bluuebunny/crossref_metadata_2025 huggingface dataset:
A Mini-Open Approach to Medial Pinning in Pediatric Supracondylar Humeral Fractures May Be Safer Than Previously Thought
Authors: Rees Andrew B. , Schultz Jacob D. , Wollenman Lucas C. , Moore-Lotridge Stephanie N. , Martus Jeffrey E. , Schoenecker Jonathan G. , Mencio Gregory A.
Published: October 2021

Background:

Displaced pediatric supracondylar humeral fractures (SCHFs) are stabilized after reduction by smooth pins. Although some SCHFs are biomechanically stable after lateral-only entry pinning (lateral pinning), an additional medial entry pin (cross-pinning) confers superior stabilization in some SCHFs. There is a recognized risk of iatrogenic ulnar nerve injury with medial entry pinning. The best existing evidence has estimated an iatrogenic ulnar nerve injury rate of approximately 3.4% in cross-pinning. In similar studies, the rate of iatrogenic nerve injury (all nerves) in lateral pinning is estimated at 1.9%. This study aimed to use a large, single-center, single-technique (mini-open) retrospective case series to determine the rate of iatrogenic ulnar nerve injury in cross-pinning.

Methods:

Patients undergoing percutaneous cross-pinning via the mini-open technique for SCHFs from 2007 to 2017 were retrospectively reviewed. Injury characteristics, operative variables, fixation technique, and complications, such as iatrogenic nerve injury, were recorded. Patients who underwent operative treatment at another hospital, had no postoperative follow-up, or died due to polytrauma were excluded.

Results:

In this study, 698 patients undergoing cross-pinning during the study period were identified. Patients treated with cross-pinning had severe fractures, including a total of 198 preoperative neurovascular injuries (28.4%), 32 patients (4.6%) with skin tenting, and 19 patients (2.7%) with open fractures. Iatrogenic nerve injury was reported in 3 cases (0.43%), all of which affected the ulnar nerve. In 2 of 3 cases of iatrogenic nerve injury, the ulnar nerve symptoms resolved at a mean follow-up of 15 weeks.

Conclusions:

The mini-open approach for medial pin insertion is safer than previous estimates. Here, in the largest single-center study of cross-pinning for SCHFs, the iatrogenic ulnar nerve injury rate of 0.43% was nearly 10 times lower than estimated rates from recent meta-analyses. Considering all nerves, the iatrogenic injury rate for this cross-pinning cohort was also lower than the estimated iatrogenic nerve injury rate for lateral pinning.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Central Hyperthermia Due to Intracerebral Hemorrhage Treated with Baclofen: A Case Report
Authors: Park Jiyong Iruon , Hwang Sung-Kyun
Published: October 2021

We report the treatment of a rare case of central hyperthermia due to intracerebral hemorrhage (ICH) in the basal ganglia with baclofen. Central hyperthermia is associated with a high mortality rate and poor prognosis among patients with failure of the thermoregulation system. A 35-year-old man arrived at the emergency room with the sudden loss of consciousness and right-sided hemiparesis. Computed tomography revealed an ICH in the left basal ganglia with a midline shift. Following craniotomy and evacuation of the ICH, the patient developed persistent hyperthermia. Laboratory investigations for fever did not aid in determining the origin, and the fever did not respond to any antibiotics or antipyretics. Oral baclofen was started at a dose of 30 mg/day, which was increased to 90 mg/day. The patient’s temperature markedly decreased to the normal range. Baclofen can be considered for treating suspected central hyperthermia in patients with ICH.
An integrated assessment of seismic hazard exposure and its societal impact in Seven Sister States of North Eastern Region of India for sustainable disaster mitigation planning
Authors: Agrawal Navdeep , Gupta Laxmi , Dixit Jagabandhu , Dash Sujit Kumar
Published: October 2021

The Seven Sister States of the North Eastern Region of India, located on the complex seismotectonic belt, is characterized by high seismicity. A comprehensive seismic hazard exposure assessment is carried out by quantifying hazard using a probabilistic approach, vulnerability by factor analysis, and exposure mapping by integrating seismic hazard and vulnerability. Peak ground acceleration (PGA) values at bedrock are calculated with the help of ground motion prediction equations (GMPE) for 10% probability of exceedance in 50 years (475 years) and 100 years (950 years), and 2% probability of exceedance in 50 years (2475 years). The resulting spatial distribution of the PGA values considering return periods of 475, 950, and 2475 years are presented through seismic hazard maps. The social vulnerability analysis indicates that 21 districts covering 91.43% area of the state of Assam and the entire state of Tripura are under high vulnerability. With the help of spatial cluster analysis, it is found that 17.14% of the study area are having an average social vulnerability index (SVI) score of 0.329 and therefore can be considered as hotspots. Through seismic hazard analysis, it is observed that more than 50% of the area of North East India is under moderate to very high exposure class. The seismic hazard maps developed can help in disaster mitigation planning and execution leading to sustainable development goals and targets.
Effects of High-Intensity Interval Training on Improving Arterial Stiffness in Chinese Normal Weight Obese Female University Students: A Pilot Randomized Controlled Trial
Authors: Hu Jingyun , Zhu Lei , Yang Ruoyu , Wang Liyan , Liang Leichao , Yang Yuanyuan , Jia Shihao , Chen Ruiyi , Liu Qianle , Ren Yu , Cai Ming
Published: October 2021

Background: High intensity interval training (HIIT) has been reported to exert better effects on cardiovascular fitness in obesity, but little known about the arterial stiffness (AS) in normal weight obesity (NWO) females. Thus, this study investigated the changes of body composition, heart rate (HR), blood pressure (BP), blood lipids as well as the parameters of propensity for AS (arterial velocity pulse index (AVI) and arterial pressure volume index (API)).Methods: Forty NWO female university students were randomly assigned to the control group (n=20) or the HIIT group (30 minutes at 90% HRmax, n=20). The participants in HIIT group accepted a four-week HIIT intervention for five days a week. The above parameters of body composition, cardiometabolic biomarkers, lipid profile, and AS were assessed before and after the HIIT intervention. Results: HIIT significantly improved the body composition in decreasing the BMI (p=0.001), BF% (p<0.001), BFM (p<0.001), LBFM (p<0.001), LMC (p=0.016), and Obesity degree (p=0.001), and increased the SMM (p=0.020), Protein content (p=0.035), TBW (p=0.017), FFM (p=0.019), BCM (p=0.020), and Inbody score (p<0.001). HIIT also affected the cardiometabolic biomarkers by decreasing the HR (p=0.001), SBP (p<0.001), and DBP (p<0.001). As for the lipid profile, HIIT obviously ameliorated the blood lipids metabolism by decreasing the levels of TC (p=0.001), TG (p<0.001), LDL (p<0.001), and TC/HDL (p<0.001), and increasing the levels of HDL (p<0.001). In addition, the AS was improved by HIIT intervention through decreasing the AVI (p<0.001) and API (p<0.001).Conclusions: Our results provided herein demonstrate that this pattern of a 4-week HIIT had a positive impact on physical fitness in the aspect of body composition, lipid profile, and cardiovascular function in NWO female university students.Trial registration: ChiCTR2100050711. Registered 3 September 2021. Retrospectively registered.
Transcriptomic Analysis of Stropharia Rugosoannulata Reveals Potential Carbohydrate Metabolism and Cold Resistance Mechanisms Under Low-Temperature Stress
Authors: Hao Haibo , Zhang Jinjing , Wu Shengdong , Bai Jing , Zhuo Xinyi , Zhang Jiaxin , Kuai Benke , Chen Hui
Published: October 2021

Low temperature is an important environmental factor that restricts the growth of Stropharia rugosoannulata; however, the molecular mechanisms underlying S. rugosoannulata responses to low-temperature stress are largely unknown. In this study, we performed a transcriptome analysis of a high-sensitivity strain (DQ-1) and low-sensitivity strain (DQ-3) under low-temperature stress. The liquid hyphae of S. rugosoannulata treated at 25°C and 10°C were analyzed by RNA-Seq, and a total of 9499 differentially expressed genes (DEGs) were identified. GO and KEGG enrichment analyses showed that these genes were enriched in “xenobiotic biodegradation and metabolism”, “carbohydrate metabolism”, “lipid metabolism” and “oxidoreductase activity”. Further research found that carbohydrate enzyme (AA, GH, CE, and GT) genes were downregulated more significantly in DQ-1 than DQ-3 and several cellulase activities were also reduced to a greater extent. Moreover, the CAT1, CAT2, GR, and POD genes and more heat shock protein genes (HSP20, HSP78 and sHSP) were upregulated in the two strains after low-temperature stress, and the GPX gene and more heat shock protein genes were upregulated in DQ-3. In addition, the enzyme activity and qRT–PCR results showed trends similar to those of the RNA-Seq results. This result indicates that low-temperature stress reduces the expression of different AA, GH, CE, and GT enzyme genes and reduces the secretion of cellulase, thereby reducing the carbohydrate metabolism process and mycelial growth of S. rugosoannulata. Moreover, the expression levels of different types of antioxidant enzymes and heat shock proteins are also crucial for S. rugosoannulata to resist low-temperature stress. In short, this study will provide a basis for further research on important signaling pathways, gene functions and variety breeding of S. rugosoannulata related to low-temperature stress.
A Radiomic Model To Classify Response To Neoadjuvant Chemotherapy in Breast Cancer
Authors: McAnena Peter , Moloney Brian , Browne Robert , O’Halloran Niamh , Walsh Leon , Walsh Sinead , Sheppard Declan , Sweeney Karl , Kerin Michael , Lowery Aoife
Published: October 2021

Background Medical image analysis has evolved to facilitate the development of methods for high-throughput extraction of quantitative features that can potentially contribute to the diagnostic and treatment paradigm of cancer. There is a need for further improvement in the accuracy of predictive markers of response to neo-adjuvant chemotherapy (NAC). The aim of this study was to develop a radiomic classifier to enhance current approaches to predicting the response to NAC breast cancer. Methods Data on patients treated for breast cancer with NAC prior to surgery who had a pre-NAC dynamic contrast enhanced (DCE) breast MRI were included. Response to NAC was assessed using the Miller-Payne system on the excised tumour. Tumour segmentation was carried out manually under the supervision of a consultant breast radiologist. Features were selected using least absolute shrinkage selection operator (LASSO) regression. A support vector machine (SVM) learning model was used to classify response to NAC. Results 74 patients were included. Patients were classified as having a poor response to NAC (reduction in cellularity <90%, n=44) and an excellent response (>90% reduction in cellularity, n=30). 4 radiomics features (discretized kurtosis, NGDLM contrast, GLZLM_SZE and GLZLM_ZP) were identified as pertinent predictors of response to NAC. A SVM model using these features stratified patients into poor and excellent response groups producing an AUC of 0.75. Addition of estrogen receptor (ER) status improved the accuracy of the model with an AUC of 0.811. Conclusion This study identified a radiomic classifier incorporating 4 radiomics features to augment subtype based classification of response to NAC in breast cancer.
Soil Quality Field Tools
Authors: Ditzler Craig A. , Tugel Arlene J.
Published: October 2021

The mission of the Soil Quality Institute (SQI) of the USDA Natural Resources Conservation Service is to develop and disseminate tools for soil quality assessment. In keeping with this mission, the SQI, through partnerships, has developed two assessment tools for use by farmers and field staff. We review these efforts here. The first, the Soil Quality Card Design Guide, provides a nine‐step process for conducting workshops to guide farmers in the development of locally adapted soil quality assessment cards. The second, the Soil Quality Test Kit Guide, provides instructions and interpretations for 11 field tests representing physical, chemical, and biological properties of soil. In this paper, we present a summary of soil quality cards developed in seven states. An important strength of the soil quality card design process lies with the active participation of farmers to design the cards themselves as part of locally lead conservation activities. We also present results from soil quality test kit training workshops showing that the test kit provides an excellent framework for teaching soil quality concepts in the field. Regular use to compare effects of management systems or monitor changes over time will likely be limited to farmers with fairly high skill levels, specialists, and agricultural consultants.
Graphic Analysis of Genotype, Environment, Nitrogen Fertilizer, and Their Interactions on Spring Wheat Yield
Authors: Ma B. L. , Yan W. , Dwyer L. M. , Frégeau‐Reid J. , Voldeng H. D. , Dion Y. , Nass H.
Published: October 2021

Interest in growing hard red spring wheat (Triticum aestivum L.) in eastern Canada is increasing due to its potential returns relative to other small‐grain cereals and oilseed crops. The objectives of this study were to determine the effects of year, site, genotype, N application, and their interactions on the yield of hard red spring wheat (HRSW) and to demonstrate the application of the recently developed biplot methodology in visualizing agronomic research data. Ten HRSW cultivars were grown in five locations across three provinces from 1998 to 2000, constituting a total of 11 year–site combinations. In each environment, four levels of fertilizer N (50, 100, 150, and 200 kg ha−1) were applied. The N main effect, N × environment interaction, and N × genotype interaction were not significant. However, biplot analysis did reveal crossover N × environment interactions: Although higher N rates generally led to higher yield, the opposite was true in some environments. This was attributed to heavy Fusarium head blight (Fusarium graminearum Schwabe) and/or foliar diseases in these environments, which was exacerbated by higher N rates. The strong genotype × environment interactions were mainly associated with two cultivars that yielded well in most environments but very poorly in two environments in which Fusarium head blight was severe. This study thus highlighted the importance of Fusarium head blight resistance in HRSW production in eastern Canada. An environment × factor biplot was described for the first time, which was highly effective in revealing the interrelationship among environmental factors and in revealing the weather and soil patterns of the environments.
Evaluation of Soil Nitrate as a Predictor of Nitrogen Requirement for Sugar Beet Grown in a Mediterranean Climate
Authors: Bilbao Marcelino , Martínez Juan J. , Delgado Antonio
Published: October 2021

Rational N fertilization is important to reduce environmental impact of fertilization and to increase profitability in crop production. An evaluation of preplant soil nitrate concentration in soil to estimate optimum N rate for autumn‐sown sugar beet (Beta vulgaris L.) was done by performing 33 N response experiments in different locations between 1989 and 2000. For each location and year, the N rate for maximum beet and sucrose production and the economic optimum N rate for adjusted beet production (yield adjusted for sucrose concentration) were estimated. Nitrate N concentration in the soil (0–30 cm deep) before fertilization ranged between 6 and 156 mg kg−1. This concentration allows one to distinguish between N responsive and nonresponsive sites when no particular leaching (tile‐drained soils in rainy winters—more than 470 mm from October to January—or furrow irrigated) or water stress limitations exist (rainfed locations with less than 350 mm annual rainfall—less than 170 mm during spring). A critical value for the preplant soil nitrate was determined, above which no response to N fertilizer can be expected. This value was 39 mg kg−1 for beet production and 33 mg kg−1 for adjusted beet production. Preplant soil nitrate also provided an accurate estimation of the optimum N rate for adjusted beet production under the same conditions (R2 = 0.93). It is concluded that soil nitrate before planting can be a useful method for assessing N fertilizer rate in production of sugar beet under a Mediterranean climate in soils where leaching is not favored by tile draining or where yield potential is not excessively limited by water supply.
Weed Management in Strip Tillage Corn
Authors: Hendrix Byron J. , Young Bryan G. , Chong She‐Kong
Published: October 2021

Field studies were conducted in 2000 and 2001 to determine if differences exist in weed emergence patterns, weed control, corn (Zea mays L.) plant population, and grain yield in strip tillage, conventional tillage, and no‐tillage production. Weed emergence peaked at 2 and 4 wk after planting (WAP) in 2000 and 2001, respectively. Weed emergence at 2 WAP in 2000 was greater in conventional tillage compared with no‐tillage and strip tillage. Tillage system did not affect total weed species emergence in 2001. In both years, lower control of giant foxtail (Setaria faberi Herrm.) and common waterhemp (Amaranthus rudis Sauer) occurred following acetochlor {[2‐chloro‐N‐(ethoxymethyl)‐N‐(2‐ethyl‐6‐methylphenyl)acetamide]} plus atrazine {[6‐chloro‐N‐ethyl‐N′‐(1‐methylethyl)‐1,3,5‐triazine‐2,4‐diamine]} applied pre‐emergence in no‐tillage compared with conventional tillage. Control of common waterhemp in 2001 and giant foxtail in both years was similar with glyphosate [N‐(phosphonomethyl)glycine] applied postemergence regardless of tillage system. Corn population was greater in conventional tillage compared with no‐tillage in 2000 and greater than the population in no‐tillage and strip tillage in 2001. When averaged across weed management strategies, corn yield was greatest in strip tillage in 2000 and conventional tillage in 2001.
Production and Environmental Aspects of Cropping Intensification in a Semiarid Environment of Southeastern Australia
Authors: Sadras Víctor O. , Roget David K.
Published: October 2021

Low and highly variable rainfall are major sources of risk for farms in semiarid environments, including the Mallee region of Australia where risk management is largely based on a conservative, low‐input approach. This approach has substantial opportunity costs (missing the benefits of wetter seasons) and low yield per unit rainfall. We combined field and modeling experiments to evaluate an intensive, flexible cropping approach based on (i) an opportunistic combination of crops, including wheat (Triticum aestivum L), canola (Brassica napus L.), and grain legumes, and (ii) a close matching of N input to soil and seasonal conditions. In a 4‐yr field trial established on a coarse‐textured soil, an intensive cropping approach doubled gross margin and halved its coefficient of variation in relation to current practice. Modeling experiments revealed the underlying mechanisms of this response and estimated the effect of cropping intensification on N leaching and deep drainage. Simulated yield improvement under intensive cropping was related to increased water use efficiency [biomass per unit evapotranspiration (ET)] at the expense of N use efficiency (biomass per unit of N uptake); this is consistent with the theoretical expectation that plant growth is maximized when all resources are equally limiting. Simulations indicated no substantial increase in N leaching and moderate decrease in drainage beyond the root zone with the more intensive approach. The approach to intensification in this research provides a platform to improve production and profit and to reduce its seasonal variation with neutral or positive effects on environmentally relevant processes.
MANAGEMENT OF POLYTRAUMA IN CASES OF SUSPECTED SUICIDAL FALLS IN COVID-19 PANDEMIC - A CASE SERIES
Authors:   Professor and Unit Head Dept of Orthopaedics Grant Govt Medical College, Mumbai., P. Mahajan Neetin , Kumar G.S Prasanna ,   Senior Resident Dept of Orthopaedics Grant Govt Medical College, Mumbai., C. Patil Tushar ,   Junior Resident Dept of orthopaedics Grant Govt Medical College, Mumbai., Dadhaniya Ravi ,   Junior Resident Dept of orthopaedics Grant Govt Medical College, Mumbai.
Published: October 2021

Introduction:The most challenging hurdle faced by national health systems worldwide in the last century is the ongoing COVID 19 pandemic. Initial cases of atypical pneumonia of unknown origin started in Wuhan, Hubei province, China which started the outbreak of COVID 19 in December 2019. This infection later on spread to rest of the world. Case series:Here we present a series of 3 patients who came to our casualty with polytrauma after a suspected suicidal fall from height. The patients were managed by adequate surgical interventions. Postoperative physiotherapy started with gradual mobilization. We did a psychiatric reference and proper counseling of all 3 patients patients both pre and postoperatively. Conclusion:We conclude that this COVID-19 pandemic has taken a great toll both physically and mentally on people in the form of increased mortality and morbidity as shown daily in media, increased unemployment and strict self isolation has further put a strain on peoples mind leading to psychiatric disorders and suicidal behaviour. This has increased cases of polytrauma due to suspected suicidal falls. We have adequately treated such patients who came to our institute operatively and with psychiatric support.
AN EMPIRICAL STUDY ON THE IMPACT OF ECONOMIC DEVELOPMENT IN FOOD SECURITY IN EMERGING AND DEVELOPED ECONOMIES
Authors:   Faculty of Economics and Management of Sousse Laboratory, University of Sousse Street of Khalifa El Karoui Sahloul - BP n 526 - 4002 Sousse Tunisia., Nafti Sawssen
Published: October 2021

In this paper, we empirically investigate if food security is specific to a space, a level of development or an economic mode, using Panel data. Our study initially exploited a total sample of 52 emerging and developed countries, for the period 1980-2006, then, we subdivided the sample in two subsamples according to the classification of the World Bank and according to the income. In this way, food safety can be defined as the capacity of all people to a sufficient, healthy and nutritive food, the physical and the economic access. Our results indicate that the countries in the process of development are the most vulnerable to food safety (in quantity: undernourishment) because of the increases of the percentage of poverty. But the developed countries suffers also by this problem( in quality: obesity).
STUDIES OF PHOTOIONIZATION PROCESSES OF NITROGEN-LIKE O+ION USINGTHE SCREENING CONSTANT BY UNIT NUCLEAR CHARGEMETHOD
Authors:   Atoms Lasers Laboratory, Department of Physics, Faculty of Sciences and Technologies, University Cheikh Anta Diop, Dakar, Senegal., Diop Babou , Diouf Abdou ,   Atoms Lasers Laboratory, Department of Physics, Faculty of Sciences and Technologies, University Cheikh Anta Diop, Dakar, Senegal., Gning Youssou ,   Department of Physics Chemistry, UFR Sciences and Technologies, University Iba Der Thiam, Thies, Senegal., Faye Maurice ,   Department of Physics Chemistry, UFR Sciences and Technologies, University Iba Der Thiam, Thies, Senegal., Sow Malick ,   Atoms Lasers Laboratory, Department of Physics, Faculty of Sciences and Technologies, University Cheikh Anta Diop, Dakar, Senegal., Sow Boubacar ,   Atoms Lasers Laboratory, Department of Physics, Faculty of Sciences and Technologies, University Cheikh Anta Diop, Dakar, Senegal.
Published: October 2021

In this present work, we have calculated the energies positions of the 2s22p2(1D)nd2P, 2s22p2(1D)nd2S, 2s22p2(1D)ns 2D, 2s22p2(1S)nd2D and 2s2p3(3P)np2D Rydberg series in the photoionization spectra from the 2PÂ° metastable state of the O+ ion. Calculations were performed up to n = 40 applyingthe Screening Constant by Unit Nuclear Charge (SCUNC) via its semi empirical formalism. The quantum defect and the effective charge are also calculated.The results agree within 98% to Aguilars experimental data, and with Sows theoretical results to within 99%. These data can be a useful guideline for future experimental and theoretical studies.
Rapid Recognizing the Producing Area of a Tobacco Leaf Using Near-Infrared Technology and a Multi-Layer Extreme Learning Machine Algorithm
Authors: Li Ruidong , Huang Wenyong , Shang Guanlan , Zhang Xiaobing , Wang Xin , Liu Jianguo , Wang Yong , Qiao Junfeng , Fan Xing , Wu Kai , Zi Wenhua
Published: October 2021

A novel recognition method was put forward to identify the producing areas of the flue-cured tobacco leaves rapidly and non-destructively by using a near-infrared (NIR) spectrometer and a multi-layer-extreme learning machine (ML-ELM) algorithm. In contrast to traditional linear discriminant analysis (LDA) and extreme learning machine (ELM) algorithms, the accuracy, sensitivity and specificity were the highest for the proposed ML-ELM algorithm. The ML-ELM models for different producing areas of Yunnan tobacco leaves had the best generalization ability and prediction results. Besides, the above three algorithms were also identified by using the chemical index data. The experimental results indicated that the NIR spectroscopy technology together with ML-ELM algorithm achieved the best prediction performance both using the NIR spectral data and chemical index data. It indicates that the combination of NIR and ML-ELM can recognize different producing areas of Yunnan tobacco leaves rapidly, accurately, and non-destructively.
Diversity and health risk potentials of the Enterococcus population in tropical coastal water impacted by Hurricane Lane
Authors: Saingam Prakit , Di Doris Y. W. , Yan Tao
Published: October 2021

Hurricane-caused stormwater runoffs transport diverse terrestrial pollutants, adversely impact microbiological water quality, and introduce fecal and other pathogens to coastal water environments. This study investigated the genotypic diversity, phylogenetic composition, antibiotic resistance patterns, and virulence gene repertoire of the Enterococcus population in the Hilo Bay coastal water after the immediate impact of Hurricane Lane. DNA fingerprinting of Enterococcus isolates exhibited large genotypic diversity, while 16S rRNA gene sequencing identified four major species, including E. faecalis (34.7%), E. faecium (22.4%), E. hirae (22.4%), and E. durans (18.4%). Four common enterococcal virulence genes (cylA, esp, asa1, and gelE) were detected in the Enterococcus population, with significant portions of E. durans (33.3%), E. faecalis (41.2%), E. faecium (36.4%), and E. hirae (27.3%) isolates possessing two or more virulence genes. Considerable antibiotic resistance to rifampin, erythromycin, tetracycline, and nitrofurantoin was detected in the Enterococcus population, with one E. durans isolate showing vancomycin resistance. The results indicate considerable health implications associated with Enterococcus spp. in the hurricane-impacted tropical coastal water, illustrating the needs for more comprehensive understanding of the microbiological risks associated with storm-impacted coastal water.
Analysis on the effect of large-scale compound ecological engineering system on pollution control of the estuary of a lake
Authors: Jiang Yongbo , Xu Xiaoyi , Wu Wei , Wang Bin , Sun Yidong , Chen Xiaobin , Shen Zhengdong , Huang Tianyin
Published: October 2021

The quality of the water and the water environment in the estuary of a lake directly affect the water quality and ecological functions of the entire lake. Multi-technology systems, which integrate biotechnological analysis of a lake estuary and restoration of the ecological functions of the water in situ, have gradually been adopted for lake management and restoration. The Xielugang Estuary is located north of the Yangcheng Middle Lake and always exhibits a certain degree of eutrophic phenomena. To ensure the safety of the ecological environment in Yangcheng Lake, a multi-level purification and ecological system with ‘intercept precipitation–ecological restoration–coupled biological treatment’ was developed. Water quality monitoring results for the inlet and outlet of different units in the system from October 2020 to May 2021 showed that the system was effective. We also found that the purification capacity of the composite system was high and the system could significantly enhance the reduction of total nitrogen, total phosphorus, potassium permanganate index and total suspended solids. The average removal rates for these components were 41.34, 61.76, 35.21 and 67.21%, respectively, and the removal rate for typical heavy metals (Zn, Cu, Cd, and Pb) was 30.4–48.9%. The composite system substantially improved the water quality of the estuary and the wetland ecological function, demonstrating its effectiveness and significance.
Enhancing chlorine resistance in polyamide membranes with surface & structure modification strategies
Authors: Idrees Muhammad Faisal , Tariq Umar
Published: October 2021

Higher efficient reverse osmosis (RO) membrane development is a significant issue due to the payoff among salt rejection and water flux and permissive chlorine attacking and fouling potential. Weak chlorine resistance is a distinctive challenge for composite polyamide thin-film reverse osmosis membranes. A commercial aromatic membrane was modified by grafting nitrogen-doped graphene oxide quantum dots (N-GOQDs) to enhance chlorine resistance, embedding two-dimensional MXene Ti3C2Tx, introducing synthetically reductive thioether units and oxidized graphitic carbon nitride (OGCN). In this work, salt rejection, chlorine resistance, and water flux increased compared to the pristine membrane. Comprehensive arrangement of desalination performance and chlorine resistance was achieved by varying time and concentrations of prepared chemicals. For instance, improved chlorine resistance, after 12 hours of grafting time by N-GOQDs doped membrane, was 32.8%, after 6 hours of exposure time by MXene Ti3C2Tx membrane was 27.4%, after 1 hour of exposure time by thioether membrane was 28.1% and after 40 hours of doping time by OGCN membrane was 31.3%. N-GOQDs doped membrane showed a good chlorine resistant property, but on the other hand, thioether nano units showed other properties more effectively, including water flux, salt rejection, and less reaction time.
Simultaneous removal of fluoride, manganese and iron by manganese oxide supported activated alumina: characterization and optimization via response surface methodology
Authors: You Kun , Gao Yujia , Qian Weiyi , Fu Jinxiang , Wang Juliang , Zhou Weiwei
Published: October 2021

Fluoride, iron and manganese simultaneous exceedance of standard can be observed in groundwater in northeastern China. This work aims to apply a highly efficient method combining adsorption and oxidation for the synchronous removal of the inorganic ions. An innovative adsorbent (manganese-supported activated alumina) was synthesized by the impregnation method and showed a significant adsorption capacity better than that of fresh activated alumina. The characterization (scanning electron microscope; Brunauer, Emmett and Teller; X-ray diffraction and Fourier transform infrared spectroscopy) results verified the successful introduction of MnOOH and MnO2, and the improvement of surface microstructure enhanced the removal ability. The effect of single factors, such as pH value, reaction time or dosage on the removal performance has been verified. The maximum removal efficiencies of fluoride, iron and manganese were optimized via Response surface methodology considering the independent factors in the range of MO@AA dosage (5–9 g/L), pH (4–6) and contact time (4–12 h). Noted that compared with control, MO@AA exhibited 59.4% of improved fluoride performance. At pH of 5.79, contacting time of 12 h and 8.21 g/L of MO@AA, fluoride, iron and manganese removal were found to be 91, 100 and 23%, respectively. Herein, MO@AA was distinguished as good applicability for the treatment of fluoride-, iron- and manganese-containing groundwater.
Um altar funerário romano em Bustelo (Penafiel, Porto, Norte de Portugal)
Authors: Soeiro Teresa , Redentor Armando
Published: October 2021

This paper presents the study of an inscribed Roman funerary altar, found in 2020 in the old monastery of Bustelo (Penafiel). The circumstances of the finding were recorded as well as the possible post-Roman era route of the piece and its reuse. The study of the typological characteristics of the support is carried out and the text is analysed from the epigraphic and historical points of view, seeking to contextualize the monument in the regional epigraphy. Taking into account the current knowledge about Roman sites in the vicinity of the finding place, the potential connexion with contemporary settlements of the altar making and primary use is discussed.
An Enhanced SMS Text Message–Based Support and Reminder Program for Young Adults With Type 2 Diabetes (TEXT2U): Randomized Controlled Trial (Preprint)
Authors: Middleton Timothy , Constantino Maria , McGill Margaret , D'Souza Mario , Twigg Stephen M , Wu Ted , Thiagalingam Aravinda , Chow Clara , Wong Jencia
Published: October 2021

BACKGROUND

Clinic attendance, metabolic control, engagement in self-management, and psychological health are suboptimal in young-onset (age of onset <40 years) type 2 diabetes.

OBJECTIVE

We examined the effectiveness of an enhanced SMS text message–based support and reminder program in improving clinic attendance, metabolic control, engagement in self-management, and psychological health in young-onset type 2 diabetes.

METHODS

A 12-month, parallel-arm, randomized controlled trial comparing an enhanced, semipersonalized SMS text message–based intervention (incorporating 1-8 supportive and/or informative text messages per month) against standard care was conducted in a specialized clinic for young adult type 2 diabetes. The primary outcome was maintenance of 100% attendance at scheduled quarterly clinical appointments. Secondary outcomes included (1) metabolic indices, (2) pathology and self-monitored blood glucose (SMBG) data availability, and (3) psychosocial well-being.

RESULTS

A total of 40 participants were randomized, and 32 completed their 12-month study visit. The average participant age was 32.7 (SD 5.1) years, 50% (20/40) were male, and baseline glycated hemoglobin A1c (HbA1c) was 7.3% (SD 1.9%) (56 mmol/mol, SD 20). A higher proportion of the intervention group achieved 100% attendance (12/21, 57%, vs 5/19, 26%, for the control group); Kaplan-Meier analysis demonstrated significantly greater cumulative attendance in the intervention group (P=.04). There were no between-group differences in HbA1c, BMI, lipids, or availability of pathology and SMBG data. Odds of recording an improvement in the Diabetes Empowerment Scale–Short Form score were higher in the intervention group at 6 months (odds ratio [OR] 4.3, 95% CI 1.1-17), with attenuation of this effect at study end (OR 3.1, 95% CI 0.9-11). Program acceptability was high; >90% of participants would recommend the program to new patients.

CONCLUSIONS

An enhanced SMS text message–based support and reminder program doubled scheduled clinic attendance rates for patients with young-onset type 2 diabetes. The program was highly acceptable and provided early support for patient empowerment but had no significant effect on measures of metabolic control or self-management.

CLINICALTRIAL

Australian and New Zealand Clinical Trials Registry (ACTRN12618000479202); https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373579
Six-Month Outcomes from the NEXit Junior Trial of a Text Messaging Smoking Cessation Intervention for High School Students: Randomized Controlled Trial With Bayesian Analysis (Preprint)
Authors: Bendtsen Marcus , Bendtsen Preben , Müssener Ulrika
Published: October 2021

BACKGROUND

The prevalence of daily or occasional smoking among high school students in Sweden was approximately 20% in 2019, which is problematic since lifestyle behaviors are established in adolescence and track into adulthood. The Nicotine Exit (NEXit) Junior trial was conducted in response to a lack of evidence for the effects of text message smoking cessation interventions among high school students in Sweden.

OBJECTIVE

The aim of this study was to estimate the 3- and 6-month effects of a text messaging intervention among high school students in Sweden on smoking cessation outcomes.

METHODS

A 2-arm, single-blind randomized controlled trial was employed to estimate the effects of the intervention on smoking cessation in comparison to treatment as usual. Participants were recruited from high schools in Sweden using advertising and promotion by school staff from January 10, 2018, to January 10, 2019. Weekly or daily smokers who were willing to make a quit attempt were eligible for inclusion. Prolonged abstinence and point prevalence of smoking cessation were measured at 3 and 6 months after randomization.

RESULTS

Complete case analysis was possible on 57.9% (310/535) of the participants at 6 months, with no observed statistically significant effect on 5-month prolonged abstinence (odds ratio [OR] 1.27, 95% CI 0.73-2.20; P=.39) or 4-week smoking cessation (OR 1.42; 95% CI 0.83-2.46; P=.20). Sensitivity analyses using imputation yielded similar findings. Unplanned Bayesian analyses showed that the effects of the intervention were in the anticipated direction. The findings were limited by the risk of bias induced by high attrition (42.1%). The trial recruited high school students in a pragmatic setting and included both weekly and daily smokers; thus, generalization to the target population is more direct compared with findings obtained under more strict study procedures.

CONCLUSIONS

Higher than expected attrition rates to follow-up 6 months after randomization led to null hypothesis tests being underpowered; however, unplanned Bayesian analyses found that the effects of the intervention were in the anticipated direction. Future trials of smoking cessation interventions targeting high school students should aim to prepare strategies for increasing retention to mid- and long-term follow-up.

CLINICALTRIAL

IRCTN Registry ISRCTN15396225; https://www.isrctn.com/ISRCTN15396225

INTERNATIONAL REGISTERED REPORT

RR2-10.1186/s13063-018-3028-2
A self-testing kits distribution intervention improved HIV testing of men who have sex with men and their sexual partners: a 12-month stepped-wedge randomized controlled trial in China (Preprint)
Authors: Jin Xia , Chu Zhenxing , Zhang Xiangjun , Lu Tianyi , Zhang Jing , Wang Hongyi , Ye Zehao , Cui Sitong , Liu Zhaozhen , Wei Jie , Jia Le , Gao Yangyang , Hu Qinghai , Jiang Yongjun , Wang Ning , Shang Hong , Xu Junjie
Published: October 2021

BACKGROUND

Men who have sex with men (MSM) have high HIV incidence and prevalence burdens but relatively low HIV testing rates. Literature showed insufficient evidence on the efficacy of Social media (WeChat) based HIV self-testing (HIVST) kits distribution approaches among MSM and their sexual partners.

OBJECTIVE

This study evaluated an Social media (WeChat) based HIVST distribution intervention in increasing HIV testing uptake among MSM and their sexual partners in China.

METHODS

The study used a 12-month stepped-wedge randomized controlled trial design and an online survey mode. MSM who were HIV-negative or with unknown HIV status were recruited through social media marketing and outreaches by community opinion leaders between August and December 2018 in Shenyang, Beijing, Chongqing, and Shenzhen. Participants were randomly allocated to four groups, which were intervened by sequence. The intervention group received free HIVST kits on top of the control condition that participants received standard education and care. Participants were followed up from January to December 2019. Generalized linear models were used to assess HIV testing coverage and frequency difference between the intervention and the control stage.

RESULTS

Each group enrolled 140 eligible MSM with a total of 560 participants. Twelve participants were diagnosed with HIV infections, and 4 of them were in the follow-up period. Participants in the intervention stage were nine times likely to receive an HIV test than in the control stage (85.6% vs. 39.2%, risk ratio [RR]=9.21, 95%CI 5.92~14.33). The intervention also increased participants’ HIV testing frequency (1.48 vs. 0.59 times, risk difference [RD]=0.89, 95%CI 0.82~0.96). Moreover, the intervention increased HIV testing proportion (49.0% vs. 30.1%, RR=2.23, 95%CI 1.46~3.40) and mean HIV testing frequency (0.69 vs. 0.35 times, RD=0.26, 95%CI 0.15~0.38) among participants sexual partners who received HIVST through secondary distribution.

CONCLUSIONS

An Social media (WeChat) based HIVST distribution intervention effectively increased HIV testing coverage and frequency in MSM and their sexual partners. Future programs could apply this approach in HIV education and testing efforts to reduce HIV incidence.

CLINICALTRIAL

This study was registered at the Chinese Clinical Trials website (http://www.chictr.org.cn/index.aspx) with the registration tracking number of ChiCTR1800019453 on November 12, 2018.

INTERNATIONAL REGISTERED REPORT

RR2-10.2196/17788
Pilot Project for a Web-Based Dynamic Nomogram to Predict Survival 1 Year After Hip Fracture Surgery: Retrospective Observational Study (Preprint)
Authors: McLeod Graeme , Kennedy Iain , Simpson Eilidh , Joss Judith , Goldmann Katriona
Published: October 2021

BACKGROUND

Hip fracture is associated with high mortality. Identification of individual risk informs anesthetic and surgical decision-making and can reduce the risk of death. However, interpreting mathematical models and applying them in clinical practice can be difficult. There is a need to simplify risk indices for clinicians and laypeople alike.

OBJECTIVE

Our primary objective was to develop a web-based nomogram for prediction of survival up to 365 days after hip fracture surgery.

METHODS

We collected data from 329 patients. Our variables included sex; age; BMI; white cell count; levels of lactate, creatinine, hemoglobin, and C-reactive protein; physical status according to the American Society of Anesthesiologists Physical Status Classification System; socioeconomic status; duration of surgery; total time in the operating room; side of surgery; and procedure urgency. Thereafter, we internally calibrated and validated a Cox proportional hazards model of survival 365 days after hip fracture surgery; logistic regression models of survival 30, 120, and 365 days after surgery; and a binomial model. To present the models on a laptop, tablet, or mobile phone in a user-friendly way, we built an app using Shiny (RStudio). The app showed a drop-down box for model selection and horizontal sliders for data entry, model summaries, and prediction and survival plots. A slider represented patient follow-up over 365 days.

RESULTS

Of the 329 patients, 24 (7.3%) died within 30 days of surgery, 65 (19.8%) within 120 days, and 94 (28.6%) within 365 days. In all models, the independent predictors of mortality were age, BMI, creatinine level, and lactate level. The logistic model also incorporated white cell count as a predictor. The Cox proportional hazards model showed that mortality differed as follows: age 80 vs 60 years had a hazard ratio (HR) of 0.6 (95% CI 0.3-1.1), a plasma lactate level of 2 vs 1 mmol/L had an HR of 2.4 (95% CI 1.5-3.9), and a plasma creatinine level of 60 vs 90 mol/L had an HR of 2.3 (95% CI 1.3-3.9).

CONCLUSIONS

In conclusion, we provide an easy-to-read web-based nomogram that predicts survival up to 365 days after hip fracture. The Cox proportional hazards model and logistic models showed good discrimination, with concordance index values of 0.732 and 0.781, respectively.
Assessing information available for health professionals and potential participants on lung cancer screening program websites: a cross-sectional study (Preprint)
Authors: Dodd Rachael , Zhang Chenyue , Sharman Ashleigh Rebecca , Carlton Julie , Tang Ruijin , Rankin Nicole M
Published: October 2021

BACKGROUND

Lung cancer is the number one cause of cancer death worldwide. The US Preventive Services Task Force (USPSTF) updated recommendations for lung cancer screening in 2021, adjusting the age of screening to 50 years (from 55 years), and reducing the number of pack-years total firsthand cigarette smoke exposure to 20 (down from 30). With many individuals using the internet for healthcare information, it is important to understand what information is available for individuals contemplating lung cancer screening.

OBJECTIVE

To assess the eligibility criteria and information available on lung cancer screening program websites for both health professionals and potential screeners.

METHODS

A descriptive cross-sectional analysis in March 2021 of 151 lung cancer screening program websites of academic (n=76) and community medical centers (n=75) in the United States for data related to information for health professionals and potential screeners was conducted. Presentation of eligibility criteria for potential participants and presence of information available specific to the health professionals about lung cancer screening, were the primary outcomes. Secondary outcomes included presentation of information about cost, smoking cessation, and inclusion of an online risk assessment tool, any clinical guidelines and multimedia used to present information.

RESULTS

Eligibility criteria is included in nearly all websites, with age range (92.1%) and smoking history (93.4%) included. Age was only consistent with the latest recommendations in 14.5% of the websites and no websites had updated smoking history. Half the websites mention screening costs as related to the type of insurance held. About one in six (15%) featured an online assessment tool to determine eligibility. A similar proportion (15%) hosted information specifically for health professionals. About a third (29%) of websites referred to smoking cessation. Almost a third of websites (30.5%) used multimedia to present information, such as short videos or podcasts.

CONCLUSIONS

Most US websites of lung cancer screening programs provide information about eligibility criteria, but this is not consistent and has not been updated across all websites following the latest USPSTF recommendations. Online resources require updating to present standardized information that is accessible for all.