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Author(s):  
Ayeh Shamsadini ◽  
Somayeh Bagheri-Kelayeh

Background and Objective: Co-occurring central sleep apnea (CSA) and obstructive sleep apnea (OSA) are a developing apprehension because many patients referred to sleep studies have co-morbidities such as cardiovascular and/or neurological disorders which increase the possibility of central and obstructive episodes. Here, we report a patient without excessive daytime sleepiness and a combination of CSA and OSA. Case Report: We present a 16-year-old boy with a history of snoring, poor quality of sleep, nightmare, sleep walking, and sleep talking since he was two-years old. His STOP-Bang score was 7. Standard attended polysomnography (PSG) with audio-video monitoring was performed. The PSG results contained Apnea Hypopnea Index (AHI): 30.2 (number of OSAs was 50 and number of CSAs was 49 during sleep). Then, a titration study was performed and continuous positive airway pressure (CPAP) setting as low as eight cmH2O was effective in eliminating obstructive events, but there was emerging CSAs in favour of Treatment Emergent CSA (TCSA). Conclusion: This case represents a non-sleepy phenotype of OSA in combination with many CSAs in PSG. We suggest that further studies be performed on the association between the concomitant presence of CSA and OSA among nonsleepy patients with OSA.


Animals ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 3348
Author(s):  
Laura Falchi ◽  
Maria Teresa Zedda ◽  
Salvatore Pau ◽  
Mauro Ledda ◽  
Valentino Melosu ◽  
...  

In ovine species, transcervical artificial insemination (TCAI) is limited by the poor quality of frozen–thawed semen and by the convoluted cervical lumen hampering the passage of inseminating devices. The aim of the study was to test the efficiency of three newly designed catheters with bent tips of 3.5 mm, 5.0 mm or 8.0 mm in terms of reproductive performances (experiment 1) and to compare the results of TCAI with the best performing catheter of experiment 1 to those obtained in ewes submitted to surgical incision of cervical folds (SICF) prior to insemination (experiment 2). The following parameters were assessed: time to pass the cervix; depth of cervical penetration; site of deposition of semen; pregnancy (PR); and lambing rates (LR). The results of experiment 1 indicated that the 5.0 mm tip catheter resulted in deeper and faster TCAI and higher PR and LR compared to 3.5 mm and 8.0 mm tip catheters (p < 0.05). In experiment 2, TCAI with the 5.0 mm catheter did not differ from TCAI after SICF in terms of depth of semen deposition, time to pass the cervix, PR and LR (p < 0.05). In conclusion, the use of a catheter that allowed transcervical uterine deposition of semen without excessive manipulation led to satisfactory pregnancy rates.


2021 ◽  
Author(s):  
◽  
Alexander Deng

<p>Microwave backhaul networks are the dominant technology used to connect together access and core networks for their flexibility and cost-effectiveness in deployment. Unfortunately, microwave backhaul networks are susceptible to interference and are statically managed leading to poor Quality of Service (QoS) in the form of high delays and loss as well as being inefficient on energy. The use of Software Defined Networking (SDN) is proposed to address these problems by dynamically managing resources to work around the interference and remove static allocations. Two new algorithms, CUT and OptiCUT were designed to compute an optimal topology, to minimise loss and delay while at the same time reducing power consumption.</p>


2021 ◽  
Author(s):  
Fantu Abebe Eyowas ◽  
Marguerite Schneider ◽  
Shitaye Alemu ◽  
Sanghamitra Pati ◽  
Fentie Ambaw Getahun

Abstract Background Multimorbidity, the presence of two or more chronic non-communicable diseases (NCDs) in a given person affects all aspects of individuals’ lives. Poor quality of life (QoL) is one of the major consequences of living with multimorbidity. Although healthcare aims to support multimorbid individuals to achieve better quality of life, little is known about the effect of multimorbidity on quality of life of patients attending chronic outpatient medical care in Ethiopia. Objectives This study aimed to determine the association between multimorbidity and quality of life among clients attending chronic outpatient medical care in Bahir Dar city, Northwest Ethiopia. Methods A multi-centered facility-based study was conducted among 1440 participants aged 40+ years attending chronic outpatient medical care. Two complementary methods (interview and review of medical records) were employed to collect data on sociodemographic characteristics and presence of chronic diseases. We used the short form (SF-12 V2) instrument to measure quality of life. The data were analyzed by STATA V.16 and multivariate partial proportional odds model was fitted to identify covariates associated with quality of life, adjusting for relevant confounding factors. Statistical significance was considered at p-value <0.05.Results Multimorbidity was identified in 54.8% (95% CI=52.2%-57.4%) of the sample. A significant proportion (33.5%) of the study participants had poor quality of life and one fourth (25.8%) of them had moderate quality of life. Advanced age and living with multimorbidity were associated with poor quality of life. Conversely, being female, strong social support, high socioeconomic status, and adequate functioning and satisfaction with care were the variables positively associated with higher categories of quality of life.Conclusion The magnitude of multimorbidity in this study was high and individuals living with multimorbidity had a relatively poor quality of life than those without multimorbidity. Care of people with chronic multiple conditions may need to be oriented to the realities in multimorbidity burden and its implication on quality of life. Interventions targeting modifiable associated factors and studies exploring the longitudinal effect of multimorbidity on quality of life are needed.


2021 ◽  
Author(s):  
◽  
Alexander Deng

<p>Microwave backhaul networks are the dominant technology used to connect together access and core networks for their flexibility and cost-effectiveness in deployment. Unfortunately, microwave backhaul networks are susceptible to interference and are statically managed leading to poor Quality of Service (QoS) in the form of high delays and loss as well as being inefficient on energy. The use of Software Defined Networking (SDN) is proposed to address these problems by dynamically managing resources to work around the interference and remove static allocations. Two new algorithms, CUT and OptiCUT were designed to compute an optimal topology, to minimise loss and delay while at the same time reducing power consumption.</p>


2021 ◽  
Author(s):  
Danny Mvula Muanga Badila ◽  
Sphindile Nonhle Mapumulo ◽  
Christiane Horwood ◽  
Vaughn Mitchell John ◽  
Mala Ali Mapatano

Abstract Background: Contravention of prisoners’ basic human rights, over-crowding, poor living conditions, food insecurity, disease and lack of access to medical care in prisons constitute a serious public health concern in many low-income countries in Africa, including the Democratic Republic of Congo (DRC). This study aimed to explore prisoners’ experiences of food insecurity and strategies prisoners employ to overcome food insecurity in two prisons in Kinshasa, DRC.Methods: A qualitative study was conducted among 31 prisoners, both men and women. In-depth interviews were conducted in N’dolo and Makala prisons by two researchers in the local language (Lingala). For security reasons of prisoners interviews were not audio recorded, however, interviewers took thorough notes during interviews. Thematic analysis was used to analyze dataResults: Prisoners in both prisons described experiences of food insecurity. Food was normally served once a day, late in the afternoon. Prisoners complained about a monotonous diet, and that the food was of poor quality, inadequate quantity, and was unhygienically prepared. Most prisoners relied on outside support from family and friends for food provision, but those who did not have such support endured hunger and severe food insecurity. Prisoners employed different coping strategies to manage their hunger, which strategies they described for less severe, severe and very severe food insecurity depending on what they had to do to survive. Strategies included prisoners sharing food with each other, drinking water throughout the day, selling their belongings to buy food, begging food from visitors, looking for food in rubbish bins, or exchanging sex for food.Conclusion: Urgent attention is needed to improve nutrition and living conditions in Congolese prisons. All stakeholders need to formulate a comprehensive plan that will address issues faced by prisoners and improve their quality of life. Regular inspection of prisons is essential to ensure prisoners are treated fairly and their human rights are respected.


2021 ◽  
Author(s):  
Andrew Hill ◽  
Manya Mirchandani ◽  
Leah Ellis ◽  
Victoria Pilkington

Abstract Background Ivermectin is an antiparasitic drug being investigated in clinical trials for the prevention of COVID-19. However, there are concerns about the quality of some of these trials. Objectives To conduct a meta-analysis with randomised controlled trials of ivermectin for the prevention of COVID-19, while controlling for the quality of data. Methods We conducted a sub-group analysis based on the quality of randomised controlled trials evaluating ivermectin for the prevention of COVID-19. Quality was assessed using the Cochrane Risk of Bias measures (RoB 2) and additional checks on raw data, where possible. Results Four studies were included in the meta-analysis. One was rated as being potentially fraudulent, two as having a high risk of bias and one as having some concerns for bias. Ivermectin did not have a significant effect on preventing RT-PCR confirmed COVID-19 infection. Ivermectin had a significant effect on preventing symptomatic COVID-19 infection in one trial with some concerns of bias, but this result was based on post-hoc analysis of a multi-arm study. Conclusions This meta-analysis demonstrates that the currently available randomised trials evaluating ivermectin for the prevention of COVID-19 are insufficient and of poor quality.


2021 ◽  
Vol 6 ◽  
Author(s):  
Adekunle Adedeji ◽  
Tosin Yinka Akintunde ◽  
Erhabor S. Idemudia ◽  
Elhakim Ibrahim ◽  
Franka Metzner

Poor social integration is associated with poor quality of life among minority groups. The current study hypothesized that trust and sociability may significantly explain the quality of life performance among Sub-Saharan African migrants in Germany. Data from 518 migrants were analyzed. Hierarchical multiple linear regression models were calculated to assess the predictive effect of trust and sociability on aggregate quality of life. Results show that general trust and sociability explained about 21% of the variance in quality of life score (adjusted R2 = .206; p &lt; .001) for the total sample. Socioeconomic and demographic features suggested an added predictive effect of about 8% for total sample (adjusted R2 = .279; p &lt; .001), 10% for male (adjusted R2 = .322; p &lt; .001) and 4% for female (adjusted R2 = .211; p &lt; .001). The results support trust and sociability as essential in connecting to a new environment and enhancing the quality of life.


Author(s):  
Ofeimu, Josiah (Ph.D) ◽  

The study examined the management of secondary education for functional leadership, values re-orientation and sustainable national development in Nigeria. The descriptive survey design was adopted. The population comprised 142 principals of public junior and senior secondary schools in Edo Central Senatorial District of Nigeria. The entire population was used. The questionnaire was used for data collection and was validated by experts. The test-re-test reliability method was used and a reliability coefficient of 0.76 was obtained. The mean and percentage were used for data analysis. The study found that corruption, poor funding, get-rich quick syndrome among the youths, cultism, poor management of resources by school administrators, poor quality of teaching staff, low quality leadership by school heads, teachers being poor role model, lack of parental support in the area of students’ discipline and political instability were problems affecting management of the education system. It was recommended that the curriculum of the school should be re-adjusted and premium placed on values and dignity in hard work and that the quality of the teachers and instructors must be enhanced through in-service training.


Author(s):  
Zhicheng Guo ◽  
Cheng Ding ◽  
Xiao Hu ◽  
Cynthia Rudin

Abstract Objective. Wearable devices equipped with plethysmography (PPG) sensors provided a low-cost, long-term solution to early diagnosis and continuous screening of heart conditions. However PPG signals collected from such devices often suffer from corruption caused by artifacts. The objective of this study is to develop an effective supervised algorithm to locate the regions of artifacts within PPG signals. Approach. We treat artifact detection as a 1D segmentation problem. We solve it via a novel combination of an active-contour-based loss and an adapted U-Net architecture. The proposed algorithm was trained on the PPG DaLiA training set, and further evaluated on the PPG DaLiA testing set, WESAD dataset and TROIKA dataset. Main results. We evaluated with the DICE score, a well-established metric for segmentation accuracy evaluation in the field of computer vision. The proposed method outperforms baseline methods on all three datasets by a large margin (≈ 7 percentage points above the next best method). On the PPG DaLiA testing set, WESAD dataset and TROIKA dataset, the proposed method achieved 0.8734±0.0018, 0.9114±0.0033 and 0.8050±0.0116 respectively. The next best method only achieved 0.8068±0.0014, 0.8446±0.0013 and 0.7247±0.0050. Significance. The proposed method is able to pinpoint exact locations of artifacts with high precision; in the past, we had only a binary classification of whether a PPG signal has good or poor quality. This more nuanced information will be critical to further inform the design of algorithms to detect cardiac arrhythmia.


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