bluuebunny/crossref_metadata_2025 huggingface dataset:
Hydrodynamic Model Optimization for Marine Tourism Development Suitability in Vicinity of Poso Regency Coastal Area, Central Sulawesi, Indonesia
Authors: Hermawan Surya , Mihardja Edwin , Pambudi Devian Aryo , Jason Jason
Published: December 2022

Poso regency, Central Sulawesi, Indonesia, has a coastal area that has marine tourism potential to be developed. It is expected that marine tourism can bring socio-economic impact to the com-munity. This research was conducted with the objective of assessing the suitability of the area to be developed as a marine and coastal tourism site to provide benefits to the coastal community. Hydrodynamic model will be used in this research as coastal area mapping. As an approach, Analysis Hierarchy Process (AHP) is utilized whose parameters consist of depth, coast type, coast width, brightness, current speed, water base materials, observation of dangerous biota and availability of fresh water. Based on the overall mapping area of 98,644 ha, the research results show that the area that can be utilized is 7,979 ha with a very suitable category, while there is an area of 1,045 ha which can still be classified in the appropriate category.
DIGITALESCAPE Project. Remote Sensing, New Technologies and Archaeology for the Preservation and Diffusion of the Cultural Heritage at Risk in the Sierra Sur and Sierra Morena Region.
Authors: Villarejo Antonio J. Ortiz , Barrado José M. Delgado
Published: December 2022

The province of Jaén (Andalusia, Spain), despite being declared the European territory with the largest number of defensive constructions (castles and fortifications), has few conservation plans, with many remains included on the Red List of Spanish Heritage lying abandoned. This presents a problem for the conservation of the landscape and the optimal use of the province’s tourism potential. Two actions are proposed to alleviate this situation: The creation of an archaeological and environmental risk chart with which to answer such ques-tions as “How have climate change, anthropic alterations and environmental characteristics af-fected the state of conservation of certain heritage sites?” and to put forward proposals for im-proving their protection using as a basis digital and technological tools, such as remote sensing (SAR), taking advantage of data from the Sentinel 2A and 2B satellites, HBIM, RPAS and GIS. To foster the promotion of smart tourism by digitalising and virtualising tourist routes and ar-chaeological remains by building a Smart Tourism App for mobile devices. Finally, public administrations will be apprised of the need to implement a conservation policy for cultural assets and their surroundings in a simple, quick and cost-effective manner.
A Critical Review on Briquettes Developed from Spent Coffee Ground Wastes
Authors: Srinivasan Gokul Raghavendra , Mahajan Aditya , Seth Rajiv , Mahajan Rakesh
Published: December 2022

Coffee is regarded as the highly consumed beverage throughout the world and has established a key spot in the world economy as an important commodity for trading. In general, they are produced by brewing their roasted and ground beans, which release aromatic coffee; as well as produce an equivalent amount of spent coffee grounds (SCG). Previously, they were discarded as wastes or used as natural pest repellent or garden fertilizer; however, in recent times, are valorized into biofuels owing to their high calorific value. In fact, SCG briquettes have gained wide attention for supplying energy renewably, especially to the rising energy demand; and also have been identified as an effective measure to reduce their pollution. With this in mind, this present chapter focuses on reviewing the availability and chemistry involved in these SCG wastes, pre-treatments and preparations required for their briquetting, compacting techniques followed, and fuel characteristics of their briquettes, from various available works of literature. Here, their availability showcases the amount of SCG wastes generated with respect to time and consumption, wherein understanding their chemistry helps in deciding the pre-treatments necessary for their briquetting. Meanwhile, preparation techniques briefs about the necessary pre-treatments undertaken before compaction by different researchers; and the fuel characteristics define the physicochemical and mechanical properties of their briquettes, developed using various compaction methods. Besides, combustion behaviors of these briquettes are explained in terms of their burning characteristics and emission levels, as reported in literatures; which help in deciding their suitability as a replacement for existing fossil coal. Eventually, all the reported data were in accordance with their permissible standards and suggested these SCG as a highly renewable solid biofuel.
High-Throughput Drug Screening on Borrelia Garinii and Borrelia Afzelii Identified Hypocrellin A as an Active Drug Candidate against Borrelia Species
Authors: Li Tingting , Xin Yuxian , Liu Dongxia , Sun Jingrong , Li Jingwei , Zhang Ying , Feng Jie
Published: December 2022

Lyme disease (LD) is a tick-transmitted infection caused by Borrelia burgdorferi sensu lato species which includes B. burgdorferi, B. afzelii, and B. garinii. The majority of patients with early LD can be cured by standard treatment, yet some still suffer from post-treatment Lyme disease syndrome (PTLDS). The presence of Borrelia persisters has been proposed as a contributing factor, which cannnot be completely killed by the currently used antibiotics for Lyme disease. Finding new pharmaceuticals targeting Borrelia persisters is crucial in developing more effective treatment. Here, we first confirmed the existence of persisters in cultures of B. garinii and B. afzelii and then conducted high-throughput screening of a custom drug library against persister-rich stationary-phase cultures of B. garinii and B. afzelii. Among 2427 compounds screened, hypocrellin A (HA), anthracycline class of drugs, and topical antibiotics along with some other natural compounds were identified to have strong potential in killing persisters of B. garinii and B. afzelii. HA was the most active anti-Borrelia compound, capable of eradicating stationary-phase Borrelia persisters, in particular when combined with doxycycline and/or ceftriaxone. Liposoluble antioxidant vitamin E was found to antagonize the activity of HA, indicating HA’s target is the cell membrane where HA-triggered reactive oxygen species (ROS) generation took place in the presence of light. HA was found to have distinct bactericidal activity against Borrelia species but had poor or no activity against Gram-positive and Gram-negative bacteria. Identification of the above-mentioned drug candidates may help to develop more effective therapies for LD.
Team, Career, and Management: Mental Maps of Working Conditions and Intention to Stay of Physicians in Academic Medicine
Authors: Hasebrook Joachim , Hecke Juliane , Volkert Thomas , Singer Maren , Hinkelmann Jürgen , Michalak Leonie , Hahnenkamp Klaus
Published: December 2022

Job satisfaction has a strong impact on the intention to stay which is an important aspect to counter skills shortage in academic medicine. In an interview study combining qualitative and quantitative methods we investigated how the mental representation of working conditions influences job satisfaction and its impact on the intention to stay. In a first study chief physicians participated in interviews about job satisfaction in academic hospitals. Answers were segmented into statements, ordered by topics and rated according to their valence. In a second study assistant physicians (residents) during and after their training period talked about strength, weaknesses and potential improvements of working conditions. Again, answers were segmented, ordered, rated and used to develop a ‘job satisfaction scale’. In a third study, assistant physicians participated in a computer-led repertory grid procedure composing ‘mental maps’ of job satisfaction factors, filled in the job satisfaction scale and rated if they would recommend work and training in their clinic as well as their intention to stay. Comparing the interview results with recommendation rates and intention to stay show that a negative attitude is linked to high workload and poor career perspectives. A positive attitude towards work environment and high intention to stay are linked to sufficient personnel and technical capacities, reliable duty scheduling and fair salaries. The third study using repertory grids showed that the perception of current teamwork and future developments concerning work environment were the main aspects to improve job satisfaction and the intention to stay. The results of the interview studies were used to develop an array of adaptive improvement measure. The results support prior findings that job dissatisfaction is mostly based on generally known “hygiene factors” and whereas job satisfaction is due to individual aspects.
Solving STODS - Surgical Temporary Ocular Discomfort Syndrome
Authors: Hirabayashi Matthew , Barnett Bradley P.
Published: December 2022

The term STODS (Surgical Temporary Ocular Discomfort Syndrome) has been coined to describe the ocular surface perturbations induced by surgery. As one of the most important refractive elements of the eye, Guided Ocular Surface and Lid Disease (GOLD) optimization is fundamental to success in achieving refractive outcomes and mitigating STODS. Effective GOLD optimization and the prevention/treatment of STODS, requires an understanding of the molecular, cellular and anatomic factors that influence ocular surface microenviroment and the associated perturbations induced by surgical intervention. By reviewing the current understanding of STODS etiologies, we will attempt to outline a rationale for a tailored GOLD optimization depending on the ocular surgical insult. With a bench to bedside approach, we will highlight clinical examples of effective GOLD perioperative optimization can mitigate STODS deleterious effect on preoperative imaging and postoperative healing.
The Right Opera at the Wrong Time: The Tender Land, Aaron Copland, and the Red Scare
Authors: Crawford Emily E.
Published: December 2022

Aaron Copland’s only full-length opera, The Tender Land has had a difficult production history. Critics of the 1954 New York City Opera Premiere bemoaned the atypical storyline, the music declared too dry, and the singing too sparse. The opera’s failure to dazzle initial audiences is likely because it was originally written for television. Copland was commissioned to write this opera for television in 1952, but was rejected by NBC in 1953, with no official explanation given as to why. The New York City Opera premiere, therefore, was not an accurate representation of Aaron Copland's vision. The opera eventually did find receptive audiences, each success marked by a smaller, more intimate venue, not unlike the intimacy afforded on a sound stage. Perhaps most notable of these was the touring 1993 University of Minnesota production that performed in barns and farmhouses throughout the Midwest. Through this tour, the opera reached a rural community mirrored in the story, providing much more opportunity for the audience to connect to the characters. However, the question remains what caused NBC to initially reject the opera. This paper exposes the likely political obstacles that prevented Copland’s opera from premiering in its intended medium, and the subsequent consequences of displacing The Tender Land from its television premiere.
ESTADO DE DERECHO Y VULNERABILIDAD SOCIAL EN LA SIERRA DE GUERRERO, MÉXICO
Authors: Torres Oregón Fredyd , Estrada Rodríguez José Luis
Published: December 2022

Esta ponencia se deriva de un estudio realizado en la sierra de Guerrero, en la cual persisten localidades abandonadas por el Estado mexicano, lo cual ha generado un desplazamiento forzado de cientos de familias que huyen de las amenazas y violencia generada por grupos delic!ivos. El obje!ivo de la investigación consiste en analizar cómo se desarrolló la captura del estado de Guerrero por estos grupos delic!ivos, que se han apoderado de amplias zonas de la en!idad. La metodología empleada en esta inves!igación combina la antropología clásica y la autoetnografía. Los resultados muestran que los grupos delic!ivos asentados en zonas de la sierra de Guerrero han modificado comportamientos sociales en las localidades. Se llega a la conclusión de que la vida de los habitantes de la sierra se rige bajo pactos implícitos entre grupos delic!ivos y el Estado mexicano.
Profile of Students’ Conceptual Understanding of Physics in Senior High School
Authors: Khoiri Nur , Ristanto Sigit , Kurniawan Affandi Faisal
Published: December 2022

This research aimed to identify the profile of physical concept mastery of Senior High School/Aliyah School students in Semarang as a result of the transition from offline to online learning. The research employed the descriptive quantitative approach in which the tests and questionnaires were used to collect data. The school type (Senior High School/Aliyah School), school ownership (Private/State), and student’s interest in learning are all considered in the profile analysis. This study was carried out in Semarang, Indonesia, with a sample of 250 students from MAN 2 Semarang, SMA Negeri 1 Semarang, and SMA Negeri 9 Semarang. The findings revealed: 1) The percentage of students with concept mastery scores with the highest answer being questioned was 12 (88.2%). The results showed: 1) The percentage of students with concept mastery scores that really the highest answer lies in question 12 with a percentage of 88.2% on fluid material (Bernoulli’s Law) with a cognitive level of C2. While the percentage value of the student’s mastery of concepts which is the lowest, lies in questions number 3 (Uniform Speed and Uniform Acceleration subject matter) and 4 (moment of inertia/center of gravity and rigid body balance subject matter) with a percentage of 57% each with successive levels of cognition, C3 and C4, 2) Following tutoring is not effective because it does not affect physical learning achievement, and 3) there is a positive (unidirectional) significant (mean) relationship between independence and learning motivation on physical learning achievement. The results of this study can be used as a reference for researchers, educational policymakers, and stakeholders related to the handling of post-pandemic education.
Demonstration of an autonomous sailing vessel for monitoring nearshore and offshore marine environments
Authors: Wilkins Justin , McQueen Andrew , Miksis-Olds Jennifer , Verlinden Chris , Jones Michael , Lotufo Guilherme , Rosen Gunther , Suedel Burton
Published: December 2022

This technical note describes the US Army Engineer Research and Development Center (ERDC) application of an autonomous sailing vessel (ASV) to monitor water quality near underwater unexploded ordnance in Vieques, Puerto Rico, and the Center for Acoustics Research and Education, University of New Hampshire, application of the ASV to monitor the ocean soundscape along the Atlantic Outer Continental Shelf.
The Sediment Budget Estimator (SBE): A process model for the stochastic estimation of fluxes and budgets of sediment through submarine channel systems
Authors: Eggenhuisen Joris T. , Tilston Mike C. , Stevenson Christopher J. , Hubbard Stephen M. , Cartigny Matthieu J.B. , Heijnen Maarten S. , de Leeuw Jan , Pohl Florian , Spychala Yvonne T.
Published: December 2022

Turbidity currents transport vast amounts of sediment through submarine channels onto deep-marine basin-floor fans. There is a lack of quantitative tools for the reconstruction of the sediment budget of these systems. The aim of this paper is to construct a simple and user-friendly model that can estimate turbidity-current structure and sediment budget based on observable submarine-channel dimensions and general characteristics of the system of interest. The requirements for the model were defined in the spirit of the source-to-sink perspective of sediment volume modeling: a simple, quantitative model that reflects natural variability and can be applied to ancient systems with sparse data availability. The model uses the input conditions to parameterize analytical formulations for the velocity and concentration profiles of turbidity currents. Channel cross section and temporal punctuation of turbidity-current activity in the channel are used to estimate sediment flux and sediment budget. The inherent uncertainties of geological sediment-budget estimates motivate a stochastic approach, which results in histograms of sediment-budget estimations, rather than discrete values. The model is validated against small-scale experimental turbidity currents and the 1929 Grand Banks turbidity current. The model performs within acceptable margins of error for sediment-flux predictions at these smallest and largest scales of turbidity currents possible on Earth. Finally, the model is applied to reconstruct the sediment budget related to Cretaceous slope-channel deposits (Tres Pasos Formation, Chile). The results give insight into the likely highly stratified concentration profile and the flow velocity of the Cretaceous turbidity currents that formed the deposits. They also yield estimates of the typical volume of sediment transported through the channels while they were active. These volumes are demonstrated to vary greatly depending on the geologic interpretation of the relation between observable deposit geometries and the dimensions of the flows that formed them. Finally, the shape of the probability density functions of predicted sediment budgets is shown to depend on the geological (un)certainty ranges. Correct geological interpretations of deep marine deposits are therefore indispensable for quantifications of sediment budgets in deep marine systems.
Discretion and its Effects: Analyzing the Role of Street-Level Bureaucrats’ Policy Enforcement Style
Authors: Hassan Mohammed Salah , Alhalbusi Hussam , Ahmad Ahmad Bayiz , Abdelfattah Fadi , Thamir Zahraa , Ariffin Raja Noriza Raja
Published: December 2022

This study examines street-level bureaucrats’ discretion as it informs their enforcement style during personal encounters with clients and considers how that style defines bureaucrats’ perceptions of their clients. A conceptual model is developed based on street-level bureaucracy theory and existing implementation literature and is tested using field data collected from a sample of 241 labor inspectors in the Malaysian Department of Labor. Structural Equation Modelling results show that discretion was positively related to client meaningfulness, and the relationship between discretion and client meaningfulness was significantly mediated by the accommodation and facilitation dimensions of enforcement style. The findings are significant as they illuminate street-level bureaucrats’ behavior and perceptions during encounters with clients and confirm that enforcement style is a three-dimensional concept. Moreover, this research argues that the perceptions of bureaucrats toward their clients redefines their behavior during the policy enforcement process and ultimately shapes their encounters with the public. Furthermore, theory and practical implications derived from the findings are discussed.
Regulation of iNOS -NF-kappa B- COX-2 inflammatory pathway by alpha-pinene neuroprotective effects in brain ischemia model
Authors: Erfani Sohaila , Khoshnazar Seyedeh Mahdieh , afzali Fatemeh Ephtekhar , Abdolmaleki Arash , Moghadam Bahram Farhadi
Published: December 2022

Objectives Cerebral ischemia-reperfusion leads to brain tissue injury. Inflammation and apoptosis play pivotal roles in the pathology. α-Pinene is an organic compound of many aromatic plants and is known as a potent agent to possess antioxidant, and anti-inflammatory properties. Here, we sought to identify the anti-inflammatory and anti-apoptosis mechanism by which α-Pinene improves brain ischemia injury.
Methods Male Wistar rats underwent MCAO surgery for 1 hour and different doses of alpha-pinene (25, 50, and 100 mg/kg) were intraperitoneally injected immediately after reperfusion to test this hypothesis. IV, NDS, gene and protein expression of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear factor kappa B (NF-κB) p65, and caspase-3 were assessed 24h after reperfusion.
Key findings Results demonstrated that iNOS, COX2 and NF-KB gene and protein expression increased in the hippocampus, cortex, and striatum after 24 h of reperfusion, and alpha-pinene significantly inhibited iNOS, COX2 and NF-KB expression. Also, alpha-pinene significantly reduced the ischemia/reperfusion-induced caspase-3 activation in CA1 area of hippocampus.
Conclusions Results showed that alpha-pinene protects the cerebral against ischemic damage caused by MCAO, and this effect may be through the regulating iNOS, COX2 and NF-KB and caspas-3 inflammatory and apoptotic pathways.
Molecular characterization and comparisons of potato wart (Synchytrium endobioticum) in historic collections to recent findings in Canada and the Netherlands
Authors: de Vossenberg Bart van , Gent Marga van , Meffert Johan P. , Nguyen Hai D.T. , Smith Donna , Kempen Thijn van , Helderman Carin M. , Rosendahl-Peters Karin C.H.M. , Braak Naomi te , Flath Kerstin , Przetakiewicz Jarosław , Perez Willmer , Çakir Emel , Sikharulidze Zoia V. , Leeuwen Gerard C.M. van , Lee Theo A.J. van der
Published: December 2022

Synchytrium endobioticum (Schilb.) Perc. is a chytrid fungus causing potato wart disease and is one of the most important quarantine diseases on cultivated potato. Infected host tissues develop warts rendering the crop unmarketable. Resting spores that can remain viable and infectious for decades are formed in warted tissues which are released into the surrounding soil when the host tissue decays.
To better understand the pathogen’s diversity and to potentially uncover pathways of migrations and introduction events, molecular characterization was performed on the historical S. endobioticum resting spore collection of the Dutch National Plant Protection Organization. Mitochondrial genomes were assembled and annotated, and four novel structural variants were identified from these materials with intronic presence-absence variation in cox1 or cob genes and structural variation in the dpoB – TIR region. Several fungal isolates were shown to contain mixtures of structural variants.
We analyzed the mitogenomic sequences obtained from recent potato wart disease findings in Canada and the Netherlands in the context of the historical materials and found that fungal isolates from the new Dutch outbreak contained a specific mixture of mitogenomic variants previously not observed in the Netherlands. Based on the mitogenomic profile, pathotype 38(Nevşehir) was suspected which was later verified by pathotyping.
To further facilitate dissemination of data and interactive visual analytics we created a public Nextstrain webpage with S. endobioticum mitogenomic sequences and associated metadata on their geographic origin, pathotype identity and (mixture) of mitogenomic variants ( https://nextstrain.nrcnvwa.nl/Sendo ).
Efficacy and safety of nabufen and sufentanil in the prevention of visceral pain after gynecological laparoscopic surgery:a randomised controlled trial
Authors: gu xiaoxia , Peng Xue , Chen ZhiYuan , Pang Ping , Shao Ruizhao , Hu Kui , Wang Jingjing , Liang Guangbin
Published: December 2022

Background
To compare the efficacy and safety of different compatibility schemes in the prevention of visceral pain after gynecological laparoscopic surgery.
Methods
from April 2019 to April 2020, patients undergoing elective gynecological laparoscopic surgery in our hospital were randomly divided into four groups: group A: sufentanil 3 μ g / kg; group B: low-dose nalbuphine group: 0.1 mg / kg of nabufen + 3 μ g / kg of sufentanil; group C: medium dose of nabufen group: 1 mg / kg of nabufen + 2 μ g / kg of sufentanil; group D: high-dose nabufen 2 There were 30 cases in each group. The degree of pain and the number of adverse reactions at 2, 4, 8, 12, 24 and 48 hours after operation were observed and recorded. The number and dosage of morphine used as a remedial analgesic were recorded. The pain degree was assessed by VAS. The total amount of analgesic pump used, the total number of times of pressing and effective times of pressing were recorded. The adverse reactions also was recorded.
Results
the analgesic effect of group B was similar to that of group A, while the invalid pressing times, total pressing times and remedial analgesia rate of group C and group D were significantly lower than those of group A ( P < 0.05). There was no significant difference between group C and group D in the number of invalid compressions, the total number of compressions and the rate of remedial analgesia ( P > 0.05), suggesting that increasing the dose of nalbuphine could not significantly increase the analgesic effect. The incidence of postoperative nausea and vomiting, skin pruritus, lethargy and Ramsay Sedation score in group B and group C were significantly lower than those in group A ( P < 0.05). Ramsay Sedation score and incidence of drowsiness were lower than those in group D.
Conclusion
the combination of 1 mg / kg nabufen and 2 μ g / kg sufentanil is a safe and effective combination scheme for the prevention of visceral pain after gynecological laparoscopic surgery with small adverse reactions.
Trial registration:
http://www.chictr.org.cn/showproj.aspx?proj=40635
Registration number：ChiCTR1900025076 . Prospectively registered on 10 August 2019.
Trustworthy Deep Learning for Encrypted Traffic Classification
Authors: Li Zheng , Liu Yanbei , Zhang Changqing , Shan Wanjin , Zhang Haifeng , Zhu Xiaoming
Published: December 2022

Network traffic classification refers to the identification of collected network traffic data of various applications, which is widely used in research fields such as network resource allocation, traffic scheduling and intrusion detection systems. With the widespread application of encryption technology in the network, encrypted traffic classification has become a hot research topic. At present, most existing methods only focus on the accuracy of network traffic classification. Yet, few work studies the reliability of the classification model, which plays an important role in network regulation and network security. In this paper, we propose a novel traffic classification method based on trustworthy deep learning model, which can effectively improve the reliability of encrypted traffic classification models by correcting the confidence of model output. Specifically, we firstly perform data preprocessing on the original network traffic, and then adopt a ConvNet for feature learning and a ClassifyNet for traffic classification in the initial stage. At the same time, we utilize a trustworthy confidence criterion to design a ConfidNet trained according to the probability of the true class. The ConfidNet can provide a reliable confidence measure for the prediction of the classification model. Finally, we demonstrate the effectiveness of our framework through comprehensive experiments on two benchmark datasets ISCX VPN-nonVPN and USTC-TFC2016, and show that our method can improve the reliability of the classification model and has a good ability to identify misclassified samples compared with state-of-the-art methods.
The spatio-temporal landscape of the transcriptome and metabolome of cotton fiber cells during their initiation and late development
Authors: Sun Xuwu , Qin Aizhi , Wang Xingxing , Ge Xiao-Yang , Liu Zhixin , Guo Chenxi , Yu Xiaole , Zhang Xianliang , Lu Yao , Yang Jincheng , He Jiuming , Zhou Yaping , Liu Yumeng , Hu Mengke , Liu Hao , Zhao Zihao , Hu Guanjing , Li Wei , Zang Xinshan , Dai Shuai , Sun Susu , Yong-Villalobos Lenin , Herrera-Estrella Luis , Tran Lam-Son Phan , Ma Xiongfeng
Published: December 2022

Cotton fibers develop from epidermal cells in the outer integument of ovules. The regulatory process underlying fiber cell development has been extensively studied, little is known about the spatio-temporal profiles of transcriptomes and metabolomes during its development. Here we characterized the dynamics of transcriptome and metabolome during the early developmental stages of cotton fiber cells using a combination of spatial transcriptomic, single-cell transcriptomic, and spatial metabolomic analyses. We identified the key genetic regulators and metabolites that initiate and determine the fate of fiber cells. Both knockdown and gain-of-function analyses of one new identified marker gene BEE3/Gh_A09G062900 revealed its important role in the initiation of cotton fiber. We also designed a website for the public visualization of spatial gene expression in cotton that provides important reference datasets of spatio-temporal gene expression and can be used to further decipher the genetic and metabolic regulation of cotton fiber development (http://CottonOvule.cricaas.com.cn/).
A protocol for establishing a core outcome set for studies examining treatments for Problematic Internet use
Authors: Wu Liu , Wang Yang , Zhao Xinyu , Zhou Mingze , Gao Ping , Yi Ting , Cui Jiarui , Li Hui , Zhu Tianmin
Published: December 2022

Background
Randomised controlled trials (RCTs) evaluating Problematic internet use (PIU) have reported many different outcomes, which are themselves often defined and measured in distinct ways. Numerous clinical trials have been conducted on the efficacy and safety of different interventions in the treatment of PIU, resulting in many different outcome measures and different ways of measuring them. In order to facilitate the future research of PIU, it is necessary to produce the core Outcome Set (COS), which can help to translate the results into high-quality evidence.
Methods and analysis:
This mixed-method project has a three-phase tool: Phase 1, a scoping review of the literature to identify outcomes that have been reported in clinical trials and systematic reviews of interventions for PIU. Phase 2, a systematic review of PIU literature was conducted to identify potential outcome indicators. Phase 3, final outcome indicators were determined through Modified Delphi Method, Consensus Meetings, Stakeholder Perspectives and Stakeholder Consultations.
Conclusions
We will develop a COS that should be reported in future clinical trials of PIU.
Trial registration:
Core Outcome Measures in Effectiveness Trials (COMET) Initiative database registration: www.comet-initiative.org/Studies/Details/2109. Registered in August 2022.
Facilitating implementation of primary care mental health over time and across organizational contexts: a qualitative study of role and process
Authors: Ritchie Mona J. , Parker Louise E. , Kirchner JoAnn E.
Published: December 2022

Background: Healthcare organizations have increasingly utilized facilitation to improve implementation of evidence-based practices and programs (e.g., primary care mental health integration). Facilitation is both a role, related to the purpose of facilitation, and a process, i.e., how a facilitator operationalizes the role. Scholars continue to call for a better understanding of this implementation strategy. Although facilitation is described as dynamic, activities are often framed within the context of a staged process. We explored two understudied characteristics of implementation facilitation: 1) how facilitation activities change over time and in response to context, and 2) how facilitators operationalize their role when the purpose of facilitation is both task-focused (i.e., to support implementation) and holistic (i.e., to build capacity for future implementation efforts.
Methods: We conducted individual monthly debriefings over thirty months with one external expert and two internal regional facilitators who were supporting PCMHI implementation in two VA networks. We developed a list of facilitation activities based on a literature review and debriefing notes. We coded what activities occurred and their intensity by quarter. We also coded whether facilitators were “doing” these activities for sites or “enabling” sites to perform them.
Results: Implementation facilitation activities did not occur according to a defined series of ordered steps but in response to specific organizational contexts through a non-linear and incremental process. Amount and types of activities varied between the networks. Concordant with facilitators’ planned role, the focus of some facilitation activities was primarily on doing them for the sites and others on enabling sites to do for themselves; a number of activities did not fit into one category and varied across networks.
Conclusions: Findings indicate that facilitation is a dynamic and fluid process, with facilitation activities, as well as their timing and intensity, occurring in response to specific organizational contexts. Understanding this process can help those planning and applying implementation facilitation to make conscious choices about the facilitation role on the doing/enabling continuum, and the activities that facilitators can use to operationalize this role. Additionally, this work provides the foundation from which future studies can identify potential mechanisms of action through which facilitation activities enhance implementation uptake.
The Search for Optimal Oxygen Saturation Targets in Sepsis Patients: a retrospective study
Authors: Wang Kaijin , Hao Qin , Hu Zhong , Wang Jin , Zheng Juan , wang yang
Published: December 2022

Background
Hypoxemia or hyperoxia oxygenation might increase in-hospital mortality in patients with sepsis. However, the optimal oxygenation target remained unknown. We performed a study to explore and validate the optimal oxygen saturation targets in sepsis patients.
Methods
Medical records of sepsis patients from 2008 to 2019 were retrieved from the Medical Information Mart for Intensive Care (MIMIC)-IV database. A generalized additive model (GAM) was established to comprehensively analyze the U-shaped nonlinear relationship between in-hospital mortality and time-weighted average (TWA)-SpO2 during oxygenation. The lowest and flattest area was identified as the optimal oxygenation target. A logistic regression was utilized to verify the optimal oxygenation target. Finally, a mediation analysis was adopted to estimate the direct effect of the TWA-SpO2 level by excluding the indirect effect of the fraction of inspired O2(FiO2).
Results
3800 sepsis patients with 630,704 SpO2 records were enrolled in our study, among whom 705 (18.5%) passed away at hospital discharge. The median age of the patients was 54.31 [52.22, 76.66] years, and 2326 (61.21%) were male patients. The GAM analysis demonstrated a U-shaped nonlinear relationship between TWA-SpO2 and in-hospital mortality during oxygenation. The SpO2 interval corresponding to the curve's lowest region of in-hospital mortality was 95%~98%. In accordance with the relationship between the TWA-SpO2 and the target interval range, the patients were segregated into hypoxemia, hyperoxia, and optimal oxygenation group, respectively. The multivariate logistic regression results also presented that the in-hospital mortality risk in the hypoxia oxygenation groups increased by 60.4% (OR=1.60, 95%CI 1.23~2.09, P<0.001), while patients in the hyperoxia oxygenation group also increased by 61.3% (OR=1.61, 95 %CI: 1.26-2.06, P<0.001), by adopting the sepsis patients of the optimal oxygenation group as the control. Finally, the mediation effect analysis results presented that the direct effect of the TWA-SpO2 was 0.072 (95% CI: 0.030-0.110, P<0.001).
Conclusions
The optimal pulse oximetry targets for oxygenation in sepsis patients were likely 95%~98%, corresponding with the lowest risk of in-hospital mortality. It was also observed after the indirect effect of FiO2 was removed.
Trial registration: Our study was registered with the Chinese Clinical Trials Registry on January 11, 2021, where the registration number was ChiCTR2000040149. http://www.chictr.org.cn/edit.aspx?pid=64427&htm=4.
Impact of climate change on nomadic herders’ livelihoods: a case study of the Bakarwal tribe in the western Himalayas in India
Authors: Ahmed Sharief , Iqbal Zaffar , Antahal Prakash C.
Published: December 2022

This study quantifies the impact of climate change on the livelihoods of nomadic herders in the western Himalayas in India, who depend on natural resources for their livelihood, and are herding livestock. In this research paper, we collected primary data from 235 nomadic herders on their perceptions regarding the variables of climate change. We analysed the primary data using factor analysis and found that due to climate change, in the last few decades, nomads have experienced less and untimely rainfall and increased temperature, which ultimately results in the fallen growth of pasture, degraded quality and quantity of pasture, pasture plants being replaced by weedy plants, shrunken the harvesting time of pasture, drying of sources of water in later days at winter residence, seasons have changed, experiencing unstable weather, and reduced grazing areas are bringing the drought-like situation in the area. Further, this creates significant challenges in raising livestock with less pasture, water availability, increased environmental diseases risk bringing starvation and death of animals, falling the quality and quantity of milk, wool and meat, and lowered the market price of final goods. This has a serious impact on the economic activities of nomadic herders in the region. Climate change also forced the nomadic herders in the region to early migration, which allowed them to face difficulties such as ice over mountain passes, less grass along the paths for grazing, unexpected avalanches, thunderstorms or hailstorms and intense rains on the way to uplands. Finally, this study brings to the notice of policymakers, climatologists, local governments, and animal health departments that climate change is endangering the life of nomadic herders, and we should develop appropriate plans to minimize the loss.
The ethanolic extract of Salvia lachnostachys Benth is not maternotoxic, does not alter reproductive performance, but has teratogenic potential
Authors: Ortiza Hudman Cunha , Neves Silvia Cordeiro , Kassuya Cândida Aparecida Leite , Coelho Henrique Rodrigues Scherer , Martins Allana C. F. , Vilela Marcelo Luiz Brandão , Nascimento Valter Aragão , Karuppusamy Arunachalam , Stefanello Maria Élida Alves , Oliveira Rodrigo Juliano , Gomes Roberto Silva
Published: December 2022

Salvia lachnostachys Benth is native to Brazil and has anti-inflammatory, anti-arthritic, cytotoxic, antitumor, and antihyperalgesic activities. The present study aimed to evaluate the effects of S. lachnostachys (EESl) ethanolic extract on reproductive performance, embryofetal development, and DNA integrity of pregnant female mice. Pregnant females were randomly divided into three experimental groups (n = 10): The Control group was treated with a vehicle, and treatment groups were administered with EESl at 100 and 1000 mg/kg, respectively. Treatment occurred by gavage throughout the gestational period until day 18. Afterward, reproductive performance, embryofetal development, and DNA integrity parameters were evaluated. The results indicated that EESl did not alter any reproductive performance parameters. However, it changed embryofetal outcome through reduced placental weight (EESl 100 mg/kg), decreased fetal weight (EESl 100 and 1000 mg/kg), and increased frequency of small for gestational age fetuses (EESl 1000 mg/kg). In addition, EES1 increased the frequency of external, visceral, and skeletal malformations. Because of the above, it is considered that EESl is not maternotoxic, does not alter reproductive performance, but does alter embryofetal development. Its use in the gestational period is not indicated due to its teratogenic potential.
Identification of low-acuity attendances in routine clinical information documented in German Emergency Departments
Authors: Slagman Anna , Fischer-Rosinský Antje , Legg David , Möckel Martin , Schmieder Kristin
Published: December 2022

Introduction It has not yet been possible to ascertain the exact proportion, characterization or impact of low-acuity emergency department (ED) attendances on the German Health Care System since valid and robust definitions to be applied in German ED routine data are missing. Methods Internationally used methods and parameters to identify low-acuity ED attendances were identified, analyzed and then applied to routine ED data from two EDs of the tertiary care hospitals Charité - Universitätsmedizin Berlin, Campus Mitte (CCM) and Campus Virchow (CVK). Results Based on the three routinely available parameters `disposition´, `transport to the ED´ and `triage´ 16.3% (n = 15 047) out of 92 477 presentations to the two EDs of Charité - Universitätsmedizin Berlin (CVK, CCM) in 2016 could be classified as low-acuity presentations. Conclusion This study provides a reliable and replicable means of retrospective identification and quantification of low-acuity attendances in German ED routine data. This enables both intra-national and international comparisons of figures across future studies and health care monitoring.
Primary cardiac myxofibrosarcoma of the left atrial and pericardium: a case report
Authors: Azuma Ryota , Sato Kazuyoshi , Sunadoi Hiroki , Ishii Yasushi , Tomaru Utano , Motohashi Masatoshi
Published: December 2022

Background: Primary cardiac myxofibrosarcoma is quite rare and commonly arises in the left atrial. Myxofibrosarcoma is an aggressive and has high mortality because of high rate of recurrence. It is considered that complete surgical resection is important but effective treatment options are not established.
Case presentation: We report a case of 75-year-old woman who developed myxofibrosarcoma spreading to left atrial and pericardium. To prevent sudden death by obstruction of mitral valve, we performed surgical resection of the tumor. The patient developed brain metastasis at two months after surgery, and eventually passed away due to brain hemorrhage at three postoperative months.
Conclusion: In this report, we described a very rare case of primary cardiac myxofibrosarcoma located not only in the left atrial but also in the pericardium. To prevent the recurrence of myxofibrosarcoma, combination of surgery, radiotherapy and chemotherapy should be needed.
Ecodatacube.eu: Analysis-ready open environmental data cube for Europe
Authors: Witjes Martijn , Parente Leandro Leal , Krizan Josip , Antonic Luka , Hengl Tomislav
Published: December 2022

The paper describes production steps and accuracy assessment of an analysis-ready (complete, consistent,
correct and current) open environmental data cube (2000–2021+) for continental Europe; at working
resolutions from 10 m to 30 m and with quarterly to annual estimates. The data cube is based on processing
and harmonizing earth observation (EO) images: Landsat GLAD ARD (2000–2020+), Sentinel-2 images
(2017–2021+) and Digital Elevation data. These datasets were created with accessibility, user-friendliness,
interoperability and synthesis in mind. This has required systematic spatiotemporal harmonization, efficient
compression, and imputation of missing values. To ensure a missing value percentage below 1%, the EO
data was first aggregated into four quarterly periods approximating the four seasons common in Europe
(winter, spring, summer and autumn), and then split into three percentiles (25th, 50th and 75th). Remaining
missing data in the Landsat time-series was imputed with a temporal moving window median (TMWM)
approach. The accuracy assessment shows TMWM gap-filling achieves higher performance in Southern
Europe, and lower performance in mountainous regions such as the Scandinavian Mountains, the Alps, and
the Pyrenees. The intended uses of the EcoDataCube platform include vegetation, soil, land cover and land
use mapping projects, environmental monitoring and automated generation of data for statistical offices
including Eurostat. Results further show that combining all four datasets produced in this work (DTM,
Landsat 30 m, Sentinel-2 30 m and Sentinel-2 10 m) yields the highest land cover classification accuracy,
with different datasets improving the results for different land cover classes. The Environmental data cube
for Europe is available under CC-BY license as Cloud-Optimized GeoTIFFs (ca. 12 TB in size) through
STAC and the EcoDataCube data portal.
Utilization of Carbonated Calcium Phosphate Cement for Contouring Cranioplasty in Patients with Syndromic Craniosynostosis
Authors: Wagner Connor S , Pontell Matthew E , Shakir Sameer , Xu Emily , Zhang Emily , Swanson Jordan W , Bartlett Scott P , Taylor Jesse A
Published: December 2022

Purpose
Carbonated calcium phosphate (CCP) cement is an alloplastic material which has been increasingly utilized for cranioplasty reconstruction, however there is a paucity of data investigating its use in patients with syndromic craniosynostosis. The purpose of this study was to characterize our institutional experience with CCP cement for secondary contouring cranioplasty in these patients to establish safety and aesthetic efficacy.
Methods
Patients with syndromic craniosynostosis undergoing cranioplasty with CCP cement from 2009-2022 were retrospectively reviewed for prior medical and surgical history, cranioplasty size, cement usage, and postoperative complications. Aesthetic ratings of the forehead region were quantified using the Whitaker scoring system at three time-points: preoperative (T1), < 6 months postoperative (T2), and > 1 year postoperative (T3).
Results
Twenty-one patients were included. Age at surgery was 16.2 ± 2.8 years, forehead cranioplasty area was 135 ± 112 cm2, and mass of cement was 17.2 ± 7.8 grams. Patients were followed for 3.0 ± 3.1 years. Whitaker scores decreased from 1.9 ± 0.4 at T1 to 1.4 ± 0.5 at T2 (p = 0.005). Whitaker scores at T2 and T3 were not significantly different (p = 0.720). Two infectious complications (9.5%) were noted, one at 4.5 months postoperatively and the other at 23 months, both requiring operative removal of CCP cement.
Conclusion
Our results suggest that aesthetic forehead ratings improve after CCP contouring cranioplasty and that the improvement is sustained in medium-term follow-up. Complications were uncommon, suggesting that CCP is relatively safe though longer-term follow-up is needed before reaching definitive conclusions.
Zinc Oxide Calcium Silicate Composite Attenuates Acute Tramadol Toxicity in Mice
Authors: ElShebiney Shaimaa A. , Elgohary Rania , Kenawy Sayed H. , El-Bassyouni Gehan T. , Hemzawy Esmat M.A.
Published: December 2022

Background Seizures are considered to be the most common symptom encountered in emergency- rushed tramadol-poisoned patients; accounting for 8% of the drug-induced seizure cases. Although, diazepam clears these seizures, the risk of central respiratory depression cannot be overlooked. Henceforth, three adsorbing composites were examined in a tramadol acute intoxication mouse model. Methods Calcium Silicate (Wollastonite) either non-doped or wet doped with iron oxide (3%Fe2O3) or zinc oxide (30% ZnO) were prepared. The composites’ adsorption capacity for tramadol was determined in vitro. Tramadol intoxication was induced in Swiss albino mice by a parenteral dose of 120 mg/kg. Proposed treatments were administered within 1 min at 5 increasing doses, i.p. The next 30 minutes, seizures were monitored as an intoxication symptom. Plasma tramadol concentration was recorded after two hours of administration. Results The 3% Fe2O3-containing composite (CSFe3), was found to be composed of mainly wollastonite with very little alpha–hematite. On the other hand, hardystonite and wellimite were developed in the 30%ZnO-containing composite (CSZn3). Micro-round and irregular nano-sized microstructures were established (The particle size of CS was 56nm, CSFe3 was 49 nm, and CSZn3 was 42 nm). The CSZn3 adsorption capacity reached 1497 mg of tramadol for each gram. Tramadol concentration was reduced in plasma and seizures were inhibited after its administration to mice at three doses. Conclusion The calcium silicate composite doped with ZnO presented a good resolution of tramadol-induced seizures accompanied by detoxification of blood, indicating its potential for application in such cases. Further studies are required.