Positive Rank Research Articles

Evaluating progress towards implementation of the European HTA Regulation: Insights generated from the European Access Academy's multi-stakeholder survey

ObjectivesWe conducted a multi-stakeholder survey to assess stakeholders' perceptions of the progress made towards the implementation of the European Regulation on Health Technology Assessment (EU HTA R) and to identify and prioritize the remaining challenges for implementation. MethodsUsing two iterative Delphi cycles, an exploratory, semi-quantitative survey was developed to identify how stakeholders 1) experienced preparatory activities of the Regulation, and 2) prioritized remaining challenges for successful implementation. The survey was distributed among the network of the European Access Academy and via social media to ensure coverage of key stakeholders. Descriptive analyses were performed on quantitative response items, and relative importance was calculated for ranking items. Free-text responses supplemented participants' answers to quantitative questions. ResultsN = 61 responses were received from N = 15 countries including Global/ EU-wide institutions (Patients and Patients’ representatives: 7; Clinicians’ representatives: 5; Regulators: 3; Health Technology Developers (HTDs): 20; HTA bodies: 10; Payers: 7; Policy Makers: 2; Academic representatives: 7). The majority of respondents were aware of preparatory activities, with 74 % (N = 45) observing the drafting of Guidance Documents and 64 % (N = 39) noting the establishment of the Coordination Group. Respondents ranked the success of preparatory activities neutral with a slight tendency towards a positive ranking. Key challenges were Member States' readiness for Joint Clinical Assessments, HTA capacity/ capability constraints, and the applicability/ feasibility of the methodological framework. ConclusionsThis study identified the key remaining challenges for the successful establishment of the EU HTA process. Key findings emphasize the readiness of national systems and procedures as pivotal factors. Balancing operational efficiency with strategic objectives, including the development of a European Value Framework, is imperative for harnessing the full potential of the joint HTA process and enhancing patient access to innovative technologies on a pan-European scale. Public interest summaryIn January 2022, the European Union (EU) adopted the European Regulation on Health Technology Assessment (HTA). By harmonizing HTA practices and promoting collaboration across Member States, the joint procedure as set out in the regulation aims to improve efficient use of resources and ensure long-term sustainability of EU-wide HTA cooperation. Close to reaching the half-way mark of the preparation phase in mid-2023, we conducted a multi-stakeholder survey to assess perceptions of the progress made towards implementation of a joint procedure and to prioritize remaining challenges. The responses indicated a neutral to positive perception of the preparatory activities (i.e., establishing a coordination group and a stakeholder network, and creating guidance documents). Respondents prioritized challenges related to the readiness of Member States, limitations in HTA capacity and capability, and applicability of the assessment methods. Further research is needed to define targeted strategies for specific stakeholder groups to effectively address the identified challenges.

Effect of Combination of Facial Acupuncture Therapy with Lavender Aromatherapy on Reducing Postpartum Maternal Anxiety Levels in Medan Tuntungan District

Following childbirth, moms will undergo emotional fluctuations characterized by mood swings, anxiety, dizziness, and feelings of despair. Impaired maternal understanding of infant care can lead to psychological issues that impact the mother's physical well-being, including disrupted sleep patterns and reduced appetite. Failure to promptly manage anxiety in postpartum mothers can lead to the development of baby blues syndrome and postpartum depression. This study employs a Quasi Experiment design with a pre-posttest not include a control group to quantitatively investigate the impact of combining facial acupressure therapy with lavender aromatherapy on anxiety reduction in postpartum mothers. The investigation was conducted in Medan Tuntungan District, located in Medan City. One hundred postpartum women constituted the sample in this study. The data collection process involved administering treatment (facial acupressure therapy with lavender aromatherapy), followed by observation and interviews conducted using the HARS instrument. The analysis conducted using the Wilcoxon Signed Ranks Test revealed a negative ranks value of 94. This indicates that out of the 100 postpartum women who participated in the study, 94 mothers reported a reduction in anxiety levels. The positive rankings index is 0, indicating that none of the 100 postpartum moms who participated in the study reported a rise in anxiety levels. The tie value of 6 indicates that among the 100 postpartum moms who participated in the study, 6 mothers did not show any significant difference in anxiety levels before and after undergoing a combination of Facial Acupressure Therapy with Lavender Aromatherapy. Moreover, it is established that the significance value at this stage of analysis is 0.000 or greater than ? (0.05). Therefore, it can be inferred that there is a significant impact of the combination of Facial Acupressure Therapy with Lavender Aromatherapy on the reduction of anxiety levels in postpartum mothers.

Pairing powers of pythagorean pairs

A pair (a,b) of positive integers is a pythagorean pair if a2+b2 is a square. A pythagorean pair (a,b) is called a pythapotent pair of degreeh if there is another pythagorean pair (k,l), which is not a multiple of (a,b), such that (ahk,bhl) is a pythagorean pair. To each pythagorean pair (a,b) we assign an elliptic curve Γah,bh for h≥3 with torsion group isomorphic to Z/2Z×Z/4Z such that Γah,bh has positive rank over Q if and only if (a,b) is a pythapotent pair of degree h. As a side result, we get that if (a,b) is a pythapotent pair of degree h, then there exist infinitely many pythagorean pairs (k,l), not multiples of each other, such that (ahk,bhl) is a pythagorean pair. In particular, we show that any pythagorean pair is always a pythapotent pair of degree 3. In a previous work, pythapotent pairs of degrees 1 and 2 have been studied.

Impact of the “Mengabu (Facing Ash Storms) Disaster Preparedness” Program on Adolescents’ Knowledge About Disaster Preparedness in Kresik Tuo Village, Kayu Aro District, Kerinci Regency, Jambi

Natural disasters have become an integral part of people's lives in Indonesia, disrupting daily activities and causing significant impacts. Indonesia, located in the Ring of Fire, faces a high risk of volcanic eruptions, including the active Mount Kerinci which has the potential to cause disasters such as volcanic ashfall. Kresik Tuo Village, located near Mount Kerinci, faces a direct threat from this eruption. The community, especially the youth, need to improve their preparedness and knowledge to deal with potential disasters. The "MENGABU Siaga dalam Bencana" program is designed to improve the preparedness of the Kresik Tuo Village community in dealing with potential volcanic ashfall, with the hope of contributing to the development of community preparedness strategies in disaster-prone areas. To improve the knowledge of youth in Kresik Tuo Village related to disasters and disaster preparedness. The study used the Pre-Experimental research method with a Prepost Test Design. Sampling used a non-probability sampling technique with convenience sampling according to the inclusion and exclusion criteria of 40 respondents. Wilcoxon test shows that there is a significant increase in the knowledge of youth preparedness for the eruption of Mount Merapi after being given the "Mengabu Siaga dalam Bencana" program. All respondents experienced an increase in knowledge, as indicated by a positive ranks value of 40 and a p value = 0.000. Conclusion: The results of the study indicate that there is a significant effect of the "Mengabu (Mengabu Storm Ash) Siaga Dalam Bencana" Program on Youth Preparedness Knowledge for Disasters in Kresik Tuo Village, Kayu Aro District, Kerinci Regency, Jambi in increasing youth knowledge.

Peningkatan teknologi bagi agroindustri pliek-u sebagai upaya pelestarian kearifan lokal di Aceh [Technology improvement on pliek-u agroindustry as an effort to maintain a local wisdom in Aceh

Pliek-u is a specialty food product in Aceh with local wisdom values that should be preserved. The Program of Community Service Based Product (PKMBP) aimed to improve the pliek-u agro-industry by adapting simple processing technologies so that it could lighten work, produce quality products, and attract the interest of the younger generation as pliek-u entrepreneurs in future. The method applied consist of surveys, preparation of tools and materials, assembly of a solar tunnel dryer type Hohenheim Aceh and a hydraulic press, training and dissemination of technology through field schools, and evaluation of the program with pre-tests and post-tests. Data analysis was carried out using the Wilcoxon rank test with alpha of 5%. The results of the program were the construction of 1 unit of Hohenheim Aceh tunnel dryer, 1 unit of hydraulic press, and the implementation of training and dissemination activities which have been published in the form of videos on YouTube media and press releases through online media. The results of the Wilcoxon rank test also showed that of the 13 participants whose data were valid, 100% of participants received positive rankings and the pre-test scores were significantly different from the post-test scores. Thus, it can be concluded that the program carried out has contributed to increasing the knowledge, expertise capacity, and interest of participants in pliek-u processing technologies since the profile of conventional agroindustry can be transformed to be better agroindustry by the use of solar tunnel dryer type Hohenheim Aceh and hydraulic press. In addition, the use of technologies will ensure the halal requirement of pliek-u.

The Effectiveness of Using Lontara Bugis Makassar Script in English Vocabulary Teaching

Vocabulary teaching, especially in early childhood, must be emphasized, because having sufficient vocabulary will make it easier for children to communicate. The Lontara script is a regional language that is now almost forgotten by the younger generation; therefore, this research tries to integrate the Lontara script in learning English vocabulary. The type of research used in this research is quantitative research with experimental methods. In this study, researchers used the One-Group Pre-Test-Post-Test Design. The data obtained can be interpreted to be in positive ranks, with an average value (mean ranks) equal to 24.50, and a total value (sum of ranks) equal to 1176.00. This means that there is an increase in post-test scores after treatment, which means that the integration of Lontara Bugis script in learning English vocabulary is effective in improving understanding of English vocabulary for fifth-grade students at MI Darul Abrar Balle Village, MIS Arrahman Labuaja, and MIS UKI Siputanre Cakkela, which are in Kahu District, Bone Regency, South Sulawesi Province.

Patient Perception on Physiotherapy and the Breath of Hope in Breast Cancer Patients Undergoing Chemotherapy: Impact of Breathing Exercises in Enhancing Lung Function and Quality of Life: A Quasi-Experimental Study

Background: Breast cancer is the leading type of cancer among women globally, significantly impacting mortality and morbidity rates. Respiratory complications and diminished quality of life are common among patients undergoing chemotherapy, highlighting the need for effective supportive treatments. Objective: This study aimed to evaluate the efficacy of respiratory physiotherapy interventions, specifically breathing exercises, in improving lung function and quality of life in breast cancer patients undergoing chemotherapy. Methods: This quasi-experimental study enrolled thirty female breast cancer patients from the oncology wards of Allied Hospital and PINUM, Faisalabad. Participants were selected using a purposive sampling technique and were provided with respiratory physiotherapy, including spirometry and breathing exercises, three times a week for six months. Data were collected through initial and final assessments of lung function and quality of life, using self-administered questionnaires and spirometry. Ethical considerations followed the Declaration of Helsinki guidelines, with all participants providing informed consent. Statistical analysis was conducted using SPSS Version 25, employing the Wilcoxon signed-rank test. Results: The interventions showed statistically significant improvements in lung capacity; Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) witnessed positive ranks in 22 and 21 patients respectively, with mean ranks of 11.50 and 11.00, and sum of ranks at 253.00 and 231.00 (p<.001 for both). Quality of life assessments indicated improvements across physical, emotional, and cognitive functions with significant p-values (<.001 to .025). About 70% of participants reported a good perception, and 10% reported an excellent perception of the physiotherapy's effectiveness in improving their condition. Conclusion: The study confirms that structured respiratory physiotherapy significantly enhances lung function and quality of life in breast cancer patients undergoing chemotherapy. These findings advocate for the integration of tailored respiratory physiotherapy into standard care protocols to improve clinical outcomes for this patient group. Keywords: Breast Cancer, Chemotherapy, Respiratory Physiotherapy, Breathing Exercises, Lung Function, Quality of Life, Patient Perception, SPSS Analysis, Oncology Rehabilitation.

The Influence of the Inquiry Learning Model on Students' Interest in Learning and Social Studies Learning Outcomes Class IV SDN Were'a

Study This aim For explain the influence of the Inquiry Learning model on interest learning and results learn social studies students Class IV SDN Were'a . Types of research This is study quantitative use analysis descriptive . Research design using one-group pretest-posttest design and subjects study is participant educate class VI at SDN Were'a year lesson 2023/2024. Based on results study can concluded that the use of the Inquiry learning learning model is influential to interest and results learn social studies participants educate class IV ware'e shown​ from : (1) the Wilcoxon test results show positive ranks between interest learning social studies experience enhancement mark from pretest to posttest. The mean rank is 5.00 while the sum of ranks is 45.00; Paired Sample T Test results show calculated t value is 12.421 > from t table 2.262 then Ho is rejected and Ha is accepted which means There is influence use Inquiry Learning method with interest learning social studies in students class IV ware'e .; and result analysis regression shows the calculated t value is 4.290 > t table 2.364 then ha is accepted and ho is rejected and the R Square value is 0.76324 meaning the influence of X on Y is 76% , meanwhile the rest influenced by other variables that are not researched . Referring to the hypothesis above so can concluded the use of the Inquiry Learning model is influential to interest study and (2) positive Wilcoxon test results between ranks results learning social studies experience enhancement mark from pretest to posttest. Meank rank is 5.50 while the sum of ranks is 45.00; Based on the t table, the t table is 2.262. Because the calculated t value is 17,881 > t table 2.262 , Ho is rejected and Ha is accepted It means There is influence use method Learning Inquiry with results learning social studies in students class IV waree ; and based on results analysis regression Calculated t value based on the coefficient table of 4.747 > t table 2.364 then Ha is accepted and Ho is rejected and the R Square value is 0.763 meaning the influence of X on Y is 76% , meanwhile the rest influenced by other variables that are not researched .

How framing bias impacts preferences for innovation in bone tissue engineering.

It is currently unknown if surgeons and biomaterial scientists &or tissue engineers (BS&orTE) process and evaluate information in similar or different (un)biased ways. For the gold standard of surgery to move "from bench to bedside", there must naturally be synergies between these key stakeholders' perspectives. Because only a small number of biomaterials & tissue engineering innovations have been translated into the clinic today, we hypothesised this lack of translation is rooted in the psychology of surgeons and BS&orTE. Presently, both clinicians and researchers doubt the compatibility of surgery and research in their daily routines. This has led to the use of a metaphorical expression "squaring of the circle," which implies an unsolvable challenge. As bone tissue engineering belongs to the top 5 research areas in tissue engineering we choose the field of bone defect treatment options for our bias study. Our study uses an online survey instrument for data capture: incorporating a behavioural economics cognitive framing experiment methodology. Our study sample consisted of surgeons (n=208) and BS&orTE (n=59). And we employed a convenience sampling method, with participants (conference attendants) being approached both in person and via email - 22 October 2022-13 March 2023. We find no distinct positive-negative cognitive framing differences by occupation. That is, any framing bias present in this surgical decision-making setting does not appear to differ significantly between surgeon and BS&orTE specialisation. When we explored within group differences by frames, we see statistically significant (p<0.05) results for surgeons in the positive frame ranking autologous bone graft transplantation lower compared to surgeons in the negative frame. Further, surgeons in the positive frame rank Ilizarov bone transport method higher compared to surgeons in the negative frame (p<0.05).

COMPARISON BETWEEN GASING AND CONVENTIONAL METHODS ON MATHEMATICS LEARNING OUTCOMES IN ELEMENTARY SCHOOL

The method of this study was a quantitative approach applying a field study with a quasi-experimental method. This research aimed to describe the comparison of the student’s achievement between gasing and conventional methods in mathematics learning outcomes at class IV of MI Ma'arif NU Banteran. The population was class IV which totalled 78 students. The sample used in this research was class IV A with 27 students as the experimental class and class IV B with 26 students as the control class. The data collection technique used is a test technique, then data analysis includes validity test, normality test, homogeneity test, Wilcoxon test, and N-Gain test. Based on the results of data analysis, it can be seen from the Wilcoxon test, it was found that differences in learning outcomes for students in the experimental class (gasing) and control class (conventional) obtained positive Ranks with a value of N 50, meaning that the entire sample experienced an increase in learning outcomes from pretest to posttest. Mean Ranks is 25,50 the Asymp. Sig. (2-taled) of 0,000. The Asymp. The sig value is less than 0.05, so it can be concluded that the hypothesis is accepted.

The radiomorphological appearance of the invasive margin in pancreatic cancer is associated with tumor budding

PurposePancreatic cancer (PDAC) is characterized by infiltrative, spiculated tumor growth into the surrounding non-neoplastic tissue. Clinically, its diagnosis is often established by magnetic resonance imaging (MRI). At the invasive margin, tumor buds can be detected by histology, an established marker associated with poor prognosis in different types of tumors.MethodsWe analyzed PDAC by determining the degree of tumor spiculation on T2-weighted MRI using a 3-tier grading system. The grade of spiculation was correlated with the density of tumor buds quantified in histological sections of the respective surgical specimen according to the guidelines of the International Tumor Budding Consensus Conference (n = 28 patients).Results64% of tumors revealed intermediate to high spiculation on MRI. In over 90% of cases, tumor buds were detected. We observed a significant positive rank correlation between the grade of radiological tumor spiculation and the histopathological number of tumor buds (rs = 0.745, p < 0.001). The number of tumor buds was not significantly associated with tumor stage, presence of lymph node metastases, or histopathological grading (p ≥ 0.352).ConclusionOur study identifies a readily available radiological marker for non-invasive estimation of tumor budding, as a correlate for infiltrative tumor growth. This finding could help to identify PDAC patients who might benefit from more extensive peripancreatic soft tissue resection during surgery or stratify patients for personalized therapy concepts.

Implementation of Archery Class Management at the Pre-Extracurricular Program Stage To Increase Elementary School Students' Interest

One of the non-academic extracurricular activities that can be developed in elementary schools is archery, because it has many benefits at the stage of student growth and development. This research is quantitative with a one group pretest-posttest pre-experimental design. The research was carried out at SD Muhammadiyah Jogokaryan with subjects aged 10-12 years. The sample was taken using a simple random sampling method in classes IV - VI totaling 15 students. The interest data collection technique is by giving a questionnaire before and after the implementation of the archery extracurricular pre-program. The implementation of the extracurricular archery pre-program is carried out by students practicing archery at a distance of 4-8 meters by shooting 6 arrows in each session and carried out in 12 sessions. The results of the Wilcoxon test on the output ranks have a negative rank value between the pre-test and post-test at a value (n) of 2, a mean rank of 3.50 and a sum rank of 7.00, meaning there is no decrease from the pre-test value to the post-test value. The positive rank value between the pre-test and post-test is a value (n) of 13, meaning that 13 students experienced an increase in interest scores from the pre-test score to the post-test score. The mean rank increase in value is 8.69 and the sum of ranks is 113.00. Meanwhile, the tie value is 0, meaning that there are no pairs of data that remain the same between the pre-test and post-test. Apart from that, it is known that the significance value is 0.003 &lt;0.05, meaning that there is a significant increase in the results of student interest scores between the pretest and posttest. Furthermore, based on the results of the n-gain score test, the average value is 0.58, so it is considered moderate effectiveness. The conclusion is that the implementation of archery class management at the pre-extracurricular program stage has a significant effect on increasing students' interest in participating in archery extracurriculars. However, the effectiveness of implementing archery training at the pre-extracurricular program stage in increasing interest is included in the moderate effectiveness category which is allegedly due to limited socialization and facilities and infrastructure for archery sports. The factors that influence archery performance include practice management, teaching methods, class management, and student interest. Meanwhile, teacher professionalism in classroom management also contributes significantly to the effectiveness of learning and increasing student interest. External support such as the school environment and parents also have a significant influence on student participation in extracurricular activities. Keywords: Class management, Pre-extracurricular program, Interest in archery, students.

Value of third-generation of VNCa dual-energy CT for differentiating diffuse marrow infiltration of multiple myeloma from red bone marrow.

This study aims to investigate the ability of bone marrow imaging using third-generation dual-energy computed tomography (CT) virtual noncalcium (VNCa) to differentiate between multiple myeloma (MM) with diffuse bone marrow infiltration and red bone marrow (RBM). Bone marrow aspiration or follow-up results were used as reference. We retrospectively reviewed 188 regions of interests (ROIs) from 21 patients with confirmed MM and diffuse bone marrow infiltrations who underwent VNCa bone marrow imaging between May 2019 and September 2022. At the same time, we obtained 98 ROIs from 11 subjects with RBM for comparative study, and 189 ROIs from 20 subjects with normal yellow bone marrow for the control group. The ROIs were delineated by 2 radiologists independently, the interobservers reproducibility was evaluated by interclass correlation coefficients. The correlation with MRI grade results was analyzed by Spearman correlation coefficient. Receiver operating characteristic (ROC) curve analysis was used to determine the optimal threshold for differentiating between these groups and to assess diagnostic performance. There were statistically significant differences in VNCa CT values of bone marrow among the MM, RBM, and control groups (all P < .001), with values decreasing sequentially. A strong positive rank correlation was observed between normal bone marrow, subgroup MM with moderately and severe bone marrow infiltration divided by MRI and their corresponding CT values (ρ = 0.897, 95%CI: 0.822 to 0.942, P < .001). When the CT value of VNCa bone marrow was 7.15 HU, the area under the curve (AUC) value for differentiating RBM and MM was 0.723, with a sensitivity of 50.5% and a specificity of 89.8%. When distinguishing severe bone marrow infiltration of MM from RBM, the AUC value was 0.80 with a sensitivity 70.9% and a specificity 78.9%. The AUC values for MM, RBM, and the combined group compared to the control group were all >0.99, with all diagnostic sensitivity and specificity exceeding 95%. VNCa bone marrow imaging using third-generation dual-energy CT accurately differentiates MM lesions from normal bone marrow or RBM. It demonstrates superior diagnostic performance in distinguishing RBM from MM with diffuse bone marrow infiltration.

Long-term outcomes of the Italian Mycobacterium avium subspecies paratuberculosis control programme for dairy cattle.

The considerable epidemiological and economic implications of paratuberculosis, caused by Mycobacterium avium subspecies paratuberculosis (MAP), have placed importance on control efforts aimed at preventing MAP transmission. In this context, Italy issued national guidelines for the control and status certification of MAP in dairy cattle in 2013. We assessed the long-term outcomes of the Italian MAP control programme for 14 dairy farms located in northern Italy by retrospectively reviewing the results of yearly serological tests, presence of clinical cases, MAP faecal shedding in serologically positive animals, farm management and health ranking as indicators of herd health between 2014 and 2021. A significantly higher number of serologically positive animals were observed between 2014 and 2016 than between 2017 and 2021, as well as an improving trend in the paratuberculosis health ranking for nine of the 14 farms. No clinical cases were reported. MAP shedding was detected in 9.4% of serologically positive animals. Discarding colostrum and prioritised culling of seropositive animals assisted by adoption of standardised serological testing were presumed to have a key role in MAP control, despite the reluctance of some farmers to address hygienic issues and improve the separation of calves from adult animals. The small number of farms included in this study and the fact that these were not randomly selected may limit the generalisability of the findings. The Italian paratuberculosis control plan has provided measures to limit the uncontrolled spread of MAP infection within and between herds by promoting animal trading between farms certified as negative or low risk.

Torsion phenomena for zero-cycles on a product of curves over a number field

For a smooth projective variety X over an algebraic number field k a conjecture of Bloch and Beilinson predicts that the kernel of the Albanese map of X is a torsion group. In this article we consider a product X=C1×⋯×Cd\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$X=C_1\ imes \\cdots \ imes C_d$$\\end{document} of smooth projective curves and show that if the conjecture is true for any subproduct of two curves, then it is true for X. For a product X=C1×C2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$X=C_1\ imes C_2$$\\end{document} of two curves over Q\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\mathbb {Q} $$\\end{document} with positive genus we construct many nontrivial examples that satisfy the weaker property that the image of the natural map J1(Q)⊗J2(Q)→εCH0(C1×C2)\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$J_1(\\mathbb {Q})\\otimes J_2(\\mathbb {Q})\\xrightarrow {\\varepsilon }{{\\,\ extrm{CH}\\,}}_0(C_1\ imes C_2)$$\\end{document} is finite, where Ji\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$J_i$$\\end{document} is the Jacobian variety of Ci\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$C_i$$\\end{document}. Our constructions include many new examples of non-isogenous pairs of elliptic curves E1,E2\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$E_1, E_2$$\\end{document} with positive rank, including the first known examples of rank greater than 1. Combining these constructions with our previous result, we obtain infinitely many nontrivial products X=C1×⋯×Cd\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$X=C_1\ imes \\cdots \ imes C_d$$\\end{document} for which the analogous map ε\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$\\varepsilon $$\\end{document} has finite image.

Spatial-temporal Evolution and Driving Factors Analysis of Ecological Environment Quality in Daihai Basin based on AWRSEI

Watersheds are an important ecological security barrier and social and economic development area. In order to evaluate the ecological environment quality of arid and semi-arid watersheds more objectively and accurately, based on the remote sensing ecological index (RSEI), the salinity index was introduced to construct a remote sensing ecological index (AWRSEI) suitable for arid and semi-arid watersheds, and the Daihai watershed was taken as an example to analyze its applicability. Based on the AWRSEI model, four phases of Landsat TM/OLI composite images were used to quantitatively evaluate the ecological and environmental quality of the Daihai Basin from 2001 to 2020. The spatio-temporal evolution of the ecological and environmental quality of the Daihai Basin was analyzed using the coefficient of variation and spatial autocorrelation, and the cause analysis and driving factor explanation power analysis were carried out using geographic detectors. The results showed that:① the average correlation coefficient between AWRSEI and various ecological factors was 0.860, which was more representative than that of a single index component. The load positive and negative values and ranking of the first principal component were consistent with those of RSEI, the contribution rate of eigenvalues was 3.69% higher than those of RSEI, and the evaluation results were closer to the real surface conditions, which is suitable for the ecological environment quality assessment of arid watersheds. ② The annual average of the AWRSEI index in the Daihai Basin from 2001 to 2020 was 0.427, which indicated a poor ecological environment quality basis. During the study period, the average of AWRSEI showed a fluctuating trend and reached the highest value of 0.502 in 2020. The overall ecological environment quality improved significantly, the deterioration area decreased by 20.51%, and the improvement area increased by 12.71%. In terms of spatial distribution, the ecological environment quality of forest land in the southern and northwestern high-altitude areas of the Daihai Basin was good, whereas that in the northern and southern mid-altitude areas was poor, and that in the northern area was better than that in the southern area. ③ The average variation coefficient of AWRSEI in the Daihai Basin was 0.280, the ecological environment quality was stable, and the overall change fluctuation was small; the high fluctuation was mainly concentrated in the southern part of the lake and the residential area. There was a significant spatial autocorrelation in the ecological environment quality of the Daihai Basin, and the high-high agglomeration area was mainly distributed in the forest area at high altitude and the cultivated land area at low altitude. Low-low concentration areas were scattered in the middle altitude area. ④ The improvement of the ecological environment in Daihai Basin from 2001 to 2020 was mainly due to the increase in NDVI and the decrease in NDBSI and NDSI. NDVI and NDBSI were the combination with the strongest interaction and the strongest interpretation of the ecological environment. Land use was the dominant factor of AWRSEI and had the strongest explanatory power. The combination of land use and meteorological factors was the strongest interaction, and the relationship between each driving factor was enhanced.

Koszul modules with vanishing resonance in algebraic geometry

We discuss various applications of a uniform vanishing result for the graded components of the finite length Koszul module associated to a subspace K⊆⋀2V\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$K\\subseteq \\bigwedge ^2 V$$\\end{document}, where V is a vector space. Previously Koszul modules of finite length have been used to give a proof of Green’s Conjecture on syzygies of generic canonical curves. We now give applications to effective stabilization of cohomology of thickenings of algebraic varieties, divisors on moduli spaces of curves, enumerative geometry of curves on K3 surfaces and to skew-symmetric degeneracy loci. We also show that the instability of sufficiently positive rank 2 vector bundles on curves is governed by resonance and give a splitting criterion.

Modification of velopharyngeal closure pressures during phonation by neuromuscular electrical stimulation in healthy individuals.

Rhinophonia aperta may result from velopharyngeal insufficiency. Neuromuscular electrical stimulation (NMES) has been discussed in the context of muscle strengthening. The aim of this study was to evaluate in healthy subjects whether NMES can change the velopharyngeal closure pattern during phonation and increase muscle strength. Eleven healthy adult volunteers (21-57 years) were included. Pressure profiles were measured by high resolution manometry (HRM): isolated sustained articulation of /a/ over 5 s (protocol 1), isolated NMES applied to soft palate above motor threshold (protocol 2) and combined articulation with NMES (protocol 3). Mean activation pressures (MeanAct), maximum pressures (Max), Area under curve (AUC) and type of velum reactions were compared. A statistical comparison of mean values of protocol 1 versus protocol 3 was carried out using the Wilcoxon signed rank test. Ordinally scaled parameters were analyzed by cross table. MeanAct values measured: 17.15±20.69 mmHg (protocol 1), 34.59±25.75 mmHg (protocol 3) on average, Max: 37.86±49.17 mmHg (protocol 1), 87.24±59.53 mmHg (protocol 3) and AUC: 17.06±20.70 mmHg.s (protocol 1), 33.76±23.81 mmHg.s (protocol 3). Protocol 2 produced velum reactions on 32 occasions. These presented with MeanAct values of 13.58±12.40 mmHg, Max values of 56.14±53.14 mmHg and AUC values of 13.84±12.78 mmHg.s on average. Statistical analysis comparing protocol 1 and 3 showed more positive ranks for MeanAct, Max and AUC. This difference reached statistical significance (p=0.026) for maximum pressure values. NMES in combination with articulation results in a change of the velopharyngeal closure pattern with a pressure increase of around 200% in healthy individuals. This might be of therapeutic benefit for patients with velopharyngeal insufficiency.

A Study to Assess the Knowledge and Attitude regarding Voluntary Blood Donation among College Going Male Students, a Quasi-experimental Study

Introduction: Voluntary blood donation in developing countries like India is constrained by misconception, fear, and widespread myths regarding blood donation.(1) Donated blood is an essential component in the management of many diseases. It is the main lifesaving for an individual with loss of large volumes of blood from accidents, hemorrhages or surgery.(2) Blood and its product demands is increasing, which can be ensured by increasing awareness and interest in blood donation in different groups of people. Youth is one of those groups. Misconception and low levels of awareness lead to unsatisfactory voluntary blood donation practices among them. The aim is to assess the knowledge and attitude of college students towards voluntary blood. Material and Methods: After prior permission from the College Authority, all the students who were present on the day of the study and who acknowledged their consent for participation were enrolled in the study. A pre-tested, semi-open-ended questionnaire was used as a study tool first as a pre-test to check their prior knowledge and attitude, followed by a health talk. Then, the same questionnaire was used to check their improvement of knowledge about blood donation. Results: As per the Wilcoxon rank test there is a significant improvement in the knowledge of study participants after health talk; out of a total 105 male students, 102 show positive rank (W+). Conclusion: Health education regarding voluntary blood donation is effective in improving the knowledge and attitude of youth. This will further improve the situation of voluntary blood donation by youth.

Pengaruh Pemberian Buah Kurma pada Ibu Hamil Trimester III dengan Anemia terhadap Kadar Hemoglobin

Anemia is an important health problem throughout the world. Approximately 51% of pregnant women suffer from anemia twice as often as non-pregnant women. Anemia in pregnancy is those who have Hb levels &lt;11 gr% in the first trimester and third trimester and Hb levels &lt;10.50 gr%. Dates are a food that contains high energy with an ideal composition, containing carbohydrates, tryptophan, omega-3, vitamin C, vitamin B6, Ca2+,Zn, and Mg. Research design with Quasi Experimental non-Equivalent control group design. The research sample size was 15 pregnant women.The research results showed that the hemoglobin level before giving dates was the lowest 9 gr/dL and the highest 15 gr/dL. And the average is 10 gr/dL. Hemoglobin level values after giving dates were the lowest, 11.5 gr/dL, the lowest and the highest, 16 gr/dL. And the average is 13 gr/dL. The Shapiro-Wilk value is 0.039 &lt; 0.05, so the data is not normal. Because the data was not normal, the test was continued with the non-parametric Wilcoxon test. Positive ranks 15 means that all 15 samples experienced an increase in HB from the previous value to the next value. Meanwhile, mean rank 8 is the average increase in HB. The positive number is 120,Ties 0 means there is no similarity in HB values before and after. This research concludes that there is an effect of giving dates on increasing hemoglobin levels in pregnant women.