bluuebunny/crossref_metadata_2025 huggingface dataset:
CLASSIFICATION RULE FOR DETERMINING THE TEMPERATURE REGIME OF INDUCTION GRAY CAST IRON
Authors: Stanovska Iraida , Duhanets Vasyl , Prokopovych Lada , Yakhin Serhiy
Published: February 2021

The complexity of using instruments for measuring the technological parameters of induction melting in a continuous mode, and sometimes the impossibility of this, requires the creation of reliable indirect methods for assessing the numerical values of these parameters. This is especially important for quality control of control systems that ensure a given melting temperature regime. The paper proposes a classification rule based on parametric classification methods, which makes it possible to determine the temperature regime of induction melting based on the SiO2 content in the slag and the distribution coefficient.
Checking the classifying ability of the obtained rule showed that it is high, since for all the numerical data of the factor-signs, both the high-temperature and low-temperature modes were classified correctly. The restrictions on the application of the classification rule are shown, among them: the restrictions imposed by the range of variation of the values of the attribute factors, and the restrictions imposed by the small sample of the initial data, as well as the arbitrary area of their distribution in the space of the factor-attributes.
The rule is presented in a normalized form, and also converted to natural form for ease of practical use.
Application of the rule can be recommended to technologists of metallurgical production of foundries to check the compliance of the technological process operations with the specified melting regulations. It can also be used to diagnose processes or temperature control systems that determine the quality of the resulting cast iron. To do this, it is enough to substitute the actual values of SiO2, and Kd into the classification rule. The value of the distribution coefficient Кd is calculated according to the actual data on the content of FeO and MnO in the slag
MODELING THE PROTECTION OF PERSONAL DATA FROM TRUST AND THE AMOUNT OF INFORMATION ON SOCIAL NETWORKS
Authors: Yevseiev Serhii , Laptiev Oleksandr , Lazarenko Sergii , Korchenko Anna , Manzhul Iryna
Published: February 2021

The article analyzes the parameters of social networks. The analysis is performed to identify critical threats. Threats may lead to leakage or damage to personal data. The complexity of this issue lies in the ever-increasing volume of data. Analysts note that the main causes of incidents in Internet resources are related to the action of the human factor, the mass hacking of IoT devices and cloud services. This problem is especially exacerbated by the strengthening of the digital humanistic nature of education, the growing role of social networks in human life in general. Therefore, the issue of personal information protection is constantly growing. To address this issue, let’s propose a method of assessing the dependence of personal data protection on the amount of information in the system and trust in social networks. The method is based on a mathematical model to determine the protection of personal data from trust in social networks. Based on the results of the proposed model, modeling was performed for different types of changes in confidence parameters and the amount of information in the system.
As a result of mathematical modeling in the MatLab environment, graphical materials were obtained, which showed that the protection of personal data increases with increasing factors of trust in information. The dependence of personal data protection on trust is proportional to other data protection parameters. The protection of personal data is growing from growing factors of trust in information.
Mathematical modeling of the proposed models of dependence of personal data protection on trust confirmed the reliability of the developed model and proved that the protection of personal data is proportional to reliability and trust
Morphological and molecular characterization of two species of Neothada Khan, 1973 (Nematoda: Tylenchidae) from Iran, with notes on N. cancellata
Authors: Hosseinvand Manouchehr , Eskandari Ali , Ghaderi Reza
Published: February 2021

Three species of the genus Neothada, including N. cancellata, N. hades and N. major, collected from the rhizosphere of mosses in Khuzestan, southwestern Iran, are redescribed and illustrated. Neothada hades and N. major are new records from Iran. Neothada hades has 14 longitudinal incisures excluding the lateral field, body length of 586 (505–674) µm, stylet 10.5 (10.0–10.8) µm in length bearing distinct basal knobs, and an elongated-conical tail 70.4 (65–74) µm long with a finely to bluntly rounded terminus. N. major possesses 18–20 longitudinal incisures excluding the lateral field, body length of 657 (600–728) µm, stylet 10.9 (10.3–11.7) µm long with basal swellings but not distinct knobs, and an elongated-conical tail 78.2 (70–83) µm long ending to a finely to bluntly rounded terminus. Molecular phylogenetic studies of the two species (N. hades and N. major) with 664 bp of D2-D3 expansion segments of 28 S rDNA revealed that they form a clade with N. cancellata.
Strengthening School’s Management Capacity for Better Education Outcomes in Eswatini: Calling for a Paradigm Shift
Authors: Zwane Sbongile Patricia Khumalo
Published: February 2021

This paper provides a critical analysis of the various competencies necessary for the development and training of effective principals in the light of the current school administrative and management practice in Eswatini. In order to provide a cadre of effective school administrators, it is important that administrators get equipped with a range of the essential administrative and management skills. The Eswatini education school system allows for ascendency into management and administrative positions without the requisite knowledge and experience. Promoted officers invariably tend to get presented with the learning-on-the-job kind of experiential management engagement. Yet the Principals and their Deputies are disproportionately critical in the facilitation and implementation of the current education reform processes. Furthermore, there seems to be rare if at all any occasions where they are assisted to deal with the “culture shock” in their new roles as Managers of schools —they are left to swim or sink on their own. This paper presents findings drawn from observations, experiential practice and interaction with some principals in the Manzini Region. It further suggests pathways for addressing the critical administrative and management gaps in the school education system. These include constructive utilization of pre-deployment capacity building forums, on the job training, supportive supervision, monitoring and evaluation for optimal educational outcomes. Keywords: Principals, Management, Administration, Development, Supportive Supervision, Monitoring, Evaluation & Educational Outcomes.
Triggers of Acute Asthma in Patients Attending Emergency Centre in a Peri-urban District Hospital, Johannesburg, South Africa
Authors: Musonda JMM
Published: February 2021

Introduction: Many avoidable triggers lead to acute asthma attack and subsequent visit to the emergency centre. The aim of the study was to determine triggers of acute asthma in order to target prevention efforts in patients attending emergency centre in a district hospital, Johannesburg, South Africa. Objectives were to describe acute asthma patients, identify triggers and severity at presentation. Methods involved a prospective descriptive cross-sectional study conducted from April to August 2015, in consenting adult participants. A researcher or trained assistant completed the semi-structured questionnaire in English. Results: Overall, 239 patients enrolled (139 males, 100 females with the median age 31 years). Majority presented with moderate acute asthma (52.72%). Active cigarette smoking (p-value<0.001) and/or passive cigarette smoking (p-value=0.004) were identified potential triggers for acute asthma attack. Chi-square or Fisher Exact test analysis were used for associations between variables and severity. Bivariate logistic regression was used to ascertain triggers associated with acute asthma attack. P-value < 0.05 was statistically significant. Confidence interval was 95%. There were no significant associations between the severity of acute asthma attack and acute respiratory infection (p-value=0.818), use of medication-related asthma triggers (p-value=0.942) and knowledge of asthma allergens (p-value =0.086). Conclusion: The majority patients presented in moderate acute asthma attack which was most probably triggered by active and/ or passive cigarette smoking. Hence, frequent visits to hospital in acute asthma attack could be minimized by removing avoidable triggers from households.
Mosquito-Avoidance Practices among Caregivers of Children Under Five in Somolu Local Government Area, Lagos State, Nigeria
Authors: OreOluwa Ojo
Published: February 2021

Malaria control efforts currently lay emphasis on reducing transmission by limiting human-vector contact. Meanwhile, Mosquito-Avoidance Practices (MAPs) have been shown to be sub-optimal in urban areas, especially among under-five children (U-5C), resulting in high child morbidity and mortality. This study was therefore designed to investigate MAPs among caregivers of U-5C living in Somolu; an urban Local Government Area (LGA) in Lagos State, Nigeria. A cross-sectional survey was conducted involving 394 female caregivers of U-5C. The LGA was stratified into three layers based on the level of planning and drainage using a geographic information system (GIS). Data were collected using a semi-structured, interviewer-administered questionnaire and were analysed using descriptive statistics and Chi-square test at p=0.05. Mean age of respondents was 33.6±7.7 years. The proportion who mentioned mosquito nets as a MAP by strata were: S1-59.3%, S2-80.7% and S3-64.3%. Other MAPs reported included: spraying insecticide: S1-20.5%, S2-26.3% and S3-17.1%, shutting door after sunset: S1-9.6%, S2-10.5% and S3-11.4%, and clearing surroundings: S1-2.9%, S2-5.3% and S3-2.9%. Ownership of bed nets was: S1-76.0%, S2-75.4% and S3-68.6%, and out of these, S1-73.1%, S2-70.7% and S3-72.4% reported that their child slept under the net the night before the survey. The most common mosquito-avoidance practice among caregivers of under-five children was the use of bed nets, and this did not differ by level of planning and drainage of the study site. Therefore, strategies to improve and sustain the use of bed nets and to promote the use of other effective mosquito-avoidance practices should be encouraged.
Lessons Learned from the Quality of Care Project
Authors: Chikwem Roy
Published: February 2021

Each year 40,000 women die during pregnancy and childbirth, and over 250,000 babies die in their first month of life in Nigeria. Save the Children International worked to improve the lives and health status of an estimated 435,000 mothers and their babies in Lagos and Jigawa over a period of three years through its Quality of Care (QoC) project in Nigeria. This integrated project drew on existing partnerships with national, state and global experts to strengthen essential training, improve the clinic environment including supervision and monitoring, develop and disseminate communication messages for behaviour change as well as advocate for implementation of transformative policies. A combination of document review, qualitative and quantitative data collection approaches were adopted. These data were then triangulated to respond to the objectives of the evaluation. The findings show that the project has changed the way healthcare is provided in target facilities in Jigawa and Lagos as a result of their participation on the project.
A Critical Analysis of the Effects of Strategic Management on Small Scale Businesses; A case study of Patent Medicine Stores in Abuja, Nigeria
Authors: Fadeyi Akinsola
Published: February 2021

The impact of strategic management in businesses cannot be over-emphasised irrespective of the size or nature of the business. The strategy provides the key to success in today’s changing business environment; hence, the success of a business can be traced to a well-pronounced factor, which is strategic management. As expressed by Jauch (2015), strategy formulation is a grand plan to be followed to achieve a set objective in small-scale businesses. For improved profitability and sustainability, small-scale businesses need to manage their operations intentionally. To utilise the limited resources effectively for higher profitability, small-scale businesses need a strategy; when resources are finite, when there is uncertainty about competitive strength and behaviour, when decisions must be coordinated between far places and overtime, and when there is uncertainty about control of initiative Miller (2013). However, the study critically analysed the effect of strategic management on small-scale businesses of Patent Medicine Stores in Abuja, Nigeria, especially in the 21st century. The methodology comprises the research and questionnaire design, data collection and data analysis techniques. The researcher was able to retrieve 53 questionnaires out of 70 and test the hypothesis using the chi-square method. From the result after the research, the researcher discovered that strategic management has a great effect on small-scale businesses of patent medicine stores in Abuja, Nigeria. Conclusively, business owners and managers must formulate policies and strategies if their businesses must continue to exist, serve and sustain competition.
Job Satisfaction among Hemodialysis and Labour Ward Nurses: A Comparative Descriptive Study
Authors: Komolafe Monisayo Olayemi
Published: February 2021

Introduction: Increasing CKD cases means higher demands for haemodialysis nurses. Haemodialysis nurses are required to fulfil many demanding roles such as advocate, caregiver, educator, mentor and technician while patients attend a dialysis unit. The complexities of the role that are performed by these nurses along with organization factors within the work environment have led to haemodialysis nurses experiencing high levels of burnout thus impacting on satisfaction derived from job done. Objectives: To compare job satisfaction among haemodialysis nurses with that of labour ward nurses and determine if the type of patient managed affects job satisfaction of nurses. Methodology: The multidimensional Job satisfaction scale designed and validated by Murat Ozpehlivan and Zafer Acar was used to determine job satisfaction among sixty-six hemodialysis nurses and sixty-four labour ward nurses in a cross sectional comparative descriptive study. Statistical significance difference between the two group of nurses attributed to events with a p-value lower than 5% (p < 0.05). Results: The overall mean job satisfaction score was higher among the labour ward nurses 67.95 ± 13.39 compared to the mean score among renal nurses 65.07 ± 14.24 (T= 1.81, p = 0.240). The mean score of labour ward nurses regarding satisfaction based on patient managed 74.51 ± 14.96 is higher than the mean score among renal participants of 71.21 ± 14.70 (T= 1.27, p = 0.201). Conclusion: Hemodialysis nurses in Nigeria are satisfied with the job they do and this is comparable to that of nurses in labour ward.
Post-partum spontaneous coronary artery dissection refractory to conservative management
Authors: Etchill Eric , Clarke Nicholas , Giuliano Katerine , Lawton Jennifer , Choi Chun Woo
Published: February 2021

This case report describes a 31-year-old female who was diagnosed with a spontaneous coronary artery dissection (SCAD) of her left anterior descending artery during the post-partum period. She failed nonoperative management and was found to have extensive propagation of the dissected vessel upon experiencing recurrent chest pain. She ultimately underwent coronary artery bypass grafting which restored perfusion and cardiac while motion. A brief discussion of the presentation, diagnosis, and management of SCAD follows.
Pulmonary artery banding in a modified Mustard operation improves biventricular geometry and function
Authors: Hosny Hatem , Said Faisal , Afifi Ahmed , Hassan Walaa , Nagy Mohamed , Romeih Soha , Yacoub Magdi
Published: February 2021

Patients with transposition of great arteries, with intact interventricular septum (TGA-IVS) and deconditioned left ventricle, represent a considerable challenge in developing countries. The modified Mustard operation was shown to provide a significant improvement for these patients, particularly by enhancing atrial functions and left ventricular filling. Yet, the problems of the systemic right ventricular dysfunction and the resulting secondary tricuspid regurgitation (TR) remain to be of major concern. In addition, the deviation of the interventricular septum towards the left side markedly impairs ventriculo-ventricular interaction and predisposes to dynamic left ventricular outflow tract obstruction (LVOTO). We report that adding a moderately loose pulmonary artery banding to the modified Mustard operation in a case of TGA-IVS results in improvement of biventricular geometry and function, tricuspid and mitral valve functions and disappearance of dynamic LVOTO.
Initial investigation of free-breathing 3D whole-heart stress myocardial perfusion MRI
Authors: Fair Merlin J , Gatehouse Peter D , Reyes Eliana , Adluru Ganesh , Mendes Jason , Khan Tina , De Silva Ranil , Wage Rick , DiBella Edward V , Firmin David N
Published: February 2021

Objective: Myocardial first-pass perfusion imaging with MRI is well-established clinically. However, it is potentially weakened by limited myocardial coverage compared to nuclear medicine. Clinical evaluations of whole-heart MRI perfusion by 3D methods, while promising, have to date had the limit of breathhold requirements at stress. This work aims to develop a new free-breathing 3D myocardial perfusion method, and to test its performance in a small patient population. Methods: This work required tolerance to respiratory motion for stress investigations, and therefore employed a “stack-of-stars” hybrid Cartesian-radial MRI acquisition method. The MRI sequence was highly optimised for rapid acquisition and combined with a compressed sensing reconstruction. Stress and rest datasets were acquired in four healthy volunteers, and in six patients with coronary artery disease (CAD), which were compared against clinical reference information.Results: This free-breathing method produced datasets that appeared consistent with clinical reference data in detecting moderate-to-strong induced perfusion abnormalities. However, the majority of the mild defects identified clinically were not detected by the method, potentially due to the presence of transient myocardial artefacts present in the images. Discussion: The feasibility of detecting CAD using this 3D first-pass perfusion sequence during free-breathing is demonstrated. Good agreement on typical moderate-to-strong CAD cases is promising, however, questions still remain on the sensitivity of the technique to milder cases.
Comparison of classifications of 2-dimensional local fields, type II
Authors:   St. Petersburg State University of Aerospace Instrumentation, Ivanova Olga Yu. , Zhukov Igor B. ,   St. Petersburg State University
Published: February 2021

The article contributes to the theory of elimination of wild ramification for 2-dimensional local fields. It continues the study of classification of complete discrete valuation fields introduced in the work of Masato Kurihara. The main object of study is a 2-dimensional local field K of mixed characteristic with a finite residue field of odd characteristic. If such a field is weakly unramified over its constant subfield k (the maximal usual local field inside it), i. e., if eK/k = 1, its structure is well known. It is also known that any 2-dimensional local field can be turned into a standard one by means of a finite extension of its constant subfield (Epp’s theorem). However, the estimate of the minimal degree of such extension is an open question in general. In Kurihara’s article the 2-dimensional are subdivided into 2 types as follows. Consider a non-trivial linear relation between differentials of the two local parameters of the field. The field belongs to Type I, if the valuation of the coefficient by the uniformizer is less than that by the second local parameter, and to Type II otherwise. This paper is devoted to the fields of Type II. For them we consider the invariant Δ, the difference between valuations of coefficients in the above mentioned linear relation (it is non-positive for the fields of Type II). The minimal degree of the required extension of k cannot be less than eK/k for trivial reasons. However, such extension of degree eK/k does not exist in general. In this article it is proved that it exists if the absolute value of Δ is sufficiently large. The corresponding estimate for Δ depends only on eK/k.
Specifics of Project Management of Development and Implementation of DPO Programs in Universities: Role of Educational and Scientific Centers
Authors: Kulapov M. N. , Karasev P. A. , Fateev M. A. , Słoniec J.
Published: February 2021

In the article the features of organization of the system of supplementary education in Russian universities in the conditions of modern reality are considered. Among them are the accelerating shift of professions, the concept of "long life learning", the digitalization of all spheres, including education, as well as a stable segment of the programs of professional education in the educational portfolio of a university is needed for its of sustainable competitiveness. As an example, there are proposed some perspective forms of organization of educational and scientific process which are new for the Russian practice of managing education. One of these forms could be an educational-scientific center in a university as a union of the departments and research units in the relevant subject area, structurally separated from the classical forms of faculty and completely different from it. The last one is classically managed individually, collegially or on the basis of linear-functional approach, especially in Russia. The education & science center of Management in the Plekhanov Russian University of Economics is given as an example. It is a really successful division of the university, which has a confidently leading position in the internal rating system for KPI and a stable portfolio of orders for research and vocational programs for the corporate segment, which ensures the implementation of financial plans and guarantees the sustainability of a university’s budget. The article provides generalized practical recommendations for building the processes of development, promotion and implementation of vocational programs, taking into account the differentiation by basic target groups of consumers (students), diverse technologies for their training and creating basic versions of the educational products.
Bifurcation of Corporate Management: Traditional and Innovation Logics
Authors: Sadykova X. V.
Published: February 2021

In conditions of the global management crisis caused by COVID-19 the issues dealing with management efficiency become especially topical. Integrated corporate structures embracing big banks and corporations make the basis both for economic and political force. Though the disintegration strategy is becoming more and more popular, multinational companies are not weakened and continue influencing governments of many countries of the world. Decisions made in these organizations can impact not only economy of a certain country, its ecology, social policy but often the future of states and regions. That is why corporate strategies, which should be relevant to present day realities, become so important. Today the majority of integrated corporate structures stick to traditional logics in corporate management realizing it within the frames of Freedman theory. The article compares and summarizes traditional and innovation theories of corporate management, shows their advantages and drawbacks, analyzes the experience of big global companies and provides legal substantiation of splitting responsibility inside corporations. An attempt was made to prove groundlessness of traditional logics of profit maximization in today’s world and to identify ways to shifting focus to the company development.
The Opposite Orientation of Product Marketing and Finance Tool Marketing
Authors: Galanov V. A. , Galanova A. V.
Published: February 2021

Product marketing orientates to the increasing appeal of customer goods, while finance tool market – to rising appeal of private saving investment. The authors show that these two forms of marketing hide competition between the growth in consumption and the growth in investment in today’s economy. The growth in consumption reduces relatively the resources of economy for GDP growth, while the growth in investment cut resources providing the rise in population living standard. Ways and methods of marketing available on market do not necessarily promote shaping of reasonable structure and volumes of consumption. No marketing methods of raising finance investment can compete with appeal of private consumption, because of the essence of consumption itself and because of relatively low volume of private savings of the Russian population. This situation, according to the authors, forms an economic basis of maintaining rather low rates of GDP growth in the future.
Analyzing the Draft Federal Budget of Russia for 2021–2023: Sources of Financing and Mechanism of Overcoming Finance Challenges
Authors: Alieva Z. B.
Published: February 2021

The subject of the research is global processes dealing with pandemic. Measures aimed at curbing the corona-virus infection spread caused an unprecedented decline in economic activity in the world and in Russia, resulted in a serious drop in raw material and finance markets, decrease in revenues of budgets and incomes of people. The article analyzes key figures of the draft federal budget for 2021 and the planned period of 2022–2023. The focus is made on social obligations of the federal budget for the planned period, which are not subjected to sequestrating and dynamics of sequestrating federal budget expenses on national projects financing in 2021–2022 is given. The article shows key lines in implementing the program of mobilizing the profit part of the federal budget. The author proposed one way of overcoming finance challenges on the regional level, i.e. the card system of food distribution. In this context the article provides the overseas and home experience in theory and practice of the issue, gives ideas of Russian economists – supporters and opponents of social food cards. Designing budget on the basis of mentioned-above approaches could support economy in the period of restoration and promote reaching the national goals of development, i. e. the growth in real incomes of the population, cutting the level of poverty, providing conditions for healthy, comfortable life of Russian citizens.
Trends of Regional Banking System Develoment (Illustrated by entities of the North-West Federal Area)
Authors: Pechenskaya-Polishchuk M. A. , Volkov A. A.
Published: February 2021

The article studies the lines in the development of banking system in regions of the North-West Federal Area. By analyzing the banking system on the regional level within the period being researched the authors identified such key trends as a decline in the number of regional banks, a growth in the total profit of the banking system in the federal area, a rise in the volume of credits granted to individuals, legal entities and individual entrepreneurs, a drop in credits given to entities of small and medium entrepreneurship, a cut in interest rates of credits to legal entities and a sharp increase in overdue debt under credit on mortgage. On the basis of the analysis the key figures of the banking system on the regional level (illustrated by regions of the North-West federal area) the authors identified negative and positive trends, which allowed them to substantiate the key lines in the development of regional banking system. The principle findings of the research can be useful for management of regional banks and state authorities. Such methods as comparative analysis, longitude, synthesis, system analysis and economic-statistic methods were used in the research.
Strategic Landmarks for Small Business Development in Pandemic
Authors: Baurina S. B.
Published: February 2021

Today small business functions in conditions of continuously changing external environment. This situation of uncertainty is more typical of Russian business environment than of countries with relatively stable social, economic and political structure. Today’s crisis standing of economy seriously influences small business functioning and stipulates changes in strategies of its development. The article identifies measures of state support of small business in the period of pandemic. Preferences of small business representatives concerning state support during pandemic were assessed. Sectors of business, which were damaged most of all in present conditions: tourism, hospitality and restaurant business, sphere of leisure, entertainment and sport. The necessity to respond quickly and adapt to negative conditions of external environment was grounded for small enterprises. Different variants of strategy for small business development in Russia were proposed, such as strengthening market positions, extension of market, entering the new market with existing product, diversification. The article gives a brief characteristic of these strategies and identifies factors of choosing them. Apart from that it studies possible strategies of business growth oriented to sale increase: selling to effective clients, extension of the client base, introduction of new offers (new products or services). Brief and at the same time deep analysis of the current situation requires the availability of the crisis team focusing on key problem solving.
Medidas de Acessibilidade a Oportunidades em Estudos Urbanos
Authors: Hishiyama Jefferson , Gonzales Taco Pastor Willy
Published: February 2021

Este estudo tem como objetivo identificar as abordagens de mensuração da acessibilidade, seus indicadores e principais temas de aplicação nos sistemas de uso do solo e transportes. Por meio de método híbrido de revisão sistemática da literatura e análise bibliométrica de redes de acoplamento bibliográfico, foram selecionadas 54 publicações e identificados 7 temas de aplicações (transporte público, sistemas de transporte, planejamento urbano, uso do solo, ambiente construído, análises econômicas e novas tecnologias). Verificou-se a versatilidade das medidas de acessibilidade em estudos urbanos e observou-se maior oportunidade de contribuição científica em temas emergentes relacionados a novas tecnologias e suas implicações no planejamento urbano e de transportes.
Association between Breastfeeding and Parental Socioeconomic Status: Analysis of the Korean National Health and Nutrition Examination Survey, 2013–2017
Authors: Byun Joung-Hee , Lee Jusuk , Kim Taehong
Published: February 2021

Purpose: The importance of breastfeeding is well known. Socioeconomic status is one of the factors affecting breastfeeding. We investigated the association between breastfeeding and parental socioeconomic status to help design future breastfeeding promotion projects.Methods: Data on demographic characteristics and socioeconomic status of parents of 1,220 children aged under 60months were extracted from the 2013–2017 Korea National Health and Nutrition Examination Survey.Results: Some socioeconomic factors were associated with breastfeeding. Maternal factors such as education level (≥13 years: odds ratio [OR], 2.79; 95% confidence interval [CI], 1.21–6.42), middle high income level (OR, 2.30; 95% CI, 1.18–4.49), no smoking status (OR, 3.07; 95% CI, 1.28–7.36) and body mass index (BMI) (<25 kg/m2 : OR, 1.82; 95%CI, 1.12–2.95) were associated with breastfeeding (p<0.05). In addition, paternal factors such as age (30s: OR, 4.88; 95%CI, 1.82–13.04) and education level (≥13 years: OR, 7.94; 95% CI, 3.12–20.18) were associated with breastfeeding (p<0.05). After controlling for confounding factors, mother’s BMI, father’s age, and father’s educational level were found to be statistically significant predictors of breastfeeding.Conclusion: This study demonstrated that some parental socioeconomic factors were associated with breastfeeding in Korea.
The Effect of Domperidone Toward Breast Milk Production on Sectio Caesarea Mother
Authors: Dinengsih Sri , Suralaga Cholisah
Published: February 2021

Mothers that give birth with section caesaria (SC) often experience difficulty to get a adequate breast milk production. Various kinds of effort have been conducted to overcome this problem, including pharmacological intervention. One of the medicines that could be possibly used is domperidon. Domperidon is an antagonist receptor of peripheral dopamine that works by choking inhibition effect of prolactin secretion facilitated by dopamine to improve breast milk production.The research aimed to unveil the effect of domperidon toward breast milk production on mother that give birth with SC in Indonesia. This is a quasi-experiment research with two groups post-test only design. The sample of this research 30 were post sectio caesarea patients consisting of 15 patients in intervention group and 15 patients in control group. Purposive sampling was used in the research to get the samples. The instrument used was observation sheets. Result analysis was conducted by calculating the frequency distribution and bivariate analysis with Mann Whitney test. The average score of breast milk production among post-SC mother in the intervention group was 22,60, while the average score of breast milk production among post-SC mother in control group was 15,47, Asymp. value Sig (2 tailed) 0,020 (0,020 < 0,05). Domperidone has been approved to have a significant effect to improve breast milk production on post-SC mothers. Improving breast milk production could be conducted non-pharmacologically, but pharmacological therapy could also be considered if the non-pharmacological therapy doesn’t work well in improving breast milk production.
Effect of Yoga Exercise on Cortisol Hormone Levels in Pregnant Women in Kinik Pratama Asih Waluyojati Banguntapan Bantul Yogyakarta
Authors: Kumorojati Ratih , Alfie Alfie , Warseno Agus
Published: February 2021

Maternal mortality rates in 2016 rose compared to 2015. The causes of maternal death in 2016 were Severe Preeclampsia (PEB) as much as 33% (4 cases), Bleeding by 17% (2 cases), Heart Failure 17% (2 cases), Sepsis 17% (2 cases) and Other 16% (2 cases). Some studies state that preeclampsia occurs due to the influence of anxiety during pregnancy. Pregnancy is a period of crisis that involves also psychological factors, hormonal changes causing the mother's emotions to become lame. In addition to physical factors, psycho social factors can add anxiety in pregnant women. High stress in pregnancy can increase stress hormones, it can also lead to increased blood pressure and birth weight loss. Prevention can be done by pregnant women to have a healthy condition both the mother and her fetus, as well as through the normal labor process that is by exercising, gymnastics, dancing, and yoga. At this time yoga becomes one of the self help that can support the process of pregnancy, birth. Physiological of yoga performed during pregnancy is reversing the effects of stress involving the parasympathetic part of the central nervous system. The effects of such stress will be inhibited by relaxation, so that the hormones that cause body dysregulation (cortisol) will be reduced in number. The hormone cortisol is an increased hormone in anxiety so by masterminding this hormone can lower the anxiety levels of pregnant women which has an impact on the decreased risk of PEB. Look at the effect of Yoga exercise on cortisol hormone levels in pregnant women. This type of quantitative research is True Experimental research method, with Posttest-Only Control Group Design. Respondents who used pregnant women who participated in prenatal yoga, samples taken with the Formula Freeder obtained 16 pregnant women with control as many as 16. Data analysis was performed using the Pearson Chi-Square test with a result of p <0.00 which indicates a correlation. There is an effect of yoga on cortisol levels in pregnant women.
Hidden Variables in Deep Learning Digital Pathology and Their Potential to Cause Batch Effects: Prediction Model Study
Authors: Schmitt Max , Maron Roman Christoph , Hekler Achim , Stenzinger Albrecht , Hauschild Axel , Weichenthal Michael , Tiemann Markus , Krahl Dieter , Kutzner Heinz , Utikal Jochen Sven , Haferkamp Sebastian , Kather Jakob Nikolas , Klauschen Frederick , Krieghoff-Henning Eva , Fröhling Stefan , von Kalle Christof , Brinker Titus Josef
Published: February 2021

Background

An increasing number of studies within digital pathology show the potential of artificial intelligence (AI) to diagnose cancer using histological whole slide images, which requires large and diverse data sets. While diversification may result in more generalizable AI-based systems, it can also introduce hidden variables. If neural networks are able to distinguish/learn hidden variables, these variables can introduce batch effects that compromise the accuracy of classification systems.

Objective

The objective of the study was to analyze the learnability of an exemplary selection of hidden variables (patient age, slide preparation date, slide origin, and scanner type) that are commonly found in whole slide image data sets in digital pathology and could create batch effects.

Methods

We trained four separate convolutional neural networks (CNNs) to learn four variables using a data set of digitized whole slide melanoma images from five different institutes. For robustness, each CNN training and evaluation run was repeated multiple times, and a variable was only considered learnable if the lower bound of the 95% confidence interval of its mean balanced accuracy was above 50.0%.

Results

A mean balanced accuracy above 50.0% was achieved for all four tasks, even when considering the lower bound of the 95% confidence interval. Performance between tasks showed wide variation, ranging from 56.1% (slide preparation date) to 100% (slide origin).

Conclusions

Because all of the analyzed hidden variables are learnable, they have the potential to create batch effects in dermatopathology data sets, which negatively affect AI-based classification systems. Practitioners should be aware of these and similar pitfalls when developing and evaluating such systems and address these and potentially other batch effect variables in their data sets through sufficient data set stratification.
Association of Electronic Health Record Vendors With Hospital Financial and Quality Performance: Retrospective Data Analysis
Authors: Beauvais Bradley , Kruse Clemens Scott , Fulton Lawrence , Shanmugam Ramalingam , Ramamonjiarivelo Zo , Brooks Matthew
Published: February 2021

Background

Electronic health records (EHRs) are a central feature of care delivery in acute care hospitals; however, the financial and quality outcomes associated with system performance remain unclear.

Objective

In this study, we aimed to evaluate the association between the top 3 EHR vendors and measures of hospital financial and quality performance.

Methods

This study evaluated 2667 hospitals with Cerner, Epic, or Meditech as their primary EHR and considered their performance with regard to net income, Hospital Value–Based Purchasing Total Performance Score (TPS), and the unweighted subdomains of efficiency and cost reduction; clinical care; patient- and caregiver-centered experience; and patient safety. We hypothesized that there would be a difference among the 3 vendors for each measure.

Results

None of the EHR systems were associated with a statistically significant financial relationship in our study. Epic was positively associated with TPS outcomes (R2=23.6%; β=.0159, SE 0.0079; P=.04) and higher patient perceptions of quality (R2=29.3%; β=.0292, SE 0.0099; P=.003) but was negatively associated with patient safety quality scores (R2=24.3%; β=−.0221, SE 0.0102; P=.03). Cerner and Epic were positively associated with improved efficiency (R2=31.9%; Cerner: β=.0330, SE 0.0135, P=.01; Epic: β=.0465, SE 0.0133, P<.001). Finally, all 3 vendors were associated with positive performance in the clinical care domain (Epic: β=.0388, SE 0.0122, P=.002; Cerner: β=.0283, SE 0.0124, P=.02; Meditech: β=.0273, SE 0.0123, P=.03) but with low explanatory power (R2=4.2%).

Conclusions

The results of this study provide evidence of a difference in clinical outcome performance among the top 3 EHR vendors and may serve as supportive evidence for health care leaders to target future capital investments to improve health care delivery.
Constructing an Adapted Cascade of Diabetes Care Using Inpatient Admissions Data: Cross-sectional Study (Preprint)
Authors: Ryan Irene , Herrick Cynthia , Ebeling Mary F E , Foraker Randi
Published: February 2021

BACKGROUND

The diabetes mellitus cascade of care has been constructed to evaluate diabetes care at a population level by determining the percentage of individuals diagnosed and linked to care as well as their reported glycemic control.

OBJECTIVE

We sought to adapt the cascade of care to an inpatient-only setting using the electronic health record (EHR) data of 81,633 patients with type 2 diabetes.

METHODS

In this adaptation, linkage to care was defined as prescription of diabetes medications within 3 months of discharge, and control was defined as hemoglobin A1c (HbA1c) below individual target levels, as these are the most reliably captured items in the inpatient setting. We applied the cascade model to assess differences in demographics and percent loss at each stage of the cascade; we then conducted two-sample chi-square equality of proportions tests for each demographic. Based on findings in the previous literature, we hypothesized that women, Black patients, younger patients (<45 years old), uninsured patients, and patients living in an economically deprived area called the Promise Zone would be disproportionately unlinked and uncontrolled. We also predicted that patients who received inpatient glycemic care would be more likely to reach glycemic control.

RESULTS

We found that out of 81,633 patients, 28,716 (35.2%) were linked to care via medication prescription. Women and younger patients were slightly less likely to be linked to care than their male and older counterparts, while Black patients (n=19,141, 23.4% of diagnosed population vs n=6741, 23.5% of the linked population) were as proportionately part of the linked population as White patients (n=58,291, 71.4% of diagnosed population vs n=20,402, 71.0% of the linked population). Those living in underserved communities (ie, the Promise Zone) and uninsured patients were slightly overrepresented (n=6789, 8.3% of diagnosed population vs n=2773, 9.7% of the linked population) in the linked population as compared to patients living in wealthier zip codes and those who were insured. Similar patterns were observed among those more likely to reach glycemic control via HbA1c. However, conclusions are limited by the relatively large amount of missing glycemic data.

CONCLUSIONS

We conclude that inpatient EHR data do not adequately capture the care cascade as defined in the outpatient setting. In particular, missing data in this setting may preclude assessment of glycemic control. Future work should integrate inpatient and outpatient data sources to complete the picture of diabetes care.
What do malaysian think of the quality of healthcare delivered?: a qualitative analysis of written impression (Preprint)
Authors: Zulkifli Nur Wahida
Published: February 2021

BACKGROUND

The public opinion and experience on the health care services are crucial to provide valuable insight towards improving and strengthening the health care systems.

OBJECTIVE

This study aims to explore the public perspective regarding the quality of health care services rendered by the health care facilities in Malaysia.

METHODS

The snowballing strategy was used to reach the target through an online opinion poll with three open-ended questions on the strengths of the healthcare facilities, their expectation and suggestion for improvement along with the sociodemographic characteristic. Data were analysed using a thematic approach.

RESULTS

A total of 800 participants (68% of females and 32% of males) participated. Their responses were grouped into 5 main themes namely: (1) system; (2) input; (3) service delivery; (4) outputs; (5) outcomes. Public feel that they are respected and treated with care by the healthcare providers. However, most of the participants highlighted the issue of long waiting time when they visited healthcare facilities. In relation to this issue, they suggested the facilities to have more staff especially doctors to improve current service.

CONCLUSIONS

In conclusion, enhancing service delivery by reducing the waiting time, should be the main focus as viewed by the public. The quality of services provided would certainly be improved by having sufficient resources including healthcare workers.
A Mobile App for Self-Triage for Pediatric Emergency Patients in Japan: 4 Year Descriptive Epidemiological Study (Preprint)
Authors: Katayama Yusuke , Kiyohara Kosuke , Hirose Tomoya , Matsuyama Tasuku , Ishida Kenichiro , Nakao Shunichiro , Tachino Jotaro , Ojima Masahiro , Noda Tomohiro , Kiguchi Takeyuki , Hayashida Sumito , Kitamura Tetsuhisa , Mizobata Yasumitsu , Shimazu Takeshi
Published: February 2021

BACKGROUND

When children suffer sudden illness or injury, many parents wonder whether they should go to the hospital immediately or call an ambulance. In 2015, we developed a mobile app that allows parents or guardians to determine the urgency of their child’s condition or call an ambulance and that indicates available hospitals and clinics when their child is suddenly sick or injured by simple selection of the child’s chief complaints and symptoms. However, the effectiveness of medical apps used by the general public has not been well evaluated.

OBJECTIVE

The purpose of this study was to clarify the use profile of this mobile app based on data usage in the app.

METHODS

This study was a descriptive epidemiological study with a 4-year study period running from January 2016 to December 2019. We included cases in which the app was used either by the children themselves or by their parents and other guardians. Cases in which the app was downloaded but never actually used were excluded from this study. Continuous variables are presented as median and IQR, and categorical variables are presented as actual number and percentages.

RESULTS

The app was used during the study period for 59,375 children whose median age was 1 year (IQR 0-3 years). The app was used for 33,874 (57.05%) infants, 16,228 (27.33%) toddlers, 8102 (13.65%) elementary school students, and 1117 (1.88%) junior high school students, with 54 (0.09%) having an unknown status. Furthermore, 31,519 (53.08%) were male and 27,329 (46.03%) were female, with sex being unknown for 527 (0.89%) children. “Sickness” was chosen for 49,101 (78.51%) patients, and “injury, poisoning, foreign, substances and others” was chosen for 13,441 (21.49%). For “sickness,” “fever” was the most commonly selected option (22,773, 36.41%), followed by “cough” (4054, 6.48%), and “nausea/vomiting” (3528, 5.64%), whereas for “injury, poisoning, foreign substances and others,” “head and neck injury” was the most commonly selected option (3887, 6.22%), followed by “face and extremities injury” (1493, 2.39%) and “injury and foreign substances in eyes” (1255, 2.01%).

CONCLUSIONS

This study clarified the profile of use of a self-triage app for pediatric emergency patients in Japan.