bluuebunny/crossref_metadata_2025 huggingface dataset:
Using procalcitonin (PCT) to guide antibiotics escalation in suspicious infected patients: a new application of PCT in ICU
Authors: Wang Xu , He Huaiwu , Long Yun , Shan Guangliang , Li Dongkai , Zhou Xiang , Su Longxiang , Zhang Qing
Published: February 2020

Background

Empirical antibiotic therapy before pathogen recognition is a tricky problem for suspicious infected patients in ICU. Procalcitonin (PCT) is efficient in degrading antibiotics level without increasing complications for its sensitivity and specificity in bacterial infection. Considering this, we hypothesized that PCT might be significant in indicating timely antibiotics escalation and improve patients’ outcomes.

Methods

This was a single-center retrospective study including patients with suspected infection who were admitted to Peking Union Medical College Hospital from January 2014 to June 2018. Patients were labelled as “antibiotic escalation” or “non-escalation” according to their antimicrobial use 48 h before and after the "PCT alert". “PCT alert” was defined as PCT ≥1.0 ng/mL that had not decreased by at least 10% from the previous day or from baseline, or a single measurement ≥ 1.0 ng/ml. Indicators that possibly influenced the prognosis were collected. 28-day intensive care unit (ICU)-free days were calculated; ICU stays >20 days and ≤20 days were considered nonprolonged ICU stays (nPISs) and prolonged ICU stays (PISs), respectively. Difference analysis and binary logistic regression were performed to determine the factors that influenced the 28-day ICU-free days .

Results

A total of 1109 patients were included, 654 in the PIS group, other 455 in nPIS group. The PIS group had higher rates of pathogen identification (33.94% vs 28.13%, P=0.047) and escalated antibiotic therapy (35.47% vs 20.66%, P<0.001) but a lower proportion of surgical patients (39.45% vs 54.95%, P<0.001) than the nPIS group. Regarding PCT, the values on the 1st day (20.36±43.89 vs 14.89±30.37 ug/L, P=0.014) and on the “alert day” (24.24±46.38 vs 18.75±32.69 ug/L; P=0.021) were higher in the PIS group than nPIS group, but no significant difference in the white blood cell (WBC) count was revealed.
According to the binary logistic regression model, antibiotic escalation (OR=0.552, 95% CI 0.347-0.877, P=0.012) was a negative factor for PIS, while postsurgical status (OR=1.959, 95% CI 1.269-3.023, P=0.002) and age (OR=1.020, 95% CI 1.007-1.034, P=0.003) were positive factors.

Conclusions

PCT is significant in evaluating the effect of empirical antibiotic therapy. Escalating microbial ranks when “alert PCT” appeared can increase 28-day ICU-free days.
Validation of the Wisconsin Upper Respiratory Symptom Survey-24, Chinese version
Authors: Wang Yuanyuan , He Zehui , Chen Simin , Liu Yuntao , Li Fang , Barrett Bruce , Lundborg Cecilia Stålsby , Zhang Zhongde , Su Guobin
Published: February 2020

Background The Wisconsin Upper Respiratory Symptom Survey (WURSS) is a validated English questionnaire to evaluate the severity of upper respiratory tract infections (URTIs). We aimed to develop a Chinese version of WURSS-24 (WURSS-24-C) and evaluate its reliability, validity and minimal important difference (MID). Methods The WURSS-24 was translated into Mandarin Chinese using the forward-backward translation procedure. People with Jackson-defined common cold symptoms within 48 hours of onset were recruited in Guangzhou, China, and followed for up to 14 days. The SF-8 (24 hours recall) assessing general mental and physical health was used as external comparator. Reliability, validity, and MID were evaluated. Results The WURSS-24-C was developed and found to be acceptable, relevant, and easy to complete in cognitive debriefing interviews. A total number of 300 participants (age 28.4±9.3, female 70%) were monitored for 2,500 person-days. Factor analysis: Exploratory factor analysis (EFA) suggested 4 domains, defined as activity and function, systemic symptoms, nasal symptoms, and throat symptoms. Confirmatory factor analysis (CFA) supported this 4-domain model with a Comparative Fit Index (CFI) of 0.93. Reliability assessment of the 4-domain-structure found Cronbach’s alphas of 0.943, 0.859, 0.882 and 0.849, respectively. Convergent validity indicator: The Pearson correlation coefficients between daily WURSS-24-C and the SF-8 were -0.780 and -0.721, for the SF-8 physical and mental health respectively. Estimates of MID for individual items varied from -0.41 to -1.14. Conclusion The WURSS-24-C is a reliable and valid questionnaire for assessing illness-specific quality-of-life health status in Chinese speaking patients with URTIs.
Research on comprehensive evaluation of Payment for ecological services effect of environmental pollution loss in Industrial Park
Authors: Han Xiuyan , Cao Tianyi
Published: February 2020

Background: China's industrial parks are the main force of economic development，payment for ecological services（PES）effect of environmental pollution loss in industrial parks is significant for sustainable development of industrial parks. In order to explore effective method of Payment for ecological services effect evaluation（ECEE）of the environmental pollution loss（EPL）in industrial parks, based on literature review and current situation analysis, 24 evaluation indicators of four kinds were selected to build the evaluation indicator system. According to requirements of Payment for ecological services effect evaluation of environmental pollution loss in industrial parks, niche suitability model (NFM) is introduced, based on analysis and improvement of which, spatial niche suitability model (SNSM) is constructed. Then, the application test of SNSM is carried out using related research data, taking Nanjing MV Industrial Park as an example. Results: The evaluation results show that the Payment for ecological services effect of environmental pollution loss in Nanjing MV industrial park shows an upward trend from 2011 to 2018, but the upward situation is imbalanced, and effect improvement of ecological environment compensation inputs and ecological environmental pollution is obviously lagging behind, and still the future work focus of Nanjing MV Industrial Park. Conclusions: Through comparative analysis, it is shown that the evaluation results of spatial niche suitability model are more in line with the actual situation of Nanjing MV Industrial Park, and this method is more suitable for the comprehensive evaluation of Payment for ecological services effect of environmental pollution loss. The research results of this paper provide an effective quantitative analysis method for Payment for ecological services effect management and prevention of Payment for ecological services risks of industrial parks.
Novel homozygous mutation in TUBB8 associated with oocyte maturation defect-2 in a consanguineous marriage family
Authors: Xing Qiong , Wang Ruyi , Chen Beili , Li Lin , Pan Hong , Li Tengyan , Ma Xu , Cao Yunxia , Wang Binbin
Published: February 2020

Purpose: To study the genetic basis of oocyte maturation defects, we performed clinical and genetic analysis of a pedigree. Variations in many genes may lead to the occurrence of oocyte maturation defects, but the specific functional mechanisms need to be further studied.Methods: One proband with oocyte maturation defect-2 receiving ovulation induction therapy and her parents were selected for clinical detection, whole exome sequencing and Sanger sequencing. One normal woman received ovulation induction therapy. Mutations were assessed after frequency screening of public exome databases. Then homozygous variants shared by the proband and her parents were selected.Results: Arrest of oocytes maturation was observed. A new missense mutation in TUBB8 (TUBB8: NM_177987: exon 2: c. C161T: p. A54V) was identified, which was shown to be novel compared with public databases. The variant was highly conserved among primates, and was suggested to be deleterious by online software prediction. Conclusions: The homozygote of this variant (TUBB8: NM_ 177987: exon 2:c.C161T: p.A54V) might affect spindle assembly, cause arrest of oocyte maturation and lead to oocyte maturation defect-2.
THEORETICAL FOUNDATIONS MANAGE LIQUIDITY AND SOLVENCY
Authors: Liuta O. , Pihul N. , Hliadko K.
Published: February 2020

The article deals with the essence of the definitions "liquidity" and "solvency" of the enterprises. It is stated that the definitions are complementary and closely related to each other, but herewith they should be distinguished. The article provides an interpretation of the economic category "liquidity and solvency management" of the enterprise, namely, the authors of the article state that it is a process of developing and making effective management decisions by the economic entities to fulfill their obligations in full and within the established deadline at the expense of the available means of payment in order to ensure the sustainable development of the entity both in the current and future periods. Besides, the article determines the purpose and main tasks of liquidity and solvency management of the enterprise, the main steps in the process of managing the liquidity and solvency of the economic entities, as well as the main stages of their analysis. Also, the article determines and characterizes the absolute and the relative indicators with the help of which it is possible to carry out the analysis of the liquidity and solvency. There was carried an analysis of liquidity and solvency according to the groups of indicators. The analysis of liquidity and solvency of the domestic economic entities which was carried out for the period of 2013 - 2017 indicates a low level of liquidity and prospective solvency of Ukrainian enterprises. Such a situation negatively affects the efficiency of their functioning, which is due to the inability of economic entities to discharge short-term liabilities in time. This estimation was made on the basis of an analysis of liquidity and financial firmness ratios, which are the basis for drawing conclusions on prospective solvency. The authors of the article noted that liquidity and solvency management of enterprises are the important components of the financial management of business entities and that the implementation of effective liquidity and solvency management is the basis for ensuring the further development of enterprises, which in turn will affect their investment attractiveness and competitiveness.
Keywords:
liquidity, solvency, management, prospective solvency, liquidity and solvency ratios.
The representation theory of seam algebras
Authors: Langlois-Rémillard Alexis , Saint-Aubin Yvan
Published: February 2020

The boundary seam algebras \mathsf{b}_{n,k}(\beta=q+q^{-1})𝖻n,k(β=q+q−1)
were introduced by Morin-Duchesne, Ridout and Rasmussen to formulate
algebraically a large class of boundary conditions for two-dimensional
statistical loop models. The representation theory of these algebras
\mathsf{b}_{n,k}(\beta=q+q^{-1})𝖻n,k(β=q+q−1)
is given: their irreducible, standard (cellular) and principal modules
are constructed and their structure explicited in terms of their
composition factors and of non-split short exact sequences. The
dimensions of the irreducible modules and of the radicals of standard
ones are also given. The methods proposed here might be applicable to a
large family of algebras, for example to those introduced recently by
Flores and Peltola, and Crampé and Poulain d’Andecy.
Preparation and characterization of PAN nanofibers containing boehmite nanoparticles for the removal of microbial contaminants and cadmium ions from water
Authors: Borhani Sedigheh , Asadi Arezo , Dabbagh Hossein A.
Published: February 2020

Nanofibers of polyacrylonitrile (PAN)/boehmite were prepared by electrospinning a homogeneous solution of PAN/DMF (dimethyl formamide). Enhancing the amount of boehmite nanoparticles (NPs) led to increase in the nanofibers' diameter. Samples had high pure water flux, which did not change significantly with boehmite concentration, but decreased with increasing electrospinning duration. Escherichia coli bacteria removal was remarkably more efficient, as it was enhanced from 72.33% to 97.37% with increase in the boehmite NPs' concentration from 0 to 10% wt. High bacterial removal efficiency could be attained by the large surface area of NPs, as well as the electrostatic force of attraction between NPs and microorganisms. The increase in boehmite concentration from 10 to 30 and 50% did not noticeably affect bacterial removal. Prolonging electrospinning time significantly enhanced bacteria removal. Hence, it was shown that 6-hour electrospinning of PAN/boehmite nanofiber layers composed of 50% boehmite led to 99.7%, 99.39%, 99.8%, and 74% E. coli, Staphylococcus aureus bacteria removal, particles' separation efficiency of 2 μm and cadmium adsorptivity, respectively, which were better than those obtained by using pure PAN nanofibers. E. coli bacterial removal efficiency of the sample was increased to 99.99% by repeating filtering four times. Considering the results, this PAN/boehmite nanofibers' membrane has potential application to purification of drinking water.
Removal of brilliant green (BG) from aqueous solution by using low cost biomass Salix alba leaves (SAL): thermodynamic and kinetic studies
Authors: Fiaz Rashida , Hafeez Muhammad , Mahmood Rashid
Published: February 2020

The removal of brilliant green dye (BGD) from aqueous solution by using Salix alba leaves (SAL) was carried out via batch studies. The maximum removal efficiency was found to be 95.2% with initial dye concentration 50 mg/L at 0.15 g adsorbent dosage, pH = 6, and 298 K temperature, and the equilibrium was observed within 3½ hours. The adsorption capacity increased (2.21–15.89 mg/g) from 10 to 50 mg/L of dye concentration. Kinetic and isotherm studies were also carried out. The results showed that pseudo-second order model better describes the adsorption mechanism. The isotherm equilibrium data analysis was carried out by using Freundlich and Langmuir models and the sorption process was observed to conform with the Langmuir isotherm with linear correlation coefficient (R2 = 0.99). The thermodynamic properties ΔG°, ΔH°, and ΔS° delineated that BGD adsorption over SAL was feasible, spontaneous, and endothermic between 303 and 323 K temperature.
Choosing various likelihood functions on uncertainty assessment in groundwater simulation-optimization model
Authors: Norouzi Khatiri Khadije , Niksokhan Mohammad Hossein , Sarang Amin
Published: February 2020

The main goal in this research is study of impacts of various likelihood functions on DREAM(zs) (Differential Evolution Adaptive Metropolis) method results in simulation-optimization model of aquifer. In this study, DREAM(zs) algorithm has been developed to study aquifer simulation-optimization model uncertainties. DREAM(zs) is used to investigate uncertainty of parameters of the simulation-optimization model in Isfahan-Barkhar aquifer, Isfehan province, Iran. This study is carried out on an aquifer simulation model of MODFLOW that is coupled with MOPSO (multi-objective particle swarm optimization) optimization. Three likelihood functions, L1, L2, and L3, are considered as informal and the remaining (L4 and L5) are represented as formal categories. Likelihood function L1 is Nash–Sutcliffe efficiency and L2 is based on minimum mean square error. L3 uses estimation of model error variance and L4 focuses on the relationship between the traditional least squares fitting and the Bayesian inference. In likelihood function L5 the serial dependence of residual errors is calculated using a first-order autoregressive model of the residuals. Results suggested that the parameters sensitivity depend on the likelihood function selection, and sensitivity of all parameters is not similar in different likelihood functions. MOPSO algorithm outputs indicated that likelihood function No. 5 has a higher speed in reaching convergence and this function also showed that objective functions had a better performance compared to the other likelihood functions.
Effects of total suspended solids, particle size, and effluent temperature on the kinetics of peracetic acid decomposition in municipal wastewater
Authors: Amerian Tasnim , Farnood Ramin , Sarathy Siva , Santoro Domenico
Published: February 2020

In this study, the influence of total suspended solids (TSS) and particle size as well as effluent temperature on peracetic acid (PAA) decomposition kinetics in municipal wastewater was investigated. PAA decomposition was best described following second order kinetics in primary effluent (PE) and first order kinetics in secondary effluent (SE) samples. For synthetic samples prepared by varying TSS levels, PAA demand increased on average by about 0.042 mg/L in PE and 0.034 mg/L in SE for every 10 mg/L increase in TSS. Similarly, the PAA decay rate constant in these samples increased at a rate of 0.0014 L/mg.min and 0.00039 min−1, respectively, per 10 mg/L TSS. To examine the effect of particle size, synthetic samples with narrow size fractions (20–45, 45–75, and 75–90 μm) were prepared. It was found that samples with smaller particle size fractions had a greater PAA demand and decay rate constant. Effluent temperature also enhanced the PAA decomposition rate with the calculated activation energies for PE and SE samples being 29,980 J/mol and 34,860 J/mol, respectively.
A Construção Social de um Mercado de Serviços Pessoais
Authors: Dios Maria Luísa Célia Escalona de
Published: February 2020

O artigo apresenta a dimensão relacional na construção de um mercado de serviços pessoais sob o aporte teórico da antropologia da economia. Utilizando o método etnográfico o texto aborda o trabalho relacional exercido na relação entre prestadores de serviços pessoais - que se autodenominam personals - e seus clientes, além de identificar as varias dimensões do trabalho relacional no cotidiano deste tipo de prestação de serviço pelas perspectivas de Viviana Zelizer e Nina Bandelj.
Palavras-chave: Trabalho relacional. Dimensões do trabalho relacional. Relações de proximidade. Prestação de serviços pessoais.
As “regiões” nas entrelinhas do trabalho político: bases sociais, investimentos intelectuais e carreiras parlamentares (MG, RS, PE e MA)
Authors: Dos Reis Eliana , Grill Igor Gastal , Pereira Ariel
Published: February 2020

Este artigo se insere na agenda de estudos sobre a “dupla arte de representar” de parlamentares brasileiros, cujas carreiras políticas combinam inscrições em domínios culturais. O desdobramento que propomos aqui é o de compreender as lógicas que presidem o trabalho de produção e mobilização – inseparavelmente como trunfo político e afirmação de uma condição de intelectual – de princípios de visão e de classificação de configurações regionais. Seguindo achados e materiais de pesquisas anteriores, adotamos uma abordagem comparativa aplicada a quatro configurações regionais (Minas Gerais, Pernambuco, Rio Grande do Sul e Maranhão). A ênfase aqui recai sobre a análise dos perfis dos agentes e da sua produção escrita, procurando pontuar pistas que nos permita refletir sobre como determinados agentes, que ocupam posições políticas diversas, engendram bens simbólicos, fundando representações sobre as “regiões” consoantes com as representações que forjam sobre si mesmos e, inclusive, fundamentando seu potencial como porta-vozes autorizados a descrever, prescrever e representar (no duplo sentido) causas, indivíduos, grupos e fronteiras.
Problemas Socioambientais na Urbanização de Zonas Costeiras
Authors: Leite Rogério Proença , Pereira Simone de Araujo
Published: February 2020

A partir da década de 1970, um novo fenômeno demográfico é identificadonos Estados Unidos, o qual consiste em deslocamentos migratórioscom relevantes saídas de grandes núcleos urbanos. Dependendode suas características, esse fenômeno foi descrito como populationturnaround, caracterizado por um processo emigratório que ocorrepara zonas rurais, ou como counterurbanisation, quando a emigraçãose dá para áreas menos adensadas na mesma cidade. No âmbito dessefenômeno, verifica-se, atualmente, o que estamos chamando de “costeirização”,que consiste na emigração de núcleos urbanos para zonascosteiras, ambientes naturais, que têm sido demandados como capazesde fornecer melhores condições de vida, com traços de dissociaçãoe ruptura com um intenso ambiente urbano, numa tentativa de“redesign sinergético” em que se busca associar a natureza da costamarítima com o conforto e a infraestrutura encontrados em ambientesurbanizados. Identifica-se esse fenômeno na cidade litorânea “Barrados Coqueiros”, na qual foi desenvolvida a presente análise.Palavras-Chave: Population turnaround. Counterurbanisation. Costeirização.
Pengembangan multimedia interaktif topik prinsip Archimedes untuk mengoptimalkan student centered learning
Authors: Diyana Tsania Nur , Supriana Edi , Kusairi Sentot
Published: February 2020

Tujuan dari penelitian pengembangan ini adalah untuk menghasilkan produk multimedia interaktif pada mata pelajaran Fisika topik prinsip Archimedes untuk siswa kelas XI. Penggunaan multimedia sangat membantu siswa dalam memaksimalkan belajar mandiri (student centered learning) serta membantu siswa untuk memahami konsep dengan lebih baik. Metode penelitian pengembangan yang digunakan adalah Research and Development (R&D) dengan model ADDIE. Kelayakan multimedia interaktif topik prinsip Archimedes berbasis power point diperoleh dari hasil uji empiris pada 3 mahasiswa dengan hasil rata-rata 5.08 kategori sangat baik. Berdasarkan hasil penelitian kelayakan media yang telah dilaksanakan maka diperoleh kesimpulan bahwa multimedia interaktif topik prinsip Archimedes layak digunakan sebagai alternatif pembelajaran di luar waktu sekolah oleh siswa. Selain itu, dapat menjadi bahan belajar mandiri (student centered learning) yang mampu meningkatkan pemahaman konsep siswaKata kunci: Multimedia interaktif, prinsip archimedes, student centered learning Developing interactive multimedia in Archimedes principles to optimize student centered learning AbstractThe purpose of this development research is to produce interactive multimedia products on Physics subjects on the topic of Archimedes principles for grade XI students. The use of multimedia is very helpful for students in improving independent learning (student-centered learning) and helps students to understand concepts better. The research development method used is Research and Development (R&D) with the ADDIE model. The feasibility of interactive multimedia on the topic of Archimedes principles based on power point was obtained from the results of empirical tests on 3 students with an average result of 5.08 very good categories. Based on the results of a feasibility study on media that has been done it could be concluded about interactive multimedia, the principle of Archimedes used as an alternative worthy of learning outside of school time by students. Also, it can be self-learning materials that can improve student understandingKeywords: Interactive multimedia, Archimedes principles, student centered learning
Accuracy of Optical Heart Rate Sensing Technology in Wearable Fitness Trackers for Young and Older Adults: Validation and Comparison Study
Authors: Chow Hsueh-Wen , Yang Chao-Ching
Published: February 2020

Background

Wearable fitness trackers are devices that can record and enhance physical activity among users. Recently, photoplethysmography (PPG) devices that use optical heart rate sensors to detect heart rate in real time have become popular and help in monitoring and controlling exercise intensity. Although the benefits of using optical heart rate monitors have been highlighted through studies, the accuracy of the readouts these commercial devices generate has not been widely assessed for different age groups, especially for the East Asian population with Fitzpatrick skin type III or IV.

Objective

This study aimed to examine the accuracy of 2 wearable fitness trackers with PPG to monitor heart rate in real time during moderate exercise in young and older adults.

Methods

A total of 20 young adults and 20 older adults were recruited for this study. All participants were asked to undergo a series of sedentary and moderate physical activities using indoor aerobic exercise equipment. In this study, the Polar H7 chest-strapped heart rate monitor was used as the criterion measure in 2 fitness trackers, namely Xiaomi Mi Band 2 and Garmin Vivosmart HR+. The real-time, second-by-second heart rate data obtained from both devices were recorded using the broadcast heart rate mode. To critically analyze the results, multiple statistical parameters including the mean absolute percentage error (MAPE), Lin concordance correlation coefficient (CCC), intraclass correlation coefficient, the Pearson product moment correlation coefficient, and the Bland-Altman coefficient were determined to examine the performances of the devices.

Results

Both test devices exhibited acceptable overall accuracy as heart rate sensors based on several statistical tests. Notably, the MAPE values were below 10% (the designated threshold) in both devices (GarminYoung=3.77%; GarminSenior=4.73%; XiaomiYoung=7.69%; and XiaomiSenior=6.04%). The scores for reliability test of CCC for Garmin were 0.92 (Young) and 0.80 (Senior), whereas those for Xiaomi were 0.76 (Young) and 0.73 (Senior). However, the results obtained using the Bland-Altman analysis indicated that both test optical devices underestimated the average heart rate. More importantly, the study documented some unexpected outlier readings reported by these devices when used on certain participants.

Conclusions

The study reveals that commonly used optical heart rate sensors, such as the ones used herein, generally produce accurate heart rate readings irrespective of the age of the user. However, users should avoid relying entirely on these readings to indicate exercise intensities, as these devices have a tendency to produce erroneous, extreme readings, which might misinterpret the real-time exercise intensity. Future studies should therefore emphasize the occurrence rate of such errors, as this will likely benefit the development of improved models of heart rate sensors.
Benefits and Disadvantages of Electronic Patient-reported Outcome Measures: Systematic Review
Authors: Meirte Jill , Hellemans Nick , Anthonissen Mieke , Denteneer Lenie , Maertens Koen , Moortgat Peter , Van Daele Ulrike
Published: February 2020

Background

Patient-reported outcome measures (PROMs) are important in clinical practice and research. The growth of electronic health technologies provides unprecedented opportunities to systematically collect information via PROMs.

Objective

The aim of this study was to provide an objective and comprehensive overview of the benefits, barriers, and disadvantages of the digital collection of qualitative electronic patient-reported outcome measures (ePROMs).

Methods

We performed a systematic review of articles retrieved from PubMED and Web of Science. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed during all stages. The search strategy yielded a total of 2333 records, from which 32 met the predefined inclusion and exclusion criteria. The relevant ePROM-related information was extracted from each study.

Results

Results were clustered as benefits and disadvantages. Reported benefits of ePROMs were greater patient preference and acceptability, lower costs, similar or faster completion time, higher data quality and response rates, and facilitated symptom management and patient-clinician communication. Tablets were the most used ePROM modality (14/32, 44%), and, as a platform, Web-based systems were used the most (26/32, 81%). Potential disadvantages of ePROMs include privacy protection, a possible large initial financial investment, and exclusion of certain populations or the “digital divide.”

Conclusions

In conclusion, ePROMs offer many advantages over paper-based collection of patient-reported outcomes. Overall, ePROMs are preferred over paper-based methods, improve data quality, result in similar or faster completion time, decrease costs, and facilitate clinical decision making and symptom management. Disadvantages regarding ePROMs have been outlined, and suggestions are provided to overcome the barriers. We provide a path forward for researchers and clinicians interested in implementing ePROMs.

Trial Registration

PROSPERO CRD42018094795; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=94795
A security study in Portuguese Public Hospitals - GDPR perspective (Preprint)
Authors: Santos-Pereira Cátia
Published: February 2020

BACKGROUND

GDPR was scheduled to be formally adopted in 2016 with EU member states being given two years to implement it (May 2018). Given the sensitive nature of the personal data that healthcare organization process on a 24/7 basis, it is critical that the protection of that data in a hospital environment is given the high priority that data protection legislation (GDPR) requires.

OBJECTIVE

This study addresses the state of Public Portuguese hospitals regarding GDPR compliance in the moment of GDPR preparation period (2016-2018) before the enforcement in 25 May 2018, and what activities have started since then. The study focuses in three GDPR articles namely 5, 25 and 32, concerning authentication security, identity management processes and audit trail themes.

METHODS

The study was conducted between 2017 and 2019 in five Portuguese Public Hospitals (each different in complexity). In each hospital, six categories of information systems critical to health institutions were included in the study, trying to cover the main health information systems available and common to hospitals (ADT, EPR, PMS, RIS, LIS and DSS). It was conducted interviews in two phases (before and after GDPR enforcement) with the objective to identify the maturity of information systems of each hospital regarding authentication security, identity management processes and traceability and efforts in progress to avoid security issues.

RESULTS

A total of 5 hospitals were included in this study and the results of this study highlight the hospitals privacy maturity, in general, the hospitals studied where very far from complying with the security measures selected (before May 2018). Session account lock and password history policy were the poorest issues, and, on the other hand, store encrypted passwords was the best issue. With the enforcement of GDPR these hospitals started a set of initiatives to fill this gap, this is made specifically for means of making the whole process as transparent and trustworthy as possible and trying to avoid the huge fines.

CONCLUSIONS

We are still very far from having GDPR compliant systems and Institutions efforts are being done. The first step to align an organization with GDPR should be an initial audit of all system. This work collaborates with the initial security audit of the hospitals that belong to this study.
Cadaveric simulation vs standard training for postgraduate trauma & orthopaedic surgical trainees: protocol for the CAD:TRAUMA study multi-centre randomised controlled educational trial (Preprint)
Authors: James Hannah , Pattison Giles T R , Fisher Joanne D , Griffin Damian R
Published: February 2020

BACKGROUND

The quantity and quality of surgical training in the UK has been negatively affected by reduced working hours and NHS financial pressures. Traditionally surgical training has occurred by the master-apprentice model involving a process of graduated responsibility, but a modern alternative is to use simulation for the early stages of training. It is not known if simulation training for junior trainees can safeguard patients and improve clinical outcomes. This paper details the protocol for a multicentre randomised controlled educational trial of a cadaveric simulation training intervention versus standard training for junior postgraduate orthopaedic surgeons-in-training.

OBJECTIVE

To assess the impact of cadaveric simulation training on patient outcomes following three common orthopaedic operations

METHODS

We will recruit postgraduate orthopaedic surgeons-in-training in the first three years (of eight) of the specialist training programme. Participants will be block randomised and allocated to either cadaveric simulation or standard ‘on-the-job’ training, learning three common orthopaedic procedures, each of which is a sub-study within the trial. The procedures are 1) Dynamic Hip Screw(DHS), 2) hemiarthroplasty and 3) ankle fracture fixation. These procedures have been selected as they are very common procedures which are routinely performed by junior surgeons-in-training. A pragmatic approach to sample size is taken in lieu of a formal power calculation as this is novel exploratory work with no a priori estimate of effect size to reference. The primary outcome measure is the technical success of the surgery performed on patients by the participating surgeons-in-training during the follow-up period for the three sub-study procedures, as measured by the implant position on the post-operative radiograph. The secondary outcome measures are procedure time, post-operative complication rate and patient health state at 4 months post-operation (EQ-5D – substudies 1 and 2 only).

RESULTS

Not applicable - this is a trial protocol.

CONCLUSIONS

The results of this trial will be submitted to a peer-reviewed journal and will inform educational and clinical practice.

CLINICALTRIAL

ISRCTN20431944; Pre-results
Acceptance and uptake of wearable cardiac technologies in older adults: A systematic review and meta-synthesis (Preprint)
Authors: Ferguson Caleb , Turkmani Sabera , Hickman Louise , Breen Paul , Gargiulo Gaetano , Inglis Sally
Published: February 2020

BACKGROUND

An array of wearable cardiac monitoring technologies have become available to consumers in recent years. A primary focus of research has been on the performance, accuracy, specificity and sensitivity of devices, with limited understanding of the barriers and enablers informing acceptance or uptake of these technologies, specifically in older adults

OBJECTIVE

This review aimed to explore experiences of older adults and health professionals in relation to using wearable cardiac health monitoring technologies and identify barriers and enablers of acceptance and uptake of these devices.

METHODS

A meta-synthesis was undertaken to synthesise qualitative studies.

RESULTS

A total of seven studies were included. Four interrelated themes emerged: (1) Feelings of trust, safety and confidence; (2) Functionality and affordability; (3) Risk of stigmatisation; and (4) Assurance of device data.

CONCLUSIONS

This systematic review provides evidence of barriers and enablers in acceptability and uptake of wearable telemonitoring devices based on experiences of older adult, health professionals, and carers. Most significant factors that impact the uptake directly relate to the design aspects of the devices, appropriate and timely feedback, user-friendly technology and issues related to the affordability and cost. Findings highlight the need for end user engagement in the co-design and implementation of such interventions

CLINICALTRIAL

N/A
Acceptance, Usage, and Barriers of Electronic Patient-Reported Outcomes Among German Rheumatologists: Survey Study (Preprint)
Authors: Krusche Martin , Klemm Philipp , Grahammer Manuel , Mucke Johanna , Vossen Diana , Kleyer Arnd , Sewerin Philipp , Knitza Johannes
Published: February 2020

BACKGROUND

The use of patient-reported outcomes (PROs) allows for patient-centered, measurable, and transparent care. Electronic PROs (ePROs) have many benefits and hold great potential to improve current usage of PROs, yet limited evidence exists regarding their acceptance, usage, and barriers among rheumatologists.

OBJECTIVE

This study aims to evaluate the current level of acceptance, usage, and barriers among German rheumatologists regarding the use of ePROs. The importance of different ePRO features for rheumatologists was investigated. Additionally, the most frequently used PROs for patients with rheumatoid arthritis (RA) were identified.

METHODS

Data were collected via an online survey consisting of 18 questions. The survey was completed by members of the Working Group Young Rheumatology of the German Society for Rheumatology (Arbeitsgemeinschaft Junge Rheumatologie der Deutschen Gesellschaft für Rheumatologie [DGRh]) at the 2019 annual DGRh conference. Only members currently working in clinical adult rheumatology were eligible to complete the survey.

RESULTS

A total of 119 rheumatologists completed the survey, of which 107 (89.9%) reported collecting PROs in routine practice and 28 (25.5%) already used ePROs. Additionally, 44% (43/97) were planning to switch to ePROs in the near future. The most commonly cited reason for not switching was the unawareness of suitable software solutions. Respondents were asked to rate the features of ePROs on a scale of 0 to 100 (0=unimportant, 100=important). The most important features were automatic score calculation and display (mean 77.50) and simple data transfer to medical reports (mean 76.90). When asked about PROs in RA, the respondents listed pain, morning stiffness, and patient global assessment as the most frequently used PROs.

CONCLUSIONS

The potential of ePROs is widely seen and there is great interest in them. Despite this, only a minority of physicians use ePROs, and the main reason for not implementing them was cited as the unawareness of suitable software solutions. Developers, patients, and rheumatologists should work closely together to help realize the full potential of ePROs and ensure a seamless integration into clinical practice.
Wuhan 2019 Novel Coronavirus Pneumonia: A Case Report of Serial Computed Tomographic Findings in a Female Patient (Preprint)
Authors: Wei Jiangping , Xu Huaxiang , Xiong Jingliang , Shen Qinglin , Fan Bing , Ye Chenglong , Dong Wentao , Hu Fangfang
Published: February 2020

UNSTRUCTURED

Background: From December 2019, the 2019 Novel Coronavirus (2019-nCoV) Pneumonia broke out in Wuhan, China. In this study, we present the finding of serial computed tomography in a female patient with 2019-nCoV.
Case presentation: We report a 40-year-old female who presented with the symptoms of fever, chest tightness, and fatigue. She was further diagnosed with 2019-nCoV confirmed by rRT-PCR. In terms of her chest CT findings, patchy consolidation shadows, and ground-glass opacities (GGOs) rapidly progressed in both lungs, peripherally. After treatment, the previous lesions were almost absorbed, leaving the fibrous lesions.
Conclusions: If there is a history of fever or contact with the epidemic area, combined with the above CT findings, it is necessary to detect the nucleic acid of new coronavirus in time.
Professional Development for Science Teachers on Integrating STEM: A Case Study
Authors: DeJarnette Nancy K. , McCulloch Ryan , Ngoh Nelson N. , Badara Ioana A.
Published: February 2020

In the United States, the Next Generation Science Standards (NGSS) bring both commitment and challenges to science education in K-12 schools. New focus areas within the NGSS are engineering education and the integration of multiple disciplines as seen in science, technology, engineering and mathematics (STEM). Providing professional development (PD) is necessary in order to assist K-12 teachers with the implementation of the NGSS in their classrooms (NGSS Lead States, 2013). This case study shares the results of a unique style of PD workshops provided for K-12 teachers on the NGSS and engineering design where participants were immersed in inquiry-based STEM activities with an earth and space science theme. Twenty-six teachers agreed to participate in the study. This qualitative research focused on self-reported data through surveys, interviews, focus groups, and observation of participants during the workshops. Findings from this case study revealed self-reported increases in teachers’ dispositions and self-efficacy regarding their implementation of the NGSS in an integrated STEM teaching context.
Evaluation of the effectiveness of the use of case-technology in teaching computer modeling of future teachers of informatics
Authors: Markovich Olga S. , Sergeev Alexey N.
Published: February 2020

Problem and goal. The article describes the problem of using case-technology in teaching computer modeling to future teachers of informatics. The relevance of solving this problem is determined by the need to find new approaches to combining the fundamental and applied training of future teachers in order to form a holistic competency that provides a solution to professional pedagogical problems. The purpose of this study was to design a model of training future teachers of informatics in the field of computer modeling using case-technology, as well as testing this model during a pedagogical experiment. Methodology. The basis of the developed methodological approach was the use of subject-oriented cases in teaching computer modeling to future teachers of informatics. This type of cases is considered as a set, which includes: 1) situational problem; 2) tasks, the implementation of which leads to the solution of the problem; 3) materials needed to complete tasks; 4) software tools for solving the problem. The model of training of future teachers of informatics using case-technology is considered as a set of target (formation of competence of the teacher of informatics in the field of computer modeling), content (the content of the course “Computer Modeling”) and process components (three stages of design, development and direct application of the subject-oriented case of computer modeling in the classroom). To assess the effectiveness of the case-technology application, a pedagogical experiment was conducted, involving the implementation of training in experimental and control groups. Results. The article presents the results of an experiment conducted at the Volgograd State Socio-Pedagogical University. During the experiment in the control and experimental groups, a course of computer modeling was implemented with the preservation of the content, but with the use of case-technology in the experimental group. Criterion evaluation of the effectiveness of the formation of competence of the teacher of informatics in the field of computer modeling was carried out in the subject and research aspects. The results of the experiment showed that in the experimental groups increased the number of students represented at high, as well as medium and high levels of formation of both the subject and research component of the competence. Conclusions. The study showed that the proposed approach to the use of case-technology provides high results. The obtained and statistically confi data of the experiment allow us to speak about the effectiveness of the use of case-technology as a means of teaching computer modeling to future teachers of informatics.
Estudio de los parámetros de proyección térmica por plasma de blancos de TiO2 usados en magnetrón sputtering
Authors: Jaramillo-Raquejo Daniela , Palacio-Espinosa Claudia Constanza , Ageorges Hélène
Published: February 2020

La síntesis de películas delgadas por pulverización catódica o sputtering requiere la utilización de blancos o targets, que actúan como los materiales a partir de los cuales se elaboran los recubrimientos. Este trabajo está enfocado en la implementación del proceso de proyección térmica por plasma atmosférico para la fabricación de blancos de TiO2, que posteriormente puedan emplearse en la deposición de recubrimientos de TiO2 por magnetrón sputtering. Se partió de tres polvos de TiO2 comerciales de la marca Oerlikon Metco, los cuales fueron proyectados mediante diferentes parámetros de proyección para evaluar su efecto en la microestructura (porcentaje de poros y grietas en sección transversal) de los blancos de TiO2 obtenidos. Los blancos fueron caracterizados por microscopía electrónica de barrido y procesamiento de imágenes y utilizados en algunas pruebas de deposición sputtering para estimar la tasa de deposición. Los resultados permitieron identificar las variables que tienen un efecto más significativo sobre la microestructura de los blancos. En orden decreciente a la magnitud del efecto, estas variables son: la relación de gases generadores de plasma, la distancia de proyección, el flujo del gas de arrastre, la corriente en el arco eléctrico y la distribución de tamaños de partícula de la materia prima. Los porcentajes de defectos microestructurales encontrados durante la ejecución de las pruebas variaron entre 0.41 ± 0.30 % y 6.80 ± 2.03 %, rango que demuestra la importancia que puede llegar a tener el control de los parámetros de proyección en la fabricación de blancos mediante esta técnica.
Design of a Wireless Sensor Network for Optimal Deployment of Sensor Nodes in a Cocoa Crop
Authors: Celis-Peñaranda Jose M. , Escobar-Amado Christian D. , Sepúlveda-Mora Sergio B. , Castro-Casadiego Sergio A. , Medina-Delgado Byron , Guevara-Ibarra Dinael
Published: February 2020

In this study, factorial experiments were conducted in two different scenarios to design a Wireless Sensor Network for monitoring a cocoa crop in a rural area in Colombia. Node sensors measured temperature, relative humidity, soil moisture, Ultra-Violet light, and visible light intensity. The factors considered in the experiments were distance between node sensors, height from the ground, and type of antenna; in turn, Received Signal Strength Indicator and data transfer time were the outputs. The wireless sensor network was deployed in the crop, covering approximately 3 % of the area and using 7 different nodes in a cluster tree topology. First, an open field scenario with line of sight was used to determine the appropriate height of the node sensors. Second, a scenario in the actual cocoa crop was utilized to find the appropriate distance between modules and type of antenna. We found, based on our calculations and experimental data, that a height of 1.25 m was required to avoid the Fresnel zone and improve the RSSI of the network. Furthermore, we determined that a distance below 35 m was needed to guarantee signal reception and avoid long data transfer times. The wire antenna exhibited a better performance. Finally, the proposed methodology and monitoring system can be used for agronomic applications in rural areas in Colombia to increase crop yield.
Cepstral Analysis and Hilbert-Huang Transform for Automatic Detection of Parkinson’s Disease
Authors: López-Pabón Felipe O. , Arias-Vergara Tomas , Orozco-Arroyave Juan R.
Published: February 2020

Most patients with Parkinson’s Disease (PD) develop speech deficits, including reduced sonority, altered articulation, and abnormal prosody. This article presents a methodology to automatically classify patients with PD and Healthy Control (HC) subjects. In this study, the Hilbert-Huang Transform (HHT) and Mel-Frequency Cepstral Coefficients (MFCCs) were considered to model modulated phonations (changing the tone from low to high and vice versa) of the vowels /a/, /i/, and /u/. The HHT was used to extract the first two formants from audio signals with the aim of modeling the stability of the tongue while the speakers were producing modulated vowels. Kruskal-Wallis statistical tests were used to eliminate redundant and non-relevant features in order to improve classification accuracy. PD patients and HC subjects were automatically classified using a Radial Basis Support Vector Machine (RBF-SVM). The results show that the proposed approach allows an automatic discrimination between PD and HC subjects with accuracies of up to 75 % for women and 73 % for men.