bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Responses and Adaptation in a Changing Climate: A Framework Integrating Biological, Psychological and Behavioural Aspects
Authors: Cianconi Paolo , Hanife Batul , Grillo Francesco , Zhang Kai , Janiri Luigi
Published: July 2021

Climate change is one of the biggest challenges of our times. Its impact on human populations is not yet completely understood. Many studies have focused on single aspects with contradictory observations. However, climate change is a complex phoenomenon that cannot be adequately addressed from a single discipline's perspective. Hence, we propose a comprehensive conceptual framework on the relationships between climate change and human responses. This framework includes biological, psychological and behavioural aspects, and provides a multidisciplinary overview and critical information for focused interventions. The role of tipping points and regime shifts is explored, and a historical perspective is presented to describe the relationship between climate evolution and socio-cultural crisis. Vulnerability, resilience and adaptation are analyzed from an individual and a community point of view. Finally, emergent behaviours and mass effect phenomena are examined that account for mental maladjustment and conflicts.
Sweet bread chemical properties optimalization based on baking temperature and duration
Authors: Devi Dwi Siskawardani  , Warkoyo Warkoyo , Onthong Jumpen
Published: July 2021

Bread is main food in several country. Sweet bread is one popular type that has a lasting sweet taste and soft textured with or without stuffing. Baking is the most important process of bread production. The temperature and time required in the baking varies according to the type of bread, big dough, and baking pan in the oven used. This research aimed to identify the optimum level of baking temperature and duration to the chemical properties of sweet bread. Randomized Complete Block Design (RCBD) Factorial with 2 factors and 3 replications were applied for this research. The first factor was baking temperature consisted 4 level (T1= 180 oC, T2= 190 oC, T3= 200 oC, T4= 210 oC), and the second factor was baking duration which composed 4 level (A1= 10 minutes, A2= 15 minutes, A3= 20 minutes, A4= 25 minutes). The results showed that there wasn’t interaction between baking temperature and duration to water content, fat, protein, and carbohydrate, but it was interaction to the ash content. The baking temperature and duration separatelly had significantly effect to the all parameter. The best result according to the SNI 01-3840-1995 was S4W4 (185 oC: 14 minutes) with water content (23.572%), fat (10.906), protein (1.105%), carbohydrate (62.940 %), and  ash content (1.736 %).
Strategi Implementasi Profesionalisme Guru pada Masa Pandemi di MI Hikmatun Najah
Authors: Partono Partono
Published: July 2021

Abstract

The purpose of this study is to find out about the efforts or strategies for implementing teacher professionalism during the pandemic because learning activities are no longer carried out face-to-face but are completely digital / online. This type of research is field research with a descriptive qualitative approach that tries to explore the meaning of teacher professionalism as a step to develop the quality of educational institutions while still adjusting educational goals. The results of this study indicate that the majority of MI Hikmatun Najah teachers can implement their professionalism through online learning properly and right. They still carry out their duties and obligations in a professional manner even though the learning process is online / online. This research also shows that teachers can put their professionalism in accordance with the place and conditions.

Abstrak

Tujuan penelitian ini adalah untuk mengetahui tentang upaya-upaya atau strategi implementasi profesionalisme guru pada masa pandemi dikarenakan kegiatan pembelajaran tidak lagi dilakukan dengan tatap muka melainkan dengan serba digital/online. Jenis penelitian ini adalah penelitian lapangan dengan pendekatan kualitatif deskriptif yang mencoba mengeksplorasi makna profesionalisme guru sebagai langkah mengembangkan mutu lembaga pendidikan dengan tetap menyesuaikan tujuan pendidikan.. Hasil penelitian ini menunjukan bahwa mayoritas guru MI Hikmatun Najah dapat mengimplementasikan sikap profesionalisme mereka melalui pembelajaran online dengan baik dan tepat. Mereka tetap melaksanakan tugas dan kewajiban mereka secara profesional walaupun proses pembelajaran melalui online/daring. Penelitian ini juga menunjukkan bahwa para guru dapat menempatkan sikap profesionalisme mereka sesuai dengan tempat dan kondisi.
Coastal Texas Protection and Restoration Feasibility Study : Coastal Texas flood risk assessment : hydrodynamic response and beach morphology
Authors: Melby Jeffrey , Massey Thomas , Diop Fatima , Das Himangshu , Nadal-Caraballo Norberto , Gonzalez Victor , Bryant Mary , Tritinger Amanda , Provost Leigh , Owensby Margaret , Stehno Abigail
Published: July 2021

The US Army Corps of Engineers, Galveston District, is executing the Coastal Texas Protection and Restoration Feasibility Study coastal storm risk management (CSRM) project for the region. The project is currently in the feasibility phase. The primary goal is to develop CSRM measures that maximize national net economic development benefits. This report documents the coastal storm water level and wave hazard, including sea level rise, for a variety of flood risk management alternatives. Four beach restoration alternatives for Galveston Island and Bolivar peninsula were evaluated. Suites of synthetic tropical and historical non-tropical storms were developed and modeled. The CSTORM coupled surge-and-wave modeling system was used to accurately characterize storm circulation, water level, and wave hazards using new model meshes developed from high-resolution land and sub-aqueous surveys for with- and without-project scenarios. Beach morphology stochastic response was modeled with a Monte Carlo life-cycle simulation approach using the CSHORE morphological evolution numerical model embedded in the StormSim stochastic modeling system. Morphological and hydrodynamic response were primarily characterized with probability distributions of the number of rehabilitations and overflow.
La imaginación cívica en Latinoamérica
Authors: Castro Pérez Raúl
Published: July 2021

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Emprendimiento y resiliencia: caso de las bodegas de barrio en el Perú durante la pandemia de covid-19
Authors: Acuña Sillo Elba Lourdes
Published: July 2021

Las bodegas de barrio en el Perú representan uno de los canales de venta más importantes en los hogares pe- ruanos y tienen una participación mayor al 70% en las ventas minoristas. Con una pirámide socioeconómica de la población en la que predominan los sectores medio, bajo y muy bajo con una capacidad de compra limitada, las bo- degas tienen un arraigo muy fuerte en los barrios del Perú. Además de destacar en el abastecimiento de productos de primera necesidad, también tienen un rol social y antropo- lógico en la vida de los vecindarios peruanos. La pandemia de covid-19 redujo las principales fuentes de ingresos de los bodegueros, que debieron adaptarse a este nuevo con- texto al acoger tecnologías digitales como las redes socia- les y aplicativos móviles para superar una crisis como nun- ca antes vista. El presente ensayo debate la relación entre el emprendimiento y la resiliencia de las bodegas de barrio del Perú. Aunque la pandemia de covid-19 ha producido mejoras sustanciales en la gestión de las bodegas, todavía existen muchas oportunidades para la digitalización de este importante canal de ventas en el Perú.
Plataforma digital para interação social dos Engenheiros sem Fronteiras - núcleo Belo Horizonte
Authors: Prado Gabriel Henrique Souza , Jácome João Pedro Coelho , Fontoura Francisco Augusto , Paiva Daniel Henrique Matos de , Marchese Luísa Mosqueira , Silva Marcos Paulo Souza , Duarte Samuel França , Dias Maciel Wesley
Published: July 2021

Neste trabalho, foi desenvolvida uma plataforma digital de comunicação e interação social para a Organização da Sociedade Civil Engenheiros Sem Fronteiras - Núcleo Belo Horizonte. A organização presta apoio social em Belo Horizonte e região metropolitana. Desde sua fundação, já atuou em mais de 50 projetos, beneficiando diretamente mais de 3.500 pessoas. A plataforma é composta por um website responsivo e um aplicativo para dispositivos móveis. O objetivo de desenvolver o website foi divulgar informação institucional, promover o voluntariado e possibilitar o recebimento de recursos financeiros através de doações. Por outro lado, o objetivo de desenvolver o aplicativo foi criar uma rede entre entidades do terceiro setor e comunidades carentes, promovendo interação entre prestadores de serviço e a população. O trabalho foi conduzido com base na metodologia Scrum para desenvolvimento ágil. A justificativa para desenvolvimento da plataforma foi a ampliação da presença organizacional no ambiente digital. A relevância do trabalho para a organização e para a sociedade foi o fortalecimento da comunicação institucional, a melhoria do recebimento de doações e a criação de uma rede solidária entre Organizações da Sociedade Civil, comunidades e cidadãos em situação de vulnerabilidade social. Assim, o trabalho se juntou a outros esforços para o combate às desigualdades sociais na região. O resultado do trabalho foi uma plataforma que segue os princípios para melhoria de usabilidade e da experiência do usuário, ampliando a capacidade de atuação da organização. A plataforma ajudou a promover o desenvolvimento social e profissional dos cidadãos nas áreas assistidas pela instituição.
Percepção dos professores sobre a importância do Projeto de Extensão "DR" na sala de aula
Authors: Oliveira Duda Barbosa de , Pereira Isabela Antonio , Silva Gleice Barros da , Tomio Luiz Felipe , Dallasta Ana Caroline , Oliveira Jackeline Pires Domingues de , Valcarenghi Daniela , Bueno Edneia Casagranda , Fontoura Leia Viviane
Published: July 2021

O presente artigo se propõe a analisar a percepção dos professores de duas escolas da Rede Municipal de Ensino sobre a importância das 435 oficinas que o Projeto de Extensão #DR desenvolveu no decorrer do ano de 2019, envolvendo 710 discentes do 6º ao 9º ano do ensino fundamental. O Projeto tem como objetivo promover o enfrentamento às vulnerabilidades que impactam o desenvolvimento integral do adolescente, juntamente com a comunidade escolar e os profissionais da Estratégia de Saúde da Família. Diante disso, as ações foram desenvolvidas através de metodologias ativas com inspiração Freiriana, que compreendem os estudantes como protagonistas de seu aprendizado, de modo que o saber produzido nas oficinas parte daquilo que faz sentido na realidade em que os adolescentes estão inseridos. Os professores avaliaram, por meio de um questionário estruturado, indicadores como a postura da equipe de extensionistas, a validade das atividades realizadas e as sugestões e/ou comentários que os docentes julgaram pertinentes. Na percepção dos professores, a validade das oficinas obteve pontuação entre 9,0 e 9,3 e a postura da equipe entre 9,0 e 9,7. Os comentários dos professores evidenciaram que os objetivos e premissas do Projeto estão em consonância com as recomendações do Ministério da Saúde e do Ministério da Educação, agregando, ainda, melhorias que podem ser implementadas no Projeto. Constatou-se que as temáticas abordadas foram relevantes e que as ações favoreceram a promoção da saúde, o fortalecimento do desenvolvimento integral dos adolescentes e o enfrentamento de riscos e vulnerabilidades.
Reproduza conhecimento: do campo ao ambiente virtual
Authors: Rauber Lucio Pereira , Amaral Diullay Cássia Venâncio
Published: July 2021

O surto de COVID-19 exigiu que a sociedade se adaptasse a um novo formato de realizar as tarefas corriqueiras. O mesmo ocorreu com o programa de extensão rural “Reproduza”. O projeto passou a organizar palestras on-line sobre temas pertinentes à área de reprodução de ruminantes e relatar as atividades realizadas pelo programa de extensão com pequenos informativos técnicos semanais na rede social Instagram (@ifc.reproduza), criada especialmente para esse fim. Entre os meses de setembro e novembro de 2020, foram organizados dois ciclos com três palestras em cada, em formato on-line pela plataforma Google Meet. Foram realizadas pesquisas de satisfação sobre cada tema abordado e solicitadas sugestões para os próximos ciclos. Para a análise estatística dos dados, utilizou-se a comparação de proporções. Foram publicados na página do projeto 125 postagens informativas com temas pertinentes à área da reprodução de ruminantes e divulgação das atividades executadas durante a pandemia, respeitando todos os critérios de segurança. Quanto aos dois ciclos de palestras, o público ouvinte foi de cerca de 400 pessoas. Os estudantes que participaram eram oriundos de mais de 85 universidades diferentes, de 23 estados brasileiros e duas dessas universidades eram internacionais. Os resultados obtidos mostram o ambiente virtual como ferramenta eficaz para socialização das atividades de campo e capacitação, facilitando o estreitamento da relação entre instituição, professor, estudantes e comunidade externa.
Teach me to play, gamer! Imitative learning in computer games via linguistic description of complex phenomena and decision trees
Authors: Rubio-Manzano Clemente , Lermanda Tomas , Martinez-Araneda Claudia , Vidal-Castro Christian , Segura-Navarrete Alejandra
Published: July 2021

In this article, we present a new machine learning model by imitation based on the linguistic description of complex phenomena. The idea consists of, first, capturing the behaviour of human players by creating a computational perception network based on the execution traces of the games and, second, representing it using fuzzy logic (linguistic variables and if-then rules). From this knowledge, a set of data (dataset) is automatically created to generate a learning model based on decision trees. This model will be used later to automatically control the movements of a bot. The result is an artificial agent that mimics the human player. We have implemented, tested and evaluated this technology. The results obtained are interesting and promising, showing that this method can be a good alternative to design and implement the behaviour of intelligent agents in video game development.
Stellate ganglion block improves the proliferation and function of splenic CD4+ T cells through inhibition of post- hemorrhagic shock mesenteric lymph-mediated autophagy
Authors: Li Ying , Du Hui-Bo , Jiang Li-Na , Wang Chen , Yin Meng , Zhang Li-Min , Zhang Hong , Zhao Zhen-Ao , Liu Zhan-Kuang , Niu Chun-Yu , Zhao Zigang
Published: July 2021

Background and objectiveSevere hemorrhagic shock leads to excessive inflammation and immune dysfunction, which resulted in high mortality related to mesenteric lymph return. Recent study showed that stellate ganglion block (SGB) increased survival rate in rats suffered hemorrhagic shock. However, whether SGB ameliorates immune dysfunction induced by hemorrhagic shock, it remains unknown. The aim of present study is therefore to verify the favorable effect of SGB on the proliferation and function of splenic CD4 + T cells isolated from rats underwent hemorrhagic shock, and investigate its mechanism focusing autophagy and PHSML.Materials and methodsMale rats underwent SGB or sham SGB pretreatment and conscious acute hemorrhage followed by resuscitation and multiple treatments. After three hours of resuscitation, splenic CD4 + T cells were isolated for the measurements of proliferation and cytokine production following stimulation with ConA in vitro. Furthermore, the CD4 + T cells isolated from normal rats were treated with post-hemorrhagic shock mesenteric lymph (PHSML) drained from rats treated with SGB or not. And the proliferation, cytokine production and autophagy biomarkers were detected.ResultsHemorrhagic shock reduced CD4 + T cells proliferation and function to produce interleukin (IL)-2, IL-4 and tumor necrosis factor-α-induced protein 8 like 2 (TIPE2). SGB pretreatment or administration of autophagy inhibitor 3-methyladenine (3-MA) significantly normalized these indicators. In contrast, administration of autophagy agonist rapamycin (RAPA) or intravenous injection of PHSML inhibited the beneficial effect of SGB on CD4 + T cells obtained from hemorrhagic shocked rats. Furthermore, PHSML incubation decreased the proliferation and cytokine production, increased LC3 II/I and Beclin-1 expressions, and reduced p-PI3K and p-Akt expressions of normal CD4 + T cells. More critically, these adverse effects of PHSML were abolished by 3-MA administration, as well as incubation with PHSML obtained from SGB treated rats.ConclusionsSGB improves splenic CD4 + T cells function following hemorrhagic shock, which is related to the inhibition of PHSML-mediated autophagy.
Network-Based Inference of Hub Genes In Epithelial Membrane Protein 2-Treated Human RPE cells
Authors: Wan Hua , Zhang Wei , Gao Wei , Tao Zijiao , Lu Xiang , Chen Feng
Published: July 2021

Backgrounds Identification of hub genes (HGs) using transcriptome data of human retinal pigment epithelial cells (hRPECs) samples treated with epithelial membrane protein 2 (EMP2) was helpful to accurately evaluate the functional relevance of genetic alterations in activity proteins (APs) in these cells. Results We performed differential expression genes (DEGs) analyses of public RNA-seq transcriptome data of EMP2 treated hRPECs, vector control (VC) and wild type (WT) hRPECs. VIPER (Virtual Inference of Protein activity by Enriched Regulon analysis) was used to convert DEGs outcomes to APs signatures and ARACNE (Algorithm for the Reconstruction of Accurate Cellular Networks) was used to construct transcription regulatory networks (TRNs) to identify hub genes (HGs). Conclusions In addition to identifying a significant fraction of DEGs among EMP2-OE groups and EMP-KD groups when compared to VC or WT groups, respectively, we also accurately inferred aberrant TGNs and found several HGs induced by EMP2-overexpressed hRPECs under hypoxia. Thus, we raised a hypothesis that EMP2 may regulate hRPECs angiogenesis via a PDGFA regulatory network, which would help to understand the complex biology of angiogenesis in EMP2 and hypoxia treated hRPECs.
Trends and Pattern of Antibiotic Use in Children in Northern Spain. Lessons From Interpreting Data About Antimicrobial Consumption in Outpatients
Authors: Calle-Miguel Laura , Méndez Carlos Pérez , García Elisa García , Pavón Belén Moreno , Solís-Sánchez Gonzalo
Published: July 2021

Monitoring of antibiotic prescription and consumption behavior is crucial. The Access, Watch and Reserve (AWaRe) classification of antibiotics has been recently introduced in order to measure and improve patterns of antibiotic use. In this study, retrospective data about systemic antibiotic consumption (expressed in defined daily dose per 1000 inhabitants per day [DID]) in pediatric outpatients in a region in Northern Spain (around 100000 children up to 14 years old) from 2005 to 2018 were analysed and compared with antibiotic consumption in general population in Spain. The pattern of use was analysed by the percentage of the current AWaRe categories, the Access-to-Watch index and the amoxicillin index. Data were calculated annually and compared into two periods. Mean antibiotic consumption in pediatric outpatients was 14.0 DID (CI 95% 13.38–14.62). It remained stable throughout the study and was lower than consumption in general population in Spain, particularly from 2016. Changes in the consumption of the main active principles have led to an improvement in the three metrics of the pattern of use. It is important to have a thorough knowledge of the methodology applied in studies about antibiotic consumption. There is a lack of an optimal standardized metric for pediatric population.
Non-COVID-19 Healthcare Utilisation for Elderly People at the Onset of the COVID-19 Pandemic in Korea
Authors: Park K. , Byeon J. , Yang Y. , Cho H.
Published: July 2021

Background: At the onset of the coronavirus disease 2019 (COVID-19) pandemic, health care systems were severely disrupted in many countries and in particular, elderly people vulnerable to COVID-19 may have been reluctant to receive their medical treatment. Methods: We conducted interrupted time series analyses (ITSA) using nationwide medical utilization data, with focus on different disease categories for the patients of 65–84-year-olds, i.e., acute upper respiratory infections (AURIs) vs. chronic diseases.Results: AURIs and chronic diseases showed a sharp contrast with respect to the change in healthcare service utilisation. First, the utilisation rate for chronic diseases changed little whereas for AURIs it dropped by 20.4% year-over-year (yoy) at the onset of the pandemic (week 6, 2020). Second, as social distancing relaxed (week 17, 2020), the AURIs patients trended up and even reached to 7.8% above yoy whereas no significant change found for chronic diseases.Conclusions: The uninterrupted treatment for chronic diseases in contrast to the AURIs implies that the governmental and public responses to the pandemic outbreak worked for efficient healthcare provision to non-COVID patients as well as effective slowdown against the COVID transmission.
A Systematic Literature Review (SLR) On The Beginning of Resume Parsing in HR Recruitment Process & SMART Advancements in Chronological Order
Authors: Rawat Aakankshu , Malik Siddharth , Rawat Seema , Kumar Deepak , Kumar Praveen
Published: July 2021

Talent acquisition, also known as recruitment, is definitely amongst one of the most difficult decisions that an organization has to take. The workforce is the most crucial pillar of any organization and surely a deciding factor for its fate. Each organization/company/firm has a dedicated department in place for completely managing an employee’s life cycle starting from recruitment till termination, known as the Human Resource (HR) department. National Cash Register Co. was the first company ever to include an HR department in 1900 for resolving conflicts among existing employees. Since then, the world of recruitment has grown rapidly with a lot of advancements to fast-track the hiring process. Realising the importance of hiring fitting and apt employees, HR units around the world have undergone substantial changes from traditional recruitment methodologies to network recruitment and finally to smart hybrid recruitment strategies for efficient hiring with a significantly less human workload. The purpose of this Systematic Literature Review (SLR) article is to shed light on all the advancements in the hiring process from a technical perspective. The article follows the defined format and all appropriate guidelines of an SLR and would provide an extensive study of various Machine Learning (ML) and Deep Learning (DL) approaches to facilitate hiring. The main emphasis has been given to “Resume/CV Parsing” as an enhancer of fast-track hiring. The SLR would be instrumental in providing various fast-track approaches to go with for resume parsing, the scope of improvement and also focus on various challenges/ethical considerations to keep in mind while automating the hiring process.
Fear of An Unprecedented, Invisible Enemy: Difficulties Experienced In Establishing Criteria For The Release of COVID-19 Patients From Isolation
Authors: Hagiya Hideharu , Hasegawa Kou , Otsuka Fumio
Published: July 2021

Introduction: The novel coronavirus disease 2019 (COVID-19) has emerged as a global pandemic, and the United States and European authorities established criteria for the release of COVID-19 patients from isolation in October 2020. However, a huge discrepancy exists between the hospital-discharge protocol for COVID-19 patients and the release of patients from in-hospital isolation. Our initially proposed criteria for in-hospital release from isolation was not adhered to by healthcare workers (HCWs) due to prevailing concerns regarding disease infectivity. Herein, we report difficulties encountered in attempting to establish a common understanding of the management of emerging infections. Methods: We performed a Google Form-based questionnaire survey targeting HCWs from Okayama University Hospital, Japan, via e-mail on January 21–28, 2021. The anonymous investigation required respondents to provide information regarding their background as well as perceptions regarding the requirement, level of understanding, and readiness for developing release criteria.Results: We obtained 150 eligible responses, including 57 (38.0%) from medical doctors and 53 (35.3%) from nurses. Most HCWs managing COVID-19 patients advocated for the implementation of the criteria, whereas those not working in that capacity did not (p<0.001). Over half of the HCWs indicated discomfort at seeing COVID-19 patients transitioning to general management even after meeting the criteria. Conclusions: It was challenging to establish a common understanding regarding the ideal criteria for in-hospital release of COVID-19 patients from isolation in our hospital. The dissemination of our experiences and multifaceted discussions with HCWs would be of great value as a countermeasure against the emergent pandemic.
The Traditional Knowledge About Herbal Use In Veterinary Medicine At The Balkan Peninsula
Authors: Radoslava Savić Radovanović R. , Biljana Andjelski Radičević H. , Nataša Rajić Savić S. , Nemanja Zdravković , Ivan Pavlović N. , Dragan Ilić V.
Published: July 2021

Background. The traditional knowledge about herbal use in veterinary medicine in Serbs is voluminous. However, that wealth is threatened to oblivion because new times give modern methods of treatment. Hence, the aim of this report was to present the collected data about folk methods of treatment and nutrition by the help of available plants related to the animals in Serbs what could be applied in up to date veterinary pharmacy. Methods. The questionnaire of 28 questions was prepared regarding the breeding, nutrition and medical treatment of domestic animals as well as the herbal list of medicinal plants to use. The study is based on the ”Show-and-Tell Technique” from the groups people without veterinary or medical education, with preference to people living in the remote settlements without resident veterinary services. Results. Interviewed persons were in the age range of 30-90 years. Plant interviewee were asked to show the plant species in a fresh or dried condition (for adequate identification). The 1120 filled inquiry sheets were analysed. Ninety two herbs were presented, of whom the most frequent noted were Carlina acaulis, Asteraceae (6 times) and Geum urbanum, Rosaceae (5 times). The most frequent treated diseases were of digestive (47%) and pulmonary system (25%), skin (hair, hoof) (8%) and urinary system (7%). Among “other” cathegory answers like “generaly good for helath” are included. Conclusion. It is still open question for the scientific branches of veterinary pharmacology to find out active ingredients, mechanism of action and application of some plants in the scope of veterinary pharmacology, phytochemistry and phytopharmacology. In that way the listed herbs in this work, which are still not in use nowadays, could be recognized as commercially available.
Longitudinal Study of Psychological Status during the COVID-19 Pandemic
Authors: Okuyama Junko , Seto Shuji , Fukuda Yu , Taku Kanako , Willgerodt Mayumi , Ito Kiyoshi , Imamura Fumihiko , Izumi Shinichi
Published: July 2021

Researchers believe that the impact of repeated trauma on mental health is incrementally more significant than the simple additive effect of one event. This study questioned whether this repetition only further worsens people's mental health. We found that they may report more positive changes than those who haven’t. Thus, we hypothesized that repeatedly experiencing difficult situations and suffering might increase post-traumatic growth (PTG). PTG can be defined as "positive psychological changes experienced due to coping with very difficult life situations," leading to positive outcomes and feelings of well-being. We found that those who experienced a disaster in the past were more depressed, anxious, and stressed than those who had never experienced a disaster and now experienced the COVID-19 pandemic. Additionally, past disaster experience led to a more psychological response to the COVID-19 pandemic, which, in turn, led to an increase PTG. Globally, we found that supportive social interactions, including those with family members, could develop PTG during the COVID-19 pandemic and achieve better well-being during the continuation of the pandemic in the future.
Implementation of Innovative Medical Technologies In German Inpatient Care: Patterns of Utilization And Evidence Development
Authors: Böcker Marie , Eckhardt Helene , Felgner Susanne , Errmann Hanna , Lantzsch Hendrikje , Rombey Tanja , Busse Reinhard , Henschke Cornelia , Panteli Dimitra
Published: July 2021

Background: Innovative medical technologies are commonly associated with positive expectations. At the time of their introduction into care, there is often little evidence available on their benefits and harms. Thus, it happens that some health innovations with a lack of evidence are used widely until or even though adverse study results emerge. Others with strong scientific support remain underused. The study aims at examining the diffusion patterns of innovative medical technologies in German inpatient care between 2005 and 2017 while simultaneously considering evidence development. Methods: Based on a qualitatively derived typology and a quantitative clustering process of the adoption curves, a representative sample of 21 technologies was selected for further evaluation. Published scientific evidence on efficacy and safety of the technologies was identified and extracted in a systematic approach. Derived from a two-dimensional classification according to the degree of utilization and state of scientific evidence, the diffusion processes were then assigned to the categories "Success" (widespread/positive), "Hazard" (widespread/negative), "Overadoption" (widespread/limited or no), "Underadoption" (cautious/positive), "Vigilance" (cautious/negative) and "Prudence" (cautious/ limited or no). Results: Overall, we found limited evidence regarding both the quantity and quality of published randomized controlled trials. Thus, the categories “Prudence” and “Overadoption” together account for nearly three-quarters of the years evaluated, followed by “Success” with 17 percent. Even when evidence is available, the transfer of knowledge into practice seems inhibited.Conclusions: The successful implementation of innovations into practice requires substantial further efforts by policymakers to strengthen systematic knowledge generation and translation. Creating an environment that encourages the conduct of rigorous studies, promotes knowledge translation, and rewards innovations according to their added value are prerequisites for the diffusion of valuable innovations in the health care sector.
Effects Of Exercise Training On Blood Pressure: Protocol For An Overview Of Systematic Reviews
Authors: Loaiza-Betancur Andrés F , Bedoya Edison Andrés Pérez , Díaz-López Víctor Alfonso , Echavarría-Rodríguez Andrés Mauricio , Chulvi-Medrano Iván , Gonzáles Lisette Ethel Iglesias , Meneses-Echavez Jose F
Published: July 2021

Background
This overview aims to identify, appraise, and summarize the findings of all relevant systematic reviews about the benefits and harms of different exercise training modalities on blood pressure in normotensive, pre-hypertensive, and high blood pressure adults.
Methods
This overview of systematic reviews protocol was reported following the PRISMA-P Statement. We will search MEDLINE, EMBASE, and Epistemonikos to identify systematic reviews of randomized controlled trials (RCTs) in adults with or without a diagnosis of high blood pressure that compared exercise training interventions with other or no exercise interventions. Major outcomes will be blood pressure and adverse events. Pairs of reviewers will independently screen the systematic reviews for inclusion, extract data, and appraise the methodological quality. The GRADE approach will be used to evaluate the quality of the evidence.
Discussion
Findings from this study will contribute to the knowledge base in the area by providing a systematic synthesis of the certainty of the evidence for the effects of the different training modalities on blood pressure. These assessments might also assist in both the development of clinical practice guidelines and to strengthen evidence-informed decision making in healthcare. Finally, this study might serve to inform patients, caregivers, healthcare providers, researchers, and decision-makers about the benefits and adverse events related to different exercise training modalities, as well as the knowledge gaps in the body of evidence.
Protocol registration:
PROSPERO CRD42021247062
A Deep Neural Network-based Nonlinear Dynamics Model for the Prediction of Lateral-longitudinal Vehicle Dynamics
Authors: Pan Yongjun , Nie Xiaobo , Dai Wei , Xu Feng , Li Zhixiong
Published: July 2021

The vehicle multibody model can be used for accurate coupling dynamics, but it has higher computational complexity. Numerical stability during integration is also very challenging, especially in complicated driving situations. This issue can be substantially alleviated by using a data-driven nonlinear dynamics model owing to its computational speed and robust generalization. In this work, we propose a deep neural network (DNN)-based modeling approach for predicting lateral-longitudinal vehicle dynamics. Dynamic simulations of vehicle systems are performed based on a semirecursive multibody formulation for data acquisition. The data are then used for training and testing the DNN model. The DNN inputs are the torque applied on wheels and the initial vehicle speed that imitates a double lane change maneuver with acceleration and deceleration. The DNN outputs are the longitudinal driving distance, lateral driving distance, final longitudinal velocities, final lateral velocities, and yaw angle. The dynamic responses obtained from the DNN model are compared with the multibody results. Furthermore, the accuracy of the DNN model is investigated in terms of error functions. The DNN model is finally verified via the results of a commercial software package. The results show that the DNN vehicle dynamics model predicts accurate dynamic responses in real time. The DNN model can be used for real-time simulation and preview control in autonomous vehicles.
Dialectical Behavior Therapy Skills Training as a Standalone Therapy: a Scoping Review Protocol
Authors: Thorsteinson Branden , Husarewycz M. Natalie , Loewen Hal , Thiessen Maclean
Published: July 2021

Background: Dialectical Behavior Therapy (DBT) Skills Training (DBT-ST) is one of the four core elements of standard DBT. Studies show that standalone DBT-ST appears to be a promising treatment in patients with emotion dysregulation by teaching them skills needed to change patterns associated with problems in living. It is not clear who benefits from this treatment and which components are most beneficial. Relevant studies will be easily navigated once mapped and summarized in this proposed scoping review.Methods:The proposed scoping review will be conducted following Joanna Briggs Institute (JBI) methodology for scoping reviews. Medical literature databases including MEDLINE, PsycINFO, EMBASE, CINAHL, SCOPUS, Web of Science, and Cochrane will be searched. Papers retrieved will be screened for inclusion by two independent reviewers and data will be extracted and reported in a summary table with supporting narrative. We aim to include all English academic papers addressing standalone DBT-ST including studies utilizing quantitative, qualitative, and mixed methods approaches. Discussion:The objective of this scoping review is to explore the literature, map, and summarize evidence pertaining to DBT-ST to help guide future research and treatment.
Impact of Vaccination on the COVID-19 Pandemic: Evidence from U.S. States
Authors: Chen Xiao , Huang Hanwei , Ju Jiandong , Sun Ruoyan , Zhang Jialiang
Published: July 2021

Governments worldwide are implementing mass vaccination programs in an effort to end the novel coronavirus (COVID-19) pandemic. Here, we evaluated the effectiveness of the COVID-19 vaccination program and predicted the path to herd immunity in the U.S. We estimated that vaccination reduced the total number of new cases by 4.4 million (from 33.0 to 28.6 million), prevented approximately 0.12 million hospitalizations (from 0.89 to 0.78 million), and decreased the population infection rate by 1.34 percentage points (from 10.10–8.76%). We built a Susceptible-Infected-Recovered (SIR) model with vaccination to predict herd immunity. Our model predicts that the U.S. can achieve herd immunity by the last week of July 2021, with a cumulative vaccination coverage of 60.2%. Herd immunity could be achieved earlier with a faster vaccination pace, lower vaccine hesitancy, and higher vaccine effectiveness. These findings improve our understanding of the COVID-19 vaccination and can inform future public health policies.
The Management of Anticoagulants in Patients With Atrial Fibrillation and History of Falls or Risk of Falls: The Liverpool Af-falls Project. Protocol for a Systematic Review and Meta-analysis
Authors: Galvain Thibaut , Hill Ruaraidh , Donegan Sarah , Lisboa Paulo , Lip Gregory Y. H. , Czanner Gabriela
Published: July 2021

BackgroundAtrial fibrillation affects an estimated 33 million individuals worldwide and is a major cause of stroke, heart failure, and death. Anticoagulants substantially reduces risk of stroke but are also associated with an increased risk of bleeding and especially intracranial hemorrhages which are the most feared complication. Because of this many patients are not offered anticoagulants, particularly patients at risk of falls or with history of falls. It is unclear what anticoagulant treatment these patients should be offered, and the Liverpool AF-Falls project aims to investigate this area. This protocol for a systematic review and meta-analysis aims to define what is the most appropriate anticoagulant treatment option for the for the management of atrial fibrillation patients at risk of falls or with a history of falls. MethodsThis systematic review and meta-analysis will include randomized and non-randomized studies evaluating safety and efficacy of different anticoagulant treatments (vitamin K antagonist, non-vitamin K antagonist oral anti-coagulant, anti-platelet agent and no treatment). Bibliographic databases (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Scopus, CINAHL, Web of Science and ClinicalTrials.gov) will be searched according to a pre-specified search strategy. Titles, abstracts, and full texts will be assessed by two independent reviewers and disagreement resolved with a third independent reviewer. The Cochrane Risk of Bias tool 2 will be used to assess risk of bias in randomized trials and the Newcastle-Ottawa-Scale tool will be used for non-randomized studies. Pairwise meta-analysis based on the fixed and random-effects models will be conducted. Publication bias will be evaluated with a funnel plot and the Egger’s test. Heterogeneity will be assessed with the I2 statistic. If conditions for indirect comparison are met and sufficient data are available, a network meta-analysis will be conducted using frequentist and Bayesian methodologies. DiscussionThis review will be the first to summarize direct and indirect evidence on safety and efficacy of anticoagulant treatments in atrial fibrillation patients at risk of falls or with history of falls. The findings will be important to patients, clinicians, and health policy-makers to inform best practice in the use of these treatments. Systematic review registrationPROSPERO registry number: CRD42020201086
Measurement of Heterogeneity From 18F-FDG PET For Classification of Metastatic And Benign Bone Lesions: A Study In Patients With Cervical Cancer
Authors: Liu Feng-Yuan , Lin Gigin , Tseng Jing-Ren , Chao Angel , Huang Huei-Jean , Chou Hung-Hsueh , Chang Yu-Chen , Yen Tzu-Chen , Lai Chyong-Huey
Published: July 2021

Purpose Heterogeneity assessment has been applied in medical imaging analysis. We aim to evaluate first-order and texture analysis (TA) metrics in 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) imaging for classification of metastatic and benign bone lesions in patients with cervical cancer.Materials and Methods: 18F-FDG PET studies for cervical cancer patients performed on a specific PET/CT system from 2016 to 2018 were retrieved. Bone lesions extracted from studies in 2016-2017 were used as the training dataset and those in 2018 as the validation dataset. Metastatic bone lesions were identified in each dataset, with an equal number of benign bone lesions selected. Cuboid volume of interest (VOI) consisting of 3 by 3 by 5 reconstructed voxels was defined for first-order metrics and cubic VOI consisting of smaller voxels with trilinear interpolation of standardized uptake value (SUV) was adopted for TA metrics. First-order metrics included maximum SUV (SUVmax) of lesion and mean, standard deviation (SUVsd), skewness and kurtosis of voxel SUV in VOI. A total of 4464 TA metrics based on 62 texture features were evaluated. Logistic regression was used for classification with area under the receiver operating characteristic curve (AUC) as the performance measure.Results: From the training and validation datasets, 98 and 42 metastatic bone lesions were identified respectively. SUVsd achieves a better performance than SUVmax in both training (AUC .798 vs .732, P < .001) and validation (AUC .786 vs .684, P < .001) datasets. Top-performing TA metrics achieved significantly better performance in the training dataset but failed to retain this advantage in the validation dataset.Conclusion: This study identified a simple first-order measure of heterogeneity, SUVsd, to be superior to SUVmax in the classification of metastatic and benign bone lesions. The effect of multiple hypothesis testing can result in false-positive findings in TA with multiple features and parameters and careful validation is needed.
Enhancing Leadership, Management, And Governance Competencies For Performance Improvements At Primary Health Care Entities In Ethiopia: A Before And After Study
Authors: Desta Binyam Fekadu , Muktar Sualiha Abdlkader , Abera Wondwosen Shiferaw , Demissie Heran , Argaw Mesele Damte
Published: July 2021

ObjectivesLeadership, management, and governance (LMG) interventions play a significant role in improving management systems, enhancing work climate, and creating responsive health systems. This study aimed to determine the change that occur in the performance of primary healthcare entities and compare the outputs of block and segmented LMG trainings and the intervention as a whole after implementation for one full year.ResultsTwo hundred and ninety-three LMG trained and 333 non-trained health workers participated with a response rate of 100 percent and 87 percent, respectively. Of those who attended the didactics sessions, 235 (80.9%) scored 70% or more on post-test exams. In addition, the assessment on the practical exercises after implementing the leadership projects revealed that the majority, 252 (86%) scored 80% or more on their desired measurable results. As a result of the LMG trainings, management systems, work climate, and responsiveness of the health system to new challenges were significantly improved (p<0.001). Owing to the leadership projects, within the 136 health facilities, an additional 2,290.3 units of health service coverage was gained. A comparison of the trainees revealed that more block (79.1%), than segmented I (65.02%) and segmented II (62.0%) LMG trainings were successfully completed. Therefore, providing block LMG trainings for more health workers and managers working at primary healthcare entities is 53 recommended as it willaccelera te the implementation of prioritized health sector interventions.
Implementation Factors Related to Improving the Food Environment Within Health Care Institutions: A Multiple Case Study
Authors: Walker Elizaveta , Baker Robin L , O'Brien Kerth , Messer Lynne C , Eckhardt Cara L , Goodman Julia M
Published: July 2021

Background Healthy food environment policies (HFEPs), such as sugar-sweetened beverage bans or nutritional standards for vending machines, can improve the healthfulness of retail food venues, particularly within health care institutions that have a health-focused mission. The degree to which operational managers’ and executive leaders’ perceptions of implementation challenges align or diverge, and the extent to which these perceptions affect HFEP implementation, is unknown.Methods We conducted ten semi-structured key informant interviews with managers and executive leaders who participated in HFEP development within five health care organizations. Interviews explored facilitators and barriers for HFEP adoption and maintenance. We transcribed, coded, and analyzed interviews and derived contextual facilitators and barriers.Results We identified 27 facilitators and 30 barriers, which were refined into six and five categories, respectively, and ultimately paired to create three overarching recommendations. Operational managers’ and executive leaders’ perceptions overlapped 44-75% when identifying facilitators but only 33-58% when identifying implementation barriers. Interpersonal issues such as over-delegation and mistrust were prominent among those organizations whose respondents’ perceptions diverged substantially.Conclusion As the obesity epidemic continues to increase, understanding key facilitators and barriers to HFEPs, as well as the influence on leaderships’ perceptions on the implementation process, will be key to addressing obesogenic food environments. Though leaders were generally aligned in perspectives regarding facilitators, there was greater divergence when barriers were discussed. Executive leaders are encouraged to familiarize themselves with operational barriers and refrain from over-delegating these challenges to their operational counterparts, who lack the institutional authority to override organizational or system-level decisions.
Serial Histological Changes in the Cartilaginous Eustachian Tube in the Rat Following Balloon Dilation
Authors: Kim Yehree , Kang Jeon Min , Ryu Dae Sung , Park Jung-Hoon , Kang Woo Seok , Park Hong Ju
Published: July 2021

Although balloon dilation has shown promising results in the treatment of dilatory Eustachian tube (ET) dysfunction, the histological effects of ET balloon dilation (ETBD) remain unclear. We evaluated this in a rat model. The left ET of 20 Wistar rats was dilated with a balloon catheter and the right ET was used as a control. Five rats were sacrificed immediately after ETBD, at 1, 4 and 12 weeks after the procedure for histological examination. The epithelial cells, presence of squamous metaplasia, and the proportion of the goblet cells in the epithelium; the vascular structures and dimensions of the submucosa; and presence of cartilage fracture and the area of the ET lumen were evaluated and compared between the groups. Desquamation of nearly all epithelial cells and the fracture of tubal cartilages were observed immediately after ETBD. At 1-week post-ETBD, the ciliated epithelial cells started to recover with squamous metaplasia and epithelial hyperplasia. The goblet cells recovered by 4 weeks post-ETBD and epithelial hyperplasia decreased but was still present at 12 weeks post-ETBD. The depth of the submucosa increased and neovascularization in this region was observed at 1-week post-ETBD and persisted up to 12 weeks post-ETBD. The lumen of the cartilaginous ET increased immediately after ETBD but decreased at 1-week post-ETBD. The cartilaginous ET lumen recovered to the normal value at 4 weeks post-ETBD. This study is the first to describe the serial histological changes to the cartilaginous ET after ETBD and helps our understanding of the histological changes that occur after an ETBD intervention for intractable ET dysfunction.