bluuebunny/crossref_metadata_2025 huggingface dataset:
Apply Remote Sensing to Monitoring Dynamics of Built Environmental in The Core Area and The Border of Sokok City
Authors: Evandi Silvia
Published: January 2021

The development of unmanned satellite space technology is increasingly willing, the emergence of medium resolution satellites with sensitivity and spectral variants such as Landsat is very effective in observing environmental changes, while the purpose of this study is to monitor the development of built-in land using image transformation techniques, estimating built-in land changes. The research method uses the NDVI image transformation technique, NDBI and Built Up Index, with Landsat satellite image data obtained from USGS. Accuracy sampling is done by purposive sampling with confusion matrix accuracy test technique. The research results were found. developed land for the period 2004 - 2010 with a percentage of 19.25%, for stages 2010 - 2018 with a percentage of 30.25%. The land development was built based on the area of ​​the highest sub-district in the Kubung area in the early period with a percentage of 7.20% then in the second period with a percentage of 32.23%. The quality of the accuracy of the results of image analysis using confusion matrix technique with an image accuracy level in a field sample of 185 with an image accuracy of 86.04%.
In Vivo Behavior of Bioactive Glass-Based Hybrids in Animal Models For Bone Regeneration
Authors: N Shal
Published: January 2021

This review presents the recent advances and the current state-of-the-art of bioactive glass-based hybrid biomaterials for bone regeneration. Hybrid materials comprise two (or more) constituents at the nanometre scale, in which typically, one constituent is organic and functions as the matrix phase and the other constituent is inorganic and behaves as the filler phase. Such materials, thereby, more closely resemble natural bio-nanocomposites such as bone. Various glass compositions in combination with a wide range of natural and synthetic polymers have been evaluated in vivo under experimental conditions ranging from unloaded critical-sized defects to mechanically-loaded, weight-bearing sites with highly favourable outcomes. Additional possibilities include controlled release of anti-osteoporotic drugs, ions, antibiotics, pro-angiogenic substances and pro-osteogenic substances. Histological and morphological evaluations suggest the formation of new, highly vascularised bone that displays signs of remodelling over time. With the possibility to tailor the mechanical and chemical properties through careful selection of individual components, as well as the overall geometry (from mesoporous particles and micro-/nanospheres to 3D scaffolds and coatings) through innovative manufacturing processes, such biomaterials present exciting new avenues for bone repair and regeneration.
A Public Textual Transcommunication Device
Authors: Garrigue L.
Published: January 2021

We present a public instrumental transcommunication textual software, based on a random numbers generator enabling to produce either letters or words, in common or private sessions, and adapted to group work.
Efficacy of Natural Wetlands along Wadi Zomer as a Sustainable Phytoremediation Alternative for Industrial Effluents from Nablus West, Palestine
Authors: Attili Odai , Al-Sa'ed Rashed
Published: January 2021

This paper investigated the effectiveness of natural wetlands (Phragmites australis) along Wadi Zomer in reducing the organic and inorganic pollution loads from diverse industrial discharges including occasional emergency discharges from Nablus West Sewage Treatment Plant (NWSTP), Palestine. We monitored physical and chemical parameters at four selective sampling stations (S1-S4) along Wadi Zomer with a length of 5 km downstream of NWSTP to assess the purification capacity of Wadi Zomer treatment wetlands (water, sediment, and vegetation) with Phragmites australis in pollution loads reduction. The results showed that S2 (0+0.5 km) and S3 (0+3.0 km) reflected an increase in pollution loads due to illicit industrial discharge and sewer overflow discharge from NWSTP during emergency conditions. BOD values varied significantly along the sampling sites from 6.64 mg/l (S1) to 437.10 mg/l (S3). The BOD at S1 and S2 in water samples were below the Palestinian Water Standard (PWS) compared to S3 and S4 with 437.1 and 333.9 mg/l, respectively. Water samples from all sites (S1-S4) showed a decreasing tendency in heavy metals concentrations (Fe>Cu>Zn>Cr >Ni) and were below the PWS limits, sediment samples followed the same decrease pattern for Zn, Cr, and Ni content with Wadi Zomer flow course. The concentration of Fe (6687 mg/kg) and Cu (1384.7 mg/kg) were highest in the sediment samples (S1-S4); this might be due to non-point sources of pollution. The research demonstrated that phytoremediation is a sustainable nature-based technology for the restoration of heavily polluted surface water bodies in Palestine.
Biomarkers and Clinical Features of Delirium in Elderly Individuals With Hip Fracture Surgery.
Authors: Thisayakorn Paul
Published: January 2021

Background: Post-operative delirium in elderly with hip fracture is associated with various adverse clinical outcomes. Nevertheless, the pathophysiological processes underpinning delirium have remained elusive. The aim of this study is to explore the associations between delirium and its features and immune-inflammatory and blood gas biomarkers.Methods: In this prospective study we examined 65 patients who underwent a hip fracture surgery and assessed the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU), Richmond Agitation-Sedation Scale (RASS), and Delirium Rating Scale Revised-98 (DRS-R-98) before and during 4 days after the surgery. Complete Blood Count (CBC) and venous blood gas markers were obtained at the same time points.Results: Delirium was observed in 19 patients and was accompanied by significantly increased pO2, number of white blood cells, neutrophil percentage, and neutrophil/lymphocyte ratio, and lower mean platelet volume (MPV) (after adjusting for age, central nervous system (CNS) disease, blood loss during surgery, sleep disorders, and body mass index. The severity of delirium was associated with lowered number of platelets and MPV. Psychomotor disorders were associated with lower bicarbonate levels. The requirement of physical restraint of the patients was predicted by increased percentages of neutrophils and lymphocytes. Prior CNS disease was together with these biomarkers a significant predictor of delirium and severity of delirium. Conclusion: Delirium and psychomotor disorders following hip fracture and surgery may be caused by immune-inflammatory and oxidative stress pathways probably attributable to an aseptic inflammatory process. Oxygen administration may aggravate these pathways.
Deciphering Cave Painting Code and Ancient Celestial Map in South East Asia Paleolithic Cultures Dated to 40000 Years Old
Authors: Wibowo Andri
Published: January 2021

Currently it was theoritized that cave paintings have meaning more than human and animal interactions. Based on an example from Lascaux cave, a figure of a bull is believed representing Taurus constellation together with the Pleiades. In here this study aims to assess the connections of paleolithic art works in the forms of cave paintings and zoomorphic figures resemble to bovid with possible ancient astronomy and constellation depictions in South East Asia. The study caves were Jeriji Saleh in Kalimantan and Leang Leang and Sumpang Bita caves in Sulawesi where ancient cave paintings and zoomorphic figures date to 40000 years old have been found. The results show that cave paintings in Jeriji Saleh, Leang Leang and Sumpang Bita caves were comparable to the current findings. Those paintings were having bovid like figures with Leang Leang has figure identified as extant Bubalus depressicornis. In Sumpang Bita, this species was depicted in pregnant condition similar to pregnant horse figure in Lascaux cave. Depiction of pregnant figures in cave paintings indicates the use of ancient calendar to determine season based on the animal mating season. Bovid figure in Jeriji Saleh was illustrated in the same posture like auroch bovid in Lascaux cave and this indicates that cave paintings in Jeriji Saleh have been used to visualize Taurus constellation. The postures of bovid paintings in Leang Leang were different and it is interpreted to visualize Capricorn constellation. Another significant similarity between Lascaux and Leang Leang caves can be seen in paintings depicting a shaft scene with the presences of 3 similar figures include dying man, speared bovid and small zoomorphic figures. This concludes that the caves with their wall painting were not merely functioned as media for ancient art works, whereas it has functioned as paleolithic planetarium and this knowledge was globally widespread.
An Expansion Planning Method for Extending Distributed Energy System Lifespan with ESS
Authors: Tercan Said Mirza , Elma Onur , Gokalp Erdin , Cali Umit
Published: January 2021

Growing energy demand in the distributed energy system (DES) besides new charging loads of electric vehicles (EVs) make DES infrastructure unavailable earlier than normal projections. DES lines need to be upgraded to carry the modern demand of customers. DES line upgrade (LU) cost minimized and deferred to the next years by using energy storage system (ESS). ESS offers the opportunity to use energy flexibly in the distribution grid. It is possible to use ESS to shift the inevitable upgrade costs of the distribution grid elements and increase the power quality of the distribution grid. In this study, a method is proposed to extend the lifespan of DES with ESS and reduce line upgrade and investment costs in the distribution system. For this purpose, the IEEE 33 bus test grid is used, and the proposed method is tested and analyzed with different case studies. According to the results, the proposed method can reduce the investment cost by up to 80%. Besides, ESS usage considering load increase and line conditions of the distribution grid, upgrade costs of distribution grid are shifted, resulting in an optimal dimensioning and positioning while extending the lifespan of the distribution grid elements and, at the same time, offering significant improvements in energy quality. Additionally, it is seen that the power losses of the distribution grid are reduced up to 26%, and the voltage profile of buses is improved with the usage of ESS.
Development of a Forward-Reverse Rotating cBN Electroplated End Mill Type Tool for Cutting and Grinding CFRP
Authors: Muto Fumiya , Hirogaki Toshiki , Aoyama Eiichi , Furuki Tatsuya , Inaba Kiyofumi , Fujiwara Kazuna ,   Doshisha University 1-3 Tataramiyakodani, Kyotanabe-shi, Kyoto 610-0394, Japan,   Gifu University, Gifu, Japan,   Kamogawa Co., Ltd., Ritto, Japan
Published: January 2021

Currently, the demand for carbon fiber reinforced plastic (CFRP) has increased in various fields. However, there have been few studies investigating the machined surface quality, degradation in CFRP mechanical properties with machining temperature, or machining tool cost. In particular, the machining temperature is considered to affect the machined quality because the CFRP matrix is a resin. In this study, a cubic boron nitride (cBN) electroplated end mill was developed; this novel tool can switch between cutting and grinding without needing to change the tool. To observe the relationship between the amount of abrasive grain in contact with the CFRP and the occurrence of burrs, a grinding test was conducted with different clearance angles of the end mill and different abrasive grain sizes. The temperature during the grinding processes was measured, and the burrs were estimated after the grinding processes. From these results, the contact amount of the abrasive grit suitable for grinding was derived.
La ficción de la inclusión cultural en el cine Hollywoodense: Babel y la reproducción de estereotipos culturales
Authors: Mandujano-Salazar Yunuen Ysela , Ramírez-Sánchez Andrés
Published: January 2021

En el presente artículo se realiza, desde la perspectiva de los estudios culturales, un análisis textual interpretativo de la película dramática Babel, en donde se entrelazan cuatro sociedades y culturas en un contexto realista contemporáneo. Este críticamente aclamado filme, estrenado en 2006, fue dirigido y escrito por dos mexicanos, pero producido y distribuido hacia el mundo desde Hollywood. Se tiene por objetivo extraer las imágenes y características predominantes en la representación de las sociedades mexicana, estadounidense, japonesa y marrueca, así como de sus ciudadanos, y problematizar si en esas representaciones y en los discursos que se construyen a través del argumento del filme se refuerzan o desafían estereotipos culturales y étnicos vigentes en Estados Unidos con respecto a las sociedades involucradas, sirviendo de alguna manera a los intereses políticos dominantes
Vida Cotidiana en la Comunidad Wixarika El Colorín: Memoria y Herencia de un mara’akame: José Ríos (Matsɨwa)
Authors: Marín García Jorge Luis
Published: January 2021

En la comunidad wixárika El Colorín, en el municipio Del Nayar, Nayarit, México. Se realizan principalmente dos actividades económico-productivas: la pesca y la elaboración de arte huichol. También hay un incipiente turismo y una arraigada pero mermada ganadería, al igual que una casi extinta agricultura. Pero no siempre ha sido así, dado que en algún momento predomino la agricultura y en otro momento la artesanía. Para comprender las transformaciones y reacomodos que sucedieron para llegar a lo que ahora acontece en El Colorín, se propone analizar los modos de vida en la región Aguamilpa, desde el individuo socializado en un espacio y tiempo determinado, a partir de la figura de José Ríos (Matsɨwa), tomando como fundamento teórico la sociología de la vida cotidiana. A tal fin se exponen los modos de vida, especialmente de dos periodos, como fotografías que muestran la forma en que se ha vivido en la region.
Distintos enfoques sobre el estudio de los criminales mexicanos durante el Porfiriato
Authors: Arellano Navarrete Yussel
Published: January 2021

El lema del Porfiriato, “orden y progreso”, estableció la manera en la cual los hombres de bien junto con la ciencia permitirían que México lograse salir de un pasado conflictivo que lo mantenía en retroceso, en comparación con otras naciones. Ante un aumento considerable de delitos que afectaba la seguridad privada y el bienestar de la sociedad, algunos intelectuales de la época se dieron a la tarea de establecer las causas de la criminalidad en México, según sus particularidades biológicas y sociales. El presente artículo demuestra que los textos hechos por los criminólogos porfiristas van más allá de una connotación entre clase y raza, en la que solo se trasmitieron los fundamentos teóricos que discutían las escuelas de antropología criminal francesa e italiana, por medio de tres libros que fueron importantes para su tiempo, debido a sus consideraciones teóricas, metodológicas y aportaciones al conocimiento de la delincuencia mexicana
Environmental applications of 3D printing polymer composites for dredging operations
Authors: Kennedy Alan , Ballentine Mark , McQueen Andrew , Griggs Christopher , Das Arit , Bortner Michael
Published: January 2021

This Dredging Operations Environmental Research (DOER) technical note disseminates novel methods to monitor and reduce contaminant mobility and bioavailability in water, sediments, and soils. These method advancements are enabled by additive manufacturing (i.e., three-dimensional [3D] printing) to deploy and retrieve materials that adsorb contaminants that are traditionally applied as unbound powders. Examples of sorbents added as amendments for remediation of contaminated sediments include activated carbon, biochar, biopolymers, zeolite, and sand caps. Figure 1 provides examples of sorbent and photocatalytic particles successfully compounded and 3D printed using polylactic acid as a binder. Additional adsorptive materials may be applicable and photocatalytic materials (Friedmann et al. 2019) may be applied to degrade contaminants of concern into less hazardous forms. This technical note further describes opportunities for U.S. Army Corps of Engineers (USACE) project managers and the water and sediment resource management community to apply 3D printing of polymers containing adsorptive filler materials as a prototyping tool and as an on-site, on-demand manufacturing capability to remediate and monitor contaminants in the environment. This research was funded by DOER project 19-13, titled “3D Printed Design for Remediation and Monitoring of Dredged Material.”
Planktonic Foraminiferal Endemism at Southern High Latitudes Following the Terminal Cretaceous Extinction
Authors: Huber Brian T. , Petrizzo Maria Rose , MacLeod Kenneth G.
Published: January 2021

Austral planktonic foraminiferal assemblages from immediately above the Cretaceous/Paleogene (K/Pg) boundary at Ocean Drilling Program Hole 690C (Maud Rise, Weddell Sea) and International Ocean Drilling Program Hole U1514C (southeast Indian Ocean) show a much different record of post-extinction recovery than anywhere outside the circum-Antarctic region. Species of Woodringina and Parvularugoglobigerina, genera with well-documented evolutionary successions within the early Danian P0 and Pα biozones at tropical/subtropical and mid-latitude localities, are absent from southern high latitude sequences. This study proposes new criteria for biostratigraphic correlation of the lowermost Danian Antarctic Paleocene AP0 and AP1 Zones using stratophenetic observations from Scanning Electron Microscope images of lower Danian planktonic foraminifera at deep-sea sites in the southern South Atlantic and southern Indian Ocean. The small but distinctive species Turborotalita nikolasi (Koutsoukos) is a highly reliable index species for the lowermost Danian as it consistently occurs immediately above the K/Pg boundary at multiple southern high latitude sites, which is consistent with its distribution at middle and low latitudes. Also useful for cross-latitude correlation is Parasubbotina neanika n. sp., which first appears within the lowermost Danian worldwide. The geographic distribution of the New Zealand species Antarcticella pauciloculata (Jenkins) and Zeauvigerina waiparaensis (Jenkins), as well as Eoglobigerina maudrisensis n. sp. from just above the K/Pg in the southern South Atlantic and southern Indian Ocean, helps define the extent of the Austral Biogeographic Province and provides evidence for marine communication via marine seaways across Antarctica. While An. pauciloculata was previously considered a benthic species, new stable isotope evidence demonstrates that it lived a planktonic mode of life. It is possible this species evolved from a benthic ancestor and that the benthic to planktonic transition occurred through an intermediate tychopelagic lifestyle at a time when calcareous plankton were less abundant as a result of the terminal Cretaceous mass extinction.
Cushman Special Publications: History and Scope
Authors: Culver Stephen J. , Buzas-Stephens Pamela
Published: January 2021

The content and scope of the Cushman Laboratory and Cushman Foundation Special Publications are briefly described and summarized in four tables. Seventy-seven Special Publications have been produced over the past 90+ years. Most are taxonomic works, of variable length (up to 661 pages) with copious illustrations (up to 389 plates) in the form of images of foraminiferal taxa (six Special Publications are on radiolaria and one on thecamoebians). The Special Publications underpin all other aspects of micropaleontological (particularly foraminiferal) research ranging from biostratigraphy to paleoceanography to evolutionary studies.
Soviet Dostoevsky: Dostoevsky in Soviet culture, ideology, and philosophy
Authors:   Lomonosov Moscow State University, Puschaev Yuriy V.
Published: January 2021

The article aims to analyze how Dostoevsky’s works were perceived and presented in the Soviet ideology and philosophy. Contrary to some commonly held views, it is shown that despite the restrictions, there was never any talk of a complete ban or non-publication of Dostoevsky’s works in the Soviet times including the Stalinist years. Indi­vidual works of Dostoevsky as well as collections of his works were actively published in those years. The author explores the presence of Dostoevsky in the school literature program as well as the perception of Dostoevsky’s legacy by the Soviet leaders – V. Lenin and J. Stalin. It is concluded that the official ideological position in relation to Dostoevsky was never devoid of dynamics even in the Stalinist years. Among the factors that Soviet ideologists noted as positive in Dostoevsky, the author identifies the following three: Dostoevsky’s allegedly revolutionary past, his humanism and fervent sympathy for the humiliated and offended, and his great skill of an artist and expert in the secrets of the human soul. The author also discusses the perception of Dostoevsky’s work by the Soviet philosopher E.V. Ilyenkov. The author sets the task of further research into the perception of Dostoevsky in the legacy of other creative Soviet Marxists and / or publicists of the sixties – G. Lukach, M.A. Lifshits, Yu. F. Karyakin, etc.
Vladimir Monomakh’s ethical and political program
Authors:   Institute of Philosophy, Russian Academy of Sciences, Milkov Vladimir V.
Published: January 2021

The religious grounds of Vladimir Monomakh's political views are analyzed in the arti­cle. The author reconstructs the points of the political testament of Monomakh. The main ideas of his ethic and political program are reconstructed. The Grand Duke recommended to evade sin, to be a just judge, to protect the weak, to have a mortal memory and to keep in their heart the fear of God. Actions in such paradigm imposed considerable restrictions for governors of the power because they held down them in the choice of means. The au­thor compares the ethical and political program of Monomakh with the facts of his biog­raphy. It is shown that in real political practice Monomakh retreated from his own moral program. The author concludes that Monomakh was the first Russian leader to formulate requirements to the power itself proposing an ideal image of the Christian Prince.
‘Detached Desires’ - Resituating Pornographic and Celebrity Persona Online
Authors: Longstaff Gareth
Published: January 2021

Celebrity and pornography are dominant features of late-capitalist consumption, and both serve to influence and bolster the performance, curation and construction of a sexualised and/or sexually explicit persona online. More so, a range of social and networked spaces such as Twitter XXX, Instagram, JustFor.Fans and onlyfans.com have enabled ‘ordinary’ subjects to assimilate and adapt elements of celebrity and pornographic representation in ways that have permitted them to explicitly and publicly present (and profit from) their private sexual persona. Individuals create and sustain their individual profiles through boundless processes of self-branding, self-promoting, self-objectifying, and the self-management of their sexual personas as “an ideal typification of the neoliberal self, emphasising how demotic neoliberalism, with the aid of celebrity role models instructs” not only their own, but also their viewers desires (McGuigan 2014, p. 224). This enigmatic discourse of sexual self-presentation as a form of empowerment, entrepreneurialism, and an aesthetic mode of influence may well function as an apex of neo-liberal and late capitalist ideology. It is here that the meticulous construction of sexual authenticity and tropes we connect to the banal and everyday are refined and embodied to tactically produce amateurish porn content that followers and fans identify with, algorithmically rate, consistently follow, prolifically share, and (of course) economically subscribe.
Association of Serum Uric Acid Levels with COVID-19 Severity
Authors: Hu Fang , Guo Yifan , Lin Jianghong , Zeng Yingjuan , Wang Juan , Li Man , Cong Li
Published: January 2021

Aims: Hyperuricemia has attracted increasing attention, however, limited attention has been paid to the potential dangers of lowering serum uric acid (SUA). We observed lower levels of SUA in COVID-19 patients. Therefore, we aim to explore the SUA levels in COVID-19 patients and the relationship between SUA and the severity of COVID-19. Methods: A case-control study based on 91 cases with COVID-19 and 1:3 age- and sex-matched healthy control subjects (N=273) were included. We firstly compared the SUA levels and the uric acid/creatinine (UA/Cr) ratio between COVID-19 patients and the healthy controls. Then, we examined the association of the SUA levels and UA/Cr ratios with COVID-19 severity defined according to the fifth edition of China’s Diagnosis and Treatment Guidelines of COVID-19. Results: SUA levels at admission were 2.59% lower, UA/Cr ratios 6.06% lower in COVID-19 patients compared to controls. In sex stratified analysis, SUA and UA/Cr were lower in male COVID-19 patients while only SUA was lower in female COVID-19 patient. Moreover, SUA and UA/Cr values were 4.27% and 8.23% lower in the severe group than in the moderate group among male COVID patients. A multiple linear regression analysis showed that SARS-CoV-2 infection and male sex were independent factors associated with lower SUA levels. COVID-19 male patients with low SUA levels at had higher risk of developing severe symptoms than those with high SUA levels (incidence rate ratio: 4.05; 95% CI:1.11，14.72) at admission. After completion of the first follow-up of the COVID-19 patients within 1-3 weeks after discharge, we found that male patients experienced severe symptoms had significantly lower SUA and UA/Cr ratio levels comparing to moderate patients but no significant difference between different time points. In females, female patients have both SUA and UA/Cr ratio levels lower at discharge than that at admission, however these differences disappear at follow-up exam.Conclusion: COVID-19 patients had SUA and UA/Cr values lower than normal at admission. Male COVID-19 patients with low SUA levels had a significantly higher risk of developing severe symptoms than those with high SUA levels. During the aggravation course of the disease, the level of SUA gradually decreased until discharge. At follow-up exam, the level of SUA is similar to the levels at admission.
Assessing the potential for reducing violence against young children through an adapted parenting program embedded within the public health system: Findings from a pre-post trial in Thailand
Authors: McCoy Amalee , Lachman Jamie , Ward Catherine , Tapanya Sombat , Poomchaichote Tassawan , Kelly Jane , Mukaka Mavuto , Cheah Phaik Yeong , Gardner Frances
Published: January 2021

BackgroundThis pre-post trial of the Parenting for Lifelong Health for Young Children program in Thailand aimed to: 1) explore the feasibility of study evaluation approaches; 2) assess the feasibility of delivering an adapted program; 3) report indicative effects on child maltreatment and related outcomes; and 4) examine intervention content associated with key mechanisms of change perceived by caregivers and facilitators.Method:Sixty primary caregivers of children aged 2–9 years were recruited for an 8-week parenting program embedded within the local health system. Mixed-methods approaches included quantitative caregiver-report and observational data from standardized instruments, and qualitative data from individual and group interviews with caregivers and program facilitators. Analyses involved Wilcoxon signed-rank tests, paired t-tests, Friedman’s ANOVA, and thematic analysis.ResultsParticipants reported that most (65%) were grandparents or great-grandparents. Study retention and response rates were high, and enrolled caregivers attended an average of 93% of sessions. Primary outcomes showed caregiver-reported pre-post reductions in overall child maltreatment (d=-0.58, p < 0.001), as well as reductions in physical (d=-0.58, p < 0.001) and emotional abuse (d=-0.40, p < 0.001). Combined caregiver report and observational assessments using the HOME Inventory showed reductions in abusive and harsh parenting (d=-0.52, p < 0.001). Secondary outcomes demonstrated decreases in child neglect; dysfunctional parenting; poor child monitoring and supervision; parental sense of inefficacy; child behavior problems; daily report on child problem behavior; parent overall depression, anxiety, and stress; and attitudes supporting physical punishment and harsh discipline. There were increases in overall positive parenting, daily positive parenting behavior, as well as HOME Inventory assessments on parent-child relationships. Thematic analyses from interviews and focus group data identified six key program themes associated with strengthened parent-child relationships, reduced child behavior problems, improved attitudes and strategies toward discipline, and improved management of parental stress.ConclusionsThis study represents one of few evaluations to test the feasibility of an evidence-based parenting program embedded within routine public health service delivery in a low- or middle-income country. Findings show preliminary effectiveness in reducing child maltreatment, improvements on 22 of 24 secondary outcomes, and perceived mechanisms of change that support quantitative findings. Prospects are promising for program scalability, pending randomized controlled trial results.Trial registration11/01/2019, ClinicalTrials.gov, ID# NCT03539341
Expansion of a National Differentiated Service Delivery Model Increases Access to Treatment for HIV and Other Chronic Conditions in South Africa
Authors: Liu Lingrui , Christie Sarah , Munsamy Maggie , Roberts Phil , Pillay Merlin , Shenoi Sheela , Desai Mayur , Linnander Erika
Published: January 2021

Background: South Africa is home to 7.7 million people living with HIV and supports the largest antiretroviral therapy (ART) program worldwide. Despite global investment in HIV service delivery and the parallel threat of non-communicable diseases (NCDs), there are few examples of integrated programs addressing both HIV and NCDs through differentiated service delivery. In 2014, the National Department of Health (NDoH) launched the Central Chronic Medicines Dispensing and Distribution (CCMDD) program to provide patients with chronic disease, including HIV, with differentiated access to medications via community-based pick-up points. This study describes the expansion of CCMDD to national scale.Methods: Yale monitors CCMDD enrollment as part of its mixed methods evaluation of Project Last Mile (PLM), a national technical support partner for CCMDD since 2016. From March 2016 through October 2019, cumulative weekly data on CCMDD uptake [patients enrolled, facilities registered, pick-up points contracted], type of medication collected [ART only; NCD only; and ART-NCD] and of collection site used [external pick-up points; adherence/outreach clubs; or facility-based fast lanes], were extracted for descriptive, longitudinal analysis.Results: As of October 2019, 3,436 health facilities were registered with CCMDD across 46 health districts (88% national coverage), and 2,037 external pick-up points had been established. A total of 2,069,039 patients were active on CCMDD, a significant increase since 2018 (p<0.001), including 76% collecting ART [64% ART only, 12% ART plus NCD/comorbidities] and 479,120 [24%] collecting for chronic diseases only. Further, 734,005 (35%) of patients were collecting from external pick-up points, a 73% increase in patient volume from 2018.Discussion: This longitudinal description of CCMDD provides an example of a path to national scale for a differentiated service delivery model that integrates management of HIV and noncommunicable diseases. This study demonstrates the success of the program in engaging patients who are not living with HIV, which bodes well for the potential of the program to address the rising burden of NCDs in South Africa.Conclusion: The results signal potential for expansion in resource-limited settings, particularly in the context of private sector strategic support.
Mutations in Frizzled Class Receptor 4 Associated With Congenital Cavus Foot Deformity
Authors: Yan Wenjin , Mao Haijun , Xu Xingquan , Zheng Liming , Yu Pengjun , Dai Jin , Xu Guangyue , Jiang Qing , Yang Yannick
Published: January 2021

BackgroundCongenital cavus foot deformity (CFD) (congenital =present at birth) is a disease very disabling that could connected to the mobility, neurologic entities and the imbalance of synergistic intrinsic and extrinsic muscles of the patients, and the problem is even dynamic (often progressive). Here, we report the clinical and radiographic manifestations of one Chinese Han congenital CFD family and 23 congenital CFD patients. In the congenital CFD family, the proband’s mother and brother are also CFD patients. ResultsWe performed whole-exome sequencing for three patients and two healthy people in this family, and sequenced the Frizzled Class Receptor 4 (FZD4) for the other. One novel FZD4 mutation (exon2 c.1589G>A; p.G530E, NM_012193) was identiﬁed. Then mutations in FZD4 gene were further examined in 23 congenital CFD patients, and also find FZD4 mutation (FZD4:NM_012193:exon1:c.205C>T:p.H69Y) in one congenital CFD patient. ConclusionsOur study suggested that the congenital cavus foot deformity might be associated with the identified mutations in FZD4.
The Relationship between Chinese Outpatients’ Characteristics and Healthcare-Seeking Behavioral Decision-Making: Decision Tree and Linear Regression Analyses Based on Survey Data in Jiaxing
Authors: Yu Mingming , Yang Zan
Published: January 2021

Background Chinese patients generally experience difficulties and high costs when obtaining medical services. One consensus reason for these difficulties is imbalances in hospitals’ medical standards and resources, which cannot be changed in the short term. This article explores the most perplexing healthcare-seeking problems in China by considering the laws pertaining to how different patients may see a doctor. Methods Data mining and analysis can characterize a person and explore the heuristics underlying his or her decisions using a combination of comprehensive feature data. Accordingly, a questionnaire was designed that probed numerous variables of relevance to decision-making and we analyzed the survey data using a decision tree and linear regression. The decision tree facilitated observation of the healthcare-seeking decision-making routes of different patients. In addition, linear regression analysis revealed that patients tended to choose different hospitals with different features.Results This article primarily argues that in China, having medical insurance and a profession that represents economic strength and social class are the most important factors that guide the outpatient's patterns of seeing a doctor. Further, outpatients who live far from hospitals and recognize they have a serious disease would choose different hospitals than those on the contrary. Conclusion Using a decision tree and line regression, we drew the portraits and decision-making routes behind various outpatients’ characteristics when he or she saw a doctor. It provides direction about the type and location about future hospital construction in this area, and it addresses how to avoid overcrowding at large hospitals and how to provide enhanced possibilities for diversion to smaller hospitals.
Medium and High Fidelity Simulations in Training Undergraduate Nursing and Operating Room Students. Are They Effective?
Authors: Yazdanpanah Farideh , Dehghan Azizallah , Bazrafkan Leila
Published: January 2021

Background: Simulators-Based Education is any type of educational activity that uses simulation of clinical scenarios to increase students’ awareness and skills. Simulation environments are able to create a place for students to expand their competencies in specialized skills without posing a risk to patients. In simulation, an attempt is made to bring the learning conditions so close to the real conditions, so that the learned concepts can be transferred to the real world.Methods: This is a quasi-experimental study. The statistical populations of the study were nursing and operating room (OR) students of Larestan University of Medical Sciences who were selected using census method. A total of 192 students participated in this study, which 96 students were in the control group and 96 students were in the experimental group. At the beginning of the study, students of both groups participated in the pre-test. In this study low-fidelity simulation was used to train control group, and in the experimental group training, medium- and high-fidelity simulation were applied. The post-test was performed after completion of the training program of both groups. 4 instruments were used for data collection. The data were analyzed using SPSS software (version 20.0). Results: The results of this study showed that students in the experimental group scored significantly higher in knowledge domain compare to control group students, and also performed better in the objective structured clinical examination (OSCE) (P<0.001). Also, this study showed that the average total score of students’ attitudes towards the role of simulators in the experimental group is higher than the control group. Statistical relationship was significant in some factors such as “patients’ safety (P= 0.014)”, “increasing the student's self-confidence (P= 0.041)”, “connecting the topics taught in the theoretical units (P= 0.024)”. Also, statistical relationship was meaningful in training with low-fidelity models which stated “it was not a reliable learning experience (P= 0.004)”.Conclusions: Simulation is an effective method for better teaching­-learning that can increase knowledge, improve clinical competence, feel more confident and integrate knowledge in a safe and controlled environment.
Effects of Intraoperative Lung-Protective Ventilation on Clinical Outcomes in Patients With Traumatic Brain Injury: A Randomized Controlled Trial
Authors: Jiang Lulu , Wu Yujuan , Zhang Yang , Lu Dahao , Yan Keshi , Gao Ju
Published: January 2021

Background: Secondary lung injury is the most common non-neurological complication after traumatic brain injury (TBI). Lung-protective ventilation (LPV) has been proven to improve perioperative oxygenation and lung compliance in some critical patients. This study aimed to investigate whether intraoperative LPV could improve respiratory function and prevent postoperative complications in emergency TBI patients.Methods: Ninety TBI patients were randomly allocated to three groups (1:1:1): Group A, conventional mechanical ventilation [tidal volume (VT) 10mL/kg only]; Group B, small VT (8mL/kg) + positive end-expiratory pressure (PEEP) (5cmH2O); Group C, small VT (8mL/kg) + PEEP (5cmH2O) + recruitment maneuvers (RMs). Primary outcomes were intraoperative respiratory mechanics parameters and incidences of postoperative pulmonary complications; Secondary outcomes were serum levels of brain injury markers and incidences of postoperative neurological complications.Results: Seventy-nine patients completed final analysis. Intraoperative PaO2 and dynamic pulmonary compliance of Group B and C were higher than those of Group A (P=0.028; P=0.005), while their airway peak pressure and plateau pressure were lower than those of group A (P=0.004; P=0.005). Compared to Group A, postoperative 30-day incidences of hypoxemia, pulmonary infection and atelectasis of the other two groups significantly decreased (52.0% vs. 14.3% vs. 19.2%, P=0.005; 84.0% vs. 50.0% vs. 42.3%, P=0.006; 24.0% vs. 3.6% vs. 0.0%, P=0.004). Moreover, intraoperative hypotension in Group C was more frequent than that in Group A and B (P=0.007). At the end of surgery, serum levels of glial fibrillary acidic protein and ubiquitin carboxyl-terminal hydrolase isozyme L1 in Group B were lower than those in group A and C (P=0.002; P<0.001). Postoperative incidences of neurological complications among three groups were comparable. Conclusions: Intraoperative continuous administration of small VT + PEEP is beneficial to TBI patients. Additional RMs with caution can be performed to prevent the disturbance of the stability of cerebral hemodynamics.Trial registration: Chinese Clinical Trial Registry (ChiCTR2000038314), retrospectively registered on September 17, 2020.
Comparison of Two Surgical Approaches for Displaced Intra-Articular Calcaneal Fractures: The Modified Sinus Tarsi Approach Versus The Extensile Lateral Approach
Authors: Ma Chao , Zhao Jiaju , Zhang Yong , Yi Nan , Zhou Jupu , Zuo Zhicheng , Jiang Bo
Published: January 2021

The purpose of this study was to assess the clinical efficacy and complications of a modified sinus tarsi approach (MSTA) and the extensile lateral approach (ELA) for the treatment of displaced intra-articular calcaneal fractures. In a retrospective design, 108 patients (117 feet) with Sanders II~IV calcaneal fractures were enrolled in this study, including 52 patients (56 feet) in the MSTA group and 56 patients (61 feet) in the ELA group. The postoperative functional and radiological results showed that the average AOFAS scores and VAS scores of the MSTA group were higher than that of the ELA group (p<0.05). After surgery, the Bohler Angle, Gissane Angle, and the length, width, and height of the calcaneus were significantly improved in the MSTA group and the ELA group, but there were no statistically significant differences between the two groups. The incidences of wound healing complications and postoperative sural nerve injury were lower in the MSTA group than in the ELA group (p<0.000). In conclusion, the MSTA was able to achieve similar effects of anatomical reconstruction and function recovery as the ELA, while also effectively reducing the incidences of wound healing complications and postoperative sural nerve injury and shortening the length of hospital stay.
Comparative therapeutic effectiveness of probiotic and combinations of Probiotic with prebiotics and probiotic with rumenotorics in experimentally induced ruminal acidosis sheep
Authors: Fenta Melkie Dagnaw , Jemberu Wudu temesgen , G/mariam Ashenafi Assefa , Mebratu Atsede solomon
Published: January 2021

Backgroundrumen disorder is responsible for huge economic losses in ruminants due to decrease in production and increase in expenditure towards treatment. Acidosis is one of the most ruminal disorders, characterized by changes in the rumen environment and leds to systemic acidosis. To correct this disorder, recent alternative trends in sheep rearing have led to the use of prebiotics, rumenotorics and probiotics as feed additives or treatment.Context and purposethis study was to evaluate and compares the therapeutic effectiveness of probiotics, a combination of probiotics with prebiotics, probiotics with rumenotorics and with the standard treatment under experimentally induced acidosis.Methodsthe experimental study design was conducted from September to May 2019. For therapeutic study 25 sheep were randomly divided into 5 groups with deliberately imposed ruminal acidosis as a group comprising of 5 animals each.Resultsacidosis was induced by an oral dose of 50 g/kg with wheat flour after 24-hour fasting. Four therapeutic regimes and negative control group were employed, I-Probiotics, II-Probiotics with Prebiotics, III-Probiotics with Rumenotorics and IV-Standard treatment (sodium bicarbonate) was adopted. Then, laboratory analysis of rumen fluid, physical parameters and hematological changes before and after treatment was carried out. From a comparison of each treatment groups with the control group to correct ruminal pH, the combination of probiotics with rumenotorics, the mean ± SD before treatment (4.96 ± .837) increased to (5.92 ± .54), (6.30 ± .41), (6.75 ± 0.34) after treatment, was statistically significant (p < 0.05, 0.024, 0.047, 0.002), from day one-day three, respectively, and the therapeutic regimens of probiotics with rumenotorics was highly significance compare with control group (p < 0.05, p = 0.001 & p = 0.000) improved heart rate and respiratory rate at day three after treatment and the mean PCV value of treatment Group III was 38.00 ± 6.819 before treatment changed to 34.60 ± 5.367, 29.80 ± 6.261 and 24.80 ± 10.134 after treatment, were statistically significance (p < 0.05, p = 0.003, p = 0.02 &0.006) from day one-day three, respectively.Conclusionthe present study was concluded that probiotics with rumenotorics administered together were the most successful therapeutic regimen for improvement of ruminal acidosis. Therefore, in this experimental study for the treatment of acidosis, it has been recommended that use of probiotics with substrate is the promising alternative.
Gene Expression Profiles During Tissue Remodeling Following Bladder Outlet Obstruction
Authors: Ito Saya , Nomura Takeshi , Ueda Takashi , Inui Shogo , Morioka Yukako , Honjo Hisashi , Fukui Ayako , Fujihara Atsuko , Hongo Fumiya , Ukimura Osamu
Published: January 2021

Bladder outlet obstruction (BOO) often results in lower urinary tract symptoms (LUTSs) and negatively affects quality of life. Here, we evaluated gene expression patterns in the urinary bladder during tissue remodeling due to BOO. We divided BOO model rats into two groups according to the degree of hypertrophy of smooth muscle and hypoxia-inducible factor 1α (HIF1α) mRNA levels in the bladder. The strong muscular hypertrophy group, which exhibited markedly increased HIF1α mRNA levels and bladder smooth muscle proportion compared with the control group, was considered a model for the termination of hypertrophy, whereas the mild muscular hypertrophy group was considered a model of the initiation of hypertrophy. Some genes related to urinary function showed different expression patterns between the two groups. Furthermore, we found that several genes, including D-box binding PAR bZIP transcription factor (DBP), were upregulated only in the mild muscular hypertrophy group. DBP expression was increased in urinary bladder cells in response to hypoxic stress and induced the upregulation of some genes involved in urinary function. These findings suggested that the regulatory systems of gene expression were altered during tissue remodeling following BOO. Furthermore, circadian rhythms may be involved in urinary function via regulation of gene expression following hypoxic stress.
Dynamics of Contagion and Submerged Infections During the Second Wave of The SARS-CoV-2 Epidemic in the Italian Regions
Authors: Cereda Giulia , Viscardi Cecilia , Gherardini Luca , Mealli Fabrizia , Baccini Michela
Published: January 2021

After the SARS-CoV-2 outbreak in spring 2020, Italy faced a second epidemic wave in autumn. Using a SIRD model calibrated on COVID19-related deaths, we describe the regional epidemic dynamics from August to November 2020. We explore the time-varying reproductive number, R0(t), and quantify the number of infections, included their submerged portion, under different infection fatality rate scenarios. Results indicate that during the second epidemic wave, R0(t) changed over time heterogeneously across regions, with some important common elements including a mid-October peak and a decline during November, which suggest the possible role in inflating or deflating the contagion rate of specific events (e.g. schools reopening, regional elections) and of the restrictions imposed at the national and local level to reduce the infection spread. Despite the decline of R0(t) in most regions, the prevalence of circulating infections estimated at the end of the study period was not negligible, in particular in the North of the country. This suggests that even small increases of R0(t) in December may lead in a short time to unsustainable levels of contagion spread, depending on the regional supply of hospital and ICU beds and healthcare services throughout the territory.