bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Early Detection and Case Management of Skin Diseases With an mHealth App (eSkinHealth): Protocol for a Mixed Methods Pilot Study in Côte d’Ivoire
Authors: Yotsu Rie R , Itoh Sakiko , Yao Koffi Aubin , Kouadio Kouamé , Ugai Kazuko , Koffi Yao Didier , Almamy Diabate , Vagamon Bamba , Blanton Ronald E 
Published: July 2022

Background
There is a high prevalence of skin diseases sub-Saharan Africa, including skin neglected tropical diseases (NTDs) that could lead to lifelong disabilities and deformities if not diagnosed and treated early. To achieve early detection and early treatment of these skin diseases, we developed a mobile health app, eSkinHealth.

Objective
This paper outlines a protocol for evaluating the effect of our eSkinHealth app in the early detection and effective management of skin diseases in Côte d’Ivoire.

Methods
A mixed methods pilot trial will be conducted in Côte d’Ivoire and will consist of 3 phases: (1) the development and improvement of the eSkinHealth app, (2) a pilot trial to evaluate the usability of the eSkinHealth app for local medical staff in Côte d’Ivoire, and (3) a pilot trial to evaluate the effectiveness of early detection and case management of targeted skin NTDs (Buruli ulcer, leprosy, yaws, and lymphatic filariasis) with the eSkinHealth app in Côte d’Ivoire. The pilot study will be implemented as a 2-arm trial with local health care providers and patients with skin NTDs over a 3-month follow-up period. The local health care providers will be assigned to an intervention group receiving the eSkinHealth app to be used in their daily practices or a control group. Training will be provided on the use and implementation of the app and the diagnostic pipeline to the intervention group only, while both groups will receive training on skin diseases. Our primary outcome is to evaluate the early detection and effective management of skin diseases using the eSkinHealth app in Côte d’Ivoire by the number of cases diagnosed and managed. Additionally, we will evaluate the eSkinHealth app with validated questionnaires and in-depth interviews. Procedures of our methods have been reviewed and approved by the Institutional Review Board of the Ministry of Health, Côte d’Ivoire and by Tulane University in 2021.

Results
This study was funded in 2021. We started the enrollment of patients in February 2022, and data collection is currently underway. We expect the first results to be submitted for publication in 2023.

Conclusions
Our eSkinHealth app is a field-adapted platform that could provide both direct diagnostic and management assistance to health workers in remote settings. The study will provide evidence for the usability and the effectiveness of the eSkinHealth app to improve the early detection and case management of skin NTDs in Côte d’Ivoire and, furthermore, is expected to contribute to knowledge on mobile health approaches in the control of skin NTDs.

Trial Registration
ClinicalTrials.gov NCT05300399; https://clinicaltrials.gov/ct2/show/study/NCT05300399

International Registered Report Identifier (IRRID)
DERR1-10.2196/39867
Upper Extremity Examination for Neuromuscular Diseases (U-EXTEND): Protocol for a Multimodal Feasibility Study
Authors: Gutierrez Robert , McCrady Allison , Masterson Chelsea , Tolman Sarah , Boukhechba Mehdi , Barnes Laura , Blemker Silvia , Scharf Rebecca 
Published: July 2022

Background
Neuromuscular diseases, such as spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD), may result in the loss of motor movements, respiratory failure, and early mortality in young children and in adulthood. With novel treatments now available, new evaluation methods are needed to assess progress that is not currently captured in existing motor scale tests.

Objective
With our feasibility study, our interdisciplinary team of investigators aims to develop a novel, multimodal paradigm of measuring motor function in children with neuromuscular diseases that will revolutionize the way that clinical trial end points are measured, thereby accelerating the pipeline of new treatments for childhood neuromuscular diseases. Through the Upper Extremity Examination for Neuromuscular Diseases (U-EXTEND) study, we hypothesize that the novel objective measures of upper extremity muscle structure and function proposed herein will be able to capture small changes and differences in function that cannot be measured with current clinical metrics.

Methods
U-EXTEND introduces a novel paradigm in which concrete, quantitative measures are used to assess motor function in patients with SMA and DMD. Aim 1 will focus on the use of ultrasound techniques to study muscle size, quality, and function, specifically isolating the biceps and pronator muscles of the upper extremities for follow-ups over time. To achieve this, clinical investigators will extract a set of measurements related to muscle structure, quality, and function by using ultrasound imaging and handheld dynamometry. Aim 2 will focus on leveraging wearable wireless sensor technology to capture motion data as participants perform activities of daily living. Measurement data will be examined and compared to those from a healthy cohort, and a motor function score will be calculated.

Results
Data collection for both aims began in January 2021. As of July 2022, we have enrolled 44 participants (9 with SMA, 20 with DMD, and 15 healthy participants). We expect the initial results to be published in summer 2022.

Conclusions
We hypothesize that by applying the described tools and techniques for measuring muscle structure and upper extremity function, we will have created a system for the precise quantification of changes in motor function among patients with neuromuscular diseases. Our study will allow us to track the minimal clinically important difference over time to assess progress in novel treatments. By comparing the muscle scores and functional scores over multiple visits, we will be able to detect small changes in both the ability of the participants to perform the functional tasks and their intrinsic muscle properties.

International Registered Report Identifier (IRRID)
DERR1-10.2196/40856
Determination and Risk Associated with Phthalic Esters Distribution from the Ekpan River, Effurun, Delta State, Nigeria
Authors: Edjere Oghenekohwiroro , Igiegie Daniel , Rim-Rukeh Akpofure 
Published: July 2022

Phthalates are additives or plasticizers added to make plastics soft. However, they could leach into the environment and cause harm to human health when contacted. Sites along the Ekpan river have been used for open dumping of refuse. The river also serves as a point source for the disposal of effluents from the Warri Refinery and Petrochemical Company Limited (WRPC). Hence, the need for a preliminary study of phthalates across the river system. Surface water samples were collected from six points along the Ekpan river. Phthalates were extracted using USEPA standard method 3535 and EPA method 8061. Gas Chromatography-Mass Spectrometer (GC-MS) was used for the analysis of six PAEs including di-n-butyl phthalate (DnBP or DPX), butyl benzyl phthalate (BBP), di(2-Ethylhexyl) phthalate (DEHP), di-n-octyl phthalate (D-n-OP)), Dimethyl phthalate (DMP), and Diethyl phthalate (DEP) in the river system. Analysis of phthalates in the Ekpan river system showed that DEP across the Effurun river system ranged from 4.22 – 13.81 μg/L, DPX; 3.03 – 11.5 μg/L, BBP; 0.11–1.39 μg/L, DEHP; 0.12 – 3.33 μg/L. D-n-OP and DMP were below the limit of detection of the analytical instrument used (0.1 μg/L). The distribution of PAEs along the network of the river revealed that the sampling sites in the urban region were more contaminated with PAEs due to urbanization and an increase in population across the river network. Human health risk assessment revealed that the hazard quotient (HQ) for DEP, DPX, DEHP, and D-i-NP were below 1, indicating an acceptable risk of PAEs via ingestion or bathing of the river water. In addition, the Hazard Index (HI) via ingestion and bathing of the river water was less than 1 indicating acceptable risks. According to this study, these PAEs congeners are safe for toddlers, adolescents, and adults to eat and bathe in tap water. Even DEHP, the only PAEs congener designated as a carcinogenic agent by WHO, was shown to have a tolerable cancer risk. These findings indicate that there is no harm to children, adolescents, and adults from DEHP in the river water studied.
Enumeration of Triangles and Hamiltonian Property of The Zero-Divisor Cayley Graph of The Ring G(Zₙ,⊕,⊙)
Authors: Devendra Jangiti , Madhavi Levaku , Nagalakshumma Tippaluri 
Published: July 2022

In this paper an enumeration method to find the number of triangles in the zero-divisor Cayley graph G(Zₙ,D₀ ) associated with the ring (Zₙ,⨁,⨀),n≥1 of integers modulo n, an integer and its subset D0 of zero-divisors is presented. Further it is shown that this graph is Hamiltonian, not bipartite and Eulerian graph when n is odd.
Hypertension and Physical Intimate Partner Violence among Female HIV Patients in Butiama District, North-Western Tanzania
Authors: Nyangi Getera Isack , Mackanja Elizabeth Emmanuel 
Published: July 2022

Highly active antiretroviral therapy (HAART) has greatly improved life expectancy and quality of life among people living with HIV. However, hypertension has been reported to increase among HIV patients. Yet the exact cause has not been established. We conducted a cross-sectional study involving female HIV-infected patients on ART who attended care and treatment clinics (CTCs) between August 2020 to December 2020. The participants were consecutively enrolled until the targeted sample size was attained. Hypertension was defined as systolic blood pressure (SBP) ≥ 140mmHg and, diastolic blood pressure (DBP) ≥ 90mmHg. The exposure variable of interest was self-reported physical intimate partner violence in the last 12 months which was collected and defined according to World Health Organization (WHO) criteria. We investigated 526 female HIV patients on ART with a mean age of 42.8 years. Of all participants, 87.1% were peasants, about 60% were greater than 60 years old and 22.5% were currently consuming alcohol. 23.8 % of the participants had reported a history of physical intimate partner violence in the last 12 months. The overall prevalence of hypertension in female HIV patients on ART was 31.4% and it was not statistically significant associated with physical intimate partner violence in the last 12 months before and after adjusting for other covariates. The prevalence of hypertension in female HIV patients on ART was higher but was not found to be influenced by physical intimate partner violence in the last 12 months. Further studies are recommended to investigate the influence of physical violence on hypertension among HIV patients.
Performar como mujer en el kárate Olímpico: un análisis cualitativo del Mundial 2018
Authors: Turelli Fabiana Cristina , Kirk David , Tejero-González Carlos María , Vaz Alexandre Fernandez 
Published: August 2022

Con esta investigación hemos tratado de verificar procesos subjetivos de negociación del lugar de las mujeres en el kárate, entendido como masculino, y elevado a deporte olímpico. Para tanto, realizamos un estudio cualitativo de carácter interpretativo, valiéndonos de las técnicas de recogida de informaciones observación sistematizada no-participante y análisis documental, contrastando los materiales provenientes del campo con la literatura. Nuestra base teórica ha estado apoyada en trabajos etnográficos y antropológicos que tienen en común, también con nosotros, algún grado de inspiración en la teoría crítica del deporte. La observación se ha centrado en el 24th Karate World Championships Madrid 2018. Con los resultados y discusión percibimos preliminarmente, pues se trata del inicio de una investigación mayor, algunos elementos para la reflexión, por ejemplo: sobre la mujer karateca recae una gran exigencia de eficiencia técnica; se espera que ella presente capacidad de enseñar la feminidad hegemónica de forma objetiva, algunas veces incluso atestando orientación heterosexual; se valora en el medio que la mujer corresponda a unos estándares de belleza estipulados por la industria de consumo, incluyendo estereotipos relacionados a la sensualidad. En conclusión, el espacio designado a la mujer en este ambiente masculino parece requerir negociaciones para su aceptación y pertenencia.
What do we mean by mean?
Authors: Barańska Barbara , Zambrowska Małgorzata 
Published: July 2022

In order to be successful with a certain concept at school, it is often sufficient to master some types of tasks, without having to be aware of the different perspectives that a concept can be viewed from. It is, however, definitely not enough when the goal is to understand mathematics and become flexible and creative in solving mathematical tasks. Not only school students, but also prospective teachers should be encouraged to reflect on what particular concepts actually mean and how they can be thought of.
In this article we focus our attention on the concept of mean. In the introduction we outline the gaps that our paper partially fills. Then we provide a brief review of how the Polish core curriculum and two very popular mathematics textbook series (one each for primary and secondary school) treat the topic of means. Next, we present results from a study conducted on a group of first-year students of mathematics and a group of teachers undertaking postgraduate studies qualifying for teaching mathematics as a second subject. We show the results obtained in two tasks concerning the arithmetic and geometric mean. The paper ends with several teaching suggestions and recommendations for mathematics teachers’ educators.
Anatomical risks and complications associated with myocardial bridging
Authors: Mahajan Rupali , Meshram Preeti , Ranadhir Nisha Vinod , Hattangadi Shantha 
Published: July 2022

Objective: Myocardial bridging (MB) is an asymptomatic, benign, and congenital coronary anomaly with several possible manifestations. MB is formed by a segment of a coronary artery taking an intra-myocardial course. As of date, huge knowledge gap exists in the literature in terms of MB and its associated complications.

Methods: This single-centre, observational, non-randomised study was conducted over a period of 20 months to identify the rare anomalies such as MB using coronary angiograms.

Results: Eight of 400 cases screened have been found to have MB bridging in mid left anterior descending artery (LAD) segment. The male to female ratio was 7:1 all within an age range of 24 years to 45 years. Most of the patients were asymptomatic with no history of drug usage (6/8) and family history (3/8) of coronary disorders. In symptomatic cases, the most common presenting symptoms were observed to be typical chest pain, dyspnea, nausea, light-headedness, or headaches, diaphoresis, and tachycardia. In most of the patients, MB showed systolic shortening with resultant flow limitation on coronary angiography. The segments were reported to be 1 mm to 10 mm in size and traversed 1 cm to 3 cm length. All the patients were treated symptomatically and were kept on follow-up. No mortality was observed in any case with MB.

Conclusion: Even though MB is a benign condition, but its vast array of related complications was reported to be life threatening and require prompt diagnosis and treatment. This study focus on such MB related risks by highlighting the importance of differential diagnosis and the treatment followed by to avoid all possible complications in all those patients presenting with possible signs and symptoms.
PENGGANTIAN AC TIPE SPLIT-DUCT DENGAN SISTEM WATER COOLED CHILLER DI PUSAT PERBELANJAAN X BANDUNG
Authors: Jumairi Endi , Rangkuti Chalilullah , Supriyadi Supriyadi 
Published: July 2022

Penurunan konsumsi energi sistem HVAC menjadi semakin penting karena meningkatnya biaya bahan bakar fosil yang berdampak juga kepada meningkatnya biaya pembangkit listrik dan masalah lingkungan. Karena itu, untuk mengurangi konsumsi energi di gedung tanpa mengorbankan kenyamanan dan kualitas udara dalam ruangan merupakan tantangan penelitian yang sedang berlangsung. Setiap disiplin HVAC memiliki persyaratan desain khusus dan masing-masing memberikan peluang untuk penghematan energi. Dengan tingginya konsumsi energi listrik untuk HVAC ini yang rata–rata 50% dari total penggunaan listrik gedung, maka pihak pengelola dan pemilik gedung melakukan berbagai upaya untuk melakukan penghematan energi listrik, salah satunya dengan mengganti AC splitduct yang sudah terpasang selama 20 tahun dengan water cooled chiller. Total unit AC Split Duct yang terpasang untuk mendinginkan seluruh pusat perbelanjaan adalah sebanyak 280 unit dengan total kapasitas 1860 TR, penggantian dilaksanakan secara bertahap, untuk tahap pertama dengan mengganti 43 unit AC split duct dengan total kapasitas 500 TR dengan water cooled chiller kapasitas 500 TR, sehingga dengan penggantian ini ada lantai yang disupply dari AC splitduct dan ada yang di suplai water cooled chiller system. Penulis menghitung konsumsi energi listrik yang dibutuhkan untuk kedua tipe AC ini dengan membandingkan beban actual (kWatt) dari AC splitduct dengan water cooled chiller system, dengan cakupan luas area yang sama dari kedua Tipe AC tersebut, dari nilai penghematan yang diperoleh, dihitung waktu pengembalian investasi dari water cooled chiller system
Cuidados paliativos como terapêutica no conforto do paciente
Authors: Glória Fabiana Pereira , Tavares Paulo Eugênio do Val , Coriat Junior Apaestegui , Fernandes Rayssa Nogueira Leite , Portela Tiago Wagner da Silva 
Published: July 2022

Objetivo: Averiguar as evidências cientificas sobre o conforto de pacientes em cuidados paliativos. Métodos: Trata-se de uma revisão integrativa da literatura com buscas dos dados no período de maio e junho deste ano nas bases Pubmed, Scielo e Embase, publicados nos últimos cinco anos. Resultados: Foram encontrados 15 artigos condizentes com nosso objetivo. Os estudos descrevem os cuidados paliativos como uma forma terapêutica para o conforto do paciente diante de várias patologias como as doenças crônicas, doenças incuráveis e o câncer. Apontam os principais sintomas relatados pelos pacientes e os cuidados paliativos ofertados e descritos como apoio desde o diagnóstico da doença, entre eles a comunicação efetiva, alívio da dor, hidroterapia, musicoterapia e satisfação espiritual. Considerações finais: Observa-se a necessidade de fortalecimento desses cuidados pelos profissionais de saúde-paciente-família, buscando melhorar a assistência ao paciente em cuidado paliativo, abrangendo as suas esferas física, psicológica, social e espiritual do paciente.
Increased risk of atrial fibrillation in patients with psoriasis: A meta-analysis of observational studies
Authors: Yang Hsuan Chia , Poly Tahmina Nasrin , Islam Md. Mohaimenul , Walther Bruno Andreas , Wu Chieh-Chen 
Published: July 2022

Background:
Several epidemiological studies have shown that psoriasis increases the risk of developing atrial fibrillation but evidence of this is still scarce.

Aims:
Our objective was to systematically review, synthesise and critique the epidemiological studies that provided information about the relationship between psoriasis and atrial fibrillation risk.

Methods:
We searched through PubMed, EMBASE and the bibliographies for articles published between 1 January 2000, and 1 November 2017, that reported on the association between psoriasis and atrial fibrillation. All abstracts, full-text articles and sources were reviewed with duplicate data excluded. Summary relative risks (RRs) with 95% CI were pooled using a random effects model.

Results:
We identified 252 articles, of these eight unique abstracts underwent full-text review. We finally selected six out of these eight studies comprising 11,187 atrial fibrillation patients. The overall pooled relative risk (RR) of atrial fibrillation was 1.39 (95% CI: 1.257–1.523, P < 0.0001) with significant heterogeneity (I2 = 80.316, Q = 45.723, τ2 = 0.017, P < 0.0001) for the random effects model. In subgroup analysis, the greater risk was found in studies from North America, RR 1.482 (95% CI: 1.119–1.964, P < 0.05), whereas a moderate risk was observed in studies from Europe RR 1.43 (95% CI: 1.269–1.628, P < 0.0001).

Limitations:
We were only able to include six studies with 11,178 atrial fibrillation patients, because only a few such studies have been published.

Conclusion:
Our results showed that psoriasis is significantly associated with an increased risk of developing atrial fibrillation. Therefore, physicians should monitor patient’s physical condition on a timely basis.
Myths, misconceptions and attitudinal trends among patients with acne
Authors: Ansari Farzana , Khare Ashok Kumar , Gupta Lalit Kumar 
Published: July 2022

Background
Despite acne being a common dermatological problem, there is a paucity of literature addressing the knowledge, attitude and practice about it.

Aims/Objectives
To find out what patients know about acne, its cause and treatment, as well as myths, misconceptions and attitude towards it.

Methods
A cross-sectional, descriptive questionnaire-based study on acne patients at Maharana Bhupal Hospital, RNT Medical College, Udaipur, Rajasthan, India.

Results
Most (84.8%) patients belonged to the age group of 16-25 years. The majority (63.9%) presented 12 months after the onset of acne. More than half had average knowledge, a positive attitude and good practices, related significantly to gender and education.

Limitations
A standardized questionnaire suitable for all dialects and regional languages would have yielded more uniform results.

Conclusion
Study revealed that acne patients still need to acquire accurate, adequate and easily accessible information to seek timely and appropriate treatment, and alleviate their psychological suffering.
Comparison of alternate erythrocyte sedimentation rate measurement by automated Celltac α+ (MEK 1305) and reference Westergren method
Authors: Kahar Manoj A. 
Published: July 2022

Objectives:
Manual Westergren method is routinely used for ESR measurement; however, it has many limiting factors which include inherent and technical factors. Alternate/modified Westergren methods have been devised to overcome the limitations of the manual Westergren method. These new methods must be properly evaluated before introducing in clinical laboratories.

Material and Methods:
A total of 350 randomly collected Ethylene Diamine Tetraacetic Acid (EDTA) samples from hospitalized and ambulatory patients were assayed parallelly in the recently launched Hematology Analyzer Celltac α+ (MEK 1305) and manual Westergren method. Results of these assays were subjected to statistical analysis using a coefficient of correlation, Passing-Bablok regression, and the Bland-Altman statistical methods and the results of the present study were also compared with 16 selected similar studies published in the past 22 years. Intrarun precision using patient samples and inter-run precision using manufacturer’s controls (MEK-3DN and MEK-3DL) were also determined.

Results:
The present study revealed a Pearson correlation of 0.9058, mean bias of −6.43, and limits of agreements 17.5–−30.4, between Celltac α+ (MEK 1305) and the reference Westergren method. Intrarun precision using patient samples yielded a coefficient of variation ranging from 0% to 14% and inter-run precision using commercial controls yielded a CV of 9.32% for abnormal (MEK-3DL) control and 13.6% for normal level control (MEK-3DN).

Conclusion:
With good correlation between Celltac α+ (MEK 1305) and the reference Westergren method, acceptable bias, and limits of agreements, automated Celltac α+ (MEK 1305) with its additional advantages is a valid substitute for the reference ESR method in clinical laboratories.