bluuebunny/crossref_metadata_2025 huggingface dataset:
Deutsch im Vergleich. Sprachliche Strukturen im Kontrast zum Italienischen
Authors: Katelhön Peggy , Brambilla Marina , Muco Albana
Published: December 2021

This thematic issue of Linguistik online is dedicated to Contrastive linguistics for the language pair Italian-German. The contributions collected here deal with Italian-German language comparison from different points of view. The common feature of all of them is a corpus-oriented approach. Using authentic attestations from different linguistic sources, the linguistic structures of both languages are analysed and compared with each other. The granular and fine-grained comparison enabled the authors to work out interesting results not only in the fields of morphology and syntax, but also for pragmatics, and text and discourse linguistics for both languages, which can be profitably used in foreign language didactics, theoretical linguistics and translation studies.
Programs' Efficacy to Develop Employable Skills for People With Functional Diversity: A Meta-Analysis
Authors: Gonzálvez Carolina , Marhuenda-Fluixá Fernando
Published: December 2021

Purpose: Promoting the labour integration of people with functional diversity is a key element to achieve their social inclusion. This meta-analysis aims to examine the effectiveness of experimental programs in developing employable skills for people with disabilities. Methods: Literature searches up to June 2019 were conducted in four databases (Web of Science, Scopus, PsycINFO and ERIC). Studies that met the following criteria were selected: (1) The program should develop employable skills; (2) the participants should be people with functional diversity; (3) the study should have a design with an experimental group and a control group as well as pretest and posttest measurements; (4) the study had to provide enough data to calculate the effect sizes; and (5) the study had to be written in English or Spanish. 67 independent studies met the selection criteria, among 14 articles published between 1998 and 2019. Results: The results revealed mean effect sizes in favour of the experimental group for the set of all studies according to data reported by people with functional diversity, as well as according their relatives and teachers. The two dimensions of the programs with a significant effect size in favour of the experimental group were interview skills and career planning. Furthermore, it was found that the programs showed a higher degree of effectiveness in groups formed only by people with intellectual disabilities, with a lower educational level, whose duration ranged from six to twelve months. This was particularly the case with participants from Spain and Australia. Conclusion: Promoting the labour insertion of people with disability is a key element to achieve their social inclusion. Programs that support and develop employability and that are conducted upon experimental conditions do have a positive impact upon young people with functional diversity. Upon the results, we discuss practical implications for integrating disabled persons into the labour market.
Payer Coverage of Valley Fever Diagnostic Tests
Authors:   University of Arizona College of Pharmacy, Tucson, AZ USA, Grace Rose Chloe , Kessler Joshua , , Weisbrod Jennifer , Hoang Brittanie , Grizzle Amy , Hurwitz Jason , Galgiani John
Published: December 2021

Background The nonspecific symptoms of Valley fever, or coccidioidomycosis, hinders its proper diagnosis. This results in unnecessary health care costs and antibiotic usage. Thus, this study seeks to determine the coverage of the Valley fever diagnostic test as provided by Arizona insurance companies to increase early diagnosis rates. Methods Through scripted messaging and telephone communications, we contacted 40 health insurance companies in Arizona about their coverage of CPT 86635 (antibody diagnostic assay for Coccidioides) without prior authorization under all plan types provided in both primary and urgent care settings. If prior authorization was required, we discussed the coverage of ICD-10 codes J18.9 (pneumonia, unspecified organism), J18.1 (lobar pneumonia, unspecified organism), or L52 (erythema nodosum). Results Of the 40 health insurance companies contacted, 25 did not answer our inquiries, most requiring member-specific information to share coverage data. The remaining 15 companies covered Valley fever testing, of which 4 required prior authorization for the ICD-10 codes of interest. Of these 15 companies, 14 provided coverage in primary and urgent care settings, and 13 provided coverage for all available plans. Conclusion All payers that provided information covered Valley Fever testing. Most of the insurance companies that were unable to answer our inquiry likely cover Valley fever testing, but were unable to share information with third party inquiries. Obtaining general coverage information is difficult, which can potentially impact patient care.
‘Doomed as cartoons forever’: Subjection and liberation in Sidney Lumet’s The Wiz
Authors: Salter Destiny
Published: December 2021

This article reconsiders the importance of Sidney Lumet’s film adaption of The Wiz, which was panned on release and deemed a commercial failure. Despite this, the film has always been cherished by the African American community. I examine why this is, by analysing the film's relationship to blaxploitation, its production and reception history, and some of the film’s scenes. Finally, I consider its legacy and its meaning for later generations.
Reframing the Musical: Race, Culture and Identity, Sarah Whitfield (ed.) (2019)
Authors: Nereson Ariel
Published: December 2021

Review of: Reframing the Musical: Race, Culture and Identity, Sarah Whitfield (ed.) (2019)

London: Red Globe Press, xxxii + 241 pp.,

ISBN 978-1-35200-439-7, p/bk, $34.99
Comparing Special Education Teachers’ Personality Profile With Their Choice to Teach
Authors: Scott LaRon A. , Bruno Lauren , Gnilka Philip , Kozachuk Linday , Brendli Katherine , Vitullo Vivian
Published: December 2021

Researchers have yet to examine the association of Holland personality profiles as it relates to special education teachers. In response to this need, we report the personality and vocational profiles (Holland Codes) of 134 special education teachers across a special education training program. The purpose of this paper is to summarize findings from the Self-Directed Search measure commonly used to assess the personality of participants in an occupation and suggest implications for participants’ choice in becoming a special education teacher. Our focus was on personality match with vocational choice to include participants’ demographic (e.g., gender, race/ethnicity, and geographical location) profile. Findings from the study reveal that while special educators’ overall personality profile is congruent with the Holland Codes associated with special education teachers, other features may explain participants’ choice to pursue a career as a special education teacher. Implications for teacher preparation programs and K-12 schools training are recommended based on the research findings.
New Developments in the Formation of Nanocomposites between Starch and Clay
Authors: Al-Mosawy Manar Ghyath Abd-Almutalib , Oleiwi Zeyad Kadhim
Published: December 2021

Biodegradable polymers, like Polycaprolactone (PCL), have recently received a lot of attention in the science establishment because of the growing global interest in non - petroleum-based polymeric materials. 3-amino - 4 - ((3-hydroxyphenyl) diazenyl) - N(pyrimidine-2-yl) benzenesulfonamide (AZO) one of the organic materials used to reconfigure natural clay (sodium montmorillonite). The clay particles were modified by stirring them in an aqueous medium of AZO-MMT, which increased the wavelength from 1.27 to 2.04 nm. The reconfigured clay would have been used to make PCL/corn-starch mixture nanocomposites. They were created by combining 0.5–5% AZO-MMT. X-ray diffraction (XRD) and Fourier transform infrared (FTIR) were utilized to characterize the interaction of the modifier in the clay layer. The nanocomposites were prepared by solution casting method the reconfigured clay and a PCL/corn-starch mixture at a weight ratio of 80/20, which leads to an increase in the scope of tensile strength which that considers the biggest blend. The results of survey electron microscopy, transmission electron microscopy, and XRD was proved the creation of nanocomposites materials. Additionally, that PBS/corn-starch reconfigured clay nanocomposites exhibit that superior thermal stability significantly and a great increase over the PCL/corn-starch mixture.
Effect of Nonlinear Dispersion Fiber Length and Input Power on Raman Scattering
Authors: Alawsi Suha Mousa Khorsheed , Hassan Noor Mohammed , Al-Juboury Intehaa Abdullah Mohammed
Published: December 2021

The increasing demand for information transmission makes the problem of establishing a laser system is operating in C-band (1530-1565nm) wavelength region is a significant task, which attracts a lot of researchers' attention lately. In this paper, the ability to produce signals of multi wavelengths using a single light source was adopted to employ the Raman scattering effect for establishing Raman shift configuration-based multi-wavelength fiber lasers, which is not currently addressed in available schemes. This is what prompted to simulate the performance of C-band multi-wavelength produced by Raman fiber laser that utilizing fiber Bragg grating (FBG) to amplify pumped power and also utilizing the single-mode fiber (SMF) as the nonlinear gain medium. The proposed laser system is designed by OptiSystem software. The resulted maximum output power was 22.07dB at Wavelength Division Multiplexing (WDM) of 23.01dB input power. The achieved multi-wavelength that generated by Bragg grating and SMF was containing six Stokes and anti-Stokes, they are: 1548.51nm, 1549, 31nm, 1550.116nm, 1550.91nm, 1551.72nm, and 1552.52nm, in which the resulted computed efficiency of the system was raised up to 80.23% at input power 20 dB and dispersion fiber length of 0.2 km.
Syntheses, and Characterization of Complexes Containing Beta-lactam Group with some Transitional Elements and Study their Biological Activity
Authors: Kareem N. Ghufran , Hamid Said Mohammed
Published: December 2021

In this study, a novel azo-azomethine ligand [6[2-hydroxy-4-((3-nitrophenyl)diazenyl)-1-phenyl]imine penicillanic acid] [HNDIP] is synthesized from [2-hydroxy-4-((3-nitrophenyl)diazenyl) benzaldehyde]. And reflux with 6-aminopenicillin acid, this ligand was identified by UV-Vis, FTIR, 1H-NMR, C13NMR, and mass, and it was used to prepare new complexes with [Cu(II), Ni(II), Co(II), Zn(II), and Fe(II)] metal ions. These complexes were identified by FTIR, UV-Vis, molar conduct, magnetic sensitivity, and atomic absorption for all complexes, the reaction ingredients were observed to be ratio 1:2 (metal: ligand). The ligand, a tridentate with a single negative charge, was coupled with metal ions to form claw complexes, resulting in an octahedral shape. Finally, antibacterial effectiveness was determined for the ligand and complexes against two distinct bacteria strains (Pseudomonas and klebsiella). It was discovered that the ligand and its complexes have high inhibitory activity against bacteria (Pseudomonas and Klebsiella). As a result, the chemicals created may be feasible substitutes for routinely used drugs.
Synthesis of Carbon Nanotubes Using Plant Source and Study their Properties
Authors: Rashed Athraa Mohamed , Al Khazraji Abdulqadier Hussien
Published: December 2021

In this study the normal and activated charcoal were used to prepare normal and activated multi walled carbon nanotubes (MWCNTs) from same plant (Citrus aurantium) which is a source of carbon by Chemical Flame Deposition method (CFDM). The obtained products were analyzed using FESEM, FTIR, XRD, and Raman spectroscopy. The FESEM image of normal charcoal revealed that it has much less nanopores than activated charcoal. The ratios of ID/IG for the normal and activated MWCNTs were 0.85 and 0.91 respectively, which shows that use activated charcoal as a source enhance the disorder and the defects on the carbon nanotubes. The results demonstrate and confirmed that a carbon nanotubes which were prepared from normal and activated charcoal have some disfigurements and have converging diameter nearly (31-88 nm) and (37-70nm) for normal and activated MWCNTs with length about (1-2) μm respectively.
Tribological and Rheological Investigations of MWCNT/PMMA Polymeric Composites and Hybrid Compounds
Authors: Al-Zubaidy Enas , Al-Kawaz Ammar Emad
Published: December 2021

The Nano scale self-lubricating compounds were prepared by in-situ free radical polymerization with the dispersion of MWCNT ultrasonic molecules embedded in the polymer matrix to enhance the tribological mechanical properties as well as the production of hybrid compounds to detect the tibial changes on the polymer surface, dry friction under the conditions of slip was studied, the friction coefficient was found For hybrid compounds slightly lower than the coefficient of friction of Nano composites under multiple loads and constant velocities, enhancements of Nano composites in rheological behavior were investigated and the influencing factors were determined: shear stress, shear viscosity, as well as shear rates. By using visual inspection, tracking of the behavior of compounds during extrusion was carried out and obtaining the shapes of the threads resulting from extrusion, which are usually important matters whose results depend on many industries.
Personalized reference intervals – statistical approaches and considerations
Authors: Coskun Abdurrahman , Sandberg Sverre , Unsal Ibrahim , Yavuz Fulya G. , Cavusoglu Coskun , Serteser Mustafa , Kilercik Meltem , Aarsand Aasne K.
Published: December 2021

For many measurands, physicians depend on population-based reference intervals (popRI), when assessing laboratory test results. The availability of personalized reference intervals (prRI) may provide a means to improve the interpretation of laboratory test results for an individual. prRI can be calculated using estimates of biological and analytical variation and previous test results obtained in a steady-state situation. In this study, we aim to outline statistical approaches and considerations required when establishing and implementing prRI in clinical practice.

Data quality assessment, including analysis for outliers and trends, is required prior to using previous test results to estimate the homeostatic set point. To calculate the prRI limits, two different statistical models based on ‘prediction intervals’ can be applied. The first model utilizes estimates of ‘within-person biological variation’ which are based on an individual’s own data. This model requires a minimum of five previous test results to generate the prRI. The second model is based on estimates of ‘within-subject biological variation’, which represents an average estimate for a population and can be found, for most measurands, in the EFLM Biological Variation Database. This model can be applied also when there are lower numbers of previous test results available. The prRI offers physicians the opportunity to improve interpretation of individuals’ test results, though studies are required to demonstrate if using prRI leads to better clinical outcomes. We recommend that both popRIs and prRIs are included in laboratory reports to aid in evaluating laboratory test results in the follow-up of patients.
High-fidelity nano-FTIR spectroscopy by on-pixel normalization of signal harmonics
Authors: Mester Lars , Govyadinov Alexander A. , Hillenbrand Rainer
Published: December 2021

Scattering-type scanning near-field optical microscopy (s-SNOM) and Fourier transform infrared nanospectroscopy (nano-FTIR) are emerging tools for physical and chemical nanocharacterization of organic and inorganic composite materials. Being based on (i) diffraction-limited illumination of a scanning probe tip for nanofocusing of light and (ii) recording of the tip-scattered radiation, the efficient suppression of background scattering has been critical for their success. Here, we show that indirect tip illumination via far-field reflection and scattering at the sample can produce s-SNOM and nano-FTIR signals of materials that are not present at the tip position – despite full background suppression. Although these artefacts occur primarily on or near large sample structures, their understanding and recognition are of utmost importance to ensure correct interpretation of images and spectra. Detailed experimental and theoretical results show how such artefacts can be identified and eliminated by a simple signal normalization step, thus critically strengthening the analytical capabilities of s-SNOM and nano-FTIR spectroscopy.
Plasmonic metasurfaces manipulating the two spin components from spin–orbit interactions of light with lattice field generations
Authors: Zhang Ruirui , Gu Manna , Sun Rui , Zeng Xiangyu , Zhang Yuqin , Zhang Yu , Cheng Chen , Zhan Zijun , Chen Chao , Ren Xiaorong , He Changwei , Liu Chunxiang , Cheng Chuanfu
Published: December 2021

Artificial nanostructures in metasurfaces induce strong spin–orbit interactions (SOIs), by which incident circularly polarized light can be transformed into two opposite spin components. The component with an opposite helicity to the incident light acquires a geometric phase and is used to realize the versatile functions of the metasurfaces; however, the other component, with an identical helicity, is often neglected as a diffused background. Here, by simultaneously manipulating the two spin components originating from the SOI in plasmonic metasurfaces, independent wavefields in the primary and converted spin channels are achieved; the wavefield in the primary channel is controlled by tailoring the dynamic phase, and that in the converted channel is regulated by designing the Pancharatnam–Berry phase in concurrence with the dynamic phase. The scheme is realized by generating optical lattice fields with different topologies in two spin channels, with the metasurfaces composed of metal nanoslits within six round-apertures mimicking the multi-beam interference. This study demonstrates independent optical fields in a dual-spin channel based on the SOI effect in the metasurface, which provides a higher polarization degree of freedom to modify optical properties at the subwavelength scale.
Study on vibration and noise influence for optimization of garden mower
Authors: Chen Yimin , Zhang Wenzhuo , Dong Lu , Cengiz Korhan , Sharma Amit
Published: December 2021

Advancement in engineering provides various improvement in quality life while taking consideration of important factors for safety and environment. The use of mower food maintenance of land it is very common across several parts of the world with some frequent noise generated through its operation. This article is an attempt to study the noise and frequency generated through the vibrations of mower blade. In this study, an integrated design for designing, testing and developing mower blade that generates less noise is presented. For designing efficient blade that produces less noise, we have implemented various engineering approaches such as rapid product design, process of re-engineering and reverse engineering. The simulation of the designed blade is carried out through CAD software where the design prototype is analysed for its performance. The outcomes of the prototype are tested through simulation and its performance is compared for the determination of success of proposed design at different variations in frequency level. It is observed through the experimentation that the noise and vibration differences are generated through load carrying vehicles, mowers with riding capacity and simple mowers. From the analysis, mower with riding capacity is observed as safest among all other types of machines.
Relay vibration protection simulation experimental platform based on signal reconstruction of MATLAB software
Authors: Zhang Qian
Published: December 2021

For conceptual analysis of the principle of relay vibration protection, this article establishes the simulation system model of directional current protection in MATLAB/Simulink environment through the protection algorithm. Various outcomes have been achieved for the proposed approach during the faulty conditions. The outcomes obtained during the fault period reveals that the waveform of three-phase current changes greatly, and the amplitude of three-phase current at power supply side increases sharply. After 0.02s signal acquisition and processing, the action signal acts after 0.07s, and the fault is removed. In case of two-phase short-circuit, two-phase grounding short-circuit and other faults, the fault can be removed smoothly after signal acquisition and processing. In this paper, the directional current protection simulation system based on microcomputer protection model is built, and the changes of voltage, current and action signal are demonstrated through GUI interface, and analyzed and verified.
Optimization of the Application of Inclusive Teaching Style in Improving Learning Outcomes Forehand Push Table Tennis Game in Class XI IPA 1 Private Senior Highschool PAB Saentis
Authors: Winata Devi Catur , Abadi Andy Nur , Azandi Filli , Fahmi Mhd , Harahap Bahder Johan
Published: December 2021

This study aims to find out how to improve learning outcomes of Forehand Push table tennis game through inclusive teaching style in class XI IPA 1 Private Senior Highschool PAB SAENTIS. The object of this research is class XI students with 25 students who will be given action in the form of inclusive teaching style on Forehand Push learning outcomes. In the first cycle, it could be seen that the students' initial ability to perform the Forehand Push technique was still low. Of the 25 students there are 15 people (60%) who have achieved mastery learning, while 10 people (40%) have not achieved mastery learning. With the average value of student learning outcomes is 76.3. Meanwhile, in the second cycle, it can be seen that the students' ability to perform classical learning outcomes tests has increased. Of the 25 students there are 20 (80%) who have achieved mastery learning, while 5 people (20%) have not achieved mastery learning. With the average value of student learning outcomes is 80.7, so there is a 25% increase in learning outcomes from cycle I to cycle II. It can be concluded that learning through inclusive teaching style can improve forehand push learning outcomes in class XI IPA 1 Private Senior Highschool PAB SAENTIS.
The Development of Paser Recreational Sports (Final Stage) as a New Attraction in the Cacaban Reservoir Tourism Object, Tegal Regency
Authors: Ritonga Dzullfikri , Ali Mohammad Arif , Pitojo Abadi , Sahri Sahri , Anggita Gustiana Mega , Afghani Afan , Haidar Nur Hadziq
Published: December 2021

The development of paser recreational sports (final stage) as a new attraction in the Cacaban reservoir tourist attraction. Judging from the natural resources and characteristics of the Cacaban Reservoir, Tegal Regency, the recreational sport of Paser is very suitable to be raised and developed because it has the potential to make a new attraction in increasing tourist visits. The purpose of this research is to produce a product that did not exist before, so that it can be used as a reference in organizing Paser whether it is recreational or recreational sports activities. Paser is an event that can become a new attraction in Cacaban Reservoir. This research is an umbrella research that uses the Research and Development (RnD) method with a sequence of research stages which are divided into three major stages, consisting of several implementation procedures, namely: 1) Initial stage, 2) Advanced stage, and 3) Final stage (selected focus in this article). The results of this development research indicate that the results of the second stage product expert test scores from the experts can be concluded that the Paser stage II recreational sports book product has an average score of 3.45 which is included in the "Very Eligible" category. The conclusion in this study is the development of recreational sports Paser has the potential to be a new attraction in the Cacaban Reservoir Tourism Object, Tegal Regency.
Examining the Relationship between Social Modelling and Physical Activities Involvement
Authors: Tero Darlton-Ace Chan , Biong Corazon T. , Tero Juliet C.
Published: December 2021

This study aimed to examine the relationship between social modeling and children’s involvement in physical activities (CIPA) involvement. Descriptive-correlation analysis was utilized to determine the respondents’ profile and the CIPA. Correlation analyses were used to examine relationships between key variables, modelling, and CIPA among 200 randomly selected Grades 1 to 6 pupils in selected randomly private and public schools in the Division of Iligan City. Likert Scale and Inferential Statistics were used to measure the level of self-reported responses. Results showed that all the models influenced the PA, coach ranked first with 88.5% most influential, while peers ranked second 83.5%, parents ranked third 77%, while the lowest influence were teachers 59% which could mean that coach had the highest influence, while teachers were the least influential models. Furthermore, among all the models, Coach Modelling had the closest relationship with the PA involvement. Surprisingly, parents who were supposed to be the first models at home, were not that influential on CIPA because they were too busy doing other things at home or outside their homes, not sports and physical activities.
Physical Activity Levels in Physical Education Lessons at Singapore Primary School
Authors: Jamaluddin Nur Syahida Binte , Kawabata Masato
Published: December 2021

Physical education (PE) lessons are the appropriate occasions to promote physical activity for children. Although the moderate-to-vigorous physical activity (MVPA) levels during PE lessons were investigated in several countries, MVPA levels during PE lessons were never reported at Singapore primary schools. Therefore, the present study aimed to investigate physical activity intensity levels during PE lessons at a Singapore primary school. A total of 93 students (40 girls) voluntary participated in the study: 28 in Grade 1, 39 in Grade 4, and 26 in Grade 6. They were asked to wear an accelerometer on their non-dominant hand in two PE lessons to measure physical activity levels objectively. They also completed questionnaires on their experiences during the PE lessons. The average of the MVPA levels time (%) in the scheduled lesson time across the three grades was 46.98 ± 5.25%, but the average of the MVPA levels time (%) in the actual lesson time was 69.74 ± 7.31%. These results indicated that it would be possible to achieve the recommended MVPA time in PE lessons. The findings of this study would be useful for PE teachers to reflect whether their PE lessons are efficient to promote primary school student’s physical activity levels.
Spatial change detections and inventory of wetlands in Yenagoa Urban Area: Bayelsa State, Nigeria
Authors: Promise I Eze , IC Elemuwa , Hart Lawrence
Published: December 2021

Yenegoa Town has in recent years witnessed rapid City growth and Urban development and much of these developments are unplanned and unregulated. This has seriously impacted on wetlands in several locations of the town as persistent Wetlands reclamations are being witnessed in study area. This prompted the need for the study which is aimed to map wetlands location in Yenagoa’s urban area using GIS and Remote Sensing approach. The study analyzes land use/land cover changes (LULC) using LANDSAT(5) TM, LANDSAT(5) ETM and LANDSAT(7) OLI satellite imageries of 1990, 2000, 2010 and 2020 respectively. Through this study, the pattern of urban expansion for Thirty years were been studied. The satellite imageries covering the area were acquired and analyzed using ArcGIS 10.1 and ENVI 5.0 software. The supervised image classification method was adopted and the classification results were validated using the Kappa Index of Agreement (KIA) yielding an accuracy of 0.69m for year 1990, 0.62m for year 2000, 0.58m for year 2010 and 0.73m for 2020. A total area of 13,741.4 hectares was delineated in the study area which is identified as Yenagoa’s urban area. After processing the imageries, four land use/land cover (LULC) classes where considered, and the results shows that Built-up area continuously increased in land area from 1990 -2020 with total percentage change of 273.31% (4,178.7ha) and total annual rate of change of 25.33. Vegetation have total percentage change of 38.55% (974.34Ha) and total annual rate of change of 3.85, wetland cover loss with total percentage Change of 61.96% (-51,44.99ha) and total annual rate of change of -6.19ha, and the water body have loss of total percentage of -2.16% (-8.05Ha) and total annual rate of change of -0.22ha wetland at Yenegwe loss by Total %change of -29.918% ( -197.95ha), and wetland at Igbogene loss by total percentage change of -36.028% (-358.7ha). The research findings also revealed that the wetlands in Anyama, Swali, Kpansia and Opolo Towns were completely lost from the third Epoch of 2010, this may be as a result of persistence reclamation of wetland in this parts of the study area. The Markov Chain predicted model were utilized for predicting the likely changes in land use land cover for a period of thirty years. The predicted results also indicates that wetland size of 32.47,%, 30.68% and 28.99% may likely be lost by the year 2030, 2040 and 2050 respectively in study area if no action is taking by concerned authorities to forestall the factors responsible for the lost in wetland. The study justified the dynamics of remote sensing and GIS techniques in modeling wetlands changees over these periods, wise use of wetland resources and improvement of institutional arrangement were recommended so that wetland policies can be fully integrated into the planning process across all disciplines.
Weekend Admissions for Somatic Symptom and Related Disorders and Length of Stay
Authors: Rappaport Leah G. , VanderVennen Marielle C. , Monroe Kimberly K. , McCaffery Harlan , Stewart David A.
Published: December 2021

OBJECTIVES

To evaluate whether admission on weekends affects the length of stay (LOS) for patients hospitalized with somatic symptom and related disorders (SSRDs).

METHODS

Data from 2012–2018 was obtained for all patients aged 4 to 21 years (N = 5459) with a primary discharge diagnosis of SSRDs from 52 tertiary care pediatric hospitals in the United States. We obtained patient demographics, admission date and/or time, LOS, procedure count, and comorbid conditions. We defined a weekend as 3 pm Friday to 3 pm Sunday. The Wilcoxon rank test was used for unadjusted analysis. Multiple logistic regression was used to estimate the odds of having LOS >1 day, >2 days, >3 days, and >4 days in weekend versus weekday groups.

RESULTS

Weekend admission significantly correlated with increased LOS (P < .001). Compared with weekdays, a weekend admission was associated with increased odds of having LOS >1, >2, and >3 days. This remained statistically significant while adjusting for the number of chronic conditions, procedures, and individuals with Black or Hispanic ethnicity compared with White ethnicity. LOS was not associated with sex or age of the patients.

CONCLUSIONS

Patients with SSRDs admitted on the weekend have an increased LOS compared with those admitted on a weekday. This may be due to a decrease in multidisciplinary care available during weekends. In future studies, researchers should aim to better understand the specific factors that contribute to this disparity and test interventions that may close the gap in care, including expanding to 7-day services, increasing mental health resources, and working to decrease the need for inpatient admissions.
Artificial Intelligence to Improve Health Outcomes in the NICU and PICU: A Systematic Review
Authors: Adegboro Claudette O. , Choudhury Avishek , Asan Onur , Kelly Michelle M.
Published: December 2021

CONTEXT

Artificial intelligence (AI) technologies are increasingly used in pediatrics and have the potential to help inpatient physicians provide high-quality care for critically ill children.

OBJECTIVE

We aimed to describe the use of AI to improve any health outcome(s) in neonatal and pediatric intensive care.

DATA SOURCE

PubMed, IEEE Xplore, Cochrane, and Web of Science databases.

STUDY SELECTION

We used peer-reviewed studies published between June 1, 2010, and May 31, 2020, in which researchers described (1) AI, (2) pediatrics, and (3) intensive care. Studies were included if researchers assessed AI use to improve at least 1 health outcome (eg, mortality).

DATA EXTRACTION

Data extraction was conducted independently by 2 researchers. Articles were categorized by direct or indirect impact of AI, defined by the European Institute of Innovation and Technology Health joint report.

RESULTS

Of the 287 publications screened, 32 met inclusion criteria. Approximately 22% (n = 7) of studies revealed a direct impact and improvement in health outcomes after AI implementation. Majority were in prototype testing, and few were deployed into an ICU setting. Among the remaining 78% (n = 25) AI models outperformed standard clinical modalities and may have indirectly influenced patient outcomes. Quantitative assessment of health outcomes using statistical measures, such as area under the receiver operating curve (56%; n = 18) and specificity (38%; n = 12), revealed marked heterogeneity in metrics and standardization.

CONCLUSIONS

Few studies have revealed that AI has directly improved health outcomes for pediatric critical care patients. Further prospective, experimental studies are needed to assess AI’s impact by using established implementation frameworks, standardized metrics, and validated outcome measures.
ENCEPHALOPATHIES FOLLOWING PROPHYLACTIC PERTUSSIS VACCINE
Authors: BYERS RANDOLPH K. , MOLL FREDERIC C.
Published: December 2021

Inspection of the records of the Children's Hospital for the past ten years has disclosed 15 instances in which children developed acute cerebral symptoms within a period of hours after the administration of pertussis vaccine. The children varied between 5 and 18 months in age and, in so far as it is possible to judge children of this age range, were developing normally according to histories supplied by their parents. None had had convulsions previously. Many different lots of vaccine, made by eight different manufacturers over a period of eight years, were implicated. The inoculations were given throughout the usual geographic range of children coming to this hospital. All but one, at the time of follow-up or death, showed evidence of impairment of the nervous system, which might still have been in the healing stage in three or four.

During the same period about half as many children were seen in the hospital suffering from the encephalopathy secondary to smallpox vaccination, and about twice as many from the encephalopathy complicating pertussis itself.

A variety of etiologic considerations were suggested by consideration of the reported cases and references to the literature. That constitutional factors may have been involved was suggested by both the preponderance of males as opposed to females, and by the high incidence of abnormalities of the nervous system in the family histories. The clinical course and cytologic abnormalities of spinal fluids found in acute cases indicated an encephalopathy. The literature suggested that this process might have resulted from either the activity of a specific toxin or from an antigen-antibody response. Against the former of these hypotheses was the unstable nature of the heretofore recognized toxins which could hardly survive in properly aged vaccines. The rapid onset of symptoms, occasionally within minutes of the first injection, seemed strong evidence against the second. The present study has left these etiologic considerations unanswered, but it has called attention to a risk of the prophylactic use of pertussis vaccine not hitherto recognized.

In view of the impressive evidence of the effectiveness of prophylactic pertussis vaccine now accumulating, it seems likely that babies are safer vaccinated than not. Further studies should be made to prove this point definitely, for the encephalopathy following pertussis vaccine seems more devastating than the vast majority of the nervous lesions following the use of smallpox vaccine.
EDITORIAL
Authors: FABER HAROLD K. , MILLER JOHN J.
Published: December 2021

THE Original Article in this issue of Pediatrics by Byers and Moll on encephalopathies following prophylactic pertussis vaccine will be a cause of the gravest concern to all pediatricians. While the authors are reserved in expressing an opinion as to the mechanisms responsible for the sequelae of pertussis vaccination which they describe, it is a matter of the most urgent importance that these be sought and made the basis for practical changes and improvements designed to minimize dangers which now clearly emerge, curiously enough fifteen years or so after active immunization against pertussis began to be used on a large scale in this country. At the same time, it should be pointed out that incontrovertible evidence is now at hand of the effectiveness of pertussis vaccine in preventing a disease which in the first two years of life has a very high fatality rate.

While complete answers to the problems raised by the paper of Byers and Moll cannot be given at the present time, it is pertinent to consider possible causes for the reactions they report and lines along which precautionary measures might profitably be directed.
ANAEROBIC METABOLISM IN THE NEWBORN INFANT
Authors: WILSON JAMES L. , REARDON HELEN S. , MURAYAMA MAKIO
Published: December 2021

EVIDENCE of a form of metabolism in which less oxygen per unit of energy is used in the fetus and newborn than in older animals has been recognized for some time. An "anaerobic" metabolism leading to the traditional "oxygen deficit" in muscle activity is well established. The purpose of this preliminary communication is to review published observations bearing on this point and to add some of our own that indicate the existence of a similar metabolism in human young, and to discuss its practical significance. In subsequent reports we hope to follow up these studies.

The discussion will be concerned with three general topics: (1) Direct observation of resistance of newborn animals to anoxia. (2) Studies of acidosis in normal premature and full term infants. (3) Observations of the effect of oxygen on the respiratory pattern of premature infants.

RESISTANCE OF NEWBORN ANIMALS TO ANOXIA

Selle and Witten, and Thoms and Hiestand, have shown that survival of the primitive respiratory center in decapitated rats and mice is retained much longer by the anoxic newborn than by the older animal. The heads of young rats under five to six weeks of age showed a persistence of gasping for 20 to 40 minutes in anaerobic conditions while those older than five to six weeks had lost this ability.

Fazekas, Alexander, and Himwich studied adults, infants, and fetuses in utero of various animal species under conditions of oxygen lack. Nitrogen, helium, and other gases were used to produce partial or complete displacement of oxygen from the respired atmosphere. Their observations reveal that mature animals survive after breathing undiluted nitrogen for approximately three minutes, while the average survival time for a newborn animal was as follows:[see table in source pdf].

They conclude, first, that there is a greater tolerance to oxygen lack in the young than in the adult of the same species, and second, that the difference in survival time between newborn of different species is due to their difference in maturity at birth.

These workers used sodium fluoride and sodium iodoacetate as enzyme poisons to interrupt the carbohydrate breakdown series, presumably at the phosphoglyceric acid and triosephosphate levels. Table I shows the results of their experiments on the survival time of newborn rats under various conditions.
TUBERCULOSIS OF CERVICAL LYMPH NODES
Authors: SWENSON ORVAR , SMALL WILFRED T.
Published: December 2021

Although these results were determined in a small group of patients, it is believed they indicate that surgical excision is the best treatment for cervical tuberculous adenitis. Streptomycin, which may fail as a lone therapeutic agent, may be of value as a postoperative adjunct to surgery.
RESPIRATORY PATTERNS IN NEWBORN INFANTS AS DETERMINED BY AIRFLOW AND PNEUMOGRAPHIC STUDIES AND THEIR POSSIBLE RELATIONSHIP TO A DEFICIENT VAGAL MECHANISM
Authors: MILLER HERBERT C. , BEHRLE FRANKLIN C.
Published: December 2021

Pneumographic tracings of the movements of the upper chest, lower chest and abdomen have been recorded individually and simultaneously with the velocity of air flow by means of electronic equipment in 70 newborn infants. A total of 114 recordings were made on infants from zero to 49 days of age and with birth weights of 1000 gm. or more. Most infants during the first 24 hours after birth had a respiratory pattern in which the inspiratory and expiratory movements of the upper chest, lower chest and abdomen were parallel and tended to be synchronous. In a few infants at birth and in most older infants this respiratory pattern was modified. The modification consisted in the lower chest tending to move in a direction opposite to that of the abdomen and upper chest.

The theory has been advanced that diaphragmatic breathing, which is so characterisitc of older infants, is not completely established at birth except in a few infants who perhaps are more mature. In the more mature infant, contraction of the diaphragm probably exerts a pull on the lower chest, causing its indrawing during inspiration. It has been suggested that inability to develop adequate diaphragmatic contractions may be an important factor in the many neonatal deaths that occur in the first few days of life. It has been pointed out that the newborn infant may have a poorly developed vagal mechanism and that this may be one of the factors causing diaphragmatic activity to be inadequate. Observations on three infants who died during the first 48 hours of life are reported which tend to support the theory that vagal deficiency is a possible cause of inadequate diaphragmatic activity, pulmonary hyaline membranes and neonatal death.
LABORATORY AND CLINICAL STUDIES IN CONGENITAL METHEMOGLOBINEMIA
Authors: WAISMAN HARRY A. , BAIN JAMES A. , RICHMOND JULIUS B. , MUNSEY FRANKLIN A.
Published: December 2021

Congenital idiopathic methemoglobinemia in a 12 year old boy was corrected by the administration of either ascorbic acid or methylene blue, the latter being more efficient.

The oxygen dissociation curve was normal but as would be expected the oxygen-carrying capacity of the blood was increased after methylene blue was given. Arterial oxygen saturation was determined by an oximeter to demonstrate the increased oxygen-carrying capacity after methylene blue.

Para-amino propriophenone administration caused an increase in methemoglobin level but not to the maximum value for this patient. Sodium nitrite by mouth did give the maximum level.

Enzyme studies revealed no difference in oxygen uptake of hexosediphosphate either with or without methylene blue in normal or methemoglobinemic cells in a medium which contained glucose.

No "cytochrome-reductase like" activity was demonstrated in the methemoglobinemic cell.

No definitive evidence exists to support the belief that reduced co-enzyme I reacts directly with methemoglobin in normal cells.
Round Table Discussion
Authors: DIAMOND LOUIS K. , ALLEN FRED H. , VANN DOROTHEA D. , POWERS JOHN RAY
Published: December 2021

Chairman Diamond: Erythroblastosis fetalis is a variable disease, ranging in severity from fetal death in utero to a disturbance so mild as to be unrecognizable except by delicate laboratory tests. Intrauterine death is the greatest source of fetal loss. The development of kernicterus is the most important cause of unfavorable result in untreated liveborn babies. The use of exchange transfusion has resulted in the recovery of most liveborn babies, and has nearly eliminated kernicterus in a clinic where it has been used liberally.

Etiology

Erythroblastosis fetalis occurs as a result of fetal-maternal blood group incompatibility. Table 1 shows the most important blood group factors known at present. In Column I are the common names of the various genetically and serologically independent families or "systems" of blood group [See Table 1 in source pdf] factors. In Column II are shown those factors which may cause transfusion reactions or, presumably, erythroblastosis fetalis (although e, N, and Fya have not yet been reported as causes of erythroblastosis). The blood group factors in Column III seem not to cause clinical difficulties. At least 80% of cases of erythroblastosis fetalis are caused by "Rh" (D) incompatibility. Although D is an effective antigen, as judged by the fact that at least 75% of D-negative ("Rh-negative") individuals are sensitized by transfusion of D-positive blood, only 5% of families in which the mother is D-negative and the father D-positive ever have erythroblastotic babies. A and B, which are presumably even more effective antigens than D. cause less than 20% of the cases of erythroblastosis, although 35% of matings are incompatible for A or B.
Round Table Discussion
Authors: OSBORNE EARL D. , ROSS JOHN R. , WRONG NORMAN M. , MCKEE WALTER C. , FRAUENBERGER GEORGE S.
Published: December 2021

Chairman Osborne: The material which we will cover will be material which must be spoken about in terms of groups of people, types of individuals and different classifications of diagnosis. We will lose a great deal of the effect of what we have to discuss if we get off on a small subject connected with an individual case, so I hope we can refrain from citing specific cases. You all recognize that we can't make progress if any of us are going to present specific individual problems on a specific case.

Fortunately we have some disagreement among members of the panel for where everyone agrees there is a lack of interest, especially in the field of cutaneous diseases, and particularly in the eczematous diseases. If we seem to disagree it is because the material calls for disagreement and the literature backs us up on that disagreement.

We are going to start with the general phase of the subject: the care of the skin of the newborn. I am going to ask Dr. Norman Ross to discuss the care of the skin of the newborn from the standpoint of the pediatrician.

Dr. Ross: In these newborn infants overzealous cleaning of the baby and too much anxiety on the part of the nurse following birth is apt to do far more harm than good. The baby when born has a membranous covering that should not be too thoroughly and vigorously removed. Soap is not advisable. Plain water will remove sufficient of it and, in fact, delay of thorough bathing of the infant for a few days would probably be advisable.
Pediatric Education and Managed Care: A Literature Review
Authors: Pan Richard J. D. , Finkelstein Jonathan A.
Published: December 2021

Managed care is becoming the dominant form of health care delivery and financing in the United States, necessitating changes in pediatric education. This transition is redefining the questions of what needs to be taught, who should be teaching it, where it should be taught, and how to pay for this education. We performed a literature review and examined reports from policy and professional groups to seek answers to these questions. We have identified curricular, administrative, and financial challenges to pediatric education in managed care. Although road maps for innovation have been described, there is a deficiency of research and information in key areas of pediatric education in the managed care environment.