bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Study of Corrosion, Mechanical and Electrical Characteristics of Tungsten inert Gas and Friction Stir Welded Joints
Authors: Kulkarni Bhardwaj , Pankade Sandeep
Published: March 2023

Aluminium alloys are welded using both tungsten inert gas welding (TIG) and friction stir welding (FSW). FSW doesn’t need any filler material and shielding gas which results in reduced degradation of the environment. In the present study, joints with FSW and TIG processes were compared in terms of microstructure, corrosion resistance, mechanical, and electrical properties. With a microstructural study, the average grain size of various regions was determined. Coarse grain increases the rate of exfoliation corrosion. The fine grain structure in the FSW stir zone increases the hardness. The coarse grains are a prerequisite for enhanced electrical conductivity. The coarse grains in the heat-affected zone and thermomechanically affected zones of FSW joints increase electrical conductivity. In the case of friction stir welded joints, there is an inverse relationship between hardness and electrical conductivity. As hardness increases, electrical conductivity decreases, and vice versa. Hence, in the case of FSW hardness test can be substituted by an electrical conductivity test. In the case of TIG, no relation was found between hardness and electrical conductivity. High Silicon content at the weld region of TIG significantly reduces electrical conductivity.
A systematic literature review on multi-criteria decision making in higher education
Authors: YÜKSEL Fatma Şeyma , KAYADELEN Ayşe Nilgün , ANTMEN Figen
Published: March 2023

The three components that form the basis of the educational process are the teacher, the learner, and the environment. These three components are affected by the developing and changing technology as a result of globalization considerably. Teaching and learning techniques should be updated and connected with these developments; new tools are therefore needed to make the necessary updates. Determination and application of the new tools include many decisions. Decision-makers can make more effective decisions using Multi-Criteria Decision-Making Techniques (MCDM), a complex decision-making tool that includes both quantitative and qualitative factors at present time. This study aimed to determine which MCDM methods are used in studies conducted in higher education, which is one of the most important development level indicators of countries, and to present a systematic literature review of MCDM method applications. The study was conducted in three stages: first, known electronics were searched until the end of 2021 using keywords; then, all studies were listed in a systematic taxonomy, and in the last stage, Thematic Network Analysis was used to evaluate the development of MCDM studies in the higher education area. It is determined that the Analytical Hierarchy Process (AHP) method is the most widely used method in higher education in MCDM applications. It was observed that the most common use of MCDM applications in higher education is e-learning as well. This study aims to be a guide for all researchers and practitioners who will study in both higher education and the MCDM areas.
The Influence of Preparation Parameters on Structural and Optical Properties of N-Type Porous Silicon
Authors: M'hammedi Kawther , Gabouze Noueddine
Published: March 2023

In this paper, we describe the formation of macroporous silicon (MPS) formed anodically polarized on n type Si (100) substrates at a constant current density under front side illumination using two electrolytes, HF/Ethanol and HF/Ethanol/H2O2. The effect of adding H2O2 in the solution on the resulting pores were investigated by scanning electron microscopy (SEM), infrared spectroscopy (FTIR), contact angle measurements and UV-vis spectrophotometry. The results showed that for the anodization conditions the MPS formed in peroxide based (H2O2)/HF/Ethanol solution exhibited structures with larger pore size and different pore morphologies depending on the etching time than those formed in HF/Ethanol. The pore density and the pore size of the MPS samples increased with the etching time. The infrared absorption spectrum (FTIR) carried out on the freshly prepared sample indicates that the MPS contains Si-Hx bonds which decrease with increasing the etching time. Finally, measurements of contact angle indicate that the formed MPS samples are highly hydrophobic.
Larvicidal Activity of Calcium Alginate Microcapsules Containing Clove Essential Oil Obtained by Microfluidics
Authors: Condé Débora , Mendes Luiza , Ramos Guilherme , Silva Rafael , Teixeira Alvaro , Teixeira Róbson Ricardo , Martins Gustavo , Cerceau Cristiane , Lopes Renata
Published: March 2023

Essential oils (EO) have diverse applications, such as antibacterial and antifungal activity. However, they are susceptible to oxidation in the presence of air, light, and moisture. In addition, they are thermally unstable. In this sense, it is necessary to develop techniques to increase the lifespan of EO. In this work, EO was obtained from cloves and characterized by different techniques. The major compounds found were eugenol (83%), eugenol acetate (9%), and β-caryophyllene (8%). The EO was encapsulated by extrusion using a microfluidic device. The sodium alginate was used as wall material, and the CaCl2 solution was used as a crosslinking agent. The microcapsule presented sizes of 164.7 ± 0.3 µm, with an encapsulation yield of 64 ± 14%. Functional characteristic groups of EO were observed in the microcapsule by infrared and Raman spectroscopies. The microcapsule increased the thermal decomposition of the EO from 162 to 230 °C. Release kinetics of the capsule was performed, with an equilibrium time of 72 h and release of 54% of the EO. Finally, the pure EO and encapsulated EO-microcapsules were applied in the Aedes aegypti larvae control, showing mean lethal concentration necessary to eliminate 50% (LC50) values of 74.4 and 96.9 µg mL-1 and lethal concentration necessary to eliminate 90% (LC90) of 106.2 and 133.3 µg mL-1 for pure EO and encapsulated EO, respectively. Therefore, it was concluded that these microcapsules have the potential for application in the Aedes aegypti larvae control.
Brief History of K-12 Computer Science Education in Ireland
Authors: Faherty Roisin , Nolan Karen , Quille Keith , Becker Brett , Oldham Elizabeth
Published: March 2023

This paper brings together the history of Computer Science Education in Ireland. It aims to plot Ireland's road-map leading to the implementation of formal Computer Science Education in schools. This road map starts with the first notions of introducing secondary school children to computing in the 1970s up to the roll out of a nationwide Computer Science curriculum in secondary school at the Senior Cycle level in 2018. This story is only available in disparate publications and reports, and piecing together the entire story is often difficult especially if you are from another jurisdiction and unfamiliar with the Irish education system. This paper collates the available literature as well as the authors local knowledge of the process, into one usable form that may be of interest locally and of value to other jurisdictions that are beginning their planning of national or regional curricula. This paper describes the development and the current situation of the formal curricula and standards in Computer Science at second level. The current landscape of Computing Education at primary level, which is currently in the planning stages in Ireland, will also be described. Additionally, an investigation into the current landscape of Computing Education in schools in the international jurisdictions that directly influenced the Irish roll out takes place, to evaluate their progress and summarize any lessons learned that might provide insights for Ireland going forward
Art and geology in the Renaissance: Leonardo da Vinci, Alberto Durero and Georgius Agricola
Authors: Martínez Frías Jesús , Martínez Martín Jesús Enrique
Published: March 2023

The Renaissance was a human time period in which culture stood out as a common whole. It was based on a humanistic and integrative cosmovision of mankind in the framework of nature and the universe. This article synthetically describes and analyses the relationships between Art and Geology through three exceptional and illustrative Renaissance figures: Leonardo da Vinci, Albert Dürer and Georgius Agricola. In the first two, making an approach from Art to Geology and in the latter, from Geology to Art. Leonardo is, unquestionably, the quintessential polymath and a pioneer, among other areas of knowledge, in geology and geosciences. His global contributions will be described using his own phrases, writings, drawings and paintings. In the case of Dürer, his famous work, Melancholy I, will be the main focus of study, specifically with reference to the mineralogical hypothesis regarding his enigmatic polyhedron. Thirdly, Agricola will be uncovered through his famous work, “De Re Metallica”. He was a scientist and an engineer, but also a pioneer in geology and mineralogy who used drawings to complement his geoscientific contributions. Finally, this Renaissance thematic connection will be compared to today’s world situation. It has been suggested that Digital Age could correspond to a new period similar to the Renaissance, where innovation and creativity merging Art, Science and Technology, would be enhanced and benefited from a context of global education and communication.
Geology and literary fiction
Authors: Ordaz Gargallo Jorge
Published: March 2023

In this article the relations between geological sciences and literature of fiction, especially with science-fiction, are reviewed. The consolidation of geology as a scientific specialization in the first half of XIXth century attracted some writers of adventure and fantasy novels who used, among other topics, matters based on geological knowledge. Some of the most representative works in this field, published in the XIXth and XXth centuries, by authors as Jules Verne, Arthur Conan Doyle, Edgar Rice Burroughs, H. P. Lovecraft, Vladimir Obruchev, Arthur C. Clarke, George Gaylord Simpson and Sarah Andrews, are mentioned. Their contributions are divided in sections according to the aspects involved: the hollow Earth and the exploration of its inner part; the lost worlds (superficial, subterranean and extraterrestrial), inhabited by extinct animals; the prehistoric times and its antediluvian fauna; trips to other geological epochs, above all the Mesozoic times of the great dinosaurs; volcanoes, earthquakes and other natural disasters; and mines and mineral deposits. Finally, the geology of certain literary territories and the geologist, men or women, as a main character in fiction are also taken into account.
Artists in the mines, quarries and saltworks. Land art or earthworks and ecological art
Authors: Puche Riart Octavio , Ayarzagüena Sanz Mariano
Published: March 2023

At the end of the 60s of the 20th century, a group of mostly Anglo-Saxon artists began a series of works in a context of social struggle and the beginning of the environmental movement that gave rise to what has been called land art and earthworks. Since then these initiatives have had extensive development. The historical study of these works, their symbolic meaning, their impact on the development of contemporary art and the role played as an engine of  development of the territories where such works have been carried out will be the main objective of this work.These artistic works are executed on the territory and remain inextricably linked to it, where man leaves his mark on nature. They are actions that build, destroy or modify the landscape to a greater or lesser extent, since they frequently acquire large dimensions. Since the end of the 20th century, some artistic interventions will be carried out to revalue the landscape of mines, quarries and salt mines, particularly after its closure. It can be said that these works show a certain ephemeral character, depending on the qualities of the geological materials and the climate, being exposed to the direct action of the meteors, and in any case, it is an outdoor art.Ecological or environmental artists will see their initiatives enhanced after the approval of the first protectionist laws in the 70s. These artists work in mines and quarries, mainly from the point of view of landscape and environmental recovery.
Evolution of Immunotherapy Against Pollen Allergy
Authors: Gianni Mistrello
Published: March 2023

Allergic diseases have increased worldwide during the last century and are a major disease
burden globally. Several substances can induce allergic sensitization and elicit allergic symptoms in
sensitized individuals. Pollen grains are one of the main causes of allergic rhinitis and asthma, and the
prevalence of different pollen species depends on the climate, geographical regions, flora, and seasons.
In addition to avoiding exposure to pollens, anti-allergic drugs are commonly used to mitigate the
symptoms of allergies. However, these drugs need to be administered repeatedly as long as the symptoms
prevail, usually life-long. Allergen immunotherapy (AIT) is currently the only disease-modifying
approach that can prevent the natural progression of the disease (also known as an allergic march),
provide a long-lasting therapeutic effect, and prevent the worsening of the symptoms and the occurrence
of new sensitizations in allergic individuals. Since the pioneering clinical studies conducted more
than 100 years ago using subcutaneously administered pollen extract to treat hay fever, significant advances
have been made in the field of AIT. Starting from this pioneering approach, in this review, we
have discussed the evolution of the products used for AIT with particular emphasis on pollen allergoids,
the chemically modified pollen extracts characterized by lower allergenicity and comparable
immunogenicity, and the different routes of administration used for AIT.
To Evaluate the Association Between Serum Concentration of Vitamin
D and Chronic Periodontitis in Non-menopausal Females: A Clinico
Biochemical Study
Authors: Kaur Jasleen , Kaur Supreet , Sarangal Vandana , Singh Narang Raman Deep , Singh Sahib Tej , Khindri Danish
Published: March 2023

Background:

Periodontal disease’s initiation and propagation is through a dysbiosis of
the commensal oral microbiota. But recently, through the extraordinary progress, the interrelationship
that exists between periodontal disease and systemic health has been unveiled.
Through various studies, it has been revealed that vitamin D deficiency may be associated with a
greater risk of developing chronic periodontitis and vitamin D supplementation may help to preserve
periodontal health.

Aim:

To find a co-relation between 25-hydroxy vitamin D status and the severity of periodontal diseases.
To evaluate and compare the effect of non-surgical periodontal therapy alone and in combination
with vitamin D supplementation in reducing the severity of periodontal diseases.

Methods:

The present study was conducted on 90 non-menopausal female subjects who divided
into 3 groups. Group I comprised of healthy controls. Group II comprised of patients with moderate
chronic periodontitis who were assigned to receive only Scaling and root planing (SRP). While
group III included patients with moderate chronic periodontitis who were assigned to receive SRP
along with Vitamin D supplementation. The periodontal parameters and serum levels of 25-
hydroxy vitamin D were recorded for all the participants at baseline. Group II and group III participants
were reassessed at an interval of 3 months post-treatment.

Results:

The results indicated that vitamin D deficiency affected periodontal health negatively.
Statistically highly significant improvement was observed in Group III as compared to group II,
signifying the efficacy of vitamin D supplementation adjunctive to SRP.

Conclusion:

Regular evaluation of Vitamin D levels and supplementation to treat the deficiency
may have potential periodontal health benefits.
Inhibiting Monoamine Oxidase in CNS and CVS would be a Promising Approach to Mitigating Cardiovascular Complications in Neurodegenerative Disorders
Authors: Srivastava Princika , Sudevan Sachithra Thazhathuveedu , Thennavan Arumugam , Mathew Bijo , Kanthlal S.K.
Published: March 2023

The flavoenzyme monoamine oxidases (MAOs) are present in the mitochondrial outer
membrane and are responsible for the metabolism of biogenic amines. MAO deamination of biological
amines produces toxic byproducts such as amines, aldehydes, and hydrogen peroxide, which are significant
in the pathophysiology of multiple neurodegenerative illnesses. In the cardiovascular system
(CVS), these by-products target the mitochondria of cardiac cells leading to their dysfunction and producing
redox imbalance in the endothelium of the blood vessels. This brings up the biological relationship
between the susceptibility of getting cardiovascular disorders in neural patients. In the current
scenario, MAO inhibitors are highly recommended by physicians worldwide for the therapy and management
of various neurodegenerative disorders. Many interventional studies reveal the benefit of
MAO inhibitors in CVS. Drug candidates who can target both the central and peripheral MAO could
be a better to compensate for the cardiovascular comorbidities observed in neurodegenerative patients.
Mitotic Kinase Inhibitors as Therapeutic Interventions for Prostate Cancer:
Evidence from In Vitro Studies
Authors: Javed Aadil , Özduman Gülseren , Altun Sevda , Duran Doğan , Yerli Dilan , Özar Tilbe , Şimşek Faruk , Korkmaz Kemal Sami
Published: March 2023

Prostate cancer is one of the devastating diseases characterized by genetic changes leading
to uncontrolled growth and metastasis of the cells of the prostate gland and affects men worldwide.
Conventional hormonal and chemotherapeutic agents are effective in mitigating the disease if diagnosed
at an early stage. All dividing eukaryotic cells require mitotic progression for the maintenance of
genomic integrity in progeny populations. The protein kinases, upon activation and de-activation in an
ordered fashion, lead to spatial and temporal regulation of the cell division process. The entry into
mitosis along with the progression into sub-phases of mitosis is ensured due to the activity of mitotic
kinases. These kinases include Polo-Like-Kinase 1 (PLK1), Aurora kinases, and Cyclin-Dependent-
Kinase 1 (CDK1), among others. The mitotic kinases, among others, are usually overexpressed in many
cancers and can be targeted using small molecule inhibitors to reduce the effects of these regulators on
mechanisms, such as regulation of genomic integrity and mitotic fidelity. In this review, we attempted
to discuss the appropriate functions of mitotic kinases revealed through cell culture studies and the
impact of their respective inhibitors derived in pre-clinical studies. The review is designed to elucidate
the growing field of small molecule inhibitors and their functional screening or mode of action at the
cellular and molecular level in the context of Prostate Cancer. Therefore, studies performed specifically
on cells of Prostatic-origin are narrated in this review, culminating in a comprehensive view of the
specific field of mitotic kinases that can be targeted for therapy of Prostate cancer.
E2F1 Reduces Sorafenib’s Sensitivity of Esophageal Carcinoma Cells via
Modulating the miR-29c-3p/COL11A1 Signaling Axis
Authors: Ma Zhifeng , Zhu Ting , Wang Haiyong , Wang Bin , Fu Linhai , Yu Guangmao
Published: March 2023

Objective:

Esophageal carcinoma (ESCA) is a common malignancy characterized by high morbidity and mortality. Our work managed to dissect the
modulatory mechanism of E2F1/miR-29c-3p/COL11A1 in the malignant progression and sensitivity of ESCA cells to sorafenib.

Methods:

Via bioinformatics approaches, we identified the target miRNA. Subsequently, CCK-8, cell cycle analysis, and flow cytometry were used to check
the biological influences of miR-29c-3p on ESCA cells. TransmiR, mirDIP, miRPathDB, and miRDB databases were used as tools for the
prediction of upstream transcription factors and downstream genes of miR-29c-3p. The targeting relationship of genes was detected via RNA
immunoprecipitation and chromatin immunoprecipitation, which was further validated by dual-luciferase assay. Finally, in vitro experiments
revealed the way E2F1/miR-29c-3p/COL11A1 affected sorafenib’s sensitivity, and in vivo experiments were used to verify the way E2F1 and
sorafenib impacted ESCA tumor growth.

Results:

miR-29c-3p, downregulated in ESCA, could suppress ESCA cell viability, arrest the cell cycle in the G0/G1 phase, and impel apoptosis. E2F1 was
found to be upregulated in ESCA and it could abate the transcriptional activity of miR-29c-3p. COL11A1 was found to be a downstream target of
miR-29c-3p to enhance cell viability, induce cell cycle arrest in S phase, and constrain apoptosis. Cellular and animal experiments together
demonstrated that E2F1 abated the sorafenib’s sensitivity of ESCA cells via miR-29c-3p/COL11A1.

Conclusion:

E2F1 affected the viability, cell cycle, and apoptosis of ESCA cells by modulating miR-29c-3p/COL11A1, and it attenuated the sensitivity of
ESCA cells to sorafenib, shedding new light on the treatment of ESCA.
Effect of Multifactorial Balance Rehabilitation Program on Risk of
Falls and Functional Fitness in Older Adults with Diabetic Peripheral
Neuropathy
Authors: Gupta Garima , Maiya G. Arun , Bhat Shyamasunder N. , Hande H. Manjunatha
Published: March 2023

Background:

Increasing age and the added disadvantage of diabetic peripheral neuropathy
(DPN) put the individual at a higher risk of falls and reduced functional fitness. However, there
is a dearth of literature on multifactorial balance intervention, especially targeting the needs of older
adults with DPN.

Objective:

The current study aimed to determine the effect of a multifactorial balance rehabilitation
program on fall risk and functional fitness in older adults with DPN.

Methods:

In this pre-post experimental study, 30 independently ambulating older adults (71.2 ±
4.70 years) with DPN, who were at risk of falling (timed up and go score ≥ 9.4 seconds), were
recruited. Along with the standard care, all the participants received 12 weeks of the multifactorial
balance rehabilitation program.

Results:

Fall risk using the Fullerton Advanced Balance scale and functional fitness using the Senior
Fitness Test were measured at baseline and after 12 weeks of the intervention. The intervention
reduced the risk of falling score significantly (MD = 6.17, p < .001). All six parameters of functional
fitness improved after 12 weeks of intervention. The improvement in lower limb strength
(MD = 1.53 times), upper limb strength (MD = 2.48 times), endurance (MD = 16.07 seconds), lower
limb flexibility (MD = 2.02 inches), upper limb flexibility (MD = 1.47 inches), and dynamic
balance (MD = 1.53 seconds) was statistically significant at p < 0.05.

Conclusion:

This study provided encouraging evidence about the potential of multifactorial
balance rehabilitation to reduce the risk of falling and improve functional fitness in older adults
with DPN.
Recent Advances in Biomaterial Design for Bone Regenerative Therapy: A Mini Review
Authors: Hadri Nurulhuda Athirah , Arifin Nursyahida , Ghazalli Nur Fatiha , Shaari Ramizu , Noordin Khairul Bariah Ahmad Amin , Yusop Norhayati
Published: March 2023

Longevity has been associated with morbidity and an increase in age-related illnesses,
linked to tissue degeneration and gradual loss of biological functions. Bone is an important organ
that gradually degenerates with increasing lifespan. The remodeling phase plays a huge role in
maintaining the ability of bone to regenerate and maintain its stability and function throughout
life. Hence, bone health represents one of the major challenges to elderly citizens due to the increase
of injury associated with bone degeneration, such as fragility and risks of fractures. In the
virtue of improving the regenerative function of bone tissues, a specialized field of bone tissue
engineering (BTE) has been introduced to improve the current strategies in treating bone degenerative
disorders. Most of the research performed in BTE focuses on the optimization of key components
to generate new bone formation, including the scaffold. A scaffold plays a significant role
in establishing the structural form that interconnects major elements of the tissue engineering triad.
To date, many types of biomaterials have been explored in BTE, ranging from natural and
synthetic materials to nanocomposites. However, ideal scaffolds that display excellent biocompatibility
and mechanical properties, approved for clinical practices are yet available. This paper
aims to describe the up-to-date advancements in scaffold for new bone generation, highlighting
the essential elements and strategies in selecting suitable biomaterials for bone repair.
Isoniazid Loaded PCL-PEG Copolymer Nanoparticles for
Sustained Release Application
Authors: Kulkarni Alpana , Betai Priya
Published: March 2023

Background:

Tuberculosis (TB) is still a major cause of death worldwide, despite
possibly curable therapies. Neurotoxicity, optic neuritis, and severe liver damage
are side effects of isoniazid, a powerful first-line anti-TB drug.

Objective:

We investigated the use of PCL-PEG copolymer to sustain the release of isoniazid
to reduce its adverse effects.

Methods:

In the present work, PCL-PEG copolymer was synthesized and characterized.
Isoniazid-loaded nanoparticles (Inp) were prepared using a PCL-PEG copolymer. Furthermore,
a 23 half factorial design was employed for the optimization of drug and emulsifier
concentration in Inp. Full characterization of the nanoparticles was performed in
terms of drug loading, entrapment efficiency, particle size, zeta potential, and in vitro
drug release. The morphology, FTIR, DSC, and PXRD evaluation of the optimized Batch
Inp F13 were studied. Stability was evaluated by storing the freeze-dried Inp F13 at various
temperatures.

Results:

The entrapment efficiency and drug loading of nanoparticles prepared by double
emulsion solvent evaporation were found to be the highest. The release study revealed
that all batches of nanoparticles exhibited sustained drug release (60.26 - 88.59%) for 5
days. The cytotoxicity study conducted on Mycobacterium tuberculosis revealed a gradual
release of isoniazid from Inp, reaching the maximum (on the 15th day) compared to
plain isoniazid (on the 4th day). At 0.8 μg/mL concentration, the inhibitory activity of Inp
F13 was maintained for 15 days, indicating sustained release of isoniazid.

Conclusion:

The nanoparticles having PCL:PEG in a 95:5 ratio, with 0.5% PVA and initial
drug loading of 3 mg, produced the optimum batch. Isoniazid-loaded PCL-PEG nanoparticles
allowed controlled (sustained) release of isoniazid.
Rethinking the Difficult Patient: Formative Qualitative Study Using Participatory Theater to Improve Physician-Patient Communication in Rheumatology (Preprint)
Authors: Leung Jerik , Som Avira , McMorrow Lily , Zickuhr Lisa , Wolbers John , Bain Karen , Flood Julia , Baker Elizabeth A
Published: March 2023

BACKGROUND

Effective physician-patient communication is crucial for positive health outcomes for patients with chronic diseases. However, current methods of physician education in communication are often insufficient to help physicians understand how patients’ actions are influenced by the contexts within which they live. An arts-based participatory theater approach can provide the necessary health equity framing to address this deficiency.

OBJECTIVE

The aim of this study was to develop, pilot, and conduct a formative evaluation of an interactive arts-based communication skills intervention for graduate-level medical trainees grounded in a narrative representative of the experience of patients with systemic lupus erythematosus.

METHODS

We hypothesized that the delivery of interactive communication modules through a participatory theater approach would lead to changes in both attitudes and the capacity to act on those attitudes among participants in 4 conceptual categories related to patient communication (understanding social determinants of health, expressing empathy, shared decision-making, and concordance). We developed a participatory, arts-based intervention to pilot this conceptual framework with the intended audience (rheumatology trainees). The intervention was delivered through routine educational conferences at a single institution. We conducted a formative evaluation by collecting qualitative focus group feedback to evaluate the implementation of the modules.

RESULTS

Our formative data suggest that the participatory theater approach and the design of the modules added value to the participants’ learning experience by facilitating interconnection of the 4 communication concepts (eg, participants were able to gain insight into both what physicians and patients were thinking about on the same topic). Participants also provided several suggestions for improving the intervention such as ensuring that the didactic material had more active engagement and considering additional ways to acknowledge real-world constraints (eg, limited time with patients) in implementing communication strategies.

CONCLUSIONS

Our findings from this formative evaluation of communication modules suggest that participatory theater is an effective method for framing physician education with a health equity lens, although considerations in the realms of functional demands of health care providers and use of structural competency as a framing concept are needed. The integration of social and structural contexts into the delivery of this communication skills intervention may be important for the uptake of these skills by intervention participants. Participatory theater provided an opportunity for dynamic interactivity among participants and facilitated greater engagement with the communication module content.
Step Count, Self-reported Physical Activity, and Predicted 5-Year Risk of Atrial Fibrillation: Cross-sectional Analysis (Preprint)
Authors: Shapira-Daniels Ayelet , Kornej Jelena , Spartano Nicole L , Wang Xuzhi , Zhang Yuankai , Pathiravasan Chathurangi H , Liu Chunyu , Trinquart Ludovic , Borrelli Belinda , McManus David D , Murabito Joanne M , Benjamin Emelia J , Lin Honghuang
Published: March 2023

BACKGROUND

Physical inactivity is a known risk factor for atrial fibrillation (AF). Wearable devices, such as smartwatches, present an opportunity to investigate the relation between daily step count and AF risk.

OBJECTIVE

The objective of this study was to investigate the association between daily step count and the predicted 5-year risk of AF.

METHODS

Participants from the electronic Framingham Heart Study used an Apple smartwatch. Individuals with diagnosed AF were excluded. Daily step count, watch wear time (hours and days), and self-reported physical activity data were collected. Individuals’ 5-year risk of AF was estimated, using the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)–AF score. The relation between daily step count and predicted 5-year AF risk was examined via linear regression, adjusting for age, sex, and wear time. Secondary analyses examined effect modification by sex and obesity (BMI≥30 kg/m2), as well as the relation between self-reported physical activity and predicted 5-year AF risk.

RESULTS

We examined 923 electronic Framingham Heart Study participants (age: mean 53, SD 9 years; female: n=563, 61%) who had a median daily step count of 7227 (IQR 5699-8970). Most participants (n=823, 89.2%) had a <2.5% CHARGE-AF risk. Every 1000 steps were associated with a 0.08% lower CHARGE-AF risk (P<.001). A stronger association was observed in men and individuals with obesity. In contrast, self-reported physical activity was not associated with CHARGE-AF risk.

CONCLUSIONS

Higher daily step counts were associated with a lower predicted 5-year risk of AF, and this relation was stronger in men and participants with obesity. The utility of a wearable daily step counter for AF risk reduction merits further investigation.
Assessing the Readability of Online Patient Education Materials in Obstetrics and Gynecology Using Traditional Measures: Comparative Analysis and Limitations (Preprint)
Authors: Nattam Anunita , Vithala Tripura , Wu Tzu-Chun , Bindhu Shwetha , Bond Gregory , Liu Hexuan , Thompson Amy , Wu Danny T Y
Published: March 2023

BACKGROUND

Patient education materials (PEMs) can be vital sources of information for the general population. However, despite American Medical Association (AMA) and National Institutes of Health (NIH) recommendations to make PEMs easier to read for patients with low health literacy, they often do not adhere to these recommendations. The readability of online PEMs in the obstetrics and gynecology (OB/GYN) field, in particular, has not been thoroughly investigated.

OBJECTIVE

The study sampled online OB/GYN PEMs and aimed to examine (1) agreeability across traditional readability measures (TRMs), (2) adherence of online PEMs to AMA and NIH recommendations, and (3) whether the readability level of online PEMs varied by web-based source and medical topic. This study is not a scoping review, rather, it focused on scoring the readability of OB/GYN PEMs using the traditional measures to add empirical evidence to the literature.

METHODS

A total of 1576 online OB/GYN PEMs were collected via 3 major search engines. In total 93 were excluded due to shorter content (less than 100 words), yielding 1483 PEMs for analysis. Each PEM was scored by 4 TRMs, including Flesch-Kincaid grade level, Gunning fog index, Simple Measure of Gobbledygook, and the Dale-Chall. The PEMs were categorized based on publication source and medical topic by 2 research team members. The readability scores of the categories were compared statistically.

RESULTS

Results indicated that the 4 TRMs did not agree with each other, leading to the use of an averaged readability (composite) score for comparison. The composite scores across all online PEMs were not normally distributed and had a median at the 11th grade. Governmental PEMs were the easiest to read amongst source categorizations and PEMs about menstruation were the most difficult to read. However, the differences in the readability scores among the sources and the topics were small.

CONCLUSIONS

This study found that online OB/GYN PEMs did not meet the AMA and NIH readability recommendations and would be difficult to read and comprehend for patients with low health literacy. Both findings connected well to the literature. This study highlights the need to improve the readability of OB/GYN PEMs to help patients make informed decisions. Research has been done to create more sophisticated readability measures for medical and health documents. Once validated, these tools need to be used by web-based content creators of health education materials.

CLINICALTRIAL
Beyond Audio-Video Telehealth: Perspective on the Current State and Future Directions of Digital Neurological Care in the United States (Preprint)
Authors: Kummer Benjamin R , Busis Neil A
Published: March 2023

BACKGROUND

The COVID-19 pandemic transformed neurological care by both requiring digital health modalities to reach patients and profoundly lowering barriers to digital health adoption. This combination of factors has given rise to a distinctive, emerging care model in neurology characterized by new technologies, care arrangements, and uncertainties. As the pandemic transitions to an endemic, there is a need to characterize the current and future states of this unique period in neurology.

OBJECTIVE

We sought to describe the current state of the pandemic- and postpandemic-related changes in neurological care and offer a view of the possible future directions of the field.

METHODS

We reviewed several themes across the “new digital normal” in neurology, including trends in technology adoption, barriers to technology access, newly available telehealth services, unresolved questions, and an outlook on the future of digital neurology.

RESULTS

In this new era of neurological care, we emphasize that synchronous audio-video telehealth remains the predominant form of digital interaction between neurologists and patients, mainly due to pandemic-related regulatory changes and the preexisting, steady adoption of video platforms in the prepandemic era. We also identify a persistent digital divide, with audio-only telehealth remaining a necessity for preserving care access. Asynchronous telehealth methods and services, including care coordination, interprofessional consultations, remote patient monitoring, and teletreatment are becoming increasingly important for neurological care. Finally, we identify several unanswered questions regarding the future of this “new normal,” including the lasting effects of emergency regulatory changes, the value proposition of telehealth, the future of telehealth reimbursement in neurology, as well as privacy considerations and trade-offs in asynchronous neurological care models.

CONCLUSIONS

The COVID-19 pandemic has ushered in an era of digital adoption and innovation in neurological care, characterized by novel care models, services, and technologies, as well as numerous unresolved questions regarding the future.
Evaluating the Diagnostic Performance of Symptom Checkers: Clinical Vignette Study (Preprint)
Authors: Hammoud Mohammad , Douglas Shahd , Darmach Mohamad , Alawneh Sara , Sanyal Swapnendu , Kanbour Youssef
Published: March 2023

BACKGROUND

Medical self-diagnostic tools (or symptom checkers) are becoming an integral part of digital health and our daily lives, whereby patients are increasingly using them to identify the underlying causes of their symptoms. As such, it is essential to rigorously investigate and comprehensively report the diagnostic performance of symptom checkers using standard clinical and scientific approaches.

OBJECTIVE

This study aims to evaluate and report the accuracies of a few known and new symptom checkers using a standard and transparent methodology, which allows the scientific community to cross-validate and reproduce the reported results, a step much needed in health informatics.

METHODS

We propose a 4-stage experimentation methodology that capitalizes on the standard clinical vignette approach to evaluate 6 symptom checkers. To this end, we developed and peer-reviewed 400 vignettes, each approved by at least 5 out of 7 independent and experienced primary care physicians. To establish a frame of reference and interpret the results of symptom checkers accordingly, we further compared the best-performing symptom checker against 3 primary care physicians with an average experience of 16.6 (SD 9.42) years. To measure accuracy, we used 7 standard metrics, including M1 as a measure of a symptom checker’s or a physician’s ability to return a vignette’s main diagnosis at the top of their differential list, F1-score as a trade-off measure between recall and precision, and Normalized Discounted Cumulative Gain (NDCG) as a measure of a differential list’s ranking quality, among others.

RESULTS

The diagnostic accuracies of the 6 tested symptom checkers vary significantly. For instance, the differences in the M1, F1-score, and NDCG results between the best-performing and worst-performing symptom checkers or ranges were 65.3%, 39.2%, and 74.2%, respectively. The same was observed among the participating human physicians, whereby the M1, F1-score, and NDCG ranges were 22.8%, 15.3%, and 21.3%, respectively. When compared against each other, physicians outperformed the best-performing symptom checker by an average of 1.2% using F1-score, whereas the best-performing symptom checker outperformed physicians by averages of 10.2% and 25.1% using M1 and NDCG, respectively.

CONCLUSIONS

The performance variation between symptom checkers is substantial, suggesting that symptom checkers cannot be treated as a single entity. On a different note, the best-performing symptom checker was an artificial intelligence (AI)–based one, shedding light on the promise of AI in improving the diagnostic capabilities of symptom checkers, especially as AI keeps advancing exponentially.
Implementation of Home-Based Telerehabilitation of Patients With Stroke in the United States: Protocol for a Realist Review (Preprint)
Authors: Hasan Mohamed Mosaad , Rafferty Miriam R , Tawfik Sara , Tawfik Ahmed , Beestrum Molly , Smith Justin D , Hirschhorn Lisa R , Roth Elliot J , Woods Donna M
Published: March 2023

BACKGROUND

Stroke is a common cause of mortality and morbidity. Insufficient and untimely rehabilitation has been associated with inadequate recovery. Telerehabilitation provides an opportunity for timely and accessible services for individuals with stroke, especially in remote areas. Telerehabilitation is defined as a health care team's use of a communication mode (eg, videoconferencing) to remotely provide rehabilitation services. Telerehabilitation is as effective as facility-based rehabilitation; however, it is infrequently used due to implementation barriers.

OBJECTIVE

The aim of the study is to explore the interaction between the implementation strategies, context, and outcomes of telerehabilitation of patients with stroke.

METHODS

This review will follow four steps: (1) defining the review scope, (2) literature search and quality appraisal, (3) data extraction and evidence synthesis, and (4) narrative development. PubMed via MEDLINE, the PEDro database, and CINAHL will be queried till June 2023 and supplemented with citation tracking and a gray literature search. The relevance and rigor of papers will be appraised using the TAPUPAS (Transparency, Accuracy, Purposivity, Utility, Propriety, Accessibility, and Specificity) and Weight of Evidence frameworks. The reviewers will extract and synthesize data iteratively and develop explanatory links between contexts, mechanisms, and outcomes. The results will be reported according to the Realist Synthesis publication standards set by Wong and colleagues in 2013.

RESULTS

The literature search and screening will be completed in July 2023. Data extraction and analysis will be completed in August 2023, and findings will be synthesized and reported in October 2023.

CONCLUSIONS

This will be the first realist synthesis, uncovering the causal mechanisms to explain how, why, and to what extent implementation strategies impact telerehabilitation adoption and implementation.

INTERNATIONAL REGISTERED REPORT

PRR1-10.2196/47009
Research on the Coupling Mechanism of Industrial Chain based on Circular Economy
Authors: Biswas Jourge Shovon , Hong Dai , Mahmudh Riyadzh , Jesha Janiefer Jabbar , Alssarhi Taha Omar Yaaqob
Published: March 2023

Circular economy is a new economic operation mode that emphasizes symbiosis and synergism the formation of an ecological network of resource recycling is its fundamental feature. The article takes the development of ship breaking industry in Sitakunda, Chattogram Division, Bangladesh as a case This paper analyzes on the evolution process and the micro operation law of the circular economy industrial chain, probes into the mechanism of the industrial chain coupling, and advances some countermeasures for promoting the development of the circular economy industrial chain.
Cloud Computing as a Solution for Security and Privacy Concerns
Authors: Reema Syeda
Published: March 2023

Abstract: In recent years, cloud computing has emerged as a popular and cost-effective solution for businesses and individuals to store and manage their data. However, the widespread adoption of cloud computing has raised serious concerns about the security and privacy of sensitive information stored in the cloud. This paper aims to explore the various security and privacy issues associated with cloud computing and examines how the technology can be leveraged to address these concerns. Through a comprehensive review of existing literature and case studies, This paper proposes that cloud computing can be an effective solution for security and privacy concerns in the digital age, provided certain best practices are followed by cloud service providers and users.
Hedge Fund Management in India
Authors: Shah Tejal , Pandey Kirti , Nayak Rupalben
Published: March 2023

Abstract: The study evaluates the performance of Indian Hedge Funds in comparison to the hedge fund of Asia, Emerging market, Australia, China, Japan and global hedge funds. If also examines the interrelationship between the return of Indian Hedge Funds in comparison to the return from Indian Equity market. The data were analysed by using annualized standard deviation, Sharpe ratio, correlation, ANOVA, and regression analysis. The study revealed that performance of Indian Hedge Funds is significantly behind the performance of the above listed seven hedge funds regions. It is also observed that the exists a positive correlation between Indian Hedge Funds and Indian Equity Market.
Information transmission with continuous variable quantum erasure channels
Authors: Zhong Changchun , Oh Changhun , Jiang Liang
Published: March 2023

Quantum capacity, as the key figure of merit for a given quantum channel, upper bounds the channel's ability in transmitting quantum information. Identifying different types of channels, evaluating the corresponding quantum capacity, and finding the capacity-approaching coding scheme are the major tasks in quantum communication theory. Quantum channel in discrete variables has been discussed enormously based on various error models, while error model in the continuous variable channel has been less studied due to the infinite dimensional problem. In this paper, we investigate a general continuous variable quantum erasure channel. By defining an effective subspace of the continuous variable system, we find a continuous variable random coding model. We then derive the quantum capacity of the continuous variable erasure channel in the framework of decoupling theory. The discussion in this paper fills the gap of a quantum erasure channel in continuous variable setting and sheds light on the understanding of other types of continuous variable quantum channels.
Teoria Cognitiva de Aprendizagem Multimídia (TCAM)
Authors: Thees Andréa , Machado Maria Auxiliadora
Published: March 2023

Esse trabalho apresenta parte de uma tese de doutorado que buscou responder em que medida assistir às videoaulas de matemática do YouTube pode contribuir para o estudo efetivo de conteúdos matemáticos. As videoaulas selecionadas foram assistidas e analisadas com base nos princípios da TCAM, que foram adaptados para avaliação desse formato de material audiovisual. Elaborou-se um critério de pontuação das características das videoaulas, que permitiu refletir acerca da crescente projeção do YouTube para fins educacionais. Conforme os dados coletados foi possível verificar que assistir videoaulas de matemática, disponíveis na rede social de compartilhamento de vídeos YouTube, tornou-se uma prática recorrente. Todavia, os resultados encontrados indicaram que o grau de aderência da videoaula aos princípios da TCAM irá interferir no estudo de conteúdos de matemática. Ou seja, quanto mais atraente e apelativa for a videoaula, menores as chances que a aprendizagem de conteúdos de matemática seja efetivada.