Search

In recent years, pedagogical design and practice have undergone a forced transformation that has brought many innovative methods and tools to the implementation process. The transition to online education has demanded new infrastructural solutions that have temporarily replaced traditional classroom practices. Most teachers seem to have adapted well to these new challenges. Learning support platforms and online teaching elements had to be harnessed by teachers who, in many cases, acquired this knowledge on their own, in awareness of their importance. Our study examines the need for digital learning support elements in primary schools of the German national minority in Hungary. Our research tools comprised an online questionnaire survey conducted in 2022. The goal of our study was to identify the problems that teachers faced in the transition to online teaching during the period of distance learning introduced due to the COVID pandemic in 2020 and since; the forms of support teachers received nationwide; and the measure of success in their work as language teachers. We also looked at the factors that influenced the digital elements being used. Finally, we examined whether teachers are still willing to use online learning support tools when returning to face-to-face teaching.

Abstract In early 2021, the United Kingdom (UK) had the highest per capita death rate from Covid-19 of any large country. Yet it had previously been ranked as one of the best prepared countries for a future pandemic. This gap between preparedness and performance has been the subject of intense debate, including as part of the UK Covid-19 Inquiry. In this paper, we contribute to this ongoing process of reflection by identifying the imagined public(s) within the UK’s scientific advice system. Drawing on scholarship in Science and Technology Studies (STS) that critiques framings of a singular or homogeneous ‘public’, we review meeting minutes and media briefings to reveal two imagined publics, co-constructed by the UK’s science advisors and policymakers in early 2020: first, a ‘freedom-loving’ public resistant to stringent policy interventions; and second, a public that was—in an echo of wartime rhetoric— ‘all in it together’. These imagined publics reflect a series of framing assumptions that help to make sense of the UK’s pandemic response. We focus particularly on the tensions between the homogeneous and multi-faceted imagined public, and the compound health and social inequalities that predated the pandemic but became starker and more visible as it unfolded. Our paper charts these tensions and demonstrates how these imagined publics went through stages of cohesion and fracture in the fraught early months of the pandemic. We conclude by considering the implications of this analysis for understanding the UK’s response to Covid-19, and for the future of scientific advice and emergency preparedness. Why does this matter? Studies of scientific advice reveal that how scientists and decision makers imagine the public and their concerns affect the communication of scientific advice, and the construction and value placed on relevant knowledge. Advisory scientists frame their models and their advice in terms of what they regard as politically possible.

Abstract Objective The concept of lines of therapy (LOT) in cancer treatment is often considered for decision making in tumor boards and clinical management, but lacks a common definition across medical specialties. The complexity and heterogeneity of malignancies and treatment modalities contribute to an inconsistent understanding of LOT among physicians. This study assesses the heterogeneity of understandings of the LOT concept, its major dimensions, and criteria from the perspective of physicians of different specialties with an oncological focus in Germany. Semi-structured expert interviews with nine physicians were conducted and evaluated using qualitative content analysis. Results Most interviewees agreed that there is no single definition for LOT and found it difficult to explicate their understanding. A majority of experts stated that they had already encountered misunderstandings with colleagues regarding LOT and that they had problems with deciphering LOT from the medical records of their patients. Disagreement emerged about the roles of the following within the LOT concept: maintenance therapy, treatment intention, different therapy modalities, changing pharmaceutical agents, and therapy breaks. Respondents predominantly considered the same criteria as decisive for the definition of LOT as for a change in LOT (e.g., the occurrence of a progression event or tumor recurrence).

In the face of rapid demographic transitions, Sub-Saharan African countries stand at a critical juncture where the potential for harnessing a demographic dividend to fuel economic growth is immense. This demographic shift presents both challenges and opportunities, with the right investments in health, education, and employment, countries can turn the growing youth population into a powerful engine for development, driving substantial and sustainable economic progress across the region. This study examines the demographic structure effect on economic growth in the context of structural changes in 26 sub-Saharan African countries. Using data from 1992 to 2019 in the PMG-ARDL, FMOLS, and DOLS estimates, we find that demographic structure has a positive influence on economic growth in the long run, which occurs through effective structural change, that is, structural changes that occur with an increase in labor productivity growth. Indeed, our results show that structural changes are relevant in transforming African youth debt into demographic dividends.

In this paper, the design and experimental validation of an active rectifier for ultrasound-based implanted biomedical devices are presented. One of the main contributions is the adoption of an optimized design procedure based on the $g_{m}/I_{D}$ of the transistors. Implemented in a 28-nm CMOS technology and powered by a 0.5-mm thickness and 1-mm2 surface area piezoelectric transducer, the rectifier delivers 1-mW of power to the output load. The adoption of a square wave to drive the transmitting power transducer is experimentally demonstrated to be more power effective. The rectifier exhibits a measured peak power conversion efficiency and a power density equal to 95% and 222mW/ $mm^{2}$ , respectively, revealing itself as the best trade-off between measured power conversion efficiency and power density within the literature of US-powered AC/DC converters.

PKM activities with the theme of religious harmony are very relevant and important to implement in the TTS area, especially in the city of Soe because this area has a very high level of religious diversity, so it is still vulnerable to harassment fromirresponsible members of the public with discriminatory actions, intimidation , provocateur issues that are capable of disturbing peace between religious communities. The purpose of the PKM activity is to educate the dimensions of religious harmony based on the ministry of religion's strategic plan for 2020-2024 for PAK teachers at State Senior High Schools in Soe City, TTS Regency. The method used in the PKM activities was Participatory Action Research through interaction with 15 PAK teachers from public high schools in Soe City, TTS Regency, and the data was analyzed reductively which presented the results of the PKM activities by the Study Program Lecturer Team. The Master of PAK-IAKNKupang emphasized to PAK teachers at Public High Schools throughout SoeCity that the application of the values of tolerance, equal rights, and cooperation between religious communities in the world of education, can be a solid foundation for building harmonious relations between religious communities and keeping away from negative behaviors that can divide national unity

Research aiming to explain disabled people's inequalities in the labour market has primarily focused on transitional factors between school and work, wage gaps, or socioeconomic background characteristics as explanations for (no-)entry in the labour market. There is a lack of longitudinal studies that map how disabled people fare in the labour market over time. Therefore, the objective of this paper is to identify, describe and predict stable employment paths of long-term disabled people. Our study employs detailed longitudinal data with total coverage of the Norwegian population -- we focus on 11 birth cohorts (1973-83) of disabled individuals and we follow their employment trajectories between the ages 20 and 34. To describe employment trajectories and create a typology of longitudinal labour market attachments, we employ sequence analysis and subsequently linear probability models to analyse the association between the disability's severity, gender, educational enrolment, early-work experience and employment trajectories. We identify four main types of trajectories: permanently work-disabled, stable employment, early marginalisation, and unstable employment. Our findings indicate that men are more likely than women to have stable employment trajectories. Starting higher education, as well as parental higher education, is linked with the likelihood of stable employment.

Shared mobilities, particularly carpooling, foster a paradox in Africa. While bush taxis have experienced historic success for the past 50 years due to traditional sharing practices transposed into public transport, modernization through digital platforms is struggling to take root in a sustainable way. This observation, highlighted through maps, underscores the recurring failures of initiatives taken in West Africa. Indeed, over the past 15 years, more than half of the companies created in this sector have been abandoned. In Grand-Nokoué, Benin, a qualitative and quantitative survey of 230 users combined with a documentary analysis at the West African level, makes it possible to understand their difficulties. Data from an immersion in the field reveals three major factors: a more flexible relationship to time without a culture of rigorous planning, out of step with the rational logic of platforms; a deeply rooted community conception of travel based on social proximity, contrary to sharing with strangers; a sense of insecurity towards outsiders and a primacy of individual comfort, contrary to the spirit of carpooling. The working classes, versed in ancestral practices of mutual aid in transport, could play a key role in the sustainable territorial anchoring of the new services. However, innovative initiatives in the field of platforms require strong political support, which is not yet acquired here, and, concurrently, a "progressive" familiarization that is still very much in progress.

BackgroundHand hygiene is crucial in health care centers and schools to avoid disease transmission. Currently, little is known about hand hygiene in such facilities in protracted conflict settings. ObjectiveThis protocol aims to assess the effectiveness of a multicomponent hand hygiene intervention on handwashing behavior, underlying behavioral factors, and the well-being of health care workers and students. Moreover, we report our methodology and statistical analysis plan transparently. MethodsThis is a cluster randomized controlled trial with 2 parallel arms taking place in 4 countries for 1 year. In Burkina Faso and Mali, we worked in 24 primary health care centers per country, whereas in Nigeria and Palestine, we focused on 26 primary schools per country. Facilities were eligible if they were not connected to a functioning water source but were deemed accessible to the implementation partners. Moreover, health care centers were eligible if they had a maternity ward and ≥5 employees, and schools if they had ≤7000 students studying in grades 5 to 7. We used covariate-constrained randomization to assign intervention facilities that received a hardware, management and monitoring support, and behavior change. Control facilities will receive the same or improved intervention after endline data collection. To evaluate the intervention, at baseline and endline, we used a self-reported survey, structured handwashing observations, and hand-rinse samples. At follow-up, hand-rinse samples were dropped. Starting from the intervention implementation, we collected longitudinal data on hygiene-related health conditions and absenteeism. We also collected qualitative data with focus group discussions and interviews. Data were analyzed descriptively and with random effect regression models with the random effect at a cluster level. The primary outcome for health centers is the handwashing rate, defined as the number of times health care workers performed good handwashing practice with soap or alcohol-based handrub at one of the World Health Organization 5 moments for hand hygiene, divided by the number of moments for hand hygiene that presented themselves during the patient interaction within an hour of observation. For schools, the primary outcome is the number of students who washed their hands before eating. ResultsThe baseline data collection across all countries lasted from February to June 2023. We collected data from 135 and 174 health care workers in Burkina Faso and Mali, respectively. In Nigeria, we collected data from 1300 students and in Palestine from 1127 students. The endline data collection began in February 2024. ConclusionsThis is one of the first studies investigating hand hygiene in primary health care centers and schools in protracted conflict settings. With our strong study design, we expect to support local policy makers and humanitarian organizations in developing sustainable agendas for hygiene promotion. Trial RegistrationClinicalTrials.gov NCT05946980 (Burkina Faso and Mali); https://www.clinicaltrials.gov/study/NCT05946980 and NCT05964478 (Nigeria and Palestine); https://www.clinicaltrials.gov/study/NCT05964478 International Registered Report Identifier (IRRID)DERR1-10.2196/52959

This phenomenographic study explores international master’s degree students’ ways of experiencing support in Finnish higher education. The study draws on Schlossberg’s Transition Model and the Culturally Engaging Campus Environments Model as a conceptual framework. The phenomenographic analysis of 17 interviews with international master’s degree students identified four ways of experiencing support as: (a) study system adjustment, (b) learning enhancement, (c) personal growth, and (d) autonomy development. The findings identified participants’ experiencing support in relationships, use of information, communication, services, the flexibility of studies, learning and study environments. The presence of two indicators, Humanizing Educational Environments and Availability of Holistic Support suggested that the campus environment was culturally responsive to academic and personal support of international degree students. The findings contribute to the understanding of support for international degree students in higher education and may be used to develop services to support international degree students’ social, cultural, and career integration into host communities.

The student body in many higher education institutions (HEIs) has become more international, although student services are often offered in a generic one-size fits all approach. Traditionally, student services served as a key indicator of student satisfaction and influenced the mobility of international students' choices regarding study programme, HEI, and country of study. However, recent research shows that student services are becoming less important in these regards. Most services offered to international students relate to the student academic experience. In this paper the authors focus on Student Development Theories (SDT) as a way to increase the understanding of how to improve international students' academic success and integration. While there are frameworks in other parts of the world (e.g. students as partners) containing similar elements, the authors contend SDT is substantially different because as a theoretical framework it acknowledges how students develop holistically, as well as what factors and environmental conditions can facilitate their development. The authors argue using SDT as a framework can provide a developmental and holistic approach to international student services. More specifically, they present models viewing student development from the multiple domains, all of which tailor programmes designed for student "success," and "social and academic integration."

Abstract Background It has long been noted that the chain from identification of need (research gap) to impact in the real world is both long and tortuous. This study aimed to contribute evidence about research ethics and governance arrangements and processes in the UK with a focus on: what works well; problems; impacts on delivery; and potential improvements. Methods Online questionnaire widely distributed 20th May 2021, with request to forward to other interested parties. The survey closed on 18th June 2021. Questionnaire included closed and open questions related to demographics, role, study objectives. Results Responses were received from 252 respondents, 68% based in universities 25% in the NHS. Research methods used by respondents included interviews/focus groups (64%); surveys/questionnaires (63%); and experimental/quasi experimental (57%). Respondents reported that participants in the research they conducted most commonly included: patients (91%); NHS staff (64%) and public (50%). Aspects of research ethics and governance reported to work well were: online centralised systems; confidence in rigorous, respected systems; and helpful staff. Problems with workload, frustration and delays were reported, related to overly bureaucratic, unclear, repetitive, inflexible and inconsistent processes. Disproportionality of requirements for low-risk studies was raised across all areas, with systems reported to be risk averse, defensive and taking little account of the risks associated with delaying or deterring research. Some requirements were reported to have unintended effects on inclusion and diversity, particularly impacting Patient and Public Involvement (PPI) and engagement processes. Existing processes and requirements were reported to cause stress and demoralisation, particularly as many researchers are employed on fixed term contracts. High negative impacts on research delivery were reported, in terms of timescales for completing studies, discouraging research particularly for clinicians and students, quality of outputs and costs. Suggested improvements related to system level changes / overall approach and specific refinements to existing processes. Conclusions Consultation with those involved in Health Services Research in the UK revealed a picture of overwhelming and increasing bureaucracy, delays, costs and demoralisation related to gaining the approvals necessary to conduct research in the NHS. Suggestions for improvement across all three areas focused on reducing duplication and unnecessary paperwork/form filling and reaching a better balance between risks of harm through research and harms which occur because research to inform practice is delayed or deterred.

Abstract When applying echo-Doppler imaging for either clinical or research purposes it is very important to select the most adequate modality/technology and choose the most reliable and reproducible measurements. Quality control is a mainstay to reduce variability among institutions and operators and must be obtained by using appropriate procedures for data acquisition, storage and interpretation of echo-Doppler data. This goal can be achieved by employing an echo core laboratory (ECL), with the responsibility for standardizing image acquisition processes (performed at the peripheral echo-labs) and analysis (by monitoring and optimizing the internal intra- and inter-reader variability of measurements). Accordingly, the Working Group of Echocardiography of the Italian Society of Cardiology decided to design standardized procedures for imaging acquisition in peripheral laboratories and reading procedures and to propose a methodological approach to assess the reproducibility of echo-Doppler parameters of cardiac structure and function by using both standard and advanced technologies. A number of cardiologists experienced in cardiac ultrasound was involved to set up an ECL available for future studies involving complex imaging or including echo-Doppler measures as primary or secondary efficacy or safety end-points. The present manuscript describes the methodology of the procedures (imaging acquisition and measurement reading) and provides the documentation of the work done so far to test the reproducibility of the different echo-Doppler modalities (standard and advanced). These procedures can be suggested for utilization also in non referall echocardiographic laboratories as an "inside" quality check, with the aim at optimizing clinical consistency of echo-Doppler data.

Abstract Background The combination of early transmitral inflow velocity and mitral annular tissue Doppler imaging (E/Em ratio) is widely applied to noninvasively estimate left ventricular (LV) filling pressures. However E/Em ratio has a significant gray zone and its accuracy in patients with heart failure is debated. Left atrial (LA) deformation analysis by speckle tracking echocardiography (STE) was recently proposed as an alternative approach to estimate LV filling pressures. This study aimed at exploring the correlation of LA longitudinal function by STE and Doppler measurements with direct measurements of LV filling pressures in patients with heart failure. Methods A total of 36 patients with advanced systolic heart failure (ejection fraction ≤35%), undergoing right heart catheterization, were studied. Simultaneously to pulmonary capillary wedge pressure (PCWP) determination, peak atrial longitudinal strain (PALS) and mean E/Em ratio were measured in all subjects by two independent operators. PALS values were obtained by averaging all segments (global PALS), and by separately averaging segments measured in the 4-chamber and 2-chamber views. Results Not significant correlation was found between mean E/Em ratio and PCWP (R = 0.15). A close negative correlation between global PALS and the PCWP was found (R = -0.81, p < 0.0001). Furthermore, global PALS demonstrated the highest diagnostic accuracy (AUC of 0.93) and excellent sensitivity and specificity of 100% and 93%, respectively, to predict elevated filling pressure using a cutoff value less than 15.1%. Bland-Altman analysis confirmed this close agreement between PCWP estimated by global PALS and invasive PCWP (mean bias 0.1 ± 8.0 mmHg). Conclusion In a group of patients with advanced systolic heart failure, E/Em ratio correlated poorly with invasively obtained LV filling pressures. However, LA longitudinal deformation analysis by STE correlated well with PCWP, providing a better estimation of LV filling pressures in this particular clinical setting.

Abstract Hypertrophic cardiomyopathy (HCM) is one of the most common inherited cardiomyopathy. The identification of patients with HCM is sometimes still a challenge. Moreover, the pathophysiology of the disease is complex because of left ventricular hyper-contractile state, diastolic dysfunction, ischemia and obstruction which can be coexistent in the same patient. In this review, we discuss the current and emerging echocardiographic methodology that can help physicians in the correct diagnostic and pathophysiological assessment of patients with HCM.

(1) Background: The objective of this analysis was to evaluate the device usage rates and patterns of use regarding Tumor-Treating Fields (TTFields) for patients with malignant pleural mesothelioma (MPM) throughout the US. (2) Methods: We evaluated de-identified data from 33 patients with MPM enrolled in FDA-required HDE protocols at 14 institutions across the US from September 2019 to March 2022. (3) Results: The median number of total TTFields usage days was 72 (range: 6–649 days), and the total treatment duration was 160 months for all patients. A low usage rate (defined as less than 6 h per day, 25%) was observed in 34 (21.2%) months. The median TTFields usage in the first 3 months was 12 h per day (range: 1.9–21.6 h), representing 50% (range: 8–90%) of the potential daily duration. The median TTFields usage after 3 months decreased to 9.1 h per day (range: 3.1–17 h), representing 38% (range: 13–71%) of the daily duration, and was lower than usage in the first 3 months (p = 0.01). (4) Conclusions: This study represents the first multicenter analysis of real-world TTFields usage based on usage patterns for MPM patients in clinical practice. The real-world usage level was lower than the suggested daily usage. Further initiatives and guidelines should be developed to evaluate the impact of this finding on tumor control.

Abstract Background The role of speckle tracking in the assessment of left atrial (LA) deformation dynamics is not established. We sought to determine the feasibility and reference ranges of LA longitudinal strain indices measured by speckle tracking in a population of normal subjects. Methods In 60 healthy individuals, peak atrial longitudinal strain (PALS) and time to peak longitudinal strain (TPLS) were measured using a 12-segment model for the left atrium. Values were obtained by averaging all segments (global PALS and TPLS) and by separately averaging segments measured in the two apical views (4- and 2-chamber average PALS and TPLS). Results Adequate tracking quality was achieved in 97% of segments analyzed. Inter and intra-observer variability coefficients of measurements ranged between 2.9% and 5.4%. Global PALS was 42.2 ± 6.1% (5–95° percentile range 32.2–53.2%), and global TPLS was 368 ± 30 ms (5–95° percentile range 323–430 ms). The 2-chamber average PALS was slightly higher than the 4-chamber average PALS (44.3 ± 6.0% vs 40.1 ± 7.9%, p < 0.0001), whereas no differences in TPLS were found (p = 0.93). Conclusion Speckle tracking is a feasible technique for the assessment of longitudinal myocardial LA deformation. Reference ranges of strain indices were reported.

Abstract Background Few data exist regarding the direct effects of caffeine and smoking on cardiac function. We sought to explore the acute effects of caffeine assumption, cigarette smoking, or both on left ventricular (LV) and right ventricular (RV) function in a population of young normal subjects. Methods Forty-five healthy subjects aged 25 ± 2 years underwent echocardiography. Fifteen of them were non-smokers and habitual coffee consumers (group 1), 15 were smokers and not habitual coffee consumers (group 2), and 15 were smokers and habitual coffee consumers (group 3). Peak systolic (Sa), early diastolic Ea, and late diastolic (Aa) velocity of mitral annulus were measured by pulsed Tissue Doppler, and left atrioventricular plane displacement was determined by M-mode. Tricuspid annular velocities and systolic excursion (TAPSE) were also determined. Measurements were performed at baseline and after oral assumption of caffeine 100 mg in group 1, one cigarette smoking in group 2, and both in group 3. Results No changes in ventricular function were observed in group 1 after caffeine administration. In group 2, cigarette smoking yielded an acute increase in mitral Aa (+12.1%, p = 0.0026), tricuspid Sa (+9.8%, p = 0.012) and TAPSE (+7.9%, p = 0.017), and a decrease in the mitral Ea/Aa ratio (-8.5%, p = 0.0084). Sequential caffeine assumption and cigarette smoking in group 3 was associated with an acute increase in mitral Aa (+13.0%, p = 0.015) and tricuspid Aa (+11.6%, p < 0.0001) and a reduction in mitral Ea/Aa ratio (-8.5%, p = 0.0084) tricuspid Ea (-6.6%, p = 0.048) and tricuspid Ea/Aa ratio (-9.6%, p = 0.0003). In a two-way ANOVA model controlling for hemodynamic confounding factors, changes in the overall population remained significant for mitral Aa and Ea/Aa ratio, and for tricuspid Aa and Ea/Aa ratio. Conclusion In young healthy subjects, one cigarette smoking is associated to an acute impairment in LV diastolic function and a hyperdynamic RV systolic response. Caffeine assumption alone does not exert any acute effect on ventricular long-axis function, but potentiates the negative effect of cigarette smoking by abolishing RV supernormal response and leading to a simultaneous impairment in both LV and RV diastolic function.

This explorative substudy aimed at determining the effect of inhaled xenon on left ventricular function by echocardiography in comatose survivors of out-of-hospital cardiac arrest.DesignA randomized two-group single-blinded phase 2 clinical drug trial.SettingA multipurpose ICU in two university hospitals.PatientsOf the 110 randomized comatose survivors after out-of-hospital cardiac arrest with a shockable rhythm in the xenon in combination with hypothermia after cardiac arrest trial, 38 patients (24-76 yr old) with complete echocardiography were included in this study.InterventionsPatients were randomized to receive either inhaled xenon combined with hypothermia (33°C) for 24 hours or hypothermia treatment alone. Echocardiography was performed at hospital admission and 24 ± 4 hours after hypothermia.Measurements and main resultsLeft ventricular ejection fraction, myocardial longitudinal systolic strain, and diastolic function were analyzed blinded to treatment. There were 17 xenon and 21 control patients in whom echocardiography was completed. Clinical characteristics did not differ significantly between the groups. At admission, ejection fraction was similar in xenon and control patients (39% ± 10% vs 38% ± 11%; p = 0.711) but higher in xenon than control patients after hypothermia (50% ± 10% vs 42% ± 10%; p = 0.014). Global longitudinal systolic strain was similar in xenon and control patients at admission (-9.0% ± 3.8% vs -8.1% ± 3.6%; p = 0.555) but better in xenon than control patients after hypothermia (-14.4.0% ± 4.0% vs -10.5% ± 4.0%; p = 0.006). In patients with coronary artery disease, longitudinal strain improved in the nonischemic myocardial segments in xenon patients. There were no changes in diastolic function between the groups.ConclusionsAmong comatose survivors of a cardiac cause out-of-hospital cardiac arrest, inhaled xenon combined with hypothermia was associated with greater recovery of left ventricular systolic function in comparison with hypothermia alone.

Early work experience is found to be an influential factor in young people's transitions from school to work. Still, we know little about whether early work experience can protect vulnerable young people from subsequent exclusion from labour and education in early adulthood. Our objective is therefore to examine how early work experience in adolescence influences the risk of being NEET (Not in Education, Employment or Training), and whether this relationship is stronger for early school leavers and young disabled people. We utilise Norwegian register data covering the entire 1985-birth cohort, followed from age 16 to 29 (n [approximately] 50 000). Linear probability models are used to estimate the NEET risk at age 25 and age 29. The findings reveal that early work experience is related to a lower NEET risk for everyone, but more strongly for the young people with disabilities or early school leaving. The findings support early work experience as a potentially important protective factor against subsequent NEET status, particularly among vulnerable young people.

Abstract Background The ultrasonic industry has recently produced echocardiographic Hand Held Devices (miniaturized, compact and battery-equipped echocardiographic systems). Their potential usefulness has been successfully assessed in a wide range of clinical conditions. The aim of the study was to verify if the routine use of a basic model of echocardiographic Hand Held Device (HHD) could be an important diagnostic tool during outpatient cardiologic consulting or in non-cardiologic hospital sections. Methods 87 consecutive patients were included in this study; they underwent routine physical examination, resting ECG and echocardiographic evaluation using a basic model of HHD performed by trained echocardiographists; the cardiologist, whenever possible, formulated a diagnosis. The percentage of subjects in whom the findings were judged reasonably adequate for final diagnostic and therapeutic conclusions was used to quantify the "conclusiveness" of HHD evaluation. Successively, all patients underwent a second echocardiographic evaluation, by an examiner with similar echocardiographic experience, performed using a Standard Echo Device (SED). The agreement between the first and the second echocardiographic exam was also assessed. Results Mean examination time was 6.7 ± 1.5 min. using HHD vs. 13.6 ± 2.4 min. using SED. The echocardiographic examination performed using HHD was considered satisfactory in 74/87 patients (85.1% conclusiveness). Among the 74 patients for whom the examination was conclusive, the diagnosis was concordant with that obtained with the SED examination in 62 cases (83.8% agreement). Conclusion HHD may generally allow a reliable cardiologic basic evaluation of outpatient or subjects admitted to non-cardiologic sections, more specifically in particular subgroups of patients, with a gain in terms of time, shortening patient waiting lists and reducing healthy costs.

In this paper the design of regulated active rectifiers (RARs) is addressed, with emphasis on energy harvesting applications. After an insightful overview of the main topologies of RARs, the analytical models are discussed and extended. Then, a data-driven comparison is carried out which, however, does not allows an absolute ranking between the different topologies. Then, a general Verilog-A model of the active rectifier is introduced and extended to simulate and compare the different regulation schemes. Unlike the data-driven comparison, the simulations based on the proposed Verilog-A models allows concluding that the PWM regulation scheme is more suitable for applications requiring an input power lower than about 1mW, whereas the Reconfigurable (1X/0X) is more effective for input power levels in the range 1mW-10mW. The adoption of the developed models allows a huge reduction of the simulation time, equal to 7X for the open loop active rectifier and about 100X for the regulated mode. The accuracy of the proposed model has been extensively verified against transistor-level simulations, showing an error lower than 5% in all conditions. The proposed model is useful during the design phase to select the rectifier topology and control scheme during the design phase and also to reduce the simulation time during pre-silicon verification on complex mixed-signal systems.

A simple yet effective approach to improve the linearity of the transconductor-capacitor ( $G_{m}-C$ ) filters is proposed without any area or power overhead. Following a generalized nodal analysis, the transconductors of classical filter topology are rewired such that their input differential voltage lies within the linear regime. The effectiveness of the proposed method is validated through the design and simulation of a fifth-order Butterworth low-pass filter (LPF) in a standard 65-nm CMOS process. The proposed filter implementation occupies 0.0164 mm2 (0.003 mm2/pole) die area and consumes 167- $\mu \text{W}$ for the cut-off frequency of 1-MHz. Operating at 1-V voltage supply, it shows an in-band total harmonic distortion (THD) of −49.14 dB for 200-mV peak-to-peak 1MHz differential voltage. An in-band 3rd-order intercept point (IIP3) of 9.36 dBm is also achieved with an in-band spurious-free-dynamic range (SFDR) greater than 53-dB, all of which reflect meaningful improvements relative to the classical architecture and despite the modest linearity performance of the internal $G_{m}$ stages.

Abstract Background Dental caries and Obesity in children are issues of public health concern. Even though researching the relationship between these two noncommunicable diseases has been conducted for many years, the results remain equivocal. This paper aimed to examine the association between dental caries and obesity among 12-year-old schoolchildren living in war-affected environment in Benghazi. Methods A secondary analysis of a cross-sectional study was conducted to determine the prevalence of caries among 12-year-old school children in Benghazi in 2017 during the armed conflict that affected the city. The data extracted for the analysis included sociodemographic of the participants (gender, maternal education and school type), caries experience (DMFT index), and anthropometric measures (height in cm, weight in kg, BMI and Z score for BMI). Comparisons of anthropometric measures were conducted according to caries experience. Linear regression models were developed to determine the association between Body Mass Index and Z score as outcome variables, caries as an explanatory variable, and covariates (gender, maternal education and school type). Beta coefficient (β) and 95% confidence intervals were calculated. All statistical tests were conducted at p ≤ 0.05. Results There were 782 children with a mean (SD) BMI of 20.7 SD5.09 and an average z (SD) score of 0.56 SD1.51. Also, 159 (20%) children had obesity. No significant association was observed between caries and anthropometric measures. However, higher BMI was observed in children from a private school (p ≤ 0.001***), females (p ≤ 0.001***) and self-reported regular sugary drinks consumers (p ≤ 0.001***). Conclusion The present study shows no significant association between dental caries and anthropometric measures. However, the study findings support the notion of tackling sugar intake as a common risk factor for caries and obesity, which should be encouraged in the Libyan culture.