bluuebunny/crossref_metadata_2025 huggingface dataset:
Limitation and Improvement Plan of Maternity Healthcare Delivery System in Korea
Authors: Hwang Jong Yun
Published: November 2021

The Korean healthcare delivery system has been operating for over 30 years since 1989. Despite a positive performance—providing quality medical services to the people by distributing medical resources—there are limitations to the maternity healthcare delivery system. If the maternity healthcare delivery system was operating successfully, there should have been sufficient delivery hospitals so that pregnant women can access the appropriate maternity medical services whenever needed. Unfortunately, according to the National Health Insurance Service, the number of maternity health facilities in Korea reduced from 1,371 in 2003 to 541 in 2019. Regrettably, a larger number of obstetric hospitals and clinics have closed in medically vulnerable areas, such as farming and fishing areas, than urban areas with sufficient medical infrastructure, creating obstetrically underserved areas. In 2020, 65 out of a total of 250 cities, counties, and districts had no obstetric hospitals or clinics. To improve the collapsing maternity healthcare delivery system, a different approach is required; one in which policy support to stop the closure of delivery hospitals is emphasized. New maternity-related medical insurance payments, such as delivery labor management fees, fetal heart monitoring reading fees, and newborn care in delivery rooms fees, and active support policies are needed to prevent the closure of delivery hospitals. In this era of low fertility, because the maternity healthcare system is essential to maintain the nation, a healthcare delivery system different from the existing one must be established.
Usability-In-Place—Remote Usability Testing Methods for Homebound Older Adults: Rapid Literature Review (Preprint)
Authors: Hill Jordan R , Brown Janetta C , Campbell Noll L , Holden Richard J
Published: November 2021

BACKGROUND

Technology can benefit older adults in many ways, including by facilitating remote access to services, communication, and socialization for convenience or out of necessity when individuals are homebound. As people, especially older adults, self-quarantined and sheltered in place during the COVID-19 pandemic, the importance of usability-in-place became clear. To understand the remote use of technology in an ecologically valid manner, researchers and others must be able to test usability remotely.

OBJECTIVE

Our objective was to review practical approaches for and findings about remote usability testing, particularly remote usability testing with older adults.

METHODS

We performed a rapid review of the literature and reported on available methods, their advantages and disadvantages, and practical recommendations. This review also reported recommendations for usability testing with older adults from the literature.

RESULTS

Critically, we identified a gap in the literature—a lack of remote usability testing methods, tools, and strategies for older adults, despite this population’s increased remote technology use and needs (eg, due to disability or technology experience). We summarized existing remote usability methods that were found in the literature as well as guidelines that are available for conducting in-person usability testing with older adults.

CONCLUSIONS

We call on the human factors research and practice community to address this gap to better support older adults and other homebound or mobility-restricted individuals.
The Essential Network (TEN): Protocol for an Implementation Study of a Digital-First Mental Health Solution for Australian Health Care Workers During COVID-19 (Preprint)
Authors: Coleshill Matthew James , Baldwin Peter , Black Melissa , Newby Jill , Shrestha Tanya , Haffar Sam , Mills Llewellyn , Stensel Andrew , Cockayne Nicole , Tennant Jon , Harvey Samuel , Christensen Helen
Published: November 2021

BACKGROUND

The COVID-19 pandemic has placed health care workers (HCWs) under severe stress, compounded by barriers to seeking mental health support among HCWs. The Essential Network (TEN) is a blend of digital and person-to-person (blended care) mental health support services for HCWs, funded by the Australian Federal Department of Health as part of their national COVID-19 response strategy. TEN is designed as both a preventative measure and treatment for common mental health problems faced by HCWs. New blended services need to demonstrate improvements in mental health symptoms and test acceptability in their target audience, as well as review implementation strategies to improve engagement.

OBJECTIVE

The primary objective of this implementation study is to design and test an implementation strategy to improve uptake of TEN. The secondary objectives are examining the acceptability of TEN among HCWs, changes in mental health outcomes associated with the use of TEN, and reductions in mental health stigma among HCWs following the use of TEN.

METHODS

The implementation study contains 3 components: (1) a consultation study with up to 39 stakeholders or researchers with implementation experience to design an implementation strategy, (1) a longitudinal observational study of at least 105 HCWs to examine the acceptability of TEN and the effectiveness of TEN at 1 and 6 months in improving mental health (as assessed by the Distress Questionnaire [DQ-5], Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder [GAD-7], Oldenburg Burnout Inventory [OBI-16], and Work and Social Adjustment Scale [WSAS]) and reducing mental health stigma (the Endorsed and Anticipated Stigma Inventory [EASI]), and (3) an implementation study where TEN service uptake analytics will be examined for 3 months before and after the introduction of the implementation strategy.

RESULTS

The implementation strategy, designed with input from the consultation and observational studies, is expected to lead to an increased number of unique visits to the TEN website in the 3 months following the introduction of the implementation strategy. The observational study is expected to observe high service acceptability. Moderate improvements to general mental health (DQ-5, WSAS) and a reduction in workplace- and treatment-related mental health stigma (EASI) between the baseline and 1-month time points are expected.

CONCLUSIONS

TEN is a first-of-a-kind blended mental health service available to Australian HCWs. The results of this project have the potential to inform the implementation and development of blended care mental health services, as well as how such services can be effectively implemented during a crisis.

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/34601
Safety Evaluation of an Expedited Omalizumab Home Self-Administration Pathway (Preprint)
Authors: Hussain Zobia
Published: November 2021

BACKGROUND

The Northern Ireland Regional Immunology Service (NIRIS) has developed an expedited omalizumab home self-administration pathway to reduce face-to-face clinic attendance during the COVID19 pandemic. This audit evaluates the safety of this pathway with a particular focus on anaphylaxis.

OBJECTIVE

To retrospectively audit the records of 39 patient undertaking expedited home self-administration at NIRIS for complications, particularly Emergency Department attendance for anaphylaxis. The target was for 100% of patients to complete a six-month course without experiencing anaphylaxis related to omalizumab administration.

METHODS

39 records of patients who underwent expedited omalizumab self-administration were audited by a single reviewer. They were prospectively collected between March 2020 and August 2021. Clinical data was collected from the Northern Ireland Electronic Care Record (NIECR).

RESULTS

100% of patients were in the process of completing or had completed a six-dose course without anaphylaxis. 7.6% of patients attended the Emergency Department during their course of omalizumab. 0% experienced anaphylaxis triggered by omalizumab. The target of 100% patients completing the expedited pathway without omalizumab-related anaphylaxis was met.

CONCLUSIONS

The expedited omalizumab home self-administration pathway is safe and may become the standard of care post-pandemic.
Missing data methods for intensive care unit SOFA scores in electronic health records studies: results from a Monte Carlo simulation
Authors: Brinton Daniel L , Ford Dee W , Martin Renee H , Simpson Kit N , Goodwin Andrew J , Simpson Annie N
Published: November 2021

Aim:
Missing data cause problems through decreasing sample size and the potential for introducing bias. We tested four missing data methods on the Sequential Organ Failure Assessment (SOFA) score, an intensive care research severity adjuster.
Methods:
Simulation study using 2015–2017 electronic health record data, where the complete dataset was sampled, missing SOFA score elements imposed and performance examined of four missing data methods – complete case analysis, median imputation, zero imputation (recommended by SOFA score creators) and multiple imputation (MI) – on the outcome of in-hospital mortality.
Results:
MI performed well, whereas other methods introduced varying amounts of bias or decreased sample size.
Conclusion:
We recommend using MI in analyses where SOFA score component values are missing in administrative data research.
Power Train Designing for Formula styled Racing Car
Authors: Sevak Malav
Published: November 2021

Abstract: A wheel assembly is an integral part of a vehicle’s design that connects the wheel to the suspension system and transfers pressure from the road to the suspension system. It also holds the brake system and facilitates steering. Power transmission is also addressed in the powertrain department. We describe the process and simulation that result in the hub, upright, and differential mounting of a formula student car and the size of the sprocket for maximum acceleration in this report. As a result of the work done on this project, the resulting car has improved acceleration, is easy and reliable to assemble, and has fewer breakdowns than the previous model. The report includes all the calculations that support the simulations and a validating statement about the bearing selection.
Multi-Agent Autonomous Cleaning
Authors: Rao Swaneet D.
Published: November 2021

Abstract: In today’s world, robots are taking over the world by doing the tasks which used to be done by humans a while ago. Robots are continuously evolving into better and more efficient autonomous agents, makes substantial growth in fields like adaptive artificial intelligence. Our main objective of this people is to create an efficient multi agent autonomous environment for robots for cleaning purposes. Keywords: Gradient Descent, Centralized controller, autonomous agents, LiDAR
How Do We Develop Modern Pre-School Education in Size 4K
Authors: Ergasheva Dilnoza Takhirovna
Published: November 2021

Abstract: Model 4Khas benefits which can help us to identify and differentiate it. Not only has it got advantages which can develop child' brain, but also it helps to adapt a child to the kindergarten and school. Child development theories fоcus on explaining how children change and grow over the course of childhood. Such theories center on various aspects of development including social, emotional, and cognitive growth. We help people find answers, solve problems and get inspired. Parents often focus on what are known as developmental milestones, which represent abilities that most children tend to display by a certain point in development. These typically focus on one of four different areas: physical, cognitive, social / emotional, and communication. Keywords: adaptation, nursery, kindergarten, child, teaching, training, modern, level, goal, communication.
Analysis of Improving the Living Standards of the Population
Authors: Asatullayevich Ismatov Sharofiddin
Published: November 2021

Annotation: This article analyzes reforms in the standard of living and welfare of the country's population, and develops scientific conclusions and recommendations for further improving the living standards and welfare of the population. Keywords: population, living standards, welfare, income, needs, wages, pensions, goods, food, consumer spending.
Forming nouns using suffixes: ? \'and\' - ? / - ? \'- ?\' i \'- ?\' - ? \',\' - ? \',\' - ? \',\' ? \',\' - ?? \',\' - ?? \',\' - ?? \'
Authors: Ashurovna Tellyaeva Rushana
Published: November 2021

Abstract: This article is about the formation of nouns using suffixes that are located between the root, stem and ending or particle. Because in Korean, particles are certainly used in sentences. Keywords: Suffixes, morphological, voice, reverence, time, probable modality, active, productive.
Facilitating consolidation and development of village unit cooperative business plan in Central Java
Authors: Sudjatmoko Agung , Suprapto Adi Teguh
Published: November 2021

The purpose of this activity was to increase the capacity of village cooperative administrators in Central Java in formulating business plans that are able to increase cooperative businesses based on the economic potential in rural areas. The activity method was carried out through capacity building training with competency-based training learning techniques. The activities have resulted that participant gained knowledge, understanding, and skills to develop a business plan so that it can be used to develop a cooperative business.
The effect of inoculum and glucose addition on polyhydroxyalkanoate production by Brevibacterium sp. B45
Authors: RATNANINGRUM Diah - , ENDAH Een Sri , ABDULLAH Akbar Hanif Dawam , SARASWATY Vienna , LISDIYANTI Puspita - , FRASNAWATY Eva - , PRIATINI Sri -
Published: November 2021

Petroleum-based plastics are the major cause of environmental pollution because the plastics need years to be degraded. The difficulties in handling waste of petroleum-based plastic have motivated researchers to produce environmentally friendly plastic materials that are biologically degradable; one of them is polyhydroxyalkanoate (PHA). Polyhydroxyalkanoate is natural biodegradable biopolymers produced by bacteria as an intracellular carbon  and  energy storage. This polymer is an alternative source of plastics  with similar physical properties to petroleum-based plastic.It can be easily biodegraded aerobically and anaerobically. This study examined the potential of one superior isolate as PHA producers, i.e.,Brevibacterium sp. B45. Brevibacterium sp. B45 was cultivated in Ramsay’s minimal medium with inoculum concentrations were 1, 2, and 3% (v/v)and glucose concentrations were 1, 3, and 5% (w/v). The cultivation of  Brevibacterium sp. B45 was carried out in a 500 mL Erlenmeyer flask on a shaker incubator with 150 rpm and 30 oC for 72 hours. PHA recovery was carried out by chloroform extraction and characterized by scanning electron microscopy (SEM), Fourier transformed infrared (FTIR), and differential scanning calorimetric (DSC) methods. The highest yield of dried biomass (2.92%) was obtained using 3% inoculum and 3% glucose. The melting temperature (Tm), enthalpy (ΔHf), and crystallinity (Xc) of the PHA product were 172.1 °C, 61.04 J g-1, and 41.08%, respectively. Data of SEM show that a porous surface characterized morphological of purified PHA grains. The functional units of purified PHA grains were C=O, CH3, C-O, C-O-C, C-C, C-H, and -OH. The purified PHA grains show a similar spectrum to the standard Poly-3-hydroxybutyrate (PHB). Therefore, it could be assumed that PHA produced by Brevibacterium sp. B45 was most likely PHB.
Respons tanaman tebu (Saccharum officinarum L.) terhadap aplikasi konsorsium biostimulan di tiga tipologi lahan
Authors: YUSUP Ciptadi Achmad , PURWANTORO Deddy , WIDIASTUTI Happy , SISWANTO . , SANTOSO Djoko , PRIYONO .
Published: November 2021

The consortium biostimulant combines several types of biostimulant applied holistically, such as phytohormones to induce physiological processes, humic acid to improve nutrition intake and land fertility, and biofertilizer arbuscular mycorrhizal fungi to improve abiotic stress tolerance. The objectives of this research were to analyze the effect of application consortium biostimulant on the growth and productivity of Bululawang sugarcane variety planted in three land typologies, i.e. irrigated heavy soil with good drainage (BPL), irrigated heavy soil with poor drainage (BPJ), and rainfed light soil with good drainage (RHL). The research was conducted on plant cane (PC) sugarcane areal in Lumajang Regency, East Java, from July 2019 to September 2020. The treatment plot area was 1 ha for each land typologies, and the observation were conducted on 10 m plant row with ten times replications. Each treatment was replicated ten times. The results showed that the application of consortium biostimulant could induce faster growth of sugarcane shoots and better roots at one month after planting (MAP). Stalk height and diameter showed significantly different values between treatment and control at the plant age 6 to 12 MAP. In addition, the sugarcane stalk weight per meter row also increases by 13.72 – 28.57%. The growth performance of sugarcane on a commercial scale increased, also sugarcane productivity increased by 11.08 – 20.36%. The potential sugar yield increased by 15.05% in BPL land typology, 4.9% in BPJ land typology, and 9.7% in RHL land typology. The difference in land typologies affected the effectiveness of the consortium biostimulant application in increasing sugarcane productivity.
Persoalan Iddah dan Ihdad Bagi Wanita Karir
Authors: Nurdin
Published: November 2021

The discussion in this study tries to reveal everything related to women's freedom in doing activities outside the home, but she also has several religious regulations that follow and limit. This articel aims to explain the positive legal views towards Iddah and Ihdad career women, and to explain the Islamic legal views towards Iddah and Ihdad career women. The author uses the library research method or library research. Based on the research results, it can be concluded that the stipulation of Iddah and Ihdad laws for women is reasonable, both in terms of religion and in terms of goodness for women. However, several prohibitions for a woman who practices iddah and ihdad can find several reasons to become a law that is appropriate in every era and situation.
Pengaruh Hidden Curriculum terhadap Pembinaan Karakter Religius Peserta Didik di Dayah Jeumala Amal Pidie Jaya dan Dayah Al-Furqan Pidie
Authors: Hayati Amal , M. Nur Azhar , Dahliana Syarifah
Published: November 2021

Hidden curriculum helps manifest the development of students’ religious characters; however, it is often neglected and not used properly in the learning process. The questions posed in this study include: How is the implementation of the hidden curriculum in the development of the religious characters of students? To what extent the hidden curriculum influences the development of the religious characters of students? and What is the impact of the hidden curriculum on the formation of the religious characters of students? This mixed methods study obtained data by means of questionnaire, interview, and observation. The subject of the study had a sample size of 153. The study employed the SPSS ver. 25 to analyze the quantitative data, whereas the qualitative data were presented descriptively. The findings indicate that the hidden curriculum has been applied inside and outside the classroom. The study revealed that the hidden curriculum implemented at Dayah Jeumala Amal and Dayah Al-Furqan reached the medium level of 40% and of 34.78%, respectively and also created students with high religious characters of 51.54% and of 43.48%, respectively. Further, the simple linear regression test obtained the value of 0.00, at the level of significance α = 0.005, indicating that there was an influence of the hidden curriculum on the development of the religious characters of students. The influences of the hidden curriculum in the forms of role model, habituation, coaching, and attitudes from an educator have resulted in the birth of exemplary values ​​that are more long lasting and impactful within the students. In addition, the influences in the social and environmental forms have triggered the establishment of a harmonious relationship with other people and yielded an attitude of concern for the environment in which the students live. Moreover, the implementation of the hidden curriculum in the form of worship carried out in schools has also enabled the development of religious attitudes, including honesty, patience, and trustworthiness, within the students.
Pendekatan Pembinaan Karakter Siswa Melalui Program Diniyah MIN 1 Banda Aceh
Authors: Rahmi Murtaza
Published: November 2021

The Diniyah program is one of the programs initiated by the Banda Aceh City government to assist schools in internalizing the value of Islamic education to students. Through this program, it is hoped that there will be improvements in student behavior or character in the future. The research objective was to see how the implementation, approaches, opportunities, and challenges of character building for students at MIN 1 Banda Aceh. This study used a qualitative approach with the research subjects of the head, teachers, and students of MIN 1 Banda Aceh. Data collection was carried out by means of observation, interviews, and documentation. The results showed that the stages of the Diniyah program implementation were carried out through a) Al-Qur'ān reading and writing program, b) Increasing memorization and muraja'ah, c) Increasing daily prayer memorization programs, d) Increasing understanding of the contents of the book, e) Increasing the understanding student worship, f) increasing student moral development, which is carried out in the classroom and outside the classroom. The approaches taken include a) awareness approach, b) habituation, c) modeling. There is an opportunity for students to have the maximum time to complete the character-building program properly and schools can improve the quality of the school for the better. The challenges include lack of family support, environment, student readiness, lack of facilities, and several other internal school conditions.
Korelasi Kompetensi Pedagogik Guru dengan Hasil Belajar Siswa Pada Pelajaran PAI di SMA Negeri 2 Bireuen
Authors: Nawawi
Published: November 2021

Kompetensi Pedagogik guru PAI mempunyai hubungan positif atau negatif terhadap hasil belajar PAI sebagaimana kompetensi pedagogik yang dimiliki guru. Maka dilakukan penelitian tentang korelasi antara kompetensi pedagogik guru dengan hasil belajar PAI di SMA Negeri 2 Bireuen. Rumusan masalah dalam hal ini adalah apakah terdapat korelasi (hubungan) antara kompetensi pedagogik guru dalam membuat perencanaan, melaksanakan dan mengevaluasi pembelajaran dengan hasil belajar siswa pada pelajaran PAI.Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara kompetensi pedagogik guru PAI dengan hasil belajar siswa pada mata pelajaran PAI di SMA Negeri 2 Bireuen. Dalam penelitian ini terdapat dua variabel yang diteliti yaitu independent dan dependent. Desain penelitian yang digunakan dalam penelitian ini adalah penelitian korelasional dengan pendekatan kuantitatif. Populasi dalam penelitian ini adalah keseluruhan Guru PAI dan siswa SMA Negeri 2 Bireuen Kabupaten Bireuen. Sampel dalam penelitian ini adalah 74 siswa kelas XI dan guru PAI SMA Negeri 2 Bireuen dengan melakukan teknik random sampling. Teknik pengumpulan data dilakukan dengan angket. Analisis data menggunakan analisis korelasi Product Moment SPSS 17.0. Hasil penelitian menunjukkan bahwa korelasi kompetensi pedagogik guru dengan hasil belajar PAI siswa terlihat rendah. Hal ini ditunjukkan melalui analisis regresi dan korelasi. Dalam uji regresi pada taraf signifikan 10% diperoleh signifikansi sebesar 0,400 > 0,10 dan uji korelasi berada pada tingkatan 0,997 dengan koefisien determinasi 8%. Oleh karena itu, kesimpulannya bahwa tidak terdapat hubungan yang positif dan signifikan antara kompetensi pedagogik guru dengan hasil belajar PAI siswa pada SMA Negeri 2 Bireuen.
Parameterization of Solar Radiation Absorption by Snow–ice Cover in the Thermodynamic Sea Ice Model of the Sea of Azov
Authors: Zavyalov D. D. ,   Marine Hydrophysical Institute, Russian Academy of Sciences, Sevastopol, Russian Federation, Solomakha T. A. ,   Marine Hydrophysical Institute, Russian Academy of Sciences, Sevastopol, Russian Federation
Published: November 2021

Purpose. The work is aimed at assessing the influence of choice of the parameterization scheme of the snow and ice radiation features upon reproduction of seasonal evolution of the snow–ice cover thickness and temperature distribution in it in the Taganrog Bay top part. Methods and Results. Thermal seasonal dynamics of the snow–ice cover thickness in the northeastern part of the Taganrog Bay was studied using a non-stationary thermodynamic model of sea ice. The model reproduces formation of ice and accumulation of snow on its surface, spatial-temporal change in their thermophysical characteristics, melting of the snow–ice cover, vertical distribution of temperature, and solar radiation absorbed in its thickness at a preset timed data on the meteorological parameters. In the numerical solution of the heat conductivity equation for snow and ice including a radiation source, a computational grid permitting to maintain spatial resolution of the temperature profiles in the snow–ice cover during its melting and growth was applied. Two variants of parameterization of solar radiation transfer in the sea ice were considered. The first version assumed exponential decay of radiation with the constant transmittance and extinction coefficients. In the second one, a two-layer scheme of the solar radiation penetration into ice was used; it simulated the near-surface transition layer. Attenuation of intensity of solar radiation in the snow thickness was described by the Bouguer–Lambert law with the extinction coefficient both as independent of the snow thermophysical characteristics and as represented by the function of its density. The numerical experiments with the purpose to reproduce seasonal evolution of the snow–ice cover thickness and its vertical temperature profile in the Taganrog Bay top part were performed for the winter season, 2016/17. Comparative analysis of the simulation results and the sea ice thickness values taken from the ESIMO ice maps made it possible to choose a combination of the model parameters that provides the best correspondence between the calculated and actual values. Conclusions. It is shown that in reproducing the seasonal changes in the ice cover thickness in the Taganrog Bay top part in winter, 2016/17, the choice of the transmittance and extinction coefficients for white ice represented by the cloudiness functions, on the one hand, and the thickness of the layer with the most intense absorption of short-wave radiation ~ 4 cm, on the other, turned out to be the most justified.
Heavy Metals in the Bottom Sediments of the Black Sea Northwestern Shelf in Recent Years
Authors: Korablina I. V. ,   Russian Federal Research Institute of Fisheries and Oceanography “VNIRO”, Azov-Black Sea Branch of VNIRO (“Azniirkh”), Rostov-on-Don, Russian Federation, Barabashin T. O. ,   Russian Federal Research Institute of Fisheries and Oceanography “VNIRO”, Azov-Black Sea Branch of VNIRO (“Azniirkh”), Rostov-on-Don, Russian Federation, Katalevsky N. I. ,   Russian Federal Research Institute of Fisheries and Oceanography “VNIRO”, Azov-Black Sea Branch of VNIRO (“Azniirkh”), Rostov-on-Don, Russian Federation
Published: November 2021

Purpose. The study is aimed at investigating metal accumulation in the 0–2 cm layer of the bottom sediments of the Black Sea northwestern shelf over 2000–2020, and at identifying the sea bottom areas subjected to the increased anthropogenic load through comprehensive assessment of the degree of their pollution taking into account their granulometric composition. Methods and Results. The bottom sediments were sampled annually from the 0–2 cm depth at the same stations. The detected metal concentrations were compared with their content in the Earth crust and the background values. The dynamics and trends of the individual metals’ content in the shelf bottom sediments were assessed for the whole period of observations. The notion of the average characteristic concentration of an element is introduced; the procedure for its calculation is represented. The pollution of bottom sediments was analyzed with the regard for the element average characteristic concentration in the bottom sediments of various granulometric types. Increase in the average content of lead, zinc and chromium was revealed from the beginning of the observation period to 2020. The seasonal dynamics of these elements was found in the whole water area under study (as well as the iron content at some areas). Conclusions. Multiple cases of the lead, manganese and chrome concentrations exceeding their content in the Earth crust were recorded; as for zinc and copper, such cases were few and sporadic. The tendencies in variation of the bottom sediments content were determined: the average long-term values of the lead concentration increased by 1.2 times, those of zinc – by 1.6 times, and those of chrome – by 2 times; the concentrations of iron, manganese and copper remained essentially the same. Seasonal dynamics of the zinc, chromium, lead and iron content was shown. For a number of metals, the cases when their absolute content exceeded their average characteristic concentration in the corresponding type of the bottom sediments had been found. The regions subjected to a multi-faceted anthropogenic load were identified; the areas of possible local inflow of the monitored elements were revealed. The bottom sediments sampled in 2019 were the most polluted.
Deprescribing Inappropriate Proton Pump Inhibitors in a Family Medicine Residency Practice Office
Authors: Lai Andrew , Odom Amy , Roskos Steven E. , Phillips Julie P.
Published: November 2021

Introduction: Proton pump inhibitors (PPIs) are often prescribed beyond their medically-approved duration of use. Long-term PPI use has been linked with numerous adverse effects and contributes to polypharmacy. This study sought to understand the effect of evidence-based education to resident and faculty physicians on deprescribing inappropriate PPIs. We hypothesized that this educational intervention would result in fewer inappropriate PPI prescriptions.
Methods: We performed a chart review on all adult patients in a family medicine residency program practice, identifying those inappropriately taking PPIs. All physicians in the practice participated in an educational intervention regarding deprescribing inappropriate PPIs and were given frequent reminders to continue their deprescribing efforts. We reviewed charts at the end of the study to identify patients with successful deprescribing attempts.
Results: Of the 187 patients prescribed inappropriate PPIs in the study, 100 remained on PPIs at the end of the study (46.6% success rate). There was a significant decrease in the number of patients inappropriately prescribed PPIs by each physician over the course of the study, from a mean of 17.0 (beginning) to 9.1 (end).
Conclusion: Physician education with reminders is an effective means of reducing the number of inappropriate PPIs prescribed in a family medicine residency practice. Future studies could investigate the effectiveness of educational interventions with other medication classes that are often prescribed inappropriately.
Outcome prediction of pediatric drowning
Authors: Park Mi So , Seo Won Hee , Je Bo-Kyung , Song Dae Jin , Kwon Jung Hyun
Published: November 2021

Purpose: Despite the well-known mortality of pediatric drowning, there is a paucity of evidence on the implications of an initial evaluation on the relevant outcome of drowning. This study aimed to investigate the association of initial clinical findings with outcome of children undergoing drowning.Methods: This retrospective study was conducted using the medical records of 56 children undergoing drowning who visited 3 Korean academic hospitals from January 2000 through May 2020. We analyzed information regarding the prehospital resuscitation, drowning time, a 4-tiered chest radiographic grade, and the baseline characteristics. The grade was defined based on the findings of initial chest radiographs. The poor outcomes were defined as the need for intensive care unit care or death aftercare. We analyzed the association of the prehospital resuscitation, submersion time, and the radiographic grade with the poor outcomes using binary logistic regression.Results: Among the 56 children, 31 (55.4%) were aged 1-4 years. Prehospital resuscitation and 1-5 minutes of submersion time were noted in the 25 (44.6%) and 30 children (53.6%), respectively. The chest radiographic grades 1 through 4 accounted for 17 (30.4%), 20 (35.7%), 12 (21.4%), and 3 children (5.4%), respectively. Poor outcomes occurred in 17 children (30.4%), including 3 deaths (5.4%). The association with the poor outcomes was noted in the submersion time of longer than 5 minutes (adjusted odds ratio, 21.49; 95% confidence interval, 1.11-415.73; compared with < 1 minute) while not in the submersion time and chest radiographic grade.Conclusion: This study confirms that submersion time is an outcome predictor of drowning.
Changes in Respiratory Management and the Impact on Bronchopulmonary Dysplasia
Authors: Chung Jane , Iyengar Anjali , Santry Laura , Swanson Eric , Davis Jonathan M , Volpe Mary Ann
Published: November 2021

Objective: Non-invasive respiratory support has reduced the need for
mechanical ventilation and surfactant administration in very premature
neonates. We sought to determine how the increased use of non-invasive
ventilation and less surfactant instillation has impacted the
development of bronchopulmonary dysplasia (BPD) and compared BPD outcome
applying four currently used definitions. Study Design: This is a
retrospective, single center cohort study of neonates born at less than
28 weeks gestation between 2010 and 2018. A respiratory practice change
(less surfactant and more non-invasive ventilation) occurred in 2014
following participation in the SUPPORT trial. Therefore, patients were
divided into 2 epochs to compare postnatal respiratory and clinical
course and BPD outcomes across four currently relevant definitions (VON,
NICHD, Canadian, NRN). Results: Clinical and demographic variables were
similar between epochs. Despite significant differences in maternal and
infant characteristics and clinical course, the incidence of BPD was not
significantly different between the 2 epochs regardless of the BPD
definition utilized. There was a wide range in the incidence of BPD
depending on the definition used. Conclusions: Despite decreased use of
invasive mechanical ventilation and surfactant administration between
the two epochs, the incidence of BPD did not change and there was wide
variation depending on the definition used. A better understanding of
the risk factors associated with BPD and a consensus definition is
urgently needed in order to facilitate the conduct of clinical trials
and the development of novel therapeutic interventions to improve
outcome.
Nitrogen enrichment causes thermal acclimation of soil microbial respiration
Authors: Sun Huimin , Chen Hongyang , Li Jintao , Zhang Yan , Liu Xiang , LI Bo , Zhou Shurong , Nie Ming
Published: November 2021

The feedback between soil carbon (C) and climate has the potential to
decrease in magnitude over time due to the thermal acclimation of
microbial respiration, while, whose strength is highly uncertain, partly
because the response of microbial respiration is regulated by multiple
environmental factors simultaneously rather than by temperature alone.
Using a 9-year two-way factorial experiment involving warming and
multilevel nitrogen enrichment treatments from an alpine grassland, we
show that microbial respiration acclimates to warming only under
nitrogen enrichment and that the strength of thermal acclimation
increases as nitrogen enrichment. We identified two contrasting
pathways—via an enhancement of acclimation by soil acidification and a
weakening of acclimation by the inhibition of soil C availability and
stimulation of soil C-degrading enzymes—with a net positive effect of
nitrogen enrichment on microbial thermal acclimation. Our findings
emphasize the importance of considering multiple environmental factors
in shaping the strength of thermal acclimation.
Shedding some light on tricuspid intervention
Authors: Fattouch Khalil , Moscarelli Marco
Published: November 2021

More than 1.6 million Americans have at least moderate to severe
tricuspid regurgitation, yet fewer than 8000 tricuspid valve operations
are performed annually in the USA.The under-treatment for isolated
tricuspid regurgitation might be related to the fact that in the past
years no clear guidelines on how and when to treat tricuspid
regurgitation were issued. Here, we discuss the meta-analysis by
Sarris-Michopoulos et al, and we comment what is available in literature
on diagnosis and decision making for tricuspid valve intervention.
Bridge to Future Livable Cities and City Clusters in the People’s Republic of China: Policy Opportunities for High-Quality Urban Development
Authors: Rau Stefan
Published: November 2021

The achievements in rapid urbanization and industrialization of the People’s Republic of China (PRC) over the past 40 years were historic. But they came at high environmental and social costs. By 2050, the country will be a high-income, four-generation urban society. Yet, according to the United Nations, the PRC’s population will have halved by 2100. Many cities will lose population and businesses. This will be equally historic and requires urgent action. The author recommends focusing on urban rehabilitation and retrofitting to make cities more livable—with a green circular zero-waste economy, aiming at low-carbon, climate-resilient cities—and making cities healthy and friendly for people of all ages.
Application of differential transformation method for an annular fin with variable thermal conductivity
Authors: Aksoy Gokhan
Published: November 2021

The thermal analysis of the annular fin is performed by applying the differential transformation method. The thermal conductivity of the annular fin has been considered as a function of temperature. The effects of non-dimensional parameters, namely thermal conductivity and thermo-geometric fin parameters on the fin efficiency and temperature distribution are determined. Obtained results from the differential transformation method are also compared with the exact analytical results and the results of the finite difference method in the constant thermal conductivity condition. It has been concluded that the differential transformation method provides accurate results in the solution of non-linear problems.
Numerical simulation on heating performance and emission characteristics of a new multi-stage dispersed burner for gas-fired radiant tubes
Authors: Fan Huanbao , Feng Junxiao , Bai Wei , Zhao Yujie , Li Weidong , Gao Jun , Liu Changpeng , Jia Lidi
Published: November 2021

To enhance the temperature uniformity and NOx reduction performance of the gas-fired radiant tubes, we proposed a new multi-stage dispersed burner based on fuel-staging combustion technology in this study. The effect of fuel nozzle structural parameters, including secondary fuel nozzle distance, D, (30 mm, 50 mm, 70 mm), secondary fuel nozzle diameter, ds, (2-6 mm), and tertiary fuel nozzle diameter, dt, (2.5 mm, 5 mm, 7.5 mm, 10 mm) on the flow field, temperature distribution, NOx generation and thermal efficiency were analyzed by numerical simulations. The results show that the multi-stage dispersed fuel nozzle could slow down the combustion rate and form a low oxygen dilution zone in the reaction process, reducing the maximum combustion temperature and NOx emission. With the increase of the secondary fuel nozzle distance, the NOx concentration at the outlet decreased from 69.0 ppm to 54.6 ppm, and a decrease of 20.9%. When the secondary fuel nozzle diameter increased from 2-6 mm, the maximum wall temperature difference gradually increased 72.8-76.3 K. The NOx emission at the outlet first decreased, then increased, and was as low as 45.6 ppm at a 5 mm diameter. Furthermore, increasing the tertiary fuel nozzle diameter could reduce the maximum wall temperature difference and NOx emission, and improve thermal efficiency. When dt = 7.5 mm, the overall performance of the radiant tube was the best, and the outlet NOx concentration, wall temperature difference and thermal efficiency were 46.1 ppm, 73.0 K, 63.7%, respectively.
Experimental investigation of the embedded micro-channel manifold cooling for power chips
Authors: Zhang Nan , Liu Ruiwen , Kong Yanmei , Ye Yuxin , Du Xiangbin , Cong Bo , Yu Lihang , Wang Zhiqiang , Dai Yang , Li Wei , Jiao Binbin , Duan Zhiyong
Published: November 2021

Power chips with high power dissipation and high heat flux have caused serious thermal management problems. Traditional indirect cooling technologies could not satisfy the increasing heat dissipation requirements. The embedded cooling directly inside the chip is the hot spot of the current research, which bears greater cooling potential comparatively, due to the shortened heat transfer path and decreased thermal resistance. In this study, the thermal behaviors of the power chips were demonstrated using a thermal test chip, which was etched with micro-channels on its substrate?s backside and bonded with a manifold which also fabricated with silicon wafer. The chip has normal thermal test function and embedded cooling function at the same time, and its size is 7 ? 7 ? 1.125 mm3. This paper mainly discussed the influence of width of micro-channels and the number of manifold channels on the thermal and hydraulic performance of the embedded cooling structure in the single-phase regime. Compared with the conventional straight micro-channel structure, the cooling coefficient of performance of the 8 ? ?50 (number of manifold distribution channels: 8, micro-channel width: 50 ?m) structure is 3.38 times higher. It is verified that the 8 ? ?50 structure is capable of removing power dissipation of 300 W (heat flux: 1200 W/cm2) at a maximum junction temperature of 69.6? with pressure drop of less than 90.8 kPa. This study is beneficial to promote the embedded cooling research, which could enable the further release of the power chips performance limited by the dissipated heat.
Multiple omental hemangiomas in a Himalayan cat: Incidental finding in a laparotomy
Authors: Amniattalab Amir , Rezazadeh Amin
Published: November 2021

This report describes the occurrence of omental hemangioma in a five-year-old Himalayan cat. The cat was affected by hemorrhagic gastroenteritis caused by Fusobacterium necrophorum. Also, chronic renal failure (CRF) was demonstrated according to high levels of blood urine nitrogen (BUN), creatinine (Cr), as well as hypoproteinemia and anemia. In this respect, in urinalysis, urine specific gravity (USG) decreased while urea, creatinine and total protein levels increased. Moreover, the complete blood count (CBC) tests showed neutrophilia, monocytosis and lymphopenia. During an exploratory laparotomy, nine masses with a size of 1-5 mm and firm consistency were found to be scattered on the omentum. Histologically, the masses consisted of capillary-cavernous vessels with well-differentiated endothelial cells. No mitotic figures, hemorrhage, or necrosis were found, but there was focal lymphocytic infiltration in the parenchyma of the masses. Immunohistochemically, expression of vimentin and von Willebrand factor (vWF) was found in the endothelial cells, while the immunoreaction to smooth muscle actin (?SMA) was negative. These findings confirmed the diagnosis of hemangioma. To the best of the authors? knowledge, this is the first report of feline omental hemangioma.
Remission of type 2 diabetes following a short-term intensive intervention with insulin glargine, sitagliptin and metformin: results of an open-label randomized parallel-design trial
Authors: McInnes Natalia , Hall Stephanie , Hramiak Irene , Sigal Ronald J. , Goldenberg Ronald , Gupta Nikhil , Rabasa-Lhoret Remi , Braga Manoela , Woo Vincent , Sultan Farah , Otto Rose , Smith Ada , Sherifali Diana , Liu Yan Yun , Gerstein Hertzel C. , Group the REMIT-sita Collaborative
Published: November 2021

Objective

The aim of the study was
to evaluate remission of type 2 diabetes following a short-term intervention
with insulin glargine, sitagliptin/metformin and lifestyle approaches.

Research Design and Methods

In this open multicenter
trial, 102 patients with type 2 diabetes were randomized to (i) a 12-week
intervention with sitagliptin/metformin, insulin glargine and lifestyle therapy
or (ii) control group. Participants with
HbA1C<7.3% [<56 mmol/mol] at 12 weeks were asked to stop diabetes
medications and were followed for evidence of relapse over 52 weeks. Diabetes relapse criteria included HbA1C
≥6.5% [≥48 mmol/mol], ≥50% of capillary glucose readings >10 mmol/L over 1
week, re-initiation of diabetes medications ± abnormal fasting plasma glucose (FPG)
or 2-hour plasma glucose on an oral glucose tolerance test (OGTT). Time-to-relapse analysis was conducted to
compare the treatment groups with (primary analysis) and without (supplementary
analysis) FPG/OGTT relapse criteria.

Results

With
the FPG/OGTT relapse criteria included, the hazard ratio of relapse was 0.72
(95% CI 0.47-1.10) in the intervention group compared to the control group
(primary analysis), and the number of participants remaining in remission was
not significantly different between treatment groups at 24, 36, 48 and 64 weeks. In the supplementary analyses without these
criteria, hazard ratio of relapse was 0.60 (95% CI 0.39-0.95), and the number
of participants remaining in remission was significantly higher (26 vs 10%) in
the intervention group at 36 weeks.

Conclusions

Although
our primary outcome was not statistically significant, the tested approach deserves
further study with further optimization of its components.