Main Reason Research Articles

Pharmacological interventions for pruritus in adult palliative care patients.

Pharmacological interventions for pruritus in adult palliative care patients.

Dynamic Loss Weighting for Multiorgan Segmentation in Medical Images.

Deep neural networks often suffer from performance inconsistency for multiorgan segmentation in medical images; some organs are segmented far worse than others. The main reason might be organs with different levels of learning difficulty for segmentation mapping, due to variations such as size, texture complexity, shape irregularity, and imaging quality. In this article, we propose a principled class-reweighting algorithm, termed dynamic loss weighting, which dynamically assigns a larger loss weight to organs if they are discriminated as more difficult to learn according to the data and network's status, for forcing the network to learn from them more to maximally promote the performance consistency. This new algorithm uses an extra autoencoder to measure the discrepancy between the segmentation network's output and the ground truth and dynamically estimates the loss weight of organs per the contribution of the organ to the new updated discrepancy. It can capture the variation in organs' learning difficult during training, and it is neither sensitive to data's property nor dependent on human priors. We evaluate this algorithm in two multiorgan segmentation tasks: abdominal organs and head-neck structures, on publicly available datasets, with positive results obtained from extensive experiments which confirm the validity and effectiveness. Source codes are available at: https://github.com/YouyiSong/Dynamic-Loss-Weighting.

Examining Soft and Hard Attributes of Health Care Service Quality and Their Impacts on Patient Satisfaction and Loyalty.

Many studies have confirmed the influences of various service quality dimensions on patient satisfaction and loyalty, but no existing theoretical model accounts for variation in how different types of patients evaluate service quality's soft and hard attributes. This research gap may cause problems for administrators needing to decide how to distribute resources appropriately across multiple departments. Therefore, this study establishes a theoretical model of the differences between inpatients' and outpatients' evaluations of hard and soft qualities and compares such evaluations' influences on patient satisfaction and loyalty. Also, to supplement statistical analysis and respond to scholars' calls for more mixed-methods studies of health care quality, this research incorporates analysis of online reviews to provide a holistic, close to real-time picture of patients' service experience perceptions. This study's survey sample comprised 292 inpatients and 137 outpatients from a Taiwanese hospital. We used partial least squares structural equation modeling to test the hypothetical model and importance-performance map analysis to identify factors that were significant to the service process but performed poorly. Finally, we used a text-mining technique to scrape 536 reviews posted on Google Maps, and Leximancer Portal to perform automated content and sentiment analyses on those data, as a means of mapping the critical concepts and themes that influenced patient experiences. This study's analyses support the ideas that both hard and soft qualities are critical dimensions of service quality, and that each has different influences on inpatients' and outpatients' satisfaction and loyalty. Specifically, the sampled inpatients strongly valued the hard qualities of the hospital but were not satisfied with it. On the other hand, soft qualities attracted outpatients' attention and influenced their satisfaction and loyalty. In addition, content analysis revealed that soft qualities were the main reason patients left comments, whether positive or negative. Waiting time emerged as another critical element in triggering patients' unfavorable reviews. Patient population type, whether inpatient or outpatient, has been found to impact perceptions of service quality within health care institutions. As such, health care administrators should be cognizant of this phenomenon and make informed and tailored decisions when addressing quality within their respective services. Emphasis on the development of both interpersonal and professional skills among health care personnel may prove beneficial in enhancing the patient experience and ultimately fostering positive online reviews.

Effect of Glycemic Disorders and Habits on the Concentration of Selected Neurotrophic Factors in Patients with Lumbosacral Intervertebral Disc Degeneration.

Unhealthy habits, such as overeating processed and high-calorie foods, alcohol abuse, and smoking, negatively impact human health. It has been suggested that the inflammatory process and the resulting growth of nerve fibers within the intervertebral disc (IVD) fissures is the main reason for the pain accompanying IVD degeneration (IVDD). The aim of this study was to determine whether smoking, alcohol consumption, overweight/obesity, or diabetes comorbidity contribute to the development of IVDD and how the aforementioned factors affect the levels of brain-derived neurotrophic factor (BDNF), glial cell-derived neurotrophic factor (GDNF), and growth associated protein 43 (GAP-43) in the study and control groups (intervertebral discs, IVDs from cadavers, and serum samples from voluntary blood donors). The study group comprised 113 patients diagnosed with IVDD who qualified for microdiscectomy. Two control groups (I and II) were used in this study. The first included 81 IVDs obtained from Caucasian human cadavers. Control group II, on the other hand, included serum samples obtained from 113 voluntary blood donors. The expression profiles of BDNF, GDNF, and GAP-43 were determined by enzyme-linked immunosorbent assay (ELISA). Our statistical analysis confirmed that patients who were overweight/obese, smoked tobacco, consumed alcohol, or had diabetes had a higher risk of IVDD (OR > 1). Statistical analysis showed that BDNF, GAP-43, and GDNF concentrations were significantly higher in the IVDs and serum samples obtained from the study group compared to the control group (p < 0.05). In addition, higher levels of BDNF, GDNF, and GAP-43 were noted in IVDD patients who consumed alcohol, smoked tobacco, were overweight/obese, or had comorbid diabetes compared to patients without these risk factors (p < 0.05). We showed that changes in energy metabolism, habits, and lifestyle, as well as the degenerative process of IVD in the lumbosacral spine contribute to changing the concentration profile of the analyzed neurotrophic factors.

What makes transitional justice possible? An analysis of the Spanish case

ABSTRACT The main purpose of this research is to identify the determinants that intervene in the transitional justice choices made in general, and those made in the Spanish case in particular. The construction of a linear regression model containing 83 transitions was developed to identify the significant explanatory factors in the transitional justice choices. The analysis enabled us to place Spain at some distance from the countries considered as successful in terms of transitional justice to classify it as an exception that is not adequately explained by the general model, while also identifying the main reasons for this.

Intentional water and tired wood: exploring causes for primary teachers’ reference to intuitive construals in science education

ABSTRACT Research reveals that teachers regularly refer to intuitive construals (IC) in formal science education. Only a few studies, however, have investigated why teachers refer to them. Alarmingly, these studies suggest didactic consideration is not the main reason for this. Instead, teachers introduce IC unintentionally or due to a lack of expertise. A possible explanation for an unconsidered reference to IC – a part of lack of expertise – is that teachers spontaneously align their language with the students’ perspective as a form of implicit didactisation. We asked fifty prospective primary teachers to explain a basic scientific phenomenon of inanimate nature to fictitious recipients of varying expertise (a science expert and a student). We reasoned that if lack of knowledge was the reason for using IC, explanations should be equally intuitive for all addressees. If spontaneous language didactisation is the reason, only the explanations for students should contain intuitive elements. Results show that the majority of participants use IC exclusively when addressing students and not when addressing experts. In a substantial minority, however, lack of knowledge is a more likely cause. We conclude that there might be a tendency towards language didactisation even outside didactic professional knowledge. Implications for teacher training are discussed.

Few-Shot Object Detection With Self-Supervising and Cooperative Classifier.

Few-shot object detection (FSOD), which detects novel objects with only a few training instances, has recently attracted more attention. Previous works focus on making the most use of label information of objects. Still, they fail to consider the structural and semantic information of the image itself and solve the misclassification between data-abundant base classes and data-scarce novel classes efficiently. In this article, we propose FSOD with Self-Supervising and Cooperative Classifier ( [Formula: see text]) approach to deal with those concerns. Specifically, we analyze the underlying performance degradation of novel classes in FSOD and discover that false-positive samples are the main reason. By looking into these false-positive samples, we further notice that misclassifying novel classes as base classes are the main cause. Thus, we introduce double RoI heads into the existing Fast-RCNN to learn more specific features for novel classes. We also consider using self-supervised learning (SSL) to learn more structural and semantic information. Finally, we propose a cooperative classifier (CC) with the base-novel regularization to maximize the interclass variance between base and novel classes. In the experiment, [Formula: see text] outperforms all the latest baselines in most cases on PASCAL VOC and COCO.

ESGN: Efficient Stereo Geometry Network for Fast 3D Object Detection

Fast stereo based 3D object detectors have made great progress recently. However, they suffer from the inferior accuracy. We argue that the main reason is due to the poor geometry-aware feature representation in 3D space. To solve this problem, we propose an efficient stereo geometry network (ESGN). The key in our ESGN is an efficient geometry-aware feature generation (EGFG) module. Our EGFG module first uses a stereo correlation and reprojection module to construct multi-scale stereo volumes in camera frustum space, second employs a multi-scale bird&#x2019;s eye view (BEV) projection and fusion module to generate multiple geometry-aware features. In these two steps, we adopt deep multi-scale information fusion for discriminative geometry-aware feature generation, without any complex aggregation networks. In addition, we introduce a deep geometry-aware feature distillation scheme to guide stereo feature learning with a LiDAR-based detector. The experiments are performed on the classical KITTI dataset. On KITTI test set, our ESGN outperforms the fast state-of-art-art detector YOLOStereo3D by 5.14% on mAP_3<i>d</i> at 62<i>ms</i>. To the best of our knowledge, our ESGN achieves a best trade-off between accuracy and speed. We hope that our efficient stereo geometry network can provide more possible directions for fast 3D object detection.

Artywistka i hejterzy

The purpose of this article is to analyze Maja Staśko’s book Polski hejt [Polish Hate] as an example of artivism (situated on the borderline between art and activism). The text shows how Staśko reveals the scale and nature of the hate she encounters every day on the internet, and evokes in the reader an affective reaction towards the haters. The article pays particular attention to the kind of amorous investment that the haters display toward the subject being hated on – this becomes the main reason for Staśko’s production of the affect of revulsion and labeling her haters with it. Key-words: Maja Staśko, hate, artivism, feminism

An Appraisal that Religion on its Own Does Not Breed Violence

It will be rare to have a discussion on human existence without mentioning violence; but it will be unfair to see religion as the main reason for violence. Although, religion has an input in violence, but religion in isolation can’t breed violence without the input of some other factors which are further explain in this article. This article adopted qualitative method and secondary data. The secondary data was collected through website, publications, journals and textbooks. The data collected through secondary data reveals that religion on its own does not breed violence but it is a component of violence that can be aided by poverty, inequality, bad governance among other factors.

Progress in Biomarkers Related to Biliary Atresia.

Biliary atresia (BA) is a congenital cholestatic disease that can seriously damage children's liver function. It is one of the main reasons for liver transplantation in children. Early diagnosis of BA is crucial to the prognosis of patients, but there is still a lack of reliable non-invasive diagnostic methods. Additionally, as some children are in urgent need of liver transplantation, evaluating the stage of liver fibrosis and postoperative native liver survival in children with BA using a straightforward, efficient, and less traumatic method is a major focus of doctors. In recent years, an increasing number of BA-related biomarkers have been identified and have shown great potential in the following three aspects of clinical practice: diagnosis, evaluation of the stage of liver fibrosis, and prediction of native liver survival. This review focuses on the pathophysiological function and clinical application of three novel BA-related biomarkers, namely MMP-7, FGF-19, and M2BPGi. Furthermore, progress in well-known biomarkers of BA such as gamma-glutamyltransferase, circulating cytokines, and other potential biomarkers is discussed, aiming to provide a reference for clinical practice.

In-depth analysis to develop a social marketing model to promote women's participation in waste segregation behaviour: A qualitative study

Waste separation is one of the key factors in managing solid waste and creating a healthy environment. Waste separation at source has always been associated with challenges. Therefore, this study was conducted to determine the perceptions of housewives and related parties regarding the factors that influence waste separation behaviour and to identify approaches to improve behaviour based on the social marketing framework. This study was conducted as a qualitative content analysis in Amol City in 2022. The data was collected through semi-structured individual interviews. A total of 25 housewives were selected as main participants and 5 stakeholders through purposive selection. The results of the study included lack of awareness of recyclable materials (product), personal, family and environmental barriers (price), lack of doorstep collection of dry waste (place), and lack of use of appropriate technology (promotion). The lack of financial resources, inappropriate political measures and the coronavirus pandemic were also the causes of this challenge. Most participants cited environmental and educational deficits as the main reason for not separating waste. It is possible to improve waste sorting behaviour at source through appropriate behavioural interventions at the individual, social and environmental levels. Researchers can use the results of this study to design, implement and evaluate waste segregation intervention programmes for housewives.

Demystifying the likelihood of reidentification in neuroimaging data: A technical and regulatory analysis

Abstract Sharing research data has been widely promoted in the field of neuroimaging and has enhanced the rigor and reproducibility of neuroimaging studies. Yet the emergence of novel software tools and algorithms, such as face recognition, has raised concerns due to their potential to reidentify defaced neuroimaging data that are thought to have been deidentified. Despite the surge of privacy concerns, however, the risk of reidentification via these tools and algorithms has not yet been examined outside the limited settings for demonstration purposes. There is also a pressing need to carefully analyze regulatory implications of this new reidentification attack because concerns about the anonymity of data are the main reason that researchers think they are legally constrained from sharing their data. This study aims to tackle these gaps through rigorous technical and regulatory analyses. Using a simulation analysis, we first tested the generalizability of the matching accuracies in defaced neuroimaging data reported in a recent face recognition study (Schwarz et al., 2021). The results showed that the real-world likelihood of reidentification in defaced neuroimaging data via face recognition would be substantially lower than that reported in the previous studies. Next, by taking a US jurisdiction as a case study, we analyzed whether the novel reidentification threat posed by face recognition would place defaced neuroimaging data out of compliance under the current regulatory regime. Our analysis suggests that defaced neuroimaging data using existing tools would still meet the regulatory requirements for data deidentification. A brief comparison with the EU’s General Data Protection Regulation (GDPR) was also provided. Then, we examined the implication of NIH’s new Data Management and Sharing Policy on the current practice of neuroimaging data sharing based on the results of our simulation and regulatory analyses. Finally, we discussed future directions of open data sharing in neuroimaging.

Adult orthodontics, motivations for treatment, choice, and impact of appliances: A qualitative study

Understanding the rationale for adult patients undertaking orthodontic treatment and the impact of appliances on their quality of life has become increasingly important to research efforts and clinical care. This study aimed to understand why adult patients undergo orthodontic treatment and their overall experience with the choice of appliance. A cross-sectional qualitative study using semistructured interviews with adult patients from 4 private specialist orthodontic practices in the London region involving a purposive homogeneous sampling technique to obtain variation regarding gender, treatment modalities (fixed ceramic [FC], removable aligner [RA], and fixed lingual [FL] appliances), and stages of treatment (early, late, and posttreatment stage) was undertaken. A piloted topic guide was used to standardize data collection. Interviews were audio recorded, and field notes were taken. Data were transcribed verbatim and analyzed using framework methodology until data saturation was reached. A total of 22 participants (FC, 8; RA, 8; and FL, 6), with a mean age of 38.9 ± 11.7 years, with the majority being female (n= 13; 59.1%), were interviewed. Psychosocial and dental health-related factors were reported as the main reasons to seek orthodontic treatment. Social factors and appliance features influence an adult's decision-making in selecting a specific orthodontic appliance. Wearing FC, RA, and FL was seen to have both positive and negative impacts on an adult's quality of life. Functional and psychological factors were the strong influencers on patients' treatment experience. The study highlighted the influence of psychosocial factors and dental health concerns in the decision-making processes of adults seeking orthodontic treatment. FC, RA, and FL appear to affect an adult's quality of life, with functional and psychosocial factors being commonly reported.

Knowledge and Attitudes Regarding the Vaccination of Brazilian Immigrants in Portugal: Risks When Returning to Their Country of Origin?

Vaccination is one of the main advancements in public health in the prophylaxis of infectious diseases. We intend to describe the general knowledge about vaccines/vaccination among Brazilian immigrants in Portugal, characterize their attitudes toward vaccination, and describe their knowledge of the yellow fever (YF) vaccine. A cross-sectional study was conducted using a self-completion questionnaire (face-to-face or remote). A total of 542 people participated in the study; the mean age was 36.81 years; 40.1% were male; 44.8% had their 12th year of schooling; and 27.0% had resided for ≥10 years in Portugal. Regarding general knowledge about vaccination, 53.8% answered at least 6/8 questions correctly. A total of 37.1% tended to have a favorable attitude toward vaccination. Concerning traveling, 76.7% attributed the risk of disease at the destination as the main reason for accepting vaccines. A total of 89.3% knew that there was a risk of YF in Brazil. A total of 40% answered correctly only one question about the YF vaccine; 21.6% did not answer any questions correctly. Thus, most of the Brazilian immigrants in this study have high general knowledge about vaccines/vaccination, few have a favorable attitude, and their knowledge about the YF vaccine is scarce. This could limit vaccination adherence when visiting Brazil, making health education actions necessary to increase knowledge and prevent YF risks.

Enhancing anticorrosive performance of epoxy‐based ZnO nanocomposite coatings via 3‐(trimethoxysilyl)propyl methacrylate modification

AbstractThe influence of 3‐(trimethoxysilyl)propyl methacrylate (TMSPM) on the properties of epoxy‐based ZnO nanocomposite coatings was investigated, considering its impact on both modified ZnO nanoparticles (NPs) and epoxy resin matrix. FTIR analysis revealed that TMSPM‐modified epoxy resin (mEP) exhibited lower hydroxyl group and epoxy group content compared to the initial epoxy resin (EP). Furthermore, the obtained results demonstrated that epoxy‐based coatings incorporating modified ZnO NPs (m‐ZnO NPs) displayed superior mechanical properties compared to those of the sample filled with the unmodified ZnO NPs (u‐ZnO NPs). However, the mechanical properties of epoxy‐based coatings loaded with m‐ZnO NPs were found to be lower than those of coatings comprising mEP resin and m‐ZnO NPs. The arrangement of anticorrosion performance of coatings followed a similar pattern. SEM analysis of the cross‐cut surface revealed better dispersion of m‐ZnO NPs compared to the u‐ZnO NPs, although small gaps were observed among the m‐ZnO NPs and the epoxy matrix. The SEM images of coatings based on mEP and m‐ZnO NPs indicated a tighter structure. This structural characteristic is considered the main reason for the highest anticorrosion performance observed in the investigated coatings incorporating both mEP and m‐ZnO NPs.

A multi-constituent model for assessing the effect of impeller shroud on the thrombosis potential of a centrifugal blood pump.

Centrifugal blood pumps can be used for treating heart failure patients. However, pump thrombosis has remained one of the complications that trouble clinical treatment. This study analyzed the effect of impeller shroud on the thrombosis risk of the blood pump, and predicted areas prone to thrombosis. Multi-constituent transport equations were presented, considering mechanical activation and biochemical activation. It was found that activated platelets concentration can increase with shear stress and adenosine diphosphate(ADP) concentration increasing, and the highest risk of thrombosis inside the blood pump was under extracorporeal membrane oxygenation (ECMO) mode. Under the same condition, ADP concentration and thrombosis index of semi-shroud impeller can increase by 7.3% and 7.2% compared to the closed-shroud impeller. The main reason for the increase in thrombosis risk was owing to elevated scalar shear stress and more coagulation promoting factor-ADP released. The regions with higher thrombosis potential were in the center hole, top and bottom clearance. As a novelty, the findings revealed that impeller shroud can influence mechanical and biochemical activation factors. It is useful for identifying potential risk regions of thrombus formation based on relative comparisons.

Comparison of non-COVID-19 critically ill patients between pre-pandemic and pandemic period admitted from emergency department to internal medicine intensive care unit

Aim: During the COVID-19 pandemic, a large number of intensive care unit beds have been organized for critically ill COVID-19 patients. However, the need for intensive care for non-COVID-19 critical patients continues. In our study, we aimed to compare non-COVID-19 critically ill patients admitted to the internal medicine intensive care unit from the emergency department before and during the pandemic period.&#x0D; Materials and Methods: Patients who were admitted to the internal medicine intensive care unit from the emergency department were grouped as pre-pandemic (March 2018-March 2020) and during the pandemic (March 2020-March 2022) and compared retrospectively in terms of the number of hospitalisations, demographic characteristics, length of intensive care unit stay and mortality.&#x0D; Results: The number of emergency department patient admissions other than surgical reasons was 579.657 during the study period. 63.33 % of these patients were admitted before the pandemic and 36.67% during the pandemic period. The number of patients included in our study was 493 before the pandemic and 460 during the pandemic period. Median age was 61 (30) in the pre-pandemic period and 64 (26.8) in the pandemic period, p=0.022. There was no significant difference in terms of comorbidities. The main reason for hospitalisation was similar and sepsis was the leading reason for hospitalisation. The frequency of acute renal failure in intensive care unit was significantly higher during the pandemic period. Mortality was 25.2% before the pandemic and 24.3% during the pandemic period, p=0.760.&#x0D; Conclusion: Although emergency department admissions decreased, the number of non-COVID-19 internal medicine intensive care unit hospitalisations did not decrease. This situation reveals the importance of organising intensive care beds for hospitalisation for non-COVID-19 reasons in order not to disrupt health services during the pandemic period.

Microscopic insights into the long-term ageing mechanism of asphalt in the hygrothermal environments

The humid, thermal, and oxidative environments cause the synergistic degradation of asphalt materials. To reveal the long-term ageing mechanism of asphalt in the hygrothermal environments, base asphalt (BA) and styrene-butadiene-styrene (SBS) modified asphalt (SMA) were selected to prepare the short-term, long-term, and hygrothermal-aged samples. Then the changes in micromorphology, molecular weight distribution, chemical compositions, and microstructures of each aged asphalt sample were characterized. The results indicate that the soaking duration is determined as 32 h for preparing the hygrothermal-aged asphalt sample. The moisture diffusion causes physical damage to asphalt, forming circular micro holes on the asphalt surface, which is the main reason to accelerate asphalt ageing. The ambient water and air can easily permeate into asphalt, further accelerating asphalt ageing. Additionally, the small and medium molecular components in the hygrothermal-aged BA are decreased, while the large molecular components become more. Meanwhile, the molecular weight distribution of SMA is relatively concentrated after hygrothermal ageing, and the SBS modifier is degraded from supermolecules to macromolecules. Further, no new chemical compositions are produced after hydrothermal ageing of BA and SMA. The hygrothermal ageing accelerates the oxidation of thioethers and unsaturated carbon bonds to convert into sulfoxide and carbonyl groups. Finally, the hygrothermal ageing destroys asphalt components, and the number of Catana phases on the BA surface is lowered. The Catana phases on the SMA surface were seriously damaged and almost disappeared in asphalt components. The surface elevations of BA and SMA are increased after hygrothermal ageing, but the surface roughness is decreased. This study provides the microscopic insight into the long-term ageing mechanism of asphalt in the hygrothermal environments.

Engineering a PtCu Alloy to Improve N2 Selectivity of NH3-SCO over the Pt/SSZ-13 Catalyst.

Improving the N2 selectivity is always a great challenge for the selective catalytic oxidation of ammonia (NH3-SCO) over noble-metal-based (especially Pt) catalysts. In this work, Cu as an efficient promoter was introduced into the Pt/SSZ-13 catalyst to significantly improve the N2 selectivity of the NH3-SCO reaction. A PtCu alloy was formed in the PtCu/SSZ-13 catalyst, as confirmed by X-ray diffraction, transmission electron microscopy, energy dispersive spectrometry mapping, and X-ray absorption spectroscopy results. As indicated by the X-ray photoelectron spectroscopy analysis, the Pt species in the alloyed PtCu nanoparticle was mainly present in the electron-rich state on PtCu/SSZ-13, while the electron-deficient Cu and isolated Cu2+ species were both present on the surface of PtCu/SSZ-13. Due to such a unique alloyed structure with an altered oxidation state, the N2 selectivity of NH3-SCO on the PtCu/SSZ-13 catalyst was remarkably improved, while the NH3-SCO activity was kept comparable to that on Pt/SSZ-13. The reaction path was changed from the NH mechanism on Pt/SSZ-13 to both NH and internal selective catalytic reduction mechanisms on the PtCu/SSZ-13 catalyst, which was considered the main reason for the enhanced N2 selectivity. This work provides a new route to synthesize efficient alloy catalysts for optimizing the N2 selectivity of NH3-SCO for NH3 slip control in diesel exhaust purification.