bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of a three-level triage scale in live triage encounters in an emergency department in Hong Kong.
Authors: Lam Rex Pui Kin , Kwok Shing Lam , Chaang Vi Ka , Chen Lujie , Lau Eric Ho Yin , Chan Kin Ling 
Published: April 2020

Abstract
Background Despite its continued use in many low-volume emergency departments (EDs), 3-level triage systems have not been extensively studied, especially on live triage cases. We have modified from the Australasian Triage Scale and developed a 3-level triage scale, and sought to evaluate its validity, reliability, over- and under-triage rates in real patient encounters in our setting. Method This was a cross-sectional study in a single ED with 24,000 attendances per year. At triage, each patient was simultaneously assessed by a triage nurse, an adjudicator (the “criterion standard”), and a study nurse independently. Predictive validity was determined by comparing clinical outcomes, such as hospitalization, across triage levels. The discriminating performance of the triage tool in identifying patient requiring earlier medical attention was determined. Inter-observer reliability between the triage nurse and criterion standard, and across providers were determined using kappa statistics. Results In total, 453 triage ratings of 151 triage cases, involving 17 ED triage nurses and 57 nurse pairs, were analysed. The proportion of hospital admission significantly increased with a higher triage rating. The performance of the scale in identifying patient requiring earlier medical attention was: sensitivity, 68.2% (95% CI 45.1-86.1%); specificity, 99.2% (95% CI 95.8-100%); positive predictive value, 93.8% (95% CI 67.6-99.1%); negative predictive value, 94.8% (95% CI 90.8-97.1%). The over-triage and under-triage rates were 0.7% and 4.6%, respectively. Agreement between the triage nurse and criterion standard was substantial (quadratic-weighted kappa = 0.76, 95% CI, 0.60-0.92, p<0.001), so was the agreement across nurses (quadratic-weighted kappa=0.81, 95% CI 0.65-0.97, p<0.001). Conclusions The 3-level triage system appears to have good validity and reasonable reliability in a low-volume ED setting. Further studies comparing 3-level and prevailing 5-level triage scales in live triage encounters and different ED settings are warranted.
New Findings on Submerged Patch-reefs and Reefal Carbonate Rocks at Water Depths of 70-100 meters on the Insular Shelf off Miyako-jima, South Ryukyus, Japan
Authors: Inoue Takahiko , Arai Kohsaku 
Published: April 2020

Abstract
Sub-bottom profiling (SBP) surveys and bathymetric mapping conducted off the shore of Miyako-jima, which belongs to the southern Ryukyus in the Ryukyu Island Arc, have revealed the presence of mound-shaped structures 3-8 m high and 50-120 m wide at depths ranging from 70-100 m. The SBP surveys showed that the mounds possess strong distinct, convex upward reflector shapes at the top, which we interpret as submerged reefs and reefal sediments. Additionally, modern stratified sediment layers that cover these mound-shaped structures indicate that those reefs began forming and advancing shoreward in a back-stepping fashion as a result of sea level rise. An analysis of the mound distribution shown by SBP and multibeam echo sounding (MBES) surveys suggest that they might have been formed during the lowstand stage of sea level change, which includes the last glacial period, because the distribution of these mounds is limited to water depths of 70 m to 100 m, which are deeper than where present-day reefs grow. The SBP images hint that such high-resolution seismic profiles, accompanied by detailed bathymetric mapping off the reefal area, have the potential to provide effective indicators of not only coral reef paleoenvironment development, but also the tectonic setting of this offshore area.
Spatial Distribution And Determinant Factors Of Birth Interval Among Reproductive Age Group Women, Based On Edhs 2016, Ethiopia, 2019.
Authors: Regasa Zegeye , Tilahun Biniyam chakilu , Mesfin Araya 
Published: April 2020

Abstract
Birth interval is time between two successive live births. Ethiopia is one of the populated African countries with total fertility rate of 4.6 and annual population growth rate of 2.6.Short birth intervals (<24 months) contribute to infant and child mortality risks. Currently, in Ethiopia women still have shorter birth intervals and studies addressing its determinants and maps to show the varied spatial distribution are scarce. This study examined individual and community level factors associated with duration of birth interval.Method: Data from the Ethiopian Demographic and Health Survey undertaken in 2016 was used for this analysis. Data was analyzed using STATA version 14, Arc Map GIS 10.3 and SaTScan. Multilevel Binary Logistic regression models were also used to explain regional inequalities in duration of birth intervals among women of reproductive age.Result: The median birth interval of the study population was 32 months (2.67 years). The result of this study reveals that 1935(25%) of women have intervals shorter than 24 months. Duration of birth interval was associated with index child died, women from highest economic level, women who breastfeed and women aged 45-49. Duration of birth interval had spatial variation across the country. A high proportion of shorter duration of birth interval was identified in Somalia and Affar Regions. Whereas the lower proportion of short birth interval found in Amhara, Tigray and Gambela.Conclusion: In this study both the individual and community level Factors were found to have significant influence on preceding birth interval of children. The spatial effect of duration of birth was captured by the spatial analysis. Additionally dissemination of information about recommended interval and cooperative effort to improve women’s economic independency and decision making power to increase maternal social status has to be conducted.
Dust Emission Source Characterization for Visibility Hazard Assessment on Lordsburg Playa in Southwestern New Mexico, USA
Authors: Pelt Robert Scott Van , Tatarko John , Gill Thomas E. , Chang Chunping , Li Junran , Eibedingil Iyasu , Mendez Marcos 
Published: April 2020

Abstract
Ephemeral lakes (playas) at the termination of drainages are a common feature of drylands. When dry, playa sediments can be highly wind-erodible, becoming potent local and regional sources of dust and PM 10 , airborne particles with diameters less than 10 µm, causing potentially sudden loss of visibility to travelers on downwind roadways. Lordsburg Playa, in southwestern New Mexico, USA is bisected by Interstate Highway 10. Dust storms emanating from the playa have been responsible for numerous visibility-related road closures (including 39 road closures between 2012- 2019) causing major economic losses, as well as hundreds of dust-related vehicle crashes, causing 41 lost lives in the last 53 years. We investigated the critical wind friction velocity thresholds and the dust emissivities of surfaces representing areas typical of Lordsburg Playa’s stream deltas, shorelines, and ephemerally flooded lakebed using a Portable In-Situ Wind ERosion Laboratory (PI-SWERL). Mean threshold friction velocities for PM 10 entrainment ranged from less than 0.30 m s -1 for areas in the delta and shoreline to greater than 0.55 m s -1 for ephemerally flooded areas of the lakebed. Similarly, we quantified mean PM 10 vertical flux rates ranging from less than 500 µ g m -2 s -1 for ephemerally flooded areas of lakebed to nearly 25,000 µg m -2 s -1 for disturbed delta surfaces. The apparently unlimited PM 10 supply of the relatively coarse sediments along the western shoreline however is problematic and indicates that this may be the source area for longer-term visibility limiting dust events and should be a focus area for dust mitigation efforts.
Efficacy and safety of intraarticular corticosteroid injections in adolescents with juvenile idiopathic arthritis in the temporomandibular joint: A Norwegian 2-year prospective multicenter pilot study.
Authors: Frid Paula , Augdal Thomas A. , Larheim Tore A. , Halbig Josefine , Rypdal Veronika , Songstad Nils Thomas , Rosen Annika , Tylleskär Karin B. , Berstad Johanna Rykke , Flatø Berit , Stoustrup Peter , Rosendahl Karen , Kirkhus Eva , Nordal Ellen 
Published: April 2020

Abstract
Background. Intraarticular corticosteroids (IACs) have been used to treat temporomandibular joint (TMJ) arthritis. However, prospective clinical studies with magnetic resonance imaging (MRI) scoring are lacking. The aim of this study was to examine efficacy and safety of a single IAC in the TMJ in adolescents with juvenile idiopathic arthritis (JIA) in a clinical setting. Methods. In this Norwegian prospective multicenter pilot study 15 patients with JIA (mostly persistent oligo-arthritis or RF negative polyarthritis categories) and a clinically and MRI-verified diagnosis of TMJ arthritis were treated with IACs and followed for two years. Demographics, systemic medication, general disease activity and outcome measures were recorded including a pain-index score and maximal incisal opening (MIO). Inflammation and bone damage scores were assessed, using two recently published MRI scoring systems with masked radiological evaluation.Results. Among the 15 patients, 13 received a single IAC (5 bilateral), and 2 repeated IACs once unilaterally. Thus, the total number of IACs was 22. Median age was 15 years and the majority had an age not thought of as critical regarding mandibular growth retardation due to steroid injection. During the 2-year observation period systemic medication with disease modifying antirheumatic drugs (DMARDs) including biologics was initiated or adjusted in 10/15 (67%) patients. At the 2-months study visit after injection we observed a minimal improvement in MIO from median 44 (1st, 3rd quartiles; 36, 48) mm to 45 (43, 47) mm, p= 0.045 and decreased MRI mean additive inflammatory score from 4.4±1.8 standard deviations (SD) to 3.4±2.0, p= 0.040. From baseline to the 2-months follow-up pain improved in 6/11 patients but pain scores were not significantly improved. MRI-assessed damage increased in two patients with repeated IACs, and decreased in 3 patients but most of the patients were stable over the 2-year follow-up. Intra-rater repeatability of the MRI scoring system domains varied from poor to excellent.Conclusions. In this pilot study of predominately single IACs to the TMJ in combination with systemic treatment we observed improvement in MRI-assessed inflammation, mostly stable condylar bone conditions and minimal clinical improvement in adolescents with JIA and TMJ arthritis. No side effects were seen.
Neuroprotective effect of paricalcitol in a rat model of transient global cerebral ischemia.
Authors: Kim Sung Wook , Oh Joo Suk , Park Jungtaek , Jeong Hyun Ho , Oh Young Min , Choi Semin , Choi Kyung Ho 
Published: April 2020

Abstract
Background Paricalcitol has been known to attenuate ischemic-reperfusion injury of various organs. However, it is not known whether paricalcitol prevents neuronal injury after global cerebral ischemia. The purpose of this study is to investigate the neuroprotective effect of paricalcitol in a rat model of transient global cerebral ischemia. Methods This is a prospective, randomized, experimental study. Male Sprague-Dawley rats survived from 10 min of four-vessel occlusion were randomized to the two treatment groups treated with paricalcitol 1 μg/kg IP and an equivalent volume of normal saline IP, respectively. Drugs were administered at 5 min, 1 day, 2 days, and 3 days after ischemia. Neurologic function score was assessed at 2 h, 1 day, 2 days, 3 days, and 4 days after ischemia. We tested the motor function 3 days after ischemia using the rotarod test. Also, we tested memory function 4 days after ischemia using the passive-avoidance test. We assessed neuronal degeneration in the hippocampus of surviving rats 4 days after ischemia. Results 8 rats were allocated to each group. No significant differences were found in terms of survival rate, motor coordination, or memory function. The neurological function score 2 h post ischemia was significantly high in the paricalcitol group (p = 0.04). Neuronal degeneration was significantly less in the paricalcitol group compared with the control (p = 0.01). Conclusions Paricalcitol significantly attenuated neuronal injury in the hippocampus. Although motor coordination, memory function, and survival rate were not significantly improved, paricalcitol remains a potential neuroprotective drug after global cerebral ischemia.
A Simplified NIH Stroke Scale for Acute Basilar Artery Occlusion Treated with Endovascular Therapy
Authors: Tong Xu , An Jiayi , Liu Raynald , Sun Xuan , Gao Feng , Wang Yilong , Wang Wenzhi , Miao Zhongrong 
Published: April 2020

Abstract
Background To design a simplified NIH Stroke Scale (sNIHSS) that requires minimal training but can reflect acute basilar artery occlusion (BAO) severity and is predictive for the 90-day outcome after endovascular therapy (EVT). Methods We analyzed the prospectively gathered data of acute BAO treated with EVT in a tertiary stroke center during a 6-year period. The sNIHSS (range: 0 to 20 points) consisted of 4 NIHSS items: level of consciousness - (1) questions and (2) commands; motor function - (3) arms and (4) legs. The 90-day outcomes included functional independence (mRS ≤ 2), favorable outcome (mRS ≤ 3) and death. Results Of 173 patients, 62, 83 and 36 achieved functional independence, favorable outcome and death, respectively. Interobserver reliability of sNIHSS was high (ICC = 0.95), and compared with NIHSS, sNIHSS had a significant reduction of assessment time (median: 1.5 min vs. 5 min, P < 0.01). A multivariable logistic model demonstrated that sNIHSS was independently associated with functional independence (OR = 0.82, 95% CI = 0.77-0.87), favorable outcome (OR = 0.86, 95% CI = 0.81-0.92) and death (OR = 1.24, 95% CI = 1.12-1.37). Additionally, the sNIHSS predicted 90-day outcomes almost as same discrimination as NIHSS by using DeLong test. The optimal cutoff value of sNIHSS was determined to be 12 points for predicting any outcome. Conclusions The sNIHSS reflects acute BAO severity well and predicts 90-day outcomes with reasonable accuracy. Nevertheless, the sNIHSS needs further validation before it can be applied as a predictive tool for acute BAO outcome.
Acupressure Therapy and Liu-Zi-Jue Qigong for Pulmonary Function and Quality of Life in Patients with Severe Novel Coronavirus Pneumonia (COVID-19): Study Protocol for a Randomized Controlled Trial
Authors: Zhang Shuaipan , Zhu Qingguang , Zhan Chao , Cheng Wei , Fang Xiaoming , Fang Min , Fang Lei 
Published: April 2020

Abstract
Background: In December, 2019, a pneumonia associated with the 2019 novel coronavirus (COVID-19) emerged in Wuhan, China. The number of cases has increased rapidly, severe patients have a poor prognosis and there are no effective therapies or vaccines for it. Only one rapid advice guideline for symptomatic supportive care has been used for it. A Traditional Chinese medicine Rehabilitation（TCMR） program consisting of acupressure therapy and Liuzijue Qigong can be used as a complementary therapy for COVID-19.Hence, we designed a randomized trial to evaluate the efficacy and advantages of TCMR for treating severe patients with COVID-19.Methods/design: This is a parallel-design, two-arm, analyst-assessor blinded, randomized controlled trial. A total of 120 patients with COVID-19 aged from 20 to 80 will be recruited and assigned randomly into a guideline therapy group and a guideline therapy plus TCMR group at a 1:1 ratio. Patients in both groups will receive guideline therapy. The patients in intervention group will perform acupressure therapy and Liuzijue Qigong exercise on the basis of conventional treatments, twice a day, and have been persistent from admission to discharge. The primary outcomes are measured with Modified Dyspnea Scale (MDS) and Activities of Daily Living (ADL). The secondary outcomes include Patient Health Questionnaire-9 (PHQ-9), Length of Hospital Stay (LHS), Respiratory Symptoms (RS), Liver function test, Renal function test and lung CT. Clinical assessments will at three points (before treatment, 7th day during hospitalization and the discharge day). Adverse events will be noted and recorded for the safety evaluation.Discussion: This trail will provide a high-quality evidence of the value of TCMR, which is consist of acupressure therapy and Liuzijue Qigong exercise for treating severe patients with COVID-19.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000029994 Registered 18 February 2020, http://www.chictr.org.cn/showproj.aspx?proj=49309
Long-term safety and effectiveness of etanercept in JIA: an 18-year experience from the BIKER registry
Authors: Armaroli Giulia , Klein Ariane , Ganser Gerd , Ruehlmann Michael J. , Dressler Frank , Hospach Anton , Minden Kirsten , Trauzeddel Ralf , Foeldvari Ivan , Kuemmerle-Deschner Jasmin , Weller-Heinemann Frank , Urban Andreas , Horneff Gerd 
Published: April 2020

Abstract
Background: At present, etanercept represents the most frequently prescribed biologic agent in patients with juvenile idiopathic arthritis (JIA). The following study evaluates the long-term safety and effectiveness of etanercept in JIA patients compared to a biologic-naïve JIA cohort using long-term data from the German biologics registry (BiKeR).Methods: JIA patients newly exposed to etanercept were documented in the BiKeR registry from January 2001 till March 2019, and baseline characteristics, effectiveness, as well as safety parameters were analysed. Response to treatment was assessed according to 10-joint Juvenile Arthritis Disease Activity Score (JADAS10), JADAS-defined minimal disease activity and remission, JIA-American College of Rheumatology (ACR) improvement criteria, as well as ACR-inactive disease definition. Safety assessments were based on adverse events (AE) reports.Results: Over 18 years, a total of 2725 new etanercept users with a diagnosis of JIA were registered. Of these, etanercept was received as a first-line biologic by 95.8% and as monotherapy without concomitant methotrexate by 31.5%. The mean disease duration at baseline was 4.1±3.7 years. Already after three months of treatment, the mean JADAS10 decreased from 15.3±7.5 at baseline to 5.6±5.7 (p<0.0001) and JADAS-minimal disease activity was reached by 844 (45.9%) patients. Following one year of therapy, JIA-ACR30/50/70/90 improvement was reached by 81/75/61/42% of patients. After nine years on continuous treatment, 31(43.1%) patients were in JADAS-defined remission on drug. During the 5988 patient-years (PY) of etanercept exposure, 2053 AEs (34.3/100PY) were observed, including 226 serious AEs (3.8/100PY). Observed exposure-adjusted rates were 0.9/100PY for serious infections, 0.4/100PY for zoster reactivation, 0.3/100PY for inflammatory bowel disease and 1.9/100PY for uveitis. There were three malignancies and three deaths.Conclusions: The current analysis adds to the established good safety profile of etanercept and reveals a durable long-term tolerability in JIA patients. Etanercept treatment provided rapid clinical improvement which was maintained up to nine years of drug use.
Conceptual framework for watershed management based on the systematization of the pilot project for Colombia of the Pamplonita river basin
Authors: Rodríguez Pérez Yenni Esperanza , Ramón Valencia Jacipt Alexander , Suárez Gélvez John Hermógenes 
Published: April 2020

Since the issuance of Decree 1729 of 2002, the need for the management of watersheds and the concepts, objectives and scope of the corresponding management plans in the country was established. The final purpose of this exercise is to define and logically and coherently link the key concepts and variables necessary to address research focused on the organization and management of watersheds. In addition, verify the state of the art and determine future research needs. For its elaboration a recognition of the literature concerning the topic was carried out, an evaluation and follow-up of the progress reports delivered by each of the components, the conclusions that came out as a result of the weekly work tables of the technical and administrative teams, the design and reading of a format applied during the systematization of the experience, and the technical analysis of the guide for the river basin development and management plans. A conceptual framework was constructed with the terms of greatest importance to be managed by a team that participates in management processes during the various phases of a study. A clear conceptual framework allows to guide the research, provides a review to decipher and understand the results of the study and facilitates the production of new knowledge and the articulation between the technical teams for the fulfillment of the objectives during the development of river basin management plans (POMCA). Taking as a reference, the experiences lived during the execution of this study, it can be said that it is fundamental that in the preparation and during the beginning of the diagnosis, professionals hold conceptualization meetings so that the different products to be obtained show a joint participation from the different knowledge groups.
El "pensamiento de la diferencia": cómo pensar de otra manera en la posmodernidad
Authors: De Santiago Guervós Luis E. 
Published: April 2020

ABSTRACT To think the difference in the time of the philosophical posmodernity is the way of thinking that treats of bringing to the light what the history of philosophy has forgotten: the another of the reason, it is, the difference. In this paper is analized this question and the strategy of the poststructuralists Deleuze, Foucault and Derrida, to break the borders of the reason. RESUMENPensar la diferencia en la época de la posmodernidad filosófica es el modo de pensar que trata de llevar a la luz aquello que la historia de la filosofía ha olvidado: lo otro de la razón, es decir, la diferencia. En este trabajo se analiza el problema y la estrategia de los posestructuralistas Deleuze, Foucault y Derrida para romper los límites de la razón.
Identifikasi Tantangan dan Strategi Perempuan dalam Berkarir di Industri Konstruksi
Authors: Saksena Heru Tri , Ophiyandri Taufika , Hidayat Benny 
Published: April 2020

T
Tenaga kerja perempuan yang berkarir di industri konstruksi kerap dihadapkan dengan tantangan-tantangan seperti terbatasnya ruang gerak, kurangnya dukungan, hingga persepsi negatif mengenai kemampuan mereka dalam bersaing di industri konstruksi. Penelitian ini memiliki tujuan untuk mengidentifikasi tantangan yang dihadapi dan strategi yang dapat digunakan oleh perempuan dalam berkarir di industri konstruksi. Pentingnya mengetahui tantangan yang dihadapi dan strategi yang dapat digunakan oleh perempuan di industri konstruksi sangat penting untuk menunjang pengembangan karir dari tenaga kerja perempuan. Penelitian ini menggunakan mixed-method yang menggabungkan metode kualitatif dan kuantitatif. Metode kualitatif digunakan sebagai dasar studi awal (preliminary studies) yang bertujuan untuk menginvestigasi komponen terhadap tantangan yang dihadapi dan strategi yang dapat digunakan perempuan dalam berkarir di industri konstruksi dan nantinya menjadi dasar penyusunan kuesioner sebagai instrumen pengambilan data kuantitatif. Metode kuantitatif dilaksanakan untuk melihat tingkatan dari tantangan yang dihadapi dan strategi yang dapat diterapkan oleh tenaga kerja perempuan dalam berkarir di industri konstruksi. Dari penelitian ini teridentifikasi 14 tantangan yang dihadapi dan 10 strategi yang dapat digunakan oleh tenaga kerja perempuan dalam berkarir di industri konstruksi. Tiga tantangan utama yang dihadapi oleh tenaga kerja perempuan di industri konstruksi adalah sedikitnya lowongan/ porsi penerimaan pegawai untuk tenaga kerja perempuan (mean=2,5574), jam kerja yang panjang (mean=1,7541), dan masalah kesehatan (mean=1,6885) dan tiga strategi utama yang dapat digunakan oleh tenaga kerja perempuan di industri konstruksi adalah menjaga kesehatan tubuh (mean=4,5410), program mentoring (mean=4,5082), dan melakukan banyak pelatihan (mean=4,4754).