Reasons for Utilizing Telemedicine during and after the COVID-19 Pandemic: An Internet-Based International Study

The COVID-19 pandemic challenges healthcare services. Concomitantly, this pandemic had a stimulating effect on technological expansions related to telehealth and telemedicine. We sought to elucidate the principal patients’ reasons for using telemedicine during the COVID-19 pandemic and the propensity to use it thereafter. Our primary objective was to identify the reasons of the survey participants’ disparate attitudes toward the use of telemedicine. We performed an online, multilingual 30-question survey for 14 days during March–April 2021, focusing on the perception and usage of telemedicine and their intent to use it after the pandemic. We analyzed the data to identify the attributes influencing the intent to use telemedicine and built decision trees to highlight the most important related variables. We examined 473 answers: 272 from Israel, 87 from Uruguay, and 114 worldwide. Most participants were women (64.6%), married (63.8%) with 1–2 children (52.9%), and living in urban areas (84.6%). Only a third of the participants intended to continue using telemedicine after the COVID-19 pandemic. Our main findings are that an expected substitution effect, technical proficiency, reduced queueing times, and peer experience are the four major factors in the overall adoption of telemedicine. Specifically, (1) for most participants, the major factor influencing their telemedicine usage is the implicit expectation that such a visit will be a full substitute for an in-person appointment; (2) another factor affecting telemedicine usage by patients is their overall technical proficiency and comfort level in the use of common web-based tools, such as social media, while seeking relevant medical information; (3) time saving as telemedicine can allow for asynchronous communications, thereby reducing physical travel and queuing times at the clinic; and finally (4) some participants have also indicated that telemedicine seems more attractive to them after watching family and friends (peer experience) use it successfully.

Beethoven's 'Kreutzer' Sonata: Nineteenth-century Art of Arrangement - One Piece, Three Ways

<p>Beethoven’s ‘Kreutzer’ Sonata transgressed the expectations – and likely captivated the minds – of early nineteenth-century musicians and audiences alike. The ‘Kreutzer’ is stylistically removed from his Op. 10 No. 1 composed less than six years earlier; it demands virtuosic technical proficiency from both performers. Through the combination of harmonic evasion playing on audience expectations in the first movement and the conversational interplay between the personalities of both performers and instrumental parts alike, this audacious work has fascinated the minds of both listener and critic from the 1803 premiere through to the modern day. In 1805 an Allgemeine musikalische Zeitung review suggested that it would require two virtuosi to study the work in order to communicate the ‘Groteskeste’ work to an audience – this is indicative of not just technical difficulty but also the importance of the dynamic relationship between the two partners of the duo to the ‘Kreutzer’. This highly charged relationship inspired Tolstoy and Prinet (and by extension Janacek and many twentieth-century film and multimedia artists) to create adaptations of ‘Kreutzer’. High-quality musical arrangements of ‘Kreutzer’ appeared as early as 1827, when Carl Czerny completed a four-hand version of ‘Kreutzer’. This was closely followed by an anonymous string quintet arrangement released by the Simrock publishing house in 1832. These arrangements translated the virtuosic sonata into different mediums for wider dissemination, making it more readily available to both musicians active in the chamber music scene, and domestic students and dilettantes proficient at the piano. Both arrangements manage to transform the ‘Kreutzer’ into a different format while retaining aspects of both the conversational relationship between musicians as well as the technical demands of Beethoven’s original sonata. The string quintet arrangement tends to fragment melodic ideas between parts, rather than transplanting entire phrases or providing a direct transcription – exceptions generally occurring at important transitions or particularly special moments. This generates a highly differentiated conversational landscape to that the original, which manifests also in the visual shift to five performers. While the arranger also reworks some of the piano writing into more idiomatic string writing, it still demands a high level of technical proficiency from all five players. The four-hand arrangement reworks the same dialogue and thematic ideas into a more intimate setting, taking an almost entirely opposite approach to the quintet. As the two instrumental parts are combined for one instrument, the difficulties from Beethoven’s piano part are divided quite literally between primo and secondo. In a similar manner, the conversational and thematic interplay resemble Beethoven’s original in a far more direct manner than the quintet. Although the four-hands medium is recognised more for study and wider transmission of concert pieces, it is difficult enough that the virtuosic essence of Beethoven’s ‘Kreutzer’ is maintained. This dissertation closely examines the relationship between the two instruments within Beethoven’s ‘Kreutzer’ Sonata, and the manner in which both the contemporary arrangements above maintain and alter that relationship through the transformation into another format. In addition, it explores why the textural and idiomatic changes in both arrangements – fundamental and ornamental – remove none of the virtuosic and captivating essence of Beethoven’s ‘Kreutzer’, while simultaneously allowing them to bridge the divide between the emergent nineteenth-century concert hall scene, close study of the score, and domestic music-making.</p>

Beethoven's 'Kreutzer' Sonata: Nineteenth-century Art of Arrangement - One Piece, Three Ways

<p>Beethoven’s ‘Kreutzer’ Sonata transgressed the expectations – and likely captivated the minds – of early nineteenth-century musicians and audiences alike. The ‘Kreutzer’ is stylistically removed from his Op. 10 No. 1 composed less than six years earlier; it demands virtuosic technical proficiency from both performers. Through the combination of harmonic evasion playing on audience expectations in the first movement and the conversational interplay between the personalities of both performers and instrumental parts alike, this audacious work has fascinated the minds of both listener and critic from the 1803 premiere through to the modern day. In 1805 an Allgemeine musikalische Zeitung review suggested that it would require two virtuosi to study the work in order to communicate the ‘Groteskeste’ work to an audience – this is indicative of not just technical difficulty but also the importance of the dynamic relationship between the two partners of the duo to the ‘Kreutzer’. This highly charged relationship inspired Tolstoy and Prinet (and by extension Janacek and many twentieth-century film and multimedia artists) to create adaptations of ‘Kreutzer’. High-quality musical arrangements of ‘Kreutzer’ appeared as early as 1827, when Carl Czerny completed a four-hand version of ‘Kreutzer’. This was closely followed by an anonymous string quintet arrangement released by the Simrock publishing house in 1832. These arrangements translated the virtuosic sonata into different mediums for wider dissemination, making it more readily available to both musicians active in the chamber music scene, and domestic students and dilettantes proficient at the piano. Both arrangements manage to transform the ‘Kreutzer’ into a different format while retaining aspects of both the conversational relationship between musicians as well as the technical demands of Beethoven’s original sonata. The string quintet arrangement tends to fragment melodic ideas between parts, rather than transplanting entire phrases or providing a direct transcription – exceptions generally occurring at important transitions or particularly special moments. This generates a highly differentiated conversational landscape to that the original, which manifests also in the visual shift to five performers. While the arranger also reworks some of the piano writing into more idiomatic string writing, it still demands a high level of technical proficiency from all five players. The four-hand arrangement reworks the same dialogue and thematic ideas into a more intimate setting, taking an almost entirely opposite approach to the quintet. As the two instrumental parts are combined for one instrument, the difficulties from Beethoven’s piano part are divided quite literally between primo and secondo. In a similar manner, the conversational and thematic interplay resemble Beethoven’s original in a far more direct manner than the quintet. Although the four-hands medium is recognised more for study and wider transmission of concert pieces, it is difficult enough that the virtuosic essence of Beethoven’s ‘Kreutzer’ is maintained. This dissertation closely examines the relationship between the two instruments within Beethoven’s ‘Kreutzer’ Sonata, and the manner in which both the contemporary arrangements above maintain and alter that relationship through the transformation into another format. In addition, it explores why the textural and idiomatic changes in both arrangements – fundamental and ornamental – remove none of the virtuosic and captivating essence of Beethoven’s ‘Kreutzer’, while simultaneously allowing them to bridge the divide between the emergent nineteenth-century concert hall scene, close study of the score, and domestic music-making.</p>

Assessing the Overall Impact of Data Analytics on Company Decision Making and Innovation

To assess the impact of big data analytics (BDA) on company decision making, data was collected from 225 company top managers and chief data officers in charge of the BDA group to empirically test this relationship. The data represents a sample of companies which have formally implemented BDA for at least three years with varying degrees of success. Despite considerable differences from company to company, on average the results corroborated the importance of the BDA function along four dimensions (BDA tools and methods, personnel technical proficiency, company readiness, and applications quality) in supporting company decision making toward business innovation. Managers responsible for implementing BDA in their companies should seriously consider these findings to improve the likelihood of success in their projects. The results also call for the identification of other potential determinants for BDA success as a tool for company innovation, as well as potential moderators and mediators for inclusion in a more comprehensive model.

​Management Practices Adopted by Farmers of Budgam in Rearing Kashmir Merino

Background: Kashmir Merino is a very important synthetic sheep breed of J and K. It is widely adopted across the Valley. It is an important source of income for the poor and marginalized farmers. An attempt was made to understand the management practices adopted by farmers of Budgam in rearing of Kashmir Merino sheep. Methods: A survey was undertaken in Budgam district understand the management practices used by farmers for rearing Kashmir Merino sheep. Result: Majority of the sheep farmers (68.42) housed Kashmir Merino sheep in Pucca house made of brick structures reinforced with either cement or mud whereas only (31.58%) housed sheep in Katcha houses. Breeding season ranges from April to May and August to December. Majority of the respondents (75.00%) reported autumn season as the main breeding season and only 25% reported spring as main breeding season. The sheep farmer was either having in possession small or marginal land holding. Sheep were reared on semi-intensive feeding systems during early spring and late autumn, intensive system during winter from December to April and extensive system from May to November. The vaccination against infectious diseases, dozing against prevalent parasites and treatment as per morbidity was carried out by expert veterinarians of Department of sheep Husbandry. Poor economic and low technical proficiency are main hurdles for farmers of Budgam to have good housing facilities to manage the breed. Management has significant effect on performance of sheep.

Teaching EndoFLIP Impedance Planimetry to Practicing Endoscopists: An “Into the Fire” Approach to Simulation

Background. There are growing interests from practicing endoscopists to implement the functional lumen imaging probe (FLIP) impedance planimetry system. We present a simulation-based curriculum using an “into the fire” approach with hands-on pre- and post-tests to teach the use of this technology. Methods. The curriculum consists of a series of pre-tests, didactic content, mentored hands-on instructions, and post-tests. Pre- and post-testing included a knowledge-based written test, a confidence survey, and an assessment form specific to the hands-on performance of FLIP. Result. Twenty-two practicing physicians completed the curriculum. After course completion, participants had improved knowledge-based written test scores from 6.8±1.7 to 8.9±0.9 ( P<0.001), confidence scores from 10.0±5.9 to 22.1±2.6 ( P<0.001), and hands-on performance score from 11.4±3.4 to 23.1±2.0 ( P<0.001) with significant improvement in all components of the hands-on skills. Conclusion. Our simulation curriculum is effective in improving confidence, knowledge, and technical proficiency when teaching the use of FLIP to practicing physicians.

Signal interruption in Baldwin City: Filling a communication vacuum in a small town “news desert”

This research sought to understand how the loss of a local newspaper impacts the community. Focus groups were conducted among a purposive sample of community leaders. The overall consensus was that residents miss having a single community information platform. Business owners lack an effective way to advertise. Respondents’ perception of the emerging communication platforms trying to fill the information void depends on the consumers’ technical proficiency and prior use of such platforms.

Tackler and ball-carrier technique during moderate and severe injuries (≥8 days lost) compared with player-matched and team-matched injury-free controls in Elite Rugby Union

ObjectiveTo analyse tackler and ball-carrier technical proficiency during moderate and severe contact injuries (≥8 days lost) in professional rugby union, and compare it with injury-free event-matched controls from the same player and from the same team.MethodsTechnical proficiency for 74 (n=74) (moderate and severe; ≥8 days lost) tackler and ball-carrier injuries during The Currie Cup (2014–2018) and 623 matched non-injury events (253 own controls, 370 team controls) were examined through video analysis using a standardised list of technical criteria.ResultsMean technical proficiency score for injured tacklers during front-on tackles was 6.19/16 (arbitrary units (AU) 95% CI 4.89 to 7.48), which was significantly different to their own controls (8.90/16 AU, 95% CI 8.37 to 9.43, p<0.001, effect size (ES)=1.21, large) and team controls (9.93/16 AU, 95% CI 9.50 to 10.40, p<0.001, ES=1.71, large). Mean technical proficiency score for injured ball-carriers during front-on tackles was 5.60/14 AU (95% CI 4.65 to 6.55), which was significantly different to their own controls (8.08/14 AU, 95% CI 7.56 to 8.60, p<0.001, ES=1.16, moderate) and team controls (8.16/14 AU, 95% CI 7.75 to 8.57, p<0.001, ES=1.25, large).ConclusionFor the tackler and ball-carrier, for both front-on and side-on/behind tackles, overall technical proficiency scores were significantly lower for the injury-causing event, when compared with the player’s own injury-free tackles and the team’s injury-free tackles. Through analysing player and team controls, player technique deficiencies for the injured player and player technique deficiencies that expose all players to injury were highlighted, which may inform injury prevention strategies and policies, and assist coaches in optimising training to reduce tackle injury risk.

Learning curves for transradial access versus transfemoral access in diagnostic cerebral angiography: a case series

BackgroundThe perception of a steep learning curve associated with transradial access has resulted in its limited adoption in neurointervention despite the demonstrated benefits, including decreased access-site complications.ObjectiveTo compare learning curves of transradial versus transfemoral diagnostic cerebral angiograms obtained by five neurovascular fellows as primary operator.MethodsThe first 100–150 consecutive transradial and transfemoral angiographic scans performed by each fellow between July 2017 and March 2020 were identified. Mean fluoroscopy time per artery injected (angiographic efficiency) was calculated as a marker of technical proficiency and compared for every 25 consecutive procedures performed (eg, 1–25, 26–50, 51–75).ResultsWe identified 1242 diagnostic angiograms, 607 transradial and 635 transfemoral. The radial cohort was older (64.3 years vs 62.3 years, p=0.01) and demonstrated better angiographic efficiency (3.4 min/vessel vs 3.7 min/vessel, p=0.03). For three fellows without previous endovascular experience, proficiency was obtained between 25 and 50 transfemoral angiograms. One fellow achieved proficiency after performing 25–50 transradial angiograms; and the two other fellows, in <25 transradial angiograms. The two fellows with previous experience had flattened learning curves for both access types. Two patients experienced transient neurologic symptoms postprocedure. Transradial angiograms were associated with significantly fewer access-site complications (3/607, 0.5% vs 22/635, 3.5%, p<0.01). Radial-to-femoral conversion occurred in 1.2% (7/607); femoral-to-radial conversion occurred in 0.3% (2/635). Over time, the proportion of transradial angiographic procedures increased.ConclusionTechnical proficiency improved significantly over time for both access types, typically requiring between 25 and 50 diagnostic angiograms to achieve asymptomatic improvement in efficiency. Reduced access-site complications and decreased fluoroscopy time were benefits associated with transradial angiography.

Refining field portable technology: quantification of arsenic field test kits

This thesis investigates issues related to the detection of arsenic from water sources and the analysis performed to quantify its presence. Through the literature it is shown that colourimetric means of analysis are essential, but current techniques suffer quantitatively, generally relying on a technicians’ ability to visually discern colour. An increased level of control, over the Gutzeit method, would serve to drastically improve the existing means of analysis. With reliance being placed on simple field portable technologies, considerable room has been left for misclassifications. Methodology and means of using these commercial products must therefore be tuned, if they are to be globally accepted as a means of quantification. This thesis compared both benchmark and colourimetric technologies, to redefine in-field analysis. Here the goals were to improve both the classification of arsenic concentrations in water and alleviate the need for technical proficiency. A framework was built under ideal conditions, moving away from the qualitative state of existing colourimetric analyses. A combination of cameras and imaging apparati were put to use, in the acquisition of colourimetric indicator images. MATLAB algorithms were applied to quantitatively discern samples with assembled calibration curves.