bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-stage decision-making method for ship speed optimisation considering inland navigational environment
Authors: Fan Ailong , Wang Zheng , Yang Liu , Wang Junteng , Vladimir Nikola
Published: December 2020

Speed optimisation is an important energy efficiency practice, which can bring good economic and environmental benefits. The methodology of the speed optimisation and dynamic programming of ships are firstly investigated. With the total fuel consumption as the objective function and main engine speed as the decision variable, a novel multi-stage speed optimisation model of ship is then developed based on dynamic programming algorithm. A Yangtze river ship is selected as a case study, the actual operational data are acquired through sensors installed onboard the ship. Using the operational data, regression analysis is applied to establish the relationship models of ship fuel consumption and speed in relative to main engine speed. Finally, simulating calculation and comparative analyses are carried out. The results indicate that the velocity and direction of water flow is a key factor affecting the speed optimisation of ships in the Yangtze river; the proposed multi-stage decision making method is effective in the speed optimisation for ship with a long-distance and changing-environment voyage. This study can provide methodological support for ship navigational optimisation.
Business Ethics Training in Human Resource Development: A Literature Review
Authors: Kreismann Dominic , Talaulicar Till
Published: December 2020

In view of corporate wrongdoings like Enron’s accounting fraud and Volkswagen’s emissions scandal, the need to prevent unethical decision-making in the business sector has become widely accepted. Human resource development is of high relevance in this regard: a multiplicity of companies utilizes ethics training programs to teach their managers and employees business ethics and to develop their ethical competences. However, knowledge about the efficacy of these training programs is still rather fragile. In the present study, we (a) develop a framework of relevant design categories to consider in creating ethics training programs; (b) consolidate empirical insights by reviewing 92 studies about the effectiveness of standalone business ethics training programs regarding their impact, dependent variable and measurement methods, design, and conceptual foundation; and (c) identify remaining research gaps and provide theoretical-conceptual considerations for further investigation.
It’s Not Just Murphy’s Law: A Case Study of Problematic Records Transmission
Authors: Willis Brendan , O’Donohue William
Published: December 2020

Quality behavioral health care depends on a multitude of factors, from the strength of the therapeutic alliance to the use of evidence-based treatments. However, one factor that can easily be overlooked is the coordination of care between providers via the transmission of client records. Overall, the transmission of client records has lagged significantly behind other technological improvements in healthcare for decades. Unfortunately, this has led to a number of barriers that can delay or outright prevent vital client information from being shared amongst clinicians. This paper examines a specific case of record transmission and explores the difficulties encountered in the timely sharing of information. The case study involved a university training clinic requesting records for a client with a complex presentation and involved requesting records from three separate facilities. However, the requested records were delayed significantly due to a variety of factors, including outmoded transmission technologies, differences in how each facility handled records requests, and the need to use facility specific record request forms. The case study illustrates a number of weaknesses in the current system of records management and transmission. Solutions to these problems are of paramount importance for efficient, safe, and timely care.
Ten-Year Clinical Characteristics and Early Outcomes of Type B Aortic Dissection Patients With Thoracic Endovascular Aortic Repair
Authors: Huang Lihong , Kan Yuanqing , Zhu Ting , Chen Bin , Xu Xin , Dong Zhihui , Guo Daqiao , Si Yi , Fu Weiguo
Published: December 2020

Objective/Background:

This study examined the 10-year hospitalization characteristics, economic patterns and early clinical outcomes of type B aortic dissection (TBAD) patients that underwent thoracic endovascular aortic repair (TEVAR) in one high-volume hospital in China.

Methods:

We performed a population-based retrospective analysis based on electronic medical record system data provided by Zhongshan Hospital Fudan University from 2009 to 2018.

Results:

We identified 1,367 cases of TBAD patients with TEVAR over the past decade. The total incidence of in-hospital complications was 7.6% (104 of 1,367), among which acute kidney injury (AKI) had the highest incidence (3.1%, 42 of 1,367). Aortic-related reintervention was performed in 7 patients (0.5%). The overall aortic-related in-hospital mortality rate was 2.7% (37 of 1,367) and had no significant time-varying trend ( P = 0.2). Among these, 27% of in-hospital deaths were caused by retrograde type A dissection (RTAD). Chronic TBAD had a higher risk of in-hospital death versus acute TBAD, with a risk ratio of 2.69 (95% confidence interval [CI]: 1.19-6.09). Patients with hypertension (risk ratio 4.63, 95% CI: 1.38, 15.54) also had a higher in-hospital death risk. These 2 factors were also the predictive factors for the composite endpoint of in-hospital adverse events (risk ratio 2.17, 95% CI: 1.43, 3.29 and risk ratio 4.83, 95% CI: 1.90, 12.28, respectively), in addition to Marfan syndrome (risk ratio 4.05, 95% CI: 1.61, 10.19). The average length of hospitalization significantly declined during the past decade (annual percentage change -6.3%, 95% CI -8.2 to -4.3), and the stent-grafts (SGs) cost was the main expenditure of the total hospitalization costs.

Conclusion:

Our study showed a favorable early outcome of TEVAR over the past decade. Greater attention should be paid to certain risk factors in order to reduce the in-hospital adverse events. SG expenditure is still the primary economic burden on Chinese TBAD patients.
Feasibility of Autofluorescence for Parathyroid Glands During Thyroid Surgery and the Risk of Hypocalcemia: First Results in Belgium and Review of the Literature
Authors: Van Slycke Sam , Van Den Heede Klaas , Brusselaers Nele , Vermeersch Hubert
Published: December 2020

Background. Post-operative hypocalcemia remains the most frequent complication after total thyroidectomy. Recently, autofluorescence imaging was introduced to detect parathyroid glands early during dissection. Aim. We aimed to check the feasibility of autofluorescence regarding the number of parathyroid glands visualised and the risk of post-operative hypocalcemia. Methods. In a prospectively gathered cohort of patients undergoing thyroid surgery, we describe the risk of hypocalcemia in relation to the number of parathyroid glands visualised during surgery (and the risk reported in the scientific literature) and the feasibility to obtain an autofluorescence of the parathyroid glands. Results. From 2010 to 2019, 1083 patients were referred for total thyroidectomy in our tertiary referral centre for endocrine surgery, of which, 40 consecutive cases were operated using autofluorescence. Among the autofluorescence group, 14 (35.0%) had all 4 parathyroid glands visualised, compared to 147 (14.1%) in the other patients, without differences in the number of parathyroid glands reimplanted. No permanent hypocalcemia occurred in the autofluorescence group and 17.5% temporary hypoparathyroidism, compared to 3.1% and 31.9% among the other patients, and 4% (95% confidence interval [CI] 3–5%) and 19% (95% CI 15–24%) in the literature. Conclusion. Autofluorescence imaging provides reliable real-time visualisation at any point during thyroid surgery and helps to identify the parathyroid glands before detection with the naked eye. To date, it cannot be used as a standard technique and does not replace meticulous dissection. To become a useful adjunct in peroperative parathyroid management, large multicentre studies need to establish a potential clinical benefit of this novel technique.
Seed Gamma Irradiation of Arabidopsis thaliana ABA-Mutant Lines Alters Germination and Does Not Inhibit the Photosynthetic Efficiency of Juvenile Plants
Authors: Babina Darya , Podobed Marina , Bondarenko Ekaterina , Kazakova Elizaveta , Bitarishvili Sofia , Podlutskii Mikhail , Mitsenyk Anastasia , Prazyan Alexander , Gorbatova Irina , Shesterikova Ekaterina , Volkova Polina
Published: December 2020

Plant growth response to γ-irradiation includes stimulating or inhibitory effects depending on plant species, dose applied, stage of ontogeny and other factors. Previous studies showed that responses to irradiation could depend on ABA accumulation and signaling. To elucidate the role of ABA in growth and photosynthetic responses to irradiation, lines Col-8, abi3-8 and aba3 -1 of Arabidopsis thaliana were used. Seeds were γ-irradiated using 60Co in the dose range 50-150 Gy. It was revealed that the dose of 150 Gy affected germination parameters of aba3 -1 and Col-8 lines, while abi3-8 line was the most resistant to the studied doses and even showed faster germination at early hours after γ-irradiation at 50 Gy. These results suggest that susceptibility to ABA is probably more important for growth response to γ-irradiation than ABA synthesis. The photosynthetic functioning of 16-day-old plants mainly was not disturbed by γ-irradiation of seeds, and no indication of photosystem II photoinhibition was noticed, revealing the robustness of the photosynthetic system of A. thaliana. Glutathione peroxidase activity and ABA concentrations in plant tissues were not affected in the studied dose range. These results contribute to the understanding of germination and photosynthesis fine-tuning and of mechanisms of plant tolerance to ionizing radiation.
Barbaloin Treatment Contributes to the Rebalance of Glucose and Lipid Homeostasis of Gestational Diabetes Mellitus Mice
Authors: Wang Yong , Wang Haiying , Yang Fengzhen
Published: December 2020

Aloe vera L has been shown to possess hypoglycemic and hypolipidemic effects on type 2 diabetic patients, and its major benefits may be linked to barbaloin, which is a major component of Aloe vera L. This study focused on investigating the potential effects and underlying mechanisms of barbaloin on gestational diabetes mellitus (GDM). The db/+ diabetic mice with GDM were daily orally administered with barbaloin or metformin during the gestational period. The results demonstrated that administration of barbaloin significantly reduced blood glucose levels and increased insulin levels in GDM mice. We further found that barbaloin treatment reduced inflammatory response and ROS levels in the liver. Finally, we revealed that the AMP-activated protein kinase (AMPK) / peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1α) signaling pathway was involved in BAT-mediated beneficial effects on mice with GDM. Our study suggested that barbaloin exerted hypoglycemic and hypolipidemic effects on GDM mice, via, at least in part, modulation of AMPK/ PGC-1α signaling in GDM mice.
Methods to Integrate Natural Language Processing Into Qualitative Research
Authors: Abram Marissa D. , Mancini Karen T. , Parker R. David
Published: December 2020

Background:

Qualitative methods analyze contextualized, unstructured data. These methods are time and cost intensive, often resulting in small sample sizes and yielding findings that are complicated to replicate. Integrating natural language processing (NLP) into a qualitative project can increase efficiency through time and cost savings; increase sample sizes; and allow for validation through replication. This study compared the findings, costs, and time spent between a traditional qualitative method (Investigator only) to a method pairing a qualitative investigator with an NLP function (Investigator +NLP).

Methods:

Using secondary data from a previously published study, the investigators designed an NLP process in Python to yield a corpus, keywords, keyword influence, and the primary topics. A qualitative researcher reviewed and interpreted the output. These findings were compared to the previous study results.

Results:

Using comparative review, our results closely matched the original findings. The NLP + Investigator method reduced the project time by a minimum of 120 hours and costs by $1,500.

Discussion:

Qualitative research can evolve by incorporating NLP methods. These methods can increase sample size, reduce project time, and significantly reduce costs. The results of an integrated NLP process create a corpus and code which can be reviewed and verified, thus allowing a replicable, qualitative study. New data can be added over time and analyzed using the same interpretation and identification. Off the shelf qualitative software may be easier to use, but it can be expensive and may not offer a tailored approach or easily interpretable outcomes which further benefits researchers.
The obstacle-surmounting analysis of a pole-climbing robot
Authors: Qiaoling Du , Xinpo Lu , Yankai Wang , Sinan Liu
Published: December 2020

Surmounting obstacles during continuously climbing in a complex environment is an important issue for pole-climbing robots. An obstacle-surmounting strategy is presented for a pole-climbing robot. The force and moment applied on the pole-climbing robot in static status were analyzed, and the analysis of pole-climbing robot’s upward vertical climbing was conducted. The climbing execution has four steps: loosening the lower gripper, curling up, striding forward, and clamping the upper gripper. To obtain the information of obstacle crossing accurately, the obstacle-surmounting conditions were analyzed in detail. We modeled the striding linkage with thickness and obtained the Denavit–Hartenberg coordinates of each vertex. The model of the grippers with thickness was proposed and the Denavit–Hartenberg coordinates of each vertex of the grippers were obtained. Then single-step negotiating an obstacle and multistep negotiating an obstacle were proposed. Experiments were conducted to verify the effectiveness of the obstacle-surmounting strategy.
Establishment and tracking control of trapezoidal steering wheel angle model for autonomous vehicles
Authors: Jiang Haobin , Li Aoxue , Zhou Xinchen , Yu Yue
Published: December 2020

Human drivers have rich and diverse driving characteristics on curved roads. Finding the characteristic quantities of the experienced drivers during curve driving and applying them to the steering control of autonomous vehicles is the research goal of this article. We first recruited 10 taxi drivers, 5 bus drivers, and 5 driving instructors as the representatives of experienced drivers and conducted a real car field experiment on six curves with different lengths and curvatures. After processing the collected driving data in the Frenet frame and considering the free play of a real car’s steering system, it was interesting to observe that the shape enclosed by steering wheel angles and the coordinate axis was a trapezoid. Then, we defined four feature points, four feature distances, and one feature steering wheel angle, and the trapezoidal steering wheel angle (TSWA) model was developed by backpropagation neural network with the inputs were vehicle speeds at four feature points, and road curvature and the outputs were feature distances and feature steering wheel angle. The comparisons between TSWA model and experienced drivers, model predictive control, and preview-based driver model showed that the proposed TSWA model can best reflect the steering features of experienced drivers. What is more, the concise expression and human-like characteristic of TSWA model make it easy to realize human-like steering control for autonomous vehicles. Lastly, an autonomous vehicle composed of a nonlinear vehicle model and electric power steering (EPS) system was established in Simulink, the steering wheel angles generated by TSWA model were tracked by EPS motor directly, and the results showed that the EPS system can track the steering angles with high accuracy at different vehicle speeds.
Abiraterone in patients with recurrent epithelial ovarian cancer: principal results of the phase II Cancer of the Ovary Abiraterone (CORAL) trial (CRUK – A16037)
Authors: Banerjee Susana , Tovey Holly , Bowen Rebecca , Folkerd Elizabeth , Kilburn Lucy , McLachlan Jennifer , Hall Marcia , Tunariu Nina , Attygalle Ayoma , Lima Joao Paulo Da Silveira Nogueira , Perry Sophie , Chatfield Peter , Hills Margaret , Kaye Stan , Attard Gert , Dowsett Mitch , Bliss Judith M.
Published: December 2020

Background:

Recurrent epithelial ovarian cancer (EOC) remains difficult to treat, with an urgent need for more therapy options. Androgens bind to the androgen receptor (AR), commonly expressed in EOC. CYP17 inhibitor abiraterone irreversibly inhibits androgen biosynthesis. The Cancer of the Ovary Abiraterone (CORAL) trial was designed to evaluate the clinical activity of abiraterone in EOC.

Patients & Methods:

CORAL was a multi-centre, open-label, non-randomised, 2-stage phase II clinical trial. Eligible patients had progression within 12 months of last systemic therapy and no prior hormonal anti-cancer agents. Patients received abiraterone 1000 mg daily plus 5 mg prednisone until progression. The primary endpoint was objective response rate (ORR) according to combined Response Evaluation Criteria in Solid Tumours/Gynaecological Cancer Intergroup (RECIST/GCIG) criteria at 12 weeks. Secondary endpoints included clinical benefit rate (CBR) at 12 weeks.

Results:

A total of 42 patients were recruited; median age 65 (range 34–85) years; 37 (88.1%) had high-grade serous tumours; 20 (48%) had at least three prior lines of therapy; 29/40 (72.5%) were AR+. In stage 1, 1/26 response was observed (in an AR+, low-grade serous EOC); response lasted 47 weeks. Overall, 12 week ORR was 1/42 (2%), CBR was 11/42 (26%) (8/29 (28%) in AR+ patients). Disease control was ⩾6 months for 4/29 (14%). One patient (AR+, low-grade serous) had a RECIST response at 82 weeks. Four (10%) had grade ⩾3 hypokalaemia; 11 (26%) had dose delays.

Conclusions:

CORAL represents the first trial of an AR targeted agent in ovarian cancer. While responses were rare, a subset of patients achieved sustained clinical benefit. Targeting AR in EOC including low-grade serous cancer warrants further investigation.

Trial registration:

CORAL is registered on the ISRCTN registry: ISRCTN63407050; http://www.isrctn.com/ISRCTN63407050
Methotrexate at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with rheumatoid arthritis: a nationwide population-based cohort study
Authors: Perng Wuu-Tsun , Hung Yao-Min , Chang Renin , Lin Cheng-Li , Chiou Jeng-Yuan , Chen Huang-Hsi , Kao Chia-Hung , Wei James Cheng-Chung
Published: December 2020

Background:

We investigated whether taking methotrexate (MTX) is associated with a lower risk of new-onset cancers in patients with rheumatoid arthritis (RA).

Methods:

We conducted a 12-year retrospective cohort study from a population-based National Health Insurance Research Database in Taiwan. A total of 21,699 patients with newly diagnosed RA were enrolled during 2000–2009. The overall cancer rate was compared between 10,352 new users of MTX and 11,347 non-users. We used the WHO Defined Daily Dose (DDD) as a tool to assess drug exposure. Cox proportional hazard regression models were used to estimate the hazard ratio (HR) of disease after controlling for demographics and other comorbidities.

Results:

After adjusting for age, sex, cancer-related comorbidities, and RA-combined medication, the HR of cancer risk was 0.87 (95% CI = 0.74–1.02) for the MTX user group compared with the MTX non-user group. The cumulative incidence of cancer in the MTX non-user group was significantly higher than that of the MTX user group (log-rank test p < 0.001). In the low accumulative dose group [cumulative dose <1125 mg, cumulative defined daily dose (cDDD) <450], the HR of cancer risk for MTX users was 1.20 (95% CI = 1.01–1.42) compared with the MTX-non-user group. However, the adjusted HR of cancer risk was reduced to 0.66 (95% CI = 0.49–0.87) in MTX middle-dose users (cumulative dose 1125–2250 mg, cDDD: 450–899) and 0.33 (95% CI = 0.23–0.48) for the MTX high-dose group (cumulative dose ⩾2250 mg, cDDD ⩾900), respectively ( p for trend < 0.0001).

Conclusion:

MTX at middle and high accumulative doses might be associated with lower risk of new-onset cancers in patients with RA.
Hypomagnesemia in persons with type 1 diabetes: associations with clinical parameters and oxidative stress
Authors: van Dijk Peter R. , Waanders F. , Qiu Jiedong , de Boer Hannah H. R. , van Goor H. , Bilo H. J. G.
Published: December 2020

Background:

Among persons with type 1 diabetes mellitus (T1DM) low concentrations of magnesium have been reported. Previous (small) studies also suggested a relation of hypomagnesemia with (poor) glycaemic control and complications. We aimed to investigate the magnitude of hypomagnesemia and the associations between magnesium with parameters of routine T1DM care in a population of unselected outpatients.

Methods:

As part of a prospective cohort study, initially designed to measure quality of life and oxidative stress, data from 207 patients with a mean age of 45 [standard deviation (SD) 12] years, 58% male, diabetes duration 22 [interquartile range (IQR) 16, 31] years and glycated haemoglobin (HbA1c) of 60 (SD 11) mmol/mol [7.6 (SD 1.0)%] were examined. Hypomagnesemia was defined as a concentration below <0.7 mmol/l.

Results:

Mean magnesium concentration was 0.78 (SD 0.05) mmol/l. A deficiency was present in 4.3% of participants. Among these persons, mean concentration was 0.66 (SD 0.03) mmol/l. There was no correlation between magnesium and HbA1c at baseline ( r = –0.014, p = 0.843). In multivariable analysis, free thiols (reflecting the degree of oxidative stress) were significantly and negatively associated with magnesium concentrations.

Conclusion:

In this cohort of T1DM outpatients, the presence of hypomagnesemia was infrequent and, if present, relative mild. Magnesium was not associated with glycaemic control nor with presence of micro- and macrovascular complications. Although these results need confirmation, in particular the negative association of magnesium with free thiols, this suggests that hypomagnesemia is not a relevant topic in routine care for people with T1DM.
Wernicke’s encephalopathy — from basic science to clinical practice. Part 1: Understanding the role of thiamine
Authors: Ott Michael , Werneke Ursula
Published: December 2020

Wernicke’s encephalopathy (WE) is an acute neuropsychiatric state. Untreated, WE can lead to coma or death, or progress to Korsakoff syndrome (KS) – a dementia characterized by irreversible loss of anterograde memory. Thiamine (vitamin B1) deficiency lies at the heart of this condition. Yet, our understanding of thiamine regarding prophylaxis and treatment of WE remains limited. This may contribute to the current undertreatment of WE in clinical practice. The overall aim of this review is to identify the best strategies for prophylaxis and treatment of WE in regard to (a) dose of thiamine, (b) mode of administration, (c) timing of switch from one mode of administration to another, (d) duration of administration, and (e) use of magnesium along thiamine as an essential cofactor. Evidence from randomized controlled trials and other intervention studies is virtually absent. Therefore, we have to resort to basic science for proof of principle instead. Here, we present the first part of our clinical review, in which we explore the physiology of thiamine and the pathophysiology of thiamine deficiency. We first explore both of these in their historical context. We then review the pharmacodynamics and pharmacokinetics of thiamine, exploring the roles of the six currently known thiamine compounds, their transporters, and target enzymes. We also explore the significance of magnesium as a cofactor in thiamine-facilitated enzymatic reactions and thiamine transport. In the second (forthcoming) part of this review, we will use the findings of the current review to make evidence-based inferences about strategies for prophylaxis and treatment of WE.
Epidemiology of occupational injuries in Ethiopian hotel industry in Ethiopia: A cross-sectional study
Authors: Abune Roza , Merga Hailu , Mengiste Embialle
Published: December 2020

Introduction:

An occupational injury is a global health issue, and in hotel industries, little is known about it. The aim of this study was therefore to assess the epidemiology of occupational injuries in international brand hotels.

Method:

An institutional cross-sectional study was conducted among 330 workers using a systematic random sampling method. Using EpiData and SPSS, respectively, data were entered and analyzed. The final results were explained and presented with the adjusted odds ratio and the 95% confidence interval, and the results of the qualitative data were triangulated with quantitative data.

Results:

Of the 330 study participants, 125 (37.9%; 95% confidence interval (32.7%, 43.8%)) reported having sustained an occupational injury. The study showed those who had four or less family members (adjusted odds ratio: 0.484, 95% confidence interval (0.286, 0.818)), those who had low educational background (adjusted odds ratio: 1.466, 95% confidence interval (1.098, 1.959)), those who had 2 years or less work experience (adjusted odds ratio: 1.065, 95% confidence interval (1.023, 1.108)), those who were working in shifts (adjusted odds ratio: 2.559, 95% confidence interval (1.197, 5.474)), and those who had sleep disturbance (adjusted odds ratio: 1.797, 95% confidence interval (1.025, 3.151)) were factors significantly associated with occupational injury.

Conclusion:

The study found that the prevalence rate was very high. Among the variables included in the analysis, having four or less family sizes, low educational background, having work experience of 2 years or less, working in shifts, and having sleep disorders/problems were statistically significant. It is therefore recommended that health and safety training and reinforcement be provided to increase awareness and understand the risk factors at the workplace.
Migration Discourse in Sweden: Frames and Sentiments in Mainstream and Social Media
Authors: Yantseva Victoria
Published: December 2020

This study undertakes a systematic analysis of media discourse on migration in Sweden from 2012 to 2019. Using a novel data set consisting of mainstream newspapers, Twitter and forum data, the study answers two questions: What do Swedish media actually talk about when they talk about “migration”? And how do they talk about it? Using a combination of computational text analysis tools, I analyze a shift in the media discourse seen as one of the outcomes of the European refugee crisis in 2015 and try to understand the role of social media in this process. The results of the study indicate that messages on social media generally had negative tonality and suggest that some of the media frames can be attributed to a migration-hostile discourse. At the same time, the analysis of framing and sentiment dynamics provides little evidence for the discourse shift and any long-term effects of the European refugee crisis on the Swedish media discourse. Rather, one can hypothesize that the role of the crisis should be viewed in a broader political and historical context.
Knowledge, Attitudes and Practices in Antibiotic Use in Family Medicine Students
Authors: Sánchez Xavier , Landázuri Andrea , Londo Paulina , Manzano Andrea , Moreno Roca Andrés , Jimbo Ruth
Published: December 2020

Background

Inappropriate prescriptions of antibiotics lead to ineffective and unsafe treatments and worsening of diseases. Medical students may have deficiencies in their prescription skills and they may need further training in the use of antibiotics for their practice. Medical skills in prescribing antibiotics can be improved through continuous medical education. The aim of this study was to assess the current levels of knowledge, attitudes, and practices (KAP) in antibiotic prescription in upper respiratory tract infections (URTI) among postgraduate family medicine students in Ecuador.

Methods

A cross-sectional study with an on-line survey, based on micro-curricular contents, to evaluate KAPs regarding antibiotic prescription in URTI among postgraduate family medicine students in 5 provinces of Ecuador.

Results

Two hundred and seventy-three physicians responded (94.1%). Most physicians treated between 1 and 5 URTI cases per day. The odds for inadequate knowledge and inappropriate practices in URTI among postgraduate family medicine students were 8.74 (95%CI, 4.94-15.46, P < .001) and 5.99, (IC95%, 2.66-13.50, P < .001) in physicians who were students of the first half of the study program.

Conclusion

The knowledge in URTI was limited among physicians. Nonetheless, they expressed a positive attitude toward not using antibiotics in URTI. A postgraduate program can significantly improve the knowledge and practices related to antibiotic prescriptions in URTI.
Medical Legal Aspects of Telemedicine in Italy: Application Fields, Professional Liability and Focus on Care Services During the COVID-19 Health Emergency
Authors: Ferorelli D. , Nardelli L. , Spagnolo L. , Corradi S. , Silvestre M. , Misceo F. , Marrone M. , Zotti F. , Mandarelli G. , Solarino B. , Dell’Erba A.
Published: December 2020

Telemedicine services can be classified into the macro-categories of specialist Telemedicine, Tele-health and Tele-assistance. From a regulatory perspective, in Italy, the first provision dedicated to the implementation of Telemedicine services is represented by the Agreement between the Government and the Regions on the document bearing “Telemedicine—National guidelines,” approved by the General Assembly of the Superior Health Council in the session of 10th July 2012 and by the State Regions Conference in the session of 20th February 2014. Scientifically, several studies in the literature state that information and communication technologies have great potential to reduce the costs of health care services in terms of planning and making appropriate decisions that provide timely tools to patients. Another clear benefit is the equity of access to health care. The evolution of telemedicine poses a series of legal problems ranging from the profiles on the subject of authorization and accreditation to those concerning the protection of patient confidentiality, the definition and solution of which, in the absence of specific regulatory provisions, is mainly left to the assessment of compatibility of the practices adopted so far, with the general regulatory framework. In terms of professional liability, it is necessary to first clarify that the telemedicine service is comparable to any diagnostic-therapeutic health service considering that the telemedicine service does not replace the traditional health service, but integrates the latter to improve its effectiveness, efficiency and appropriateness.
Recent Trends in Youth Concussions: A Brief Report
Authors: Askow Andrew T. , Erickson Jacob L. , Jagim Andrew R.
Published: December 2020

Objectives

Concussions and mild traumatic brain injuries are important medical issues, particularly among youth as the long-term health consequences of these injuries can become increasingly problematic. The purpose of this study was to examine recent trends in diagnosed concussions among pediatric patients in a large health care system.

Methods

This was a retrospective, population-based epidemiology study design that queried all patient files (pediatrics included) using electronic medical health records and further stratified patients based on type of concussion, age, sex, and year from 2013 to 2018.

Results

Electronic health records from a cohort of 8 832 419 (nmales = 4 246 492; nfemales = 4 585 931) patient visits were assessed for concussion diagnosis and filtered for those whose concussive event led to a loss of consciousness (LOC) or not (nLOC). Of these patients, 12 068 were diagnosed with a concussion (LOC = 3 699; nLOC = 8 369) with an overall incidence rate of 1.37 concussions per 1000 patients. Overall, the number of patients diagnosed with a concussion increased by 5063 (LOC = 1351; nLOC = 3712) from 2013 to 2018. Males and females presented with similar rates of concussions 5919 (49.05%) and 6149 concussions (50.95%), respectively. Of total diagnosed concussions, 4972 (LOC = 815; nLOC = 4157) were under the age of 18 and represented 41.2% of all diagnosed concussions with an incidence rate of 6.79 per 1000 patients.

Conclusion

The number of concussions diagnosed appear to be on the rise with the largest number of concussions being diagnosed in those under the age of 18. Future studies should seek to determine primary causality and the long-term health implications of concussions with or without LOC.
Diagnosis of the Domino Effect in Bankruptcy Situations Through Positioning Maps and Their Evolution 10 Years Later
Authors: Patau Josep , Somoza Antonio , Torra Salvador
Published: December 2020

This work aims to describe how the insolvency of a firm affects other business creditors. Through a sample of small and medium entities in Catalonia for the biennium 2004–2005, the situation of creditors before and after the legal event (insolvency proceedings) has been studied. The results confirm the existence of a substantial change in the composition of the financial structure of these firms (substitution of long-term debt by short-term debt; decrease in solvency and profitability, increase in financial charge, among others) and, therefore, the contagion of liquidity problems. The study covers 2 years before and after the insolvency and is dynamic in the sense that it highlights how the creditors change their source of finance and the ending situation. The main contributions of the object are the effect of insolvency on other companies closely related and also the technique used—multidimensional scaling.
An Investigation of the Relationship Among Medical Center’s Image, Service Quality, and Patient Loyalty
Authors: Phonthanukitithaworn Chanchai , Naruetharadhol Phaninee , Gebsombut Nathatenee , Chanavirut Raoyrin , Onsa-ard Wanwipada , Joomwanta Pawanrut , Chanyuan Zou , Ketkaew Chavis
Published: December 2020

This research aimed to study significant relationships among factors influencing customer satisfaction and loyalty in the health care service industry. In order to test the conceptual framework, structural equation modeling (SEM) was used to analyze the data from 252 respondents (outpatients) at four public and private hospitals in Khon Kaen City, Thailand. This empirical research determined how the health care service image, service quality, and behavioral intentions were interrelated using a scale adapted from Taiwan Customer Satisfaction and American Customer Satisfaction Indices, as the perceived quality variable was designated as a second-order construct. The findings showed that the significant factor impacting customer loyalty is customer satisfaction. Corporate image significantly enhanced both customer expectations (CEs) and perceived service quality. The researchers also observed that perceived service quality was positively related to tangibility, instrumental, and emotional supports in addition to customer satisfaction. In conclusion, this article proposed a thoughtful research scenario for management and corporate/public policymakers at the national level in Thailand. It was observed that a good image could directly enhance perceived service quality for businesses in the health service sector.

Short Abstract

We aimed to explore the relationship between image, service quality, and patient loyalty in the health service sector. A multivariate analysis (structural equation modeling) was employed to analyze the data from 252 outpatients in Khon Kaen City, Thailand. The conventional service quality model suggests that corporate image influences customer expectation, and then affects perceived service quality, then customer satisfaction, and finally, loyalty. However, this article found that, in the health service sector, a corporate image may directly influence perceived service quality without the customer expectation variable as a mediator.
Why Not Knowledge-Based HRM? Its Direct and Indirect Effect on Innovative Service Offerings
Authors: Ahmad Norwan , Imm Ng Siew , Aziz Yuhanis Abdul , Kamal Basha Norazlyn
Published: December 2020

This article is aimed at examining the effect, direct and indirect, of knowledge-based human resource management on innovative offerings of service small and medium-sized enterprises (SMEs). Knowledge-based human resource management essentially reflects the central role played by the embedded knowledge-centric human resource management practices, which may lead to new or improved services. A cross-sectional survey was implemented involving a sample of 278 business service SMEs from Malaysia and indicated two key findings from the study. First, knowledge-based human resource management was found to positively influence innovative service offerings. Second, dynamic capability in the aspects of entrepreneurial orientation, marketing capability, and technological capability were found to mediate the knowledge-based human resource management–innovative service offerings relationship. This study espouses the potentials of creating innovative service offerings among business service SMEs through embedding knowledge perspective in human resource management practices as well as investment in dynamic capabilities.
The Impact of Demographic Burden on Insurance Density
Authors: Nebolsina Elena
Published: December 2020

The article investigates the relationship between demographic burden and insurance market by employing panel vector autoregression models with six groups of endogenous variables to a dynamic panel data set of 25 economies for the period 1980–2016. Demographic burden is represented by dependency ratios measured in respect to the population younger than the age of 15 (young-age dependency ratio), population above the age of 64 (old-age dependency ratio) as well as males and females above the age of 64 being examined separately. As indicators of insurance market development, life insurance density, non-life insurance density, and total insurance density are used. The robustness of the results is verified across 10 subsamples of the main observation period. The conducted analyses show a heterogeneous impact of demographic burden on the insurance market. The impulse responses reveal that negative effects prevail in the long term, which may result from the negative impact of an increasing demographic burden on the economy. In the short term, growth in female and male old-age dependency ratios drives up life and non-life insurance density.
Innovation and Human Development Perspectives in West Africa
Authors: Azuh Dominic E. , Ejemeyovwi Jeremiah O. , Adiat Queen , Ayanda Babatunde A.
Published: December 2020

Innovation during this era of globalization plays a crucial role in the growth and development of an economy. This study empirically investigates the role of research and development (innovation) on human development in West Africa (2004—2014). The estimation techniques utilized to carry out the objective are the standard variations of the Generalized least squares—Panel Fixed and Panel Random effects estimation techniques. The empirical results show that research and development in West Africa has a statistically significant positive impact on human development which emphasizes the potentials of human development to be harnessed by consistent research and development. The study recommends increased research and development (innovation) through adequate research and development funding and university-industry partnership for real human development problems to be solved.
Using XGBoost and Skip-Gram Model to Predict Online Review Popularity
Authors: Nguyen Lien Thi Kim , Chung Hao-Hsuan , Tuliao Kristine Velasquez , Lin Tom M. Y.
Published: December 2020

Review popularity is similar to awareness and information accessibility components: Both have a profound effect on customer purchase decisions. Therefore, this study proposes a new method for predicting online review popularity that combines the extreme gradient boosting tree algorithm (XGBoost), to extract key features on the bases of ranking scores and the skip-gram model, which can subsequently identify semantic words according to key textual terms. Findings revealed that written reviews had higher review popularity than non-textual reviews (reviewer and product factors). Moreover, the proposed method achieved higher prediction accuracy than the traditional ridge regression technique of Root Mean Squared Logarithmic Error (RMSLE). The main factors affecting review popularity and key reviewers for specific textual terms were also identified. Findings could help vendors identify key influencers for their product promotion and then support the design of word-suggestion systems for online reviews.
Experiences of older primary care patients with multimorbidity and their caregivers in navigating the healthcare system: A qualitative study protocol
Authors: Lee Eng Sing , Muthulingam Gayathri , Chew Evelyn Ai Ling , Lee Poay Sian Sabrina , Koh Hui Li , Quak Stephanie Xin En , Ding Yew Yoong , Subramaniam Mythily , Vaingankar Janhavi Ajit
Published: December 2020

Background:

Patients with multimorbidity must bear not just the burden of their illness, but also the burden of treatment which is, in part, induced by their interactions with the healthcare system. The need to shuttle between different healthcare institutions and multiple healthcare providers can make navigating the healthcare system challenging, and this may be even more so for older patients with limited resources and support.

Objectives:

Few qualitative studies have explored the experiences of patients with multimorbidity in navigating the healthcare system. This study will explore the experiences of older patients with multimorbidity and their caregivers as they navigate through the healthcare system. We aim to arrive at a better understanding of patient experiences of possible gaps in the continuity of care and how the current system can be modified and adapted to better address the needs of older patients with multimorbidity.

Method:

Semi-structured, in-depth interviews will be conducted with purposively sampled older patients with multimorbidity, aged 60 and above seen in primary care, together with their caregivers. Interviews will be transcribed verbatim and analysed by the study team using inductive thematic analysis.

Conclusions:

Our study seeks to explore the navigational experiences within the healthcare system for older patients with multimorbidity in an Asian, multi-ethnic society. The findings will be shared with decision-makers in the healthcare setting in order to improve patient care for this population and ultimately maximise their positive health outcomes, and will add to better understanding how the burden of treatment arising from navigational challenges within the healthcare system may be reduced for older patients with multimorbidity.
Rhabdomyolysis in Patients Hospitalized With COVID-19 Infection: Five Case Series
Authors: Khosla Shikha G. , Nylen Eric S. , Khosla Rahul
Published: December 2020

The novel SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) is now known to cause acute respiratory distress, cytokine storm, and coagulopathy. Multiple other manifestations have been published in recent literature. Rhabdomyolysis is a syndrome of muscle damage, with release of intracellular contents into circulation. It is characterized by marked elevations of creatinine kinase levels and myoglobinuria. In this article, we describe a series of 5 cases who were admitted with COVID-19 pneumonia and had severe muscle injury, as demonstrated by significant elevation (>5 times upper limit of normal) of creatinine kinase levels likely secondary to SARS-CoV-2 virus. The median age for these patients was 65 years, and most of them suffered from diabetes and hyperlipidemia. All patients were hypertensive males. Four out of 5 patients had preserved kidney function at baseline and were chronic kidney disease (CKD) stage 2 or better. However, most of them suffered significant kidney injury and at the time of discharge one patient was CKD stage 2 or better, 2 were CKD stage 3 or worse, and 2 patients had renal failure and died due to complications of SARS-CoV-2 infection.
Low-Level Viremia Predicts Virological Failure in HIV-Infected Omani Patients Receiving Antiretroviral Therapy
Authors: Gaifer Zied , Boulassel Mohamed-Rachid
Published: December 2020

Background:

The implication and clinical significance of low-level viremia (LLV) in HIV patients are still not clear. This study aimed to characterize the clinical outcomes and to evaluate whether LLV could predict future virological failure in a well-defined cohort of HIV-infected Omani patients attending a large HIV clinic.

Methods:

Patients on regular antiretroviral therapy (ART) for at least 12 months, and had at least 2 HIV RNA measurements 1 year after starting ART, were prospectively enrolled in a cohort study. LLV was defined as plasma HIV RNA between 50-200 copies/mL that persists after at least 2 consecutive measurements after 12 months of ART. Multivariate Cox proportional hazards regression model was used to measure the association among virological failure, LLV and potential predictors.

Results:

After 12 months of starting ART, 60 patients (40%) had undetectable viral load (UVL) < 50 copies/mL, while 37 patients (24%) had LLV and 53 patients (35%) had primary virological failure > 200 copies/mL. The incidence rates of subsequent secondary virological failure for UVL and LLV groups, were 3 and 7 cases per 1000 patient-months, respectively. Compared to UVL group, LLV group had increased risk of subsequent secondary virological failure with hazard ratio of (4.437 [95% CI, 1.26-15.55]; p = 0.02). Age, duration of HIV infection, pretreatment HIV RNA level, pretreatment CD4+ cell count, and ART adherent were associated with subsequent secondary virological failure.

Conclusion:

Collectively, Omani HIV patients with LLV were at a higher risk for HIV virological failure, and should be monitored closely. Further studies are need to assess whether ART modification in LLV patients would lower the risk of virological failure.