bluuebunny/crossref_metadata_2025 huggingface dataset:
Generative Adversarial Network Image Synthesis Method for Skin Lesion Generation and Classification
Authors: Mutepfe Freedom , Kalejahi Behnam Kiani , Meshgini Saeed , Danishvar Sebelan
Published: October 2021

Background:

One of the common limitations in the treatment of cancer is in the early detection of this disease. The customary medical practice of cancer examination is a visual examination by the dermatologist followed by an invasive biopsy. Nonetheless, this symptomatic approach is timeconsuming and prone to human errors. An automated machine learning model is essential to capacitate fast diagnoses and early treatment.

Objective:

The key objective of this study is to establish a fully automatic model that helps Dermatologists in skin cancer handling process in a way that could improve skin lesion classification accuracy.

Method:

The work is conducted following an implementation of a Deep Convolutional Generative Adversarial Network (DCGAN) using the Python-based deep learning library Keras. We incorporated effective image filtering and enhancement algorithms such as bilateral filter to enhance feature detection and extraction during training. The Deep Convolutional Generative Adversarial Network (DCGAN) needed slightly more fine-tuning to ripe a better return. Hyperparameter optimization was utilized for selecting the best-performed hyperparameter combinations and several network hyperparameters. In this work, we decreased the learning rate from the default 0.001 to 0.0002, and the momentum for Adam optimization algorithm from 0.9 to 0.5, in trying to reduce the instability issues related to GAN models and at each iteration the weights of the discriminative and generative network were updated to balance the loss between them. We endeavour to address a binary classification which predicts two classes present in our dataset, namely benign and malignant. More so, some wellknown metrics such as the receiver operating characteristic -area under the curve and confusion matrix were incorporated for evaluating the results and classification accuracy.

Results:

The model generated very conceivable lesions during the early stages of the experiment and we could easily visualise a smooth transition in resolution along the way. Thus, we have achieved an overall test accuracy of 93.5% after fine-tuning most parameters of our network.

Conclusion:

This classification model provides spatial intelligence that could be useful in the future for cancer risk prediction. Unfortunately, it is difficult to generate high quality images that are much like the synthetic real samples and to compare different classification methods given the fact that some methods use non-public datasets for training.
Wearable Device for Yogic Breathing with Real-Time Heart Rate and Posture Monitoring
Authors: Puranik Anmol , Kanthi M. , Nayak Anupama V.
Published: October 2021

Background:

Yogic breathing also called as “Pranayama” is practiced with inhalation (Pooraka), holding the breath for some time (Kumbhaka) and then exhalation (Rechaka). The effective methods of yogic breathing keep oneself healthy and also improves immunity power. The yogic breathing can be practiced irrespective of one's age and gender and even in the office which helps to reduce the stress. To get the best results through yoga, a person has to follow certain timings and sit in a correct posture. Although many devices are existing in the market to monitor heart rate, posture and breathing during physical activity, there is a need of a device which is simple, cheap, and easy to use without an additional requirement of a smartphone. Moreover, the proposed device is able to evaluate the breathing data by transmitting it to a webpage through a Wi-Fi hotspot of the Microcontroller.

Methods:

The developed device has two subsystems: (i) A wrist subsystem to measure the heart rate, visual aid of breathing and vibration feedback for kapalabhati. (ii) A waist subsystem to monitor the posture with help of flex sensor and the results are displayed on the display of the wrist device. It also provides vibration feedback. The inertial measurement unit is used for breath detection. The subsystems are communicated through SPI communication. The breathing data are transmitted to a webpage through a Wi-Fi hotspot of the microcontroller.

Results:

The various yogic breathing and normal breathing exercises are tested on different normal subjects using the developed device and analyzed. The heart rate and beats per minute are evaluated. The heart rate sensor is validated using a standard medical device and it is observed that there was a 97.4% accuracy.

Conclusion:

The results show that the device is able to accurately monitor different kinds of breathing and additionally provide heart rate and posture information while performing the breathing exercises.
Detection and Classification of COVID-19 by Lungs Computed Tomography Scan Image Processing using Intelligence Algorithm
Authors: Safdarian Naser , Dabanloo Nader Jafarnia
Published: October 2021

The latest World Health Organization statistics show that the number of people living with COVID-19 disease is now more than 42 million worldwide. Some diagnosis methods include detecting and observing clinical symptoms associated with the disease (fever, dry cough, shortness of breath, sore throat, and muscle fatigue). Some other methods, such as computed tomography (CT)-scan imaging from the lungs, are the more accurate diagnostic methods. In this study, we examine the types of abnormal COVID-19 can cause in the lungs of infected subjects and detect and classify this disease. In this paper, we used data from the lung's CT-scan images from the 79 participants. To do this, in this article, for processing CT-scan images of the lungs to diagnose and classification of the COVID-19 disease in men and women of different ages, for rapid diagnosis and high accuracy of this disease by the automatic classification algorithm is used. The final results showed that the proposed method could base on different categories (gender, age categories, and type of damage caused by COVID-19) with high detection and classification accuracy. The algorithm presented in this article has accurately identified the data of healthy subjects and patients with coronavirus.
Design and Development of a 3-Axis Accelerometer Biofeedback System for Real-Time Correction of Neck Posture for Long-Time Computer Users
Authors: Shirvani Hossein , Salesi Mahmood , Samadi Mohammad , Shamsoddini Alireza
Published: October 2021

Background:

Due to long-term use of computers and not maintaining the correct position and angle of the body while working with it, various skeletal and muscular problems and pain in the neck area occurs. This study aims to use a biofeedbck system to alert the computer users of an inappropriate angle of their necks, and as a result help them to establish a correct neck position.

Method:

The user's neck angle is measured using a three dimensional accelerometer and the signal is processed, digitalized, and sent to the computer. User friendly software is designed to process the received data and warn the users when their neck angle is inappropriate.

Results:

The results show that the application of the biofeedback system reduces the users' total time with inappropriate neck angle to <50%.

Conclusion:

results demonstrated that training with the biofeedback system has been sufficient to make the habit of maintaining the neck in the correct angle.
Social Media Behavior in Plastic Surgery Practice in Turkey
Authors: Emüler Deniz Sezgin , Ayhan Mehmet Sühan
Published: October 2021

Background:

It's a widely accepted fact that social media platforms have revolutionized the way human beings communicate. Nevertheless, there is little evidence describing how the plastic surgery community has adopted social media.

Aims and Objectives:

This study aims to identify through objective data the social media activity of the members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons, their purpose and methods of use, and their opinion on the risks and violations in social media.

Materials and Methods:

An anonymous survey containing 26 questions on the use of social media was distributed to members of Turkish Society of Plastic Reconstructive and Esthetic Surgeons and prevalent patterns of social media implementation were elucidated.

Results:

88.9% of respondents were social media users and 56.95% of the users were using social media both for personal and professional posts. Reasons for using social media included the beliefs that they can accurately inform their patients (55,89%), communicate effectively with the patients (48,48%), and that they can raise awareness among patients (47,47%). 28,96% reported that it is an effective tool in promoting and advertising their practice. Most respondents (54,70%) stated that social media had positive effects on their practice, whereas 44,95% percent reported that it had neither a positive nor a negative impact.

Conclusions:

This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. There is a definite oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as the experience with social media in plastic surgery evolves.
The Primary Role of Dorsal Metacarpal Artery Perforator Flap for Hand and Finger Soft-Tissue Reconstruction
Authors: Yasar Emrah Kagan , Demir Can Ilker , Aytac Yusuf Alper , Alagoz Murat Sahin
Published: October 2021

Background:

The authors present their experience about the soft-tissue reconstruction of hands and fingers with dorsal metacarpal artery (DMA) perforator flap.

Materials and Methods:

Patients who were treated by DMA perforator flaps from 2017 to 2019 were evaluated.

Results:

There were 17 patients with average age of 36 years. DMA flaps were harvested in a fasciocutaneus fashion in all patients except one. The mean flap size was 3.3 cm × 1.8 cm, and the largest flap was 5 cm × 2 cm. The donor area was repaired primarily except for one patient. The bridge skin incision was used to prevent complications caused by compression or edema. The average time for returning to work was 48 days.

Conclusion:

The DMA perforator flap allows repair of soft-tissue defects of the distal hand and finger neither with sacrificing any major artery nor a major donor site morbidity. Rapid learning curve and relatively stable anatomical structure are the other important entities that make the DMA perforator flap convenient.
Tuberculous Tenosynovitis of the Wrist
Authors: Ekinci Can , Kocman Atacan Emre , Sürün Salih , Çetin Cengiz
Published: October 2021

Tuberculous tenosynovitis, formerly known as compound palmar ganglion, is a rare condition that presents usually as chronic painless swelling, tenosynovitis, and sometimes with compressive neuropathy. Approximately 10% of all extrapulmonary manifestations of tuberculosis involve the musculoskeletal system and among them, involvement of the wrist and hand is a very rare condition. It is really important to manage this condition before it spreads to the underlying bones causing osteomyelitis and destruction. Here, we are going to report two cases both presenting with a painless swelling and restriction of movement of their wrists for more than 6 months. In physical examination, one of the patients had also numbness over median nerve territory. After imaging, biopsies, cultures, and histopathological examinations, wrist swelling was considered as tuberculous tenosynovitis and appropriate anti-tuberculosis treatment was started.
Aggressive Management of a Giant Malignant Phyllodes with Lung Metastasis
Authors: Sian Lee Suk , Jagwani Arvind Vashdev
Published: October 2021

Phyllodes tumors of the breast are rare, occurring for <1% of all breast tumors. The name “phyllodes,” is from the Greek language and means “leaflike.” This tumor refers to the fact that its cells grow in a leaflike arrangement. Another name for this tumor is cystosarcoma phyllodes and tends to grow rapidly, but they rarely spread outside the breast. This lady who underwent an aggressive management which includes mastectomy, axillary clearance, reconstruction with a flap followed by chemotherapy and radiotherapy. With that, we can conclude that an aggressive stance on these tumors ensures a good prognosis.
Dynamic External Fixators for the Proximal Interphalangeal Joint Injuries
Authors: Kaplan Ahmet , Ergani Hasan Murat , Yasar Burak , Duru Çagdas
Published: October 2021

Backgrounds:

Proximal interphalangeal (PIP) joint injuries can cause scar contractures by different mechanisms, leading to significant functional loss, the most important thing in the treatment process is to maintain joint mobility, in this way, scar formation will be reduced. Dynamic external fixators have been used for this purpose. Although it is an old method, it has many unknown aspects.

Materials and Methods:

Nineteen patients participated in our study. The patients were divided into two groups as those who were treated immediately after the injury and those who applied in the late period. All patients were treated with pin and rubber traction systems (PRTS). After 6 weeks of traction, the fixator was removed. Patients were assessed with X-rays for the amount of distraction, Visual Analog Scale score for pain and quick DASH scores for satisfaction. The patients were also examined for passive and active range of motion (AROM) in all controls.

Results:

We compared the preoperative and postoperative data of the patients and also we compared the amount of distraction with functional gain. There was no relationship between the increase in PIP joint space distance and posttreatment PIP joint AROM values. Hence, the amount of distraction on the joint space distance has no direct effect on the functional results. Another important result of the study is that the loss of extension in the PIP joint, which can be unregarded in the early period, negatively affects the late results. The other important result of our study is that successful results can be obtained when applied in combination with surgery in delayed cases.

Conclusion:

The use of PRTS has an important role in the treatment of PIP joint injuries. In our study, we have shown that satisfactory results can be obtained in both acute and delayed cases when combined with additional surgery or applied alone. The change in joint space distance during the patient follow-up is not an important issue in terms of range of motion. Another important result we obtained from the study is the demonstration that PRTS can be successfully used in untreated joint dislocations in a single stage.
Effect of Medical Qigong Therapy on Distress, Fatigue, and Quality of Life in Head and Neck Cancer Patients Undergoing Intensity-Modulated Radiation Therapy
Authors: Sagaonkar Priyanka S. , Pattanshetty Renu
Published: October 2021

Background:

Cancer of Head and Neck (HNC) is the 2nd common cancer in India leading to around 8% of the global cancer mortality. Intensity-modulated radiation therapy (IMRT) is advanced method minimizing exposure of radiation to adjacent normal structures but is associated with higher fatigue indirectly elevating distress levels. Medical Qigong (MQ), a meditative mind therapy has numerous health benefits. The purpose of the current study was to investigate effect of MQ therapy on distress, fatigue, and quality of life in HNC patients undergoing IMRT.

Materials and Methods:

This experimental study was conducted on 16 Hospitalized HNC subjects undergoing IMRT aged 18–65 years. All the subjects performed Qigong Walk Cycle for 5 weekdays for 4 weeks from initiation of IMRT. Scores of Brief Fatigue Inventory (BFI), 6 min walk distance (6MWD), Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) were documented at the baseline and at end of 4th week and compared.

Results:

IBM SPSS Statistics version 23.0; Indian version of Windows was used for statistical analysis. The 16 HNC subjects majorly rural residents (62.5%) of mean age group 47.68 ± 10.25 years with tobacco chewing as prevalent habit (94%) with maximum cases recorded in stage III of the disease. The pre and post test score comparison of serum cortisol, BFI and 6MWD found high statistical significance with P = 0.001 while that of the total and all components of FACT HN was found to be significant with P ≤ 0.05.

Conclusion:

MQ therapy was effective in managing the levels of distress and fatigue thereby improving quality of life of all HNC subjects.
Network Pharmacology-Based Exploration of the Mechanism of Guanxinning Tablet for the Treatment of Stable Coronary Artery Disease
Authors: Sheng Song , Yang Qiao-Ning , Zhu Hao-Ning , Xian Yong-Yue
Published: October 2021

Objective:

Network pharmacology was utilized to explore the mechanism of Guanxinning (GXN) tablet for the treatment of stable coronary artery disease (SCAD).

Materials and Methods:

First, active ingredients and therapeutic targets were predicted by databases and gene chip. Then, we constructed the compound-target (C-T) network and target-disease (T-D) network to screen hub compounds and therapeutic targets based on contribution index (CI), degree, closeness, betweenness, and coreness in the networks. Enrichment analysis was performed on hub therapeutic targets, and finally, the verification of hub ingredients and hub therapeutic targets was performed through molecular docking.

Results:

With “oral bioavailability ≥30%, druglikeness ≥0.18, and half-life ≥4 h” as screening conditions, 58 active ingredients were obtained. Seven hundred and seventeen compound targets and 636 SCAD targets were retrieved using databases and gene chip, and the intersection of both (139 targets) was defined as therapeutic targets. According to CI, degree, betweenness, closeness, and coreness, 2 hub compounds and 13 hub therapeutic targets were chosen from the C-T network and T-D network, respectively. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis indicated that GXN treated SCAD from several aspects including inflammatory reaction, oxidative stress, nutritional metabolism, blood pressure regulation, ventricular remodeling, vascular smooth muscle proliferation, angiogenesis, and platelet aggregation. Tissue enrichment analysis revealed that the therapeutic targets were enriched in multiple organs and tissues. The excellent binding force between the hub compounds and hub therapeutic targets was verified by molecular docking.

Conclusions:

The treatment of SCAD by GXN has the characteristics of multiple ingredients, multiple targets, and multiple approaches. Consequently, it may theoretically treat SCAD from multiple angles and levels.
Investigation of the sequence profile of the Plasmodium falciparum 18SrRNA diagnostic target in isolates from naturally infected children with uncomplicated malaria
Authors: Oyedeji S.I. , Odoh I.M. , Ojerinde A.O. , Awobode H.O.
Published: October 2021

The gold standard for malaria diagnosis is evidence of parasitological confirmation but the traditional method by light microscopy and the routinely used rapid diagnostic tests (RDTs) have limitations. Molecular assays are known to have higher sensitivity and specificity but there are indications that they may also be compromised by genetic variability of the target sequence. The aim of this study therefore, was to evaluate the DNA sequence profile of the diagnostic target of the P. falciparum 18S rRNA PCR assay in field isolates from North-Central Nigeria. Blood samples were collected from 324 children presenting with acute febrile illness suspected to be uncomplicated malaria. Light microscopy and 18S rRNA PCR assay were employed to determine the presence of P. falciparum parasites. Sequence profile of the diagnostic target was evaluated by Sanger sequencing of the PCR products on ABI PRISM® 3100 DNA sequencer (PE Applied Biosystems). Of the 324 children enrolled into this study, 134 (41.4%) were positive for P. falciparum by microscopy while 218 (67.3%) were positive by PCR. The sensitivity of microscopy was 61.47%(95% CI= 57.88% - 69.64%) using the PCR assay as reference standard. The degree of agreement between microscopy and PCR as measured by Cohen's kappa was  moderate (κ = 0.502, 95% CI = 0.463 - 0.715).Sequence analysis showed that the DNA target of the P. falciparum 18S rRNA PCR from the field isolates were highly conserved. Only one A>T single nucleotide polymorphism was found within the target sequence  among the isolates in this study. This study showed that the DNA target sequence of the18S rRNA PCR assay is highly conserved in field isolates in the study region suggesting little or no impact of selective pressure acting on the locus and has implications for the enhanced sensitivity of the molecular assay.
Looking for the optimum security architecture in Europe: EU and NATO – together or apart?
Authors: Melnikova J. Yu.
Published: October 2021

The recent years saw the most turbulent period of transformation of the liberal world order since the end of the Cold War. This directly aff ects transatlantic relations, historically serving as a beacon of the Washington’s foreign policy. This notwithstanding, while the U.S. foreign policy priorities have been changing, the members of the transatlantic community have seemed to be drifting further apart, which causes the development of alternative projects to maintain European security. This article aims to compare the current state of aff airs in the transatlantic and the European security systems, relying on the parameters, developed within the framework of the security communities theory, so as to access their feasibility and prospects. The author proceeds from the assumption that the relevant collective identity serves as a key factor for NATO’s and EU’s CFSP success and analyzes its ideational, institutional and practical components. New discourse is perceived as a starting point for transforming the identity of communities through formulating and justifying their main tasks. NATO is currently developing its new narrative while working on the alliance’s new strategic concept, with the EU elaborating on the idea of its “strategic autonomy”, creating a more vibrant and well-grounded story than NATO. However, to be translated into common practices the discourse should be rooted into a well-developed system of institutional communication channels, which is a distinctive feature of NATO, but not the EU. As a result, NATO’s experience in common practices, though not always successful and mutually complementing, creates an inertia within the community, providing for its stability and allowing for timely resolving inner confl icts. In this regard, the EU “strategic autonomy” is a matter of continuous systemic eff ort, rather than that of time.
Tratamento não medicamentoso: exercícios físicos em miopatias autoimunes sistêmicas
Authors: Missé Rafael Giovane , Oliveira Diego Sales de , Lima Fernanda Rodrigues , Shinjo Samuel Katsuyuki
Published: October 2021

Por muito tempo programas de treinamento físico em pacientes com miopatias autoimunes sistêmicas foram considerados um importante paradoxo.
O racional era que a prática de exercícios físicos pudesse piorar a inflamação e consequentemente agravar as manifestações clínicas dessas doenças. Entretanto, hoje em dia, sabe-se que o treinamento de força muscular, aeróbio e a combinação de força e aeróbio em diferentes intensidades, volumes e frequências tem promovido efeitos positivos na força, funcionalidade muscular e até melhora da capacidade aeróbia e funcional dos doentes com miopatias autoimunes sistêmicas, mostrada na Figura 1.
Nesse contexto, o objetivo desta revisão é discutir aspectos básicos a respeito dos diferentes tipos de exercícios de força ou aeróbio, visando a elucidar o importante papel do exercício físico nas miopatias autoimunes, particularmente, dermatomiosite (DM) e polimiosite (PM).
Narcissism, activity on Facebook, and conspicuous
consumption among young adults
Authors: Niesiobędzka Małgorzata , Konaszewski Karol
Published: October 2021

Introduction

The purpose of the study was to explore relationships between narcissistic strategies, self-oriented activity on Facebook, and conspicuous consumption.

Material and methods

The sample consisted of 323 young Polish adults. Participants completed the Conspicuous Consumption Scale (CCS), the Narcissistic Admiration and Rivalry Questionnaire (NARQ), and questions regarding Facebook use.

Results

Empirical support was found for the assumption that conspicuous consumption was predicted by narcissistic rivalry. Although the direct impact of narcissistic admiration on conspicuous consumption was non-significant, this strategy influenced status consumption through self-verified behaviours on social media, the strongest predictor of conspicuous consumption.

Conclusions

This shows that narcissistic rivalry directly affects the propensity to conspicuous consumption and narcissistic admiration is related to self-verified activity on Facebook. The involvement of Facebook usage in this manner increases the acquisition and display of expensive, glamorous products as external signals of status.
Pemilihan peristiwa dalam proses pemberitaan
Authors: Othman Siti Suriani , Lee Kuok Tiung
Published: October 2021

Kajian-kajian berkenaan penghasilan berita menawarkan pelbagai penjelasan tentang mengapa berita boleh bertukar menjadi apa yang dipaparkan (Berkowitz, 1988). Namun begitu, kajian berkenaan persamaan di kalangan wartawan dalam membuat pemilihan berita pula menunjukkan hasil yang tidak konsisten (Kim & Bae, 2006). Kajian teoritikal ini secara amnya membincangkan bagaimana sesuatu peristiwa boleh menjadi berita dengan merujuk kepada beberapa pandangan dan paradigma kewartawanan dengan menggunakan kaedah penaakulan induktif. Apa yang dilakukan sebagai usaha awal ini ialah menelusuri kekuatan dan kelemahan setiap paradigma ilmu kewartawanan di samping pandangan-pandangan yang berbeza akan model kewartawanan yang ideal. Ini penting untuk mengenalpasti kekurangan sedia ada dalam usaha membentuk model pemberitaan yang bersesuaian dengan masyarakat Malaysia. Rumusan kepada hasil analisis ini mendapati nilai-nilai murni yang cuba diketengahkan oleh mana-mana ajaran agama sebenarnya adalah sama iaitu menyeru kepada kebaikan dan mencegah kemungkaran dan nilai-nilai ini sudah sedia ada dalam nilai-nilai berita yang menjadi asas kriteria kepada pemilihan sesuatu peristiwa. Justeru itu, taksonomi nilai-nilai berita yang mula dieksplorasi oleh Galtung dan Ruge (1965) wajar dijadikan sebagai asas permulaan kepada pencarian model kewartawanan yang baharu.
PERLINDUNGAN HUKUM BAGI KONSUMEN YANG DATA PRIBADINYA DIPERJUAL BELIKAN DI APLIKASI FINTECH PEER-TO-PEER LENDING
Authors: Nababan Roida , Sinaga Nelson Persada
Published: October 2021

The influence of globalization brings many influences in the progress of life. The rapid development that can be seen from the era of globalization is the development in the field of information technology, especially financial applications. Applications that are developing in the financial services sector are fintech applications. The increase in the use of fintech applications leads to abuse of the fintech application itself. Misuse of personal data of fintech consumers is by buying and selling personal data of fintech consumers. Facts related to the misuse of consumer personal data in fintech applications for sale are circulating on social media. The sale and purchase of consumer personal data using this fintech application was confirmed by a cybersecurity observer from Vaccines.com, Alfons Tanujaya, to CNN Indonesia. The sale and purchase of consumer personal data has violated Article 4 letter a of Law Number 8 of 1999 concerning Consumer Protection, hereinafter referred to as UUPK which states: "Consumers' rights are rights to comfort, security, and safety in consuming goods and/or services." Buying and selling of consumer personal data on fintech applications violates consumers' rights to obtain safety, convenience, and security when using fintech applications.
Is Cholecystectomy a cause of difficult biliary cannulation in endoscopic
retrograde cholangiopancreatography?
Authors: Cankurtaran R.E. , Atalay R , Polat Y.H. , Kivrakoglu F , Tahtacı M , Ersoy O
Published: October 2021

Background and study aim: In European Society of Gastrointestinal Endoscopy guidelines, biliary cannulation of naive papillae is defined as difficult in the presence of more than 5 papilla contacts, more than 5min cannulation time or more than one unintended pancreatic duct cannulation or opacification. It is not known whether cholecystectomy is a cause of difficult biliary cannulation. This study aimed to investigate whether cholecystectomy (CCY) is a cause of difficult biliary cannulation in patients who have undergone Endoscopic Retrograde Cholangiopancreatography (ERCP) for choledocholithiasis.

Patients and methods: Adult patients with naive papillae and those who underwent ERCP for common bile duct stones and/or sludge were included in this retrospective study. Patient demographics, clinical presentation (acute cholangitis, biliary pancreatitis or biliary colic), periprocedural data including laboratory and radiological findings and ERCP results were compared between no-CCY and post-CCY groups.

Results: 438 patients were included in the present study and 347 of these patients were in the no-CCY group and 91 patients were in post-CCY group. A statistically significant difference was found in the number of patients with difficult cannulation in the post-CCY group (n=30, 33.0%) patients compared to the no- CCY group (n=67, 19.3%) (p=0.011). According the multivariate analyses results, presence of history of cholecystectomy was found an independent risk factor of difficult cannulation (Odds ratio: 2.014; 95 % Cl 1.205-3.366; p=0.008).

Conclusions: The results showed that biliary cannulation was significantly more difficult in patients with cholecystectomy who underwent ERCP for common bile duct stones.
EL CAMBIO TECNOLÓGICO Y SU IMPACTO EN EL DESARROLLO EMPRESARIAL ECUATORIANO
Authors: Zamnbrano Quiroz Denny , Moreira Roca Juan , Cáceres Larreátegui Alba
Published: October 2021

Los avances que han tenido la ciencia y la tecnología en los últimos años han sido de cambios acelerados, llevándonos a la imperiosa necesidad de tener una formación profesional para enfrentar desde la práctica empresarial los desafíos que impone la innovación contemporánea. El objetivo del presente artículo es analizar el impacto que ha tenido el cambio tecnológico en el desarrollo empresarial, fundamentalmente a raíz de la implementación y uso de las Tic’s en las empresas. Metodológicamente el presente trabajo se desarrolló en base a una la investigación documental y de campo. Iniciando con una revisión bibliográfica de toda la documentación existente sobre la problemática, seguidamente del trabajo de campo a través de la aplicación de encuestas a los administradores de las empresas ecuatorianas, que permita obtener información, sobre las propiedades, características y aspectos importantes del uso de la tecnología en las empresas y el cambio en la estructura de estas que conlleva. Se pudo concluir que existe una correlación alta entre las variables cambio tecnológico y desarrollo empresarial con un p “Rho de Spearman” de (0,967), así mismo se validaron las hipótesis específicas demostrando que, el acceso y uso de tecnologías de la información y comunicación (0,942), la innovación de procesos (0,908), la innovación organizativa (0,883), y los sistemas de información (0,876), impactan en el desarrollo empresarial ecuatoriano.
Retrievals of ice microphysics using dual-wavelength polarimetric radar observations during stratiform precipitation events
Authors: Tetoni Eleni , Ewald Florian , Hagen Martin , Köcher Gregor , Zinner Tobias , Groß Silke
Published: October 2021

Abstract. Ice growth processes within clouds affect the type as well as the amount of precipitation. Hence, the importance of an accurate representation of ice microphysics in numerical weather and numerical climate models has been confirmed by several studies. To better constrain ice processes in models, we need to study ice cloud regions before and during monitored precipitation events. For this purpose, two radar instruments facing each other were used to collect complementary measurements. The C-band POLDIRAD weather radar from the German Aerospace Center (DLR), Oberpfaffenhofen and the Ka-band MIRA-35 cloud radar from the Ludwig Maximilians University of Munich (LMU) were used to monitor stratiform precipitation in the vertical cross-section area between both instruments. The logarithmic difference of radar reflectivities at two different wavelengths (54.5 and 8.5 mm), known as dual-wavelength ratio, was exploited to provide information about the size of the detected ice hydrometeors, taking advantage of the different scattering behavior in the Rayleigh and Mie regime. Along with the dual-wavelength ratio, differential radar reflectivity measurements from POLDIRAD provided information about the apparent shape of the detected ice hydrometeors. Scattering simulations using the T-matrix method were performed for oblate and horizontally aligned prolate ice spheroids of varying shape and size using a realistic particle size distribution and a well-established mass-size relationship. The combination of dual-wavelength ratio, radar reflectivity and differential radar reflectivity measurements as well as scattering simulations was used for the development of a novel retrieval for ice cloud microphysics. The development of the retrieval scheme also comprised a method to estimate the hydrometeor attenuation in both radar bands. To demonstrate this approach, a feasibility study was conducted on three stratiform snow events which were monitored over Munich in January 2019. The ice retrieval can obtain ice particle shape, size and mass which are in line with differential radar reflectivity, dual-wavelength ratio and radar reflectivity observations when a suitable mass-size relation is used and when ice hydrometeors are assumed to be represented by oblate ice spheroids. A furthermore finding was the importance of the differential radar reflectivity for the particle size retrieval directly above the MIRA-35 cloud radar. Especially for that observation geometry, the simultaneous slantwise observation from the polarimetric weather radar POLDIRAD could reduce ambiguities in retrieval of the ice particle size by constraining the ice particle shape.
Theoretical insights from upscaling Michaelis–Menten microbial dynamics in biogeochemical models: a dimensionless approach
Authors: Wilson Chris H. , Gerber Stefan
Published: October 2021

Abstract. Leading an effective response to the accelerating crisis of
anthropogenic climate change will require improved understanding of global
carbon cycling. A critical source of uncertainty in Earth system models
(ESMs) is the role of microbes in mediating both the formation and
decomposition of soil organic matter, and hence in determining patterns of
CO2 efflux. Traditionally, ESMs model carbon turnover as a first-order
process impacted primarily by abiotic factors, whereas contemporary
biogeochemical models often explicitly represent the microbial biomass and
enzyme pools as the active agents of decomposition. However, the combination
of non-linear microbial kinetics and ecological heterogeneity across space
and time guarantees that upscaled dynamics will violate mean-field
assumptions via Jensen's inequality. Violations of mean-field assumptions
mean that parameter estimates from models fit to upscaled data (e.g., eddy
covariance towers) are likely systematically biased. Likewise, predictions
of CO2 efflux from models conditioned on mean-field values will also be
biased. Here we present a generic mathematical analysis of upscaling
Michaelis–Menten kinetics under heterogeneity and provide solutions in
dimensionless form. We illustrate how our dimensionless form facilitates
qualitative insight into the significance of this scale transition and argue
that it will facilitate cross-site intercomparisons of flux data. We also
identify the critical terms that need to be constrained in order to unbias
parameter estimates.
Large-eddy simulations with ClimateMachine v0.2.0: a new open-source code for atmospheric simulations on GPUs and CPUs
Authors: Sridhar Akshay , Tissaoui Yassine , Marras Simone , Shen Zhaoyi , Kawczynski Charles , Byrne Simon , Pamnany Kiran , Waruszewski Maciej , Gibson Thomas H. , Kozdon Jeremy E. , Churavy Valentin , Wilcox Lucas C. , Giraldo Francis X. , Schneider Tapio
Published: October 2021

Abstract. We introduce ClimateMachine, a new open-source atmosphere modeling framework using the Julia language to be performance portable on central processing units (CPUs) and graphics processing units (GPUs). ClimateMachine uses a common framework both for coarser-resolution global simulations and for high-resolution, limited-area large-eddy simulations (LES). Here, we demonstrate the LES configuration of the atmosphere model in canonical benchmark cases and atmospheric flows, using an energy-conserving nodal discontinuous-Galerkin (DG) discretization of the governing equations. Resolution dependence, conservation characteristics and scaling metrics are examined in comparison with existing LES codes. They demonstrate the utility of ClimateMachine as a modelling tool for limited-area LES flow configurations.
Half a degree warming might cause doubled economic loss and intensified affected population of flood in China
Authors: Liu Lulu , Gao Jiangbo , Wu Shaohong
Published: October 2021

Abstract. Based on future scenario data and an improved quantitative assessment model of natural disaster risk, in this paper, we analyze the response of the characteristics of flooding events in China to 1.5 °C and 2 °C of global warming, quantitatively assess social and economic risks of the floods, and determine the integrated risk levels. The results indicate that for the RCP4.5 and RCP8.5 scenarios, the hazard and distribution area of the floods increase with increasing temperature and the influence range of floods in different levels expands more rapidly under RCP4.5 scenario. The floods mainly affect the social economy in the regions with lower altitudes and smaller slopes in eastern China. With intensification of temperature rise, the affected population and the direct economic losses would be aggravated. For 2 °C of global warming, under RCP8.5 scenario, affected population by floods would increase by 2 million and the economic risk would nearly double compared with 1.5 °C of global warming. The economic risk under RCP4.5 scenario would even reach three times that for 1.5 °C of global warming, but its proportion to GDP is lower than that of RCP8.5 scenario. Under both scenarios, the ranges of the medium-high flood risk zones would gradually expand westward and northward.
Pairing litter decomposition with microbial community structures using the Tea Bag Index (TBI)
Authors: Daebeler Anne , Petrová Eva , Kinz Elena , Grausenburger Susanne , Berthold Helene , Sandén Taru , Angel Roey ,   the High school students of biology project groups I, II, III from 2018–2019
Published: October 2021

Abstract. Including information about soil microbial communities into global decomposition models is critical for predicting and understanding how ecosystem functions may shift in response to global change. Here we combined a standardised litter bag method for estimating decomposition rates, Tea Bag Index (TBI), with high-throughput sequencing of the microbial communities colonising the plant litter in the bags. Together with students of the Federal College for Viticulture and Fruit Growing, Klosterneuburg, Austria, acting as citizen scientists, we used this approach to investigate the diversity of prokaryotes and fungi colonising recalcitrant (rooibos) and labile (green tea) plant litter buried in three different soil types and during four seasons with the aim of (i) comparing litter decomposition [decomposition rates (k) and stabilisation factors (S)] between soil types and seasons, (ii) comparing the microbial communities colonising labile and recalcitrant plant litter between soil types and seasons (iii) correlating microbial diversity and taxa relative abundance patterns of colonisers with litter decomposition rates (k)and stabilisation factors (S). Stabilisation factor (S), but not decomposition rate (k), correlated with the season and was significantly lower in the summer. This finding highlights the necessity to include colder seasons in the efforts of determining decomposition dynamics in order to quantify nutrient cycling in soils accurately. With our approach, we further showed selective colonisation of plant litter by fungal and prokaryotic taxa sourced from the soil. The community structures of these microbial colonisers differed most profoundly between summer and winter, and rooibos litter was generally a stronger selector than green tea litter. Moreover, this study indicates an equal, if not higher, importance of fungal versus prokaryotic degraders for recalcitrant and labile plant litter decomposition. Our results collectively demonstrate the importance of analysing decomposition dynamics over multiple seasons and isolating the effect of the active component of the microbial community.
How well does CMIP6 capture the dynamics of Euro-Atlantic weather regimes, and why?
Authors: Dorrington Joshua , Strommen Kristian , Fabiano Federico
Published: October 2021

Abstract. Even the most advanced climate models struggle to reproduce the observed wintertime circulation of the atmosphere over the North Atlantic and Western Europe. During winter, this particularly challenging region is dominated by eddy-driven and highly non-linear flows, which are often studied from the perspective of regimes – a small number of qualitatively distinct atmospheric states. Poor representation of regimes associated with persistent atmospheric blocking events, or variations in jet latitude, degrade the ability of models to correctly simulate extreme events. In this paper we leverage a recently developed hybrid approach – which combines both jet and geopotential height data – to assess the representation of regimes in 8,400 years of historical climate simulations drawn from CMIP6, CMIP5 and HighResMip. We show that these geopotential-jet regimes are particularly suited to the analysis of climate data, with considerable reductions in sampling variability compared to classical regime approaches. We find that CMIP6 has a considerably improved spatial regime structure, and a more trimodal eddy-driven jet, relative to CMIP5, but still struggles with underpersistent regimes, and too little European blocking, when compared to reanalysis. Reduced regime persistence can be understood, at least in part, as a result of jets that are too fast and eddy feedbacks on the jet stream that are too weak – structural errors that do not noticeably improve in higher resolution models.
Comparing and validating intra-farm and farm-to-farm wakes across different mesoscale and high-resolution wake models
Authors: Fischereit Jana , Schaldemose Hansen Kurt , Larsén Xiaoli Guo , van der Laan Maarten Paul , Réthoré Pierre-Elouan , Murcia Leon Juan Pablo
Published: October 2021

Abstract. Numerical wind resource modelling across scales from mesoscale to turbine scale is of increasing interest due to the expansion of offshore wind energy. Offshore, wind farm wakes can last several tens kilometres downstream and thus affect the wind resources of a large area. So far, scale-specific models have been developed and it remains unclear, how well the different model types can represent intra-farm wakes, farm-to-farm wakes as well as the wake recovery behind a farm. Thus, in the present analysis the simulation of a set of wind farm models of different complexity, fidelity, scale and computational costs are compared among each other and with SCADA data. In particular, two mesoscale wind farm parameterizations implemented in the mesoscale Weather Research and Forecasting model (WRF), the Explicit Wake Parameterization (EWP) and the Wind Farm Parameterization (FIT), two different high-resolution RANS simulations using PyWakeEllipSys equipped with an actuator disk model, and three rapid engineering wake models from the PyWake suite are selected. The models are applied to the Nysted and Rødsand II wind farms, which are located in the Fehmarn Belt in the Baltic Sea. Based on the performed simulations, we can conclude that average intra-farm variability can be captured reasonable well with WRF+FIT using a resolution of 2 km, a typical resolution of mesoscale models for wind energy applications, while WRF+EWP underestimates wind speed deficits. However, both parameterizations can be used to estimate median wind resource reduction caused by an upstream farm. All considered engineering wake models from the PyWake suite simulate intra-farm wakes comparable to the high fidelity RANS simulations. However, they considerably underestimate the farm wake effect of an upstream farm although with different magnitudes. Overall, the higher computational costs of PyWakeEllipSys and WRF compared to PyWake pay off in terms of accuracy for situations when farm-to-farm wakes are important.
Impact of Employee Involvement on Organizational Effectiveness in the Banking Sector in Kerala
Authors: Mathew Kochuthresia , R Resmi
Published: October 2021

It’s a common knowledge that every business organization depends on its effective functioning of human resources. Employee involvement and analysis of banking efficiency has received increasing attention in applied economics in recent years due firstly, to the rapid globalization of the financial industry and secondly, to increasing competitiveness in international financial markets. Analyzing the operational efficiency of banks in India to ascertain how efficiently they perform their basic functions. The effectiveness of each organization is based on its performance of human resources. The present study was conducted to identify the level of involvement of employees in order to achieve the effectiveness of banking sector in Ernakulam District of the state of Kerala. For this purpose, responses of 367 employees selected using stratified random sampling from six commercial banks.

Keywords: Employee Involvement, Organizational Effectiveness.
IMPROVEMENT OF THE CRIMINAL LAW FOR PROFESSIONAL CRIMES OF MEDICAL WORKERS
Authors: Sybatova M.E. , Gorodnova O.N.
Published: October 2021

The scientific novelty of the article is due to the results of a comprehensive criminal law study of medical crimes as models of criminal behavior in order to fairly qualify them and improve the norms providing for responsibility for them. The theoretical basis of the study was the opinions of practitioners, the scientific position of A.E. Senokosova and the expert conclusions of the Investigative Committee of the Russian Federation on improving criminal legislation providing for liability for medical errors.

The authors draw attention to the competition of articles 109, 118, 238 of the Criminal Code of the Russian Federation and suggest that when using them as a result of qualification, the signs of a special subject of crime – a medical worker should be taken into account. The study actualizes the issues of the effectiveness of punishment applied for criminal iatrogenies. The emphasis is made on the need to apply deprivation of the right to engage in professional activity as an additional punishment to medical workers when they commit iatrogenic crimes.