έτη 1824-1827 και συνεισέφερε πολλά στην διπλωματική εκπροσώπηση της Επανάστασης. Η Λευκάδα πάντα είχε προβλήματα με τον αιμοχαρή γείτονά της, τον Αλή Πασά και τους αρματολούς της Δυτικής Στερεάς, που διατηρούσαν άρρηκτες σχέσεις με το νησί. Οι αρχηγοί της στάσης των Χωρικών της Λευκάδας το 1819 εντάχθηκαν στην επανάσταση του 1821 και τέθηκαν επικεφαλής μικρών ομάδων Λευκαδίων χωρικών εναντίον των Οθωμανών. Κλέφτες της Ακαρνανίας αποβιβάστηκαν ή κατέφυγαν στη Λευκάδα. Παρά τα σκληρά κατασταλτικά μέτρα των Βρετανών, που στήριζαν την ουδετερότητα των Ιονίων Νήσων και τιμωρούσαν βάναυσα τους Επτανήσιους που στήριζαν την Επανάσταση, οι Λευκάδιοι συνέχισαν τον ένοπλο αγώνα κατά των Οθωμανών κυρίως στην Ακαρνανία.
Implementation of Joint Projects within the Framework of Strategic Partnership to Ensure Sustainable Development of Russian Business
Authors: Zykova Yu.
Published: May 2024

This article is devoted to formation and development of strategic partnerships to ensure sustainable business development in Russia. The article presents the author’s methodology for analyzing strategic partnerships, and also outlines the findings of its practical evaluation using the example of the analysis of the following strategic partnerships: Moscow Automotive Plant Moskvitch; Chinese automotive company JAC Motors; Optic Fiber Systems JSC; and the Japanese company Sumitomo Electric Industries. Particular attention is paid to the existing projects of the above companies, which are implemented by them jointly. The analysis has highlighted several developmental areas where these companies could develop their partnership. Also, the author considered several promising areas of cooperation between Russian and foreign companies under the conditions of sanctions pressure.
Growing Technological Relatedness to the ICT Industry and Its Impacts
Authors: Karanam Subrahmanyam Aditya , Mani Deepa , Saha Rajib L.
Published: May 2024

In today’s rapidly evolving technological landscape, industries across various sectors are increasingly leveraging information and communication technologies (ICT) to drive innovation and gain a competitive edge. Our study reveals that, as industries become more closely connected to the ICT sector, they experience a significant shift in their innovation processes and outcomes. By analyzing 1.3 million U.S. patents granted between 1981 and 2010, we demonstrate that industries with stronger ties to the ICT sector (i.e., higher “ICT-closeness”) exhibit a greater proportion of ICT technologies in their patent portfolios and enhanced complementarity between ICT and non-ICT patents. Furthermore, ICT-Closeness results in greater innovation efficiency (the number of patents per R&D capital), recombinant creation (the creation of new technological combinations), recombinant reuse (the refinement and reuse of known technological combinations), and the creation of new business models. These findings have important implications for practitioners. Specifically, our research highlights the importance of strategically integrating ICT into their technological innovations. Managers should actively seek opportunities to collaborate with and learn from the ICT sector to enhance their innovative capabilities, create new products, services, and business methods, and ultimately gain a competitive advantage. However, they must also be prepared for the heightened competition that comes with increased ICT-closeness, as it can lead to winner-take-all dynamics and market turbulence.
The significance of precise diabetes diagnosis: a case of euglycemic diabetic ketoacidosis induced by the introduction of empagliflozin with simultaneous reduction of insulin dosage
Authors: Bińczyk Wiktoria , Dróżdż Olgierd , Siudek Bartosz , Głuszczyk Agnieszka , Plizga Jakub , Grajnert Filip
Published: May 2024

Euglycemic diabetic ketoacidosis (euDKA) is a rare but severe metabolic complication of diabetes mellitus characterised by elevated anion gap metabolic acidosis despite normal or mildly elevated blood glucose levels. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) have emerged as effective antidiabetic medications, yet their use is associated with an increased risk of euDKA, especially when coupled with insulin dose reduction. We present the case of a 50-year-old male with a 20-year history of diabetes mellitus, initially managed with insulin and metformin, who developed euDKA following the introduction of empagliflozin and sitagliptin alongside a reduction in insulin therapy. Despite normoglycaemia the patient exhibited symptoms of ketoacidosis, including chronic fatigue, polydipsia, and polyuria. Diagnostic workup revealed metabolic acidosis, elevated inflammatory markers, acute kidney injury and ketonuria. Subsequent specialised laboratory tests confirmed type 1 diabetes mellitus (T1DM) with the presence of anti-glutamic acid decarboxylase (anti-GAD) antibodies and the absence of C-peptide secretion. Management involved fluid therapy, intravenous insulin and glucose administration. This case underscores the diagnostic challenges of euDKA and emphasises the importance of differentiating between T1DM and T2DM, as management strategies vary significantly. Patient education on insulin therapy and injection techniques is crucial to prevent complications such as improper insulin delivery and dose reduction, which can precipitate euDKA. In conclusion, clinicians should be vigilant for euDKA in patients on SGLT2 inhibitors, particularly when insulin dose reduction is involved. Comprehensive patient education and accurate differentiation between diabetes types are essential for timely diagnosis and optimal management, thereby reducing the risk of severe complications.
Design and Analysis of Multi Layered Al-2014 Aluminium Foam Core Sandwich Panels
Authors: Kumar Sunil , Rana Subodh , Sharma Gaurav , Mondal Dehi Pada
Published: May 2024

The sandwich panel exhibits higher stiffness than simple panels. The specific stiffness of sandwich panels depends on various factors like width, length, panel’s thickness, thickness of the face plate and core’s thickness of panels and type of materials used. Because of interaction effect between core and face plate, there is possibility of getting higher stiffness in multi-layered sandwich panels. In addition, incorporation of faceplate and core in the core structure varies the shear modulus and elastic modulus of core of the sandwich. However very limited research has been conducted on analytical modelling of multi-layered sandwich panels for their designing. In the present work analytical model has been developed to analyse the multilayer sandwich panels in terms of shear rigidity. flexural rigidity and deflection as a function of face plate thickness, core thickness, number of layers and beam width. Four types of specimens, those are single layer, double layer, triple layer and quadruple layer sandwich beam were prepared for this study. The deflection of the sandwich beam was measured by UTM (ultimate tensile machine). For core, Al- foam has been used and the theoretical values of elastic modulus and shear modulus were taken from the data available for cores of Al- foam synthesized at AMPRI, Bhopal. The deflection at 1000 N calculated theoretically for single layer and quadruple layer was 14.966 mm and 0.559 mm respectively. The practical calculation of deflection was 15.608 mm for single layer and 0.557 mm for quadruple layer. The practical and theoretical calculations were in well agreement. Further, it was understood that multi-layered sandwich panels are much more advantageous in terms of low deflection than single layer or double or triple sandwich panel.
APTIDÃO FÍSICA DE ACORDO COM O NÚMERO DE PASSOS EM MULHERES ADULTAS E IDOSAS
Authors: Da Silva Júnior João Pedro , De Jesus Guimarães Luís Fabiano , Rosa Bergamo Raiany , Leandro Araújo Timóteo , Keihan Rodrigues Matsudo Victor , Mahecha Matsudo Sandra Marcela
Published: May 2024

Introdução: A análise do número de passos tem sido associada com diversas variáveis relacionadas à saúde de idosos, na aptidão física, composição corporal, capacidade funcional e sua redução está relacionada com diversas doenças crônicas não transmissíveis. A redução do número de passos/dia está associada com desfechos negativos na composição corporal, desenvolvimento de doenças e risco de morte por câncer. Objetivo: Determinar o perfil de aptidão física e capacidade funcional de acordo com o nível de atividade física avaliados de mulheres adultas praticantes de atividades físicas. Métodos: Participaram deste estudo 159 mulheres praticantes regulares de atividade física com idade entre 50 a 86 anos (69,55±7,9 anos) participantes do Projeto Longitudinal de Envelhecimento e Aptidão Física de São Caetano do Sul. O nível de atividade física foi mensurado pelo número de passos, por pedômetro (Digiwalker C 700/SW 200), por sete dias consecutivos. A avaliação da aptidão física foi realizada pela força de membros superiores e inferiores e agilidade. A capacidade funcional foi mensurada pela mobilidade e equilíbrio. A análise estatística utilizada foi ANOVA One-Way, seguido de Post Hoc Bonferroni e nos dados não paramétricos utilizou-se os testes de Kruskal-Wallis e Mann-Whitney. O número de passos foi dividido em tercil (tercil 1 < 5.618 passos/dia; tercil 2 5.619-9.054 passos/dia e tercil 3 > 9.055 passos/dia). O nível de significância adotado foi de p<0,05. Resultados: Foi encontrado que o tercil 3 resultou em diferenças estatisticamente significantes nas variáveis antropométricas: peso, IMC, circunferência de cintura e circunferência de quadril, variáveis neuromotoras: força de membros inferiores e agilidade e na capacidade funcional em mobilidade geral e locomoção. Conclusão: mulheres que se encontram com o padrão de passos diários superior a 9050 obtiveram melhor perfil de aptidão física e capacidade funcional.
FATORES ASSOCIADOS AO USO DE SERVIÇOS PÚBLICOS DE SAÚDE BUCAL POR IDOSOS NO BRASIL
Authors: Rozin Oliveira Maria Luisa , Siebert Gabriela Taís , Sangaletti da Cruz Bruna Eduarda , Brittes da Luz Danieli , Spessato Schwerz Paola de Cassia , Cidade Fernanda Helaine , Braccini Fagundes Maria Laura , Do Amaral Júnior Orlando Luiz
Published: May 2024

INTRODUÇÃO: A saúde bucal faz parte da saúde geral e contribui ao bem-estar físico, psicológico e social dos indivíduos idosos. Entretanto, com o aumento da idade e da debilidade, um número considerável de idosos deixa de procurar os serviços de saúde bucal. OBJETIVO: descrever e verificar quais características socioeconômicos e demográficos estão associados a utilização de serviços de saúde bucal público por idosos brasileiros. MÉTODOS: trata-se de um estudo transversal, com dados da linha de base do Estudo Longitudinal da Saúde dos Idosos Brasileiros (ELSI-Brasil), realizado entre 2015 e 2016. A amostra foi delineada para representar a população brasileira com idade igual ou superior a 50 anos. RESULTADOS: Ao todo foram avaliados 2.969 indivíduos, que relataram utilizar os serviços de saúde bucal público. Ao verificar a associação entre os anos de escolaridade e uso de serviços públicos, observou-se que aqueles com 12 anos ou mais de escolaridade possuem uma prevalência de 83% a mais de utilizar os serviços públicos de saúde bucal quando comparados a quem possuem até 3 anos de escolaridade. Ao analisar ao índice de riqueza, percebeu-se que quanto maior o quintil de riqueza, maior foi a prevalência de utilização dos serviços públicos de saúde bucal. CONCLUSÃO: os resultados encontrados neste estudo sugerem que idosos com melhores condições socioeconômicas e com maior grau de escolaridade são os que mais acessam os serviços públicos de saúde bucal. Sugere-se que políticas que busquem reduzir as iniquidades e melhorem o acesso aos serviços públicos a população idosa brasileira sejam propostas.
Double set up technique as a bailout of diagonal branch coronary perforation: a case report
Authors: Syukri Muhammad , Yanni Mefri , Syafri Masrul , Phalguna Shindu , Firmansyah Alles , Indah Merlin Sari Mutma , Mahendra Ivan , Zulkarnain Hadi
Published: May 2024

Coronary artery perforation is a rare but potentially life-threatening complication of percutaneous coronary intervention (PCI). A 55-year-old male with a history of implanted stent on the left main ostium to the proximal left circumflex artery (LCX) and distal right coronary artery, and chronic total occlusion (CTO) on ostium left anterior descending (LAD). PCI was performed using a stiff wire to cross the CTO body in LAD. We performed an injection and confirmed the presence of extravasation. We successfully managed to stop the bleeding by placing the tips of floppy wire that were cut into pieces. A drainage pathway was made through thoracotomy for pericardial effusion. Angiography showed persisting extravasation at the wire insertion site. We then made our own covered stent. We implanted on the osteal LAD until proximal LCX. Repeated angiography showed no contrast extravasated from the perforation site, and the patient was stabilized and discharged.
Widefield polarization-resolved second harmonic generation imaging of entire thyroid nodule sections for the detection of capsular invasion
Authors: Eftimie Lucian G. , Padrez Yaraslau , Golubewa Lena , Rutkauskas Danielis , Hristu Radu
Published: May 2024

The identification of tumor capsular invasion as a sign of malignancy is currently employed in traditional histopathology routines for thyroid nodules. However, its limitations are associated with the assessment criteria for invasion, which often lead to disagreements among observers. The aim of this paper is to introduce a widefield imaging technique combined with quantitative collagen analysis to identify areas of capsular invasion in thyroid neoplasms. In this study, we introduce the application of widefield polarization-resolved second harmonic generation microscopy for imaging entire thyroid nodule sections on histological slides. We employ a cylindrical collagen model to extract parameters associated with the ultrastructure and orientation of collagen within the entire capsule of the thyroid nodule. We showcase the effectiveness of these parameters in distinguishing between areas of nodule capsule invasion and unaffected regions of the capsule through statistical analysis of individual parameters and employing a machine learning technique that involves generating maps via cluster analysis. Our results suggest that quantitative analysis facilitated by polarization-resolved widefield second harmonic generation microscopy could prove beneficial for the automated evaluation of capsular invasion sites in thyroid pathology.
Observation of photonic chiral edge states in penrose quasicrystals
Authors: Yang Xucheng , Wang Ziyao , Gao Hengjun , Yang Linyuan , Meng Yan , Xi Xiang , Shum Perry Ping , Gao Zhen
Published: May 2024

Photonic chiral edge states with one-way propagation and robust topological protection are hallmark features of photonic Chern insulators. To date, photonic chiral edge states have been observed in two-dimensional (2D) periodic and amorphous gyromagnetic photonic crystals. Recent theoretical studies reveal that photonic chiral edge states can also exist in 2D Penrose quasicrystals with long-range order but lack translational symmetry. Here, we report the first experimental observation of photonic chiral edge states in a 2D Penrose-tiled gyromagnetic photonic quasicrystal. By using microwave measurements, we observe a complete photonic band gap in the Penrose photonic quasicrystal despite the absence of bulk Bloch bands in momentum space. Moreover, we directly observe unidirectional backscattering-immune photonic chiral edge states within the photonic bandgap of the 2D Penrose quasicrystal. These results broaden our understanding of photonic chiral edge states and provide a new platform for exploring the intriguing properties of topological photonic quasicrystals.
Customization and acceptability of the WHO labor care guide to improve labor monitoring among health workers in Uganda. An iterative development, mixed method study
Authors: Mugyenyi Godfrey R. , Byamugisha Josaphat K. , Tumuhimbise Wilson , Atukunda Esther C. , Fajardo Yarine T.
Published: May 2024

Cognisant of persistently high maternal and perinatal mortality rates, WHO called for adoption and evaluation of new adaptable and context-specific solutions to improve labor monitoring and health outcomes. We aimed at customizing/refining the new WHO labour care guide (LCG) to suite health care provider needs (HCP) in monitoring labour in Uganda. We used mixed methods to customize/refine and pilot test the new WHO LCG using stakeholder perspectives. Between 1st July 2023 and 30th December 2023, we conducted; 1)30 stakeholder interviews to identify user needs/challenges that informed initial modifications of the WHO LCG; 2)15 HCP in-depth interviews to identify any further needs to modify the LCG; 3) Two focus group discussions and 4) Two exit expert panels to identify any further user needs to further refine proposed modifications into the final prototype. Questionnaires were administered to assess acceptability. We interviewed 125 stakeholders with median age of 36 years (IQR;26–48) exposed to the LCG for at least 12 months with 11.8(SD = 4.6) years of clinical practice. Simple useful modifications/customizations based on format, HCP’s perceived function and role in improving decision making during monitoring labour included; 1) Customizing LCG by adding key socio-demographic data; 2) Adjusting observation ordering; 3) Modification of medication dosages and 4) Provision for recording key clinical notes/labour outcome data on reverse side of the same A4 paper. All HCPs found the modified WHO LCG useful, easy to use, appropriate, comprehensive, appealing and would recommend it to others for labour monitoring. It was implementable and majority took less than 2 minutes to completely record/fill observations on the LCG after each labour assessment. Active involvement of end-users improved inclusiveness, ownership, acceptability and uptake. The modified LCG prototype was found to be simple, appropriate and easy-to-use. Further research to evaluate large-scale use, feasibility and effectiveness is warranted.
A fluctuating intensity of care: A qualitative study on the experiences of informal caregivers of patients with critical limb-threatening ischemia
Authors: van Gorkom Rebecca N. F. G. , Meulenbroek Anne L. , de Vries Jolanda , Frost Donna M. , van der Laan Lijckle
Published: May 2024

Informal caregivers play a significant role in providing care for older, often vulnerable, patients, and supporting them as they live with chronic diseases. Due to the rising prevalence of older vascular patients and their use of healthcare, the role of their informal caregivers will become more important. However, little is known about the experiences of informal caregivers of patients with critical limb-threatening ischemia and the impact of informal care on different aspects of these caregivers’ lives. In addition, literature does not describe the burden this role brings with it, or lack thereof. Therefore a qualitative study using a phenomenological approach, specifically interpretive phenomenological analysis, was used to gain insight into the experiences of the primary informal caregivers of patients with chronic limb-threatening ischemia. Data were collected via semi-structured interviews and focus groups discussions. Fifteen primary informal caregivers of patients with critical limb-threatening ischemia under the care of the vascular surgeon at a tertiary teaching hospital in the Netherlands were included. Data analysis yielded three themes: the perceived identity of this group of caregivers; the varying intensity of informal care; and the collaboration between informal carers, their care recipients and the professional care provider within the vascular surgery department. In contrast to carers of other chronic diseases, the shifting intensity of care that informal caregivers of critical limb-threatening ischemia patients experience seems to prevent long-term overload. Adapting to that fluctuating situation requires flexibility from healthcare providers within the vascular surgery department. In addition, professionals need to involve informal caregivers in the patient’s decision-making process and recognize their role in that process.
Pain and daily interference among reproductive-age women with myofascial pelvic pain: Serial mediation roles of kinesiophobia, self-efficacy and pain catastrophizing
Authors: Si Mingyu , Chen Juan , Zhang Xue , Zhu Lan , Jiang Yu
Published: May 2024

Background

Myofascial pelvic pain (MFPP), which is identified by tender points in the pelvic floor musculature, is a prevalent source of chronic pelvic pain in women. It may lead to physical and mental exhaustion, reproductive concerns, and coping difficulties in daily life and work than the disease itself. Pain-related cognitive processes can affect pain relief and quality of life. Kinesiophobia, self-efficacy and pain catastrophizing are frequently treated as mediators between pain and its related consequences. Greater kinesiophobia and pain catastrophizing have been shown to be associated with adverse functional outcomes, while higher self-efficacy has been related with improved quality of life. Regarding MFPP in females of childbearing age, it remains unclear whether the effects of kinesiophobia, self-efficacy and pain catastrophizing on daily interference are direct or indirect; the influence on each variable is, therefore, not entirely evident.

Aim

The present study aimed to evaluate the relationship between pain and daily interference in reproductive-age women with MFPP through kinesiophobia, self-efficacy and pain catastrophizing, as well as to identify areas for future investigation and intervention based on the data collected from this population.

Methods

This is a multi-center cross-sectional study. The study was conducted from November 15, 2022 to November 10, 2023, 202 reproductive-age women with MFPP were recruited from 14 hospitals in ten provinces of China. The demographic variables, Brief Pain Inventory, Tampa Scale of Kinesiophobia, Pain Self-Efficacy Questionnaire, and Pain Catastrophizing Scale were used to measure the participants’ related information. The data was described and analyzed using Descriptive analyses, Pearson correlation analysis, and Serial mediation modeling.

Results

Pain not only had a direct positive impact (B = 0.575; SE   =   0.081; 95%CI: LL = 0.415, UL = 0.735) on daily interference, but also had an indirect impact on daily interference through the independent mediating role of pain catastrophizing (B = 0.088; SE  =  0.028; 95%CI: LL = 0.038, UL = 0.148), the chain mediating of kinesiophobia and catastrophizing (B = 0.057; SE  =   0.019; 95%CI: LL = 0.024, UL = 0.098), and the four-stage serial mediating of kinesiophobia, self-efficacy and catastrophizing (B = 0.013; SE   =  0.006; 95%CI: LL = 0.003, UL = 0.027). The proposed serial mediation model showed a good fit with the collected data.

Conclusion

The findings illustrate the significance of addressing pain catastrophizing and kinesiophobia (especially catastrophizing), and increasing self-efficacy in pain therapy, and suggest that functional recovery be integrated into pain therapy for reproductive-age women suffering from MFPP.
The prevention of adverse pregnancy outcomes by periodontal treatment during pregnancy (PROBE) intervention study—A controlled intervention study: Protocol paper
Authors: Winckler Karoline , Bukkehave Kathrine Hansen , Tarnow Lise , Iversen Peter Bindslev , Damgaard Christian , Ditlev Sisse Bolm , Kofoed-Enevoldsen Allan , Fischer Heidi Marianne , Dueholm Signe Camilla Hjuler , Lauenborg Jeannet , Trier Cæcilie , Heitmann Berit Lilienthal
Published: May 2024

Introduction

Pregnancy increases the risk of periodontitis due to the increase in progesterone and estrogen. Moreover, periodontitis during pregnancy is associated with development of pregnancy and birth related complications. The aim of this study is to determine, whether periodontal treatment during pregnancy can reduce systemic inflammation and lower the risk of adverse pregnancy and birth related outcomes.

Methods and analysis

The PROBE study is a non-randomized controlled intervention study conducted among 600 pregnant women with periodontitis. The women will be recruited among all pregnant women at two Danish hospitals in Region Zealand during their nuchal translucency scan and will subsequently be screened for periodontitis. The intervention group includes 300 pregnant women, who will be offered state-of-the-art periodontal treatment during pregnancy. The control group includes additional 300 pregnant women, who will be offered periodontal treatment after giving birth. Outcome measures include periodontal measures, inflammatory, hormonal and glycaemic markers as well as the prevalence of preterm birth risk, low birth weight and risk markers of gestational diabetes mellitus (GDM) and preeclampsia that will be collected from all screened women and further during pregnancy week 20 and pregnancy week 35 for women enrolled in the intervention.

Ethics and dissemination

The study’s findings will be published in peer reviewed journals and disseminated at national and international conferences and through social media. The PROBE study is designed to provide important new knowledge as to whether periodontal treatment during pregnancy can reduce the prevalence of complications related to pregnancy and birth.

Clinical trials registration

The study was registered on clinicaltrials.gov (NCT06110143).
Prediction of heart failure patients with distinct left ventricular ejection fraction levels using circadian ECG features and machine learning
Authors: Al Younis Sona M. , Hadjileontiadis Leontios J. , Khandoker Ahsan H. , Stefanini Cesare , Soulaidopoulos Stergios , Arsenos Petros , Doundoulakis Ioannis , Gatzoulis Konstantinos A. , Tsioufis Konstantinos
Published: May 2024

Heart failure (HF) encompasses a diverse clinical spectrum, including instances of transient HF or HF with recovered ejection fraction, alongside persistent cases. This dynamic condition exhibits a growing prevalence and entails substantial healthcare expenditures, with anticipated escalation in the future. It is essential to classify HF patients into three groups based on their ejection fraction: reduced (HFrEF), mid-range (HFmEF), and preserved (HFpEF), such as for diagnosis, risk assessment, treatment choice, and the ongoing monitoring of heart failure. Nevertheless, obtaining a definitive prediction poses challenges, requiring the reliance on echocardiography. On the contrary, an electrocardiogram (ECG) provides a straightforward, quick, continuous assessment of the patient’s cardiac rhythm, serving as a cost-effective adjunct to echocardiography. In this research, we evaluate several machine learning (ML)-based classification models, such as K-nearest neighbors (KNN), neural networks (NN), support vector machines (SVM), and decision trees (TREE), to classify left ventricular ejection fraction (LVEF) for three categories of HF patients at hourly intervals, using 24-hour ECG recordings. Information from heterogeneous group of 303 heart failure patients, encompassing HFpEF, HFmEF, or HFrEF classes, was acquired from a multicenter dataset involving both American and Greek populations. Features extracted from ECG data were employed to train the aforementioned ML classification models, with the training occurring in one-hour intervals. To optimize the classification of LVEF levels in coronary artery disease (CAD) patients, a nested cross-validation approach was employed for hyperparameter tuning. HF patients were best classified using TREE and KNN models, with an overall accuracy of 91.2% and 90.9%, and average area under the curve of the receiver operating characteristics (AUROC) of 0.98, and 0.99, respectively. Furthermore, according to the experimental findings, the time periods of midnight-1 am, 8–9 am, and 10–11 pm were the ones that contributed to the highest classification accuracy. The results pave the way for creating an automated screening system tailored for patients with CAD, utilizing optimal measurement timings aligned with their circadian cycles.
Effect of chemotherapy on prognosis in patients with primary pancreatic signet ring cell carcinoma: A large real-world study based on machine learning
Authors: Huang Kun , Yuan Xinzhu , Zhao Pingwu , He Yunshen
Published: May 2024

Background

Primary pancreatic signet ring cell carcinoma (PSRCC), an extremely rare histologic variant of pancreatic cancer, has a poor prognosis. This study aimed to investigate the prognostic value of chemotherapy in PSRCC.

Methods

Patients with PSRCC between 2000 and 2019 were identified using the Surveillance Epidemiology and End Results (SEER) database. The main outcomes in this study were cancer-specific survival (CSS) and overall survival (OS). The baseline characteristics of patients were compared using Pearson’s Chi-square test. Kaplan-Meier analysis was used to generate the survival curves. Least absolute shrinkage and selection operator (LASSO), univariate and multivariate Cox regression models, and Random Survival Forest model were used to analyze the prognostic variables for OS and CSS. The variance inflation factors (VIFs) were used to analyze whether there was an overfitting problem.

Results

A total of 588 patients were identified. Chemotherapy was an independent prognostic factor for OS and CSS, and significantly associated with OS (HR = 0.33, 95% CI = 0.27–0.40, P <0.001) and CSS (HR = 0.32, 95% CI = 0.26–0.39, P <0.001).

Conclusions

Chemotherapy showed beneficial effects on OS and CSS in patients with PSRCC and should be recommended in clinical practice.
The protocol for a cluster randomized controlled trial to evaluate couple-based violence prevention education and its ability to reduce intimate partner violence during pregnancy in Southwest Ethiopia
Authors: Agde Zeleke Dutamo , H. Magnus Jeanette , Assefa Nega , Wordofa Muluemebet Abera
Published: May 2024

Background

A significant proportion of women in Ethiopia suffer from violence by their intimate partner during pregnancy, which has adverse maternal and newborn outcomes. Couple-focused interventions are effective in reducing and/or controlling violence between women and their intimate partners. However, interventions addressing intimate partners of the victims are not well studied, particularly in the Ethiopian setting. This study aims to assess the effect of couple-based violence prevention education on intimate partner violence during pregnancy.

Methods

We will use a cluster randomized controlled trial to evaluate the effectiveness of couple-based violence prevention education compared to routine care in reducing intimate partner violence during pregnancy. Sixteen kebeles will be randomly assigned to 8 interventions and 8 control groups. In the trial, 432 couples whose wife is pregnant will participate. Health extension workers (HEWs) will provide health education. Data will be collected at baseline and endline. All the collected data will be analyzed using Stata version 16.0 or SPSS version 25.0. We will use the McNemar test to assess the differences in outcomes of interest in both intervention and control groups before and after the intervention for categorical data. A paired t-test will be used to compare continuous outcome of interest in the intervention and the control groups after and before the intervention. The GEE (Generalized Estimating Equation), will be used to test the independent effect of the intervention on the outcome of the interest. Data analysis will be performed with an intention-to-treat analysis approach. During the analysis, the effect size, confidence interval, and p-value will be calculated. All tests will be two-sided, and statistical significance will be declared at p < 0.05.

Discussion

We expect that the study will generate findings that can illuminate violence prevention strategies and practices in Ethiopia.

Trial registration

It has been registered on ClinicalTrials.gov as NCT 05856214 on May 4, 2023.
Prevalence and correlates of mental disorders among Chinese overseas students during the COVID-19: A multi-regional cross-sectional analysis
Authors: Gao Yijia , Ma Yuanyan , Li Yaxin , Zhao Yuanji , Zeng Zhen , Yao Xiaozhi , Nie Yingjun
Published: May 2024

Background

The global impact of the COVID-19 pandemic extends beyond physical health, significantly affecting mental health. Chinese overseas students are particularly susceptible to the adverse psychological effects of the pandemic. Understanding the prevalence and correlates of mental disorders in this population is essential for developing targeted interventions and support systems.

Methods

Employing a snowball sampling technique, this study recruited Chinese overseas students from diverse regions. The 50-item Self-evaluation Table was utilized to assess the presence of mental disorders. Descriptive statistics, including percentages, 95% confidence intervals, means, and standard deviations, characterized the survey population. The chi-square test identified disparities among categorical variables, while logistic regression explored risk factors for mental disorders among Chinese overseas students.

Results

Out of the total sample size of 10,864 Chinese overseas students, a staggering 7,090 (65.4%) met the diagnostic criteria for mental disorders. Furthermore, the degree of mental disorder varied significantly across different regions (p < 0.001), education levels (p < 0.05), the duration of anti-epidemic measures (p < 0.05), and age (p < 0.05), while no significant differences were observed in terms of gender (p > 0.05). Several risk factors contributing to the mental disorder burden among Chinese overseas students during the pandemic were identified, including the seriousness of the epidemic in their residential area, the apprehension of getting infected, anxieties regarding academic performance, the infection control policies implemented by the host government, preventive measures taken locally to counter the epidemic, and challenges encountered in returning to their home country.

Conclusion

Given the significant challenges in mental health faced by Chinese overseas students during the COVID-19 crisis, addressing their specific needs and implementing tailored measures is imperative. Future public health emergencies should consider the potential mental disorders and disease risks faced by Chinese overseas students. By providing comprehensive support and targeted interventions, policymakers, educational institutions, and healthcare providers can help mitigate the adverse psychological effects and promote the well-being of this vulnerable population.
Developing machine learning models to predict multi-class functional outcomes and death three months after stroke in Sweden
Authors: Otieno Josline Adhiambo , Häggström Jenny , Darehed David , Eriksson Marie
Published: May 2024

Globally, stroke is the third-leading cause of mortality and disability combined, and one of the costliest diseases in society. More accurate predictions of stroke outcomes can guide healthcare organizations in allocating appropriate resources to improve care and reduce both the economic and social burden of the disease. We aim to develop and evaluate the performance and explainability of three supervised machine learning models and the traditional multinomial logistic regression (mLR) in predicting functional dependence and death three months after stroke, using routinely-collected data. This prognostic study included adult patients, registered in the Swedish Stroke Registry (Riksstroke) from 2015 to 2020. Riksstroke contains information on stroke care and outcomes among patients treated in hospitals in Sweden. Prognostic factors (features) included demographic characteristics, pre-stroke functional status, cardiovascular risk factors, medications, acute care, stroke type, and severity. The outcome was measured using the modified Rankin Scale at three months after stroke (a scale of 0–2 indicates independent, 3–5 dependent, and 6 dead). Outcome prediction models included support vector machines, artificial neural networks (ANN), eXtreme Gradient Boosting (XGBoost), and mLR. The models were trained and evaluated on 75% and 25% of the dataset, respectively. Model predictions were explained using SHAP values. The study included 102,135 patients (85.8% ischemic stroke, 53.3% male, mean age 75.8 years, and median NIHSS of 3). All models demonstrated similar overall accuracy (69%–70%). The ANN and XGBoost models performed significantly better than the mLR in classifying dependence with F1-scores of 0.603 (95% CI; 0.594–0.611) and 0.577 (95% CI; 0.568–0.586), versus 0.544 (95% CI; 0.545–0.563) for the mLR model. The factors that contributed most to the predictions were expectedly similar in the models, based on clinical knowledge. Our ANN and XGBoost models showed a modest improvement in prediction performance and explainability compared to mLR using routinely-collected data. Their improved ability to predict functional dependence may be of particular importance for the planning and organization of acute stroke care and rehabilitation.
La enseñanza del inglés al alumnado con TDAH
Authors: Pérez-Cabello Ana Mª , Gil-Pérez Margarita , Oliva-Pérez Francisco Jesús
Published: May 2024

Este trabajo persigue estudiar el desarrollo y adaptación de la enseñanza de inglés al alumnado con Trastorno por Déficit de Atención e Hiperactividad (TDAH). Dicho estudio nos permitirá descubrir las estrategias y métodos más efectivos para mejorar la enseñanza de inglés a estos estudiantes. Para ello, se realiza una encuesta destinada a docentes de inglés de 8 centros educativos de la zona de Condado de Huelva (Andalucía, España). Los resultados muestran que el profesorado adapta favorablemente la enseñanza del inglés a estos escolares. Emplean una serie de medidas, estrategias y métodos que resultan útiles para dotar a estas personas de las destrezas necesarias para la adquisición del inglés como L2. Estos resultados concuerdan con otras investigaciones sobre el tema. Muestran que estos métodos y estrategias son los que mejor se ajustan a las necesidades de atención y movimiento que requieren estos estudiantes.
Complex equilibria in strongly alkaline aqueous solutions containing Ca(II), Nd(III) and gluconate ions
Authors: Böszörményi Éva
Published: May 2024

A polihidroxi-karbonsavak, mint például a glükonát (Gluc– ), alapvető szerepet játszanak különböző ipari folyamatokban. A Gluc– komplexképző tulajdonsága miatt nagy mennyiségben kerül felhasználásra: erre példa a NaGluc, ami egy gyakori adalékanyag az építőiparban, és a cement bizonyos tulajdonságainak javítására használják. Az alacsony és közepes aktivitású radioaktív hulladéktárolókban (LL/IL) a tartályokat cementtel töltik fel a szivárgás megakadályozása érdekében, de vízbetörés esetén az erősen lúgos kémhatású pórusvíz elősegítheti, hogy a Gluc– komplexálja a fémionokat, ezért ezeket a komplexképző folyamatokat az elmúlt évtizedekben kitüntetett figyelemmel kísérték és behatóan tanulmányozták. A Gluc– bizonyítottan stabil komplpexeket képez alkáli-földfém (Ca(II), Mg(II)) és átmeneti (Cu(II), Co(II), Ni(II), Mn(II), Zn(II)) fémionokkal, ezért nem zárható ki, hogy képes a három-, és négyvegyértékű aktinoidák és lantanoidák oldhatóságának növelésére. A radioaktív hulladéktárolókra jellemző oxigénszegény környezet biztosítja, hogy az aktinoida fémionok főként redukált oxidációs állapotban (Cm(III), Am(III), Pu(III), Pu(IV)) legyenek jelen. Lehetséges komplexképző anyagok is jelen vannak ezekben a tárolókban; erre példa a cellulóz tartalmú komponensek illetve szennyező anyagok bomlásával keletkező izoszacharinát (Isa– ) vagy cementadalékként a rendszerbe kerülő Gluc– . Kiemelt fontosságú tehát annak vizsgálata, hogy ezek a ligandumok képesek-e fokozni az aktinoida fémionok oldhatóságát vízbetörés esetén, mivel a radioaktív fémionok oldhatósága szerves részét képezi a radioaktív hulladék elhelyezésével kapcsolatos kockázatbecslésnek. A stabil (III) oxidációs állapotú lantanoidák és a három vegyértékű aktinoidák között fennálló kémiai hasonlóságok miatt utóbbiak modellezhetők kevésbé körülményesen vizsgálható lantanoidákkal. A radioaktív hulladéktárolókban végbemenő lehetséges komplexképződési folyamatok egyszerűsített és releváns modelljének felállításához felhasználták már a neodímiumot (Nd(III)) és a Gluc– -ot vizesközegű mérésekhez, de a lúgos kémhatású oldatokban lejátszódó folyamatok kevésbé ismertek.
Precipitation of oxide dispersion strength steels after long-term annealing at temperature of 475 °C
Authors: Košovský Dávid , Miglierini Marcel , Kmječ Tomáš , Dekan Július , Bujdoš Marek
Published: May 2024

Oxide dispersion strengthened steels are key alloys used in nuclear installations. Steels with chromium content of up to 10 wt % are suitable due to their advantageous properties and these alloys are used for the construction of technological devices in the primary circuit of nuclear power plants. From other studies, it can be concluded that chromium has anti-corrosive properties due to the formation of a passivation layer, which results in reduced activation of the material by thermal neutrons. Macroscopic properties are determined by their microstructure, and therefore, the description of the microstructure is important. Transmission Mössbauer spectroscopy and atom probe tomography were used to characterise the material. This provides information about the physical and/or chemical environment of the resonant atoms can be obtained. Obtained spectral parameters reach saturation values from which the solubility limit of chromium in iron can be determined. In Cr-rich phase, the solubility limit can be estimated from the value of spectral parameters of the single-line in the spectrum annealed for the longest time. The suggested procedures are subsequently applied to the case studies of stainless steels suitable for the construction of various components of the III+/IVth generation of nuclear reactors (including fast and fusion reactors).
The importance of using active thermal protection following restoration work on old buildings
Authors: Šťastný Patrik , Antošová Naďa , Kalús Daniel , Mučková Veronika
Published: May 2024

The paper deals with the issue of humidity and the unhealthy environment of old buildings. Humidity is a very widespread problem not only in historical buildings, but also in newer buildings. This problem can be observed in various parts of the world and thus it can be said that it is a global problem. Humidity in these buildings causes an unhealthy environment, which has a negative effect on individual building constructions, but also on people’s health. Humidity is also associated with the form of disruption of the individual layers of the construction and the disruption of the thermal resistance of these constructions. Buildings such as these subsequently have an unhealthy environment. After a part of the description of the known issue, the contribution follows on from this part by indicating possible remedial interventions and analyses the systems of additional thermal insulation (ETICS, ATP), ensuring the improvement of the internal environment. Finally, the article presents possible connections and extensions of this research and its application directly in practice. The results of the proposed research will significantly contribute to the approach to rehabilitated older buildings and their long-term sustainability from an economic point of view, as well as the possible use of them.
UMA REVISÃO DE ESCOPO SOBRE O CUIDADO FARMACÊUTICO AO IDOSO NA ASSISTÊNCIA DOMICILIAR
Authors: Saldanha Tainá Freitas , Higa-taniguchi Keila Tomoko , Pinto Vanusa Barbosa , Rocha Priscilla Alves
Published: May 2024

O envelhecimento populacional pode aumentar o desenvolvimento de Doenças Crônicas Não Transmissíveis (DCNT), e consequentemente, ocasionar polifarmácia. Nesse contexto, os serviços farmacêuticos de atendimento domiciliar oferecem diversos benefícios para o paciente, reduzindo os Problemas Relacionados a Medicamentos (PRM). Essa revisão tem o objetivo de mapear os achados sobre os serviços farmacêuticos providos ao paciente idoso, na assistência domiciliar (AD). Métodos: Foi conduzida uma revisão de escopo com a pergunta: “Quais os serviços providos por farmacêuticos para idosos na assistência domiciliar?”. A partir da combinação do acrônimo PCC, foi realizada a estratégia de busca para rastrear os estudos nas bases de: PubMed; BVS (Biblioteca Virtual em Saúde); Cochrane Library; Web of Science; Scopus e Google Scholar. Resultados/ Discussão: Foram achados n = 497 estudos, e onze estudos foram incluídos e considerados elegíveis para extração de dados, por uma pesquisadora e uma revisora. Os serviços clínicos ofertados por  farmacêuticos na AD achados são a revisão da farmacoterapia, acompanhamento farmacoterapêutico, conciliação medicamentosa, educação em saúde e rastreamento em saúde. Os principais PRMs englobam não adesão medicamentosa, reações adversas a medicamentos e doses inadequadas. Além disso, as intervenções farmacêuticas mais relevantes nos serviços de atendimento domiciliar foram medidas para melhorar a adesão e compreensão da farmacoterapia, ajustes de doses e práticas de educação em saúde. Conclusão: O atendimento do farmacêutico na AD pode contribuir para melhoria na adesão a farmacoterapia, compreensão da terapia medicamentosa e no uso seguro dos medicamentos.
Transmitter diversity and OAM incorporated 40 Gbps free space optical system
Authors: Singh Somdeep , Singh Preeti , Kaur Pardeep
Published: May 2024

The present research evaluates optical angular momentum’s (OAM) performance in challenging atmospheric conditions and emphasizes its significance in free space optical (FSO) communication systems. It has been demonstrated that implementing the transmitter diversity (TD) technique effectively suppresses inter-channel interference, improving system performance as a whole. The best option among the studied encodings is found to be the combination of non-return-to-zero (NRZ) and carrier suppressed RZ (CSRZ), which performs better in a variety of weather scenarios and covers a wide FSO range from 72 m to 1450 m. Proposed system offered distance enhancement of 81.25 % under clear sky, 16.66 % under light rain, 10.22 % under moderate rain, 3.4 % under heavy rain, 10 % under light haze, 4 % under moderate haze, 4.44 % under heavy haze, 12.5 % under light fog, 4 % under moderate fog, 7.8 % under heavy fog, 5.8 % under light dust, 7.6 % under medium dust and 12.5 % under heavy dust as compared to existing workIn particular, during bad weather, this research offers significant insights into the design and optimisation of high-speed FSO systems.