bluuebunny/crossref_metadata_2025 huggingface dataset:
Validation of an educational comic book to guide conducts in situations of dental trauma
Authors: de Medeiros Claudia Serrado Pereira , Zanin Luciane , Sperandio Marcelo , de Souza Fonseca Silva Almenara , Flório Flávia Martão
Published: October 2023

Background/Aim

Childhood dental trauma poses a prevalent concern, and the limited knowledge of lay caregivers toward the needed immediate actions can adversely affect a child's well‐being. This study aimed to create and validate an educational comic book for lay individuals, designed to guide immediate actions in dental trauma cases, and assess its effects toward enhancing reader knowledge.

Methodology

The four‐stage study involved: (1) Literature review and script development; (2) Version 1 of the comic book creation (including illustrations, layout, and design) and Flesch Readability Index (FI) calculation; (3) Version 1 validation by expert judges, assessed by the Content Validity Index (CVI); (4) Version 1 refinement based on the judges' feedback, recalculation of FI, and a pilot test (CVI) involving lay individuals who validated the final material (Version 2). The validation process involved 67 participants, including 13 specialist judges and 54 elementary school teachers.

Results

The CVI for Version 1 was calculated at 0.89 (89%), indicating a favorable level of agreement on the evaluated criteria. The FI was determined as 91.1%, indicating a high level of readability. The FI for Version 2 was 92.1% (indicating a very easy level of comprehension). The CVI calculated for the target audience after the pilot test was 0.99 (99%), denoting a substantial agreement among the participants. In assessing the level of knowledge, a significant increase was observed in the rate of correct answers after the comic book was read by lay individuals (p < 0.05), inasmuch as the percentage rose from 50.5% before to 81.2% after reading it.

Conclusion

The educational comic book proved valid in terms of readability, appearance, and content. Furthermore, it had a positive impact on gaining the knowledge needed to take the appropriate actions, thus making it a valuable tool for guiding the lay population in cases of dental trauma.
Resource selection by New York City deer reveals the effective interface between wildlife, zoonotic hazards and humans
Authors: VanAcker Meredith C. , DeNicola Vickie L. , DeNicola Anthony J. , Aucoin Sarah Grimké , Simon Richard , Toal Katrina L. , Diuk‐Wasser Maria A. , Cagnacci Francesca
Published: October 2023

Although the role of host movement in shaping infectious disease dynamics is widely acknowledged, methodological separation between animal movement and disease ecology has prevented researchers from leveraging empirical insights from movement data to advance landscape scale understanding of infectious disease risk. To address this knowledge gap, we examine how movement behaviour and resource utilization by white‐tailed deer (Odocoileus virginianus) determines blacklegged tick (Ixodes scapularis) distribution, which depend on deer for dispersal in a highly fragmented New York City borough. Multi‐scale hierarchical resource selection analysis and movement modelling provide insight into how deer's movements contribute to the risk landscape for human exposure to the Lyme disease vector–I. scapularis. We find deer select highly vegetated and accessible residential properties which support blacklegged tick survival. We conclude the distribution of tick‐borne disease risk results from the individual resource selection by deer across spatial scales in response to habitat fragmentation and anthropogenic disturbances.
Reinforcement learning and blockchain‐based intelligent and secure vaccine recommender system
Authors: Sreenu M. , Gupta Nitin , Jatoth Chandrashekar , Gupta Deepak
Published: October 2023

By combining blockchain technology (BT) and reinforcement learning (RL), the proposed work addresses the difficulties associated with vaccine recommendations. The need for individualized recommendations is obvious as vaccine schedules become more complicated and there are more vaccines available. The proposed work presents a novel approach that combines the adaptability of RL with the security, privacy, and transparency of BT. Layers for data processing, application, consensus, and smart contracts are included in the system architecture. It provides user‐managed secure access, individualized vaccine recommendations, and decentralized data storage. The system aims to improve public health outcomes by using smart contracts to automate procedures and RL to improve recommendations. Using 10‐fold cross‐validation on the Vaccine Adverse Event Reporting System (VAERS) dataset, the experimental study verifies the performance of the system. The study focuses on metrics like accuracy, sensitivity, specificity, and F‐measure when contrasting the proposed model with current solutions. The ability of proposed model to offer precise and well‐informed vaccine recommendations is demonstrated by its consistent outperformance of competitors in accuracy and sensitivity.
Sphagnum mosses, the impact of disturbances and anthropogenic management actions on their ecological role in CO2 fluxes generated in peatland ecosystems
Authors: Pacheco‐Cancino Patricio A. , Carrillo‐López Rubén F. , Sepulveda‐Jauregui Armando , Somos‐Valenzuela Marcelo A.
Published: October 2023

Mosses of the genus Sphagnum are the dominant vegetation in most pristine peatlands in temperate and high‐latitude regions. They play a crucial role in carbon sequestration, being responsible for ca. 50% of carbon accumulation through their active participation in peat formation. They have a significant influence on the dynamics of CO2 emissions due to an efficient maximum potential photosynthetic rate, lower respiration rates, and the production of a recalcitrant litter whose decomposition is gradual. However, various anthropogenic disturbances and land use management actions that favor its reestablishment have the potential to modify the dynamics of these CO2 emissions. Therefore, the objective of this review is to discuss the role of Sphagnum in CO2 emissions generated in peatland ecosystems, and to understand the impacts of anthropogenic practices favorable and detrimental to Sphagnum on these emissions. Based on our review, increased Sphagnum cover reduces CO2 emissions and fosters C sequestration, but drainage transforms peatlands dominated by Sphagnum into a persistent source of CO2 due to lower gross primary productivity of the moss and increased respiration rates. Sites with moss removal used as donor material for peatland restoration emit twice as much CO2 as adjacent undisturbed natural sites, and those with commercial Sphagnum extraction generate almost neutral CO2 emissions, yet both can recover their sink status in the short term. The reintroduction of fragments and natural recolonization of Sphagnum in transitional peatlands, can reduce emissions, recover, or increase the CO2 sink function in the short and medium term. Furthermore, Sphagnum paludiculture is seen as a sustainable alternative for the use of transitional peatlands, allowing moss production strips to become CO2 sink, however, it is necessary to quantify the emissions of all the components of the field of production (ditches, causeway), and the biomass harvested from the moss to establish a final closing balance of C.
An Agricultural Package for MODFLOW 6 Using the Application Programming Interface
Authors: Larsen Joshua D. , Langevin Christian D. , Hughes Joseph D. , Niswonger Richard G.
Published: October 2023

An agricultural water use package has been developed for MODFLOW 6 using the MODFLOW Application Programming Interface (API). The MODFLOW API Agricultural Water Use Package (API‐Ag) was based on the approach to simulate irrigation demand in the MODFLOW‐NWT and GSFLOW Agricultural Water Use (AG) Package. The API‐Ag Package differs from the previous approach by implementing new features and support for additional irrigation providers. New features include representation of deficit and over‐irrigation, Multi‐Aquifer Well and Lake Package irrigation providers, and support for structured, vertex, and unstructured grid models. Three example problems are presented that demonstrate how the API‐Ag Package improves representation of highly managed systems and are further used to validate the irrigation demand and delivery formulations. Irrigation volumes simulated in the three example problems show excellent agreement with the MODFLOW‐NWT AG Package.
Effect of diamond volume fraction on the microstructure and mechanical properties of SPS WC–Co/diamond composites
Authors: Pirmohammadi Parinaz , Zakeri Mohammad , Razavi Mansour , Nikzad Leila
Published: October 2023

In this research, the effect of the volume percentage of diamond additive on the sintering behavior, microstructure, and mechanical properties of WC–Co was investigated. WC–Co/diamond composites with different percentages of 0%, 2.5%, 5%, 7.5%, and 10% by volume of diamond were made by spark plasma sintering at 1300°C and 40 MPa for 5 min. A small amount of phase transformation from the diamond phase to the graphite phase was observed. The amount of graphitization was low due to low temperature and short sintering time. The addition of diamond leads to a significant enhancement in both the hardness and fracture toughness of the composites, overcoming the trade‐off between hardness and toughness typically observed in WC‐based materials. The sample reinforced with 5% by volume of diamond showed simultaneously the highest hardness (22.9 GPa), the highest fracture toughness (22.7 MPa m1/2), and the highest flexural strength (1896 MPa). The uniform dispersion, good bonding of the superhard diamond phase with the matrix, and the fine microstructure caused the high hardness and toughness of composite. The main effective mechanisms in increasing the fracture toughness of the composite were crack deflection, bridging, and blocking of crack propagation by diamond particles.
People's Advertising in China: A Longitudinal Content Analysis of the People's Daily Since 1949
Authors: Swanson Lauren A.
Published: October 2023

The number of advertisements in the People's Daily newspaper has increased, as has the proportion of advertisements whose objective is to introduce new Chinese industrial products targeted towards corporate audiences. Also consistent with modernization and marketization efforts, there are more foreign advertisers and a wider variety of written and visual execution styles.
Perspectives on Advertising From the Geographical Literature: A Critical Review
Authors: Nevett Terence , Porter Gina
Published: October 2023

In recent years, geographers have been devoting increasing attention to the field of advertising, and in particular to advertising imagery. The authors of this article offer a critical review of articles with substantial advertising content that have appeared in geography journals, and assess their relevance to advertising practitioners, scholars and students. These writings are reviewed under three headings: considerations of place and space; issues related to gender and race, and aspects of international advertising. Although many geographers are critical of advertising, there is nevertheless much in their work to interest an advertising readership.
Immigrant Trajectories through the Rural‐Industrial Transition in Wales and the United States, 1795–1850
Authors: Knowles Anne Kelly
Published: October 2023

This essay offers the first detailed geographical analysis of Welsh emigration and settlement in the United States in the first half of the nineteenth century. The analysis is based upon the wealth of geographical and historical information contained in 1,771 immigrant obituaries. They show that Welsh emigration was a predominantly rural phenomenon up to mid‐century, although emigration from industrial South Wales had begun by 1830 and important industrial settlements were well‐established in the States by 1850. These data also reveal distinctive regional historical geographies of emigration. The second half of the essay compares the spatial and social characteristics of rural and industrial migration by tracing patterns of internal migration in Wales and the United States and by examining the life‐paths of four individual migrants. This evidence suggests that many rural Welsh had some contact with industry and that their transition from an agricultural to an industrial way of life was more complex and prolonged than other studies have shown. In conclusion, the essay points to the need for further study of the rural‐industrial transition as a key aspect of the development of capitalism in rural places.
A Reconsideration of Personal Boundaries in Space‐Time
Authors: Adams Paul Channing
Published: October 2023

An appropriate image of the person for geographers is an entity with fluctuating boundaries that reach through space and time in constantly changing patterns. Such extensions through space and time are not merely “internal” or psychological states of being in the world; they are integral to economic, political, and cultural processes. Human extensibility is fundamental to the ongoing processes of social structuration in which social practices are constitutive of social structures and social structures constrain persons and practices. Whereas the body is a point‐entity located at a particular space‐time, important aspects of personhood are not confined to this point entity. Authority depends on ranges of sensation, knowledge, and action through diverse communication systems. While extensibility is partly determined by the body, as categorized by society, the distinction between presence and absence can be considered as a gradation rather than a binary opposition. Extensibility transcends the body, allowing a person to overcome social and physical limitations and to participate in distant social contexts which affect his or her personal situation and shape social processes.
Encapsulation of the cobra cytotoxin P4 in liposomes
Authors: Matyas Chaim A. , Borkow G. , Ovadia M.
Published: October 2023

Cytotoxin P4 isolated from the venom of the cobra Naja nigricollis nigricollis was encapsulated in liposomes by the reverse‐phase evaporation method using phosphatidylcholine, cholesterol and phosphatidylethanolamine at molar ratios of 3:1:1. Cytotoxicity examination on murine melanoma B16F10 revealed that the activity of the entrapped cytotoxin did not change significantly and remained stable for at least 1 year at 4 degrees C without any significant leak from the liposomes (< 1%). Moreover, the activity of the cytotoxic liposomes was 20‐fold higher towards human erythrocytes. Whereas 45 micrograms of the free cytotoxin/ml were needed for total haemolysis, the cytotoxic liposomes brought about the same effect at cytotoxin concentrations of 2‐2.5 micrograms/ml, indicating the potential of the liposomes as a delivery system for the snake toxin.
Production of bovine‐pancreatic‐trypsin‐inhibitor homologues in Escherichia coli and their characterization
Authors: JA Chesshyre , JA Kraunsoe , Lowe G.
Published: October 2023

Biologically active bovine pancreatic trypsin inhibitor (BPTI) was produced in Escherichia coli using an OmpA leader‐peptide fusion‐protein system, and BPTI homologues were generated by cassette mutagenesis. Amino acids in the reactive loop of alpha 1‐proteinase inhibitor (alpha 1‐PI) were incorporated into the reactive loop of BPTI in a stepwise approach such that the contribution of individual amino acids could be assessed. The introduction of mutations into BPTI diminished the yield of heterologous protein relative to wild‐type BPTI. However, for three BPTI homologues sufficient material was isolated to allow characterization of the proteins by electrospray MS and N‐terminal peptide sequencing.
Biochemical characterization of the recombinant Boophilus microplus Bm86 antigen expressed by transformed Pichia pastoris cells
Authors: Montesino R. , Cremata J. , Rodriguez M. , Besada V. , Falcon V. , de La Fuente J.
Published: October 2023

In the present paper we report the biochemical characteristics of the recombinant tick (Boophilus microplus) gut antigen Bm86 that previously has been cloned, expressed and recovered at high levels in the methylotrophic yeast Pichia pastoris. The results demonstrate that rBm86 had a modification at position 92 (Thr replaced by Ile) and aggregated, forming particles ranging between 17 and 40 nm. The rBm86 was N‐glycosylated, having at least two non‐glycosylated sequons (Asn‐329 and Asn‐363) and a ratio of only 0.4/65 (free Cys/total Cys)/mol of protein.
Expression in Escherichia coli of thermostable elongation factor 1 alpha from the archaeon Sulfolobus solfataricus
Authors: Ianniciello G. , Masullo M. , Gallo M. , Arcari P. , Bocchini V.
Published: October 2023

The elongation factor 1 alpha from the archaeon Sulfolobus solfataricus (SsEF‐1 alpha) was expressed in Escherichia coli and purified. The SsEF‐1 alpha gene was amplified by PCR and cloned in the Ndel site of the pT7‐7 expression vector, under the control of the promoter of T7 RNA polymerase. Upon induction with isopropyl beta‐D‐thiogalactopyranoside, the recombinant SsEF‐1 alpha (recSsEF‐1 alpha) was purified from the E. coli S‐100 extract by a two‐step procedure. From 1 litre of cell culture, about 2 mg of purified recSsEF‐1 alpha was obtained. The N‐terminal sequence of the first 30 amino acid residues of recSsEF‐1 alpha was identical with that translated from the nucleotide sequence of the corresponding gene, except for the initial residue, which in recSsEF‐1 alpha was Ser instead of Met. The M(r) of recSsEF‐1 alpha (determined by electrospray MS) was almost coincident with that of the naturally occurring SsEF‐1 alpha (SsEF‐1 alpha). The thermal‐inactivation and thermophilicity profiles of SsEF‐1 alpha and recSsEF‐1 alpha were identical. Concerning the functional properties, recSsEF‐1 alpha was able to support poly(Phe) synthesis in vitro, to bind GDP and GTP and to elicit an NaCl‐dependent GTPase activity [Masullo, De Vendittis and Bocchini (1994) J. Biol. Chem. 269, 20376‐20379] with the same efficiency as that displayed by SsEF‐1 alpha.
A sensitive assay for the quantification of reverse transcriptase activity based on the use of carrier‐bound template and non‐radioactive‐product detection, with special reference to human‐immunodeficiency‐virus isolation
Authors: DH Ekstrand , RJ Awad , CF Kallander , JS Gronowitz
Published: October 2023

A non‐radioactive 96‐well microtitre plate reverse transcriptase (RT) assay, based on the use of covalently bound riboadenosine homopolymer in the wells and 5‐bromodeoxyuridined 5′‐triphosphate (BrdUTP) as dNTP, is described. The whole assay is performed in a single well, including the quantitative detection of incorporated BrdU, which is performed immunologically using alkaline phosphatase‐conjugated anti‐BrdU antibody and colorometric reading. The system also allows the use of variable amounts of primer. The kinetics and characteristics of the assay using BrdUTP is similar to the use of [3H]dTTP. The sensitivity of the assay can be varied either by altering the duration of RT assay time and/or by prolonging the alkaline phosphatase reaction. Thus the assay can detect < 0.02 pg of recombinant human‐immunodeficiency‐virus (HIV) type I RT, < 0.005 m unit of avian‐myeloblastosis‐virus RT or < 0.02 m unit of recombinant Moloney‐murine‐leukaemia‐virus RT. The assay was found to be useful with various types of cell‐culture material, and a comparative study of 16 HIV‐infected lymphocyte cultures, using 10 microliters of supernatant medium for RT assay and 22.5 microliters for p24 antigen assay showed that the new RT assay was at least 25‐fold more sensitive than the p24 antigen assay. The results also show a good correlation between the RT activities found and the p24‐antigen level detected, with exception for HIV2 isolates, as they only became positive in the RT assay. The technical performance and the capacity of the test compared with other available RT kits is discussed, as well as its use for other applications.
Characterization of aggregates of recombinant human factor VIII by size‐exclusion chromatography and immunoassay
Authors: Cho Y. , Garanchon C. , Kashi R. , Wong C. , MJ Besman
Published: October 2023

The presence of aggregates of Factor VIII (FVIII) was assessed for a highly purified form (rFVIII) and for the formulated preparation containing human serum albumin (rFVIIIf). Size‐exclusion chromatography (SEC) on Sepharose CL‐6B and TSK 4000 matrices under native conditions revealed < 1% aggregates of FVIII in either rFVIII or rFVIIIf, as determined by FVIII immunoassay of chromatographic fractions. No degradation products were observed. The immunoassay was capable of detecting FVIII immunoreactivity to levels of approximately 5 ng/ml. Overlap of FVIII clotting (FVIII:c) and immunoassay (FVIII:cAg) activities was observed for SEC fractions. Heat stressing of rFVIIIf (47.5 degrees C for 24 h) resulted in a quantitative increase in FVIII‐positive material in the void volume of a TSK 4000 column, demonstrating that aggregates of FVIII can be produced and detected by this method. We conclude that aggregates of FVIII in rFVIII and rFVIIIf constitute < or = 1% by the method described.
In vitro immunization of murine lymphocytes using immobilized immunogens
Authors: NS Geeta , Ramanadham M.
Published: October 2023

Murine splenic lymphocytes were immunized in vitro using immobilized antigens. Immobilization was achieved by covalently linking the antigens to Sepharose beads. Tetanus toxoid (TT) was used as test antigen in soluble and immobilized forms. The outcome of in vitro immunization was assayed in terms of the number of antigen‐specific antibody‐forming cells (AFCs) enumerated by filter immuno plaque assay. The AFC specific to TT were significantly higher in cultures stimulated with immobilized antigen as compared with soluble antigen. The effect of various concentrations of antigen, time kinetics, effect of serum, and leucyl‐leucine O‐methyl ester treatment on the in vitro‐immunization system has been studied. The results indicate that immobilized antigens are more potent than their soluble counterparts in vitro and hence are useful in in vitro‐immunization protocols.
39 Years of Suicide Research: A Personal View
Authors: Murphy George E.
Published: October 2023

This is a personal account of the beginning of clinical research in suicide in a hostile intellectual climate, of the methodology that has informed most of the subsequent research, and of the very durable findings of that work over 12 replications. The genius of the late Dr. Eli Robins lies at the base, not only of this research methodology, but of the diagnostic system that gives it clinical meaning. All of this is now commonplace, but it was not always so.
On the Nature, Magnitude, and Causality of Suicidal Behaviors: An International Perspective
Authors: Diekstra Rene F. W. , Garnefski Nadia
Published: October 2023

The central questions addressed in this paper are whether present generations of adolescents and adults worldwide are at greater risk of developing suicidal reactions than previous generations were and what the possible causal mechanisms involved are. On the basis of data from international and national data banks as well as an extensive review of the literature, it is concluded that a true increase in suicide mortality and morbidity has occurred over the larger part of this century among the White urban adolescent and young adult populations of North America and Europe, particularly among (young) males over the last three decades. Among the possible causal mechanisms identified are (1) the corresponding increase in the prevalence of depressive disorders; (2) the corresponding increase in the prevalence of substance (ab)use and substance abuse disorders, and a lowering of age of onset of (ab)use; (3) psychobiological changes, in particular the dramatic lowering of the age of puberty; (4) an increase in the number of social stressors with extensive consequences for youth; (5) changes in attitudes towards suicidal behaviors and the related increased availability of suicidal models.
Gender and the Primary Prevention of Suicide Mortality
Authors: Canetto Silvia Sara , Lester David
Published: October 2023

Primary prevention aims at reducing the incidence of a disorder. The first step in primary prevention involves documenting the magnitude of the problem and identifying risk factors. Consistent with primary prevention practices, we review the national and international epidemiological data on suicide mortality and then discuss the implications these data hold for primary prevention. Our approach is novel because we systematically examine the suicide epidemiology data by gender and culture. Suicide mortality appears to be highest among individuals (e.g., young adult married females in some Papua New Guinea regions; older adult, isolated, White males in the United States) for whom such behavior is culturally sanctioned. Thus, an important target for primary prevention may be local cultures of gender and suicide.
Problem Solving, Stress, and Coping in Adolescent Suicide Attempts
Authors: Wilson Keith G. , Stelzer Josef , Bergman James N. , Kral Michael J. , Inayatullah Mohamed , Elliott Catherine A.
Published: October 2023

Twenty adolescents who had made suicide attempts were compared with 20 nonpsychiatric control subjects on measures of problem solving, stress, and coping. The suicidal group did not show evidence of “rigid” thinking or of deficits in the ability to generate solutions to standardized interpersonal problems. However, they did report recent histories of more severe life stress and had inaccurate appraisal of the extent to which stressful events could be controlled. Although suicidal patients were able to generate as many adaptive strategies as control subjects for coping with their own most severe recent real‐life stressor, they actually used fewer. They were also more likely to identify maladaptive behaviors as ways of coping. These findings support a transactional model of adolescent suicidal behavior, whereby inaccuracies in the appraisal aspects of problem solving (but not in the solution‐generation aspects) in the face of high life stress lead to a reduction in the use of adaptive efforts to cope.
Cephalometric analysis performance discrepancy between orthodontists and an artificial intelligence model using lateral cephalometric radiographs
Authors: Guinot‐Barona Clara , Alonso Pérez‐Barquero Jorge , Galán López Lidia , Barmak Abdul B. , Att Wael , Kois John C. , Revilla‐León Marta
Published: October 2023

Purpose

The purpose of the present clinical study was to compare the Ricketts and Steiner cephalometric analysis obtained by two experienced orthodontists and artificial intelligence (AI)‐based software program and measure the orthodontist variability.

Materials and Methods

A total of 50 lateral cephalometric radiographs from 50 patients were obtained. Two groups were created depending on the operator performing the cephalometric analysis: orthodontists (Orthod group) and an AI software program (AI group). In the Orthod group, two independent experienced orthodontists performed the measurements by performing a manual identification of the cephalometric landmarks and a software program (NemoCeph; Nemotec) to calculate the measurements. In the AI group, an AI software program (CephX; ORCA Dental AI) was selected for both the automatic landmark identification and cephalometric measurements. The Ricketts and Steiner cephalometric analyses were assessed in both groups including a total of 24 measurements. The Shapiro–Wilk test showed that the data was normally distributed. The t‐test was used to analyze the data (α = 0.05).

Results

The t‐test analysis showed significant measurement discrepancies between the Orthod and AI group in seven of the 24 cephalometric parameters tested, namely the corpus length (p = 0.003), mandibular arc (p < 0.001), lower face height (p = 0.005), overjet (p = 0.019), and overbite (p = 0.022) in the Ricketts cephalometric analysis and occlusal to SN (p = 0.002) and GoGn‐SN (p < 0.001) in the Steiner cephalometric analysis. The intraclass correlation coefficient (ICC) between both orthodontists of the Orthod group for each cephalometric measurement was calculated.

Conclusions

Significant discrepancies were found in seven of the 24 cephalometric measurements tested between the orthodontists and the AI‐based program assessed. The intra‐operator reliability analysis showed reproducible measurements between both orthodontists, except for the corpus length measurement.

Clinical Significance

The artificial intelligence software program tested has the potential to automatically obtain cephalometric analysis using lateral cephalometric radiographs; however, additional studies are needed to further evaluate the accuracy of this AI‐based system.
A behavioural driving model of adherence to home‐based cardiac rehabilitation exercise among patients with chronic heart failure: A mixed‐methods study
Authors: Yang Zhen , Jia Honghong , Zhang Fengpei , Huang Hao , Hao Xinyi , Wang Aiping
Published: October 2023

Aims and Objectives

To develop and validate a behavioural driving model for adherence to home‐based cardiac rehabilitation exercise in patients with chronic heart failure, and to explain the potential driving mechanism of social support on exercise adherence.

Background

Despite the benefits of home‐based cardiac rehabilitation exercise, adherence among patients with chronic heart failure remains suboptimal. Several factors contributing to adherence have been confirmed; however, the specific pathway mechanisms by which these factors impact exercise adherence have not been thoroughly explored.

Design

An exploratory sequential mixed‐methods study was conducted in this study.

Methods

A total of 226 patients with chronic heart failure were recruited using convenience sampling. Quantitative data were collected using a series of self‐report questionnaires. Hierarchical regression analysis was performed to verify multiple pathways. Subsequently, 12 patients with chronic heart failure were drawn from the quantitative stage. The interview data were thematically analysed. This study followed the Good Reporting of a Mixed Methods Study (GRAMMS) guidelines (Appendix S1).

Results

Perceived social support had a direct positive predictive effect on exercise adherence. Importantly, exercise self‐efficacy and exercise fear played a chain‐mediating role between perceived social support and exercise adherence. As a result of the qualitative phase, scale, tightness and homogeneity of social support networks emerged as potential drivers of the effectiveness of social support on exercise adherence.

Conclusions

This study reveals a potential pathway mechanism for social support to improve adherence to home‐based cardiac rehabilitation exercises. Social support network plays a crucial role in the effect of social support on exercise adherence.

Relevance to Clinical Practice

To enhance exercise adherence in home‐based cardiac rehabilitation for patients with chronic heart failure, establishing a social support network is recommended. This strategy has the potential to promote exercise self‐efficacy and alleviate exercise fear.

Patient or Public Contribution

None.
Sedentary Behavior and Physical Inactivity Among Secondary School Students in the 2017 Sierra Leone Global School‐Based Student Health Survey
Authors: Starks Kristen S. , Kamara Dauda , Jacobsen Kathryn H.
Published: October 2023

BACKGROUND

The 2020 World Health Organization Guidelines on Physical Activity and Sedentary Behavior are the first to provide evidence‐based recommendations for reducing both dimensions of languorous behavior. The relationship between sitting time and exercise remains understudied among diverse adolescent populations worldwide.

METHODS

The 2017 Sierra Leone Global School‐based Student Health Survey was a nationally representative cross‐sectional study of secondary school students.

RESULTS

Of the 2798 participants, 82% did not engage in moderate or vigorous physical activity for at least an hour every day, 25% sat for 3 or more hours each day outside of school and homework, and 87% were physically inactive and/or sedentary based on those thresholds. Girls who never or rarely exercised tended to maintain light physical activity outside of school rather than sitting, while boys who exercised daily tended to be sedentary when they were not playing sports.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY

Students spend their waking hours doing a mix of sitting, light physical activity, and moderate or vigorous physical activity. Schools can help reduce sedentarism and increase movement among students.

CONCLUSIONS

Home, school, and community health interventions may be useful for increasing energy expenditure among adolescents in low‐ and middle‐income countries.
Rheological and thermal properties of an enteral nutrition formula for nutritional support patients using a combined mixture of gelatin and maltodextrin
Authors: Bazrafshan Sara , Mizani Maryam , Pazuki Gholamreza , Shahriari Shahla
Published: October 2023

Enteral nutrition is a type of nutritional support that provides the necessary sources of energy and protein for patients who suffer from dysphagia, chronic disease, and loss of appetite. In this study, a gelatin‐maltodextrin binary biopolymer system has been incorporated into a semi‐solid formula. The I‐optimal combination design approach was used to create 19 formulations, and the dynamic rheological properties, dynamic laser scattering, and zeta potential responses were evaluated over 30 days of storage at 5°C. Solid viscoelastic behavior has been approved since G′ > G″ in the frequency sweep test with no cross‐over point. Maltodextrin may interfere within the gelatin network, and increasing the maltodextrin to gelatin (from 0.14 to 1) may lead to a wider linear viscoelastic (LVE) strain range (2.16%), a lower storage modulus at LVE (52%), a lower yield stress (46%), and a lower glass transition temperature (34%). The presence of maltodextrin may reduce the temperature of the sol‐to‐solid transformation by 48% and enhance its flexibility. In contrast, increasing the gelatin‐to‐maltodextrin ratio following melting at 37°C led to an increase in the cumulant mean and polydispersity index, indicating a relatively unstable system. The range of zeta potential values between −4.4 and 1.7 mV confirmed a tendency toward coagulation. Microscopic images revealed instability because of irregular or compact chains formed in the gelatin matrix by using higher amounts of maltodextrin. Finally, the best formula had the best rheological stability and was suitable for tube‐feeding patients, with a gelatin‐to‐maltodextrin ratio of 4.35:3.64% w/w on day 17.4.
Selective dysfunction of the crural diaphragm in patients with chronic restrictive and obstructive lung disease
Authors: Joshua Jisha , Pathak Chetna , Zifan Ali , Chen Ruohui , Malhotra Atul , Mittal Ravinder K.
Published: October 2023

Background

Gastroesophageal reflux (GER) is known to be associated with chronic lung diseases. The driving force of GER is the transdiaphragmatic pressure (Pdi) generated mainly by costal and crural diaphragm contraction. The latter also enhances the esophagogastric junction (EGJ) pressure to guard against GER.

Methods

The relationship between Pdi and EGJ pressure was determined using high resolution esophageal manometry in patients with interstitial lung disease (ILD, n = 26), obstructive lung disease (OLD, n‐ = 24), and healthy subjects (n = 20).

Key Results

The patient groups did not differ with respect to age, gender, BMI, and pulmonary rehabilitation history. Patients with ILD had significantly higher Pdi but lower EGJ pressures as compared to controls and OLD patients (p < 0.001). In control subjects, the increase in EGJ pressure at all‐time points during inspiration was greater than Pdi. In contrast, the EGJ pressure during inspiration was less than Pdi in 14 patients with ILD and 7 patients with OLD. The drop in EGJ pressure was usually seen after the peak Pdi in ILD group (p < 0.0001) and before the peak Pdi in OLD group, (p = 0.08). Nine patients in the ILD group had sliding hiatus hernia, compared to none in control subjects (p = 0.003) and two patients in the OLD, (p = 0.04).

Conclusions and Inferences

A higher Pdi and low EGJ pressure, and dissociation between Pdi and EGJ pressure temporal relationship suggests selective dysfunction of the crural diaphragm in patients with chronic lung diseases and may explain the higher prevalence of GERD in ILD as seen in previous studies.
Medullary bundles in Caryophyllales: form, function, and evolution
Authors: Cunha Neto Israel L. , Rossetto Elson Felipe S. , Gerolamo Caian S. , Hernández‐Gutiérrez Rebeca , Sukhorukov Alexander P. , Kushunina Maria , Melo‐de‐Pinna Gladys F. A. , Angyalossy Veronica
Published: October 2023

The occurrence of conducting vascular tissue in the pith (CVTP) of tracheophytes is noteworthy. Medullary bundles, one of the remarkable examples of CVTP, evolved multiple times across angiosperms, notably in the Caryophyllales. Yet, information on the occurrence of medullary bundles is fragmented, hampering our understanding of their structure–function relationships, and evolutionary implications.

Using three plastid molecular markers (matK, rbcL, and rps16 intron), a phylogeny is constructed for 561 species of Caryophyllales, and anatomical data are assembled for 856 species across 40 families to investigate the diversity of medullary bundles, their function, evolution, and diversification dynamics. Additionally, correlated evolution between medullary bundles and successive cambia was tested.

Medullary bundles are ancestrally absent in Caryophyllales and evolved in core and noncore families. They are structurally diverse (e.g. number, arrangement, and types of bundles) and functionally active throughout the plant's lifespan, providing increased hydraulic conductivity, especially in herbaceous plants. Acquisition of medullary bundles does not explain diversification rate heterogeneity but is correlated to a higher diversification rate.

Disparate developmental pathways were found leading to rampant convergent evolution of CVTP in Caryophyllales. These findings indicate the diversification of medullary bundles and vascular tissues as another central theme for functional and comparative molecular studies in Caryophyllales.
The efficacy of oral corticoids in treating complex regional pain syndrome: A retrospective cohort study
Authors: van den Berg Corinne , Huygen Frank J. P. M. , Tiemensma Jitske
Published: October 2023

Objectives

There is growing evidence supporting the role of inflammatory mechanisms in complex regional pain syndrome (CRPS). Corticoids, as most effective anti‐inflammatory drugs, are widely used in treating inflammation. The aim of this study was to retrospectively assess the efficacy of oral corticoid treatment in CRPS patients.

Methods

Patients treated at the center of pain medicine in the Erasmus University Medical Centre between January 2015 and January 2020 were approached to partake in this study. Medical records were screened for age, gender, medical history, duration of CRPS, and CRPS severity score. Also, treatment effect, dose and duration, pain scores (NRS), and side effects were extracted from medical records. In addition, global perceived effect was completed in patients treated with corticoids.

Results

Between January 2015 and January 2020, twenty‐nine CRPS patients received corticoids and met the inclusion criteria. One extreme outlier was excluded and treatment effect was unknown for one patient. Average daily dose was 28.9 mg (range 10–30 mg) and the mean treatment duration was 10.5 days (7–21 days). Fourteen patients (51.9%) responded positively to treatment and thirteen (48.1%) did not respond. Side effects were reported in five patients (17.9%).

Conclusions

Corticoid treatment was effective in more than half of the patients. With only mild side effects reported the treatment also appears to be relatively safe. Further research is needed to investigate the efficacy of corticoids in treating (early) CRPS, preferably in an intervention study.
Polydopamine‐curcumin coating of titanium for remarkable antibacterial activity via synergistic photodynamic and photothermal properties
Authors: Guo Qing , Li Peiyuan , Zhang Ying , Yan Hongjun , Yan Qiuyan , Su Rixiang , Su Wei
Published: October 2023

Combined photothermal therapy (PTT) and photodynamic therapy (PDT) has emerged as a novel and effective antibacterial strategy. In order to endow titanium (Ti) with antibacterial properties, the Ti‐PDA‐Cur composite was prepared using the excellent adhesion properties of polydopamine (PDA) to load curcumin (Cur) on the surface of Ti. The Ti‐PDA‐Cur coating can produce singlet oxygen (1O2) and heat under 405 + 808 nm light irradiation, which can effectively kill Staphylococcus aureus and Escherichia coli. Moreover, the cytotoxicity and hemolysis rate of Ti‐PDA‐Cur were low, indicating its good biocompatibility. Therefore, this study provided a new strategy for the development of new Ti implants.
Kripke's knowledge argument against materialism
Authors: Renero Adriana
Published: October 2023

In his unpublished 1979 Lectures on the Philosophy of Mind, Saul Kripke offers a knowledge argument against materialism focusing on deaf people who lack knowledge of auditory experience. Kripke's argument is a precursor of Frank Jackson's better‐known knowledge argument against materialism (1982). The paper sets out Kripke's argument, brings out its interest and philosophical importance, and explores some similarities and differences between Kripke's knowledge argument and Jackson's.
Recovery of a Halodule wrightii donor meadow
Authors: Torres‐Conde Eduardo Gabriel , Alvarez‐Rocha Mariana , Lindig‐Cisneros Roberto , van Tussenbroek Brigitta I.
Published: October 2023

Few restoration studies have quantified the recovery of the donor meadow. We evaluated the recovery of a monospecific donor meadow of Halodule wrightii, the second most commonly used transplanting species, and assessed the possible effect of 24 plots of 1 m2 placed in an approximately 3,400 m2 large monospecific meadow with a mean cover of 45%, foliar shoot density of 1,280 shoots/m2, and 16 cm canopy height. Extraction densities were 9, 25, 64, and 121 small‐sized extraction cores (4.5 cm diameter, 20 cm depth), with control and procedural control without extractions (N = 4 per treatment). After 6 months, even the plots with the highest extraction densities recovered, as indicated by the shoot number in the extraction areas and seagrass cover in the plots approaching the levels in the controls. The recovery occurred under the environmental conditions: light availability (22,000 ± 51 lx), relatively stable sediments (0.8–1.16 cm) with a fine sandy composition (mean grain diameter, D50: 0.5 ± 0.22 mm), and low organic matter (0.22 ± 0.012%). The recolonization rate was 1–3 shoots per month in the 4.5 cm diameter extraction areas, independent of the extraction level. Thus, approximately 20% of the H. wrightii meadow (corresponding with 121 cores/m2) could be extracted in our study area. This high extraction intensity can be attributed to the adequate selection of donor species, meadow, and size of the planting unit.
Effects of repeated sediment bypassing on stream ecosystems in a Japanese mountainous river
Authors: Sueyoshi Masanao , Miyagawa Yukio , Onoda Yukio , Hotta Taiki , Kayaba Yuichi , Nakamura Keigo
Published: October 2023

Sediment bypassing connects the upstream and downstream regions of dam impoundments through tunnels and is expected to partly restore natural processes (flood pulse and sediment regime) in dam‐altered river ecosystems. However, few reports examined the effects of restoration on stream biota. We examined the effectiveness of repeated sediment bypassing (12 times) over a period of 5 years in a Japanese dammed river using a before‐after‐reference‐impact design. We compared the abiotic parameters (water quality and substrate environment), biotic assemblages (algae, macroinvertebrates, and fish), and similarities between the dam downstream and undammed reference reaches. The reference sites exhibited high temporal variability in abiotic environments and species composition over the 5‐year period. Most abiotic and biotic parameters downstream of the dam improved and approached those of the changing reference states. However, these indices returned to pretrial conditions after the last trial. Biotic similarities between the downstream and reference reaches gradually increased throughout successive sediment‐bypassing trials for macroinvertebrates and algae; however, these similarities diminished after the last trial. Conversely, the abundance‐based composition of fish assemblages in the restored reach consistently diverged from that of the reference conditions throughout the study period. Our results show that the success and failure of restoration by sediment bypassing may be affected by the amount of bedload in the flushing flows and other regional processes such as migratory connectivity. Sediment bypassing can partially re‐establish natural processes and is a useful tool for improving sediment‐associated environments and biota.
Case report of an extra‐oral cutaneous sinus tract of endodontic origin in a patient with autism spectrum disorder
Authors: Ruck Patrick , Morris Heather T. , Thikkurissy Sarat
Published: October 2023

Background and Overview

Extraoral cutaneous sinus tracts (EOCST) are often misdiagnosed due to their unexpected appearance without history of odontogenic pain, discomfort, or cellulitis. Diagnosis can be further confounded in those with sensory processing difficulties since patients can have a hypersensitivity to sensory input, but simultaneously demonstrate hyposensitivity and indifference toward pain. EOCST misdiagnosis and resultant mismanagement can lead to multiple surgical excisions, biopsies, and elongated antibiotic regimens, with eventual lesion recurrence.

Case Description

A 19‐year‐old white male with autism spectrum disorder in the period of transitional dental care presented with a history of a chronic EOCST. The patient required sedation for evaluation, biopsy, and was initially managed by infectious disease under the impression of an actinomycosis infection. The patient completed a twelve‐month course of antibiotic therapy with subsequent lesion re‐occurrence. Eventually, the diagnosis of an EOCST of dental origin was confirmed. It was determined that pulpal necrosis was due to localized dental trauma of the lower left central incisor, as a result of a self‐injurious behavior. Root canal treatment eventually led to the resolution of the lesion. It took three years from initial clinical presentation for the resolution of the lesion.

Conclusions and Practical Implications

Collaboration between the medical and dental healthcare team in diagnosis and treatment planning for a patient with special needs is essential to ensure prompt and appropriate care for this patient group.
Forecasting stability and growth pact compliance using machine learning
Authors: Baret Kéa , Barbier‐Gauchard Amélie , Papadimitriou Théophilos
Published: October 2023

The 2011 reform of the Stability and Growth Pact (1996) strengthened the European Commission's monitoring of EU member states' public finance. Failure to comply with the 3% limit on public deficit triggers an audit. In this paper, we present a machine learning based forecasting model for compliance with the 3% limit. We use data from 2006 to 2018 (a turbulent period including the Global Financial Crisis and the Sovereign Debt Crisis) for the 28 EU member states. After identifying 8 features as predictors among 138 variables, forecasting is performed using a support vector machine (SVM) algorithm. The proposed model achieved a forecasting accuracy of nearly 92% and outperformed the logit model used as a benchmark.