bluuebunny/crossref_metadata_2025_split huggingface dataset:
System-wide approaches to mitigate environmental and health impacts of water contamination
Authors: Ngasala Tula M. , Masten Susan J. , Gasteyer Stephen P. 
Published: December 2021

Abstract
There is an urgent need to address the challenges of inadequate safe water and proper sanitation in peri-urban communities in low-income countries. Agencies have tended to focus on a single aspect of the challenge for service delivery, which ultimately fails to capture the full scope of the problem. In this study, 63 household surveys and 15 key informant interviews regarding water and sanitation issues were conducted in a peri-urban area of Dar es Salaam, Tanzania. Results revealed that 87% of households experience water scarcity issues. More than 50% of the homes were surrounded by swampy areas with sewage and stagnant pools, with 40% reporting water source contamination due to seepage and overflowing of sewage collection systems. Key informants reported water scarcity and poor water quality due to poor sanitation practices and a compromised water supply network. We found that a highly integrated approach that invests in cultural, social, political, human, financial, and built community capitals is needed to address these challenges. Community self-efficacy and empowerment will be critical to accomplishing this and protecting public health.
Process evaluation of urban river replenished with reclaimed water from a wastewater treatment plant based on the risk of algal bloom and comprehensive acute toxicity
Authors: Sun Danyan , Lin Xiaohu , Lu Zhibo , Huang Juwen , Li Guangming , Xu Jingcheng 
Published: December 2021

Abstract
Municipal wastewater reuse has an important role to play with scarce water resources and serious water pollution. However, the impact of reclaimed water on the aquatic ecology and organisms of the receiving water needs to be assessed. This study investigated one ecological restoration project of an urban river replenished with reclaimed water, and evaluated the risk of algal bloom and acute biological toxicity in the river. Results showed that the concentrations of permanganate index and ammonia nitrogen in the river could stably remain below the standard values, the concentrations of total phosphorus were high and most of the monitoring values were between 0.42 and 0.86 mg/L. The content of chlorophyll a was relatively lower, ranging from 0.06 to 0.10 mg/m3. The maximum value of Fv/Fm was 0.42, which was lower than the algal bloom prediction threshold of 0.63. Moreover, the results of luminescence inhibition rate on luminescent bacteria showed that the reclaimed water did not cause significant biological toxicity to the aquatic ecology. The study suggested that implementing urban reclaimed water reuse projects requires a series of ecological purification and restoration technologies in the receiving water, which can effectively guarantee the stability of water quality and the safety of water ecological environment.
Application of water resource multi-objective allocation service based on digital water network
Authors: Du R. F. , Zhang Y. J. , Liu Y. G. , Liu S. H. , Wang F. , Zhang X. , Xie J. C. 
Published: December 2021

Abstract
The rational allocation of water resources plays an important role in alleviating disparities between supply and demand in areas with water shortages. With the continuous development of modern information technology, the pace of digitization is accelerating. Digital water networks provide a means of technical support, and their application is becoming more extensive. Based on the traditional study of water resource allocation combined with the development of modern information technology, this paper proposes a new operational application model of multi-objective water resource allocation based on a digital water network and applies this model to allocate water resources in the Heihe River basin in Xi'an, Shaanxi Province. First, a topological digital water network is constructed based on the connectivity criterion of water systems, and a cooperative configuration model with social, economic and ecological objectives is established. Second, the model and its solution method are componentized, and the water resource allocation business system is constructed based on the comprehensive integration platform to integrate the digital water network and the water resource multi-objective allocation business. Finally, to verify the scientificity and feasibility of the new model, the new model was applied to allocate water resources in the Heihe River basin of Xi'an city, Shaanxi Province.
Corporate Governance in the Digital Economy
Authors: Zharinov I. O. 
Published: December 2021

The task of organizing corporate governance of groups of business systems that carry out industrial activities in the Industry 4.0 paradigm and are focused on a single market segment is considered. The subjects of governance are defined as residents of corporate business relations (stakeholders) who provide management or action the business as an investor, owner, lender, etc. The objects of governance are defined as business systems and their groups (business complexes, State corporations) formed as a result of institutional and infrastructural transformations in the primary and aggregated parts of industry. The innovative component (subject), corresponding to the globalization of economic and digitalization of business processes, introduced an information system into the management channel that performs modeling and evaluating the effectiveness of corporate business relations in a virtual environment using digital twins of governance objects. Digital twins are the information components of a virtual corporation deployed on a platform of a decentralized ecosystem. The criterion for the quality of governance is the effectiveness of the corporation, formed in a balanced space of parameters relevant to financial and production indicators. The technology is described and the scheme of the corporate governance system is presented, which complementarily combines the action of business management systems and artificial intelligence (scheduler) of the virtual environment on the groups. It is proposed to extend the mechanisms of corporate governance to the business relations of the parties regulated in the digital institutional environment by electronic procedures.
Current Status and Future Perspectives of the Active Knee Joint Rehabilitation
Device
Authors: Jiang Jingang , Gao Ziwen , Song Shichang , Yu Xiaoyang , Zeng Yang 
Published: December 2021

Background:
Today, living standards and medical technology are improving, and the
aging global population is increasing. However, more and more older adults are suffering from knee
diseases. This will seriously affect patients’ daily life and their mental state. In many studies, repetitive
physical exercises and motor activities in real-world environments have been shown to help improve
knee muscle strength and restore damaged nerves. Therefore, physical knee therapy is very necessary.
The use of rehabilitation training devices for movement therapy has shown great potential.

Objective:
This study aimed at exploring the structural features, functions, and development status
of the knee rehabilitation training device.

Method:
This review explores the structure and function of various current knee rehabilitation devices
based on structural and kinematic properties of the knee joint in relation to requirements of
physical knee rehabilitation. This paper aims to present a systematic guideline and outline a reference
for future designers of rehabilitation devices.

Results:
By analyzing the structure and movement of the knee joint and combining the strategies of
physical knee rehabilitation, movement requirements during knee rehabilitation training are concluded.
According to the structure, drive form, transmission mode, and rehabilitation environment
of knee rehabilitation devices, the devices are classified and compared; some typical features are
summarized; some current problems are analyzed, and the future trends and development directions
of rehabilitation devices are discussed.

Conclusion:
Current rehabilitation equipment has a variety of structures and functions, but a good
balance between weight and volume is hardly maintained. The protection of the body needs to be
further improved. Many knee rehabilitation devices are only concepts, not physical objects, and lack
clinical trial data. Power sources and drives are large and heavy, which can compress the knee joint
and burden the patient. Strong and lightweight materials should be chosen to assist knee rehabilitation.
It will be a good development in the future.
Effect of Intravesical Chemotherapy on the Survival of Patients with Non-Muscle-Invasive Bladder Cancer Undergoing Transurethral Resection: A Retrospective Cohort Study Among Older Adults
Authors: Das Ashis K. , Mishra Devi K. , Gopalan Saji S. 
Published: December 2021

Background:
The average age of diagnosis for bladder cancer is 73 and about 75 percent of all bladder cancers are non-muscle invasive at initial diagnosis. It is recommended that non-muscle invasive bladder cancers (NMIBC) should be treated with transurethral resection of the bladder tumor (TURBT) followed by chemotherapy. However, there is no large-scale study from real-world databases to show the effectiveness of chemotherapy on the survival of older adults with NMIBC that have undergone TURBT. This study aimed to investigate the effects of chemotherapy on survival among older NMIBC patients with TURBT.

Methods:
Using the Surveillance, Epidemiology, and End Results (SEER) database (2010-2015), we performed analyses of cancer-specific mortality and overall mortality comparing chemotherapy versus no chemotherapy after TURBT. Coarsened exact matching was performed to balance the baseline patient characteristics. Cox proportional hazards and Kaplan-Meir analyses were used to evaluate survival outcomes.

Results:
A total of 3,222 matched patients with 1,611 in each arm (chemotherapy and no chemotherapy) were included in our study. After adjusting for covariates, multivariable Cox regression analyses show chemotherapy was associated with lower cancer-specific mortality (HR 0.63; 95% CI 0.42-0.94; p value 0.024). However, chemotherapy did not have any effect on overall mortality (HR 0.84; 95% CI 0.65-1.07; p value 0.159). The Kaplan-Meier curves show the protective effects of chemotherapy on cancer specific survival (p=0.032), but not on overall survival (p=0.34).

Conclusion:
Chemotherapy improved cancer specific survival among older patients with non-muscle invasive bladder cancer undergoing TURBT surgery, but it had no effect on overall survival. There is a need for more granular level real-world data on chemotherapy regimens and dosage to effectively investigate the effects of chemotherapy on the survival of older patients with NMIBC that have undergone TURBT.
A Randomized Clinical Trial of the Effect of Zinc Supplement on Depression and Anxiety in the Elderly
Authors: Afzali Abolfazl , Vakili Zarichehr , Goli Shahrbanoo , Bagheri Hossein , Mirhosseini Seyedmohammad , Ebrahimi Hossein 
Published: December 2021

Background:
Anxiety and depression in the elderly are considered important mental disorders.

Objective:
This study was designed to determine the effect of zinc Supplementation on depression and anxiety in the elderly.

Methods:
This study was a parallel randomized clinical trial. A total of 150 elderly aged 60 years and older were allocated into intervention and control groups by using the quadruple blocking method. The elderly in the intervention group received a daily dose of 30 mg zinc supplementation pill for 70 days and the elderly in the control group did not receive this supplement. Depression and anxiety in the elderly were measured using the Geriatric Depression Scale and the Beck Anxiety Inventory, respectively. A significance level of 0.05 was considered for all statistical tests.

Results:
After the intervention, the mean scores of depression and anxiety in the elderly were significantly decreased in the intervention group, as compared with the control group. Moreover, after the intervention, the serum zinc level in the elderly was significantly increased in the intervention group, as compared with the control group (P<0.05).

Conclusion:
The use of zinc supplements improved depression and anxiety in the elderly. Therefore, it is recommended to use zinc supplements as a new therapeutic strategy for the prevention and treatment of depression and anxiety in the elderly.
Registration No: This research was registered in the Iranian clinical trial system with code IRCT2017071635110N1.
Nanocrystals- A Substantial Platform for Drug Delivery Applications
Authors: Patel Akanksha , Dharamsi Abhay 
Published: December 2021

Abstract:
Poor solubility of a drug is one of the major concerns in drug delivery. Many strategies
have been employed for solving this problem, but there are still some deficiencies with current
strategies, such as low drug loading, high toxicity, poor stability, potential drug loss during storage,
and complex manufacturing method. By formulating nanocrystals, problems associated with the delivery
of drugs with low water or lipid solubility can be addressed. Unlike polymeric nanoparticles
and lipidic nanoparticles, they are not reservoir or matrix systems. Nanocrystals are colloidal suspensions
of nanosized particles stabilized by polymeric or electrostatic stabilization. They can be
prepared by Top-down or Bottom-up approaches. Some of the methods for the preparation of
nanocrystals are nanoprecipitation, media milling, high-pressure homogenization, emulsions and
microemulsions as templates, supercritical fluid technology, and co-grinding. They can be used for
oral, intravenous, ocular, inhalation, intramuscular drug delivery and drug targeting.
Formaldehyde Levels in Fabrics on the Ghanaian Market
Authors: Monnie Patience Danquah , Amanfu Rachel , Gavor Modesta Efua 
Published: December 2021

Background:
Formaldehyde is a chemical used in several textile production processes, such as hardening of fibers and antimold finishing. However, it has varying effects on humans, such as irritation of the eyes, nose, throat, wheezing, chest pains and bronchitis. In the midst of COVID-19, individuals are using various fabrics for face mask production, which may be con-taining levels of formaldehyde that can negatively affect their health.

Methods:
This study investigated formaldehyde levels in fabrics on the Ghanaian market to de-termine compliance to standards set by the Ghana Standards Authority (GSA) with the aid of ex-perimental procedures. Thirty-two (32) different brands of fabrics were selected for the investiga-tion. Formaldehyde levels were determined using a spectrophotometer (DR6000). Data were ana-lyzed using the Statistical Product and Service Solutions (SPSS) for Windows version 22. The mean performance attributes and the formaldehyde levels of the sampled fabrics were determined before and after washing. Inferential statistics (Analysis of Variance and Paired Samples t-test) at 0.05 alpha levels were used to determine significant differences between and among the groups involved.

Results:
The fabric samples tested positive for formaldehyde before and after washing, with some exceeding the standard limits set by the GSA before washing. Significant differences exist-ed between and among the samples with regard to formaldehyde levels as well as weight and weave types of the samples and formaldehyde levels.

Conclusion:
Washing significantly reduced the formaldehyde levels in the fabrics. It is recom-mended that Ghana Standards Authority takes a further look at the fabrics on the Ghanaian market to ensure manufacturers comply with set standards and consumers are also advised to wash their clothes at least once before use to reduce the level of impact formaldehyde resin may have on them.
Review of Clinical Equipoise: Examples from Oncology Trials
Authors: AlHamaly Majd A. , Alzoubi Karem H. , Khabour Omar F. , Jaber Ruba A. , Aldelaimy Wael K. 
Published: December 2021

Background:
The current standards that govern clinical research have been shaped over
the years through many historical, social, and political events. The third principle of the Belmont
Report, Justice, guides the scientific community toward the equal distribution of benefits and risks
in research involving human subjects. Clinical equipoise is the status of genuine uncertainty by the
investigator about the superiority of one treatment arm over the other. The term clinical equipoise
was proposed to provide an ethical ground to conduct randomized controlled clinical trials.

Objective:
The objective of this review is to provide the reader with an overview of the emergence
of the term equipoise and its utilization in randomized controlled trials.

Methods:
In the current review article, the major oncology clinical trials and relevant patents were
reviewed for the application/utilization of clinical equipoise.

Results:
The concept of clinical equipoise has been challenged, and different alternatives were proposed.
Yet, these alternatives received numerous critiques and failed to fully replace equipoise. In
addition, several patents related to anticancer agents tested in the described studies were examined.
No specific reference was made as part of the patent to the status of clinical equipoise. Alternatively,
a description of the study arms was provided.

Conclusion:
There is a need for revisiting the concept of equipoise and its suggested alternatives
for its ethical essence while addressing related challenges.
Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial
Authors: Burgon Trever , Casebeer Linda , Aasen Holly , Valdenor Czarlota , Tamondong-Lachica Diana , de Belen Enrico , Paculdo David , Peabody John 
Published: December 2021

Background
Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients.

Objective
In this study, we introduced a novel tool, QualityIQ, and determined the extent to which it helps primary care physicians to align care decisions with the latest best practices included in the Merit-Based Incentive Payment System (MIPS).

Methods
We developed the fully automated QualityIQ patient simulation platform with real-time evidence-based feedback and gamified peer benchmarking. Each case included workup, diagnosis, and management questions with explicit evidence-based scoring criteria. We recruited practicing primary care physicians across the United States into the study via the web and conducted a cross-sectional study of clinical decisions among a national sample of primary care physicians, randomized to continuing medical education (CME) and non-CME study arms. Physicians “cared” for 8 weekly cases that covered typical primary care scenarios. We measured participation rates, changes in quality scores (including MIPS scores), self-reported practice change, and physician satisfaction with the tool. The primary outcomes for this study were evidence-based care scores within each case, adherence to MIPS measures, and variation in clinical decision-making among the primary care providers caring for the same patient.

Results
We found strong, scalable engagement with the tool, with 75% of participants (61 non-CME and 59 CME) completing at least 6 of 8 total cases. We saw significant improvement in evidence-based clinical decisions across multiple conditions, such as diabetes (+8.3%, P<.001) and osteoarthritis (+7.6%, P=.003) and with MIPS-related quality measures, such as diabetes eye examinations (+22%, P<.001), depression screening (+11%, P<.001), and asthma medications (+33%, P<.001). Although the CME availability did not increase enrollment in the study, participants who were offered CME credits were more likely to complete at least 6 of the 8 cases.

Conclusions
Although CME availability did not prove to be important, the short, clinically detailed case simulations with real-time feedback and gamified peer benchmarking did lead to significant improvements in evidence-based care decisions among all practicing physicians.

Trial Registration
ClinicalTrials.gov NCT03800901; https://clinicaltrials.gov/ct2/show/NCT03800901
Informal Coping Strategies Among People Who Use Opioids During COVID-19: Thematic Analysis of Reddit Forums
Authors: Arshonsky Josh , Krawczyk Noa , Bunting Amanda M , Frank David , Friedman Samuel R , Bragg Marie A 
Published: December 2021

BackgroundThe COVID-19 pandemic has transformed how people seeking to reduce opioid use access treatment services and navigate efforts to abstain from using opioids. Social distancing policies have drastically reduced access to many forms of social support, but they may have also upended some perceived barriers to reducing or abstaining from opioid use.ObjectiveThis qualitative study aims to identify informal coping strategies for reducing and abstaining from opioid use among Reddit users who have posted in opioid-related subreddits at the beginning of the COVID-19 pandemic.MethodsWe extracted data from 2 major opioid-related subreddits. Thematic data analysis was used to evaluate subreddit posts dated from March 5 to May 13, 2020, that referenced COVID-19 and opioid use, resulting in a final sample of 300 posts that were coded and analyzed.ResultsOf the 300 subreddit posts, 100 (33.3%) discussed at least 1 type of informal coping strategy. Those strategies included psychological and behavioral coping skills, adoption of healthy habits, and use of substances to manage withdrawal symptoms. In addition, 12 (4%) subreddit posts explicitly mentioned using social distancing as an opportunity for cessation of or reduction in opioid use.ConclusionsReddit discussion forums have provided a community for people to share strategies for reducing opioid use and support others during the COVID-19 pandemic. Future research needs to assess the impact of COVID-19 on opioid use behaviors, especially during periods of limited treatment access and isolation, as these can inform future efforts in curbing the opioid epidemic and other substance-related harms.
Sobre la apropiación de la escultura de San Ignacio de Loyola o el Lenin connotado
Authors: Vallejo Erazo Edgar Andres 
Published: December 2021

Sobre la crítica dirigida hacia una historia hegemónica del documento escrito, hacia los estudios tradicionales del arte y la poca relevancia de los estudios de recepción en historia en general, se realiza esta aproximación teórica, que busca no solo realzar la importancia académica de objetos artísticos no estudiados tradicionalmente, ya sea por el límite de referencias históricas existentes, o por la aparente frivolidad en el conocimiento del pasado que estos puedan arrojar, sino que pretende analizarlos sobre otro tipo de lente histórico, que permita comprender a profundidad estos objetos como insumos imprescindibles para el estudio de las formas de interpretación colectiva y su devenir en el tiempo.
A partir de la teoría de recepción (Keith Moxey, 2015 y Didi-Huberman, 2018) en diálogo con Roger Chartier (2019), se desarrolla dicha propuesta teórica. Ergo, se toma como objeto de análisis, el estudio de una leyenda de la ciudad de San Juan de Pasto, Colombia; la re significación de la escultura de San Ignacio de Loyola, hacia la efigie de Vladimir Lenin, y a través de un trabajo de critica historiográfica, que pone a dialogar los estudios tradicionales que se han hecho de la misma, con las teorías del giro icónico, y la teoría de la recepción, se procede a estudiar no solo la génesis de la obra, sino su re-significación, es decir, la historia de su apropiación.