bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Literacy
Authors: Jordan Tina L. , Aubrey Harold L. , Stevenson Andre P.
Published: April 2020

Recent research literature indicates that African Americans (AA) generally execute advance directives to a much lower degree than do non-Hispanic Euro-American adults. The purpose of this research study was to investigate the degree to which social and demographic variables are associated with knowledge of advance directives among AA aging prisoners. A combined sample (N=100) of AA Aging Prisoners generated from three randomly selected sub-samples were collected from three of five state correctional facilities in a Mid-Atlantic Region in the United States. Each prisoner completed the Jordan Advance Directive Measurement Scale©. Three categorical groups emerged from the combined sample. Those groups were based on the Health Status question regarding knowledge of advance directives Null hypotheses were tested and data were analyzed using Pearson’s Chi-Square Test of Independence. There was no significant degree of independence between any of the three pairs of sub-groups. The researchers informally discovered the prisoners’ lack of basic knowledge of advance directives.
Using a prisoner advisory group to develop diversity research in a maximum-security prison
Authors: Cowburn Malcolm , Lavis Victoria
Published: April 2020

This paper addresses groupwork processes with a group of prisoners advising a research project in a maximum-security prison in England. The research project (Appreciative Inquiry into the Diversity Strategy of HMP Wakefield. RES-000-22-3441) was funded by the Economic and Social Research Council (ESRC) and lasted 9 months. The research explored the experiences of prisoners in diverse minority groupings and the strategies of the prison to accommodate the complex needs of these groups. The Prisoner Advisory Group (PAG) was made up of representatives from Black and Minority Ethnic (BME) prisoners; older prisoners (over 60s); Disabled prisoners (with physical disabilities, learning difficulties; and mental health problems); Gay, Bi-sexual and Transgender prisoners; and prisoners affiliated to Faith groups. It met regularly during the research. The paper considers the forming norming and performing aspects of establishing an effective participant voice in a prison-based project. It considers the contribution of the PAG to developing a research strategy that engaged prisoners in the research. It reflects on the nature of ‘participative research’ in general and whether such research is possible within a high-security prison environment.
Civil Participation in Military Innovation: Cooperation between the Defense Industry of Indonesia and Turkey 2010 - 2018
Authors: Luerdi Luerdi , Marisa Hizra
Published: April 2020

Studi pertahanan memiliki pemikiran bahwa inovasi militer suatu negara memiliki kaitan dengan politik luar negeri suatu negara; kemudian memberikan motivasi bagi mereka untuk melakukan diplomasi pertahanan. Namun, masih sedikit akademisi yang memberikan perhatiannya dalam hal industri pertahanan, khususnya berkaitan dengan negara middle power dan new emerging power. Penelitian ini bertujuan menjelaskan hubungan antara faktor-faktor pendorong dengan kebijakan Indonesia dalam melakukan kerjasama industri pertahanan dengan Turki. Temuan penelitian ini adalah partisipasi sipil dalam inovasi militer dan kepentingan nasional strategis merupakan faktor penting yang mendorong kerjasama tersebut. Kerjasama Indonesia-Turki meliputi riset dan pengembangan, produksi dan pemasaran bersama beberapa alat peralatan pertahanan dan keamanan. Penelitian ini menggunakan konsep inovasi militer dan diplomasi pertahanan dan melihat bahwa Indonesia mengejar agenda kemandirian teknologi pertahanab. Untuk itu, Indonesia mulai melebarkan relasi pertahanan di luar mitra tradisionalnya.Kata kunci: kerjasama, industri pertahanan, partisipasi sipil, kepentingan nasional strategis, diplomasi pertahanan. The study of defense sees that military innovations has a connection to foreign policy; therefore, motivate them to conduct defense diplomacy. However, just few scholars have their concern to defense industry subject, especially amongst middle power and new emerging power. This paper aims to explain the interaction between causal factors and Indonesia’s cooperation policy with Turkey in term of defense industry. The research has found that civilian participation within military innovation and strategic national interests were supposed to be significant determinants which encouraged the state to agree on defense industry cooperation with Turkey. The cooperation included joint research and development, production and potential sale of armaments. The research applied the concept of civil-led military innovation as well as defense diplomacy and argues that Indonesia has been pursuing its defense technology independence. Therefore, it diversifies its defense relation beyond its traditional partners.Keywords: cooperation, defense industry, civilian participation, strategic national interest, defense diplomacy.
Public Use of Masks to Control the Coronavirus Pandemic
Authors: Longrich Nicholas
Published: April 2020

The US and UK governments, as well as the World Health Organization, currently advise against the use of masks by the public to fight the ongoing Coronavirus Disease 19 (COVID-19) pandemic (1). But could they be wrong? The governments of China, South Korea, Hong Kong, Viet Nam, Czechia, Slovakia, Bosnia and Taiwan all recommend that the public wear masks to slow the spread of the coronavirus. In some countries, like Japan, masks aren’t officially recommended, but are still widely used by the public. Many countries treat masks as a strategic resource. China has ramped up production of facemasks, converting Foxconn factories that once made iPhones to make face masks. Taiwan has also ramped up the production of facemasks, prohibited their export, and implemented price controls and rationing. It’s hard to see how both approaches could be right. Increasingly, advice against the use of face masks has been questioned (1) (2) (3), including by the head of China’s CDC (4). Common sense, scientific studies, but perhaps most of all the success of countries using masks to fight the coronavirus suggest that masks may make a difference. There are fewer scientific studies available to guide decision making than we might like, and the evidence is not always clear-cut. However, decision-making in a crisis requires that decisions be made in the absence of perfect clarity. What is clear is that the exponential mathematics of pandemics mean that even if masks are of limited benefit in reducing infection rates, masks could make a large difference over time, potentially slowing the pace of the pandemic, limiting its spread, saving lives, and finally, letting countries to restart the economies that their people depend on for their livelihoods.
Automatic Quality Assessments of Laser Powder Bed Fusion Builds from Photodiode Sensor Measurements
Authors: Jayasinghe Sarini , Paoletti Paolo , Sutcliﬀe Chris , Dardis John , Jones Nick , Green Peter
Published: April 2020

This study evaluates whether a combination of photodiode sensor measurements, taken during laser powder bed fusion (L-PBF) builds, can be used to predict the resulting build quality via a purely data-based approach. We analyse the relationship between build density and features that are extracted from sensor data collected from three diﬀerent photodiodes. The study uses a Singular Value Decomposition to extract lower-dimensional features from photodiode measurements, which are then fed into machine learning algorithms. Several unsupervised learning methods are then employed to classify low density (< 99% part density) and high density (≥ 99% part density) specimens. Subsequently, a supervised learning method (Gaussian Process regression) is used to directly predict build density. Using the unsupervised clustering approaches, applied to features extracted from both photodiode sensor data as well as observations relating to the energy transferred to the material, build density was predicted with up to 93.54% accuracy. With regard to the supervised regression approach, a Gaussian Process algorithm was capable of predicting the build density with a RMS error of 3.65%. The study shows, therefore, that there is potential for machine learning algorithms to predict indicators of L-PBF build quality from photodiode build-measurements. Moreover, the work herein describes approaches that are predominantly probabilistic, thus facilitating uncertainty quantiﬁcation in machine-learnt predictions of L-PBF build quality.
The Pathophysiology of Virulence of the COVID-19 Virus
Authors: De Soto Joseph , Hakim Shazia , Boyd Frederick
Published: April 2020

Background: On Dec 19, 2019 it was reported by the public health department of China that an outbreak of pneumonia was caused by a novel Coronavirus. The virulence of the new virus COVID-19 was much greater than either the SARs or MERSs viruses and on March 11, 2020 the World Health Department (WHO) declared world -wide pandemic. Understanding the pathophysiology of virulence of the COVID-19 virus is absolutely necessary in understanding the transmission, virulence factors, reduce risk factors, clinical presentation, predict outcomes of the disease and provide guidance to any current or future treatment protocols. Methodology: A PubMed search was performed utilizing the words: Wuhan Virus, COVID-19, SARs coronavirus, ACE2, S protein, virulence, clinical presentation, epidemiology, genome, treatment, structure, MERs, pathogenesis and/or pathology alone and in combination with other terms. Each paper was evaluated by three content experts for quality, reproducibility, credibility and reputation of the journal. Results: The COVID-19 virus is much more virulent than either the SARs or MERs virus and its ability to cause serious disease inversely corresponds to the person’s ability to produce T-cells which declines linearly with age. The ACE2 receptor binding site do not vary among different ethnic groups but do in expression levels. This variance in expression level may explain for different infectivity rates among men and women and predict and explain different susceptibilities to infection by different ethnic groups. Furthermore, by understanding the underlying pathophysiology one can explain and provide guidance to the clinical effectiveness of any treatment. Conclusions: The underlying pathophysiology of COVID-19 explains not only the virulence, and clinical presentation, but, explains at a molecular level the comorbidity risk factors such as hypertension, sex, and age. Ethnic and anatomic expression patterns of ACE-2 and associated pathophysiology suggests that Native Americans and Asians may be particularly susceptible to this disease.
Research of tribotechnical characteristics of materials used in the development of compositions of lubricants for casting under pressure of aluminum alloys and polymeric products
Authors: Mikhaltsov A. M. , Skaskevich A. A. , Tsishkova Ya. I.
Published: April 2020

The article describes the requirements for lubricants (release coatings) used in injection molding of aluminum alloys and polymeric materials. A methodology for conducting research to determine the tribotechnical characteristics of materials used in the development of the composition of a lubricant for injection molding aluminum alloys and polymer products, as well as the results of a study of tribotechnical characteristics (friction coefficient) are presented. It has been established that as materials used in the development of a multifunctional lubricant composition for casting aluminum alloys and polymer products, it is advisable to use a fraction of soap stock and fus after their preliminary sedimentation (at least 3 months). It is shown that the smallest value of the coefficient of friction at the time of indenter breaking on the surface of the steel disk was obtained using a fus. Moreover, the value of the coefficient of friction is 14–33% lower than the same indicator for other studied lubricants (petroleum jelly, PMS-100 and soap stock). It was found that in the mode of reciprocal movement of the indenter on the surface of the steel disk, the coefficient of friction when using a fus is 1,7–3,3 times lower than when using Vaseline, PMS-100 and soap stock as lubricant.
Plasma Spectroscopy Diagnostics of V2O5 at a Variable of Operating Power and Pressure With Radio Frequency Magnetron Sputtering.
Authors: Et al. Salman
Published: April 2020

In this paper, we investigate the basic characteristics of "magnetron sputtering plasma" using the target V2O5. The "magnetron sputtering plasma" is produced using "radio frequency (RF)" power supply and Argon gas. The intensity of the light emission from atoms and radicals in the plasma measured by using "optical emission spectrophotometer", and the appeared peaks in all patterns match the standard lines from NIST database and employed are to estimate the plasma parameters, of computes electron temperature and the electrons density. The characteristics of V2O5 sputtering plasma at multiple discharge provisos are studied at the "radio frequency" (RF) power ranging from 75 - 150 Watt and gas pressure (0.03, 0.05 and  0.007) torr.  One can observe that the intensity of the emission lines increases with increasing the sputtering power. We find that the electron temperature excess drastically from 0.95 eV to 1.11eV when the emptying gas pressure excess from 0.03 to 0.05 Torr. On other hand excess electron temperature from 0.9 to 1.01 eV with increasing sputtering power from 100 to 125 Watt, while the electron density decrease from 5.9×1014 to 4.5×1014 cm-3 with increasing sputtering power. and electron density decrease with increasing of pressure from 4.25×1014 to 2.80×1014 cm-3, But the electron density maximum values  5.9×1014 at pressure  0.03 Torr.
Genome-wide identification of small heat shock protein (HSP20) gene family in grape and expression profile during berry development
Authors: Ji Xiao-Ru , Yu Yi-He , Ni Pei-Yi , Zhang Guo-Hai , Guo Da-Long
Published: April 2020

Background : Studies have shown that HSP20 (heat-shock protein 20) genes play important roles in regulating plant growth, development, and stress response. However, the grape HSP20 gene family has not been well studied.
Results : A total of 48 VvHsp20 genes were identified from the grape genome, which were divided into 11 subfamilies (CI, CII, CIII, CV, CVI, CVII, MI, MII, ER, CP and PX/Po) based on a phylogenetic analysis and subcellular localization. Further structural analysis showed that most of the VvHsp20 genes (93.8%) had no intron or only one intron, while genes that clustered together based on a phylogenetic tree had similar motifs and evolutionarily conserved structures. The HSP20s share a conservedα-crystalline domain (ACD) and the different components of the ACD domain suggest the functional diversity of VvHSP20s. In addition, the 48 VvHSP20 genes were distributed on 12 grape chromosomes and the majority of VvHSP20 genes were located at the proximal or distal ends of chromosomes. Chromosome mapping indicated that four groups of VvHSP20 genes were identified as tandem duplication genes. Phytohormone responsive, abiotic and biotic stress-responsive, and plant development-related cis-elements were identified from the cis-regulatory elements analysis of VvHSP20s. The expression profiles of VvHSP20s genes (VvHsp20-1, 11, 14, 17, 18, 19, 20, 24, 25, 28, 31, 39, 42, and 43) were largely similar between RNA-Seq and qRT-PCR analysis after hydrogen peroxide (H 2 O 2 ) treatment. The results showed that most VvHSP20s were down-regulated by H 2 O 2 treatment during fruit development. VvHSP20s genes were indeed found to be involved in the grape berry development and differences in their transcriptional levels may be the result of functional differentiation during evolution.
Conclusions : Our results provide valuable information on the evolutionary relationship of genes in the VvHSP20 family, which is useful for future studies on the functional characteristics of VvHSP20 genes in grape.
Mental distress, perceived need, and barriers to receive professional mental health care among university students in Ethiopia
Authors: Negash Assegid , Ahmed Matloob , Medhin Girmay , Wondimagegn Dawit , Araya Mesfin
Published: April 2020

Context: There is limited evidence on the extent of the perceived need for professional mental health care and barriers to the delivery of mental distress services among university students in low and middle-income countries. Objective: The current study was designed to assess the prevalence of mental distress, perceived need for professional mental health care and barriers to the delivery of the service for regular undergraduate university students. Methods: A multi-stage sampling technique was used to recruit 1135 regular undergraduate university students. Symptoms of mental distress were evaluated using the Self-Reported Questionnaire (SRQ-20) and a score of eight and above was used to identify positive cases. The perceived need for professional mental health care was assessed using one question with binary responses, whereas barriers to mental health care were assessed using Barriers to Access to Care Evaluation (BACE-30) tool. The association of demographic variables with total mean scores of BACE-III sub-scales was modeled using multiple linear regression. Results: The prevalence of mental distress symptoms was 34.6% and the perceived need for professional mental health care was 70.5%. The top five barriers to receiving professional mental health service were (a) thinking the problem would get better by itself, (b) being unsure where to go to get professional care, (c) wanting to solve the problem by own, (d) denying mental health problem, and (e) preferring to get alternative forms of mental care. Conclusions: The high prevalence of mental distress, mental health care gap, and the report of barriers to professional mental health care among Ethiopian regular undergraduate students is a call for action.
Continuum of Sexual and Gender-Based Violence Risks among Syrian Refugee Women and Girls in Lebanon
Authors: Roupetz Sophie , Stephanie Garbern , Saja Michael , Harveen Bergquist , Heide Glaesmer , Susan Bartels
Published: April 2020

Background: A myriad of factors including socio-economic hardships impact refugees, with females being additionally exposed to various forms of sexual and gender-based violence (SGBV). The aim of this qualitative analysis was to provide new insight into the experiences of SGBV among Syrian refugee women and girls in Lebanon.
Methods: The data are gained from a larger mixed-methods study, investigating the experiences of Syrian refugee girls in Lebanon, using an iPad and the data collection tool, SenseMaker ®. The survey intentionally did not ask direct questions about experiences of SGBV but instead enabled stories about SGBV to become apparent from a wide range of experiences in the daily lives of Syrian girls. F or this analysis, first-person stories by female respondents about experiences of SGBV were included in a thematic analysis. A random selection of male respondents who provided stories about the experiences of Syrian girls in Lebanon was also analyzed.
Results: In total, 70 of the 327 first person stories from female respondents and 42 of the 159 stories shared by male respondents included dialogue on SGBV. While experiences of sexual harassment were mainly reported by females, male respondents were much more likely to talk explicitly about sexual exploitation. Due to different forms of SGBV risks in public, unmarried girls were at high risk of child marriage, whereas married girls more often experienced some form of IPV and/or DV. In abusive relationships, some girls continued to face violence as they sought divorces and attempted to flee unhealthy situations.
Conclusions: This study contributes to existing literature by examining SGBV risks and experiences for refugees integrated into their host community, and also by incorporating the perceptions of men. Our findings shed light on the importance of recognizing the impact of SGBV on the family as a whole, in addition to each of the individual members and supports considering the cycle of SGBV not only across the woman ’ s lifespan but also across generations . Gendered differences in how SGBV was discussed may have implications for the design of future research focused on SGBV.
Treatment with radiosynoviorthesis in hemophilic patients with and without inhibitor
Authors: Sanabria Mario Edgar Tena , Sato Y. Rojas , Resendiz J.C Castañeda , Herrera G. Fuentes , Martínez Félix Alejandro Álvarez , González Yureni Irai Tena , Enríquez Juan Carlos Núñez
Published: April 2020

Background. Spontaneous bleedings occurring into joints (hemarthrosis) are the most common manifestations of hemophilia and causes severe joint damage ultimately resulting in joint disfunction known as hemophilic arthropathy. Among available therapeutic options for reducing recurrent hemarthrosis-associated damage, radiosynoviorthesis (RS) has proven effective in improving joint function. Aim. To assess the impact of RS with Yttrium(90) citrate (C-Y(90)) on frequency of hemarthroses and joint function in a group of pediatric patients. Methods . Between November 1998 and February 2017, we evaluated 27 pediatric patients with mild, moderate or severe hemophilia with haemophilic arthropathy. Overall, RS was applied in 60 joints. Some patientsreceived more than one single intra-articular injection with C-Y(90). Results. During the follow-up, one patient showed joint bleeding 15 months after RS, one patient after 12 months and one patient after 45 days. The episodes of hemarthrosis were reduced and joint function significantly improved in all patients. Conclusion. RS with C-Y(90) is a simple and safe treatment for reducing the frequency of hemarthroses in patients with hemophilia. It decreases the use of factor VIII / IX and improves joint function.
Evaluation of a sitting light volleyball intervention to adults with physical impairments: Qualitative study using Social–Ecological Model
Authors: Leung Ka Man , Chung Pak-Kwong , Chu William
Published: April 2020

Background: This study was a part of 15-week sitting light volleyball (SLVB) intervention program which examined the effects of the intervention on the physical and psychological attributes of adults with physical impairments (PWPI) in Hong Kong. Gaining a deeper understanding of the perceptions and experiences of PWPI in the SLVB intervention is critical to the development of SLVB as a physical activity and a sport. The aims of this study were (a) to assess participants’ experiences of the intervention and (b) to examine the suitability and feasibility of SLVB intervention for PWPI. Methods: Twenty participants (mean age = 53.52 years, standard deviation 9.02 years; 60% female; 25% with at least a college degree) participated in semi-structured interviews. Results: Content analysis revealed features of their experiences at the individual or intrapersonal level (physical and psychological health, enjoyment, novelty, competence, autonomy), interpersonal level (socialization and teamwork, social support), organizational and community levels (perceived sport venue environment, venue accessibility, safety, dissemination of information), and policy level (resources allocation by the government). The participants also commented on the suitability and feasibility of the SLVB intervention for PWPI, its content and coaching, the modified rules, the duration of sessions, scheduling, and the number of participants and coaches. Conclusions: This study identified several themes relevant to the promotion of PWPI engagement with SLVB and demonstrated that adopting a multilevel approach to the intervention resulted in positive outcomes for participants. Playing SLVB is suitable and feasible for PWPI. The findings contribute to the understanding of the experiences PWPI had of the SLVB intervention, which is critical to the further development of SLVB as a physical activity and a sport.
Low red/far-red ratio as a signal promotes carbon assimilation of soybean seedlings by increasing the photosynthetic capacity
Authors: Yang Feng , Liu Qinlin , Cheng Yajiao , Feng Lingyang , Wu Xiaoling , Fan Yuanfang , Raza Muhammad Ali , Wang Xiaochun , Yong Taiwen , Liu Weiguo , Liu Jiang , Du Junbo , Shu Kai , Yang Wenyu
Published: April 2020

Background: Shading includes low light intensity and varying quality. However, a low red/far-red (R/Fr) ratio of light is a signal that affects plant growth in intercropping and close- planting systems. Thus, the low R/Fr ratio uncoupling from shading conditions was assessed to identify the effect of light quality on photosynthesis and CO2 assimilation. Soybean plants were grown in a growth chamber with natural solar radiation under four treatments, that is, normal (N, sunlight), N+Fr, Low (L) +Fr, and L light. Results: Low R/Fr ratio significantly increased the total biomass, leaf area, starch and sucrose contents, chlorophyll content, net photosynthetic rate, and quantum efficiency of the photosystem II compared with normal R/Fr ratio under the same light level (P < 0.05). Proteomic analysis of soybean leaves under different treatments was performed to quantify the changes in photosynthesis and CO2 assimilation in the chloroplast. Among the 7834 proteins quantified, 12 showed a > 1.3-fold change in abundance, of which 1 was related to porphyrin and chlorophyll metabolism, 2 were involved in photosystem I (PS I), 4 were associated with PS II, 3 proteins participated in photosynthetic electron transport, and 2 were involved in starch and sucrose metabolism. The dynamic change in these proteins indicates that photosynthesis and CO2 assimilation were maintained in the L treatment by up-regulating the component protein levels compared with those in N treatment. Although low R/Fr ratio increased the photosynthetic CO2 assimilation parameters, the differences in most protein expression levels in N+Fr and L+Fr treatments compared with those in N treatment were insignificant. Similar trends were found in gene expression through quantitative reverse transcription polymerase chain reaction excluding the gene expression of sucrose synthase possible because light environment is one of the factors affecting carbon assimilation. Conclusions: Low R/Fr ratio (high Fr light) can increase the photosynthetic CO2 assimilation in the same light intensity by improving the photosynthetic efficiency of the photosystems.
A Tunisian version of the Confusion Assessment Method for the intensive care unit (CAM-ICU): translation and validation
Authors: Saida Imen Ben , Kortli Saiid , Amamou Badii , Kacem Nawres , Ghardallou Mariem , Ely Eugene Wesley , Saad Helmi Ben , Boussarsar Mohamed
Published: April 2020

Background. Delirium is common in critically ill patients and it is associated with poor outcomes. In Tunisia, however, it is still underdiagnosed as there is no validated screening tool. The aim of this study was to translate and to validate a Tunisian version of the CAM-ICU. Methods. For the validation and inter-rater reliability assessment of the Tunisian CAM-ICU, two trained intensivists independently evaluated delirium in the patients admitted to the ICU between October 2017 and June 2018. All the patients consecutively admitted to the ICU for more than 24 hours and having a Richmond Agitation-Sedation Scale greater than or equal to “-3” were assessed for delirium excluding those with stroke, dementia, psychosis or persistent coma. The results were compared with the reference evaluation carried out by a psychiatrist using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) criteria. The inter-rater reliability was calculated using the kappa (κ) statistic. The CAM-ICU concurrent validity was assessed using Cronbach’s α coefficient, sensitivity, specificity as well as positive and negative predictive values (PPV and NPV, respectively) for the two Tunisian CAM-ICU raters. Results. The study involved 137 patients [median (IQR) age: 60 [49-68] years, male sex (n=102), invasive mechanical ventilation (n=49)]. Using the DSM-V criteria evaluations, 46 patients were diagnosed with delirium. When applying the Tunisian version of the CAM-ICU, 38(27.7%) patients were diagnosed with delirium for the first rater and 45(32.6%) patients for the second one. The Tunisian CAM-ICU showed a very-high inter-rater reliability for both intensivists (κ = 0.844, p<0.001). Using the DSM-V rater as the reference standard, the sensitivity of the two intensivists’ evaluations was 80.4 vs. 95.7%. Specificity was 98.9% for both. The Cronbach’s α of the first and second raters’ evaluations using the Tunisian version of the CAM-ICU were 0.886 and 0.887, respectively. Conclusions. The Tunisian version of the CAM-ICU showed almost perfect validity and reliability in detecting delirium in critically ill patients. It could therefore be used in Tunisian ICUs or where Tunisian translators are available following appropriate training.
Deep learning-based dental plaque detection on primary teeth: a comparison with clinical assessments
Authors: You Wenzhe , Hao Aimin , Li Shuai , Wang Yong , Xia Bin
Published: April 2020

Background: The objectives are to design an artificial intelligence (AI) model based on deep learning to detect dental plaque on primary teeth and evaluate the diagnostic accuracy of the AI model. Methods : A conventional neural network (CNN) framework was adopted, and a total of 886 photos of primary teeth taken by an intraoral camera(1280×960 pixels; TPC Ligang, Shenzhen, China) were used to train the AI model. To validate the clinical feasibility, 98 photos of primary teeth taken by the intraoral camera were assessed by the AI model. Additionally, tooth photos were acquired using a digital camera (3216×2136 pixels, Canon EOS 60D, Japan). One experienced pediatric dentist looked at these photos and marked the regions the photos containing dental plaque. After a week, the dentist drew the dental plaque area on the 98 photos taken by the digital camera a second time. In another round of comparison, 102 photos of primary teeth taken by the same intraoral camera to evaluate the diagnostic ability of each approach based on photos with lower-resolution (fewer pixels). The mean intersection-over-union (MIoU) metric was employed to indicate the detection accuracy. Results : The MIoU for the detection of dental plaque on the tested tooth photos was 0.726 ± 0.165.The MIoU of the dentist when diagnosing the 98 photos taken by the digital camera for the first time was 0.695 ± 0.269, while after one week, the MIoU of the dentist was 0.689 ± 0.253. Compared to the dentist, the AI model demonstrated a higher MIoU (0.736 ± 0.174), and the results did not change after a week. When both the dentist and the AI model assessed the 102 photos taken by the intraoral camera. the MIoU of the pediatric dentist was 0.652 ± 0.195, and the MIoU of the AI model was 0.724 ±0.159. The results of a paired t-test found no significant difference between the AI model and human specialist (P > .05) in diagnosing dental plaque on primary teeth. Conclusions : The AI model showed clinically acceptable performance in detecting dental plaque on primary teeth compared with an experienced pediatric dentist.
“Everything is provided free, but they are still hesitant to access healthcare services”: Why does the Indigenous community in Attapadi, Kerala continue to experience poor access to healthcare?
Authors: George Mathew Sunil , Davey Rachel , Mohanty Itismita , Upton Penney
Published: April 2020

Background Inequity in access to healthcare services is a constant concern. While advances in healthcare have progressed in the last several decades, thereby significantly improving the prevention and treatment of disease, these benefits have not been shared equally. Excluded communities such as Indigenous communities typically face a lack of access to healthcare services that others do not. This study seeks to understand why the indigenous community in Attapadi continues to experience poor access to healthcare in spite of both financial protection and adequate coverage of health services Methods Ethnographic fieldwork was carried out among the various stakeholders living in Attapadi . A total of 52 in-depth interviews and 5 focus group discussions were conducted amongst the indigenous community, the healthcare providers and key informants. The data was coded utilising a reflexive and inductive approach leading to the development of the key categories and themes Results The health system provided a comprehensive financial protection package in addition to a host of healthcare facilities for the indigenous community to avail services. In spite of this, the community resisted the attempts of the health system to improve their access. The failure to provide culturally respectful care, the discrimination of the community at healthcare facilities, the centralisation of the delivery of services as well as the lack of power among the indigenous community to negotiate with the health system for services that were less disruptive to their lives were barriers to improving healthcare access. Power differentials between the community and the health system stakeholders also ensured that meaningful involvement of the community in the local health system did not occur. Conclusion Improving access to health care for indigenous communities would require UHC interventions to be culturally safe, locally relevant and promote active involvement of the community at all stages of the intervention. Structural power imbalances that affect access to resources and prevent meaningful involvement of indigenous communities also need to be addressed.
Two-by-two factorial randomised study within a trial (SWAT) to evaluate strategies for follow-up in a randomised prevention trial
Authors: Bradshaw Lucy , Montgomery Alan A , Williams Hywel , Chalmers Joanne , Haines Rachel
Published: April 2020

Background
Failure to collect outcome data in randomised trials can result in bias and loss of statistical power. Further evaluations of strategies to increase retention are required. We assessed the effectiveness of two strategies for retention in a randomised prevention trial using a two-by-two factorial randomised study within a trial (SWAT).

Methods
Parents of babies included in the host trial were randomised to (1) Short message service (SMS) notification prior to sending questionnaires at 3, 6, 12 and 18 months versus no SMS notification and (2) £10 voucher sent with the invitation letter for the primary follow up visit at 24 months or given at the visit. The two co-primary outcomes were collection of host trial (1) questionnaire data at interim follow-up times and (2) primary outcome at 24 months during a home/clinic visit with a research nurse.

Results
Between November 2014 and November 2016, 1394 participants were randomised: 350 to no SMS + voucher at visit, 345 to SMS + voucher at visit, 352 to no SMS + voucher before visit and 347 to SMS + voucher before visit. Overall questionnaire data was collected at interim follow-up times for 75% in both the group allocated to the prior SMS notification and the group allocated to no SMS notification (odds ratio (OR) SMS v. none 1.02, 95% CI 0.83 to 1.25). Host trial primary outcome data was collected at a visit for 557 (80%) allocated to the voucher before the visit in the invitation letter and for 566 (81%) whose parents were allocated to receive the voucher at the visit (OR before v. at visit 0.89, 95% CI 0.69 to 1.17).

Conclusion
There was no evidence of a difference in retention according to SMS notification or voucher timing. Future synthesis of SWAT results is required to be able to detect small but important incremental effects of retention strategies.

Trial registration: Host trial registration: ISRCTN registry; ID: ISRCTN21528841. Registered on 25 July 2014. SWAT Repository Store ID 25
Utility of FDG PET/CT for Assessment of Lung Nodules Identified During Low Dose Computed Tomography Screening
Authors: Hadique Sarah , Jain Pranav , Hadi Yousaf , Baig Aneeqah , Parker John E
Published: April 2020

Background: Many clinical guidelines recommend FDG PET/CT for the evaluation of pulmonary nodules ≥ 8mm detected during low dose computed tomography (LDCT) lung cancer screening. However, its added value in this setting requires confirmation. We evaluated the clinical utility of FDG PET/CT, including incidental findings, during the evaluation of lung nodules detected on LDCT screening.
Methods: A retrospective cohort study was performed among 75 patients who completed FDG PET/CT between January 2010 and December 2017, after lung nodules > 8mm had been detected on LDCT lung cancer screening. We report demographic variables, characteristics of the initial nodules on LDCT and FDG PET/CT, incidental findings on FDG PET/CT, as well as further work up performed and the influence of FDG PET/CT findings on management.
Results: Nodules were reported to be benign on FDG PET/CT in 38/75 (50.6%) patients. Physicians chose either radiological follow-up or no further work up in all 38. FDG PET/CT was indeterminate or suggested malignancy in 37 (49.3%) patients. Biopsy was performed in 32 (86%) of these patients. Incidental findings on FDG PET/CT were reported in 37/75 (49%) patients. Further work-up of incidental findings was performed in 21/75 (28%) of patients.
Conclusions : In this study, for majority of individuals with lung nodules identified during LDCT lung cancer screening, FDG PET/CT results were able to guide physicians in choosing between routine follow up or invasive biopsies. Conversely, 28% of these patients required additional investigations to address incidental findings.
What are the effects of six month personalized endurance training on work ability in middle-aged sedentary women: A randomized controlled trial
Authors: Stenner Hedwig Theda , Eigendorf Julian , Kerling Arno , Kück Momme , Hanke Alexander A. , Boyen Johanna , Nelius Anne-Katrin , Melk Anette , Boethig Dietmar , Bara Christoph , Hilfiker Andres , Berliner Dominik , Bauersachs Johann , Hilfker-Kleiner Denise , Eberhard Jörg , Stiesch Meike , Schippert Cordula , Haverich Axel , Tegtbur Uwe , Haufe Sven
Published: April 2020

Background

To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations.

Methods

We randomized 265 healthy, sedentary, middle-aged women (45-65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO 2peak ) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7-36 points, n=83), good (WAI 2, 37-43 points, n=136) and excellent (WAI 3, 44-49 points, n=46) WAI subgroups.

Results

Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3±5.0 to 39.8±4.9 points) but not in the CG (39.4±4.7 to 39.3±4.9 points), with a significant difference between groups (p<0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0±2.9 to 36.6±4.8 points, p<0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2±2.1 to, 40.4±3.7 points) and excellent (WAI 3, 45.6±1.5 to 45.7±1.8 points) subgroup.

Conclusions

A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals.
Improved cycling stability of LiCoO2 at 4.5 V via surface modification of electrodes with conductive amorphous LLTO thin film
Authors: Song Shipai , Peng Xiang , Huang Kai , Zhang Hao , Wu Fang , Xiang Yong , Zhang Xiaokun
Published: April 2020

The stability issue of LiCoO 2 cycled at high voltages is one of the burning questions for the development of lithium ion batteries with high energy density and long cycling life. Although it is effective to improve the cycling performance of LiCoO 2 via coating individual LiCoO 2 particles with another metal oxides or fluorides, the rate capacity is generally compromised because the typical coating materials are poor conductors. Herein, amorphous Li 0.33 La 0.56 TiO 3 , one of the most successful solid electrolytes, was directly deposited on the surface of made-up LiCoO 2 electrodes through magnetron sputtering. Not only the inherent conductive network in the made-up LiCoO 2 electrodes was retained, but also the Li + transport in bulk and across the cathode-electrolyte interface was enhanced. In addition, the surface chemical analysis of the cycled LiCoO 2 electrodes suggests that most of the stability issues can be addressed via the deposition of amorphous Li 0.33 La 0.56 TiO 3 . With an optimized deposition time, the LiCoO 2 electrodes modified by Li 0.33 La 0.56 TiO 3 performed a steady reversible capacity of 150 mAh/g at 0.2 C with the cut-off voltage from 2.75 to 4.5 V vs. Li + /Li, and an 84.6% capacity gain at 5 C comparing with the pristine one.
Development and validation of the Oral Health Behavior Questionnaire for Adolescents based on the Health Belief Model (OHBQAHBM)
Authors: Xiang Bilu , Wong Hai Ming , Cao Wangnan , Perfecto Antonio P. , McGrath Colman P.J.
Published: April 2020

Background: Oral health belief is a prerequisite of changing oral health behaviors especially during adolescence. However, there is a paucity of well-established questionnaire for use among adolescents. This study aimed to develop and validate an instrument to evaluate adolescents’ beliefs about oral health behaviors using health belief model. Methods: A preliminary 43-item questionnaire was developed by an expert panel. Then the questionnaire was finalized by decreasing the number of items to 35 by analyzing the results from face validity and factor analysis from 421 Hong Kong secondary school students. The content validity were evaluated by a panel of 2 behavioral scientists, 2 dentists, 2 schoolteachers and 10 adolescents. The construct validity of the questionnaire was assessed by performing exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The Cronbach’s alpha coefficient, item-total correlation and intraclass coefficient were used to test its reliability. In addition, to confirm its applicability, multiple regression analysis and path analysis were used to evaluate the possibility of HBM as predictors for oral health behaviors and oral hygiene status. Results: The initial analysis extracted six factors that jointly accounted for 62.47% of the variance observed. Based on CFA, the final version of the questionnaire consisted of 35 items and the data of the final version fitted the model well. The Cronbach’s alpha coefficient for the subscale (>0.7), item-total correlations (0.47-0.91) and the intraclass coefficient (0.82-0.91) were all above acceptable thresholds. The results of multiple regression analysis and path analysis confirmed its ability to predict oral health behaviors and status. Conclusions: The present findings indicate satisfactory validity, reliability and applicability of the proposed Oral Health Behavior Questionnaire for Adolescents based on the Health Belief Model (OHBQAHBM) for measuring oral health beliefs of adolescents. This questionnaire can be used as an instrument to measure oral health beliefs and predict oral health behavior and oral hygiene status of adolescents.
Decoding and Reasoning Mental States in Major Depression and Social Anxiety Disorder
Authors: Maleki Gheysar , Zabihzadeh Abbas , Richman Mara J. , Demetrovics Zsolt , Mohammadnejad Fatemeh
Published: April 2020

Background and objectives

Major depression (MDD) and social anxiety (SAD) disorders are debilitating psychiatric conditions characterized by disturbed interpersonal relationships. Despite these impairments in social interaction, little research has simultaneously evaluated the dysfunction in two aspects of theory of mind (ToM) in these disorders: Affective ToM or decoding mental states and cognitive ToM or reasoning mental states. Taking this into consideration, the current study attempts to compare both decoding and reasoning abilities in MDD, SAD, and healthy controls (HC).

Methods

Subjects were 37 patients with MDD, 35 patients with SAD, and 35 HCs. ToM was measured with the Reading the Mind in the Eyes Test (RMET) and the Faux Pas Task, which assessed decoding skills and reasoning mental states, respectively.

Results

Results showed that in decoding mental states, both the SAD and MDD groups achieved lower scores than HC group; moreover, there was no significant difference between SAD and MDD groups in decoding mental states. However, in reasoning mental states, SAD and HC groups had higher scores than the MDD group and no differences observed between SAD and HC groups in reasoning ability.

Conclusions

Results of this study are discussed on generalized impairment in ToM or dysfunction in both decoding and reasoning mental states in MDD and only reasoning dysfunction in SAD.
Identification of the molecular mechanism and diagnostic biomarkers in the thoracic ossification of the ligamentum flavum using metabolomics and transcriptomics
Authors: Li Jiahao , Yu Lingjia , Guo Shigong , Zhao Yu
Published: April 2020

Background: To establish a metabolite fingerprint of ossification of the thoracic ligamentum flavum (OTLF) patients using liquid chromatography-mass spectrometry (LC-MS) in combination with transcriptomic data and explore the potential molecular mechanism of pathogenesis.
Results: The study cohort was composed of 25 patients with OTLF and 23 healthy volunteers as a control group. 37 metabolites were identified out by UPLC-MS including uric acid and hypoxanthine. 9 metabolites, including uric acid and hypoxanthine, were found with a Variable Importance in Projection (VIP) score over 1 (p<0.05). Pathway enrichment indicated that purine metabolism pathways and the other four metabolism pathways were enriched. Transcriptomic data revealed that purine metabolism have a substantial change in gene expression of OTLF and that xanthine dehydrogenase (XDH) is the key regulatory factor. Receiver operating characteristic (ROC) analysis indicated that 17 metabolites, including uric acid, were found with an AUC value of over 0.7.
Conclusion: Uric acid might be the potential biomarker for OTLF and play an important role within the detailed pathway. XDH could affect purine metabolism by suppressing the expression of hypoxanthine and xanthine leading to low serum levels of uric acid in OTLF, which could be a focal point in developing new therapeutic methods for OTLF.