bluuebunny/crossref_metadata_2025 huggingface dataset:
A 5-Minute Cognitive Assessment for Safe Remote Use in Patients With COVID-19: Clinical Case Series
Authors: Beresford Thomas , Ronan Patrick J , Hipp Daniel
Published: May 2021

Background

Early clinical experience during the COVID-19 pandemic has begun to elucidate that the disease can cause brain function changes that may result in compromised cognition both acutely and during variable recovery periods. Reports on cognitive assessment of patients with COVID-19 are often limited to orientation alone. Further assessment may seem to create an inappropriate burden for patients with acute COVID-19, which is characterized by fatigue and confusion, and may also compromise examiner safety.

Objective

The aims of this study were to assess cognition in patients with COVID-19 as comprehensively as possible in a brief format, while observing safety precautions, and to establish a clear face value of the external validity of the assessment.

Methods

We adapted a brief cognitive assessment, previously applied to liver transplant candidates and medical/surgical inpatients, for remote use in patients hospitalized for COVID-19 treatment. Collecting quality assurance data from telephone-administered assessments, this report presents a series of 6 COVID-19 case vignettes to illustrate the use of this 5-minute assessment in the diagnosis and treatment of brain effects. Primary medical teams referred the cases for neuropsychiatric consultation.

Results

The age of the patients varied over four decades, and none of them were able to engage meaningfully with their surroundings on admission. On follow-up examination 6 to 10 days later, 4 of the 6 patients had recovered working memory, and only 1 had recovered calculation ability. Of the 6 patients, 2 were capable of complex judgment responses, while none of the cases completed frontal executive function testing in the normal range.

Conclusions

Cognitive assessment in patients with COVID-19 using this remote examination reveals patterns of cognitive recovery that vary among cases and are far more complex than loss of orientation. In this series, testing of specific temporal, parietal, and frontal lobe functions suggests that calculation ability, judgment, and especially frontal executive functions may characterize the effects of COVID-19 on the brain. Used widely and serially, this examination method can potentially inform our understanding of the effects of COVID-19 on the brain and of healing from the virus.
Patients’ Experiences of Using a Self-help App for Posttraumatic Stress Disorder: Qualitative Study
Authors: Riisager Lisa H G , Christensen Anne Bryde , Scharff Frederik Bernt , Arendt Ida-Marie T P , Ismail Israa , Lau Marianne Engelbrecht , Moeller Stine Bjerrum
Published: May 2021

Background

Posttraumatic stress disorder (PTSD) is a common disorder that requires more treatment options. Mobile health (mHealth) app interventions are promising for patients with PTSD, as they can provide easily accessible support, strategies, and information. However, knowledge about mHealth interventions is sparse and primarily based on quantitative studies.

Objective

The aim of this study is to qualitatively explore the experiences of patients with PTSD with regard to using an mHealth app as a stand-alone intervention before commencing psychotherapeutic treatment.

Methods

We conducted semistructured interviews with 14 participants 6 weeks after they received the app. The participants were all referred to PTSD treatment and were waiting to commence psychotherapeutic treatment. During this waiting time, the participants had no contact with the health staff. Interviews were transcribed and were analyzed using thematic analysis.

Results

A total of 3 themes were identified—the use of app, being a patient, and the overall evaluation of the app. The use of the app was described with the subtheme of habits, and the theme of being a patient included the subthemes of having negative experiences with the app and being a part of a research project. The use of the app encompassed how psychological factors and technical problems could interfere with the use of the app. The theme of being a patient depicted that the waiting time before starting treatment was long, and a subgroup of patients experienced feeling worse during this time, which they partly attributed to using the app. Several suggestions for change have been described in the overall evaluation of the app.

Conclusions

The findings in this study revealed that emotional arousal influenced the use of the app and that it was difficult for participants to establish a habit of using the app, thus reflecting the importance of supporting habit formation when implementing an mHealth app in mental health care services. This study makes an important contribution to the field of mHealth research, as it revealed that some participants had negative experiences resulting from using the app, thus reflecting the potential harm of having an mHealth app without the support of a clinician. It is therefore recommended to use a blended care treatment or an approach in which mental health care professionals prescribe an mHealth app for relevant patients to avoid increased suicidal risk.
Smart Home Sensing and Monitoring in Households With Dementia: User-Centered Design Approach
Authors: Tiersen Federico , Batey Philippa , Harrison Matthew J C , Naar Lenny , Serban Alina-Irina , Daniels Sarah J C , Calvo Rafael A
Published: May 2021

Background

As life expectancy grows, so do the challenges of caring for an aging population. Older adults, including people with dementia, want to live independently and feel in control of their lives for as long as possible. Assistive technologies powered by artificial intelligence and internet of things devices are being proposed to provide living environments that support the users’ safety, psychological, and medical needs through remote monitoring and interventions.

Objective

This study investigates the functional, psychosocial, and environmental needs of people living with dementia, their caregivers, clinicians, and health and social care service providers toward the design and implementation of smart home systems.

Methods

We used an iterative user-centered design approach comprising 9 substudies. First, semistructured interviews (9 people with dementia, 9 caregivers, and 10 academic and clinical staff) and workshops (35 pairs of people with dementia and caregivers, and 12 health and social care clinicians) were conducted to define the needs of people with dementia, home caregivers, and professional stakeholders in both daily activities and technology-specific interactions. Then, the spectrum of needs identified was represented via patient–caregiver personas and discussed with stakeholders in a workshop (14 occupational therapists; 4 National Health Service pathway directors; and 6 researchers in occupational therapy, neuropsychiatry, and engineering) and 2 focus groups with managers of health care services (n=8), eliciting opportunities for innovative care technologies and public health strategies. Finally, these design opportunities were discussed in semistructured interviews with participants of a smart home trial involving environmental sensors, physiological measurement devices, smartwatches, and tablet-based chatbots and cognitive assessment puzzles (10 caregivers and 2 people with dementia). A thematic analysis revealed factors that motivate household members to use these technologies.

Results

Outcomes of these activities include a qualitative and quantitative analysis of patient, caregiver, and clinician needs and the identification of challenges and opportunities for the design and implementation of remote monitoring systems in public health pathways.

Conclusions

Participatory design methods supported the triangulation of stakeholder perspectives to aid the development of more patient-centered interventions and their translation to clinical practice and public health strategy. We discuss the implications and limitations of our findings, the value and the applicability of our methodology, and directions for future research.
Designing an Indoor Air Quality Monitoring App for Asthma Management in Children: User-Centered Design Approach
Authors: Kim Sunyoung , Park Yunoh , Ackerman Matthew K
Published: May 2021

Background

Indoor air pollution is a well-known risk factor that triggers and exacerbates asthma, the most common pediatric chronic disease. Using a mobile app to monitor indoor air quality could be promising in engaging children in keeping their indoor air quality clean and healthy as secondary environmental prevention for asthma management. However, no app is available to allow children to monitor, assess, and improve their indoor air quality.

Objective

This study aims to design a mobile app that encourages children to monitor indoor air quality and track their asthma conditions through a user-centered, iterative design approach.

Methods

We reviewed existing apps for indoor air quality monitoring or asthma management for children and conducted two sets of semistructured interviews with 12 children with asthma. We then iteratively created prototypes and evaluated and revised them.

Results

Participants raised a series of outstanding questions on the prototype features and content that described their needs and perspectives, which informed the final designs. Following the identified requirements and recommendations, we developed two versions of the app: AirBuddy for presenting concrete information for indoor air quality and AirPet for gamifying the practice of monitoring indoor air quality.

Conclusions

By following an iterative, user-centered design process, we developed two versions of an app to encourage children with asthma to monitor indoor air quality and track their asthma condition. The user-centered design approach revealed two crucial aspects that require deeper consideration when creating a child-friendly app, including balancing brevity and expressivity and considering the longitudinal effects of gamification. As a next step, we plan to conduct a longitudinal deployment study to evaluate the real-world effects of our apps.
Mental Health and the Perceived Usability of Digital Mental Health Tools Among Essential Workers and People Unemployed Due to COVID-19: Cross-sectional Survey Study
Authors: Mata-Greve Felicia , Johnson Morgan , Pullmann Michael D , Friedman Emily C , Griffith Fillipo Isabell , Comtois Katherine A , Arean Patricia
Published: May 2021

Background

COVID-19 has created serious mental health consequences for essential workers or people who have become unemployed as a result of the pandemic. Digital mental health tools have the potential to address this problem in a timely and efficient manner.

Objective

The purpose of this study was to document the extent of digital mental health tool (DMHT) use by essential workers and those unemployed due to COVID-19, including asking participants to rate the usability and user burden of the DMHT they used most to cope. We also explored which aspects and features of DMHTs were seen as necessary for managing stress during a pandemic by having participants design their own ideal DMHT.

Methods

A total of 2000 people were recruited from an online research community (Prolific) to complete a one-time survey about mental health symptoms, DMHT use, and preferred digital mental health features.

Results

The final sample included 1987 US residents that identified as either an essential worker or someone who was unemployed due to COVID-19. Almost three-quarters of the sample (1479/1987, 74.8%) reported clinically significant emotional distress. Only 14.2% (277/1957) of the sample used a DMHT to cope with stress associated with COVID-19. Of those who used DMHTs to cope with COVID-19, meditation apps were the most common (119/261, 45.6%). Usability was broadly in the acceptable range, although participants unemployed due to COVID-19 were less likely to report user burden with DMHTs than essential workers (t198.1=–3.89, P<.001). Individuals with emotional distress reported higher financial burden for their DMHT than nondistressed individuals (t69.0=–3.21, P=.01). When the sample was provided the option to build their own DMHT, the most desired features were a combination of mindfulness/meditation (1271/1987, 64.0%), information or education (1254/1987, 63.1%), distraction tools (1170/1987, 58.9%), symptom tracking for mood and sleep (1160/1987, 58.4%), link to mental health resources (1140/1987, 57.4%), and positive psychology (1131/1986, 56.9%). Subgroups by employment, distress, and previous DMHT use status had varied preferences. Of those who did not use a DMHT to cope with COVID-19, most indicated that they did not consider looking for such a tool to help with coping (1179/1710, 68.9%).

Conclusions

Despite the potential need for DMHTs, this study found that the use of such tools remains similar to prepandemic levels. This study also found that regardless of the level of distress or even past experience using an app to cope with COVID-19, it is possible to develop a COVID-19 coping app that would appeal to a majority of essential workers and unemployed persons.
Knowledge and Attitude Toward Evidence-Based Medicine and Associated Factors Among Medical Interns in Amhara Regional State Teaching Hospitals, Northwest Ethiopia: Cross-sectional Study
Authors: Emwodew Delelegn , Melese Tesfahun , Takele Adamu , Mesfin Nebiyu , Tariku Binyam
Published: May 2021

Background

Evidence-based medicine (EBM) is widely accepted in medicine. It is necessary to improve the knowledge and attitudes of medical students in the use of evidence. In Ethiopia, little is known about medical students’ knowledge and attitudes toward EBM.

Objective

This study aimed to assess the knowledge and attitudes toward EBM and its associated factors among medical interns in teaching hospitals.

Methods

A cross-sectional survey was conducted using a random sample of medical interns in teaching hospitals in Ethiopia. Multivariable logistic regression analyses were used to identify the factors associated with the knowledge and attitudes toward EBM. Adjusted odds ratio (AOR) with 95% confidence interval and P≤.05 was used to quantify strength of association between variables.

Results

Out of a sample of 423 medical interns, 403 completed the questionnaire (95.3% response rate). Overall, 68.0% (274/403 of respondents had a favorable attitude toward EBM and 57.1% (230/403) had good knowledge of EBM. The majority (355/403, 88.1%) of participants had internet access. Only 19.6% (79/403) of respondents had received EBM-related training. Respondents’ knowledge of EBM was associated with previous EBM training (AOR 2.947, 95% CI 1.648-5.268, P<.001), understanding of sensitivity (AOR 2.836, 95% CI 1.824-4.408, P=.003), and internet access (AOR 2.914, 95% CI 1.494-5.685, P=.002). The use of an electronic database as a source of information (AOR 1.808, 95% CI 1.143-2.861, P=.01) and understanding of absolute risk reduction (AOR 2.750, 95% CI 1.105-6.841, P=.03) were predictors of positive attitudes.

Conclusions

This study demonstrates a lack of formal EBM training and awareness of basic concepts of EBM among medical interns. Medical intern attitudes toward EBM are relatively good. To enhance EBM knowledge and skills, formal teaching of EBM should be integrated into medical education.
A Virtual Cardiovascular Care Program for Prevention of Heart Failure Readmissions in a Skilled Nursing Facility Population: Retrospective Analysis
Authors: Friedman Daniel M , Goldberg Jana M , Molinsky Rebecca L , Hanson Mark A , Castaño Adam , Raza Syed-Samar , Janas Nodar , Celano Peter , Kapoor Karen , Telaraja Jina , Torres Maria L , Jain Nayan , Wessler Jeffrey D
Published: May 2021

Background

Patients with heart failure (HF) in skilled nursing facilities (SNFs) have 30-day hospital readmission rates as high as 43%. A virtual cardiovascular care program, consisting of patient selection, initial televisit, postconsultation care planning, and follow-up televisits, was developed and delivered by Heartbeat Health, Inc., a cardiovascular digital health company, to 11 SNFs (3510 beds) in New York. The impact of this program on the expected SNF 30-day HF readmission rate is unknown, particularly in the COVID-19 era.

Objective

The aim of the study was to assess whether a virtual cardiovascular care program could reduce the 30-day hospital readmission rate for patients with HF discharged to SNF relative to the expected rate for this population.

Methods

We performed a retrospective case review of SNF patients who received a virtual cardiology consultation between August 2020 and February 2021. Virtual cardiologists conducted 1 or more telemedicine visit via smartphone, tablet, or laptop for cardiac patients identified by a SNF care team. Postconsult care plans were communicated to SNF clinical staff. Patients included in this analysis had a preceding index admission for HF.

Results

We observed lower hospital readmission among patients who received 1 or more virtual consultations compared with the expected readmission rate for both cardiac (3% vs 10%, respectively) and all-cause etiologies (18% vs 27%, respectively) in a population of 3510 patients admitted to SNF. A total of 185/3510 patients (5.27%) received virtual cardiovascular care via the Heartbeat Health program, and 40 patients met study inclusion criteria and were analyzed, with 26 (65%) requiring 1 televisit and 14 (35%) requiring more than 1. Cost savings associated with this reduction in readmissions are estimated to be as high as US $860 per patient.

Conclusions

The investigation provides initial evidence for the potential effectiveness and efficiency of virtual and digitally enabled virtual cardiovascular care on 30-day hospital readmissions. Further research is warranted to optimize the use of novel virtual care programs to transform delivery of cardiovascular care to high-risk populations.
COVID-19 and Open Notes: A New Method to Enhance Patient Safety and Trust
Authors: Blease Charlotte , Salmi Liz , Hägglund Maria , Wachenheim Deborah , DesRoches Catherine
Published: May 2021

From April 5, 2021, as part of the 21st Century Cures Act, all providers in the United States must offer patients access to the medical information housed in their electronic records. Via secure health portals, patients can log in to access lab and test results, lists of prescribed medications, referral appointments, and the narrative reports written by clinicians (so-called open notes). As US providers implement this practice innovation, we describe six promising ways in which patients' access to their notes might help address problems that either emerged with or were exacerbated by the COVID-19 pandemic.
Effects of nebulized epinephrine in association with hypertonic saline for infants with acute bronchiolitis: a systematic review and meta-analysis
Authors: Pereira Renan , Almeida Versiéri , Zambrano Mariana , Zhang Linjie , Amantéa Sérgio
Published: May 2021

Management of acute bronchiolitis remains controversial due to lack of
strong evidence-based data. Nebulized epinephrine and hypertonic saline
have been studied in infants with bronchiolitis, with conflicting
results. This systematic review and meta-analysis aimed to evaluate the
efficacy on length of stay (LOS), clinical severity scores (CSS), oxygen
saturation (SaO2) and safety profile of nebulized epinephrine plus
hypertonic saline (HS) in infants with acute bronchiolitis. Outcomes
were represented by mean differences (MD) or standard mean differences
(SMD) and 95% confidence intervals (CIs) were utilized. 18 trials were
systematically selected and 16 of them contributed for the meta-analysis
(1,756 patients). Overall, a modest but significant positive impact was
observed of the combination therapy on LOS (MD of – 0.35 days, 95% CI
-0.62 to -0.08, p = 0.01, I2 = 91%). Stratification by time of CSS
assessment unveiled positive results in favor of the combination therapy
in CSS assessed 48 hours and 72 hours after the admission (SMD of -0.35,
95% CI -0.62 to -0.09, p = 0.008, I2 = 41% and SMD of -0.27, 95% CI
-0.50 to -0.04, p = 0.02, I2 = 0%, respectively). No difference in SaO2
was observed. Additional data showed a consistent safety profile, with a
low rate of adverse events (1%), most of them mild and transient. In
conclusion, nebulized epinephrine plus HS may be considered as a safe,
cheap and efficient alternative for decreasing LOS and CSS in infants
with acute bronchiolitis, especially on those who require more than 48
hours of hospitalization.
miR399-UBC24 module enhances freezing tolerance through regulating CBF signaling pathway and starch degradation
Authors: Peng Kankan , Tian Yu , Sun Xianze , Song Chunhua , Ren Zhipeng , Bao Yuzhuo , Xing Jinpu , Li Yuanshan , Xu Qinghua , Yu Jing , Zhang Da , Cang Jing
Published: May 2021

Although the regulation in Pi homeostasis of miR399 have been studied in
various plants, its molecular mechanisms in response to freezing stress
are still elusive. In this work, we found that the expression of
tae-miR399 and its target gene TaUBC24 in tillering nodes of
strong cold resistance winter wheat cultivar Dongnongdongmai1 (Dn1) was
significantly altered subjected to severe winter. tae-miR399 and its
target gene TaUBC24 were also responsive to short-term freezing stress
in tillering nodes of Dn1 seedlings. TaUBC24 physically interacted with
TaICE1. Ehanced freezing tolerance was observed in overexpressing
tae-miR399 Arabidopsis lines. Under freezing stress, overexpressing
tae-miR399 decreased the expression of AtUBC24 to increase the
expression of genes in CBF signaling pathway, Pi translocation pathway
and starch metablism, including AtCBFs, AtCOR47,
AtCOR413IM, AtPHT1;4, AtAPLs and AtBAMs,
inhibit the degradation of AtICE1 and AtPHO1, and promote the activities
of SOD, POD and CAT. These findings indicated that the increased
freezing tolerance was dependent upon elevating CBF signaling pathway,
phosphorus utilization efficiency, starch degradation, accumulation of
soluble sugar and ability of ROS scavenge. These results will aid our
understanding of molecular mechanism of how miR399-UBC24 module
plays a cardinal role in regulating plant freezing stress tolerance
through mediating the downstream pathways.
Pre-pregnancy body mass index does not impact live birth rate after frozen-thawed euploid embryo transfer: a retrospective cohort study
Authors: Liu Xitong , Tian Li , Cai He , Shi Juanzi , Bai Haiyan
Published: May 2021

Objective To assess the effects body mass index (BMI) on live birth
rates in patients undergoing in vitro fertilization (IVF) with
trophectoderm biopsy and preimplantation genetic testing for
aneuploidies (PGT-A) when transferring a single euploid blastocyst.
Design Retrospective cohort study. Setting Public fertility center in
China. Population 821 women who underwent first cycle of frozen-thawed
single euploid blastocyst transfer between 2012 and 2020. Methods
Patients were grouped by World Health Organization (WHO) BMI class:
underweight (<18.5, n=80), normal weight (18.5-24.9, n=602),
overweight (25-30, n=112), and obese (≥30, n=27). A logistic regression
model was used to assess the association between BMI and live birth
while adjusting for potential confounders. Main outcome measures
Live-birth rate was primary outcome. Results There was no difference in
the birth weight, miscarriage, preterm birth, pregnancy complication,
type of delivery and fetal gender by BMI category. The clinical
pregnancy rate was higher in the overweight and obese groups. In
multivariate logistic regression analysis, we fail to demonstrate a
statistically significant relationship between BMI and live birth in
underweight (adjusted odds ratio [AOR] 0.80; 95% confidence
interval [CI], 0.47-1.35, p=0.402), overweight (AOR 0.85; 95% CI,
0.54-1.35, p=0.491) or obese (AOR 1.07; 95% CI, 0.48-2.38, p=0.864)
patients compared with the normal weight reference group. Conclusion No
statistically significant relationship was identified between BMI and
live birth in patients undergoing IVF with PGT-A, suggesting that the
negative impact of obesity on IVF and clinical outcomes may be related
to aneuploidy.
SARS-CoV-2 re-positivity within the first 3 months of COVID-19 recovery; probable re-infection
Authors: sadr sara , Bafrani Melika Arab , Abdollahi Alireza , SeyedAlinaghi SeyedAhmad , Mohammadnejad Esmaeil , Hossienzade Roghieh , Golestan Fereshteh Shahmari , Ahmadinejad Zahra , Salehi Mohammadreza , Javaherian Mohammad , kimyaee Elahe , Jafari Fatemeh , Ghiasvand Fereshteh
Published: May 2021

Objectives Possibility of reinfection with SARS-CoV-2 changes our view
on herd immunity and vaccination, and can impact worldwide quarantine
policies. We performed RT-PCR follow-up studies on recovered patients to
assess possible development of reinfections and re-positivity. Method
During a 6-month period, 202 PCR-confirmed recovering COVID-19 patients
entered this study. Follow-up RT-PCR tests and symptoms assessment were
performed one month after the initial Positive results. patients who
tested negative were tested again one and three months later. The Serum
IgG and IgM levels were measured in the last follow-up session. Results
In the first two follow-up sessions, 82 patients continued their
participation, of which four patients tasted positive. In the second
follow-up 44 patients participated, three of whom tested positive. None
of the patients who tested positive in the first and second follow-up
session were symptomatic. In the last session, 32 patients were tested
and four patients were positive, three of them were mildly symptomatic
and all of them were positive for IgG. Conclusion A positive RT-PCR in a
recovering patient may represent reinfection. While we did not have the
resources to prove reinfection by genetic sequencing of the infective
viruses, we believe presence of mild symptoms in the three patients who
tested positive over 100 days after becoming asymptomatic, can be
diagnosed as reinfection. The IgG may have abated the symptoms of the
reinfection, without providing complete protection.
Low serum 25-Hydroxy (OH) vitamin D levels are associated with increased arterial stiffness in healthy children: An echocardiographic study from Turkey
Authors: Azak Emine , Çetin İlker
Published: May 2021

Objective: Arterial stiffness refers to arterial wall rigidity,
particularly in central vessels, and is an independent predictor of
cardiovascular disease. 25-Hydroxy (OH) vitamin D has beneficial effects
on blood pressure, vascular endothelial function, and arterial
stiffness. Therefore, we aimed to elucidate the role of 25-OH vitamin D
deficiency in arterial stiffness development and its relationship with
arterial stiffness in healthy children. Methods: This study included 80
patients with low levels of 25-OH vitamin D and 40 healthy control. The
study participants were then divided into three groups: group 1
consisted of patients with a deficient 25-OH D level of < 19.9
ng/mL, group 2 with an insufficient 25-OH D level between 20-29.9 ng/mL;
group 3 were considered control group with a sufficient serum 25-OH
vitamin D level of ≥30 ng/mL. Aortic strain, distensibility, stiffness
index, and standard left ventricular measurements were calculated using
M-mode echocardiographic data. Results: Left ventricular mass index
(LVMI) and interventricular septal diastolic thickness (IVSTd) appeared
to increase in group 1 compared to groups 2 and 3. Aortic strain and
distensibility were significantly decreased in group 1, whereas aortic
stiffness index and elastic modulus were significantly increased. The
aortic stiffness index was negatively correlated with serum 25-OH
vitamin D levels; however, aortic strain, aortic distensibility, and
LVMI were positively correlated. Conclusions: Our study results revealed
a significant relationship between 25-OH vitamin D levels indicative of
a deficiency and aortic stiffness. We suggest that arterial stiffness
may also occur in healthy children with a 25-OH vitamin D deficiency.
Investigating Origins of Ventricular Arrhythmia Arising from Right Ventricular Outflow Tract and Comparing Initial Ablation Strategies
Authors: Jiang Zhi , Qifang LIU , Tian Ye , Zhao Yidong , Liu Wei , Tian Longhai , Huang Jing , Tian Shui , Zheng Yaxi , Tri Jason , Yang Long
Published: May 2021

Background The origin distribution of right-ventricular-outflow-tract
(RVOT) ventricular arrhythmias (VAs) remains unclear. There is limited
data on the ablation effectiveness of the reversed U-curve method
compared with the antegrade method. Objectives To investigate the origin
distribution of RVOT-type VAs and compare the ablation effectiveness of
the two methods. Method Consecutive patients who had idiopathic
RVOT-type VAs were prospectively enrolled. After activation mapping,
patients were randomly assigned to supravalvular strategy using the
reversed U-curve or subvalvular strategy using the antegrade method. The
primary outcome was initial ablation (IA) success, defining as the
successful ablation within the first three attempts. Results 61 patients
were enrolled from November 2018 to June 2020. Activation mapping
revealed 34/61 (55.7%) of the earliest ventricular activating (EVA)
sites were above the pulmonary valves (PVs). The IA success rate was
25/33(75.8%) in the patients assigned to supravalvular strategy as
compared with 16/28(57.1%) in those assigned to subvalvular strategy
(P=0.172). Logistic regression revealed a substantial and qualitative
interaction between the EVA sites and IA strategies
(Pinteraction<0.001). For multiple-comparison, either strategy
had a remarkably higher IA success rate in treating its ipsilateral EVA
sites than contralateral ones (P<0.0083). Conclusion Of the
idiopathic RVOT-type VA origins, half were located above the PV. The two
strategies did not differ in the primary outcomes. However, they
complement locating the EVA sites and facilitate ipsilateral ablation,
which produces a significantly higher IA success rate. (Chinese Clinical
Trial Registry number, ChiCTR2000029331)
Uniform convergent modified weak Galerkin method for convection-dominated two-point boundary value problems
Authors: toprakseven şuayip , Zhu Peng
Published: May 2021

In this paper, a modified weak Galerkin finite element method on
Shishkin mesh has been developed and analyzed for the singularly
perturbed convection-diffusion-reaction problems. The proposed method is
based on the idea of replacing the standard gradient (derivative) and
convection derivative by modified weak gradient (derivative) and
modified weak convection derivative, respectively, over piecewise
polynomials of degree $k\geq1$. The present method is
parameter-free and has less degree of freedom compared to the weak
Galerkin finite element method. Stability and convergence rate of
$\mathcal {O}((N^{-1}\ln
N)^k)$ in the energy norm are proved. The method is uniformly
convergent, i.e., the results hold uniformly regardless of the value of
the perturbation parameter. Numerical experiments confirm these
theoretical findings on Shishkin meshes. The numerical examples are also
carried out on B-S meshes to confirm the theoretical results. Moreover,
the proposed method has the optimal order error estimates of
$\mathcal {O}(N^{-(k+1)})$ in a discrete
$L^2-$ norm and converges at superconvergence order of
$\mathcal {O}((N^{-1}\ln
N)^{2k})$ in the discrete $L_\infty-$ norm.
Dolaylı Evaporatif Soğutma için Geliştirilen Dönel Bir Çarkın Optimum Kanal Geometrisinin Belirlenmesi
Authors: ARICA Sena Özlem , HORUZ İlhami
Published: May 2021

Özgün olarak tasarımı Solidworks katı tasarım programı yardımıyla yapılmış olan dönel çark; içi boş olarak alüminyumdan imal edilmiş olup; içinden geçen iç ortam havası ile dışından geçen taze hava arasında bir eşanjör görevi görerek iki havanın karışmadan aralarında ısı transferi gerçekleşmesini sağlamaktadır. Bu çalışmada özgün olarak tasarımı yapılmış olan dönel çark için uygun kanal tasarımı belirlenmeye çalışılmış olup, uygun kanalın belirlenebilmesi için FlowVision hesaplamalı akışkanlar dinamiği analiz programı vasıtasıyla 2 ayrı kanal tipi (U şeklinde kanal ve düz kanal) olması durumu için kanal giriş ve çıkışındaki basınç kaybı, hız konturu, hız vektörü ve sıcaklık konturları karşılaştırılarak bu dönel çark için en uygun kanal tipine karar verilmeye çalışılmıştır. Analiz sonucunda; U şeklindeki kanalın giriş ve çıkışındaki basınç kaybı çok olduğundan dolayı dönel çark için uygun kanal tipinin düz şekildeki kanal olduğuna karar verilmiştir. Nitekim deney sonuçlarıda hesaplamalı akışkanlar dinamiği analiz sonuçlarını desteklemektedir.
PENERAPAN PENDEKATAN SAINSTIFIK UNTUK MENINGKATKAN HASIL BELAJAR CATUR PURUSA ARTHA DAN PAWIWAHAN MATA PELAJARAN PENDIDIKAN AGAMA HINDU DAN BUDI PEKERTI SISWA KELAS XI PARIWISATA 2 SMK NEGERI 2 SINGARAJA SEMESTER GANJIL TAHUN PELAJARAN 2019/2020
Authors: Sastrawan Gede
Published: May 2021

Penelitian ini dilaksanakan di SMK Negeri 2 Singaraja pada semester ganjil tahun pelajaran 2019/2020 yang bertujuan meningkatkan hasil belajar topik “Catur Purusa Artha dan Pawiwahan” mata pelajaran pendidikan agama Hindu dan Budi Pekerti melalui penerapan pendekatan pembelajaran saintifik. Subjek penelitian adalah peserta didik kelas XI Pariwisata berjumlah tiga puluh empat orang terdiri dari delapan belas orang laki-laki dan enam belas orang perempuan. Teknik pengambilan data penelitian pada aspek sikap dan keterampilan adalah nontes dan data penelitian aspek pengetahuan menggunakan tes. Analisis data dilakukan secara deskriptif. Hasil belajar prasiklus pada aspek sikap dengan ketuntasan klasikal 67,65% dan aspek pengetahuan 76,47% serta aspek keterampilan 76,47%. Hasil penelitian siklu-1 yaitu : (1) aspek sikap dengan peserta didik yang mencapai ketuntasan 76,47% dan yang tidak tuntas 32,35%, (2) aspek pengetahuan peserta didik yang mencapai ketuntasan 82,85% dan yang tidak tuntas 17,65%, dan (3) aspek keterampilan peserta didik yang mencapai ketuntasan 85,29% dan yang tidak tuntas 14,71%. Hasil penelitian siklus-2 yaitu : (1) aspek sikap peserta didik yang mencapai ketuntasan 85,29% dan yang tidak tuntas 14,71%, (2) aspek pengetahuan peserta didik yang mencapai ketuntasan 94,12% dan yang tidak tuntas 5,88%, dan (3) aspek keterampilan peserta didik yang mencapai ketuntasan 88,24% dan yang tidak tuntas 11,76%. Berdasarkan perkembangan hasil belajar peserta didik tersebut dapat disimpulkan bahwa penerapan pendekatan pembelajaran saintifik dapat meningkatkan hasil belajar topik “Catur Purusa Artha dan Pawiwahan” mata pelajaran pendidikan agama Hindu dan Budi Pekerti peserta didik kelas XI Pariwisata 2 semester ganjil tahun pelajaran 2019/2020.Kata kunci: pendekatan saintifik, hasil belajar.
Association between Diabetes Mellitus and Leucocytic DNA Damage
Authors: Szeto Yim Tong , Yeung Ho Yan
Published: May 2021

It has been suggested that diabetes is the disease associated with increased oxidative stress and might reflect with increased cellular DNA damage. To investigate the association between hyperglycaemic state and NDA damage of human white blood cells. The basal and UV-induced leucocytic DNA damages of 80 individuals, including 41 diabetic, 19 pre-diabetic patients and 20 normal subjects, were measured by comet assay. The HbA1c and fasting glucose levels were correlated to the DNA damage to detect the potential association. The leucocytic DNA damage was visualized under light microscope with Giemsa stain. The degree of DNA lesion was quantified by visual scoring. The diabetic patients showed the highest basal and UV induced DNA damage, while lowest scores were seen in healthy subjects. The DNA damages among diabetic, pre-diabetic patient and healthy subjects were significantly different from each other. There were significant positive correlations between the basal and UV-induced leucocytic DNA damages with HbA1c as well as fasting glucose levels. DNA damage as a marker of oxidative stress was seen in diabetic and pre-diabetic patients. The damage was positively correlated to the hyperglycaemic state of patient.
Influence of Microfinance Banks on Rural Women’s Entrepreneurial Success in Oyo State
Authors: Hambolu Agnes Taiwo , Nwabufor Ngozi Bibiana , Tony-Okeme Acharu Faith
Published: May 2021

This focus of this paper is centered on the extent to which rural women entrepreneurs can be used as a vital tool for economic development in the State when availed micro credit. The paper discussed the rate at which the micro savings from microfinance banks influenced rural Women’s entrepreneurial success in Oyo State. Two research questions were raised, two hypotheses were formulated and were tested at 0.05 level of significant. The study is premised on Gary Becker’s human capital theory of entrepreneurship which stipulates that all human behavior is based on the economics of self-interest of individuals which operate freely within the competitive market, and Dunford Chris classical theory of microfinance. The instrument for data collection was personal interview and questionnaire tagged: Influence of Microfinance Banks on Rural Women’s Entrepreneurial Success in Oyo State. This paper found that, rural women entrepreneurs significantly differ in their responses regarding extent to which micro credits influence their entrepreneurial success based on age grade. Also, the second finding revealed that single women entrepreneurs rated the influence of micro savings on their entrepreneurial success higher than the married women. However, micro savings for entrepreneurial purpose is good for both single and married rural women entrepreneurs for continuity of their businesses during financial crises. The study recommended that government should release fund to microfinance banks with specifications on sex and age so that women will be accessible to grants and loans with low interest in order to reduce poverty in our society especially among women.
A Review of Augmented Reality Systems and an Update on The Most Recent Technological Developments and Applications in Dentistry
Authors: Al-Khaled A. , Al-Khaled I. , Abutayyem H.
Published: May 2021

This literature review aims to discuss augmented reality systems and provide an update on the most recent technological developments and applications in the dental field. The studies that met the inclusion criteria in the last 20 years, from 2000 to 5 May 2020, in the PubMed database were included. The search resulted in n=72 articles, in which n=40 included and n=32 excluded. AR systems are still being tested as there are still some limitations that limit the adoption of this technology in the dental sector. Several studies have resulted in a device appropriate for clinical use, yet no regular clinical application was recorded.
Enhancing Detection Performance of Face Recognition Algorithm Using PCA-Faster R-CNN
Authors: Muhammad Hashiru Isiaka , Musa Kabir Ibrahim , Abdulrahman Mustapha Lawal , Abubakar Abdullahi , Umar Kabiru , Ishola Abdulhakeem
Published: May 2021

In this paper, we present a new face detection scheme using deep learning and achieving state-of-the-art recognition performance using real-world datasets.  We designed and implemented a face recognition system using Principal Component Analysis (PCA) and Faster R Convolutional Neural Network (Faster R CNN). In particular, we improve the state-of-the-art Faster RCNN framework by using Principal Component Analysis (PCA) technique and Faster R CNN to detect and recognise faces in a face database.  The Principal Component Analysis (PCA) was used to extract features and dimensionality reduction from the face database, while the Faster R Convolutional Neural Network algorithm was used to identify patterns in the dataset via training the neural network. The three real-world datasets used in our experiment are ORL, Yale, and California face dataset. When implemented on the ORL face dataset, the algorithm achieved average recognition accuracy of 99%, with a recognition time of 147.72 seconds for 10 runs, and the recognition time/image was 0.3 sec/image on 400 images. The Yale face dataset achieved average recognition accuracy of 99.24% with a recognition time of 63.45 seconds for 10 runs, and the recognition time/image was 0.53 sec/image on 120 images. Finally, on California Face Database (CFD), it achieved average recognition accuracy of 99.52% with a recognition time of 226.05 seconds for 10 runs, and the recognition time/image was 0.27 sec/image on 827 images. On the CFD dataset, however, the proposed approach has excellent classification performance when the recall ratio is high. The proposed method achieves a higher recall and accuracy ratio than the Faster RCNN without PCA method. For the F-score, the proposed method achieved 0.98, which is significantly higher than the 0.95 achieved by the Faster-RCNN. This demonstrates the superiority of our model performance-wise as against state-of-the-art, both in terms of accuracy and fast recognition. Therefore our model is more efficient when compared to the latest researches done in the area of facial recognition.
Review on Emotion Recognition Using Facial Expressions
Authors: Atya Abozar Atya Mohamed , Bilal Khalid Hamid
Published: May 2021

The advent of artificial intelligence technology has reduced the gap between humans and machines as equips man to create more near-perfect humanoids. Facial expression is an important tool to communicate one’s emotions as a non-verbally overview of emotion recognition using facial expressions. A remarkable advantage of such a technique recently improved public security through tracking and recognizing, thus led to the high attention to keep up the scientific research in the field. The approaches used for facial expression include classifiers like Support Vector Machine (SVM), Artificial Neural Network (ANN), Convolution Neural Network (CNN), Active Appearance and Machine learning which all used to classify emotions based on certain parts of interest on the face like lips, lower jaw, eyebrows, cheeks and many more. By comparison, the reviews have shown that the average accuracy of the basic emotion ranged from 51% up to 100%, whereas carrying through 7% to 13% in the compound emotions, hence indicated that the indispensable emotion is much comfortable to recognize.
A Web-Based Aggregate Information Portal
Authors: Bayem Donatus I. , Osuagwu Henry O. , Ugwu Chimezie F.
Published: May 2021

A Web portal aggregates an array of information for a target audience and affords a variety of services including search engines, directories, news, e-mail, and chat rooms, and they have evolved to provide a customized gateway to Web information. Also, a high level of personalization and customization has been possible. The portal concept could further be established to function as a classy Web interface that can serves as sustenance for variety of the task performance. The aggregate information Web portal will serve as portals for the information needs of users on the web. The Web based portal enable marketing of users broadly across a wide variety of interests. Most of the popular usage of the Web based aggregate information portal probably refers to the visual and user interface (UI) design of a Web site. It is a crucial aspect since the visitor is often more impressed with looks of website and easy to use rather than about the technologies and techniques that are used behind the scenes, or the operating system that runs on the web server. In other words, it just does not matter what technologies that is involved in creating, when the site is hard to use and easy to forget. This paper explores the factors that must be painstaking during the design and development of a Web based aggregate information portal. Design as a word in the context of a Web application can mean many things. A working Web based aggregate information portal, kaseremulticoncept was developed to support the various users’ task performances. A number of technologies was studied and implemented in this research, which includes multi-tier architecture, server and client side scripting techniques and technologies such as PHP programming languages and relational databases such as MySQL, Structured Query language (SQL) and XAMPP Server.
«Calma», de Óscar L. Figueruelo Burrieza
Authors: Panero García María Pilar
Published: May 2021

Reseña del libro Calma (Barcelona, Avant, 2020), de Óscar L. Figueruelo.

Óscar Figueruelo (1972) debuta como novelista con una historia sobre el miedo a lo desconocido ambientada en una comarca de pequeños pueblos y su agro circundante.
Marksowskie ujęcie klas społecznych a paradygmat nauk o polityce
Authors: Machalica Bartosz
Published: May 2021

The paper outlines the Marxist theory of social classes in reference to the paradigm of the political science.The first part demonstrates the classical Karl Marx’s theory of social classes. Further on, the paper presentsthe main elements of the neo-Marxist class theory, including the works of Erik Olin Wright. Next, the paperpoints to the utility of ‘the social class’ term in the political science paradigm, in reference to the worksof Artur Bodnar, Mirosław Karwat, Julian Hochfeld and others. Subsequently, the paper advocates thestatement to the effect that politics is the concentrated emanation of economic relations, which alludes tothe significance of the Marxist social class theory.
Kryzys Bundeswehry po zjednoczeniu Niemiec
Authors: Rydel Jan
Published: May 2021

The Bundeswehr, the armed forces of the Federal Republic of Germany, which was one of the strongestarmies in NATO during the Cold War, is currently in serious crisis. After the reunification of Germany, thenumber of soldiers was quickly reduced and the defence spending dropped to 1.2 percent of the GDP. In2004, the doctrine of using the Bundeswehr changed too. It was concluded that there was no risk of anattack on the German territory, so general conscription was abandoned and the supplies of weapons andammunition needed for mobilization were liquidated. The army was to specialise in peace and stabilisationmissions in endangered areas of the world. However, at present, Germany has far fewer soldiers on missionsthan, for example, France and Great Britain, and it consistently refrains from joining missions during which itis likely to participate in real combat operations. At present, the German army does not have a single brigadecapable of taking part in a combat, and a small number of Luftwaffe airplanes and helicopters are technicallysound, including Marine vessels. The situation of the Bundeswehr is complicated by the widespread pacifismin German society and the resulting lack of trust in, and aversion to the military.
Ewolucja organów gminy jako element transformacji systemowej Polski po 1989 roku
Authors: Kotarba Bogusław
Published: May 2021

The systemic transformation in Poland affected virtually all spheres of the country’s social and economic life.One of its important elements was the restitution of the local government, which was both the object andthe subject of the transformation processes. Based on the analysis of statutory regulations regarding thestrengthening of the position of the executive body of the municipality, the paper confirms the thesis thatthe municipal government was subject to system transformation and that it maintained its subjectivity in theprocess of introducing new systemic solutions.The analysis used the institutional and legal analysis method, as well as the comparative and behavioralmethod.