bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex Differences in Infant Mortality: A Population Data Linkage Study of Brazilian Male-Female Twin Pairs
Authors: Calais-Ferreira Lucas , Mendonça Everton , Barreto Marcos E , Dite Gillian M , Hickey Martha , Ferreira Paulo H , Scurrah Katrina J , Hopper John L
Published: December 2020

IntroductionEpidemiological studies of twin pairs provide researchers with the opportunity to better understand the roles of genetics and the environment on human traits and health conditions. Twin births are also of interest for public health, given they are five times more likely to be of low birth weight and preterm compared to singletons. Male twin newborns are at high risk of mortality, although the causes of such disadvantage are still largely unknown.

Objectives and ApproachWe deterministically linked population birth to death records of twins born in Brazil from 2012–2016, and probabilistically linked twins within pairs through a bespoke algorithm. We studied male-female twin pairs to investigate sex differences in infant mortality stratified by early neonatal (0–6 days), late neonatal (7–27 days) and late infant (28–365 days) deaths. We used conditional logistic regression to estimate odds ratios (OR) for male sex, adjusting for birth weight and matching for familial factors by design.

ResultsOur algorithm successfully matched 101,382 twin pairs, 28,558 were male-female pairs included in the study. Average birthweight was 100g greater for males compared with females. We found that males were at higher risk of infant mortality than their female co-twins even after adjusting for birth weight and familial factors (aOR = 1.42, 95% CI: 1.22–1.66). The aORs for neonatal death increased from those born at less than 28 weeks to those born at 28–31, 32–26 and 37+ weeks: 1.47 (1.02–2.13), 1.73 (1.17–2.57), 1.99 (1.17–3.38), and 3.35 (1.29–8.73), respectively.

Conclusion / ImplicationsMale twins have greater risk of infant and neonatal mortality compared with female co-twins, more so the higher the gestational age. Unmeasured familial and maternal factors may influence the role of birth weight in the association between sex and poor early life outcomes.
The Lumos Pilot Project: Feasibility of Linking General Practice Data to Other Health-Related Data
Authors: Correll Patricia , Power Adrian , Moubarak Samantha , Irvine Katie , Feyer Anne-Marie
Published: December 2020

IntroductionDelivering integrated care is an aspiration of health systems around the world. General Practices (GPs) operate between other types of health care and are therefore key to effective integrated care. However, information to understand the patient journey across the health system, such as between primary and acute care, is currently impeded in Australia by lack of interoperable clinical software, privacy concerns, and cross-jurisdictional barriers. This presents a challenge to the formation of an evidence base for the design and implementation of integrated health services.

Objectives and ApproachThe Lumos Pilot Project aims to address these challenges. Following ethics approval in February 2016, the pilot was rolled out over five stages to develop a proof of concept for extracting and linking GP data to other health-related data. The objectives were to:I. Build cross-jurisdictional collaborations between primary care and the state health system in New South Wales (NSW), Australia.II. Develop methodologies to address confidentiality requirements.III. Develop technological solutions that will allow for a large scale program.

ResultsData were extracted from 102 GPs, covering nearly 1 million patients, and linked to emergency department, hospital and mortality records. GPs were recruited to participate through collaborations with all NSW Primary Health regions. Privacy preserving record linkage was successfully implemented in the fifth stage of the project. This process encoded patient identifiers prior to extraction from the GP and negated the need for identified information during data linkage. Software was developed and tested across all stages of the project so that once enrolled, GP data extraction and transfer were fully automated.

Conclusion / ImplicationsThe resultant dataset has provided a new picture of patients’ healthcare journeys while preserving patient privacy. The technological solutions allow for a large scale up of GP recruitment in future.
Natural History of Cardiac and Peripheral Vascular Death In ESKD: An Australian And New Zealand Data Linkage Study
Authors: Khou Victor , De La Mat VictorNicole L , Kelly Patrick J , Webster Angela C
Published: December 2020

IntroductionCardiovascular disease is a leading cause of death in patients with end-stage kidney disease (ESKD). However, ascertaining the impact of cardiovascular deaths has not been well characterised over long periods of follow-up and across different treatment states. Further insights into the lifetime risk of cardiovascular death are required to better inform clinical practice and economic planning.

Objectives and ApproachWe performed a population-based cohort study on incident patients receiving ESKD treatment from the Australian and New Zealand Dialysis and Transplant registry (ANZDATA). Cardiac/vascular deaths were determined from ICD-10-AM codes listed in the underlying cause of death obtained via data linkage with the Australian National Death Index and New Zealand Mortality Collection database. We estimated mortality rates from cardiac/vascular death across time from ESKD treatment, and calculated probability of death and transplant status over time using multistate models.

ResultsAcross 60,823 incident ESKD patients and 381,874 person-years of follow-up, 22% (7,551) of deaths were from cardiac/vascular disease. At 15 years from treatment, 15.6% of patients had died from cardiac/vascular causes, most of whom never received a transplant (13.6% vs 2.0% of cohort). Within the first year of dialysis, cardiac/vascular mortality was highest in the second month, at 3,632/100,000pys. Improvements in cardiac/vascular mortality with calendar year were only seen after 9 months of dialysis. Transplant recipients had consistently lower cardiac/vascular mortality rates (598/100,000 pys) compared to dialysis patients. However, comorbid cardiovascular disease was a risk factor for graft failure and death in transplant recipients (HR:1.52, 95% CI:1.42-1.62).

Conclusion / ImplicationsDespite improvements in cardiac/vascular outcomes over time, cardiovascular death remains common in ESKD, particularly in the first few months of treatment. A greater focus on secondary prevention in earlier stages of chronic kidney disease may improve outcomes in new ESKD patients.
Linking Registry Data with Australian Medicare And Medication Dispensing Claims Data: Feasibility, Benefits and Limitations
Authors: Andrew Nadine E , Cadilhac Dominique A , Sundararajan Vijaya , Thrift Amanda G , Anderson Phil , Lannin Natasha A , Shehata Sam , Kilkenny Monique F
Published: December 2020

IntroductionRecent advances in Australia mean that it is possible to link national clinical registries with government held administrative datasets. However, formal evaluations of such activities and the potential impact for research are lacking.

Objectives and ApproachWe aimed to assess the feasibility and accuracy of linking registrants from the Australian Stroke Clinical Registry (AuSCR) with the Medicare enrolment file. Following data custodian and ethics approvals, personal linkage identifiers were submitted to the Australian Institute of Health and Welfare (AIHW). De-identified data from AuSCR and the AIHW were submitted into the Secure Unified Research Environment and merged using project specific person-based IDs. We calculated the proportion of patients linked with the Medicare enrolment file that were present in the associated Medicare and medication dispensing datasets and the proportion with claims after their date of death. Logistic regression was used to identify factors associated with a non-merged patient.

Results17,980 AuSCR registrants (January 2010-July 2014) were submitted for linkage (median age 76 years; 46% female; 67% ischaemic stroke; 16% TIA). Of these, 93% were merged with Medicare (N=16,648) and 95% with subsidised medication dispensing claims data (N=17,079). In those who died, 127 (0.8%) had one or more Medicare claim and 411 (2.4%) had one or more medications dispensed after their death date. Asian born registrants were less likely to be merged with Medicare (adjusted Odds Ratio [aOR]: 0.54; 95% Confidence Interval [CI]: 0.40, 0.72) than Australian born registrants. Those aged ≥85 years were less likely to be merged with Medicare data than those aged <65 years (aOR 0.24; 95% CI: 0.19, 0.29) but were more likely to be merged with dispensing data (aOR: 2.22 (95% CI: 1.73, 2.84).

Conclusion/ImplicationsLinkage between a national clinical quality registry and the Medicare spine is feasible. These linkages will provide novel insights into post-stroke care.
Secure Automated File Exchange (SAFE) – Enabling More Efficient Transfers of Sensitive Data
Authors: Schneider Matthias
Published: December 2020

IntroductionWith the explosion in data being collected and made available for research, linkage units receive an increasing amount of data. At the same time, researchers also expect access to more current data. This increase in the influx of data can create resource constraints for linkage units, which need to mobilise more staff time for data processing, as well as data custodians, who are required to provide data updates more frequently.

Objectives and ApproachSA NT DataLink has designed the Secure Automated File Exchange (SAFE), in collaboration with the University of South Australia. SAFE provides a framework to safely transfer encrypted data from custodians into SA NT DataLink’s systems. A given custodian uses one private key to send personally identifying data via Secure File Transfer Protocol (SFTP). This data flows via the university’s IT infrastructure, where it is checked for encryption, directly into a Demilitarised Zone (DMZ) within SA NT DataLink’s Data Linkage Unit’s (DLU) highly protected environment. The same custodian then uses a separate private key to provide the corresponding encrypted anonymised content data, again via SFTP. Given the less sensitive nature of this data type, it is deposited on secure university on-site storage, from where it is manually transferred by Data Integration Unit (DIU) staff to SA NT DataLink’s Custodian Controlled Data repository (CCDR).

ResultsSA NT DataLink considers implementing SAFE with one data provider as a trial project. After successful testing, a rollout to other data custodians is possible. In parallel, alternative technical solutions for automated data transfers are being evaluated.

Conclusion / ImplicationsAutomated data transfer solutions will reduce effort by data custodians to send data and for linkage units to receive and process data updates. Moreover, by limiting manual intervention, they will limit vulnerability to data privacy breaches and the risk of introducing errors into the data. However, data workflow automation is dependent on data provider requirements and the availability of resources to process received data.
Do You Need My Health Data - Just Ask: Using Blockchain Technology for Collaborative Patient-Centric Health Care
Authors: Rupasinghe Tharuka
Published: December 2020

IntroductionAcquiring healthcare data for secondary use should benefit from a transparent and highly auditable process when handling patient consent. In the current healthcare infrastructure, the healthcare providers hold the stewardship for the patient data, which includes an authority to determine the data access often without involving the respective patients. The current approach to obtaining patient consent as a one-off task is inadequate to facilitate continuous communication among the patients, healthcare providers and data requestors to manage more personalised data access.

Objectives and ApproachThis study explores a novel dynamic patient consent mechanism based on blockchain technology and smart contracts. The aim is to enable patients to actively participate in this process by dynamically managing data consent preferences. Furthermore, it also explores the feasibility of implementing a transparent and auditable collaborative access control infrastructure for clinical data analytics, where all the stakeholders can be involved in determining access to health data.

ResultsThe solution has been designed leveraging the blockchain and smart contracts to ensure auditability and transparency of the consent management process where a set of smart contracts controls access to data with minimum human-interferences. In addition, multiple design goals such as data security, privacy, interoperability, legal compliance and accessibility have also been considered when designing a prototype solution. An empirical evaluation is planned to obtain feedback from stakeholders involved in health data sharing for secondary use.

Conclusion / ImplicationsThe contribution of this research study is to augment the existing data acquisition procedures for clinical data analytics using blockchain and smart contracts. The proposed novel approach aims to empower and enable patients to play a more active role in controlling access to their data for secondary use. The study will also illuminate the opportunities and challenges which blockchain-based technologies can address related to creating collaborative patient-centric healthcare.
MASK: A Success Story for An International Collaboration
Authors: Azimaee Mahmoud , Kalappa Gangamma , Milosevic Nikola , Nenadic Goran , Dadafarin Hesam , Yassaie Mahshid , Chen Branson , Ji Sean , Barron Daniella , Candido Elisa , Qian Cheng , Vermeulen Marian
Published: December 2020

IntroductionA significant amount of valuable information in Electronic Health Records (EHR) such as laboratory test results or echocardiogram interpretations is embedded in lengthy free-text fields. Often patients’ personal information is also included in these narratives. Privacy legislation in different jurisdictions requires de-identification of this information prior to making it available for research. This process can be challenging and time-consuming. In particular, rule-based algorithms may lead to over-masking of essential medical terms, conditions, or devices that are named after individuals.

Objectives and ApproachWe aimed to enhance ICES’ existing rule-based application to make it contextually-driven by applying Artificial Intelligence (AI). The ICES team collaborated with computer scientists at the University of Manchester who had already published work in this area and Evenset, a Toronto-based software company. Based on the Manchester University de-identification framework for name entity recognition, three machine learning-based algorithms for name entity recognition were implemented: CRF, BiLSTM recurrent neural networks with GLoVe and ELMo word embeddings. The models were trained on three different types of ICES data: Laboratory results, Electronic Medical Record (EMR) and echocardiogram data. Evenset developed the user interface and the masking modules.

ResultsPreliminary tests have generated very promising results. To improve accuracy of the models, additional data annotation to expand the training datasets is currently being undertaken at ICES. The final framework will be available as an open-source tool for public.

Conclusion / ImplicationsA collaborative approach for solving complex problems like de-identification of text-based medical data is highly efficient, especially where there are unique sets of expertise, resources, data and clinical knowledge among stakeholders.
Hospital Admissions for Patients with Rheumatoid Arthritis in Western Australia Hospitals Have Declined Significantly Over Time (1995-2014)
Authors: Almutairi Khalid Bander , Nossent Johannes , Preen David , Keen Helen , Inderjeeth Charles
Published: December 2020

IntroductionRheumatoid arthritis (RA) imposes a considerable burden on society in terms of morbidity, long-term disability, and costs. RA prevalence is poorly described in Australia, and linked health datasets can provide a more meaningful picture for RA epidemiology in the Australian population.

Objectives and ApproachWe extracted data on all patients identified in the WA Hospital Morbidity Data Collection between 1995 and 2014, with the International Classification of Diseases (ICD) codes for RA (ICD 10 M05.00–M06.99, and the corresponding ICD 9 codes). We estimated RA point- and period prevalence rates per 1000 hospital separations and annual average percentage changes, with the total number of hospital separations each year obtained from the Australian Institute of Health and Welfare, which served as the denominator.

ResultsA total of 17,125 patients were admitted to WA hospitals with a diagnostic code for RA over the study period (1995-2014). The total number of hospital separations for RA patients was 50,353, indicating an average of three hospital separations per patient over twenty years. The RA prevalence was 3.4 per 1000 separations over the study period, with a -2.89% annual average decrease since 1995.The RA point prevalence remained constant in the early part of the study period, at 7.9 per 1000 separations, then decreased in the later years, from 3 per 1000 separations in 2009 to 1.9 per 1000 separations in 2014.

Conclusion / ImplicationsThese data demonstrate that hospitalisation for RA has decreased considerably in WA over the last two decades. As this decrease roughly coincides with the introduction of biological drug treatment for RA, the reduced need for hospital admission is likely due to improvements in RA management.
Defining Acute Kidney Injury Episodes
Authors: Davies Gareth , Scale Tim , Akbari Ashley , Chess James , Lyons Ronan A
Published: December 2020

IntroductionAcute Kidney Injury (AKI) is a common, serious condition effecting up to 20% of all hospital admissions in the UK. AKI has an agreed definition for its recognition, however there is no consensus for the duration of an AKI episode.

Objectives and ApproachWe aimed to describe four different potential definitions of an AKI episode. AKI was identified using an SQL (Structured Query Language) based algorithm (an implementation of the NHS England eAlert algorithm) applied to serum creatinine (SCr) results from a South Wales population of ~518,000 people, held in the Secure Anonymised Information Linkage (SAIL) Databank. Using a person’s index AKI case, we applied four different rules to define an episode of AKI. These definitions are: ALERTS - until they no longer trigger an AKI eAlert, 90 DAYS - until 90 days post first AKI test and <1.2/<1.5 until the SCr recovers to <1.2 or 1.5 times their baseline creatinine.

ResultsThere were 1,832,122 SCr tests in 340,908 people between 2011-2013, of which 93,843 were alerts (5.12%). This fell to 81,948 alerts in 21,979 patients when dialysis and transplant patients were excluded. Of these patients with AKI 7,792 (35.5%) were dead at 1 year after their first episode. There were 31,482, 33,758, 26,657, 34,904 episodes in patients by <1.2, <1.5, 90 Days and ALERTS definitions respectively.

8333 patients had first episodes occurring in 2011. The number of these having 2/3/4/5+ later episodes within 1yr were 2332/869/344/326, 2602/1095/485/609, 1534/331/71/17, 2728/1190/543/730 by <1.2, <1.5, 90 Days and ALERTS definitions respectively.

Conclusion / ImplicationsAKI episodes can be created in SAIL using SQL, and by adjusting the definition we see a variation in the number of episodes that a patient experiences. Once described, this cohort can be used to define a gold standard for AKI in future analysis.
Using A Privacy Preserving Record Linkage to Facilitate an Ongoing Crosswalk Between Research and Health Administrative Databases
Authors: Behan Brendan , Gee Tom , Evans Susan Gilbert , Dharsee Moyez , Evans Ken , Azimaee Mahmoud , Ross Kelley , Cartagena Rosario , Victor Charles , Green-Noble Lindsay , Mikkelsen Tom , Nylen Kirk
Published: December 2020

IntroductionThe Ontario Brain Institute has developed Brain-CODE, an informatics platform designed to support the collection, storage, federation, sharing and analysis of different neuroscience research data types across several brain disorders. Linking such “deep” research data with “broad” health administrative data allows for improved characterization of disorders and supports the development of related health and social policies (Anderson et al., 2015). A privacy preserving record linkage protocol, developed through the Indoc Consortium, has been used to facilitate such linkages between Brain-CODE and administrative data holdings at the Institute for Clinical Evaluative Sciences (ICES; e.g., emergency department use, inpatient records, prescription drug utilization) (Gee et al., 2018).

Objectives and ApproachThree linkage pilots in the areas of neurodevelopmental disorders, epilepsy, and stroke research have been completed with >99% success match rates across all projects. However, each of these projects required a significant amount of human and computational resources to complete. With other similar data linkages being planned, it was determined that a more permanent solution was required rather than completing linkages on a project-by-project basis. The governance and technical elements to support the creation and maintenance of such a crosswalk between Brain-CODE and ICES were reviewed with an implementation plan subsequently developed.

Results:A methodology for creating a crosswalk between Brain-CODE and ICES has been established. The same privacy preserving record linkage protocol, as used in the previous linkage pilots, will support the creation of this crosswalk. A plan has been established to update this crosswalk annually to account for new study participants on Brain-CODE.

Conclusion / ImplicationsThe creation of this crosswalk will allow for a more streamlined approach of data linkage between Brain-CODE and ICES. Such an approach can significantly reduce overall resourcing requirements, enable more efficient data linkages, and contribute to the coupling of “broad” and “deep” data.
Measuring Community Strengths – Using Data from The First Nations Regional Health Survey Linked with A Whole-Population Administrative Data Repository
Authors: Nickel Nathan C , Phillips-Beck Wanda , Campbell Rhonda , Chateau Dan , Sarkar Joykrishna , Chartier Mariette , Enns Jennifer , Burland Elaine , Quddus Farzana , Brownell Marni
Published: December 2020

IntroductionAdministrative data studies routinely report that First Nations mothers and children experience a disproportionate burden of poor health. Due to the nature of administrative data, research often takes a deficits-oriented approach. First Nations health research needs to consider the role that community- and individual-level strengths play in promoting wellbeing and examine how these interact with the delivery and outcomes of health programs.

Objectives and ApproachThe First Nations Health and Social Secretariat of Manitoba (FNHSSM) and the University of Manitoba partnered to construct measures of community-level strengths that can be linked with administrative data to examine the delivery and outcomes associated with population health programs delivered in First Nations communities.

We linked data from the FNHSSM-administered Regional Health Survey (RHS) with administrative data housed in the Manitoba Population Research Data Repository. We identified 60 questions from the child, youth, and adult versions of the RHS to measure community strengths. We used principal component analysis to identify strength-based constructs. We used Eigen values and percent of variance explained to determine the final number of factors. We used random group resampling and bootstrap methods to test for community-level homogeneity. Community-level factor scores were calculated as the scaled combination of RHS questions within each factor and averaged to the community.

ResultsWe identified 12 constructs of community strength: 5 from child responses, 4 from youth, and 3 from adult responses. Strength-based constructs common to all age groups included knowledge of traditional language, involvement in cultural events, and connection with community.

Conclusion / ImplicationsColonial approaches to health research perpetuate deficit-based dialogues and negative portrayal of First Nations peoples. First Nations health research should consider how community strengths promote health and interact with program delivery. Including measures of community strength leads to richer understandings of factors that promote wellness among First Nations peoples.
US Federal Data Policy: An Update on The Federal Data Strategy and The Evidence Act
Authors: O’Hara Amy
Published: December 2020

IntroductionThe US federal data landscape is evolving through the implementation of the Foundations for Evidence-Based Policymaking Act of 2018 and the 2020 Action Plan of the Federal Data Strategy (FDS). The Act and Plan seek better data governance; making data accessible and useful for the American public, businesses, and researchers; and improving how the government uses data to make decisions and for program oversight.

Objectives and ApproachThis paper provides a brief overview of the Evidence Act, describing what has already been implemented and what is forthcoming and how it involves population data linkages. We will also describe the FDS, using the Five Safes framework to categorize its priorities for federal agencies.

ResultsWe explain how the Evidence Act established new roles for Chief Data, Evaluation, and Statistical Officials. We describe efforts to set learning agendas and data inventories in agencies. We point to some successes, such as new repositories for tools and metadata, and progress on forming an advisory committee to explore how the US could build a National Secure Data Service. We tie the FDS action plan to these Evidence Act efforts, showing how agencies and communities of practice are expected to develop over time. We focus on the ten actions that involve shared solutions across government that focus on ethics, privacy, tools and standards.

Conclusion / ImplicationsThis paper shares updates on US federal data policy that started with the 2016 Commission for Evidence-based Policymaking, up through the current administration’s efforts to leverage data as a strategic asset. We highlight accomplishments, opportunities, and challenges for federal policy, noting how political will and funding ultimately affect progress.
South African experience consolidating person-level health data for both service and research in a single environment
Authors: Boulle Andrew , Heekes Alexa , Mutemaringa Themba , Smit Mariette , Foster Rosemary , Tiffin Nicki
Published: December 2020

IntroductionThere are few examples of functional health information exchange environments or data linkage centres in the African settings. New opportunities are emerging as unique health identifiers and patient registration systems are being established nationally in many countries, and increasingly individuated health data are available for linkage, often linked to priority global health initiatives such as to support HIV and tuberculosis services.

Objectives and ApproachWe sought to establish a province-wide health information exchange and data centre for individuated health data, leveraging a unique identifier and available individuated data. The intention with the Provincial Health Data Centre (PHDC) was to create a single well-governed environment which could simultaneous fulfil the functions of an exchange directly supporting care, as well as support research requests. Often the demands of academics, funders and global agencies for reporting result in data consolidation for research and reporting taking precedence over service delivery.

ResultsThrough pragmatic use of data from all sources, the PHDC is able to usefully enumerate many health conditions of interest with sufficient fidelity for both service and research purposes. For research data requests, there has been a huge improvement in data governance alongside increased data availability as a result of the single environment with clear procedures for patient protection, and the benefits of data linkage prior to anonymisation. Many of the inference approaches have benefited hugely from interactions with researchers, which has in turn improved the quality of outputs for routine care.

Conclusion / ImplicationsIn maturing digital health environments which are establishing consolidated data environments for the first time, aspiring from the start to a single well-governed environment for both patient care and research, is a virtuous model with many benefits over fragmented data linkage efforts
Evaluating Full Day Kindergarten – Is It Associated with Improved Short- And Long-Term Education Outcomes Among Metis Children?
Authors: Nickel Nathan C , Sanguins Julianne , Sarkar Joykrishna , Enns Jennifer , Struck Shannon , Chartier Mariette , Burland Elaine , Quddus Farzana , Hinds Aynslie , Chateau Dan , Chartrand A Frances , Brownell Marni
Published: December 2020

IntroductionEarly education outcomes influence children’s educational trajectories with long-term effects extending into adulthood. Aboriginal peoples face numerous systemic barriers to academic success. It remains unknown if full-day kindergarten (FDK) is associated with improved academic outcomes among Metis children – a distinct Aboriginal people recognized by the Canadian Constitution.

Objectives and ApproachThe Manitoba Metis Federation and the Manitoba Centre for Health Policy partnered to identify whether FDK was associated with improved short- and long-term outcomes among Metis children. We created a cohort of Metis children by linking several provincial databases held in the Manitoba Population Research Data Repository (1998-2011). Education data were used to identify all Metis children who attended FDK (n=247) vs half day kindergarten (HDK; n=547). FDK children were matched by age and sex to children in HDK. We used a step-wedged design and applied propensity scores to adjust for measured confounding. We tested for differences in grades 3, 7, 8 outcomes and high school graduation using generalized linear models.

ResultsFDK children were more likely to live in a low-income neighbourhood. 72% FDK and 74% HDK students met or approached numeracy expectations in grade 3; and 55% FDK and 48% HDK met or approached numeracy expectations in grade 7. For reading expectations, 77% FDK and 75% HDK met or approached grade 3 reading expectations; in grade 8, 62% in each group met or approached expectations for reading and writing. High school graduation rate for FDK children was 84% and for HDK children was 64%. After adjusting for confounding we found FDK children were more likely to graduate high school than HDK children; other outcomes were non-significant.

Conclusion / ImplicationsKindergarten programs may be insufficient to overcome structural barriers that Metis children face. Culturally appropriate education strategies are needed to support improved outcomes amongst this population.
The Impact of Megatrends on Marketing Communications Education. Results of an International Survey Among Educators
Authors: REKETTYE Jr Gabor , PAPP-VARY Arpad
Published: December 2020

This paper examines the global megatrends affecting business practices and marketing and marketing communications education using the results of an international survey carried out by the authors to under- stand the effects of global megatrends, which included businesspeople as well as academics. For the research, the survey focuses only on academics and educators. The comparison of results includes advanced, developing and transition countries. The international nature of the study allowed a further comparison of expert opinions. The high share of educators in the sample allowed the researchers to make three predictions on requested changes in business and marketing education. The projections formulated in the study highlight the most significant changes: digital revolution or the advance of technology, the changing nature of marketing communications indicating the need for integration and emphasizing the importance of online com- munication, and finally the cultural sensitivity graduates must possess as a result of the changes taking place in higher education institutions.
Social Media Inﬂuencer Advertising versus Advertising on Social Media Account of a Brand. Evidence from an Experimental Design
Authors: BALABAN Delia Cristina , RACZ Roberta Gabriela
Published: December 2020

Nowadays, the relevance of advertising on social media is es- sential, especially for the young audience category for which traditional media is no longer a real consumer option. This paper aims to explore the differences in the efficiency of online advertising with and without the sup- port of a social media influencer. We conducted a two-level survey-based online between subjects experiment and we manipulate advertising on an influencer account versus advertising on a brand account on social me- dia without the support of the influencer. We compared the effects of the posts promoting Pantene shampoo on the Instagram account of a relevant Romanian beauty influencer Ioana Grama (335K followers) and the posts promoting the same product from the brand Romanian Instagram account (5K). The online survey was disseminated between April 4, 2020–May 7, 2020, to a young female population N=80 participants, age 16 to 32 years, that were randomly assigned in the two above mentioned groups. The stimulus included real posts in the questionnaire consisted of: Instagram posts of the Pantene Romania account for the “brand account” group and posts of the Romanian beauty influencer Ioana Grama for the “influencer” group. Results showed that advertising on influencer account is more effi- cient than advertising on the brand account regarding the effects on brand attitude.
Qual o Diagnóstico?
Authors: Mario Baggio Junior Baggio Junior Jose , Ariel Pereira Mosquera Joubert , Gustavo Ferreira Gomes Luis , Luis Gali Wagner , Valentim Lima Sarabanda Alvaro
Published: December 2020

Paciente YB, 50 anos, sexo feminino, com hipotireoidismo, disfunção ventricular esquerda grave, ventrículo esquerdo não compactado e taquicardia ventricular mal tolerada, submetida a implante de cardioversor-des brilador implantável (CDI) de dupla câmara em fevereiro de 2012 com sucesso (gerador Secura DR Medtronic, eletrodo atrial 4076 Medtronic e eletrodo ventricular Sprint Quattro 6947 Medtronic). Retorna assintomática nove meses após o implante para avaliação de rotina.
The Concept of A Marriage Agreement in the Compilation of Islamic Law
Authors: Yunus Haerunnisa , Rusli Rusli , Abidin Abidin
Published: December 2020

The aim of this paper is to discusse the concept of a marriage agreement in the Compilation of Islamic Law. This study is literature review research with a qualitative methods. The  data was gathered through content analysis and written material. Data analysis was analyzed using grounded theory approach and thematic building. The result of research shows basically, there is no difference between the Marriage Law and the Islamic Law Compilation regarding the marriage agreement. Second, the legal consequences of the marriage agreement made by each party—husband and wife, are binding. Therefore, if a violation occurs, each party can take legal action.
Method of Sharing Marriage Properties in the Religious Court, Palu
Authors: Thariq Godal Moh. , Hasyim Syarif , Musyahidah Musyahidah
Published: December 2020

The aim of this paper is to discusses Marriage properties method sharing  in the Religious Court of Palu City.  This study uses qualitative methods and data was gathered through observation, in-depth interviews, and written material. Data analysis was analyzed using grounded theory approach. The results of this study indicate that terminating the distribution of marital assets is sufficient to provide justice for the plaintiffs and defendants. Joint assets are divided in half for each party if under normal conditions, namely the husband provides support for the family and the wife takes care of the household. The division of joint assets based on contributions in marriage is one of the considerations by the judge in deciding joint property cases. This means that the sharing of joint assets does not refer to Article 97 of the Compilation of Islamic Law, namely that joint assets are divided in two for each party, but divided by 2/3 for the wife and 1/3 for the husband in certain cases (casuistik). Judges in the decision on the distribution of joint assets are still based on legal principles and norms.
Digital construction of the signaling/ rescue system located in coastal aquatic areas
Authors: Mihai Carmen , Rus Madalina Alice , Ene Alexandra Gabriela , Scarlat Razvan
Published: December 2020

For signaling and rescue, at international level, modular systems made of composite structures are used, which ensure the maintaining at the water surface of them, in a fixed point, in any meteorological conditions etc. According to the diversity of activities carried out in the marine and/ or river sector and depending on them, worldwide signaling systems are applied: for the safety of navigation, for data recording and processing activities and for the marking of ecological protection areas (National Strategy for Sustainable Development of Romania 2030, 2017; La Depeche, 2014). For this last category, the signaling of the navigable channel is made in accordance with the "Basic Regulations for Navigation on the Danube" edited by the Danube Commission, 1991 edition, Budapest, while for the maritime buoyage system the IALA agreement is used, concluded in Paris, on the 15th April 1982 and involves the use of floats and buoys made of composite materials. The work aims to create a digital signaling/ rescue system applied in the coastal aquatic area (Council Regulation (EC) No. 509/2006; Decision No. 1600/2002/EC). In this respect, using FEM modelling, the geometric domain was defined, the composite structure of which the system is made was modeled, the structure with finite elements was generated (discretization, properties modelling, specific finite elements obtaining), the constraints and loads were modeled and finally, in the post-processing stage, the results (deformation, Von Mises stress, displacements) were visualized and studied
Improvement of mechanical, thermal and morphostructural properties of SBS thermoplastic elastomer using kaolin and dolomite microparticles with modified surface
Authors: Sonmez Maria , Juganaru Mircea , Ficai Anton , Oprea Ovidiu , Trusca Roxana , Georgescu Mihai , Gurau Dana , Ficai Denisa , Alexandrescu Laurentia , Constantinescu Doina , Stelescu Maria Daniela , Nituica Mihaela , Marin Minodora
Published: December 2020

The aim of this paper was to assess the influence of the modification of the surface of dolomite and kaolin with SiO2 and TiO2 precursors, on the block copolymer styrene-butadiene-styrene (SBS) type thermoplastic rubber properties. These composite materials were obtained by compounding SBS with various ratio of powders. Based on the SEM images it can conclude that the powders were homogenously dispersed in to the SBS matrix. The dolomite particles can be clearly identified in the SEM images as particles of 10 micrometers. The samples obtained with modified dolomite have similar morphology. The EDS elemental distribution confirming a good corroboration between the elements of the dolomite, kaolin and titanium or silicon elements. Based on the thermal analysis according to the residual mass, the presence of 20% mineral phase can be confirmed. According to the DSC curves a strong stabilization of the composite appears, because of the presence of the mineral component. According to the physical-mechanical data all the composite materials exhibit improved mechanical properties. Additionally, the modification of the kaolin and/or dolomite bring important improvements in mechanical properties. The samples 13 and 14 exhibit high tensile and tear strength. These composites can be used for various applications, such as, for instance, soles for firefighters' footwear.
Cotton fabrics coated with Ag-TiO2 and Ag-TiO2/reduced graphene oxide nanocomposites
Authors: Chirila Laura , Rosu Marcela Corina , Olaru Sabina , Tudoran Cristian , Cosma Dragos-Viorel , Urda Alexandra , Mateescu Alice-Ortansa , Mateescu Gheorghe , Vasile Georgiana
Published: December 2020

Ag-TiO2 and Ag-TiO2/reduced graphene oxide nanopowders were deposited onto 100% cotton fabrics via electrostatic spraying method. The surface of cotton fabrics was pre-treated by plasma at atmospheric pressure using argon and nitrogen mixture. The as-prepared cotton fabrics were characterized in terms of structural and optical properties by X-ray diffraction (XRD) and optical reflectance measurements. The photocatalytic self-cleaning ability of Ag-TiO2 and Ag-TiO2/reduced graphene oxide coated cotton fabrics was evaluated by the photo-discoloration of methylene blue and berries juice stains, under 6 h simulated visible light irradiation. The combined functionalized coating on cotton fabrics demonstrated an improved photocatalytic effect compared with untreated cotton fabrics. The antimicrobial activity of Ag-TiO2 and Ag-TiO2/reduced graphene oxide coated cotton fabrics was tested against the Staphylococcus aureus and Candida albicans test strains as model microorganism of skin bacteria and fungi, respectively. An antimicrobial effect against the Staphylococcus aureus is observed even if the inhibition zone is not present. Untreated fabrics showed no antibacterial activity. No inhibitory effect on fungi colony growth was observed.
Design and evaluation of doxycycline/collagen/chondroitin sulfate delivery systems used for cartilage regeneration
Authors: Marin Maria-Minodora , Albu Kaya Madalina Georgiana , Ghica Mihaela Violeta , Danila Elena , Coara Gheorghe , Popa Lacramioara , Chelaru Ciprian , Kaya Durmus Alpaslan , Anuta Valentina , Dinu-Pirvu Cristina-Elena , Cristescu Ioan
Published: December 2020

Cartilage damage is difficult to self-heal due to an avascular microenvironment and distinct mechanical properties. These features are a challenge in designing a cartilaginous tissue with repairing effect without producing any local infections. Thus, a biodegradable scaffold in which the drug can be incorporated is preferable. Drug delivery systems based on collagen sponges have progressively become remarkable biomaterials for different medical applications. The aim of this work was to design and characterize some collagen/chondroitin sulfate supports with doxycycline for cartilage tissue regeneration. The doxycycline should prevent the development of potential infections. Collagen, chondroitin sulfate and doxycycline gels were cross-linked with different concentrations of glutaraldehyde and then freeze-dried in order to obtain collagen matrices. The structural characteristics for the new synthesized biomaterials were firstly assessed by infrared spectroscopy (FT-IR), and scaffolds morphology was then evaluated by optical microscopy and water uptake. The enzymatic biodegradation was also performed. Also, the sponges surface properties were quantified through contact angle. The in vitro doxycycline kinetics release was performed with a dissolution equipment and the release mechanism was investigated. The obtained results recommend these new scaffolds based on doxycycline/collagen/chondroitin sulfate as a promising approach for the treatment of cartilage problems.
Obtaining of high density carbon materials by coke sintering resulting from heat treatment of tar for applications in sensors manufacture
Authors: Marinescu Maria-Roxana , David Elena , Ghiculescu Liviu-Daniel
Published: December 2020

In this research, high-density and high-strength carbonized carbon blocks were manufactured by coke sintering resulted from heat treatments of biomass pyrolysis tar. First, the molecular weight distribution of the tar was controlled through a pressurized heat treatment at 365°C and then this heat-treated tar was treated using a delayed coking system to obtain the self-sintering coke. Finally, carbon blocks were molded from the self-sintering coke and carbonized at 1100°C for 2h. Through rapid decomposition of the high molecular weight compounds in the tar at 360°C, the molecular weight distribution of tar was confirmed to be controllable by this treatment stage. During carbonization was observed a swelling in carbon blocks manufactured that contain more than 15 wt% of volatile matter from 150-500°C. The optimum conditions of the two heat treatments stage were established to be 310°C for 3 h and 500°C for 1.5 h. The highest density and highest strength of the carbonized carbon blocks manufactured were 1.44 g/cm3 and 68.7 MPa, respectively.
Pelt waste degradation using active microbial consortia
Authors: Constantinescu Rodica Roxana , Zainescu Gabriel , Ferdes Mariana , Caniola Iulia
Published: December 2020

In tanneries, environmental problems have special implications in terms of optimizing the consumption of used chemicals, applied technologies, the degree of recovery of useful substances from leather waste. Biodegradation is the process by which organic substances are broken down by microorganisms. From an ecological point of view, biodegradability assessments of new materials and compounds in the industry are essential to understand and quantify their impact on the environment. The sustainable development of the leather industry has focused on major environmental issues, such as clean production methods and waste management. Tanneries generate huge quantities of solid wastes as pelt waste. If these bio-waste materials are not utilized properly, they are potential source of pollution. Microbiological degradation of pelt waste is amongst the permanent concerns of leather processing units. The process may have the purpose of decomposing waste to exploit by-products as biocompost or to obtain proteases through a biotechnological process. These enzymes can be used after purification in various processes that have animal protein as a substrate. They can also be used in raw state for enzymatic hydrolysis. The paper aims at development of an experimental model on the bioenzymatic degradation process of protein waste from tanneries.
Biological pretreatment of waste from the leather industry to obtain biogas through anaerobic co-digestion processes - A review
Authors: Ferdes Mariana , Constantinescu Rodica Roxana
Published: December 2020

The leather industry produces a relatively high amount of hard degradable waste, with a negative impact on the environment. This waste usually contains two major categories of residues, namely animal fat and residues containing mostly proteins, suitable for biogas conversion. Obtaining biogas from leather waste by co-digestion with vegetable waste can be a sustainable and eco-friendly alternative to conventional energy from fuels. Anaerobic co-digestion is now considered to reduce waste from various sources and turn it into energy, generating in addition a digestate used as fertilizer in agriculture. This waste is relatively resistant to transformation into an easily fermentable substrate for anaerobic digestion to produce biogas. Thus, the methane yield can be significantly improved by biological treatments with enzymes and enzyme complexes, with microorganisms selected and used as inoculum or by mixed methods, which include other physical or chemical treatments. This paper aims to show the main methods of biological treatment of leather industry waste, in order to increase the yield of biogas by co-digestion with plant materials.