bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of a national mass distribution campaign of long-lasting insecticide-treated nets and indoor residual spraying on clinical malaria in Malawi, 2018–2020
Authors: Topazian Hillary M , Gumbo Austin , Brandt Katerina , Kayange Michael , Smith Jennifer S , Edwards Jessie K , Goel Varun , Mvalo Tisungane , Emch Michael , Pettifor Audrey E , Juliano Jonathan J , Hoffman Irving
Published: May 2021

Introduction

Malawi’s malaria burden is primarily assessed via cross-sectional national household surveys. However, malaria is spatially and temporally heterogenous and no analyses have been performed at a subdistrict level throughout the course of a year. The WHO recommends mass distribution of long-lasting insecticide-treated bed nets (LLINs) every 3 years, but a national longitudinal evaluation has never been conducted in Malawi to determine LLIN effectiveness lifespans.

Methods

Using District Health Information Software 2 (DHIS2) health facility data, available from January 2018 to June 2020, we assessed malaria risk before and after a mass distribution campaign, stratifying by age group and comparing risk differences (RDs) by LLIN type or annual application of indoor residual spraying (IRS).

Results

711 health facilities contributed 20 962 facility reports over 30 months. After national distribution of 10.7 million LLINs and IRS in limited settings, malaria risk decreased from 25.6 to 16.7 cases per 100 people from 2018 to 2019 high transmission seasons, and rebounded to 23.2 in 2020, resulting in significant RDs of −8.9 in 2019 and −2.4 in 2020 as compared with 2018. Piperonyl butoxide (PBO)-treated LLINs were more effective than pyrethroid-treated LLINs, with adjusted RDs of −2.3 (95% CI −2.7 to −1.9) and −1.5 (95% CI −2.0 to −1.0) comparing 2019 and 2020 high transmission seasons to 2018. Use of IRS sustained protection with adjusted RDs of −1.4 (95% CI −2.0 to −0.9) and −2.8% (95% CI −3.5 to −2.2) relative to pyrethroid-treated LLINs. Overall, 12 of 28 districts (42.9%) experienced increases in malaria risk in from 2018 to 2020.

Conclusion

LLINs in Malawi have a limited effectiveness lifespan and IRS and PBO-treated LLINs perform better than pyrethroid-treated LLINs, perhaps due to net repurposing and insecticide-resistance. DHIS2 provides a compelling framework in which to examine localised malaria trends and evaluate ongoing interventions.
Factors associated with the length of stay at health facilities after childbirth among mothers and newborns in Dhading, Nepal: a cross-sectional study
Authors: Ikeda Subaru , Shibanuma Akira , Silwal Ram , Jimba Masamine
Published: May 2021

Objective

To measure the length of stay at a health facility after childbirth, identify factors associated with the length of stay and measure the gap between the timings of the last check-up and discharge.

Design

A cross-sectional study.

Setting

Five public health facilities in Dhading, Nepal.

Participants

351 randomly selected mothers who gave birth at selected health facilities within 1 year of data collection between 10 and 31 August 2018.

Outcome measure

Length of stay (hours) at a health facility after childbirth. Adequate length was defined as 24 hours or longer based on the WHO guidelines.

Results

Among 350 mothers (99.7%) out of 351 recruited, 61.7% were discharged within 24 hours after childbirth. Factors associated with shorter length of stay were as follows: travel time less than 30 min to a health facility (incidence rate ratio (IRR)=0.69, 95% CI 0.61 to 0.78); delivery attended by auxiliary staff (IRR=0.86, 95% CI 0.75 to 0.98); and delivery in a primary healthcare centre (IRR=0.67, 95% CI 0.58 to 0.79). Factors associated with longer length of stay were as follows: aged 22 years or above at the first pregnancy (IRR=1.25, 95% CI 1.13 to 1.40); having maternal complications (IRR=2.41, 95% CI 2.16 to 2.70); accompanied by her own family (IRR=1.17, 95% CI 1.03 to 1.34), accompanied by her husband (IRR=1.16, 95% CI 1.04 to 1.29); and delivered at a facility with a physical space where mother and newborn could stay overnight (IRR=1.20, 95% CI 1.07 to 1.34). Among mothers without complications, 32% received the last check-up 3 hours or less before discharge.

Conclusions

Multiple factors, such as mothers’ conditions, health facility characteristics and external support, were associated with the length of stay after childbirth. However, even if mothers stayed long, they might have not necessarily received timely and proper assessment before discharge.
Evaluating pictorial support in person-centred care for children (PicPecc): a protocol for a crossover design study
Authors: Nilsson Stefan , Wiljén Angelica , Bergquist Jonas , Chaplin John , Johnson Ensa , Karlsson Katarina , Lindroth Tomas , Schwarz Anneli , Stenmarker Margaretha , Thunberg Gunilla , Esplana Linda , Frid Eva , Haglind Malin , Höök Angelica , Wille Joakim , Öhlen Joakim
Published: May 2021

Introduction

This study protocol outlines the evaluation of the pictorial support in person-centred care for children (PicPecc). PicPecc is a digital tool used by children aged 5–17 years to self-report symptoms of acute lymphoblastic leukaemia, who undergo high-dose methotrexate treatments. The design of the digital platform follows the principles of universal design using pictorial support to provide accessibility for all children regardless of communication or language challenges and thus facilitating international comparison.

Methods and analysis

Both effect and process evaluations will be conducted. A crossover design will be used to measure the effect/outcome, and a mixed-methods design will be used to measure the process/implementation. The primary outcome in the effect evaluation will be self-reported distress. Secondary outcomes will be stress levels monitored via neuropeptides, neurosteroids and peripheral steroids indicated in plasma blood samples; frequency of in-app estimation of high levels of distress by the children; children's use of analgesic medicine and person centeredness evaluated via the questionnaire Visual CARE Measure. For the process evaluation, qualitative interviews will be carried out with children with cancer, their legal guardians and case-related healthcare professionals. These interviews will address experiences with PicPecc in terms of feasibility and frequency of use from the child’s perspective and value to the caseworker. Interview transcripts will be analysed using an interpretive description methodology.

Ethics and dissemination

Ethical approval was obtained from the Swedish Ethical Review Authority (reference 2019-02392; 2020-02601; 2020-06226). Children, legal guardians, healthcare professionals, policymaking and research stakeholders will be involved in all stages of the research process according to Medical Research Council’s guidelines. Research findings will be presented at international cancer and paediatric conferences and published in scientific journals.

Trial registration

ClinicalTrials.gov;NCT04433650.
Patients’ perception of the outpatient pharmaceutical service quality in hospital pharmacies with auditable pharmaceutical transactions and services in Ethiopia: a cross-sectional study
Authors: Kassa Desalegn Gebrehaweria , Xiang Cheng , Hu Shuchen , Hayat Khezar , Andegiorgish Amanuel Kidane , Fang Yu , Yang Caijun
Published: May 2021

Objective

To ensure the availability of quality pharmaceutical products and effective pharmaceutical services, a package of interventions named auditable pharmaceutical transactions and services (APTS), was implemented in the tertiary and secondary hospitals across Ethiopia since 2014. This study aimed to evaluate outpatients’ perception of pharmaceutical service quality in hospitals with APTS in Ethiopia.

Design

Cross-sectional study.

Setting

Seven hospitals of Tigray, Ethiopia.

Participants

794 patients coming for pharmaceutical services.

Main outcome measures

SERVQUAL instrument was employed to collect the patient’s perception of pharmaceutical services. The mean perception score of pharmaceutical service quality was the main outcome measurement.

Results

Out of 810 patients approached, 794 participated in the study (response rate of 98.02%). Overall, the mean perception score of the service quality was 3.1 of 5. Among the five dimensions of SERVQUAL, dimension of empathy achieved the highest result with a mean score of 3.71, and tangibility was the second (3.19), followed by responsiveness (3.08), assurance (2.87) and reliability (2.81). The perception of patients in tertiary hospitals of service quality was more positive compared with patients in secondary hospitals (3.265>3.011, p=0.04). However, the difference was only significant in the dimension of assurance when considering the five dimensions separately. Respondents who were older, widowed, illiterate, farmer, retired or Orthodox were found to have better quality service experience compared with others (p=0.001).

Conclusion

Generally, outpatients’ perception of pharmaceutical service quality was positive. However, two dimensions of the service quality (assurance and reliability) were negatively perceived. To improve the service quality, we recommended the following: (1) managers should provide more training for pharmacists to strengthen their professional knowledge and encourage them to cooperate with other professionals; (2) the government needs to develop guidelines on information provided to patients and train the pharmacists to follow them; (3) hospitals can apply various procurement methods and efficient inventory management methods.
Control Crohn Safe with episodic adalimumab monotherapy as first-line treatment study (CoCroS): study protocol for a randomised controlled trial
Authors: Janssen Laura , Romberg-Camps Mariëlle , van Bodegraven Ad , Haans Jeoffrey , Aquarius Michèl , Boekema Paul , Munnecom Tamara , Brandts Lloyd , Joore Manuela , Masclee Adrian , Jonkers D , Pierik M
Published: May 2021

Introduction

Crohn’s disease (CD) is a chronic inflammatory bowel disease with a heterogeneous clinical presentation, relapse rate and treatment response. At present, no markers are available to adequately predict disease course at diagnosis. To prevent overtreatment of patients with a relative mild disease course, a step-up approach starting with corticosteroids is usually applied. Timely introduction of potentially disease modifying drugs and tight control of mucosal inflammation are crucial to prevent disease-related complications in patients with a complex disease course. We hypothesise that episodic treatment with adalimumab monotherapy in combination with close monitoring after drug discontinuation improves long-term outcome and reduces drug-related side effects, while preventing overtreatment.

Methods and analysis

In this pragmatic multicentre randomised controlled trial, newly diagnosed CD patients or CD patients with a flare, naïve to thiopurines and biologicals, will be included and randomised 1:1 to open-label episodic (ie, 24 weeks) adalimumab monotherapy or step-up care starting with corticosteroids. The primary outcome is the number of yearly quarters of corticosteroid free clinical (Monitor Inflammatory Bowel Disease At Home score ≤3) and biochemical (C reactive protein within normal range and faecal calprotectin ≤200 µg/g) remission at week 96. Secondary outcomes are total healthcare costs, cumulative corticosteroid dose, proportion of patients with endoscopic remission at week 24, corticosteroid-free clinical remission, time to remission and patient-reported outcome measures on quality of life, (work) disability and treatment adherence. Safety outcomes are drug-related and disease-related adverse events and disease progression on MRI-enterography at week 96.

Ethics and dissemination

This study is approved by the Medical Research Ethics Committee of azM/UM in Maastricht dated 21 August 2019 (METC18-076) and is monitored by the Clinical Trial Centre Maastricht according to Good Clinical Practice guidelines. Written informed consent will be obtained from all patients. Study results will be published in international peer-reviewed medical journals.

Trial registration number

NCT03917303.
Performance of seven different paediatric early warning scores to predict critical care admission in febrile children presenting to the emergency department: a retrospective cohort study
Authors: Romaine Sam T , Sefton Gerri , Lim Emma , Nijman Ruud G , Bernatoniene Jolanta , Clark Simon , Schlapbach Luregn J , Pallmann Philip , Carrol Enitan D
Published: May 2021

Objective

Paediatric Early Warning Scores (PEWS) are widely used in the UK, but the heterogeneity across tools and the limited data on their predictive performance represent obstacles to improving best practice. The standardisation of practice through the proposed National PEWS will rely on robust validation. Therefore, we compared the performance of the National PEWS with six other PEWS currently used in NHS hospitals, for their ability to predict critical care (CC) admission in febrile children attending the emergency department (ED).

Design

Retrospective single-centre cohort study.

Setting

Tertiary hospital paediatric ED.

Participants

A total of 11 449 eligible febrile ED attendances were identified from the electronic patient record over a 2-year period. Seven PEWS scores were calculated (Alder Hey, Bedside, Bristol, National, Newcastle and Scotland PEWS, and the Paediatric Observation Priority Score, using the worst observations recorded during their ED stay.

Outcomes

The primary outcome was CC admission within 48 hours, the secondary outcomes were hospital length of stay (LOS) >48 hours and sepsis-related mortality.

Results

Of 11 449 febrile children, 134 (1.2%) were admitted to CC within 48 hours of ED presentation, 606 (5.3%) had a hospital LOS >48 hours. 10 (0.09%) children died, 5 (0.04%) were sepsis-related. All seven PEWS demonstrated excellent discrimination for CC admission (range area under the receiver operating characteristic curves (AUC) 0.91–0.95) and sepsis-related mortality (range AUC 0.95–0.99), most demonstrated moderate discrimination for hospital LOS (range AUC 0.69–0.75). In CC admission threshold analyses, bedside PEWS (AUC 0.90; 95% CI 0.86 to 0.93) and National PEWS (AUC 0.90; 0.87–0.93) were the most discriminative, both at a threshold of ≥6.

Conclusions

Our results support the use of the proposed National PEWS in the paediatric ED for the recognition of suspected sepsis to improve outcomes, but further validation is required in other settings and presentations.
Perceived facilitators and barriers to chronic disease management in primary care networks of Singapore: a qualitative study
Authors: Foo Chuan De , Surendran Shilpa , Tam Chen Hee , Ho Elaine , Matchar David Bruce , Car Josip , Koh Gerald Choon Huat
Published: May 2021

Objective

The increasing chronic disease burden has placed tremendous strain on tertiary healthcare resources in most countries, necessitating a shift in chronic disease management from tertiary to primary care providers. The Primary Care Network (PCN) policy was promulgated as a model of care to organise private general practitioners (GPs) into groups to provide GPs with resources to anchor patients with chronic conditions with them in the community. As PCN is still in its embryonic stages, there is a void in research regarding its ability to empower GPs to manage patients with chronic conditions effectively. This qualitative study aims to explore the facilitators and barriers for the management of patients with chronic conditions by GPs enrolled in PCN.

Design

We conducted 30 semistructured interviews with GPs enrolled in a PCN followed by a thematic analysis of audio transcripts until data saturation was achieved.

Setting

Singapore.

Results

Our results suggest that PCNs facilitated GPs to more effectively manage patients through (1) provision of ancillary services such as diabetic foot screening, diabetic retinal photography and nurse counselling to permit a ‘one-stop-shop’, (2) systematic monitoring of process and clinical outcome indicators through a chronic disease registry (CDR) to promote accountability for patients’ health outcomes and (3) funding streams for PCNs to hire additional manpower to oversee operations and to reimburse GPs for extended consultations. Barriers include high administrative load in maintaining the CDR due to the lack of a smart electronic clinic management system and financial gradient faced by patients seeking services from private GPs which incur higher out-of-pocket expenses than public primary healthcare institutions.

Conclusion

PCNs demonstrate great promise in empowering enrolled GPs to manage patients with chronic conditions. However, barriers will need to be addressed to ensure the viability of PCNs in managing more patients in the face of an ageing population.
Effects of non-pharmacological and non-surgical interventions on health outcomes in systemic sclerosis: protocol for a living systematic review
Authors: Discepola Marie-Nicole , Carboni-Jiménez Andrea , Kwakkenbos Linda , Henry Richard S , Boruff Jill , Krishnan Ankur , Boström Carina , Culos-Reed S Nicole , Hudson Marie , Leader David M , Mattsson Malin , Mouthon Luc , Wojeck Robyn , Yakes Jimenez Elizabeth , Sauve Maureen , Welling Joep , Guillot Geneviève , Benedetti Andrea , Thombs Brett D
Published: May 2021

Introduction

Systemic sclerosis (SSc; scleroderma) is a rare, chronic, autoimmune disease with a high level of burden, a significant impact on the ability to carry out daily activities, and a considerable negative impact on health-related quality of life. Non-pharmacological interventions could be provided to potentially improve mental and physical health outcomes. However, the effectiveness of non-pharmacological interventions on health and well-being among individuals with SSc has not been well established. The proposed living systematic review aims to identify and evaluate randomised controlled trial (RCT) evidence on the effectiveness of non-pharmacological and non-surgical interventions on mental and physical health outcomes and on the delivery of such services in SSc.

Methods and analysis

Eligible studies will be RCTs that examine non-pharmacological and non-surgical interventions aimed at improving health outcomes among individuals with SSc or the delivery of services intended to improve healthcare or support of people with SSc (eg, support groups). All RCTs included in a previous systematic review that sought studies published between 1990 and March 2014 will be evaluated for inclusion. Additional trials will be sought from January 2014 onwards using a similar, augmented search strategy developed by a health sciences librarian. We will search the MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library and Web of Science databases and will not restrict by language. Two independent reviewers will determine the eligibility of identified RCTs and will extract data using a prespecified standardised form in DistillerSR. Meta-analyses will be considered if ≥2 eligible RCTs report similar non-pharmacological interventions and comparable health outcomes. We will conduct a qualitative synthesis for interventions that cannot be synthesised via meta-analysis.

Ethics and dissemination

We will post initial and ongoing results via a website, publish results periodically via peer-reviewed journal publication, and present results at patient-oriented events.

PROSPERO registration number

CRD42020219914.
Cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study: a protocol
Authors: Stock Sarah Jane , Bhide Amarnath , Richardson Heather , Black Mairead , Yuill Cassandra , Harkness Mairi , Reid Maggie , Wee Fiona , Cheyne Helen , McCourt Christine , Rana Dikshyanta , Boyd Kathleen Anne , Sanders Julia , Heera Neelam , Huddleston Jane , Denison Fiona , Pasupathy Dharmintra , Modi Neena , Smith Gordon , Norrie John
Published: May 2021

Introduction

The aim of the cervical ripening at home or in-hospital—prospective cohort study and process evaluation (CHOICE) study is to compare home versus in-hospital cervical ripening to determine whether home cervical ripening is safe (for the primary outcome of neonatal unit (NNU) admission), acceptable to women and cost-effective from the perspective of both women and the National Health Service (NHS).

Methods and analysis

We will perform a prospective multicentre observational cohort study with an internal pilot phase. We will obtain data from electronic health records from at least 14 maternity units offering only in-hospital cervical ripening and 12 offering dinoprostone home cervical ripening. We will also conduct a cost-effectiveness analysis and a mixed methods study to evaluate processes and women/partner experiences. Our primary sample size is 8533 women with singleton pregnancies undergoing induction of labour (IOL) at 39+0 weeks’ gestation or more. To achieve this and contextualise our findings, we will collect data relating to a cohort of approximately 41 000 women undergoing IOL after 37 weeks. We will use mixed effects logistic regression for the non-inferiority comparison of NNU admission and propensity score matched adjustment to control for treatment indication bias. The economic analysis will be undertaken from the perspective of the NHS and Personal Social Services (PSS) and the pregnant woman. It will include a within-study cost-effectiveness analysis and a lifetime cost–utility analysis to account for any long-term impacts of the cervical ripening strategies. Outcomes will be reported as incremental cost per NNU admission avoided and incremental cost per quality adjusted life year gained.

Research ethics approval and dissemination

CHOICE has been funded and approved by the National Institute of Healthcare Research Health Technology and Assessment, and the results will be disseminated via publication in peer-reviewed journals.

Trial registration number

ISRCTN32652461.
Experience of emergency department patients after a visit for hyperglycaemia: implications for communication and factors affecting adherence postdischarge
Authors: Yan Justin , Azzam Dimah , Columbus Melanie , Van Aarsen Kristine , Liu Selina , Spaic Tamara , Shepherd Lisa
Published: May 2021

Background

While studies have reported factors affecting adherence to diabetic care plans from a chronic disease perspective, no studies have addressed issues with post-discharge adherence facing patients with diabetes after an emergency department (ED) presentation for hyperglycaemia. This study’s objectives were to describe patient perspectives on their experience during and after an ED visit for hyperglycaemia and to identify factors that influence postdischarge adherence.

Methods

We conducted a qualitative description (QD) study of adult patients who had visited a Canadian ED for hyperglycaemia. Consistent with QD, purposive sampling was utilised, seeking diversity across age, gender and diabetes type. Participants took part in semistructured interviews and thematic analysis was used to identify and describe core themes. Frequent team meetings were held to review the analysis and to develop the final list of themes used to recode the data set. Analytic insights were tracked using reflective memos and an audit trail documented all steps and decisions.

Results

22 patients with type 1 and 2 diabetes were interviewed from June to October 2019. Participants identified several factors that impacted their ability to adhere to discharge plans: communication of instructions, psychosocial factors (financial considerations, shame and guilt, stigma and mental health), access to follow-up care and paediatric to adult care transitions.

Conclusions

This study describes the patient experience with the communication of discharge instructions, as well as factors affecting adherence post-ED discharge for hyperglycaemia. Our findings suggest four strategies that could improve the patient experience, improve adherence to discharge plans and potentially decrease the frequency of recurrent ED visits for hyperglycaemia.
Management and outcome of patients with acute ischemic stroke and tandem carotid occlusion in the ESCAPE-NA1 trial
Authors: Marko Martha , Cimflova Petra , Poppe Alexandre Y , Kashani Nima , Singh Nishita , Ospel Johanna , Mayank Arnuv , van Adel Brian , McTaggart Ryan A , Nogueira Raul G , Demchuk Andrew M , Rempel Jeremy L , Joshi Manish , Zerna Charlotte , Menon Bijoy K , Tymianski Michael , Hill Michael D , Goyal Mayank , Almekhlafi Mohammed A
Published: May 2021

Background

The optimal treatment and prognosis for stroke patients with tandem cervical carotid occlusion are unclear. We analyzed outcomes and treatment strategies of tandem occlusion patients in the ESCAPE-NA1 trial.

Methods

ESCAPE-NA1 was a multicenter international randomized trial of nerinetide versus placebo in 1105 patients with acute ischemic stroke who underwent endovascular treatment. We defined tandem occlusions as complete occlusion of the cervical internal carotid artery (ICA) on catheter angiography, in addition to a proximal ipsilateral intracranial large vessel occlusion. Baseline characteristics and outcome parameters were compared between patients with tandem occlusions versus those without, and between patients with tandem occlusion who underwent ICA stenting versus those who did not. The influence of tandem occlusions on functional outcome was analyzed using multivariable regression modeling.

Results

Among 115/1105 patients (10.4%) with tandem occlusions, 62 (53.9%) received stenting for the cervical ICA occlusion. Of these, 46 (74.2%) were stented after and 16 (25.8%) before the intracranial thrombectomy. A modified Rankin Score (mRS) of 0–2 at 90 days was achieved in 82/115 patients (71.3%) with tandem occlusions compared with 579/981 (59.5%) patients without tandem occlusions. Tandem occlusion did not impact functional outcome in the adjusted analysis (OR 1.5, 95% CI 0.95 to 2.4). Among the subgroup of patients with tandem occlusion, cervical carotid stenting was not associated with different outcomes compared with no stenting (mRS 0–2: 75.8% vs 66.0%, adjusted OR 2.0, 95% CI 0.8 to 5.1).

Conclusions

Tandem cervical carotid occlusion in patients with acute large vessel stroke did not lower the odds of good functional outcome in our study. Functional outcomes were similar irrespective of the management of the cervical ICA occlusion (stenting vs not stenting).
Environmental variability and fishing effects on the Pacific sardine fisheries in the Gulf of California
Authors: Giron-Nava Alfredo , Ezcurra Exequiel , Brias Antoine , Velarde Enriqueta , Deyle Ethan , Cisneros-Montemayor Andrés M. , Munch Stephan B. , Sugihara George , Aburto-Oropeza Octavio
Published: May 2021

Small pelagic fish support some of the largest fisheries globally, yet there is an ongoing debate about the magnitude of the impacts of environmental processes and fishing activities on target species. We use a nonparametric, nonlinear approach to quantify these effects on the Pacific sardine (Sardinops sagax) in the Gulf of California. We show that the effect of fishing pressure and environmental variability are comparable. Furthermore, when predicting total catches, the best models account for both drivers. By using empirical dynamic programming with average environmental conditions, we calculated optimal policies to ensure long-term sustainable fisheries. The first policy, the equilibrium maximum sustainable yield, suggests that the fishery could sustain an annual catch of ∼2.16 × 105 tonnes. The second policy with dynamic optimal effort, reveals that the effort from 2 to 4 years ago impacts the current maximum sustainable effort. Consecutive years of high effort require a reduction to let the stock recover. Our work highlights a new framework that embraces the complex processes that drive fisheries population dynamics yet produces simple and robust advice to ensure long-term sustainable fisheries.
In vivo public monitoring in emergency exposure scenarios
Authors: Ciciani Luca , Vilardi Ignazio , Rizzo Alessandro , Antonacci Giuseppe , Battisti Paolo , Castellani Carlo-Maria , Sperandio Luciano
Published: May 2021

In a nuclear or radiological accident scenario, where members of the public can potentially take up anthropogenic radionuclides released in atmosphere, verified methods to fast screen for internal contamination a large number of individuals directly on the field can play a major role to adopt appropriate countermeasures. At the ENEA Casaccia Research Centre (Rome, Italy), a spectrometric monitoring method, based on a portable HpGe detector Trans-Spec-DX-100, has been developed. In this work, the results of the 2019 measurement campaign, where the method sensitivity was tested, in terms of detection limits (DL) for common fission and (some) activation products by acquiring gamma spectra on 102 uncontaminated volunteers (57 adults, 45 children between 7 and 12 years of age) are presented. The spectra, collected with acquisition time of 180 s, have been analysed according to the Standard ISO 28218 for the activity detection limit (Bq) calculations and according to ICRP Publications 134, 137, and 141 for the related minimum measurable committed effective dose. The measurements were taken in open field on a paved surface, in the presence of an environmental radiation background, given in term of ambient dose equivalent rate, $$\dot{H}$$

H
˙

*(10), equal to 0.230 ± 0.020 μSv/h, in order to study both the potentiality and the limitation of the technique with a significant statistic. The results are presented and discussed particularly focusing on the specific characteristics of the technique, in respect to features reported by the European Council Directive 2013/59/Euratom and the International Atomic Energy Agency (IAEA) document STI/PUB/1708 (2015), and to techniques described in the current literature.
Carboniferous tetrapod biostratigraphy, biochronology and evolutionary events
Authors: Lucas Spencer G.
Published: May 2021

Tetrapod (amphibian and amniote) fossils of Carboniferous age are known almost exclusively from the southern part of a palaeoequatorial Euramerican province. The stratigraphic distribution of Carboniferous tetrapod fossils is used to identify five land-vertebrate faunachrons: (1) Hortonbluffian (Givetian–early Visean), the time between the first appearance datum (FAD) of tetrapods to the beginning of the Doran; (2) Doran (late Visean–early Bashkirian), the time between the FAD of the baphetid
Loxomma
and the beginning of the Nyranyan; (3) Nyranyan (late Bashkirian–Moscovian), the time between the FAD of the eureptile
Hylonomus
and the beginning of the Cobrean; (4) Cobrean (Kasimovian–late Gzhelian), the time between the FAD of the eupelycosaur
Ianthasaurus
and the beginning of the Coyotean; and (5) Coyotean (late Gzhelian–early Permian), the time between the FAD of the eupelycosaur
Sphenacodon
and the beginning of the Seymouran. This biochronology provides insight into some important evolutionary events in Carboniferous tetrapod evolution.
Voice in Human–Agent Interaction
Authors: Seaborn Katie , Miyake Norihisa P. , Pennefather Peter , Otake-Matsuura Mihoko
Published: May 2021

Social robots, conversational agents, voice assistants, and other embodied AI are increasingly a feature of everyday life. What connects these various types of intelligent agents is their ability to interact with people through voice. Voice is becoming an essential modality of embodiment, communication, and interaction between computer-based agents and end-users. This survey presents a meta-synthesis on agent voice in the design and experience of agents from a human-centered perspective: voice-based human–agent interaction (vHAI). Findings emphasize the social role of voice in HAI as well as circumscribe a relationship between agent voice and body, corresponding to human models of social psychology and cognition. Additionally, changes in perceptions of and reactions to agent voice over time reveals a generational shift coinciding with the commercial proliferation of mobile voice assistants. The main contributions of this work are a vHAI classification framework for voice across various agent forms, contexts, and user groups, a critical analysis grounded in key theories, and an identification of future directions for the oncoming wave of vocal machines.
PLS-SEM for Software Engineering Research
Authors: Russo Daniel , Stol Klaas-Jan
Published: May 2021

Software Engineering (SE) researchers are increasingly paying attention to organizational and human factors. Rather than focusing only on variables that can be directly measured, such as lines of code, SE research studies now also consider unobservable variables, such as organizational culture and trust. To measure such latent variables, SE scholars have adopted Partial Least Squares Structural Equation Modeling (PLS-SEM), which is one member of the larger SEM family of statistical analysis techniques. As the SE field is facing the introduction of new methods such as PLS-SEM, a key issue is that not much is known about how to evaluate such studies. To help SE researchers learn about PLS-SEM, we draw on the latest methodological literature on PLS-SEM to synthesize an introduction. Further, we conducted a survey of PLS-SEM studies in the SE literature and evaluated those based on recommended guidelines.
IoT Cloud Security Review
Authors: Chen Fei , Luo Duming , Xiang Tao , Chen Ping , Fan Junfeng , Truong Hong-Linh
Published: May 2021

Recent years have seen the rapid development and integration of the Internet of Things (IoT) and cloud computing. The market is providing various consumer-oriented smart IoT devices; the mainstream cloud service providers are building their software stacks to support IoT services. With this emerging trend even growing, the security of such smart IoT cloud systems has drawn much research attention in recent years. To better understand the emerging consumer-oriented smart IoT cloud systems for practical engineers and new researchers, this article presents a review of the most recent research efforts on
existing, real, already deployed
consumer-oriented IoT cloud applications in the past five years using typical case studies. Specifically, we first present a general model for the IoT cloud ecosystem. Then, using the model, we review and summarize recent, representative research works on emerging smart IoT cloud system security using 10 detailed case studies, with the aim that the case studies together provide insights into the insecurity of current emerging IoT cloud systems. We further present a systematic approach to conduct a security analysis for IoT cloud systems. Based on the proposed security analysis approach, we review and suggest potential security risk mitigation methods to protect IoT cloud systems. We also discuss future research challenges for the IoT cloud security area.
A Survey of Software Log Instrumentation
Authors: Chen Boyuan , Jiang Zhen Ming (Jack)
Published: May 2021

Log messages have been used widely in many software systems for a variety of purposes during software development and field operation. There are two phases in software logging: log instrumentation and log management. Log instrumentation refers to the practice that developers insert logging code into source code to record runtime information. Log management refers to the practice that operators collect the generated log messages and conduct data analysis techniques to provide valuable insights of runtime behavior. There are many open source and commercial log management tools available. However, their effectiveness highly depends on the quality of the instrumented logging code, as log messages generated by high-quality logging code can greatly ease the process of various log analysis tasks (e.g., monitoring, failure diagnosis, and auditing). Hence, in this article, we conducted a systematic survey on state-of-the-art research on log instrumentation by studying 69 papers between 1997 and 2019. In particular, we have focused on the challenges and proposed solutions used in the three steps of log instrumentation: (1) logging approach; (2) logging utility integration; and (3) logging code composition. This survey will be useful to DevOps practitioners and researchers who are interested in software logging.
Methods for Host-based Intrusion Detection with Deep Learning
Authors: Ring John H. , Van Oort Colin M. , Durst Samson , White Vanessa , Near Joseph P. , Skalka Christian
Published: May 2021

Host-based Intrusion Detection Systems
(HIDS) automatically detect events that indicate compromise by adversarial applications. HIDS are generally formulated as analyses of sequences of system events such as bash commands or system calls.
Anomaly-based
approaches to HIDS leverage models of normal (a.k.a. baseline) system behavior to detect and report abnormal events and have the advantage of being able to detect novel attacks. In this article, we develop a new method for anomaly-based HIDS using deep learning predictions of sequence-to-sequence behavior in system calls. Our proposed method, called the

ALAD

algorithm, aggregates predictions at the
application
level to detect anomalies. We investigate the use of several deep learning architectures, including WaveNet and several recurrent networks. We show that

ALAD

empowered with deep learning significantly outperforms previous approaches. We train and evaluate our models using an existing dataset, ADFA-LD, and a new dataset of our own construction, PLAID. As deep learning models are black box in nature, we use an alternate approach, allotaxonographs, to characterize and understand differences in baseline vs. attack sequences in HIDS datasets such as PLAID.
Hindcasting Violent Events in Colombia Using Internet Data
Authors: Daughton Ashlynn R. , Valle Sara Y. Del , Ross Chrysm Watson , Fairchild Geoffrey
Published: May 2021

Colombia experienced a decades-long civil war between the government and many left-wing guerrilla groups. It was marked by violence, kidnappings, and large quantities of human displacement. Monitoring and forecasting civil wars are important to mitigate their potential impact but require access to ground truth data. We examine the use of Internet data streams, namely Google search queries, tweets related to politics, and traditional news sources to retrospectively forecast (i.e., hindcast) state-based armed violence in Colombia. We compare the results of statistical models using three combinations of these features to evaluate the predictive capabilities of each data stream. Our results show that the combination of Internet and traditional news data models perform most consistently, although Internet-only is surprisingly promising. Overall, we are able to produce high-quality models hindcasting the presence or absence of state-based armed violence in Colombia up to 6 months in advance. These results support the use of exogenous data streams to forecast evolving situations around the globe.
Environmental Aspects of Oxide Nanoparticles: Probing Oxide Nanoparticle Surface Processes Under Different Environmental Conditions
Authors: Sit Izaac , Wu Haibin , Grassian Vicki H.
Published: May 2021

Surface chemistry affects the physiochemical properties of nanoparticles in a variety of ways. Therefore, there is great interest in understanding how nanoparticle surfaces evolve under different environmental conditions of pH and temperature. Here, we discuss the use of vibrational spectroscopy as a tool that allows for in situ observations of oxide nanoparticle surfaces and their evolution due to different surface processes. We highlight oxide nanoparticle surface chemistry, either engineered anthropogenic or naturally occurring geochemical nanoparticles, in complex media, with a focus on the impact of ( a) pH on adsorption, intermolecular interactions, and conformational changes; ( b) surface coatings and coadsorbates on protein adsorption kinetics and protein conformation; ( c) surface adsorption on the temperature dependence of protein structure phase changes; and ( d) the use of two-dimensional correlation spectroscopy to analyze spectroscopic results for complex systems. An outlook of the field and remaining challenges is also presented.
The Economics of Currency Risk
Authors: Hassan Tarek A. , Zhang Tony
Published: May 2021

This article reviews the literature on currency and country risk with a focus on their macroeconomic origins and implications. A growing body of evidence shows that countries with safer currencies enjoy persistently lower interest rates and a lower required return to capital. As a result, they accumulate relatively more capital than countries with currencies that international investors perceive as risky. Whereas earlier research focused mainly on the role of currency risk in generating violations of uncovered interest parity and other financial anomalies, more recent evidence points to important implications for the allocation of capital across countries, the efficacy of exchange rate stabilization policies, the sustainability of trade deficits, and the spillovers of shocks across international borders.
The Rise of Digital Money
Authors: Adrian Tobias , Mancini-Griffoli Tommaso
Published: May 2021

Payment systems around the world are evolving with the emergence of digital money issued by private firms and central banks. We provide a conceptual framework to compare and contrast traditional forms of money with their new digital equivalents. We suggest that some forms of digital money, while less stable as a store of value, could be rapidly adopted given their advantages as a means of payment. We review the benefits and risks that would emerge. One approach to managing risks would be to require full backing of selected digital money with central bank reserves. We call the arrangement synthetic central bank digital currency (sCBDC), a private-public partnership that combines the advantages of private sector innovation and customer orientation with the safety and stability of central bank–backed money. We offer policy considerations, directions for research, and an overview of the literature to date. The analysis of digital currencies is an exciting new field crossing into monetary and financial economics that will reshape the monetary and financial systems for many years to come.
Neurophysiology of Human Perceptual Decision-Making
Authors: O'Connell Redmond G. , Kelly Simon P.
Published: May 2021

The discovery of neural signals that reflect the dynamics of perceptual decision formation has had a considerable impact. Not only do such signals enable detailed investigations of the neural implementation of the decision-making process but they also can expose key elements of the brain's decision algorithms. For a long time, such signals were only accessible through direct animal brain recordings, and progress in human neuroscience was hampered by the limitations of noninvasive recording techniques. However, recent methodological advances are increasingly enabling the study of human brain signals that finely trace the dynamics of the unfolding decision process. In this review, we highlight how human neurophysiological data are now being leveraged to furnish new insights into the multiple processing levels involved in forming decisions, to inform the construction and evaluation of mathematical models that can explain intra- and interindividual differences, and to examine how key ancillary processes interact with core decision circuits.
Social Issues in Contemporary Russia: Women's Rights, Corruption, and Immigration Through Three Sociological Lenses
Authors: Zaloznaya Marina , Gerber Theodore P.
Published: May 2021

This article reviews social science research on women's rights, corruption, and immigration in Russia. Intentionally diverse, our selection of topics illustrates how the same three analytical lenses have been applied across a broad range of scholarship on the postcommunist world. Each lens is bifocal and entails a tension between two extremes. The victims versus agents lens refers to a tendency of scholars to portray their subjects either as passive victims of macrostructural and cultural conditions or as agents who adapt to survive, or even thrive, despite significant challenges. The similar versus exotic lens pits the assumption that Russia is a modern European country against the view that it is too distinctive to be meaningfully compared with the West or analyzed with Western theories. Finally, the old versus new lens represents competing views on the extent to which the institutional, cultural, and structural legacies of the Soviet Union, perestroika, and the 1990s continue to shape Russian society. The broad goal of our review is to highlight the intellectual promise of studying Russia sociologically.
Negative Social Ties: Prevalence and Consequences
Authors: Offer Shira
Published: May 2021

Recent decades have seen a surge of interest in negative ties and the negative aspects of social relationships. Researchers in different fields have studied negative ties and their consequences for various individual outcomes, including health and well-being, social status in schools and other organizations, and job performance and satisfaction, but they have mainly done so in disconnect. The result is a dearth of theoretization, manifested in a multitude of concepts and measures, that has made synthesis difficult and left numerous questions unanswered. By critically assessing these literatures, this review maps unresolved issues and identifies important lacunae in current investigations of negative ties. It is organized around three key issues: What are negative ties? How prevalent are they and where do they come from? And what are their consequences? The review concludes by proposing an agenda for future research.
Reinforcement Learning-Based Autonomous Navigation and Obstacle Avoidance for USVs under Partially Observable Conditions
Authors: Yan Nan , Huang Subin , Kong Chao
Published: May 2021

Unmanned surface vehicles (USVs) have been widely used in research and exploration, patrol, and defense. Autonomous navigation and obstacle avoidance, as the essential technology of USVs, are the key conditions for successful mission execution. However, fine modeling of conventional algorithms cannot meet the real-time precise behavior control strategy of USVs in complex environments, which poses a great challenge to autonomous control policy. In this paper, a deep reinforcement learning-based UANOA (USVs autonomous navigation and obstacle avoidance) method is proposed. The UANOA achieves the autonomous navigation task of USVs by real-time sensing of partially complex ocean information around and real-time output of rudder angle control commands of USVs. In our work, we employ a double Q-network to achieve end-to-end control from raw sensor input to output of discrete rudder action, and design a set of reward functions that can be adapted to USV navigation and obstacle avoidance. To alleviate the decision bias caused by partial observable of USVs, we use the long short-term memory (LSTM) networks to enhance the ability to remember the ocean environment of USVs. Experiments demonstrate that UANOA ensures a USV arrives at the target points with optimal path planning in complex ocean environments without any collisions occurring, and UANOA outperforms deep Q-network (DQN) and random control policy in convergence speed, sailing distance, rudder angle steering consumption, and other performance measurements.