bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of cryotherapy on the reduction of pain levels in gout arthritis patients in Jambi city
Authors: Novrika Bri , Akhriansyah Mareta 
Published: November 2020

Background: Gouty arthritis is a disease caused by metabolic disorders with an increase in uric acid concentration which causes local joint pain. The management of gouty arthritis with pharmacological therapy usually uses several conventional drugs. The high prevalence of chronic pain experienced by sufferers has made the patient undergo non-pharmacological therapy with cold compresses (cryotherapy) to be more appropriate for joints with signs of inflammation such as redness and swelling that occur in patients with rheumatoid arthritis. Ice (ice packs) and ice water in the treatment of injuries and treatment modalities commonly used in the management of pain and injuries.Methods: This study used a quasi-experiment design with a two-group pre-test and post-test design approach. This study was conducted on patients with gout arthritis at PSTW Budi Luhur Jambi city with 16 respondent and control groups respectively. Data analysis in this study used univariate and bivariate using the independent t-test.Results: The results showed the average decreased levels of pain in patients with gouty arthritis in the control group without treatment pretest 3:50 whereas for the average posttest 3:19 and the average value decreased levels of pain in patients with gouty arthritis in the intervention group before performed cryotherapy 3:38 while for the average after treatment is 1.38, the statistical test p value is 0.000Conclusions: The influence cryotherapy to decrease rate gout arthritis pain in patients PSTW Budi Luhur in the city of Jambi.
Demographic profile of subjects undergoing sphenoidotomy for sphenoid sinusitis, in a tertiary care centre of Punjab- analysis of 75 subjects
Authors: Munjal Manish , Sethi Suneet , Chowdhary Anurag , Munjal Shubham , Sood Ananya , Thind Amrita , Walia Rishabh 
Published: November 2020

Background: The demographic profile of patients with Sphenoiditis undergoing surgical intervention, in the state of Punjab was studied. The emphasis was on the age, gender and clinical presentation in this prospective study.Methods: There were 75 patients of sphenoethmoidal recess pathology with sphenoditis, who were selected from the Rhinology clinics of Otorhinolaryngology and head Neck services of Dayanand Medical College and Hospital Ludhiana , in a period one and a half years (November 2002 to October 2004). All patients were taken up for Functional endoscopic sinus surgery of the sphenoid sinus surgery with sphenoidotomy.Results: The age range of subjects with sphenoiditis was between 12 years to 70 years. The mean age was 38.13 years. The maximum number of patients were in 19-30 years age group and the minimum in 31-40 years age group. Males outnumbered the females by a ratio of 1.7:1. The most common was posterior nasal drip (69.33% cases) behind the Eustachian tube and the least common complaint was diplopia (5.33% cases. Ocular involvement was observed in 32%. The right eye was more frequently involved (17.33%) as compared to the left (12%).Conclusions: Patients with Sphenoid sinusitis were seen in the broad age range from 19 to 30 years with a male predominance. Posterior nasal discharge behind the Eustachian tube, rather than the typical occipital ache was the primary complaint .Right sided eye involvement with ptosis and lateral rectus palsy were commonly noted.
Puerperal sepsis and maternal outcome in developing countries: an observational study
Authors: Kumar Naina , Yadav Ashu 
Published: November 2020

Background: Puerperal sepsis is a major cause of maternal morbidity, mortality. Present study was conducted to know burden of severe puerperal sepsis, risk factors, maternal outcome. Methods: Present observational cohort study was conducted in the Obstetrics and Gynecology department of rural tertiary center of Northern India over eight months (1st January-31st July 2018). All women who had delivered or aborted in an institution or those referred from outside within 42 days of delivery/abortion having clinical features, investigations suggestive of puerperal sepsis were enrolled. Socio-demographic factors, clinical features, examination findings, investigations, details of antecedent pregnancy, complications, risk factors, and maternal outcome were recorded. Statistical analysis was done using SPSS version 22 software.Results: A total of 66 cases with severe puerperal sepsis were observed during the study period of which 55 (83.3%) were referred from outside. The most common mode of delivery in antecedent pregnancy was vaginal (42.4%) followed by cesarean section (33.3%) and one (1.5%) forceps delivery. There were 15 (22.7%) post-abortal cases. Maternal anemia was found to be significantly linked with sepsis and adverse maternal outcome (p<0.05). Most common presenting features were fever (100%), tachycardia (100%), breathlessness (100%), malodourous vaginal discharge (100%), abdominal distention (53.0%), scar infection (16.7%), vaginal or rectal bleeding (16.7%), peritonitis (27.3%), septic shock (12.1%). A total of 38 (57.6%) cases required surgical intervention with seven (10.6%) developing multiorgan failure and 15 (22.7%) succumbed to death.Conclusions: Though puerperal sepsis is a preventable condition, it continues to be one of the major causes of maternal morbidity, mortality.
Experience of lifelong education in Western countries: The revelation of adult education
Authors: Zhou Haiying 
Published: November 2020

<p>Summary Adult Education in China provides a large number of educational opportunities for the general public , trained a large number of talented people , The largely compensates for higher education's Insufficient , But there are many problems . the appearance of these problems directly or indirectly affects the quality of education for adult teaching . , affect lifelong education in our country The construction of the system . for This, should draw on the successful experience of lifelong education in Western countries , combined with China's national conditions , Clear the concept of adult education goal , make adult education Education Development Program , Improving the quality of teaching for adults , Further promote the development of lifelong education in our country .</p>
THE ANALYSIS OF VILLAGE MIDWIFE PERFORMANCE IN REDUCING MATERNAL AND INFANT MORTALITY RATE
Authors: Hiola Tumartony Thaib , Badjuka Bun Yamin M. 
Published: November 2020

Background: The most essential aspect to reduce the number of maternal and newborn mortality is midwife competence. Midwives have a great role to be able to handle variety of health services (antepartum, intrapartum, and postpartum) to avoid or decrease the maternal and infant mortality rate. Performance of health workers, particularly midwives, is the most crucial in affecting the quality and quantity of midwives’ services to enhance the national health development.Aim: This study analyzed factors affecting village midwife performance for reducing maternal and infant mortality in seek for achieving Bone Bolango cemerlang or bright Bone Balango as the vision of Bone Bolango District in 2021.Methods: This study was an analytical survey with a cross-sectional approach. It was conducted from March to June 2019 in the working area of Bone Bolango District Health Office. There were 227 people from 19 primary healthcare centers as the population, and the sample size was 227 selected by using the total sampling technique. The data were collected by distributing questionnaires to the respondents and using secondary data. The data processing was done through chi-square test and multiple logistic regression with backward wald method.Results: Midwife performance in Bone Bolango District was assessed based on several variables. Most of them were ≥ 25 years old (80.6%); worked for ≥ five years (58,6%); mostly had not participated in any normal childbirth care training (76.7%); had a good competence (96.5%); had good resources/equipment (79.7%); had a good reward (92.5%); had a good attitude (76.2%); had a good motivation (90.7%). There were 12 maternal mortalities from 2017 to 2019 handled by only 11 midwives (4.8%). On the other hand, infant mortality rate (IMR) reached 25 cases in the same years; of 227 midwives, these cases were handled by only 21 midwives (9.3%).Conclusion: A midwife as a part of the health workers has an important role to increase the quality of maternal and child well-being program. Some variables that became indicators of midwife performance and had an effect on reducing the MMR and IMR included work period, reward, and motivation. This study recommends that all midwives have to be provided with a normal childbirth care training in the working area and increased rewards in the process of labor and delivery. Keywords: midwives, performance, maternal mortality rate, infant mortality rate.
Artificial intelligence predicts the immunogenic landscape of SARS-CoV-2: toward universal blueprints for vaccine designs
Authors: Malone Brandon , Simovski Boris , Moliné Clément , Cheng Jun , Gheorghe Marius , Fontenelle Hugues , Vardaxis Ioannis , Tennøe Simen , Malmberg Jenny-Ann , Stratford Richard , Clancy Trevor 
Published: November 2020

Abstract
This protocol predicts blueprints for vaccine design that contain a broad repertoire of T-cell epitopes optimized for the global population. The protocol first requires a screening of the SARS-CoV-2 proteome using immunogenicity predictors to generate comprehensive epitope maps. Then, these epitope maps are used as input to Monte Carlo simulations designed to identify statistically significant “epitope hotspot” regions in the virus that are most likely to be immunogenic. The epitope hotspots that share significant homology with proteins in the human proteome are removed to reduce the chance of inducing off-target autoimmune responses. Finally, a database of the actual HLA genotypes of citizens is used to develop a “digital twin” type simulation to model how effective different combinations of hotspots would work in a diverse human population. The approach identifies an optimal constellation of epitope hotspots that could provide maximum coverage in the human population.
On the issue of dynamic loading of the Kirovets K-4 tractor transmission
Authors: Василевский М.Р. , Александров В.А. 
Published: November 2020

Данное исследование имеет прикладной характер и направлено на решение проблемы, возникшей на АО «Петербургский тракторный завод» (далее – АО «ПТЗ»). Была поставлена задача – теоретически определить динамическую нагруженность трансмиссии трактора Кировец К-4, чтобы исключить возможность неправильной конструкторской компоновки трансмиссии трактора, вследствие чего могло бы возникать разрушение карданного вала между двигателем внутреннего сгорания и коробкой передач. Исследование проведено на трехмассовой математической модели. Математической описание составлено в форме уравнений Лагранжа II рода.
This research is of a direct applied nature and is aimed at solving the problem that arose at JSC «Peterburgsky Traktotny Zavod» (hereinafter referred to as JSC "PTZ"). The task was set to theoretically determine the dynamic load of the Kirovets K-4 tractor transmission, in order to exclude the possibility of incorrect design layout of the tractor transmission, in consequence of which, there could be a destruction of the driveshaft between the internal combustion engine and the transmission. The study was conducted on a three-mass mathematical model. The mathematical description is in the form of Lagrange equations of the second kind.
Intercomparing the robustness of machine learning models in simulation and forecasting of streamflow
Authors: Loganathan Parthiban , Mahindrakar Amit Baburao 
Published: November 2020

Abstract
The intercomparison of streamflow simulation and the prediction of discharge using various renowned machine learning techniques were performed. The daily streamflow discharge model was developed for 35 observation stations located in a large-scale river basin named Cauvery. Various hydrological indices were calculated for observed and predicted discharges for comparing and evaluating the replicability of local hydrological conditions. The model variance and bias observed from the proposed extreme gradient boosting decision tree model were less than 15%, which is compared with other machine learning techniques considered in this study. The model Nash–Sutcliffe efficiency and coefficient of determination values are above 0.7 for both the training and testing phases which demonstrate the effectiveness of model performance. The comparison of monthly observed and model-predicted discharges during the validation period illustrates the model's ability in representing the peaks and fall in high-, medium-, and low-flow zones. The assessment and comparison of hydrological indices between observed and predicted discharges illustrate the model's ability in representing the baseflow, high-spell, and low-spell statistics. Simulating streamflow and predicting discharge are essential for water resource planning and management, especially in large-scale river basins. The proposed machine learning technique demonstrates significant improvement in model efficiency by dropping variance and bias which, in turn, improves the replicability of local-scale hydrology.
Value of a made-in-Ontario management system standard for municipal wastewater and stormwater utilities
Authors: Tovilla Edgar 
Published: November 2020

Abstract
This paper builds on previous research to address the question of whether there is practical value for a made-in-Ontario municipal management system standard (MSS) for wastewater and stormwater related activities, in addition to the Drinking Water Quality Management System Standard (DWQMS) that is already statutorily required. This research specifically addressed the questions: is there value in a mandatory or voluntary MSS; are there neutral, positive, or negative effects of having an MSS; and what standard is more adequate? Through a focus group method, this research finds evidence in support of and wide recognition of the practical value an MSS in assisting municipalities in meeting their environmental objectives, addressing property damage risks, providing an additional mechanism of public accountability, and improving alignment with the legal structure. It was also apparent that there is no political appetite in the provincial government to embark on a mandated MSS, so the preferred option at this time appears to be a provincially endorsed, voluntary, sector-specific standard for wastewater and for stormwater, which could constitute a catalyst to boost voluntary uptake of MSS by small to medium municipalities (as is already occurring with large municipalities). This standard could be based on a customized variation of the ISO 14001 and DWQMS.
Baricitinib in Rheumatoid Arthritis – Real World Cross-Sectional Study
Authors: Sagdeo Amol , Askari Ayman , Morrissey Hana , Ball Patrick A. 
Published: November 2020

Introduction:
Rheumatoid Arthritis (RA) is the most common cause of inflammatory polyarthritis. In RA, increased circulating levels of pro-inflammatory cytokines contribute to the overall symptomatology of fatigue, pain, and joint stiffness. Baricitinib is an orally administered biologic DMARD, used in RA patients, inhibiting signaling via JAK1/JAK2 inhibition, reducing the release of pro-inflammatory cytokines.

Objective:
To explore the efficacy and tolerability for baricitinib in a local population.

Methods:
A cross-sectional study was carried out to review data of RA patients on Baricitinib from the researchers’ own clinic, since its approval in August 2017. The data was collected from an anonymized electronic patient records report. The clinical response was then classified into mild, moderate, and significant improvement.

Results and Discussion:
Overall, 27 out of 37 patients (72.9%) showed clinical improvement with baricitinib. In 9(24.3%) out of 37 patients, the dose had to be reduced to either 2mg/day or 2mg/day - 4mg/day on alternate days. In four of the 9 patients’ where the dose was reduced due to infections (UTI or sinuses), they subsequently experienced fewer infections while maintaining moderate improvement in their RA.

Conclusion:
There is a need for longer-term and larger studies to evaluate the full side effects profile of baricitinib in the local population.
Oral Mucosal Lesions and DMFT Index Assessment in Rheumatoid Arthritis Patients in Birjand, Iran, in 2018
Authors: Parvaei Parvin , Dorri-giv Afsaneh , Sharifzadeh Gholamreza , Malakimoghadam Hakimeh , Atabati Elham 
Published: November 2020

Introduction:Rheumatoid Arthritis (RA) may cause malfunction in the immune system and the inability to observe oral hygiene in patients due to physical deficits. A bacterial infection caused as such can constitute a significant risk factor for the development of systemic infection. The present study aimed to investigate the oral mucosal lesions, the DMFT index, and the Modified Gingival Index (MGI) in RA patients treated in Birjand city.Materials and Methods:This descriptive cross-sectional study was performed with 80 RA patients referred to rheumatology clinics of Birjand in 2018. Data were collected through observation, clinical examination, information forms, and medical records. After the patients were informed about the research purposes and signed consent forms for participation, they were examined at the rheumatology clinics. The collected data were analyzed in SPSS software (version 19).Results:Of the 80 patients, n = 64 (80%) had oral mucosal lesions. Dry mouth (66.3%) was the most common finding. The mean DMFT index score was 18.7.Conclusion:Oral mucosal lesions and the mean DMFT index score seem to be at high levels in RA patients, possibly due to the complications of the disease or the consumed medications.
Analysis of the Influence of Osteosynthesis Technique and Patient-specific Factors on the Outcome of Subtrochanteric Fracture Treatment
Authors: Schulze Christoph , Kollig Erwin , Estel Katharina , Hacke Claudia , Gutcke Andre , Bieler Dan 
Published: November 2020

Objective:The number of subtrochanteric femoral fractures will continue to grow on account of demographic developments. The treatment of choice is reduction and surgical stabilisation. Intramedullary (IO) and extramedullary (EO) techniques are available for this purpose. A final assessment has not been made of which technique is superior with regard to treatment outcome, complication rates, and revision rates. The objective of this retrospective study was to compare surgical procedures with regard to weight bearing, length of hospital stay, the occurrence of complications, and the necessity of surgical revisions.Methods:This retrospective study included 77 patients (74.9 ± 14.9 years; 42.9% male). Associations between surgical procedures and treatment outcomes, complications and revision rates were calculated by linear and logistic regression analysis. To investigate the effect of surgical procedure within patients with fracture type 2 B according to Russel-Taylor classification, a subgroup analysis was performed.Results:In case of fracture type 2 B, according to Russell-Taylor classification, EO took 80 minutes longer on average than the intramedullary technique (p = 0.001), although surgeon experience plays an important role. Common complications were more frequently associated with IO than with EO. Surgical revisions were required more often in the extramedullary group (OR 4.5; 95% CI: 0.87 – 23.19). Patients in the intramedullary group were discharged 3.4 days earlier from the hospital (p = 0.024). Older patients had a higher risk for the occurrence of complications, but BMI and the experience of the surgeon did not. Patients with intramedullary stabilisation frequently showed better postoperative weight-bearing stability.Conclusion:The intramedullary technique offers advantages to both patients and hospitals with regard to outcome, duration of surgery, and length of stay in the hospital. Although, extramedullary implants are less expensive, this advantage is clearly reduced by the longer duration of surgery and hospital stays.
Efficient Technique for PAPR and BER Reduction in Downlink Large Scale MU-MIMO-OFDM System
Authors: Singh Jagtar , Kedia Deepak 
Published: November 2020

Background & Objective:
The Orthogonal Frequency Division Multiplexing (OFDM)
based large scale multiuser multiple input multiple output (LS-MU-MIMO) system is a preferred
choice for signal transmission because it can substantially enhance the spectral and energy efficiency
of the next-generation wireless systems. However, there are several practical issues in implementing
large multiuser-MIMO-OFDM systems and one of the critical issues is the high Peak-to-Average-
Power Ratio (PAPR). Due to the use of a large number of antennas at the Base Station (BS) of an LSMU-
MIMO-OFDM system, it requires a large number of Power Amplifiers (PAs) which are needed
to be connected to each antenna element. The high PAPR in an OFDM based LS-MU-MIMO system
results in the decrease in the efficiency of PAs and enhancement in nonlinear signal distortions. This
work is concerned with the reduction in PAPR of LS-MU-MIMO-OFDM systems using the SCFDMA
scheme for the downlink transmission. The reduction in PAPR is achieved on the basis of discrete
Fourier transform spreading (DFT-S) scheme known as DFT-SC-FDMA. The SC-FDMA
scheme can achieve the reduction in PAPR of MIMO-OFDM signal up to the level of single-carrier
transmission. Further, the reduction in PAPR is achieved with the sub mapping schemes such as localized
FDMA (LFDMA) and distributed FDMA (DFDMA), Interleaved FDMA (IFDMA).

Result:
In this work, we propose to perform jointly multiuser MMSE precoding, SC-IFDMA and antenna
reservation technique to reduce the PAPR and Bit Error Rate (BER) of the large MU-MIMO
system. To show the effectiveness of the proposed scheme in the reduction of PAPR with different
modulation techniques, subcarriers, and subcarrier mapping schemes, the results are compared with
the existing OFDM based large MU-MIMO system.

Conclusion:
The MATLAB simulation results confirm that our proposed combination of MMSE MUprecoding,
SC-IFDMA and antenna reservation technique is able to reduce PAPR and BER to a significant
extent for LS-MU-MIMO-OFDM systems.