bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Private Healthcare Expenditures in Kazakhstan and Proposals for their Reduction
Authors:   Chief Analyst of the Department of Macroeconomic Research of Center for Economics and Health Technology Assessment, Republican Center for Health Development, Omirbayeva Bibigul , Zagidullina Galina ,   Head of the Department of Macroeconomic Research of Center for Economics and Health Technology Assessment, Republican Center for Health Development
Published: September 2020

Private expenditures are the part of the health financing system in all countries. However, a catastrophically high level of private expenditures can lead to financial instability of the entire healthcare system, and the national economy as a whole. A high level of private expenditures on health services suggests that the population prefers to pay for medical services at their own expense. This means that the allocated state funds are not being used efficiently enough; there is still a lack of access to medical services. In addition, the unregulated high level of prices for medical services is often an obstacle to access to necessary medical care, and also contributes to the growth of pocket payments, causing problems of financial protection of the population. Current analytical report also includes an analysis of the structure of pocket expenditures of the population for health services in the Republic of Kazakhstan in order to develop recommendations for their reduction. In the Message to the people of Kazakhstan, “Kazakhstan-2050 Strategy: A New Political Course for a Successful State,” the strategic goal was set as becoming one of the 30 most developed countries in the world. To achieve this goal, the existing development gap between the OECD countries and Kazakhstan in all sectors and spheres of activity, including healthcare, must be bridged. In this regard, a comparative analysis of pocket spending on health in Kazakhstan and the OECD countries was carried out. The analysis was based on data from the tables of national health accounts of Kazakhstan for 2010-2018. Differences in per capita health expenditures were compared. In addition, the structure of pocket expenses in dynamics was analyzed, and also based on consumer price indices, the growth in consumption of volumes of medical services at the expense of households was compared. As a result of the study, possible options for reducing pocket expenses were proposed in the context of Kazakhstan's transition from a budget model to an insurance one.
Uncertainty Quantification of the Traffic Assignment Model
Authors: Seger Mundher , Kisgyörgy Lajos
Published: September 2020

Forecasting of traffic flow in the traffic assignment model suffered to a wide range of uncertainties arising from different sources and exacerbating through sequential-stages of the travel demand model. Uncertainty quantification can provide insights into the level of confidence on the traffic assignment model outputs, and also identify the uncertainties of the input Origin-Destination matrix for enhancing the forecasting robustness of the travel demand model. In this paper, a systematic framework is proposed to quantify the uncertainties that lie in the Origin-Destination input matrix. Hence, this study mainly focuses on predicting the posterior distributions of uncertainty Origin-Destination pairs and correcting the biases of Origin-Destination pairs by using the inverse uncertainty quantification formulated through Least Squares Adjustment method. The posterior distributions are further used in the forward uncertainty quantification to quantify the forecast uncertainty of the traffic flow on a transport network. The results show the effectiveness of implementing the inverse uncertainty quantification framework in the traffic assignment model. And demonstrate the necessity of including uncertainty quantification of the input Origin-Destination matrix in future work of travel demand modelling.
No evidence of hemoglobin damage by SARS-CoV-2 infection
Authors: DeMartino Anthony W. , Rose Jason J. , Amdahl Matthew B. , Dent Matthew R. , Shah Faraaz A. , Bain William , McVerry Bryan J. , Kitsios Georgios D. , Tejero Jesús , Gladwin Mark T.
Published: September 2020

SARS-CoV-2 disease (COVID-19) has affected over 22 million patients worldwide as of August 2020. As the medical community seeks better understanding of the underlying pathophysiology of COVID-19, several theories have been proposed. One widely shared theory suggests that SARS-CoV-2 proteins directly interact with human hemoglobin (Hb) and facilitate removal of iron from the heme prosthetic group, leading to the loss of functional hemoglobin and accumulation of iron. Herein, we refute this theory. We compared clinical data from 21 critically ill COVID-19 patients to 21 non-COVID-19 ARDS patient controls, generating hemoglobin-oxygen dissociation curves from venous blood gases. This curve generated from the COVID-19 cohort matched the idealized oxygen-hemoglobin dissociation curve well (Pearson correlation, R2 = 0.97, P<0.0001; CV(RMSD) = 7.3%). We further analyzed hemoglobin, total bilirubin, lactate dehydrogenase, iron, ferritin, and haptoglobin levels. For all analyzed parameters, patients with COVID-19 had similar levels compared to patients with ARDS without COVID-19. These results indicate that patients with COVID-19 do not exhibit any hemolytic anemia or a shift in the normal hemoglobin-oxygen dissociation curve. We therefore conclude that COVID-19 does not impact oxygen delivery through a mechanism involving red cell hemolysis and subsequent removal of iron from the heme prosthetic group in hemoglobin.
Untargeted metabolic profiling in dried blood spots identifies disease fingerprint for pyruvate kinase deficiency
Authors: Van Dooijeweert Birgit , Broeks Melissa H. , Verhoeven-Duif Nanda M. , Van Beers Eduard J. , Nieuwenhuis Edward E.S. , Van Solinge Wouter W. , Bartels Marije , Jans Judith J. , Van Wijk Richard
Published: September 2020

The diagnostic evaluation and clinical characterization of rare hereditary anemia (RHA) is to date still challenging. In particular, there is little knowledge of the broad metabolic impact of many of the molecular defects underlying RHA. In this study we explored the potential of untargeted metabolomics to diagnose a relatively common type of RHA: pyruvate kinase deficiency (PKD). In total, 1,903 unique metabolite features were identified in dried blood spot samples from 16 PKD patients and 32 healthy controls. A metabolic fingerprint was identified using a machine learning algorithm, and subsequently a binary classification model was designed. The model showed high performance characteristics (AUC 0.990, 95% CI: 0.981-0.999) and an accurate class assignment was achieved for all newly added control (n=13) and patient samples, (n=6) with the exception of one patient (accuracy 94%). Important metabolites in the metabolic fingerprint included glycolytic intermediates, polyamines and several acyl carnitines. In general, the application of untargeted metabolomics in dried blood spots is a novel functional tool that holds promise for the diagnostic stratification and studies on the disease pathophysiology in RHA.
Retrograde transradial Approach for Hemodialysis Access Intervention: A Single-Center Study
Authors: Hossain GM Mokbul , Mandal Naresh Chandra , Hasan Rakibul , Dey Nirmal Kanti , Mamun Abdullah Al , Saklayen SMG , Sarker Swadesh Ranjan , Sarker Motiur Rahman , Huque AKM Ziaul , Ferdous Shajadi , Rony Md Mujibur Rahman
Published: September 2020

Perianastomotic stenosis is a common scenario after creation of arteriovenous fistula for hemodialysis. Most of the interventionists prefer transvenous approach. But transradial approach can easily visualize radial artery and cephalic venous tree up to central vein. This retrospective study was performed from November 2012 to January 2017 in Ibn Sina Hospital, Dhanmondi, Dhaka. Total patients undergoing hemodialysis access were 148 (male 74, female 74, male-female ratio 1:1). Number of radiocephalic fistula was 95 (64%), brachiocephalic fistula 50 (34%) & others 3 (2%). Most of the punctures were done by palpation. Sometimes puncture was made by ultrasonogram guidance. Puncture needle size was 21 gauge, 2.5cm or 4cm long. Sheath size was 6 F x 4 cm or 7 F x 4cm. Majority of the cases (140) were successfully approached through retrograde transradial route. Few cases (8) were approached through retrograde venous route due to thrombosis of radial artery for previous intervention or creation of radiocephalic fistula in an end to end fashion. It was concluded that retrograde transradial approach to dilate perianastomotic stenosis as well as outflow vein is a good option.

Bangladesh Heart Journal 2020; 35(1) : 54-60
Successful Management of a Giant Mycotic Coronary Artery Aneurysm Develeped after Multivessel PCI with Drug-Eluting Stent
Authors: Mahmod Muhammad Salim , Rahman Mohammad Arifur , Zahangir Nuruddin Mohammod , Basak Rajib Kumar , Khan Mohammad Maknunur Rahman
Published: September 2020

Coronary artery stent infection has been reported with both bare metal stent and drug eluting stent and can present as mycotic coronary artery aneurysm, pseudoaneurysm. myocardial abscess, pericarditis or exudative effusion. Infection at the site of coronary stent implantation is rare and is believed to result typically from either direct stent contamination at the time of delivery or transient bacteraemia from access site. Recently, several case reports of pseudoaneurysm formation after DES implantation have been reported in the literature. We describe the successful surgical management of giant mycotic pseudoaneurysm of RCA presenting as fever of unknown origin with AMI (inferior) three months after multivessel PCI in LAD & RCA with DES in radial route. This report illustrates the importance of early detection and prompt management of these rare coronary pseudoaneurysms, which is a highly lethal condition. At three months follow-up after surgery, the patient was asymptomatic with fair LVEF 58%

Bangladesh Heart Journal 2020; 35(1) : 66-70
The Effect of Aortic Coarctation Surgical Repair on QTc and JTc Dispersion in Severe Aortic Coarctation Newborns: A Short-Term Follow-Up Study
Authors: NIGRO G. , RUSSO V. , RAGO A. , PAPA A. A. , CIOPPA N. D. , SCARPATI C. , PALLADINO T. , CORCIONE A. , SARUBBI B. , CAIANIELLO G. , RUSSO M. G.
Published: September 2020

Sudden death is a possible occurrence for newborns younger than 1 year with severe aortic coarctation (CoA) before surgical correction. In our previous study, we showed a significant increase of QTc-D and JTc-D in newborns with isolated severe aortic coarctation, electrocardiographic parameters that clinical and experimental studies have suggested could reflect the physiological variability of regional and ventricular repolarization and could provide a substrate for life-threatening ventricular arrhythmias. The aim of the current study was to evaluate the effect of surgical repair of CoA on QTc-d, JTc-d in severe aortic coarctation newborns with no associated congenital cardiac malformations. The study included 30 newborns (18M; 70±12 h old) affected by severe congenital aortic coarctation, without associated cardiac malformations. All newborns underwent to classic extended end-to-end repair. Echocardiographic and electrocardiographic measurements were performed in each patient 24 h before and 24 h after the interventional procedure and at the end of the follow-up period, 1 month after the surgical correction. All patients at baseline, 24 h and one month after CoA surgical repair did not significantly differ in terms of heart rate, weight, height, and echocardiographic parameters. There were no statistically significant differences in QTc-D (111.7±47.4 vs 111.9±63.8 ms vs 108.5±55.4 ms; P=0.4) and JTc-D (98.1±41.3 vs 111.4±47.5 vs 105.1±33.4 ms; P=0.3) before, 24 h and 1 month after CoA surgical correction. In conclusions, our study did not show a statistically significant decrease in QTc-D and JTc-D, suggesting the hypothesis that the acute left ventricular afterload reduction, related to successful CoA surgical correction, may not reduce the ventricular electrical instability in the short-term follow-up.
Pancreatic Injury Secondary to Renal Ischemia/Reperfusion (I/R) Injury: Possible Role of Oxidative Stress
Authors: HUSSEIN A. M. , ABD-ELKHABIR A. , ABOZAHRA A. , BAIOMY A. , ASHAMALLAH S. A. , SHEASHAA H. A. , SOBH M. A.
Published: September 2020

Recent studies demonstrated remote effects of renal ischemia/reperfusion (I/R) injury on some organs such as brain, liver, and lungs. We investigated the effects of renal I-R injury on function, histology and oxidative stress state of pancreas. Twenty -four male adult Sprague-Dawley rats were divided equally into 2 groups; sham group: rats underwent midline laparotomy and dissection of renal pedicles without renal ischemia, and ischemic group: rats underwent bilateral renal ischemia for 45 min. Renal functions (serum creatinine and BUN), pancreatic functions (serum amylase, lipase and insulin) and fasting blood glucose were measured at 2 h, 1 day, 3 days and 7 days after ischemia. Also, pancreatic histology and malondialdehyde (MDA), catalase and reduced glutathione (GSH) were examined at 2 h and 7 days after ischemia. The ischemic rats showed significant increase in serum creatinine and BUN with significant increase in serum amylase and lipase at 2 h, 1 day and 3 days after ischemia. Blood glucose and fasting insulin showed no significant change apart from significant increase in insulin in sham group at 1 day after ischemia. Pancreas isolated from ischemic rats showed significant increase in histopathological damage score and significant increase in MDA and catalase enzyme with decrease in GSH. In conclusion, bilateral renal ischemia for 45 min caused significant impairment of pancreatic functions and histology. This might be due to deficiency of antioxidant and increased lipid peroxidations in pancreatic tissues.
Effect of Sacroiliac Joint Mobilization on Chronic Non-Spacific Low Lumbar Pain and Function in Women
Authors: Jarulaitis Justinas , Zachovajevas Pavelas
Published: September 2020

Background. Research aim was to investigate the effect of sacroiliac joint mobilization on chronic non-specific lumbar pain and function in women.Methods. 1. VAS scale evaluation; 2. Measurement of lumbar range of motion; 3. Lumbar muscle stamina tests. Twenty women who felt chronic non-specific lumbar pain and havd sacroiliac joint disfunction were investigated in this research.Results. The results of the study showed that the pain decreased from 3.87 ± 0.41 to 1.86 ± 0.33 points in the study group, and from 3.4 ± 0.52 to 1.6 ± 0.28 points in the control group (p < 0.05). The mean value of the abdominal muscle endurance test in the study group increased by 21.2 ± 3.65 s, in the control group – by 19.6 ± 3.69 s (p < 0.05). The isometric means of the abdominal muscle endurance test increased by 21.7 ± 2.58 s in the study group – and by 18.1 ± 4.07 s in the control group (p < 0.05). After physiotherapy, a statistically significant improvement in torso movement amplitudes was observed in both groups, but no statistically significant change was observed between the groups.Conclusions. Spinal stabilization exercises combined with sacroiliac joint mobilization were more effective treatment than the use of stabilization exercises alone, as they statistically significantly reduced the intensity of perceived pain and increased torso muscle endurance.Keywords: sacroiliac joint mobilization, chronic non-specific lumbar pain, functional lumbar indicators.
The Effects of Bibliotherapy and Equine – Assisted Therapy on Traumatized Children
Authors: Sučylaitė Jūratė , Grakauskaitė-Šličienė Donata
Published: September 2020

Background. Early childhood traumas leave serious consequences: during adolescence and adulthood people often experience internal conflicts, more often suffer from mental and somatic diseases, so it is important to look for therapies that can neutralize or reduce the effects of early traumas. One of the options is to apply a complex of bibliotherapy and equine assisted therapy. However, there is a lack of studies analysing how these two therapies affect the development.The aim was to explore the influence of bibliotherapy and equine-assisted therapy on the emotions and behaviour of children with early trauma.Methods. Qualitative research used interview, observation, and projection techniques.Results. Bibliotherapy created preconditions for the emergence of repressed feelings and for deeper, more sensitive dialogue with the psychologist. Riding helped to relax, captured the attention of the present, strengthened positive emotions.Conclusions. 1. Equine – assisted therapy affects the body and gives positive emotions, reduces child’s inner anxiety, improves mood and consolidates bibliotherapy results. 2. The combination of bibliotherapy and equine – assisted therapy creates the conditions for stabilizing and even transforming the negative emotions of children with early trauma and restoring the fullness of childhood life.Keywords: psychological trauma, child development, emotions, horse assisted therapy, bibliotherapy.
‘lips move, uttering inaudibly’: The Female Voice in Samuel Beckett's…but the clouds …
Authors: Vashisht Jivitesh
Published: September 2020

While the dialogue between Samuel Beckett's …but the clouds… and W. B. Yeats's ‘The Tower’ has been thoroughly examined, much less attention has been paid to the female voice that inaudibly recites the poetic fragment in what constitutes the teleplay's chief intertextual gesture towards Yeats's poem. Aligning this oversight with the more pervasive disregard within Beckett Studies to the gendered specificity of Beckett's voices, this essay elaborates the absent presence of the female voice in the teleplay – crystallised in the image of W's silently moving lips – from the interlocking perspectives of intertextuality, technology, and spectatorship. It draws attention to Beckett's sustained preoccupation with the female voice during the composition process, as well as the intertextual and technological operations through which he orchestrates its paradoxical status. Even though as a speech-deprived female body functions as the locus of these overlapping processes, I argue that … but the clouds… ultimately subverts associations of the feminine with discursive inadequacy and bodily impairment; if anything, Beckett here attributes deficiency and incompletion to male subjectivity and the televisual medium.
A vida propagada na TV: ressignificações de temáticas e consumo no cotidiano de jovens da periferia da Amazônia brasileira
Authors: Arantes de Asís Claudia María , Scheibe Roberta
Published: September 2020

Este artigo reflete como jovens ressignificam apanhados multiculturais televisivos em outras mídias, a partir do cotidiano em que estão imersos e da sociedade e da mídia na qual fazem parte, a partir de duas pesquisas realizadas na Amazônia brasileira, uma em âmbito nacional e outra local, mais especificamente em uma área periférica da capital do Amapá, Macapá. A pesquisa na área periférica que ocorreu em 2014 ganha, neste artigo, novas problematizações e dimensões analíticas que se convergem nos imperativos de consumo televisivo e seus contextos sociais, culturais, econômicos e tecnológicos. Este texto baseia-se nos artefatos teóricos, sobretudo, de Martín-Barbero, Clifford Geertz e Stuart Hall para embasar o uso de veículos midiáticos frente ao público específico jovem, em contexo amazônico.
Nuevos hábitos de consumo televisivo: retos de la audiencia en diferido
Authors: González Neira Ana , Fernández Martínez Luis Manuel
Published: September 2020

La televisión se encuentra en una clara fase de renovación debido a los procesos de convergencia mediática. Los recientes cambios tecnológicos han alterado la definición espaciotemporal del visionado por lo que se hace necesario acercarse a un tipo de consumo que se va afianzando progresivamente: la audiencia en diferido. Esta investigación pone en relación este tipo de audiencia frente a la audiencia lineal o tradicional en el mercado televisivo en España a través de los datos de consumo de 2018. Sigue la línea de trabajos previos, pero con un marco temporal actualizado en el que el consumo televisivo se ha alterado notablemente por la penetración de las plataformas OTT (over the top). Los resultados obtenidos indican que se trata de un visionado creciente en España, con una clara preferencia hacia las series españolas. Existe una clara discordancia entre los espacios con mayor éxito en consumo lineal y en diferido. Estos resultados permiten abordar una reflexión sobre la dificultad de programar para un prime time que se consume fuera del prime time, las razones del incremento de este tipo de consumo o las dificultades que plantean las métricas actuales de audiencia.
Producción audiovisual infantil española: ‘Pocoyó’ y ‘Jelly Jamm’ como referentes de series de animación educativas para el 2º ciclo de Educación Infantil
Authors: Melgarejo Moreno Irene , Rodríguez Rosell María del Mar
Published: September 2020

En los últimos años las series de animación infantiles de producción española tienen un carácter destacado en las parrillas televisivas mundiales. Las cifras de audiencia y el éxito obtenido, no sólo en España sino en todo el mundo, posicionan a Pocoyó (La 2, 2005-2011) y Jelly Jamm (Cartoonito, 2011-2013) como contenidos líderes; la primera se distribuye en más de 150 países y la segunda ha sido estrenada en 130 países y vendida en 150. Animaciones educativas no formales que bien podrían ser extrapolables a ámbitos socioculturales formales, como puede ser el escolar. Con esta investigación se realiza un análisis de contenido de los capítulos correspondientes a la primera temporada de ambas series, para asociarlas al currículum del 2º ciclo de Educación Infantil, de tal forma que se permita el trabajo de las áreas y contenidos a través del uso del producto audiovisual dentro de los contextos escolares. No sólo la naturaleza del producto de televisión y el género educativo al que pertenecen las hace idóneas para ser implementadas en las aulas, sino que nos encontramos ante productos que podrían ser propuestos como recursos didácticos para la promoción de la alfabetización mediática desde los primeros años escolares.
Representación de la diversidad funcional en series contemporáneas españolas de ‘prime time’
Authors: Palenzuela Zanca Julia , Marcos Ramos María , González de Garay Domínguez Beatriz
Published: September 2020

El siguiente estudio analiza el grado de representación y autonomía de los personajes con diversidad funcional en la ficción española en horario de prime time durante la segunda mitad del año 2016, el año 2017 y la primera mitad del año 2018. Para ello, han sido analizados 1.237 personajes de 47 series de ficción, emitidas en las seis cadenas generalistas nacionales: La 1, La 2, Antena 3, Cuatro, Telecinco y La Sexta. Por medio de un método validado por estudios previos, se ha llegado a la conclusión de que existe una infrarrepresentación de 8,6 puntos porcentuales por parte de la ficción española de personajes con diversidad funcional en comparación con la realidad, no siendo apenas mostrada su autonomía como individuos, tanto en el ámbito de las actividades cotidianas, como en el hecho de protagonizar las narraciones en las que aparecen. Por ello, se asume la necesidad de revisar los modelos de representación de minorías sociales en los medios de comunicación masivos y se propone ampliar el estudio hacia el análisis de contenidos audiovisuales localizados en las plataformas de contenido online. Además, se plantea la promoción de personas y personajes con diversidad funcional en la industria televisiva española.
‘Steven Universe’: un héroe dialógico como engranaje del cambio
Authors: Aguado-Peláez Delicia
Published: September 2020

El objetivo de la presente investigación es reflexionar sobre la representación de los sistemas de dominación y resistencias presentes en la serie de animación infantil/juvenil imaginada por Rebeca Sugar: Steven Universe (Cartoon Network, 2013-2019). Para ello, se analizan las cinco temporadas (160 episodios) utilizando como herramientas metodológicas el análisis de contenido cualitativo y la interseccionalidad, especialmente la «matriz de dominación» diseñada por Patricia Hill Collins. En este sentido, hay que destacar que esta producción utiliza las licencias de la ciencia ficción fantástica para narrar, en clave infantil, la interacción de sistemas de dominación como el capitalismo, el colonialismo, el racismo o el sexismo. Pero también habla de las estrategias que desarrollan los personajes para superarla, especialmente, a través del diálogo y la empatía y de la introducción de temáticas tan diversas como la búsqueda de identidad, los derechos LGBTI+ o la crisis de los refugiados, entre otras. En conclusión, se puede afirmar que Steven Universe apuesta por una transformación del campo mediático en clave de diversidad y justicia social.
Diseño de un proyecto de capacitación en competencias digitales de los colectivos vulnerables, mediadores en educación permanente y MYPES-PYMES en Aragón
Authors: Pérez-Calle Begoña , Marta-Lazo Carmen , Nogales-Bocio Antonia Isabel
Published: September 2020

El objetivo del presente artículo es la presentación del diseño de un proyecto, en fase inicial, cuyos resultados nos permitirán dilucidar cuáles son las verdaderas necesidades de competencia digital de la ciudadanía, en concreto de tres sectores estratégicos, para profundizar en el estudio: los agentes mediadores dentro de la educación permanente, el sector de MYPES-PYMES y los colectivos vulnerables, siendo estos últimos los que requieren una atención preferente para la inclusión social. La metodología empleada en el proyecto —y por lo tanto descrita en este trabajo— pasa por realizar una revisión de las líneas estratégicas de la convocatoria de los criterios y procedimientos de selección de operaciones (CPSO) aprobados por el Comité de Seguimiento del Programa Operativo Aragón de FEDER 2014-2020. El planteamiento del proyecto y el modo en que se adecúa a los ejes prioritarios de inversión europeos lo convierten en una propuesta transferible a la comunidad científica internacional.
The Dimensionality of Cosponsorship Behavior in the House of Representatives
Authors: Carrizosa Andres
Published: September 2020

Legislative stability exists in the House of Representatives, but there is not a consensus on whether this stability is produced by a Preference Induced Equilibrium (PIE), which predict that if preferences are unidimensional an equilibrium can be found at the position of the median legislator, or a Structure Induced Equilibrium (SIE), which predicts that multidimensional legislative preferences must be constrained by institutions to produce stable outcomes. While both explanations predict that roll-call behavior will be unidimensional, they make competing predictions for less constrained behavior such as cosponsorship behavior. By relying on Bayesian item-response methods that allow for the assessment of dimensionality of both cosponsorship behavior and roll-call behavior on a comparable scale--which has been problematic in the past--I provide evidence in support of a SIE in the House. While roll-call behavior is unidimensional, only around 30% of cosponsorship behavior is explained by the first dimension of legislative preferences.
Clinical Features, Risk Factors and Hospital Mortality of Acute Stroke Patients
Authors: Anwar Mahfuj-Ul , Afrin Sajeda , Mondol ASM Rahenur , Islam Khan Mohammad Nurul , Chandra Sarkar Narayan , Sarkar Kamruzzaman , Jahan Shah Sarwer , Rani Moni , Mondal Ratindra Nath
Published: September 2020

Background: Stroke is a leading cause of mortality and disability worldwide. To prevent complications and permanent defects, early diagnosis, distinguishing the type and risk factor of stroke is crucial. Methodology: It was a hospital based cross sectional study, purposive sampling method was used, and a total of 469 stroke patients admitted into Department of Medicine, Rangpur medical college hospital, Bangladesh were included in this study. Results: In this study we have studied of 469 acute stroke patients. Among them 81% (380) were ischemic stroke patients and 19% (89) were hemorrhagic stroke. Overall male were more than female 308 (65.7%) vs 161(34.4%). The mean age for the ischemic stroke group was 64.1 ± 10.9 years, which was significantly higher than that of the hemorrhagic group (59.8 ± 9.60years) (P<0.05). Acute hemorrhagic stroke patients presented with acute onset of focal neurological deficit 61.8%, headache 64%, vomiting 59.6%, alteration of consciousness 48.3% and convulsion 27%. On the other hand, acute ischemic stroke patient presented with alteration of consciousness 65.5%, acute onset of focal neurological deficit 39.5%, paralysis 41%, deficit after awakening 32.4% and aphasia 34.7%. Among the risk factors of stroke in acute ischemic stroke patients hypertension was 59.2%, diabetes mellitus 20%, history of previous stroke 16.1%, ischemic heart disease 14.5% and atrial fibrillation 10.3% were present, on the other hand in acute hemorrhagic stroke patients hypertension 76.4%, smoking 70.8% and diabetes mellitus 6.7% were present. 26.97% of the acute hemorrhagic stroke and 13.9% of the acute ischemic stroke patients died in hospital. Conclusion: Common presentation of stroke was acute onset of focal neurological deficit; headache and vomiting were more in hemorrhagic stroke patient; alteration of consciousness, paralysis was predominant in ischemic stroke patient.
Global Neural Activities Changes under Human Inhibitory Control Using Translational Scenario
Authors: Chikara Rupesh Kumar , Ko Li-Wei
Published: September 2020

This study presents a new approach to exploring human inhibition in a realistic scenario. In previous inhibition studies, the stimulus design of go/no-go task generally used a simple symbol for the go and stop signals. We can understand the neural activity of inhibition through simple symbol scenario. In the real world, situations of human inhibition are more complex than performing an experiment in the laboratory scale. How to explore the neural activities of inhibition in a realistic environment is more complex. Consequently, we designed a battlefield scenario to investigate the neural activities of inhibition in a more realistic environmental setting. The battlefield scenario provides stronger emotion, motivation and real-world experiences for participants during inhibition. In the battlefield scenario, the signs of fixation, go and stop were replaced by images of a sniper scope, a target and a non-target. The battlefield scenario is a shooting game between the enemy and the soldiers. In battlefield scenario participants played the role of the soldiers for shooting target and to stop shooting when a non-target appeared. Electroencephalography (EEG) signals from twenty participants were acquired and analyzed using independent component analysis (ICA) and dipole source localization method. The results of event-related potential (ERP) showed a significant modulation of the peaks N1, N2 and P3 in the frontal and cingulate cortices under inhibitory control. The partially overlapping ERP N2 and P3 waves were associated with inhibition in the frontal cortex. The ERP N2, N1 and P3 waves in the cingulate cortex are related to sustained attention, motivation, emotion and inhibitory control. In addition, the event-related spectral perturbation (ERSP) results shows that the powers of the delta and theta bands increased significantly in the frontal and cingulate cortices under human inhibitory control. The EEG-ERP waves and power spectra in the frontal and cingulate cortices were found more increased than in the parietal, occipital, left and right motor cortices after successful stop. These findings provide new insights to understand the global neural activities changes during human inhibitory control with realistic environmental scenario.
Gastric Juice Expression of Th-17 and T-Reg Related Cytokines in Scleroderma Esophageal Involvement
Authors: Nicola Stefania , Rolla Giovanni , Bucca Caterina , Geronazzo Giada , Ridolfi Irene , Ferraris Andrea , Fusaro Enrico , Peroni Clara Lisa , Dughera Luca , Brussino Luisa
Published: September 2020

Background: Systemic sclerosis (SSc) is a connective tissue disorder which key feature is a fibrotic process. The role of Endothelin-1 (ET-1) and T-helper (Th)-1 cells in lung and skin fibrosis is well known, although Th17- and Treg-cells were found to be involved. However, no studies analyzed cytokines expression in gastric-juice of SSc patients. Our study aimed to evaluate proinflammatory and profibrotic cytokines in gastric-juice of SSc patients and to investigate their correlations with esophageal dysmotility. Methods: Patients performed upper-gastrointestinal-endoscopy with gastric-juice collection, esophageal manometry and thoracic CT-scan. GM-CSF, ET-1, Th-1 (IFN-γ, IL-1β, TNF-α, IL-2, IL-6, IL-9), Th-17 (IL-17, IL-21, IL-22, IL-23) and T-reg (IL-10, TGF-β) related cytokines were measured in 29 SSc-patients and 20 healthy-controls. Results: Patients showed significant lower levels of IL-6, IL-17, IL-22 and ET-1 (p < 0.005) compared with controls. Patients with atrophic gastritis presented significant lower levels of IL-2, IL-9, IL-6, TGF-β, GM-CSF, IL-17 and ET-1 (p < 0.005) compared to patients without gastritis. Increased values of IL-2, IL-9, IL-1β, IL-17, ET-1 and GM-CSF (p < 0.005) were observed in patients with esophageal impairment. This is the first report of cytokines measurement in gastric juice of patients with SSc. The high IL-17 concentrations in gastric-juice of scleroderma patients with esophageal dysmotility support the signature of Th-17 cells in scleroderma esophageal fibrosis.
Time Fractional Fisher–KPP and Fitzhugh–Nagumo Equations
Authors: Angstmann Christopher N. , Henry Bruce I.
Published: September 2020

A standard reaction–diffusion equation consists of two additive terms, a diffusion term and a reaction rate term. The latter term is obtained directly from a reaction rate equation which is itself derived from known reaction kinetics, together with modelling assumptions such as the law of mass action for well-mixed systems. In formulating a reaction–subdiffusion equation, it is not sufficient to know the reaction rate equation. It is also necessary to know details of the reaction kinetics, even in well-mixed systems where reactions are not diffusion limited. This is because, at a fundamental level, birth and death processes need to be dealt with differently in subdiffusive environments. While there has been some discussion of this in the published literature, few examples have been provided, and there are still very many papers being published with Caputo fractional time derivatives simply replacing first order time derivatives in reaction–diffusion equations. In this paper, we formulate clear examples of reaction–subdiffusion systems, based on; equal birth and death rate dynamics, Fisher–Kolmogorov, Petrovsky and Piskunov (Fisher–KPP) equation dynamics, and Fitzhugh–Nagumo equation dynamics. These examples illustrate how to incorporate considerations of reaction kinetics into fractional reaction–diffusion equations. We also show how the dynamics of a system with birth rates and death rates cancelling, in an otherwise subdiffusive environment, are governed by a mass-conserving tempered time fractional diffusion equation that is subdiffusive for short times but standard diffusion for long times.
Regularization Methods Based on the Lq-Likelihood for Linear Models with Heavy-Tailed Errors
Authors: Hirose Yoshihiro
Published: September 2020

We propose regularization methods for linear models based on the Lq-likelihood, which is a generalization of the log-likelihood using a power function. Regularization methods are popular for the estimation in the normal linear model. However, heavy-tailed errors are also important in statistics and machine learning. We assume q-normal distributions as the errors in linear models. A q-normal distribution is heavy-tailed, which is defined using a power function, not the exponential function. We find that the proposed methods for linear models with q-normal errors coincide with the ordinary regularization methods that are applied to the normal linear model. The proposed methods can be computed using existing packages because they are penalized least squares methods. We examine the proposed methods using numerical experiments, showing that the methods perform well, even when the error is heavy-tailed. The numerical experiments also illustrate that our methods work well in model selection and generalization, especially when the error is slightly heavy-tailed.
Skin Healing of Deep Second Degree Burn Injuries in Four Individuals Sustained in a Boat Explosion—Results after Different Approaches
Authors: März Vincent , Vogt Peter
Published: September 2020

Intermediate and deep second-degree skin burn injuries are an ongoing challenge for burn surgeons, with the difficult decision regarding whether to handle them with either conservative or operative methods. In this study, the outcome of similar deep second-degree skin burn injuries is shown with the example of four family members. Clinical outcomes of the four family members which were treated at our burn center in 2017 were analyzed. The areas of burned skin (IIa°-IIb°) extended from 14% to 38% of the total burned skin area. Surgical treatment was adjusted to the rate of epithelialization after the first debridement. The excellent cosmetic long-term results of this patient cohort support the importance of stage-related therapy of deep dermal burn injuries. An initial debridement followed by early coverage is the key to early reconstitution of the epidermal barrier. However, with regard to the late effects of skin substitutes, more sensory alterations, dysesthesia, hyperpigmentation and unstable skin areas are still visible after coverage with glycerol conserved skin. The best results were seen after the use of autologous STGS and synthetic skin.
Robust Linear Control of Boost and Buck-Boost DC-DC Converters in Micro-Grids with Constant Power Loads
Authors: Yfoulis Christos , Papadopoulou Simira , Voutetakis Spyridon
Published: September 2020

Power distribution systems nowadays are highly penetrated by renewable energy sources, and this explains the dominant role of power electronic converters in their operation. However, the presence of multiple power electronic conversion units gives rise to the so-called phenomenon of Constant Power Loads (CPLs), which poses a serious stability challenge in the overall operation of a DC micro-grid. This article addresses the problem of enhancing the stability margin of boost and buck-boost DC-DC converters employed in DC micro-grids under uncertain mixed load conditions. This is done with a recently proposed methodology that relies on a two-degree-of-freedom (2-DOF) controller, comprised by a voltage-mode Proportional Integral Derivative (PID) (Type-III) primary controller and a reference governor (RG) secondary controller. This complementary scheme adjusts the imposed voltage reference dynamically and is designed in an optimal fashion via the Model Predictive Control (MPC) methodology based on a specialized composite (current and power) estimator. The outcome is a robust linear MPC controller in an explicit form that is shown to possess interesting robustness properties in a wide operating range and under various disturbances and mixed load conditions. The robustness and performance of the proposed controller/observer pair under steady-state, line, and mixed load variations is validated through extensive Matlab/Simulink simulations.
Cost of Equity of Coal-Fired Power Generation Projects in Poland: Its Importance for the Management of Decision-Making Process
Authors: Saługa Piotr W. , Szczepańska-Woszczyna Katarzyna , Miśkiewicz Radosław , Chłąd Mateusz
Published: September 2020

Our knowledge of discount rates plays an important role both in the discounted cash flow decision-making process and in the later phases of a project’s lifetime. It is useful than both for management and cash-flow monitoring purposes at operating stages. Investors putting money into power generation projects expect an appropriate rate of return to compensate them for a minimum acceptable real return available in the market (risk-free rate of interest) and the project’s specific risk. Due to its essential nature in the financial and economic evaluation of projects (it is the only parameter that reflects the risk), it is reasonable to assume that investors would also be interested in constituent components of that indicator. The discount rate is one parameter in the discounted cash flow analysis that takes into account the risk of a venture. Further, the previous research in this area has focused mainly on the dimension of this variable, and the structure of this parameter has not been dealt with any other studies. The proposed idea of this study met the expectations of the industry—it aimed to present a typical project implemented in the energy industry, a relatively simple methodology that allowed estimating the components within the cost of equity capital of the enterprise. In the power generation sector, one can find various types of discount rates—assessed for multiple technologies, at different development stages, and expressed differently. Owing to the know-how and decades-long experience, coal-fired power projects’ remarks may be a good benchmark for alternative low carbon technologies. That is why, in this work, a discount rate for valuing investment in new coal-fired power projects was evaluated. This assessment was made on the “bare-bones” assumption, meaning evaluations at 100% equity, after-tax, in constant (real) currency units. The analysis of the discount rate structure was performed by applying the procedure of the classical sensitivity analysis having the accuracy of key input parameters. Finally, the risk factors within the risk-adjusted discount rate were calculated. The obtained results showed the importance of individual risk factors within the risk-adjusted discount rate used in coal energy projects, which would enable a more pragmatic approach to controlling this parameter by decision-makers and understanding the risk.
A Coordinated Dispatching Model Considering Generation and Operation Reserve in Wind Power-Photovoltaic-Pumped Storage System
Authors: Cui Dai , Xu Fei , Ge Weichun , Huang Pengxiang , Zhou Yunhai
Published: September 2020

Large-scale grid integration of renewable energy increases the uncertainty and volatility of power systems, which brings difficulties to output planning and reserve decision-making of power system units. In this paper, we innovatively combined the non-parametric kernel density estimation method and scenario method to describe the uncertainty of renewable energy outputs, and obtained a representative set of renewable energy output scenarios. In addition, we proposed a new method to determine the reserve capacity demand. Further, we derived the quantitative relationship between the reserve demand and the power system reliability index, which was used as the constraint condition of a day-ahead power generation dispatch. Finally, a coordinated dispatching model of power generation and reserve was established, which had the lowest penalty for curtailment of wind power and photovoltaic, as well as the lowest total operating cost for thermal power units, gas power units, and pumped storage power station. By simulating three different working conditions, the proposed model was compared with the traditional deterministic model. Results showed that our proposed method significantly improved system efficiency while maintaining system reliability.
Analysis of the Existing Barriers for the Market Development of Power to Hydrogen (P2H) in Italy
Authors: Saccani Cesare , Pellegrini Marco , Guzzini Alessandro
Published: September 2020

New technological solutions are required to control the impact of the increasing presence of renewable energy sources connected to the electric grid that are characterized by unpredictable production (i.e., wind and solar energy). Energy storage is becoming essential to stabilize the grid when a mismatch between production and demand occurs. Among the available solutions, Power to Hydrogen (P2H) is one of the most attractive options. However, despite the potential, many barriers currently hinder P2H market development. The literature reports general barriers and strategies to overcome them, but a specific analysis is fundamental to identifying how these barriers concretely arise in national and regional frameworks, since tailored solutions are needed to foster the development of P2H local market. The paper aims to identify and to analyze the existing barriers for P2H market uptake in Italy. The paper shows how several technical, regulatory and economic issues are still unsolved, resulting in a source of uncertainty for P2H investment. The paper also suggests possible approaches and solutions to address the Italian barriers and to support politics and decision-makers in the definition and implementation of the national hydrogen strategy.
Outlook for Direct Use of Sunflower and Castor Oils as Biofuels in Compression Ignition Diesel Engines, Being Part of Diesel/Ethyl Acetate/Straight Vegetable Oil Triple Blends
Authors: Aguado-Deblas Laura , Estevez Rafael , Hidalgo-Carrillo Jesús , Bautista Felipa M. , Luna Carlos , Calero Juan , Posadillo Alejandro , Romero Antonio A. , Luna Diego
Published: September 2020

Today, biofuels are indispensable in the implementation of fossil fuels replacement processes. This study evaluates ethyl acetate (EA) as a solvent of two straight vegetable oils (SVOs), castor oil (CO), and sunflower oil (SO), in order to obtain EA/SVO double blends that can be used directly as biofuels, or along with fossil diesel (D), in the current compression-ignition (C.I.) engines. The interest of EA as oxygenated additive lies not only in its low price and renewable character, but also in its very attractive properties such as low kinematic viscosity, reasonable energy density, high oxygen content, and rich cold flow properties. Revelant fuel properties of EA/SVO double and D/EA/SVO triple blends have been object of study including kinematic viscosity, pour point (PP), cloud point (CP), calorific value (CV), and cetane number (CN). The suitability of using these blends as fuels has been tested by running them on a diesel engine electric generator, analyzing their effect on engine power output, fuel consumption, and smoke emissions. Results obtained indicate that the D/EA/SO and D/EA/CO triple blends, composed by up to 24% and 36% EA, respectively, allow a fossil diesel substitution up to 60–80% providing power values very similar to conventional diesel.In addition, in exchange of a slight fuel consumption, a very notable lessening in the emission of pollutants as well as a better behavior at low temperatures, as compared to diesel, are achieved.
Digitization of Broccoli Freshness Integrating External Color and Mass Loss
Authors: Makino Yoshio , Amino Genki
Published: September 2020

Yellowing of green vegetables due to chlorophyll decomposition is a phenomenon indicating serious deterioration of freshness, and it is evaluated by measuring color space values. In contrast, mass reduction due to water loss is a deterioration of freshness observed in all horticultural crops. Therefore, in this study, we propose a novel freshness evaluation index for green vegetables that combines the degree of greenness and mass loss. The green color retention rate was measured using a computer vision system, and the mass retention rate was measured by weighing. Linear discriminant analysis (LDA) was performed using both variables (greenness and mass) as covariates to obtain a single freshness evaluation value (first canonical variable). The correct classification of storage period length by LDA was 96%. Green color retention alone allowed for classification of storage durations between 0 day and 10 days, whereas LDA could classify storage durations between 0 day and 12 days. The novel freshness evaluation index proposed by this research, which integrates greenness and mass, has been shown to be more accurate than the conventional evaluation index that uses only greenness.