Miracle-dz/UniFAR-FTUs huggingface dataset:
Patients’ and Care Professionals’ Evaluation of the Effect of a Hospital Group on Integrated Care in Chinese Urban Health Systems: A Propensity Score Matching and Difference-in-differences Regression Approach

Background: A hospital group is an organizational integration strategy that has recently been widely implemented in Chinese urban health systems to promote integrated care. This study aims to evaluate the effect of hospital group on integrated care from the perspectives of both patients and care professionals. Methods: Two cross-sectional surveys were conducted in Shenzhen city of China, in June 2018 and July 2021. All thirty Community Health Stations (CHSs) in the hospital group were included in the intervention group, with 30 CHSs in the same district selected as the control group by simple random sampling. All care professionals within both the intervention and the control groups were invited to participate in the surveys. Twelve CHSs were selected from 30 CHSs in the intervention and the control groups by simple random sampling, and 20 patients with type 2 diabetes mellitus (T2DM) were selected from each of these selected CHSs to participate in the survey by systematic sampling. The Rainbow Model of Integrated Care-Measurement Tool (Chinese version) was used to assess integrated care. Propensity score matching and difference-in-differences regression (PSM-DID) were used to evaluate the effect of the hospital group on integrated care. Results: After matching, 528 patients and 1896 care professionals were included in the DID analysis. Results from care professionals indicated that the hospital group significantly increased technical competence of the health system by 0.771 points, and cultural competence by 1.423 points. Results from patients indicated that the hospital group significantly decreased organizational integration of the health system by 0.649 points. Conclusion: The results suggests that the effect of the hospital group on integrated care over and above routine strategies for integrated care is limited. Therefore, it is necessary to pay attention to implementing professional, clinical and other integration strategies beyond establishing hospital groups, in urban Chinese health systems.
Role of the ortho-bridge system in the length unstable subtrochanteric femur fracture in school going children: a retrospective clinical study of 19 cases

Background Treating subtrochanteric femur fractures in pediatric patients remains challenging, and an optimal fixation device has yet to be established. This study aimed to asess the clinical and radiological outcomes of Ortho-Bridge System (OBS) treatment for length-unstable subtrochanteric femur fractures in children aged 5–16 years. Methods We conducted a retrospective review of pediatric patients with subtrochanteric femur fractures treated with OBS between January 2018 and December 2021. The study included 19 children (12 boys, 7 girls) with an average age of 10.4 ± 2.6 years. Two of the patients had pathological fractures associated with aneurysmal bone cyst. Demographic information, mechanism of accident, fracture type, associated neurovascular injuries, surgical duration and blood loss, were collected from the hospital database. Time to union and postoperative complications were recorded. Clinical and radiological outcomes were assessed using the Harris scoring system at the latest follow-up. Results Injuries resulted from vehicle accidents in 10 patients (52.6%), falls over 3 meters in height in 3 patients (15.8%), and sports-related injuries in 6 patients (31.6%). The average patient weight was 41.5 kg (range: 21–78). Of the fractures, 14 (73.7%) were complex, and 5 (26.3%) were spiral. The average surgical duration was 111 min (range: 90–180), and the average surgical blood loss was 134 ml (range: 70–300). The mean time to union was 12.7 weeks (range: 8–16). No cases of infection, malunion, implant failure, or femoral head osteonecrosis were reported. Leg length discrepancy of 10 mm was observed in one patient. All patients achieved excellent results according to the Harris scoring system. Conclusion This study suggests that the OBS may serve as an effective alternative fixation option for managing length-unstable subtrochanteric femur fractures in school-aged children.
Water Risk-Proofed: Risk Assessment in Water Desalination

Desalination plants, heavily reliant on Industrial Control Systems (ICS), have emerged as increasingly vital resources in the wake of escalating global water scarcity. This raises an urgent need to prioritize their security, calling for the implementation of robust risk assessment measures. Recognizing these pressing issues, this paper proposes a risk assessment approach for ICS within water desalination facilities. The strategy integrates the capabilities of Bayesian Networks (BNs) and Dynamic Programming (DP). It evolves BNs into Multilevel Bayesian Networks (MBNs), an innovative form that adeptly navigates the intricacies of system complexity, facilitates efficient inference, and dynamically adapts risk profiles. The proposed methodology considers the perspective of potential attackers, which is critical for a comprehensive risk assessment and a robust defense strategy. The DP aspect enhances this approach by dissecting complex problems and identifying optimal attack paths. The work demonstrates the comprehensive risk assessment by executing multiple attacks on a water desalination plant with various strategies. It takes into account the probabilistic interdependence relationships within the system. Additionally, the paper formulates a mathematical risk assessment using system models and graphical representation, yielding realistic results.
Efficacy of Learning Materials on Learners’ Readiness for Primary Education in Kenya

The early years of a child are of utmost importance in terms of development since they provide substantial prospects that influence subsequent achievements in academia. The field of early childhood education (ECE) has significant importance in equipping young children with the necessary skills and knowledge to succeed in primary academic settings, achieved via the implementation of well-designed curricula. Nevertheless, empirical research indicates that early childhood development and education (ECDE) learners frequently commence grade one without enough preparation, primarily as a result of challenges related to insufficient resources, concerns regarding educational quality, and a lack of relevance. Grounded in Gross' theory of curriculum implementation, this research examined how educational resources contribute to the implementation of the Early Childhood Development and Education (ECDE) curriculum in Kenya. The study utilized a descriptive survey approach and a mixed (embedded) research paradigm. The participant pool included a broad group, including 3 Civil Society Organizations (CSOs), 11 Section Heads, 14 ECDE centres-in-charge, and 150 ECDE instructors. The determination of the sample size, consisting of 178 individuals, was conducted utilizing Yamane's formula. This process involved the utilization of purposive, stratified, and simple random sampling procedures. The data collection methods employed in this study encompassed interviews, questionnaires, and focus group discussions (FGD). The qualitative data was subjected to content analysis and thereafter presented in a narrative format, while the quantitative data underwent examination using descriptive statistics. In the context of inferential statistics, parametric tests were employed. Logistic regression analysis determined the impact of educational resources and intervening factors on fundamental reading skills. The model, with a p-value of 5.865, significantly explained 59.9% of literacy skill variability, correctly classifying 68% of instances. Intervening variables increased the odds of learner readiness by 1.314. The obtained Sig values of.011 and.030 for intervening variables and educational resources, respectively, were below α =. 05, leading to the rejection of the null hypothesis and indicating a significant effect on ECDE pupils' preparedness for primary schooling. Recommendations include government-led training for educators on resource utilization and increased support for universities to acquire high-quality textbooks, ensuring comprehensive instructional strategies for teacher trainees.
Adaptive yoga versus low-impact exercise for adults with chronic acquired brain injury: a pilot randomized control trial protocol

Background Each year, millions of Americans sustain acquired brain injuries (ABI) which result in functional impairments, such as poor balance and autonomic nervous system (ANS) dysfunction. Although significant time and energy are dedicated to reducing functional impairment in acute phase of ABI, many individuals with chronic ABI have residual impairments that increase fall risk, decrease quality of life, and increase mortality. In previous work, we have found that yoga can improve balance in adults with chronic (i.e., ≥6 months post-injury) ABI. Moreover, yoga has been shown to improve ANS and brain function in healthy adults. Thus, adults with chronic ABI may show similar outcomes. This protocol details the methods used to examine the effects of a group yoga program, as compared to a group low-impact exercise, on primary and secondary outcomes in adults with chronic ABI. Methods This study is a single-blind randomized controlled trial comparing group yoga to group low-impact exercise. Participants must be ≥18 years old with chronic ABI and moderate balance impairments. Group yoga and group exercise sessions occur twice a week for 1 h for 8 weeks. Sessions are led by trained adaptive exercise specialists. Primary outcomes are balance and ANS function. Secondary outcomes are brain function and structure, cognition, quality of life, and qualitative experiences. Data analysis for primary and most secondary outcomes will be completed with mixed effect statistical methods to evaluate the within-subject factor of time (i.e., pre vs. post intervention), the between-subject factor of group (yoga vs. low-impact exercise), and interaction effects. Deductive and inductive techniques will be used to analyze qualitative data. Discussion Due to its accessibility and holistic nature, yoga has significant potential for improving balance and ANS function, along with other capacities, in adults with chronic ABI. Because there are also known benefits of exercise and group interaction, this study compares yoga to a similar, group exercise intervention to explore if yoga has a unique benefit for adults with chronic ABI. Clinical trial registration:ClinicalTrials.gov, NCT05793827. Registered on March 31, 2023.
Evaluating and expanding usability and user satisfaction of an online research portal

Whilst online learning has gained rapid momentum, the development of online technology and practices that support the delivery of online courses with a large research component has been slow. In 2017, the School of Psychological Sciences at Monash University, Australia, developed a potentially scalable and transferable online research portal. This is an all-in-one platform that is designed to facilitate and support online research and research supervision, for supervisors and students. The research portal has evolved to currently provide research and research supervision support to over 700 online psychology students at the university. This paper describes the development, implementation and impact of the research portal and presents data from a preliminary evaluation of its usability and user satisfaction. Both research students and supervisors from the fully online fourth-year Graduate Diploma of Psychology Advanced program at Monash University participated in a series of focus groups, individual usability testing sessions, and surveys, and reported favourably on the research portal’s research supervisor and supervisee user satisfaction and usability. Qualitative and quantitative feedback provided useful information supporting research portal improvement and expansion possibilities, allowing an increasingly valuable contribution to online research supervision, research and research teaching. Implications for practice or policy All research students will be able to complete their research-related professional training online. Research supervisors and students will be able to access a standardised best practice online research supervision and research tool across courses and topics. Course leaders will be able to expand online education with an online research supervision and research tool that supports all research programs. Universities will be able to provide a research learning pathway for all students.
Calculation Model and Method of Gain-Loss Game Distribution Mechanism on Projectile and Target Intersection Confront

Aiming at the problem of damage calculation under the confront game mechanism formed by the projectile and target intersection in the weapon range damage test, this paper proposes a target damage calculation model and method of gain-loss game distribution mechanism on projectile and target intersection confront based on the characteristics of the projectile and target intersection confront game. In this method, the damage of the confront game between the projectile and the target is regarded as the participants of the two-person zero-sum non-cooperative game. According to the gain-loss relationship between the participants of the projectile and the target, we establish a damage assessment calculation model with the confront game between the projectile and the target, and derive the payoff function of the attack-defense game between the projectile and the target. We also establish a target damage calculation model with value / cost index function, determine the value / cost index function of projectile attack target, and give the calculation algorithm of projectile attack target damage based on game theory, and also research the allocation method of projectile attack target based on value / cost index function, at last, give the optimized target damage evaluation system. Through quantitative calculation and analysis, it is found that the effect of target damage is different under different conditions of game strategies, especially the value of value / cost index function is different. The obtained game damage probability presents a random number of Gaussian distribution. When the optimal distribution value is satisfied, the target damage effect is the best, which verifies the scientific type and rationality of the damage calculation model proposed in this paper.
Dazhu Hongjingtian Injection for Ischemic Stroke: Protocol for a Prospective, Multicenter Observational Study

Background Although results from in vitro studies and small randomized controlled trials have shown positive effects of Dazhu hongjingtian injection (DZHJTI) on acute ischemic stroke (AIS), their generalizability to routine clinical practice remains to be established. Objective The primary aim of this study is to evaluate the effectiveness of DZHJTI treatment for AIS with regard to changes in the stroke-related neurological deficit from baseline to outpatient follow-up, mortality, subsequent vascular events, disability, and traditional Chinese medicine syndrome in real-world clinical settings. By monitoring for adverse events or significant changes in vital signs and laboratory parameters, we also aim to assess the safety of DZHJTI. Methods This prospective, multicenter cohort study plans to enroll 2000 patients with AIS within 14 days of symptom onset from 30 hospitals across China. Eligible patients will be followed up for 6 months after initiating medication treatments. The primary outcome will be the change in the National Institute of Health Stroke Scale score from baseline to outpatient follow-up. The secondary outcomes include overall mortality, stroke recurrence, new-onset major vascular events, global disability, and improvement of traditional Chinese medicine syndrome in 6 months. Adverse events or clinically significant changes in vital signs and laboratory parameters, regardless of the severity, will be recorded during the trial to assess the safety of DZHJTI. An augmented inverse propensity weighted estimator will be used to reduce variability and improve accuracy in average treatment effects estimation. Results The clinical trial registration was approved in October 2022, and the recruitment and enrollment of participants started in November 2022. The study’s outcomes are expected to be published in 2025 in reputable, peer-reviewed health-related research journals. Conclusions This real-world cohort study is the first to assess the effectiveness and safety of DZHJTI in treating AIS. It may provide additional clinical evidence, including the duration of response, long-term drug effectiveness, and subgroup efficacy data. The study results will be valuable for clinicians and patients seeking optimal treatment for AIS and could lead to better use of DZHJTI and improved patient outcomes. Trial Registration ITMCTR ITMCTR2022000005; http://tinyurl.com/554ns8m5 International Registered Report Identifier (IRRID) DERR1-10.2196/52447
MFA-UNet: a vessel segmentation method based on multi-scale feature fusion and attention module

Introduction The accurate segmentation of retinal vessels is of utmost importance in the diagnosis of retinal diseases. However, the complex vessel structure often leads to poor segmentation performance, particularly in the case of microvessels. Methods To address this issue, we propose a vessel segmentation method composed of preprocessing and a multi-scale feature attention network (MFA-UNet). The preprocessing stage involves the application of gamma correction and contrast-limited adaptive histogram equalization to enhance image intensity and vessel contrast. The MFA-UNet incorporates the Multi-scale Fusion Self-Attention Module(MSAM) that adjusts multi-scale features and establishes global dependencies, enabling the network to better preserve microvascular structures. Furthermore, the multi-branch decoding module based on deep supervision (MBDM) replaces the original output layer to achieve targeted segmentation of macrovessels and microvessels. Additionally, a parallel attention mechanism is embedded into the decoder to better exploit multi-scale features in skip paths. Results The proposed MFA-UNet yields competitive performance, with dice scores of 82.79/83.51/84.17/78.60/81.75/84.04 and accuracies of 95.71/96.4/96.71/96.81/96.32/97.10 on the DRIVE, STARE, CHASEDB1, HRF, IOSTAR and FIVES datasets, respectively. Discussion It is expected to provide reliable segmentation results in clinical diagnosis.
PENERAPAN MEDIA PEMBELAJARAN BERBASIS CANVA DALAM POKOK BAHASAN PERUBAHAN MATERI PADA KURIKULUM MERDEKA DI KELAS X SMK ABDURRAB PEKANBARU

AbstractThe importance of learning innovation in the Merdeka Curriculum is to ensure that education can keep up with the times and the needs of students in an era that continues to change. The independent curriculum prioritizes freedom of thought and creativity. The purpose of this study was to determine the application of canva-based learning media in the subject of material changes in the independent curriculum in class X of SMK Abdurrab Pekanbaru. This research method uses qualitative methods. Types of descriptive research. This research was conducted at SMK Abdurrab Pekanbaru. The subjects used are grade X students who have implemented an independent curriculum. The result of this research is that Canva application-based learning media can be applied in the subject of material changes in the independent curriculum. The use of the Canva application can be an effective tool to shape the creativity of SMK Abdurrab Pekanbaru students.Keywords: Canva, Curriculum Merdeka, and Material Change
Inorganic scintillator surface enhancements with 2-D photonic crystals to improve light collection

Inorganic scintillators are widely used in various applications of gamma spectroscopy such as nuclear nonproliferation and safeguards, medical applications, space applications, and astronomy. This is due to good energy resolution, stable performance, somewhat low cost, and relatively high detection efficiency. However, many inorganic scintillators have high refractive indices and suffer significant light losses due to total internal reflection (TIR). This project proposes using optimized periodic nanostructures called photonic crystals to recover some of the light originally lost due to TIR. Photonic crystals provide an optical bridge (constructive interference) between the scintillator and the photosensor for the trapped light photons. Improving the light extraction can improve the energy and time resolutions of the scintillator, allowing for a wider range of research and industry applications. Photonic crystals can be optimized in terms of their dimensions, shapes, and materials to maximize the light extraction. Preliminary optimization tests were performed using a LYSO scintillator coupled with Si3N4 photonic crystals. First, a realistic light input source is obtained by simulating the scintillation process in Monte Carlo code Geant4. The simulated scintillation photons are collected at the LYSO-PMT boundary to obtain their energy and angular distributions. In the next step, a deterministic code OptiFDTD is used to simulate light interactions with different nanostructures. Currently, the simulations are limited to 2-D block nanostructures. The optimization tests vary the height, width, and spacing of the photonic crystals. Preliminary optimization tests show an improvement in the light transmission by more than 60%. The optimized geometry will be manufactured in the lab using various manufacturing techniques such as ion milling, electron beam lithography, or 3D printing. Various gamma sources will be used to experimentally characterize the LYSO scintillators with and without photonic crystals. These experiments will also be used to validate the simulations and demonstrate the effectiveness of the photonic crystals in improving the energy resolution. Once validated, the simulations will be used to determine optimized photonic crystals for other inorganic scintillators, such as bismuth germanate, sodium iodide, and lanthanum bromide.
Lung Expansion Therapy for the Potential Populations: A Literature Review

Secretion retention, atelectasis, and reduced lung compliance occur when endotracheal or tracheostomised patients cough ineffectively. There is a possibility of infection if the collapsed regions of the lungs are not reinflated. Therefore, to improve clinical outcomes, such as diaphragm mobility and thickness, lung volume, and thickness of the abdominal muscles, and decrease the length of hospitalizations, mechanical and manual techniques, such as balloon blowing exercises and incentive spirometer, are required. PubMed, Google Scholar, Pedro, Clinical Keys, Helinet, ProQuest, and Science Direct databases were used for the literature search considering the inclusion and exclusion criteria. The several manual and mechanical methods that were employed for lung expansion treatment for the potential populations are highlighted in this overview of the literature. Ten studies were considered in this review: five on balloon-blowing exercises, four on tracheostomy with incentive spirometry exercises, and one on incentive spirometry with balloon-blowing exercises. The effects were examined on individual outcomes that included rate of perceived exertion (RPE), diaphragm mobility, pulmonary function, volume of breath, length of hospitalization, and postoperative day complications. The structured protocols proved to be effective in improving lung expansion and pulmonary function for the potential population that involved healthy adults, noncritical COVID-19 adults, smokers, thoracotomy patients, and tracheostomised patients. The road to recovery is yet unexplored and underachieved because of the lack of evidence.