bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of subchondral bone marrow lesion localisation with weight bearing pain in people with knee osteoarthritis: data from the Osteoarthritis Initiative
Authors: Aso Koji , Shahtaheri Seyed Mohsen , McWilliams Daniel F. , Walsh David A.
Published: January 2021

Background Subchondral bone marrow lesions (BMLs) detected on MRI in knee osteoarthritis (OA) are associated with knee pain. The prevalence and progression of subchondral BMLs are increased by mechanical knee load. However, associations of subchondral BML location with weight-bearing knee pain are currently unknown. In this study, we aim to demonstrate associations of subchondral BML location and size with weight-bearing knee pain in knee OA.Methods We analyzed 1412 and 582 varus knees from cross-sectional and longitudinal Osteoarthritis Initiative datasets, respectively. BML scores were semi-quantitatively analysed with the MRI Osteoarthritis Knee Score for 4 subchondral regions (median and lateral femorotibial, medial and lateral patellofemoral) and subspinous region. Weight-bearing and non-weight-bearing pain scores were derived from WOMAC pain items. Correlation and negative binomial regression models were used for analysis of associations between the BML scores and pain at baseline, and changes in the BML scores and changes in pain after 24-month follow up.Results Greater BML scores at medial femorotibial and lateral patellofemoral compartments were associated with greater weight-bearing pain scores, and statistical significance was retained after adjusting for BML scores at the other 4 joint compartments and other OA features, as well as for non-weight-bearing pain, age, sex and Body Mass Index (BMI) (medial femorotibial; B=0.08, p=0.02. patellofemoral; B=0.13, p=0.01). Subanalysis revealed that greater medial femorotibial BML scores were associated with greater pain on walking and standing (B=0.11, p=0.01, and B=0.10, p=0.04, respectively). Lateral patellofemoral BML scores were associated with pain on climbing, respectively B=0.14, p=0.02. Increases or decreases over 24 months in BML score in the medial femorotibial compartment were significantly associated with increases or decreases in weight-bearing pain severity after adjusting for non-weight-bearing pain, age, sex, baseline weight-bearing pain, BMI, and BML at the other 4 joint compartments (B=0.10, p=0.01). Conclusions Subchondral BML size at the medial femorotibial joint compartment was specifically associated with the severity and the change in weight-bearing pain, independent of non-weight-bearing pain, in knee OA. Specific associations of weight-bearing pain with subchondral BMLs in weight-bearing compartments of the knee indicate that BMLs in subchondral bone contribute to biomechanically-induced OA pain.
The association of priori and posteriori dietary patterns with the risk of incident hypertension: Tehran Lipid and Glucose Study
Authors: Ramezankhani Azra , Hosseini-Esfahani Firoozeh , Mirmiran Parvin , Azizi Fereidoun , Hadaegh Farzad
Published: January 2021

Background: The aim of this study was to investigate the association of dietary patterns with incident hypertension.Materials/methods: This prospective study was conducted on 4793 individuals of Tehran lipid and glucose study participants, aged ≥18 years who were followed for a median of 6.3 years from 2008-11 to 2016-18. A valid and reliable semi-quantitative food frequency questionnaire was used to assess usual dietary intakes. Anthropometrics and blood pressure were assessed at baseline and during follow up examinations. Dietary patterns were derived using principal component analysis (PCA). Healthy eating index (HEI) and dietary approach to stop hypertension (DASH) score were measured based on dietary recommendations. Time-dependent Cox models adjusting for confounders were used to examine the association between dietary patterns and the risk of hypertension.Results: During follow-up, a total of 727 incident cases of hypertension were identified. The mean±SD age at baseline was 40.3±13.5 and 37.9±12.1 years in men and women, respectively. Two dietary patterns (the healthy and unhealthy) were extracted by PCA. Compared with participants in the first quartile, a 23% (HR: 1.23; 95%CI: 1.00-1.53; P trend: 0.056) increased risk of hypertension was found in the fourth quartile of HEI score. This association was disappeared after further adjustment for confounders. Increasing DASH score, the healthy and unhealthy dietary pattern were not associated with risk of hypertension.Conclusion: Our findings showed that higher adherences to the posteriori- and priori-dietary patterns were not associated with risk of hypertension in this population.
Examination On Level Of Scale Efficiency In Public Hospitals In Tanzania
Authors: Fumbwe Fatuma , Lihawa Robert , Andrew Felician , Kinyanjui George , Mkuna Eliaza
Published: January 2021

Purpose:Tanzania has implemented policies that aim at improvinghealth sector performance as well as the general health status of citizens. Establishment of community insurance fund, increase government budget allocation in health sector, establishment of institutions for critical and special diseases like Tanzania Ocean road cancer institute, Muhimbili Orthopaedic Institute and many other that aim at improving sector efficiency. These efforts and policies had a direct impact on improving the health sector and achieving Sustainable Development Goals (SDGs). Despite these improvement efforts, the health sector continues to face enormous challenges. Among the major challenges identified is the level of inefficiencies in healthcare delivery. It is for this reason; this paper examines the scale efficiency level in Tanzania’s public hospitals.Methods:Using data from the Ministry of Health, this paper employs the Data Envelopment Analysis (DEA) to examine Tanzania’s public hospital efficiency levels.Results:Findings showed that the average scale efficiency was 78.6%.and 72.9%for regional and district hospitals respectively. Additionally, 43.8% of the regional referral hospitals attained the most productive scale size compared to 21.05% in district hospitals.Conclusion: The study concludes that there is dire need for the ministry of health to consider resource reallocation across public hospitals. Periodic re-estimation of efficiency levels coupled with increased health care input injection is of urgent need.
Molecular characterization of G6PD mutations reveals the high frequency of G6PD Aures in the Lao Theung population
Authors: Sanephonasa Amkha , Cheepsunthorn Chalisa Louicharoen , Khaminsou Naly , Savongsy Onekham , Nuchprayoon Issarang , Leecharoenkiat Kamonlak
Published: January 2021

Background The prevalence and genotypes of G6PD deficiency vary worldwide, with higher prevalence in malaria endemic areas. The first-time assessment of G6PD deficiency prevalence and molecular characterization of G6PD mutations in the Lao Theung population were performed in this study. Methods A total of 252 unrelated Lao Theung participants residing in the Lao People's Democratic Republic (PDR) were recruited. All participant samples were tested for G6PD enzyme activity and G6PD gene mutations. The amplification refractory mutation system (ARMS)-PCR for detecting G6PD Aures was developed.Results The G6PD mutations were detected in 11.51% (29/252) of the participants. Eight G6PD mutations were detected. The G6PD Aures was the most common mutation identified in this cohort, which represented 58.62 % (17/29) of all mutation. The mutation pattern was homogenous, predominantly involving the G6PD Aures mutation (6.75%), followed by 1.19% G6PD Union and 0.79% each G6PD Jammu, G6PD Mahidol and G6PD Kaiping. One subject (0.4%) each carried G6PD Viangchan and G6PD Canton. Interestingly, one case of coinheritance of G6PD Aures and Quing Yan was detected in this cohort. Based on levels of G6PD enzyme activity, the prevalence of G6PD deficiency in the Lao Theung population was 9.13 % (23/252). The prevalence of G6PD deficient males and females (activity < 30 %) in the Lao Theung population was 6.41 % (5/78) and 1.72 % (3/174), respectively, and the prevalence of G6PD intermediate (activity 30-70 %) was 5.95 % (15/252).Conclusion The G6PD Aures mutation is highly prevalent in the Lao Theung ethnic group. The common G6PD variants in continental Southeast Asian populations, G6PD Viangchan, Canton, Kaiping, Union and Mahidol, were not prevalent in this ethnic group. The technical simplicity of the developed ARMS-PCR will facilitate the final diagnosis of the G6PD Aures.
Sorafenib as a Second-Line Treatment in Metastatic Renal Cell Carcinoma in Mexico: A Prospective Cohort Study
Authors: Martin-Aguilar Ana Elena , Núñez-López Haidé Nayeli , Ramirez-Sandoval Juan C.
Published: January 2021

Background: Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI).Methods: A prospective observational cohort in Mexico (2012–2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12–16 weeks.Results: The mean age of the cohort was 59 years (interquartile range [IQR] 50-72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6 months (95% confidence interval [CI]: 6.7–10.5) and 40 months (95% CI: 34.5–45.4) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 58.2–83.8). On multivariable analyses, age >65 years was associated with a longer PFS (HR 0.51; 95% CI: 0.31-0.86; p = 0.018). The median PFS in subjects aged >65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2–18.8] vs. 7.2 months [95% CI: 5.3–9.1]; p = 0.012). Adverse events grade ≥3 associated with sorafenib occurred in 38 (29%) patients.Conclusion: Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects >65 years old.
Survey of Perceptions and Educational Needs of Primary Care Providers Regarding Management of Patients with Class II and III Obesity in Ontario, Canada
Authors: Zevin Boris , Martin Mary Imelda , Dalgarno Nancy , Chan Linda , Sivapalan Nardhana , Houlden Robyn , Birtwhistle Richard , Smith Karen , Barber David
Published: January 2021

Background: Primary care providers (PCPs) are typically the primary contact for patients with obesity seeking medical and surgical weight loss interventions; however, previous studies suggest that fewer than 7% of eligible adult patients are referred to publically funded medical and surgical weight loss interventions (MSWLI)Methods: We performed an anonymous survey study between October 2017 and June 2018 to explore the knowledge, experiences, perceptions, and educational needs of PCPs in Southeastern Ontario in managing patients with class II and III obesity. Results: Surveys were distributed to 591 PCPs (n=538 family physicians; n=53 nurse practitioners) identified as practicing in the Southeastern Ontario and 103 (15.6%) participated. PCPs serving a rural population estimated that 14.2±10.9% of patients would qualify for MSWLI compared to 9.9±8.5% of patients of PCPs serving an urban population (p=.049). Overall, 57.5% of respondents did not feel competent prescribing MSWLI to patients with class II/III obesity, while 69.8% stated they had ‘good’ knowledge of the referral criteria for MSWLI. 22.2% of respondents were hesitant to refer patients for bariatric surgery (BS) due to concerns about postoperative surgical complications and risks associated with surgery. Only 25% of respondents were comfortable providing long-term follow up after BS, and only 39.1% had participated in continuing education on management of patients with class II/III obesity in the past five years. Conclusion: The majority of PCPs believe there is a need for additional education about MSWLI for patients with class II/III obesity. Future studies are needed to develop and compare the effectiveness of additional education and professional development around risks of contemporary BS, indications to consider referral for MSWLI, management and long-term follow-up of patients after BS.
Differences in the clinical characteristics and outcomes of COVID-19 patients in the epicenter and peripheral areas of the pandemic from China: a retrospective, large-sample, comparative analysis
Authors: Wang Gang , Luo Feng Ming , Liu Dan , Liu Jia Sheng , Wang Ye , Chen Hong , Tian Pan Wen , Fan Tao , Tang Li , Yu He , Wang Lan , Feng Mei , Ni Zhong , Wang Bo , Song Zhi Fang , Wu Xiao Ling , Wang Hong Jun , Tong Xiang , Xue Miao , Lei Xian Ying , Long Bo , Jia Chao , Xiao Jun , Shang Juan , Xiong Nian , Luo Jian Fei , Liang Zong An , Li Wei Min
Published: January 2021

Background: There is limited information on the difference in epidemiology, clinical characteristics and outcomes of the initial outbreak of the coronavirus disease (COVID-19) in Wuhan (the epicenter) and Sichuan (the peripheral area) in the early phase of the COVID-19 pandemic. This study was conducted to investigate the differences in the epidemiological and clinical characteristics of patients with COVID-19 between the epicenter and peripheral areas of pandemic and thereby generate information that would be potentially helpful in formulating clinical practice recommendations to tackle the COVID-19 pandemic.Methods: The Sichuan & Wuhan Collaboration Research Group for COVID-19 established two retrospective cohorts that separately reflect the epicenter and peripheral area during the early pandemic. The epidemiology, clinical characteristics and outcomes of patients in the two groups were compared. Multivariate regression analyses were used to estimate the adjusted odds ratios (aOR) with regard to the outcomes.Results: The Wuhan (epicenter) cohort included 710 randomly selected patients, and the peripheral (Sichuan) cohort included 474 consecutive patients. A higher proportion of patients from the periphery had upper airway symptoms, whereas a lower proportion of patients in the epicenter had lower airway symptoms and comorbidities. Patients in the epicenter had a higher risk of death (aOR=7.64), intensive care unit (ICU) admission (aOR=1.66), delayed time from illness onset to hospital and ICU admission (aOR=6.29 and aOR=8.03, respectively), and prolonged duration of viral shedding (aOR=1.64). Conclusions: The worse outcomes in the epicenter could be explained by the prolonged time from illness onset to hospital and ICU admission. This could potentially have been associated with elevated systemic inflammation secondary to organ dysfunction and prolonged duration of virus shedding independent of age and comorbidities. Thus, early supportive care could achieve better clinical outcomes.
Genomic variation in the American pika: signatures of geographic isolation and implications for conservation
Authors: Klingler Kelly Brie , Jahner Joshua P , Parchman Thomas L , Ray Chris , Peacock Mary
Published: January 2021

Background: Distributional responses by alpine taxa to repeated, glacial-interglacial cycles throughout the last two million years have significantly influenced the spatial genetic structure of populations. These effects have been exacerbated for the American pika (Ochotona princeps), a small alpine lagomorph constrained by thermal sensitivity and a limited dispersal capacity. As a species of conservation concern, long-term lack of gene flow has important consequences for landscape genetic structure and levels of diversity within populations. Here, we use reduced representation sequencing (ddRADseq) to provide a genome-wide perspective on patterns of genetic variation across pika populations representing distinct subspecies. To investigate how landscape and environmental features shape genetic variation, we collected genetic samples from distinct geographic regions as well as across finer spatial scales in two geographically proximate mountain ranges of eastern Nevada. Results: Our genome-wide analyses corroborate range-wide, mitochondrial subspecific designations and reveal pronounced fine-scale population structure between the Ruby Mountains and East Humboldt Range of eastern Nevada. Populations in Nevada were characterized by low genetic diversity (𝜋=0.0006–0.0009; 𝜃W=0.0005–0.0007) relative to populations in California (𝜋=0.0014–0.0019; 𝜃W=0.0011–0.0017) and the Rocky Mountains (𝜋=0.0025–0.0027; 𝜃W=0.0021–0.0024), indicating substantial genetic drift in these isolated populations. Tajima’s D was positive for all sites (D=0.240-0.811), consistent with recent contraction in population sizes range-wide. Conclusions: Substantial influences of geography, elevation and climate variables on genetic differentiation were also detected and may interact with the regional effects of anthropogenic climate change to force the loss of unique genetic lineages through continued population extirpations in the Great Basin and Sierra Nevada.
Root canal curvature as a prognostic factor influencing the diagnostic accuracy of radiographic working length determination and postoperative canal axis modification: An in vitro comparative study. 
Authors: Faraj Bestoon
Published: January 2021

Background: Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique. Methods: Radiographic image analysis were performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10-25o) and severe canal curvature (26-70o). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real working length was established by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland). Results: There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P >0.05). Conclusion:  A standardized digital periapical radiographic method performed similarly to the CBCT technique closest to its real canal length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.
A Revealed Preference Analysis to Develop Composite Scores Approximating Lung Allocation Policy in the U.S.
Authors: Stewart Darren E , Wood Dallas W , Alcorn James B , Lease Erika D , Hayes Michael , Hauber Brett , Goff Rebecca E
Published: January 2021

Background: The patient ranking process for donor lung allocation in the United States is carried out by a classification-based, computerized algorithm, known as the match system. Experts have suggested that a continuous, points-based allocation framework would better serve waiting list candidates by removing hard boundaries and increasing transparency into the relative importance of factors used to prioritize candidates. We applied discrete choice modeling to match run data to determine the feasibility of approximating current lung allocation policy by one or more composite scores. Our study aimed to demystify the points-based approach to organ allocation policy; quantify the relative importance of factors used in current policy; and provide a viable policy option that adapts the current, classification-based system to the continuous allocation framework.Methods: Rank ordered logistic regression models were estimated using 6,466 match runs for 5,913 adult donors and 534 match runs for 488 pediatric donors from 2018. Four primary attributes are used to rank candidates and were included in the models: (1) medical priority, (2) candidate age, (3) candidate’s transplant center proximity to the donor hospital, and (4) blood type compatibility with the donor.Results: Two composite scores were developed, one for adult and one for pediatric donor allocation. Candidate rankings based on the composite scores were highly correlated with current policy rankings (Kendall’s Tau ~0.80, Spearman correlation >90%), indicating both scores strongly reflect current policy. In both models, candidates are ranked higher if they have higher medical priority, are registered at a transplant center closer to the donor hospital, or have an identical blood type to the donor. Proximity was the most important attribute. Under a points-based scoring system, candidates in further away zones are sometimes ranked higher than more proximal candidates compared to current policy. Conclusions: Revealed preference analysis of lung allocation match runs produced composite scores that capture the essence of current policy while removing rigid boundaries of the current classification-based system. A carefully crafted, continuous version of lung allocation policy has the potential to make better use of the limited supply of donor lungs in a manner consistent with the priorities of the transplant community.
Experience and practice of the Emergency Operations Center, Chinese Center for Disease Control and Prevention: A case study of response to the H7N9 outbreak 
Authors: DING FAN , Li Qun , Jin Lianmei
Published: January 2021

Background: Emergency Operations Center (EOC) is a place to provide response to public health emergencies. Chinese Center for Disease Control and Prevention (China CDC)’s EOC was officially established in 2016, which has been the core department for the public health emergencies and risk response. In recent years, we have been continuously improving the function of EOC through many incidents. In the study, we hope to share the construction status, operation management experience of China CDC’s EOC and the response process in the human avian influenza A (H7N9) outbreak.Main text: The China CDC’s EOC mainly focus on building the five core elements including sites/places and facilities, information and data, plans and procedures, training and exercises, and logistics. Based on summarizing previous emergency response, the China CDC’s EOC established its own incident management and the standardized response procedures. The event-specific data, context-specific data and event management data could be obtained through various source. The logistics department of the EOC also provides comprehensive support. And that the well-trained staff is another necessary conditions for its operation. Through sharing the response process of H7N9 outbreak, it further explains the EOC’s functions in the five phases of outbreak response, such as the formulation of the incident response framework, monitoring, personnel dispatch and resource mobilization.Conclusions: The EOC contributes to faster and more efficient responses during emergencies which enable a greater reduction in morbidity and mortality. Compared with the traditional incident response process, under the command and coordination of China CDC’s EOC, each group involved in the response has a clearer goal, responsibilities and tasks at each stage. Meanwhile, each group also gave full play to its own expertise and advantages. As a whole, incident response tended to be more specialized and precise, which generally improves the efficiency of incident response. However, different countries and regions have different response processes to the events. We still suggested that appropriate emergency operation plan should be made according to the complexity of incident response in the region when constructing response mechanism, through our experience. And the China CDC’s EOC is still at growing and groping phase.
 Improvement of urinary tract symptoms and quality of life in Benign Prostate Hyperplasia patients associated with consumption of a newly developed whole tomato-based food supplement. A phase II prospective, randomized double-blinded, placebo-controlled study.
Authors: Cormio Luigi , Calò Beppe , Falagario Ugo , Iezzi Manuela , Lamolinara Alessia , Vitaglione Paola , Silecchia Giovanni , Carrieri Giuseppe , Fogliano Vincenzo , Iacobelli Stefano , Natali Pier Giorgio , Piantelli Mauro
Published: January 2021

Background: Benign prostatic hyperplasia (BPH) is the most common urologic disease among elderly men. The diagnosis of BPH is usually driven by lower urinary tract symptoms (LUTS) that can significantly affect patients’ quality of life. This phase II prospective, randomized double-blinded, placebo-controlled study aimed to determine the efficacy and safety of a novel whole tomato-based food supplement on LUTS of patients diagnosed with BPH.Methods: Forty consecutive patients with histologically proved BPH were randomized 1:1 to receive daily for two months a sachet (5 grams) of a newly developed whole tomato food supplement (WTFS) (treatment = Group A) or placebo (Group B). Patients were asked to fill the International Prostatic Symptom Score (IPSS) questionnaire before and after treatment.Results: All but 1 patient in Group B successfully completed the scheduled regimen. No side effects were recorded. Unlike placebo, treatment significantly reduced (P < 0.0002) LUTS since mean IPSS decreased from 9.05+1.15 to 7.15+1.04 (paired t-test, two-tailed P-value < 0.001), and improved life quality (P < 0.0001). A trend toward a reduction of total PSA levels was observed in WTFS treated patients (8.98 ng/mL+1.52 vs 6.95+0.76, P = 0.065), with changes being statistically significant only in the subgroup of patients with baseline levels above 10 ng/mL (18.5 ng/mL+2.7 vs 10.3+2.1, P = 0.009)Conclusions: The new WTFS may represent a valid option for the treatment of symptomatic BPH patients. Unlike pharmacological treatments, the supplement is side effects free and highly accepted among patients
Physician-led prehospital management is associated with reduced mortality in severe blunt trauma patients: A retrospective analysis of the Japanese nationwide trauma registry
Authors: Endo Akira , Kojima Mitsuaki , Uchiyama Saya , Shiraishi Atsushi , Otomo Yasuhiro
Published: January 2021

Background: Although the results of previous studies suggested the effectiveness of physician-led prehospital trauma management, it has been uncertain because of the limited number of high-quality studies. Furthermore, the advantage of physician-led prehospital management might have been overestimated due to the shortened prehospital time by helicopter transportation in some studies. The present study aimed to evaluate the effect of physician-led prehospital management independent of prehospital time. Also, subgroup analysis was performed to explore the subpopulation that especially benefit from physician-led prehospital management.Methods: This retrospective cohort study analyzed the data of Japan’s nationwide trauma registry. Severe blunt trauma patients, defined by Injury Severity Score (ISS) ≥16, who were transported directly to a hospital between April 2009 and March 2019 were evaluated. In-hospital mortality was compared between groups dichotomized by the occupation of primary prehospital healthcare provider (i.e., physician or paramedic), using 1:4 propensity score-matched analysis. The propensity score was calculated using potential confounders including patient demographics, mechanism of injury, vital signs at the scene of injury, ISS, and total time from injury to hospital arrival. Subpopulations that especially benefit from physician-led prehospital management were explored by assessing interaction effects between physician-led prehospital management and patient characteristics.Results: A total of 30,551 patients (physician-led: 2,976, paramedic-led: 27,575) were eligible for analysis, of whom 2,690 propensity score-matched pairs (physician-led: 2,690, paramedic-led: 10,760) were generated and compared. Physician-led group showed significantly decreased in-hospital mortality than paramedic-led group (in-hospital mortality: 387 [14.4%] and 1,718 [16.0%]; odds ratio [95% confidence interval] = 0.88 [0.78–1.00], p = 0.044). Patients with age <65 years, ISS ≥25, Abbreviated Injury Scale in pelvis and lower extremities ≥3, and total prehospital time <60 min were likely to benefit from physician-led prehospital management.Conclusions: Physician-led prehospital trauma management was significantly associated with reduced in-hospital mortality independent of prehospital time. The findings of exploratory subgroup analysis would be useful for the future research to establish efficient dispatch system of physician team.
Miniature Head Lettuce Yield and Anthocyanin Concentration under High Tunnels and the Field in Georgia
Authors: O’Connell Suzanne
Published: January 2021

This study evaluated the yield of eight miniature lettuce (Lactuca sativa) cultivars (i.e., mini-lettuce) grown under organically managed high tunnels compared with a field system during two spring seasons in Georgia. Mini-lettuce required an average of 36 to 40 days to harvest in both systems with a 86% to 97% marketability rate. The high tunnels provided a heat gain on the coldest days, decreased leaf wetness, and resulted in a lower daily light integral compared with the field. In 2015, mini-lettuce yields were similar between the high tunnel and field, but in 2016, yields were greater under the high tunnels. In 2016 only, there was a significant system by cultivar interaction for yield, suggesting that the high tunnels provided a yield increase for ‘Baby Green Oakleaf’ and ‘Spretnak’ mini-lettuce. Differences in the daily light integral between the high tunnels and field appeared to affect the accumulation of anthocyanins in red-pigmented mini-lettuce. Anthocyanin concentrations were 26% to 194% greater in mini-lettuce grown in the field compared with under high tunnels. The cultivar Rhazes had the greatest anthocyanin concentrations of all red-pigmented mini-lettuce evaluated but also lower yields.
PERSEPSI MAHASISWA IAIN TULUNGAGUNG TERHADAP PELAKSANAAN PROGRAM MAGANG DI MTSN 2 KOTA BLITAR
Authors: Fahrudin Ahmad , Fauziah Arbaul
Published: January 2021

Abstract: The aim of this study was to evaluate the perceptions of IAIN Tulungagung students on the implementation of the internship program at MTSN 2 Blitar. This study was conducted on March to November 2020. This study used a qualitative approach and secondary data was analyzed descriptively and exploratively. The informants in this study were students of the Tarbiyah and Teacher Training Faculty (FTIK) IAIN Tulungagung who carried out the Internship program 1 and 2 at MTsN 2 Blitar, East Java. Data were collected using questionnaires, observation, documentation, and interviews. As much as 92% of students stated that there was preparation or provision of apprenticeship program at IAIN Tulungagung before the students went to the field. At the same percentage, students claimed to be happy in carrying out an internship program. This was indicated by the existence of special preparations every day before entering the class which was stated by 84% of students. All students (100%) had high enthusiasm for teamwork. According to 84% of students, this was triggered by the atmosphere in the partner institutions to support the implementation of internships. Thus, all students (100%) can conduct socialization in a flexible manner with the school. Even though the implementation of internship was well, there were 30% of students who stated that there were obstacles in its implementation. The condition caused the dissatisfaction was felt by 23% of students. As many as 76% of students stated that there were administrative tasks and as many as 69% of students stated that there were several other tasks given by the school during the internship.

Keywords: enthusiasm, internship, student, perception
Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm – findings from the DALSC cohort
Authors: Evald Therese A. , Møhl Bo
Published: January 2021

Background:

Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed.

Method:

Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence.

Results:

The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation.

Limitations:

i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias.

Conclusion:

The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3–7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.
Spatial structure of unstable normal modes in a glass-forming liquid
Authors: Shimada Masanari , Coslovich Daniele , Mizuno Hideyuki , Ikeda Atsushi
Published: January 2021

The phenomenology of glass-forming liquids is often described in terms of their underlying, high-dimensional potential energy surface.
In particular, the statistics of stationary points sampled as a function of temperature provides useful insight into the thermodynamics and dynamics of the system.
To make contact with the real space physics, however, analysis of the spatial structure of the normal modes is required.
In this work, we numerically study the potential energy surface of a glass-forming ternary mixture.
Starting from liquid configurations equilibrated over a broad range of temperatures using a swap Monte Carlo method, we locate the nearby stationary points and investigate the spatial architecture and the energetics of the associated unstable modes.
Through this spatially-resolved analysis, originally developed to study local minima, we corroborate recent evidence that the nature of the unstable modes changes from delocalized to localized around the mode-coupling temperature.
We find that the displacement amplitudes of the delocalized modes have a slowly decaying far field, whereas the localized modes consist of a core with large displacements and a rapidly decaying far field.
The fractal dimension of unstable modes around the mobility edge is equal to 1, consistent with the scaling of the participation ratio.
Finally, we find that around and below the mode-coupling temperature the unstable modes are localized around structural defects, characterized by a disordered local structure markedly different from the liquid's locally favored structure.
These defects are similar to those associated to quasi-localized vibrations in local minima and are good candidates to predict the emergence of localized excitations at low temperature.
The role of Fintech in predicting the spread of COVID-19
Authors: Abu Daqar Mohannad , Constantinovits Milan , Arqawi Samer , Daragmeh Ahmad
Published: January 2021

This study aims to investigate the role of Fintech in predicting the spread of COVID-19 based on consumers’ Fintech perceptions and behavior before and after the outbreak of COVID-19. The study used a questionnaire-based survey distributed in different countries of the world using the LinkedIn platform for this purpose to reach the targeted population. The snowball sampling technique was used. The study targeted consumers with Fintech experience, especially in digital payments services. 507 samples were retrieved. For the analysis, the Structural Equation Modeling (SEM) was used. The study revealed novel results in predicting COVID-19 spread; these three variables (Fintech Behavior before COVID-19, Fintech Behavior after COVID-19, and Fintech Perception after COVID-19) could predict 52.5% of the variance in the dependent variable (COVID-19 Spread) (R² = 0.525, p < 0.05). The findings show that Higher Fintech perception and behavior among Fintech users will help in reducing the spread of COVID-19 by avoiding the use of contact payment methods. Contactless payment methods are the main tools in Fintech that might help in avoiding the probability of COVID-19 spread. Consumers’ Fintech perceptions and behavior are the most influencing factors that could predict the spread of COVID-19 in this study, where digital payments are the main concern. It is recommended that consumers adopt digital payment methods and tools, especially contactless payment methods, to fulfill their financial services. Other researchers are also encouraged to use the same model to predict the spread of this virus in the Fintech context.
A ESTRUTURA E O FUNCIONAMENTO DO ENSINO E A FORMAÇÃO ESCOLAR
Authors: Rodrigues Rogério
Published: January 2021

Este artigo tem como objetivo analisar a estrutura e o funcionamento do ensino fundamental e médio para além da compreensão comum que se faz no campo educacional. Partimos da hipótese que a organização da unidade escolar constitui-se também no conjunto das relações humanas para além de aspectos objetivos presentes nas determinações das leis educacionais. O método utilizado tem como proposição investigativa a teoria crítica na interpretação e análise dos fundamentos filosóficos da estrutura e funcionamento do ensino. Os resultados indicam que na área da educação escolar a legislação escolar encontra-se dentro do jogo que se produz na interface entre os sujeitos, na legalidade e legitimidade instituídas por um não saber, mas que opera como ajuste no ordenamento da unidade escolar. Conclui-se que as práticas institucionais escolares podem ser interpretadas como a forma política da organização da unidade escolar como algo que adere à legitimidade e resulta em ações quando os sujeitos implicam a Lei e, principalmente, submetidos à autoridade. Toda a estrutura e funcionamento da unidade escolar deveriam pautar-se numa gestão que seja democrática, principalmente, em dar voz a todos aqueles que têm algo a dizer sobre o seu modo de existir e pensar no campo da cultura.
Tanítóság a dualizmuskori szaklapok hasábjain
Authors: Frank Tamás
Published: January 2021

Nóbik A. (2019). A pedagógiai szaksajtó és a néptanítói szakmásodás a dualizmus korában. Szeged: Szegedi Egyetemi Kiadó – Juhász Gyula Felsőoktatási Kiadó. http://real.mtak.hu/113973/
Bias-correction schemes for calibrated flow in a conceptual hydrological model
Authors: Bum Kim Kue , Kwon Hyun-Han , Han Dawei
Published: January 2021

We explore post-processing methods that can reduce biases in simulated flow in a hydrological model (HYMOD). Here, three bias-correction methods are compared using a set of calibrated parameters as a baseline (Cases 1 and 5). The proposed bias-correction methods are based on a flow duration curve (Case 2), an autoregressive model based on residuals obtained from simulated flows (Case 3), and a rating curve (Case 4). A clear seasonality representing a more substantial variability in winter than summer was evident in all cases. The extended range of residuals was usually observed in winter, indicating that the HYMOD may not reproduce high flows appropriately. This study confirmed that bias-corrected flows are more effective than the baseline model in terms of correcting a systematic error in the simulated flow. Moreover, a comparison of root mean square error over different flow regimes demonstrates that Case 3 is the most effective at correcting systematic biases over the entire flow regime. Finally, monthly water balances for all cases are evaluated and compared during both calibration and validation periods. The water balance in Case 3 is also closer to the observed values. The effects of different post-processing approaches on the performance of bias-correction are examined and discussed.
Evaluating three commonly used infiltration methods for permeable surfaces in urban areas using the SWMM and STORM
Authors: Parnas Frida E. Å. , Abdalla Elhadi M. H. , Muthanna Tone M.
Published: January 2021

Climate change and urbanization increase the pressure on combined sewer systems in urban areas resulting in elevated combined sewer overflows, degraded water quality in receiving waters, and changing stream flows. Permeable surfaces offer infiltration potential, which can contribute to alleviate the runoff to combined sewer systems. The variation in urban soil characteristics and the initial moisture conditions before a rainfall event are important factors affecting the infiltration process and consequently runoff characteristics. In this study, the urban hydrological models SWMM and STORM are used to evaluate the Green-Ampt, Horton, and Holtan infiltration methods for three urban sandy soils. A sensitivity analysis was carried out on a set of key parameter values. In addition, long-term simulations were conducted to evaluate the ability to account for initial soil moisture content. The results showed that the Holtan method's ability to account for both available storage capacity and maximum infiltration rate, as well as evapotranspiration in the regeneration of infiltration capacity, gave the best result with regard to runoff behaviour, especially for long-term simulations. Furthermore, the results from the urban sandy soils with different infiltration rate at saturation, together with a high sensitivity to the degree of sensitivity for maximum infiltration rate under dry conditions and minimum infiltration rate under wet conditions, indicate that field measurements of infiltration rate should be carried out at saturation for these soils.
Response of flood events to extreme precipitation: two case studies in Taihu Basin, China
Authors: Jiang Feiqing , Dong Zengchuan , Luo Yun , Liu Moyang , Zhou Tao , Wang Xinkui , Zhu Zhenye
Published: January 2021

Flood events are typically triggered by extreme precipitation in rain-dominant basins. In this study, to better understand the genetic mechanisms and characteristics of floods, copula functions are used to analyze the response of flood events to extreme precipitation. The coincidence probabilities of the typical extreme flood and precipitation events are calculated; different return periods of their arbitrary combinations are calculated, whereas the dangerous domains for flood control under different return periods are identified; furthermore, flood risk analysis under different extreme precipitation scenarios is performed via their conditional exceedance probabilities. The Xitiaoxi catchment (XC) and Dongtiaoxi catchment (DC) in the Zhexi Region of the Taihu Basin are selected as the study area. The results show that in four scenarios with precipitation frequencies of 80%, 90%, 93.33%, and 95%, the probabilities of the dangerous flood are 9.72%, 10.57%, 10.86%, and 11.01% in the XC, respectively, and 5.91%, 6.31%, 6.44%, and 6.51% in the DC, respectively. This study provides a practical basis and guidance for the computation of rainstorm designs, management of flood control safety, and water resource scheduling in the Taihu Basin.
Risk dynamics modeling of reservoir dam break for safety control in the emergency response process
Authors: Shen Guangze , Lu Yi , Zhang Shichen , Xiang Yan , Sheng Jinbao , Fu Jilei , Fu Shan , Liu Mengyang
Published: January 2021

Dam break is an accident that may heavily threat downstream residents' life and property safety, especially in China. As revealed by accident investigation statistics, both flawed organizational behavior and inadequate downstream resident risk awareness have affected the safety risk of reservoir dams. Multiple information transferring mode and dynamic processes perform with the characteristics of social-technical systems. Based on the system dynamics approach, this study proposed a risk causation model aiming for factor interactions involving organizational, human, and technical system levels. The derived simulation model represented the historical risk evolution process of Gouhou reservoir in China and the rationality of the proposed model was verified. To further improve the efficiency of the organizational response and monitor real-time dam safety, a software tool called Dam Emergency Response Aids (DERA) was constructed to evaluate the potential safety benefits of risk control measures, and to overcome the defects of static emergency plans. By integrating relevant professional modules and data, the mobile application (APP) has been applied on the Jinniu Mountain reservoir dam in Nanjing of China and helped to maintain its excellent safety operation until now. It shows that the risk dynamics model proposed can improve the abilities of dam operating management organization for more effective responses under emergency circumstances.
A high-rate and stable nitrogen removal from reject water in a full-scale two-stage AMX® system
Authors: Jung Minki , Oh Taeseok , Rhu Daehwan , Liberzon Jon , Kang S. Joh , Daigger Glen T. , Kim Sungpyo
Published: January 2021

This paper reports long-term performance of a two-stage AMX® system with a capacity of 70 m3/d treating actual reject water. An air-lift granulation reactor performed partial nitritation (PN–AGR) at an average nitrogen loading rate (NLR) of 3.1 kgN/m3-d, producing an average effluent –N/NH4+–N ratio of 1.04. The average nitrogen removal rate of the system was 3.91 kgN/m3-d following an anaerobic ammonium oxidation (Anammox) stage moving bed biofilm reactor (A–MBBR). Although the total nitrogen concentrations in the reject water fluctuated seasonally, overall nitrogen removal efficiency (NRE) of the two-stage AMX® system was very stable at over 87%. The two-stage AMX® system, consisting of a PN–AGR followed by an A–MBBR, operated at a stable NLR of 1.86 kgN/m3-d (1.64 kgN/m3-d including the intermediate tank), which is 1.8 times higher (1.6 times including the intermediate tank) than other commercialized single-stage partial nitritation/Anammox (PN/A) processes (which operate at a NLR of about 1 kgN/m3-d). The PN–AGR was affected by high influent total suspended solids (TSS) loads, but was able to recover within a short period of 4 days, which confirmed that the two-stage PN/A process is resilient to TSS load fluctuations.