bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fire resistance of timber-concrete composite slabs
Authors: Ogrin Anita , Hozjan Tomaž 
Published: August 2020

AbstractThe paper presents a simplified method for calculation of resistance of a TCC slab in fire conditions.
Within the method the tensile and the compressive failure criteria in the outermost fibres of the cross-section are checked. The influence of the fire is applied through one-dimensional charring of the timber part of the cross-section in accordance with current standards on reduction of properties of materials. The concrete-timber connection is assumed to be ideal during the determination of resistant moment of the TCC cross-section. On the other hand, the calculation of the deflection of the TCC slab is conducted with the reduction of the connection’s rigidity. The ineffective zone of the timber as well as the cracked tensile zone of concrete part do not contribute to the effective stiffness of the TCC slab. The method is validated against the results of full sized fire tests of one way spanning TCC slabs form literature. Calculated and experimentally determined midspan deflections and failure times of the TCC slabs are compared and their considerable agreement is observed. Due to its convenience and accuracy, the present simplified method represents a useful tool for designers of TCC structures in fire conditions.
ISTIKHDAMU BITHAQATI AL-WASA`ILI AL-BASHARIYYATI "POP-UP" FI TA'LIMI AL-LUGHATI AL-'ARABIYYATI BI MADDATI AL-CHIWARI WA ATSARUHU FI QUDRATI AL-TALAMIDZI 'ALAIHI
Authors: Anisa Astri , Marlina Lina , Wahyudin Dedih 
Published: August 2020

The purpose of this research is to study students' abilities in hiwar before and after using Pop Up Card visual media and understand the relationship between the two. This research method is an Experiment with Quasi-Experimental Design. The results of this study are about the ability of students before using visual media Pop Up Cards to achieve sufficient ability with an average value of 63.82. And finally it can reach 70, 00. And the importance of students' ability towards hiwar where the calculated T value is greater than the T table value which is 7.55> 2.00. الأغراض من هذا البحث هي معرفة قدرة التلاميذ على الحوار قبل و بعد استخدام بطاقة الوسائل البصرية “Pop Up” ومعرفة الأثر بينهما. والمنهج في هذا البحث هي المنهج التجريبية بتصميم التجريبية القبلية. ومن النتائج المحصولة من هذا البحث هي أن قدرة التلاميذ قبل استخدام بطاقة الوسائل البصرية “Pop Up” تدل على درجة كافية بقيمة المتوسط 63.82. و بعد استخدامها تدل على درجة جيدة بقيمة المتوسط 70.00. و يؤثر في قدرة التلاميذ على الحوار حيث إن قيمة "ت" الحسابية أكبر من قيمة "ت" الجدولية يعني 7.55 > 2.00 .
The Environmental Health Impact of Hurricane Katrina on New Orleans
Authors: Diaz James H. , Brisolara Kari F. , Harrington Daniel J. , Hu Chih-yang , Katner Adrienne L. 
Published: August 2020

Hurricane Katrina caused unprecedented flood damage to New Orleans, Louisiana, and has been the costliest hurricane in US history. We analyzed the environmental and public health outcomes of Hurricane Katrina by using Internet searches to identify epidemiological, sociodemographic, and toxicological measurements provided by regulatory agencies. Atmospheric scientists have now warned that global warming will increase the proportion of stronger hurricanes (categories 4–5) by 25% to 30% compared with weaker hurricanes (categories 1–2). With the new $14.6 billion Hurricane Storm Damage Risk Reduction System providing a 100-year storm surge–defensive wall across the Southeast Louisiana coast, New Orleans will be ready for stronger storms in the future.
Water and Sanitation in Urban America, 2017–2019
Authors: Capone Drew , Cumming Oliver , Nichols Dennis , Brown Joe 
Published: August 2020

Objectives. To estimate the population lacking at least basic water and sanitation access in the urban United States. Methods. We compared national estimates of water and sanitation access from the World Health Organization/United Nations Children’s Fund Joint Monitoring Program with estimates from the US Department of Housing and Urban Development on homelessness and the American Community Survey on household water and sanitation facilities. Results. We estimated that at least 930 000 persons in US cities lacked sustained access to at least basic sanitation and 610 000 to at least basic water access, as defined by the United Nations. Conclusions. After accounting for those experiencing homelessness and substandard housing, our estimate of people lacking at least basic water equaled current estimates (n = 610 000)—without considering water quality—and greatly exceeded estimates of sanitation access (n = 28 000). Public Health Implications. Methods to estimate water and sanitation access in the United States should include people experiencing homelessness and other low-income groups, and specific policies are needed to reduce disparities in urban sanitation. We recommend similar estimation efforts for other high-income countries currently reported as having near universal sanitation access.
Disability, Ethics, and Health Care in the COVID-19 Pandemic
Authors: Sabatello Maya , Burke Teresa Blankmeyer , McDonald Katherine E. , Appelbaum Paul S. 
Published: August 2020

This article considers key ethical, legal, and medical dilemmas arising for people with disabilities in the COVID-19 pandemic. We highlight the limited application of existing frameworks of emergency planning with and for people with disabilities in the COVID-19 pandemic, explore key concerns and issues affecting the health care of people with disabilities (i.e., access to information and clinician–patient communication, nondiscrimination and reasonable accommodations, and rationing of medical goods), and indicate possible solutions. Finally, we suggest clinical and public health policy measures to ensure that people with disabilities are included in the planning of future pandemic-related efforts. The devastation evoked by the COVID-19 pandemic raises challenging dilemmas in bioethics. It also speaks to social justice issues that have plagued historically marginalized communities in the United States. Responses to the pandemic must be bound by legal standards, principles of distributive justice, and societal norms of protecting vulnerable populations—core commitments of public health—to ensure that inequities are not exacerbated, and should provide a pathway for improvements to ensure equitable access and treatment in the future.
Reimagining Public Health in the Aftermath of a Pandemic
Authors: Brownson Ross C. , Burke Thomas A. , Colditz Graham A. , Samet Jonathan M. 
Published: August 2020

The coronavirus disease 2019 (COVID-19) pandemic is an unprecedented challenge for society, affecting those already subject to unacceptable health inequalities and resulting in vast economic impacts. The pandemic reminds everyone of the value and necessity of public health.In the context of an era that will be shaped by COVID-19, we outline the coming series of challenges and transitions in public health and the needed actions over the next 5 years to reinvent our public health systems. Multiple limitations in current US and global public health systems have been uncovered by the pandemic, including insufficient preparedness and surveillance capabilities complicated by long-standing and worsening health inequalities and the rapid spread of misinformation that needs to be countered. We foresee 3 phases for public health over the next 5 years: (1) reactive crisis management, (2) efforts to maintain initial gains, and (3) efforts to sustain and enhance progress.A reinvented public health system will depend highly on leadership and political will, rethinking how we categorize and address population-level risk, employing 21st-century data sciences, and applying new communication skills.
Management of Comminuted Distal Radius Fractures
Authors: Meaike Joshua J. , Kakar Sanjeev 
Published: August 2020

» Distal radius fractures occur in a bimodal age and sex distribution. Their incidence continues to rise with an increasingly active aging population.» The current American Academy of Orthopaedic Surgeons guidelines for operative intervention are radial shortening of >3 mm, dorsal tilt of >10°, or intra-articular displacement or step-off of >2 mm.» The method of reduction and fixation should be selected on a case-by-case basis with a focus on patient factors, fracture behavior, surgical proficiency, and functional outcomes.
Targeted next-generation sequencing assays using triplet samples of normal breast tissue, primary breast cancer, and recurrent/metastatic lesions
Authors: Akahane Toshiaki , Kanomata Naoki , Harada Oi , Yamashita Tetsumasa , Kurebayashi Junichi , Tanimoto Akihide , Moriya Takuya 
Published: August 2020

Abstract
Background: Next-generation sequencing (NGS) has shown that recurrent/metastatic breast cancer lesions may have additional genetic changes compared with the primary tumor. These additional changes may be related to tumor progression and/or drug resistance. However, breast cancer-targeted NGS is not still widely used in clinical practice to compare the genomic profiles of primary breast cancer and recurrent/metastatic lesions.Methods: Triplet samples of genomic DNA were extracted from each patient’s normal breast tissue, primary breast cancer, and recurrent/metastatic lesion(s). A DNA library was constructed using the QIAseq Human Breast Cancer Panel (93 genes, Qiagen) and then sequenced using MiSeq (Illumina). The Qiagen web portal was utilized for data analysis.Results: Successful results for three or four samples (normal breast tissue, primary tumor, and at least one metastatic/recurrent lesion) were obtained for 11 of 35 breast cancer patients with recurrence/metastases (36 samples). We detected shared somatic mutations in all but one patient, who had a germline mutation in TP53. Additional mutations that were detected in recurrent/metastatic lesions compared with primary tumor were in genes including TP53 (three patients) and one case each of ATR, BLM, CBFB, EP300, ERBB2, MUC16, PBRM1, and PIK3CA. Actionable mutations and/or copy number variations (CNVs) were detected in 73% (8/11) of recurrent/metastatic breast cancer lesions.Conclusions: The QIAseq Human Breast Cancer Panel assay showed that recurrent/metastatic breast cancers sometimes acquired additional mutations and CNV. Such additional genomic changes could provide therapeutic target.
Exploring the reasons why women prefer to give birth at home in rural northern Ghana: A qualitative study
Authors: Adatara Peter , Strumpher Johanita , Ricks Esmeralda 
Published: August 2020

Abstract
Background: Skilled birth care during childbirth is reported in the literature as one critical strategy for reducing maternal morbidity and mortality. Despite the importance of birth care provided by skilled birth attendants, women in rural areas of northern Ghana still give birth utilising the birth services provided by Traditional Birth Attendants. The aim of this study,therefore, was to explore and describe the reasons why a small group of rural women chose homebirth in rural northern Ghana.Methods: A qualitative approach was adopted to explore the reasons why women prefer to deliver at home in rural areas of northern Ghana. Individual interviews were used to obtain a full description of factors and experiences of women associated with home births in rural areas in Ghana. The research population consisted of 10 women who utilised birth care services provided by Traditional Birth Attendants in a rural community of northern Ghana. Data collected from the interviews were transcribed verbatim and analysed to identify themes.Results: This study, which was conducted among a small group of women, yielded interesting results on why these women still give birth at home in rural northern Ghana. It was found out that perceived poor quality of care and conduct of skilled birth attendants; the perception that women received better care from Traditional Birth Attendants; financial constraints and lack of access to healthcare facilities in the rural areas by these women accounted for majority of the reasons why women in rural northern Ghana still give birth at home.Conclusion: The study highlighted some barriers experienced by participants to the utilisation of birth care services provided by skilled birth attendants in rural northern Ghana. Management of healthcare facilities should facilitate the implementation of supportive supervision in the maternity units to improve the quality of care and attitude delivered by skilled birth attendants in maternity care in rural communities.
The regulatory role of the RANKL/RANK/OPG signaling pathway in the mechanisms of tooth eruption in patients with impacted teeth
Authors: Brodetska Ludmila , Natrus Larysa , Lisakovska Olha , Kaniura Olexandr , Iakovenko Liudmyla , Skrypnyk Irina , Flis Petro 
Published: August 2020

Abstract
Background: Tooth impaction is a common problem in orthodontic practice and in some cases accompanied by pain and pathological changes of surrounding teeth. Understanding the cellular and molecular mechanisms underlying tooth impaction allows finding the most effective orthodontic treatment for patients with impacted teeth (IT). RANK (receptor activator of NF-κB) / RANKL (RANK ligand) / OPG (osteoprotegerin) signaling pathway controls bone resorption and may be involved in the regulation of tooth eruption. The study aimed to evaluate bone remodeling based on the assessment of the RANKL/RANK/OPG status in patients with IT. Methods: Bone samples from 18 patients (mean age 25.27±3.34) were divided into 3 groups: 1 – bone tissue of healthy persons (control group); 2 – bone tissue, that was taken near the healthy tooth in patients with tooth impaction; 3 – bone tissue, that was collected near the IT. Levels of RANKL, RANK, OPG, osteocalcin (OC), NF-κB p65 subunit, NFATc1, and caspase-3 were determined by western blotting. The difference between groups was assessed using ANOVA followed by Tukey’s post-hoc test. P-value ≤ 0.05 was considered statistically significant.Results: We established a 1.73-fold elevation of RANK level in the IT area vs. control, indicating the recruitment of preosteoclasts. An increase in RANKL, OPG, and OC content was demonstrated (1.46-, 1.48-, and 1.42-fold respectively), reflecting the high activity of osteoblasts near the IT. Despite the activation of the RANKL/RANK/OPG system in the impaction area, NF-κB and NFATc1 levels did not change compared vs. control, indicating a blocked/delayed process of osteoclastogenesis. We found a decrease in the content of procaspase-3 (1.28-fold), while the level of its active form p17 increased by 2.26 folds near the healthy tooth in patients with IT compared with control. In the area of ​​IT, we observed an increase in procaspase-3 and p17 levels (1.32 and 1.78 folds). This reflects impairments of caspase-3 activation and accumulation of its inactive form in the IT area that may contribute to the tooth eruption failure.Conclusions: Tooth impaction may be associated with the disturbances in the caspase-3 cascade activation and the imbalance in the RANKL/RANK/OPG system, and as a result, blocked bone resorption.
What makes advocacy work? Stakeholders’ voices and insights from prioritisation of Maternal and Child Health programme in Nigeria
Authors: Uzochukwu Benjamin , Onyedinma Chioma , Okeke Chinyere , Onwujekwe Obinna , Manzano Ana , Ebenso Bassey , Etiaba Enyi , Ezumah Nkoli , Mirzoev Tolib 
Published: August 2020

Abstract
Background : The Nigerian government introduced and implemented a health programme to improve maternal and child health (MCH) called Subsidy Reinvestment and Empowerment programme for MCH (SURE-P/MCH). It ran from 2012 and ended abruptly in 2015.This was followed by increased advocacy for sustaining the MCH (antenatal, delivery, postnatal and immunization) services as a policy priority. Advocacy is important in allowing social voice, facilitating prioritization, and bringing different forces/actors together. Therefore, the study set out to understand how advocacy works - through understanding what effective advocacy implementation processes comprise and what mechanisms are triggered by which contexts to produce the intended outcomes.

Methods: The study used Realist Evaluation design through a mixed methods case study approach. The programme theory was developed from three substantive social theories (power politics, media influence communication, and the three-streams theory of agenda-setting), data and programme design documentation, and subsequently tested. We report information from 22 key informant interviews including national and State policy and law makers, policy implementers, CSOs, Development partners, NGOs, health professional groups, media practitioners and review of relevant documents on advocacy events post-SURE-P.

Results: Key advocacy organizations and individuals were involved in advocacy activities. The nature of their engagement included organizing workshops, symposiums, town hall meetings, individual meetings, press conferences, demonstrations, and engagements with media. Effective advocacy mechanism involved alliance brokering to increase influence, the media supporting and engaging in advocacy, and the use of champions, influencers, and spouses (Leadership and Elite Gendered Power Dynamics). The key contextual influences which determined the effectiveness of advocacy measures for MCH included the political cycle, availability of evidence on the issue, networking with policy champions, and alliance building in advocacy. All these enhanced the entrenchment of MCH on the political and financial agenda at the State and Federal levels.

Conclusions: Our result suggest that advocacy can be a useful tool to bring together different forces by allowing expression of voices and ensuring accountability of different actors. In the context of poor health outcomes, interest from policymakers and politicians in MCH, combined with advocacy from key policy actors, can improve prioritization and sustained implementation of MCH services.
The association between pelvic asymmetry and non-specific chronic low back pain as assessed by the Global Postural System.
Authors: Yu Qiuhua , Huang Huanjie , Zhang Zhou , Hu Xiaoqian , Li Wenfeng , Li Le , Chen Min , Liang Zhenwen , Lo Wai Leung Ambrose , Wang Chuhuai 
Published: August 2020

Abstract
Background: Empirical evidence that demonstrates the relationship between pelvic asymmetry and non-specific chronic low back pain (NCLBP) is currently lacking.Objective: To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults.Design: A cross-sectional, regression study.Methods: People who were aged between 18 and 30 and were diagnosed with NCLBP were recruited. Healthy individuals who were matched for age, sex, and education level were recruited as controls. Global Postural System (GPS) was employed to assess pelvic asymmetry. Prior to exploring the association, the reliability of GPS was assessed by the ICC (2, k) for interrater reliability, ICC (3, k) for intra-rater reliability, standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the relationship between pelvic asymmetry and the occurrence of NCLBP.Results: Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters. The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odds ratio=1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odds ratio=1.21) were associated with NCLBP.Limitation: This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population.Conclusions: The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. Two pelvic parameters were associated with the presence of NLBP. Measurement of pelvic asymmetry may assist in the early identification of potential occurrence of NCLBP but further work is required.
Validating and Updating GRASP: An Evidence-Based Framework for Grading and Assessment of Clinical Predictive Tools
Authors: Khalifa Mohamed , Magrabi Farah , Gallego Blanca 
Published: August 2020

Abstract
Background: When selecting predictive tools, clinicians are challenged with an overwhelming and ever-growing number, most of which have never been implemented or evaluated for comparative effectiveness. The authors developed an evidence-based framework for grading and assessment of predictive tools (GRASP). The objective of this study is to update GRASP and evaluate its reliability.Methods: A web-based survey was developed to collect responses of a wide international group of experts, who published studies on clinical prediction tools. Experts were invited via email and their responses were quantitatively and qualitatively analysed using NVivo software. The interrater reliability of the framework, to assign grades to eight predictive tools by two independent users, was evaluated.Results: We received 81 valid responses. On five-points Likert scale, experts overall strongly agreed with GRASP evaluation criteria=4.35/5, SD=1.01, 95%CI [4.349, 4.354]. Experts strongly agreed with six criteria: predictive performance=4.88/5, SD=0.43, 95%CI [4.87, 488] and evidence levels of predictive performance=4.44/5, SD=0.87, 95%CI [4.44, 4.45], usability=4.68/5, SD=0.70, 95%CI [4.67, 4.68] and potential effect=4.62/5, SD=0.68, 95%CI [4.61, 4.62], post-implementation impact=4.78/5, SD=0.57, 95%CI [4.78, 4.79] and evidence direction=4.25/5, SD=0.78, 95%CI [4.25, 4.26]. Experts somewhat agreed with one criterion: post-implementation impact levels=4.18/5, SD=1.14, 95%CI [4.17, 4.19]. Experts were neutral about one criterion; usability is higher than potential effect=2.96/5, SD=1.23, 95%CI [2.95, 2.97]. Sixty-four respondents provided recommendations to six open-ended questions regarding updating evaluation criteria. Forty-three suggested potential effect is higher than usability. Experts highlighted the importance of quality of studies and strength of evidence. Accordingly, GRASP concept and its detailed report were updated. The framework’s interrater reliability was tested, and two independent reviewers produced accurate and consistent results in grading eight predictive tools using the framework.Conclusion: Before implementation, internal and external validation of predictive performance of tools is essential in evaluating sensitivity and specificity. During planning for implementation, potential effect is more important that usability to evaluate acceptability of tools by users. Post-implementation, it is crucial to evaluate tools’ impact on healthcare processes and clinical outcomes. The GRASP framework aims to provide clinicians with a high-level, evidence-based, and comprehensive, yet simple and feasible, approach to evaluate, compare, and select predictive tools.