bluuebunny/crossref_metadata_2025 huggingface dataset:
ANÁLISE DA APLICAÇÃO DO DIREITO PENAL NOS CRIMES VIRTUAIS
Authors: Araujo Claudio Rodrigues
Published: April 2021

A Internet vem tendo cada vez mais expansão, bem como o número dos seus usuários. A procura por informações, entretenimento, diversão, relacionamento, dentre outras, são algumas das principais atividades que são advindas por ela. No entanto, certos usufruidores fazem seu emprego de maneira prejudicial, fazendo a prática dos crimes virtuais. O país não é possuinte de uma legislação em especificidade acerca da temática, tem-se alguns artigos e leis que terão abordagem no decorrer do trabalho, mas de antemão, não possuem suficiência para punir os agentes que cometem os crimes virtuais. Desta forma, o presente trabalho tem como objetivo identificar como é feita a aplicação do Direito Penal aos crimes virtuais, evidenciando as insuficiências de uma legislação em especificidade acerca da temática. Conclui-se que, o Código Penal do país faz a tipificação de várias atuações que possuem enquadramento no ambiente web, entretanto, possui penas brandas e sem suficiência para a coibição da prática desses atos. Com isso, a ausência de uma legislação em especificidade ao cybercrime faz a intensificação da ideia de que a internet é uma terra sem leis. Por fim, é fundamental produzir uma legislação que venha a versar acerca dos crimes cometidos na internet, sendo que, são comuns e trazem para suas vítimas prejuízos reais. Com isso, tendo conhecimento dos resultados advindos dos crimes virtuais, é preciso fazer a criação de uma lei que não mais permita que a internet tenha utilização de maneira que prejudique seus usuários.
AVALIAÇÃO DO NAVIO ELÉTRICO E AUTÔNOMO YARA BIRKELAND COMO TECNOLOGIA DISRUPTIVA POR MEIO DE UMA ANÁLISE COMPARATIVA
Authors: Fontes Yago Magalhães
Published: April 2021

Devido ao planejamento e a produção do primeiro navio elétrico e autônomo através das empresas norueguesas Yara International e Kongsberg Maritime, criaram-se questionamentos sobre a possibilidade de tal navio poder ou não se tornar uma tecnologia disruptiva para o setor de comércio exterior e logística. O nomeado Yara Birkeland, por ser um navio elétrico e autônomo, levantou questões sobre sua capacidade de transporte, assim como sua segurança e agilidade no decorrer de suas operações. Tal interesse em questionar a qualidade das operações do Yara Birkeland é compreensivel, levando em consideração que, hodiernamente ainda não há quaisquer legislação internacional definida especificamente para navios autônomos, e também que a padronização do uso de um navio completamente elétrico pouparia o uso de milhões de litros de combustíveis navais. Sabendo disso, este trabalho foi realizado tendo como foco avaliar e demonstrar a disruptividade do Yara Birkeland através de uma análise comparativa com um navio de similar proporção, porém, movido a combustível fossíl. O estudo apresenta primeiramente o navio Yara Birkeland, posteriormente sua análise comparativa com o navio convencional Taxiarchis, e então sua avaliação de dados onde foi possível compreender que, na medida de suas proporções, o Yara Birkeland ainda não possuí capacidade de se tornar uma tecnologia disruptiva específicamente para a substituição de navios cargueiros convencionais nas atividades de movimentação de cargas internacionais.
Neonatal Bacterial Meningitis: Single Reference Center Experience and Review of Current Literature: A Retrospective Cohort Study
Authors: Aykanat Alper , Celik Hasan Tolga , Hazirolan Gulsen , Yigit Sule , Yurdakok Murat
Published: April 2021

OBJECTIVE: Despite improvements in neonatal care, neonatal bacterial meningitis is still an emerging problem worldwide with high rates of mortality. The present study evaluates data on suspected- and culture-proven neonatal bacterial meningitis in the light of a single tertiary reference center experience in Turkey in comparison with the globe.
STUDY DESIGN: In this retrospective cohort study newborns admitted to Hacettepe University Ihsan Dogramaci Children’s Hospital Neonatal Intensive Care Unit during a 5-year-period between April 2014-May 2019 and who underwent atraumatic lumbar puncture were included.
RESULTS: Two hundred sixty-four patients fulfilled the inclusion criteria. Most common symptoms in all patients raised suspicion in favor of NBM and resulted in lumbar puncture were fever (34.5%, n=91), respiratory distress (31.1%, n=82), lethargy (31.1%, n=82), and apnea (26.1%, n=69). The incidence of culture-proven NBM among suspected patients was 5.7% (n=15/264); while the incidence is 3.1 per 1000 (15/4574) at all Neonatal Intensive Care Unit admissions. Respiratory distress (60.0%, n=9/15) and apnea (40.0%, n=6/15) were the most common symptoms in patients with NBM; which may be due to the predominance of premature newborns in the NBM group. The most common microorganisms in CSF cultures were coagulase-negative Staphylococci with Methicillin-resistant Staphylococcus epidermidis being most common among all.
CONCLUSIONS: The present study underlines high rates of culture-proven neonatal bacterial meningitis among suspected newborns despite improvements in modern health care, which raises attention to careful evaluation of these patients and early administration of properly-selected antibiotics. Our incidence rates are in keeping with studies from the developed world.
MULTIMODAL LEARNER’S DICTIONARY WITH HISTORICAL AND CULTURAL COMPONENTS IN EFL CLASSROOM
Authors: DROZHASHCHIKH Nataliya V. , BASHMAKOVA Anastasiya Yu.
Published: April 2021

This article studies the problem of making a multimodal computer dictionary with historical and cultural components for EFL classrooms. The relevance of the research topic is associated with the development of computer lexicography as a branch of applied linguistics at the intersection with digital humanities and digital pedagogy, as well as with the active development of new methods and tools in the practice of teaching foreign languages. The object of the research is a multimodal learners’ computer dictionary that visualizes semantic changes in lexicon of the English language, in particular, the key lexemes of the thematic field “еducation”. The purpose of this article is to substantiate the problems of creating an educational multimodal dictionary of a historical and cultural type in computer lexicography. One of the objectives of the research is to study the specific semantic features of the units in the thematic field “education” in the multimodal learner’s dictionary. The multimodal dictionary plays an important role in the interaction of the user with the virtual system, where the dictionary is not only an additional reference book but also a multifunctional means of teaching and obtaining information about the culture of the target language countries, including the dynamics of its development. The introduction of such dictionaries into teaching is the key to successful immersion in the culture of the target language country and mastering language competencies. This article presents the elements of typology and principles of building computer dictionaries, notes the role of a multimodal computer dictionary in teaching a foreign language, and proposes a model of a learner’s multimodal dictionary of historical and cultural type for EFL classroom, as well as outlines the stages of dynamic development in English vocabulary.
EXPRESSION OF PURPOSE IN OLD FRENCH LEGAL DOCUMENTS
Authors: LYKOVA Nadezhda N.
Published: April 2021

The article examines the ways of expressing purpose in the early texts of laws written in Old French. The analysis is carried out using the text interpretation method, context-situational method and the method of actual division. It is found that, if in the works of art of this period, subordinate ends are used quite rarely, then in old French legal documents the semantic relation of the goal is often conveyed and not only by subordinate goals, but much more often with the help of equivalent prepositional-infinitive and prepositional-substantive constructions. The emerging system of alliances, introducing a clause of purpose, and their features (variability, polysemy) are revealed. The appearance time of the target union “pour que” is specified. The use of moods in subordinate purposes is explained by the anticipation in the speaker’s mind of the action result, presenting it as desired. The article analyzes the cases of preposition and postposition of a subordinate goal, due to the structure of a complex sentence, the rhythm of the phrase, the logical-communicative division specifics of the sentence. Equivalent means of expressing the goal — prepositional constructions with an infinitive and a noun — are used when the subjects of two actions coincide. In these constructions, the preposition “pour” is mainly used, as a part of the subordinate unions expressing the goal. Analyzing the goals that are guided by different subjects of law, there is found a connection which is established between the spheres of the emotional and moral, social.
TV SERIES AS A SOCIAL PROJECT IN MODERN MASS DISCOURSE: NATIONAL SPECIFICATIONS
Authors: KISLOVA Larisa S. , VETOSHKINA Maria A.
Published: April 2021

The article is devoted to the analysis of such a phenomenon as a television series in the modern mass discourse. Popular culture invariably defends conservative and therefore popular values in society and operates with a number of elementary moral attitudes. Perceiving a work of mass culture, it is possible to imagine what is love, society, history and everyday life. TV series in a modern format, allow visual content to supplant verbal content and are able to construct this or that reality. TV series is a specific cultural mo­del, transformation and functioning of which is the result of a special attitude of the audience to television. The hero of telemelodrama is an emotionally impressionable person, touched by virtue and horrified by evil, since at the center of any television series there are elements of sentimentalism — a direction that appeals to feelings a person who unconditionally idealizes virtue, clearly distinguishes between good and evil, goodies and bad guys. The aim of the study is to consider friction of the television series as one of the most successful projects in modern mass discourse. In the text of the article, on the basis of a typological approach, the corpus of temporary television series, the transformation of the series adapted to the original. The theoretical and methodological basis of the work was made up of works Jose Ortega y Gasseta, Umberto Eco, M. A. Chernyak, M. A. Litovskaya, N. A. Kupina, N. A. Nikolina, V. M. Mikhalkovich and other researchers of the phenomenon of mass culture. In this article the nature of this phenomenon is formulated for the first time, it is created on the basis of national material, and features popular La­tin American, Turkish, Russian content. TV series recreate the national picture of the world, broadcast revealing national specifics and introducing the viewer to the peculiarities of human life in a particular geographic space. According to the logic of the creators, the series should immerse the viewer in a state of catharsis, forcing empathy, crying and even to have a feeling of fear. As a rule, the series creates more eventful reality, it is not just organically built into the living space, but becomes its integral part. Thus, the television series is a promising social project, claiming to be one of the dominant positions in the modern cultural context.
Effect of Chlorhexidine Varnish and Fluoride Varnish on White Spot Lesions in Orthodontic Patients- a Systematic Review
Authors: Govindaraj Aravinthrajkumar , Dinesh S.P. Saravana
Published: April 2021

Aim:

The aim of this study is to critically review the studies that studied the effect of Chlorhexidine varnish and fluoride varnish on White Spot Lesion (WSL) in patients undergoing orthodontic treatment.

Materials and Methods:

The electronic database PubMed, The Cochrane Library, Medline, Embase, Google Scholar, Web of Knowledge along with a complimentary manual search of all orthodontic journals till the first week of December 2019 was searched. English language study performed on humans, randomized or nonrandomized clinical trials, comparing the effect of fluoride and chlorhexidine varnish on WSL was included in the review. Quality assessment of included studies was performed.

Clinical Significance:

The need for an adjunct oral hygiene aid to reduce the incidence and prevalence of white spot lesions in orthodontic patients is necessary. The use of these varnishes will aid in the same and thus make the adverse effects of fixed orthodontic treatment negligible.

Review of Literature:

Enamel demineralization is a significant risk associated with orthodontic treatment when oral hygiene is poor. Prevention of demineralization during orthodontic treatment is one of the greatest challenges faced by clinicians despite modern advances in caries prevention. The development of White Spot Lesions (WSLs) is attributed to prolonged plaque accumulation around the brackets.

Results:

The search identified a total of 3 studies that were included in this review. One study had Low risk of bias and the remaining 2 studies had moderate overall risk. Results showed that there was a reduction in the incidence of white spot lesions in orthodontic patients after application of chlorhexidine and Fluoride varnish.

Conclusion:

Low level evidence is available to conclude that the use of chlorhexidine varnishes and fluoride varnishes reduces the prevalence of white spot lesions in patients undergoing fixed orthodontic treatment. Due to its limitations, the results of this systematic review should be handled with caution and further well-planned Randomized Clinical Trial (RCT) are needed to provide a discrete conclusion.
Clarithromycin versus Amoxicillin alone or with Clavulanate in Acute Maxillary Sinusitis: A Meta-analysis of Clinical Trials
Authors: Hoban Daryl J. , Nauta Jos
Published: April 2021

Objective:

A meta-analysis was performed to explore the relative effects of clarithromycin and amoxicillin (with or without clavulanate potassium) in the treatment of acute maxillary sinusitis.

Methods:

Six studies were identified in the peer-reviewed literature. All were randomized single-blind (investigator-blind) or open-label trials in outpatients diagnosed with acute maxillary sinusitis. A total of 1580 patients were enrolled, of whom 1194 were clinically evaluable.

The total daily dose of clarithromycin was 1000 mg; the total daily dose of amoxicillin (with or without clavulanate potassium) was either 1500 or 2000 mg. The duration of study drug treatment varied from 8 to 14 days. Endpoints comprised clinical and radiological success within 48 h of the end of study drug treatment plus bacteriologic cure and eradication.

Success and cure rate differences were analyzed using fixed- and random-effect models. The absence of between-study heterogeneity was tested using Cochran’s Q-test.

Results:

Clinical success rates varied between 85.8% and 97.9% for clarithromycin and between 84.2% and 96.8% for amoxicillin. The combined rate difference in clinical success rates between clarithromycin and amoxicillin was +1.9% (P=0.14). Radiological success rates (four studies) varied from 78.2% to 94.0% for clarithromycin and 79.7% to 95.0% for amoxicillin, with a combined rate difference of zero (P=1.00). Bacteriologic cure rates (four studies) were 87.1–94.6% for clarithromycin, compared with 89.8–98.1% for amoxicillin, with a combined difference in cure rates of –3.2% (P=0.16). Overall bacterial eradication rates were comparable between the two treatments (clarithromycin, 89.3%; amoxicillin, 92.1%).

Conclusion:

These data, with their limitations properly acknowledged, identify clarithromycin as a valid and viable alternative to amoxicillin for the treatment of acute maxillary sinusitis in adults.
Thinking for Three: Mothers’ and Fathers’ Narratives on Transition to Parenthood
Authors: Ghinassi Simon , Elmi Benedetta , Fioretti Chiara , Smorti Andrea , Tani Franca
Published: April 2021

Background:

The birth of the first child represents a challenging event in the new-parents' life. Although literature highlighted that this period is experienced in a different way by the new mothers and new fathers, little is known about the broader evolutionary challenge that the transition to parenthood entails, also due to the difficulty of starting to think for three.

Objective:

The present study aims to explore the new-parents' autobiographical narratives after childbirth, to examine the meaning they construct of this event, and investigate the differences between the experience of new mothers and new fathers.

Methods:

Thirteen couples were recruited for the study. After childbirth, an individual open interview was conducted in order to collect information of the personal experience of becoming a parent. All interviews, audio-recorded and transcribed verbatim, were analyzed by T-Lab software in order to explore similarities and differences between them, using thematic analysis to perform unsupervised clustering of narrations to highlight the emerging themes, and we evaluated the elementary contexts of the narratives. A subsequent in-depth analysis regarding the process of delivery was conducted through the LIWC

Results:

Similar but not overlapping themes emerged from narratives. Overall, parents have to face three crucial issues: giving a meaning to the childbirth experience, reorganizing family life, and managing the newborn. However, new-mothers and new-fathers live this period not only with different roles, but also referring to different contexts and seem to house two different spaces: one mental and one physical. Fathers more than mothers highlighted the social aspects of childbirth.

Conclusion:

Results highlight that childbirth represents an important turning point, which implies the transition from thinking for two to thinking for three. In this process, the two parents play, narratively, two different roles. Limitations, strengths, and implications are discussed.
Recent Progress and Prospect on Tooth Modification of Involute Cylindrical
Gear
Authors: Han Lin , Qi Yang
Published: April 2021

Background:

Recent reviews on tooth modification of involute cylindrical gear are presented.
Gear pairs are widely employed in motion and power transmission systems. Manufacturing
and assembling errors of gear parts, time-varying mesh stiffness, and transmission error of gear pair
usually induce vibration, noise, non-uniformly load distribution, and stress concentration, resulting
in earlier failure of gear. Tooth modification is regarded as one of the most popular ways to suppress
vibration, reduce the noise level, and improve the load distribution of gear pairs.

Objective:

The objective of this study was to provide an overview of recent research and patents on
tooth modification methods and technology.

Methods:

This article reviews related research and patents on tooth modification. The modification
method, evaluation, optimization, and machining technology are introduced.

Results:

Three types of modifications are compared and analyzed, and influences of each on both
static and dynamic performances of gear pair are concluded. By summarizing a number of patents
and research about tooth modification of cylindrical gears, the current and future development of
research and patent are also discussed.

Conclusion:

Tooth modification is classified into the tip or root relief along with tooth profile, lead
crown modification along tooth width, and compound modification. Each could be applied in different
ways. In view of design, optimization under the given working condition to obtain optimal
modification parameters is more practical. Machining technology and device for modified gear is a
key to get high-quality performance of the geared transmission. More patents on tooth modification
should be invented in the future.
In silico study: Potential prediction of Curcuma longa and Cymbopogon citratus essential oil as Lipoxygenase inhibitor
Authors:   Biology Education Study Program, Faculty of Teacher and Training Education, Nusa Nipa University,  Jl. Kesehatan No 03, Sikka, NTT, Indonesia 86113, Bare Yohanes , Indahsari Lilin ,   Biology Education Study Program, State Islamic Institute of Palangkaraya, Jl. G.Obos Komplek Islamic Center , Palangkaraya, Kalimantan Tengah , Indonesia 73112, Sari Dewi ,   Research Center for Smart Molecules and Natural Genetic Resources, Brawijaya University,  Jl. Veteran, Malang, Jawa Timur, Indonesia 65145, Watuguly Theopilus ,   Department of Biology Education, Faculty of Teacher and Training Education, Pattimura University,  Jl. Ir. M. Putuhena, Kampus Poka-Ambon Maluku
Published: April 2021

Abstract: Inflammation is the human body response by the injure as a results the inflammation will release LOX. To curve the conditions we use the bioactive from the nature are essential oil from Curcuma longa and Cymbopogon citratus because has a potential has pharmacologist activity. The purpose of this research to investigate the role essential oil from Curcuma longa and Cymbopogon citratus through LOX gene. Several chemical substances, including 3,7-dimethyl-1,3,6-octatriene, camphor, eugenol, curzerene and isoborneol were retrivied from PubChem database. The PyRx 0.8 was used to minimize and convert the sdf file to pdb format file of ligands. Those compounds were predicted their interaction using STITCH online server. Ligands and protein were docked by HEX Cuda 8.0.0 program, 3D and 2D views were evaluated using Discovery studio ver.19.0.0 and LigPlot+ ver 2.2, respectively. We found fourteen amino acid residues from LOX which bound the chemical compounds. Those interaction was supported by hydrogen bond with variety energy binding. To sum up, the essential oil from Curcuma longa and Cymbopogon citratus has a potential function as inhibitor LOX by inhibiting fourteen active side of the LOX gene.
Federated Learning for Thyroid Ultrasound Image Analysis to Protect Personal Information: Validation Study in a Real Health Care Environment
Authors: Lee Haeyun , Chai Young Jun , Joo Hyunjin , Lee Kyungsu , Hwang Jae Youn , Kim Seok-Mo , Kim Kwangsoon , Nam Inn-Chul , Choi June Young , Yu Hyeong Won , Lee Myung-Chul , Masuoka Hiroo , Miyauchi Akira , Lee Kyu Eun , Kim Sungwan , Kong Hyoun-Joong
Published: April 2021

Background

Federated learning is a decentralized approach to machine learning; it is a training strategy that overcomes medical data privacy regulations and generalizes deep learning algorithms. Federated learning mitigates many systemic privacy risks by sharing only the model and parameters for training, without the need to export existing medical data sets. In this study, we performed ultrasound image analysis using federated learning to predict whether thyroid nodules were benign or malignant.

Objective

The goal of this study was to evaluate whether the performance of federated learning was comparable with that of conventional deep learning.

Methods

A total of 8457 (5375 malignant, 3082 benign) ultrasound images were collected from 6 institutions and used for federated learning and conventional deep learning. Five deep learning networks (VGG19, ResNet50, ResNext50, SE-ResNet50, and SE-ResNext50) were used. Using stratified random sampling, we selected 20% (1075 malignant, 616 benign) of the total images for internal validation. For external validation, we used 100 ultrasound images (50 malignant, 50 benign) from another institution.

Results

For internal validation, the area under the receiver operating characteristic (AUROC) curve for federated learning was between 78.88% and 87.56%, and the AUROC for conventional deep learning was between 82.61% and 91.57%. For external validation, the AUROC for federated learning was between 75.20% and 86.72%, and the AUROC curve for conventional deep learning was between 73.04% and 91.04%.

Conclusions

We demonstrated that the performance of federated learning using decentralized data was comparable to that of conventional deep learning using pooled data. Federated learning might be potentially useful for analyzing medical images while protecting patients’ personal information.
An App-Based Intervention to Support First Responders and Essential Workers During the COVID-19 Pandemic: Needs Assessment and Mixed Methods Implementation Study
Authors: Vilendrer Stacie , Amano Alexis , Brown Johnson Cati G , Favet Marissa , Safaeinili Nadia , Villasenor Jacqueline , Shaw Jonathan G , Hertelendy Attila J , Asch Steven M , Mahoney Megan
Published: April 2021

Background

The COVID-19 pandemic has created unprecedented challenges for first responders (eg, police, fire, and emergency medical services) and nonmedical essential workers (eg, workers in food, transportation, and other industries). Health systems may be uniquely suited to support these workers given their medical expertise, and mobile apps can reach local communities despite social distancing requirements. Formal evaluation of real-world mobile app–based interventions is lacking.

Objective

We aimed to evaluate the adoption, acceptability, and appropriateness of an academic medical center–sponsored app-based intervention (COVID-19 Guide App) designed to support access of first responders and essential workers to COVID-19 information and testing services. We also sought to better understand the COVID-19–related needs of these workers early in the pandemic.

Methods

To understand overall community adoption, views and download data of the COVID-19 Guide App were described. To understand the adoption, appropriateness, and acceptability of the app and the unmet needs of workers, semistructured qualitative interviews were conducted by telephone, by video, and in person with first responders and essential workers in the San Francisco Bay Area who were recruited through purposive, convenience, and snowball sampling. Interview transcripts and field notes were qualitatively analyzed and presented using an implementation outcomes framework.

Results

From its launch in April 2020 to September 2020, the app received 8262 views from unique devices and 6640 downloads (80.4% conversion rate, 0.61% adoption rate across the Bay Area). App acceptability was mixed among the 17 first responders interviewed and high among the 10 essential workers interviewed. Select themes included the need for personalized and accurate information, access to testing, and securing personal safety. First responders faced additional challenges related to interprofessional coordination and a “culture of heroism” that could both protect against and exacerbate health vulnerability.

Conclusions

First responders and essential workers both reported challenges related to obtaining accurate information, testing services, and other resources. A mobile app intervention has the potential to combat these challenges through the provision of disease-specific information and access to testing services but may be most effective if delivered as part of a larger ecosystem of support. Differentiated interventions that acknowledge and address the divergent needs between first responders and non–first responder essential workers may optimize acceptance and adoption.
Using a Scenario-Based Approach to Teaching Professionalism to Medical Students: Course Description and Evaluation
Authors: Ashcroft James , Warren Patrick , Weatherby Thomas , Barclay Stephen , Kemp Laurence , Davies Richard Justin , Hook Catherine Elizabeth , Fistein Elizabeth , Soilleux Elizabeth
Published: April 2021

Background

Doctors play a key role in individuals’ lives undergoing a holistic integration into local communities. To maintain public trust, it is essential that professional values are upheld by both doctors and medical students. We aimed to ensure that students appreciated these professional obligations during the 3-year science-based, preclinical course with limited patient contact.

Objective

We developed a short scenario-based approach to teaching professionalism to first-year students undertaking a medical course with a 3-year science-based, preclinical component. We aimed to evaluate, both quantitatively and qualitatively, student perceptions of the experience and impact of the course.

Methods

An interactive professionalism course entitled Entry to the Profession was designed for preclinical first-year medical students. Two scenario-based sessions were created and evaluated using established professionalism guidance and expert consensus. Quantitative and qualitative feedback on course implementation and development of professionalism were gathered using Likert-type 5-point scales and debrief following course completion.

Results

A total of 70 students completed the Entry to the Profession course over a 2-year period. Feedback regarding session materials and logistics ranged from 4.16 (SD 0.93; appropriateness of scenarios) to 4.66 (SD 0.61; environment of sessions). Feedback pertaining to professionalism knowledge and behaviors ranged from 3.11 (SD 0.99; need for professionalism) to 4.78 (SD 0.42; relevance of professionalism). Qualitative feedback revealed that a small group format in a relaxed, open environment facilitated discussion of the major concepts of professionalism.

Conclusions

Entry to the Profession employed an innovative approach to introducing first-year medical students to complex professionalism concepts. Future longitudinal investigations should aim to explore its impact at various stages of preclinical, clinical, and postgraduate training.
Proof-of-Concept Support for the Development and Implementation of a Digital Assessment for Perinatal Mental Health: Mixed Methods Study
Authors: Martin-Key Nayra Anna , Spadaro Benedetta , Schei Thea Sofie , Bahn Sabine
Published: April 2021

Background

Perinatal mental health symptoms commonly remain underdiagnosed and undertreated in maternity care settings in the United Kingdom, with outbreaks of disease, like the COVID-19 pandemic, further disrupting access to adequate mental health support. Digital technologies may offer an innovative way to support the mental health needs of women and their families throughout the perinatal period, as well as assist midwives in the recognition of perinatal mental health concerns. However, little is known about the acceptability and perceived benefits and barriers to using such technologies.

Objective

The aim of this study was to conduct a mixed methods evaluation of the current state of perinatal mental health care provision in the United Kingdom, as well as users’ (women and partners) and midwives’ interest in using a digital mental health assessment throughout the perinatal period.

Methods

Women, partners, and midwives were recruited to participate in the study, which entailed completing an online survey. Quantitative data were explored using descriptive statistics. Open-ended response data were first investigated using thematic analysis. Resultant themes were then mapped onto the components of the Capability, Opportunity, and Motivation Behavior model and summarized using descriptive statistics.

Results

A total of 829 women, 103 partners, and 90 midwives participated in the study. The provision of adequate perinatal mental health care support was limited, with experiences varying significantly across respondents. There was a strong interest in using a digital mental health assessment to screen, diagnose, and triage perinatal mental health concerns, particularly among women and midwives. The majority of respondents (n=781, 76.42%) expressed that they would feel comfortable or very comfortable using or recommending a digital mental health assessment. The majority of women and partners showed a preference for in-person consultations (n=417, 44.74%), followed by a blended care approach (ie, both in-person and online consultations) (n=362, 38.84%), with fewer participants preferring online-only consultations (n=120, 12.88%). Identified benefits and barriers mainly related to physical opportunity (eg, accessibility), psychological capability (eg, cognitive skills), and automatic motivation (eg, emotions).

Conclusions

This study provides proof-of-concept support for the development and implementation of a digital mental health assessment to inform clinical decision making in the assessment of perinatal mental health concerns in the United Kingdom.
Pathway-Driven Coordinated Telehealth System for Management of Patients With Single or Multiple Chronic Diseases in China: System Development and Retrospective Study
Authors: Wang Zheyu , An Jiye , Lin Hui , Zhou Jiaqiang , Liu Fang , Chen Juan , Duan Huilong , Deng Ning
Published: April 2021

Background

Integrated care enhanced with information technology has emerged as a means to transform health services to meet the long-term care needs of patients with chronic diseases. However, the feasibility of applying integrated care to the emerging “three-manager” mode in China remains to be explored. Moreover, few studies have attempted to integrate multiple types of chronic diseases into a single system.

Objective

The aim of this study was to develop a coordinated telehealth system that addresses the existing challenges of the “three-manager” mode in China while supporting the management of single or multiple chronic diseases.

Methods

The system was designed based on a tailored integrated care model. The model was constructed at the individual scale, mainly focusing on specifying the involved roles and responsibilities through a universal care pathway. A custom ontology was developed to represent the knowledge contained in the model. The system consists of a service engine for data storage and decision support, as well as different forms of clients for care providers and patients. Currently, the system supports management of three single chronic diseases (hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease) and one type of multiple chronic conditions (hypertension with type 2 diabetes mellitus). A retrospective study was performed based on the long-term observational data extracted from the database to evaluate system usability, treatment effect, and quality of care.

Results

The retrospective analysis involved 6964 patients with chronic diseases and 249 care providers who have registered in our system since its deployment in 2015. A total of 519,598 self-monitoring records have been submitted by the patients. The engine could generate different types of records regularly based on the specific care pathway. Results of the comparison tests and causal inference showed that a part of patient outcomes improved after receiving management through the system, especially the systolic blood pressure of patients with hypertension (P<.001 in all comparison tests and an approximately 5 mmHg decrease after intervention via causal inference). A regional case study showed that the work efficiency of care providers differed among individuals.

Conclusions

Our system has potential to provide effective management support for single or multiple chronic conditions simultaneously. The tailored closed-loop care pathway was feasible and effective under the “three-manager” mode in China. One direction for future work is to introduce advanced artificial intelligence techniques to construct a more personalized care pathway.
Partisan Differences in Twitter Language Among US Legislators During the COVID-19 Pandemic: Cross-sectional Study
Authors: Guntuku Sharath Chandra , Purtle Jonathan , Meisel Zachary F , Merchant Raina M , Agarwal Anish
Published: April 2021

Background

As policy makers continue to shape the national and local responses to the COVID-19 pandemic, the information they choose to share and how they frame their content provide key insights into the public and health care systems.

Objective

We examined the language used by the members of the US House and Senate during the first 10 months of the COVID-19 pandemic and measured content and sentiment based on the tweets that they shared.

Methods

We used Quorum (Quorum Analytics Inc) to access more than 300,000 tweets posted by US legislators from January 1 to October 10, 2020. We used differential language analyses to compare the content and sentiment of tweets posted by legislators based on their party affiliation.

Results

We found that health care–related themes in Democratic legislators’ tweets focused on racial disparities in care (odds ratio [OR] 2.24, 95% CI 2.22-2.27; P<.001), health care and insurance (OR 1.74, 95% CI 1.7-1.77; P<.001), COVID-19 testing (OR 1.15, 95% CI 1.12-1.19; P<.001), and public health guidelines (OR 1.25, 95% CI 1.22-1.29; P<.001). The dominant themes in the Republican legislators’ discourse included vaccine development (OR 1.51, 95% CI 1.47-1.55; P<.001) and hospital resources and equipment (OR 1.22, 95% CI 1.18-1.25). Nonhealth care–related topics associated with a Democratic affiliation included protections for essential workers (OR 1.55, 95% CI 1.52-1.59), the 2020 election and voting (OR 1.31, 95% CI 1.27-1.35), unemployment and housing (OR 1.27, 95% CI 1.24-1.31), crime and racism (OR 1.22, 95% CI 1.18-1.26), public town halls (OR 1.2, 95% CI 1.16-1.23), the Trump Administration (OR 1.22, 95% CI 1.19-1.26), immigration (OR 1.16, 95% CI 1.12-1.19), and the loss of life (OR 1.38, 95% CI 1.35-1.42). The themes associated with the Republican affiliation included China (OR 1.89, 95% CI 1.85-1.92), small business assistance (OR 1.27, 95% CI 1.23-1.3), congressional relief bills (OR 1.23, 95% CI 1.2-1.27), press briefings (OR 1.22, 95% CI 1.19-1.26), and economic recovery (OR 1.2, 95% CI 1.16-1.23).

Conclusions

Divergent language use on social media corresponds to the partisan divide in the first several months of the course of the COVID-19 public health crisis.
Using an Information Package to Reduce Patients’ Risk of Renal Damage: Protocol for a Randomized Feasibility Trial
Authors: Leitch Sharon , Smith Alesha , Zeng Jiaxu , Stokes Tim
Published: April 2021

Background

Non-steroidal anti-inflammatory drugs (NSAIDs) are a common cause of renal damage, especially when taken together with angiotensin-converting enzyme inhibitors (ACE-i) or angiotensin II receptor blockers (ARBs) plus a diuretic — a combination known as the “triple whammy.” New Zealand patients are at high risk of the “triple whammy” because they can easily purchase NSAIDs without a prescription and in nonpharmacy retail settings (eg, the supermarket), there is no legal requirement to include patient information sheets with medication, and direct-to-consumer drug advertising is permitted. A patient information package has been developed for those at greatest risk of the “triple whammy,” consisting of a printable PDF and an interactive online learning activity. This information package aims to inform patients about their elevated risk of harm from NSAIDS and discourage use of NSAIDs. A randomized control trial was planned to assess the effect of the information package.

Objective

This study aims to pilot the trial procedures for recruiting patients and providing patient information online and to assess the acceptability of the patient information package.

Methods

A two-armed randomized feasibility trial will be undertaken in Northland, New Zealand. We will recruit 50 patients who are at least 18 years old from those who have signed up to receive email alerts through their general practice. Patients eligible for this study have been prescribed an ACE-i or ARB plus a diuretic in the past 3 months. They will be randomly allocated to 2 study arms. The intervention arm will receive access to an information package plus usual care; the control arm will receive usual care alone. Online surveys will be used to assess NSAID knowledge and NSAID use at baseline and after 2 weeks for both arms. The intervention arm will also evaluate the information package in an additional survey based on Normalization Process Theory (NPT) concepts. We will report the number and proportion of participants who are eligible and consent to participate in the trial. Response and drop-out rates will be reported for each trial arm. The numbers of patients who interact with the education package will be reported together with the patient evaluation of it.

Results

Funding has been obtained from the Health Research Council of New Zealand (HRC 18-031). The University of Otago Human Research Ethics Committee (H21/016) has approved this trial. Consultation has been undertaken with The Ngai Tahu research consultation committee. The trial commenced on April 12, 2021.

Conclusions

This feasibility trial will test the study processes prior to commencing a randomized controlled trial and will determine the acceptability of the patient information package. We anticipate this work will provide useful information for other researchers attempting similar work.

International Registered Report Identifier (IRRID)

PRR1-10.2196/29161
Soil gas radon measurements for investigating the actual status of seismic quiescence along the bounding fault of the Ghab pull-apart basin in western Syria
Authors: Al-Hilal Mohamed , Abdul-Wahed Mohamad K.
Published: April 2021

El propósito de este trabajo consistió en investigar posibles cambios de radón relacionados con la zona de falla que pudieran mostrar alguna relación con la tectónica local a lo largo de la zona de falla de la cuenca de Ghab. A pesar de su actividad histórica, la falla de Ghab presenta actualmente una falta de actividad sísmica con un periodo largo de quietud sísmica. Se escogieron 7 sitios para realizar muestreos de radón utilizando un equipo ALPHAGUARD. El valor promedio normal de radón de fondo se obtuvo con medidas realizadas lejos de la zona de influencia de la falla. Se definió un rango estadístico de variaciones anómalas de radón con límites marcados por el valor promedio mas/menos dos desviaciones estándar (X+/- 2DS). Los resultados iniciales muestran incrementos de radón en las estaciones de monitoreo a lo largo de la zona de falla con picos 4-5 veces mayores que el nivel de fondo. Aunque estas concentraciones anómalas relativamente grandes podrían confirmar la utilidad del radón como un posible indicador para trazar los límites de la falla, no prueban necesariamente una relación con la actividad tectónica del área. Sin embargo, estos incrementos de radón podrían indicar una evidencia de zonas con mayor permeabilidad asociadas a la deformación de la estructura en la zona de ruptura.
Atmospheric corrections of the cosmic ray fluxes detected by the Solar Neutron Telescope at the Summit of the Sierra Negra Volcano in Mexico
Authors: Barrantes M. , Valdés-Galicia J. F. , Musalem O. , Hurtado A. , Anzorena M. , García R. , Taylor R. , Muraki Y. , Matsubara Y. , Sako T. , Sasai Y. , Hinaro N. , Tateiwa N. , Tsujihara H. , González L. X. , Ortiz E. , Shibata S. , Watanabe K. , Sakai T.
Published: April 2021

Un Telescopio de Neutrones Solares (TNS) fue instalado en la cima del volcán Sierra Negra, Pue., México (19.0º N , 97.3º W, 4580 m sobre el nivel del mar); el cual se encuentra en operación desde el 2004. En este trabajo, utilizamos los valores de la presión barométrica, de la presión dinámica, de la temperatura ambiental y de la humedad relativa obtenidos por una estación meteorológica cercana al TNS, para calcular los coeficientes de corrección atmosféricos para el flujo registrado de rayos cósmicos. Cuando los datos de rayos cósmicos están libres de las variaciones de origen atmosférico, analizamos los perfiles de tiempo observados por el TNS durante seis decrecimientos tipo Forbush seleccionados para el período 2011-2013. Los resultados obtenidos por varios canales de depósito de energía (30,60,90 MeV) son discutidos para establecer la confiabilidad del TNS para este tipo de eventos.
Productividad laboral y salario real: relaciones de causalidad en Venezuela
Authors: Vera Leonardo Vicente , Vera Juan Andrés
Published: April 2021

Para la disciplina económica no ha sido fácil encontrar una relación de causalidad clara o bien establecida entre la productividad laboral y el salario real, pese a la estrecha relación estadística y los comovimientos que varios estudios reportan. Las implicaciones de política pueden ser muy diferentes dependiendo del nexo causal que exista entre ambas variables. Usando pruebas de causalidad de Granger convencionales y pruebas de causalidad en ambiente de cointegración, tanto con datos anuales como con datos trimestrales para Venezuela, este trabajo presenta evidencia que muestra, en contraste con el enfoque ortodoxo, que la causalidad estadística va de los salarios reales hacia la productividad laboral.
La concentración empresarial y estrategias de inclusión
Authors: Córdova León Fernando , Duque Espinoza Gabriela , Sigüencia Muñoz Adrián
Published: April 2021

El crecimiento económico inclusivo y sostenible, objetivo fundamental de desarrollo, busca evitar la desigualdad. Bajo este contexto, se tiene como objeto determinar las características de las empresas con mayor concentración de riqueza en Ecuador, así como identificar las variables que inciden en la inclusión empresarial, y proponer alternativas para un crecimiento inclusivo con participación de MIPyME. Mediante el coeficiente Gini se establece la concentración económica y se estudia la gestión financiera de las empresas. Los resultados revelaron altos índices de desigualdad; rentabilidad sobre activos, endeudamiento, edad y apalancamiento financiero, como predictores de la probabilidad de formar parte del grupo de éxito empresarial.
Chemical Profile and Clinical Efficacy of Micro-Fragmented Adipose Tissue in the Treatment of Knee Osteoarthritis
Authors: Haberl Jack , Hogaboom Nathan , Malanga Gerard
Published: April 2021

Intra-articular injections of adipose-derived mesenchymal stromal cells (AD-MSCs) have emerged as a regenerative therapy to combat the progression of knee osteoarthritis (OA). These multipotent cells have been shown to alter the inflammatory processes inside the knee joint at the cellular level, thus creating a treatment option that both modifies the underlying causes of OA and benefits those who are not surgical candidates. This review article serves to present the following objectives: (1) to summarize the techniques used to harvest AD-MSCs, via micro-fragmentation and enzymatic processing, (2) to characterize the chemical profile and immunomodulatory role of these cells from the current literature, (3) to comprehensively review the clinical efficacy of these interventions, from animal to human studies that investigate the safety concerns, biomolecular changes, and key functional outcomes, and (4) to present areas of future research needed to optimize these interventional regenerative therapies in the treatment of knee OA.
Karabakh Knot of Geopolitical Contradictions in the South Caucasus
Authors: Kogut V. G. , Nuryshev G. N.
Published: April 2021

The aim of the work was to study the geopolitical processes in the South Caucasus, representing the “Eurasian Balkans”. Based on the discourse analysis, the geopolitical position of the region and the geopolitical interests of its main actors were considered. The transformation of the Karabakh knot of geopolitical contradictions from a regional confrontation into a special “chess game” with the active participation of Western countries is shown. In this game Turkey is trying to become the leading center for development a new geopolitical structure of interaction between the Eurasian Turkic-speaking states as opposed to the Russian Eurasian project. It is concluded that only Russia can become the guarantor of peace and exert geopolitical influence on the wider region of the Greater Caucasus.