bluuebunny/crossref_metadata_2025 huggingface dataset:
Guideline evaluation and implementation mechanisms in school health services (GuideMe): Protocol for a hybrid randomized factorial trial
Authors: Sagatun Åse , Engell Thomas , Brekke Malene , Sjølie Hege , Ekornes Stine M. , Waldum-Grevboe Kristin Sofie , Pape Kristine , Kvaløy Kirsti , Jeneson Annette , Trøan Anna Stigum , Askeland Anne Liv , Stien Line , Holen Solveig
Published: September 2023

Background Norwegian school health services received a national best-practice guideline in 2017. To promote healthy life skills and identify adolescents needing support, the guideline includes strong recommendations for individual consultations with all 8th graders and increased collaboration with schools. To help implement the recommendations, a blended implementation strategy (SchoolHealth) was co-created with school nurses, students, and stakeholders. SchoolHealth consists of three implementation elements: Digital dialog and administration tool (audit and feedback+), Dialog support (external consultation), and Collaboration materials (targeted dissemination). This hybrid study will test the main and combined effects of the elements on guideline fidelity and effectiveness.
Methods The GuideMe study is a factorial cluster randomized controlled trial examining SchoolHealth's effectiveness on guideline fidelity and guideline effectiveness goals. Forty Norwegian secondary schools will be randomized to eight different combinations of the elements in SchoolHealth. Participants will include school nurses and school personnel from these schools, and 8th grade students (n=1200). Primary outcomes are school nurses' fidelity to the guidelines and student's ability to cope with their life (i.e., health literacy, positive health behaviors and self-efficacy). Quantitative methods will be used to test effects and mechanisms, while mixed- and qualitative methods will be used to explore mechanisms, experiences, and other phenomena in depth. Participants will complete digital questionnaires at the start and end of the schoolyear, and after the consultation during the schoolyear. The study will run in two waves, each lasting for one school year. The multifactorial design allows testing of interactions and main effects due to equal distribution of all factors within each main effect. Sustainment and scale-up of optimized SchoolHealth elements using national infrastructure are simultaneously prepared.
Discussion The study will investigate possible effects of the implementation elements in isolation and in combination, and hypothesized implementation mechanisms. In-depth study of user experiences will inform improvements to elements in SchoolHealth. The results will yield causal knowledge about implementation strategies and the mechanisms through which they assert effects. Mixed-methods will provide insights into how and when the elements work. Optimizing guideline implementation elements can support adolescents in a crucial life phase.
Trail registration ISRCTN reg.nr. 24173836 Registration date 08/08/2022
Improving routine use of clinical pathway decision support through integration of an EHR with a clinical library resource designed to provide evidence-based guidance within oncology workflows
Authors: Ichiuji Mary , Asakura Laura , Cain Carol , Aye Nancy , Kolevska Tatjana , Chen David , Brasfield Farah , Kotak Dinesh
Published: September 2023

Background:
The rapid evolution, complexity, and specialization of oncology treatment makes it challenging for physicians to provide care based on the latest and best evidence. We hypothesized that physicians would use evidence-based trusted care pathways if they were easy to use and integrated into clinical workflow at the point of care.
Methods:
Within a large integrated care delivery system, we assembled clinical experts to define and update drug treatment pathways, encoded them as flowcharts in an online library integrated with the electronic medical record, communicated expectations that clinicians would use these pathways for every eligible patient, and combined data from multiple sources to understand usage over time.
Results:
We were able to achieve > 75% utilization of eligible protocols ordered through these pathways within two years, with >90% of individual oncologists having consulted the pathway at least once, despite no requirements or external incentives associated with pathway usage. Feedback from users contributed to improvements and updates to the guidance.
Conclusions:
By making our clinical decision support easily accessible and actionable, we find that we have made considerable progress toward our goal of having physicians consult the latest evidence in their treatment decisions.
SENP6 restricts the IFN-I-induced signaling pathway and antiviral activity by deSUMOylating USP8
Authors: Xiong Sidong , Guo Jing , Zheng Hui
Published: September 2023

Type I interferon (IFN-I) has broad-spectrum antiviral properties and is commonly used to treat viral infection in the clinic. Here, we show that SENP6 is a potent regulator of IFN-I antiviral activity. SENP6 does not affect IFN-I production induced by viruses but regulates IFN-I-activated signaling. Mechanistically, SENP6 constitutively interacts with USP8 and inhibits USP8 SUMOylation, which in turn restricts the interaction between USP8 and IFNAR2. Disassociation of USP8 with IFNAR2 enhances IFNAR2 ubiquitination and degradation, thus attenuating IFN-I antiviral activity. Consistently, downregulation of SENP6 promotes the interaction between USP8 and IFNAR2, which reduces IFNAR2 ubiquitination and therefore enhances IFN-I-induced signaling. This study deciphers a deSUMOylation-deubiquitination crosstalk that critically controls the IFN-I response to virus infection.
Medical equipment inventory management practices in public health facilities at Homabay county, Kenya
Authors: Morande Frederick , Karimi Peter Ndirangu , Rutungwa Eugene , Ngenzi Joseph Lune
Published: September 2023

Background
Medical equipment performs a critical function in the daily running of health care. The management of these assets is key in ensuring quality healthcare since they aid in diagnosing and treating diseases. This study evaluated the medical equipment inventory management practices in public health facilities at Homabay County.
Methods
A cross-sectional design was used targeting nineteen public hospitals in Homabay County. A structured questionnaire was used to collect data from healthcare workers who managed medical equipment inventory in the selected health facilities. The collected data was keyed into a Microsoft Excel sheet and analyzed using STATA version 14. Ethical Approval to conduct the study was given by KNH-UON-ERC. The county government of Homabay authorised accessibility to health facilities.
Results
Majority (97.56%) of respondents kept inventory records for medical equipment, and all of them were manual and decentralized. Most (93.9%) of the participants conducted physical stock, and only 51.2% of the equipment records were up to date. Only 12.2% of the facilities had policies and guidelines on equipment management.
Conclusion
The management of medical equipment was sub-optimal. The procurement, maintenance and disposal policies were inadequate.
Ettringite instability on supersulfated cement: Investigation under different curing regimes
Authors: Pinto Leticia Poggere , Pinto Leticia Poggere , Luz Caroline Angulski da , Hooton R. Douglas
Published: September 2023

The global discussion on CO2 emission reduction policies has encouraged the search for sustainable concrete binder materials, such as supersulfated cement (SSC), since this binder is composed mainly of blast-furnace slag. However, despite having relevant environmental and mechanical properties, when compared to Portland cement, little is known regarding its complex process of hydration and durability. It is known that the primary hydration products of SSC are ettringite and calcium-silicate-hydrate (C–S–H), and the instability of the former has been observed in some studies. Thus, the aim of the present study was to investigate the influence of the SSC curing process on the formation of ettringite. SSC pastes were produced and subjected to four different curing processes. The hydration process was followed by potentiometry (pH), compressive strength tests, X-ray diffraction (XRD), and thermogravimetry (TG/DTG), carried out from 7 to 92 days. The best mechanical strength results were obtained at 58 days, but at 92 days, a drop in strength was observed, accompanied by ettringite instability in all of the curing processes investigated. The results verified the formation of calcium sulfate hemihydrate and calcite, indicating the occurrence of intense natural carbonation of ettringite.
Acute cerebral infarction of anterior circulation in a patient with the common trunk of the left common carotid artery and the brachiocephalic trunk:a case report
Authors: Xu Junpeng , Ma Hengchao , Liu Bin , Yang Haonan , Mao Zhiqi
Published: September 2023

Introduction:The common trunk of the left common carotid artery and the brachiocephalic trunk (LCCA&BT) is a rare congenital vascular anomaly. Unexplained bilateral infarcts are uncommon, and their mechanisms are unknown. After searching the relevant literature, there is no report of acute anterior circulation cerebral infarction of the left common carotid artery and the brachiocephalic trunk at home and abroad.
Patient concerns: A 77-year-old right-handed elderly man with good past health and no family history of stroke came to the acute stroke ward for "sudden right limb weakness for 3 days". Preexisting diabetes mellitus with normal blood sugar control and no other risk factors for cerebrovascular disease.
Diagnosis:CTA of the head and neck showed that the left common carotid shared the trunk with the brachiocephalic trunk, which replaced the normal cervical vascular structures, including the brachiocephalic and common carotid arteries. Cranial magnetic resonance plain scan showed high diffusion-weighted imaging(DWI) signal in the left lateral ventricle and right frontal subcortex, and low apparent diffusion coefficient(ADC) signal in the left lateral ventricle. Cranial magnetic resonance dynamic enhancement confirmed bilateral frontal lobe acute cerebral infarction, scattered ischemic lesions and softening lesions in the brain. However, the source of thrombus in the ischemic focus of the patient could not be judged.
Intervention : Considering that the patient had acute anterior circulation cerebral infarction, antiplatelet, lipid-lowering, plaque stabilization, and blood sugar control treatments were given.
Outcomes: After our treatment, the patient's symptoms were relieved, and there was no dizziness, no unstable walking, no recurrence of acute cerebral infarction, and a good recovery after 3 and 6 months of follow-up.
Conclusion: This case highlights the importance of the common trunk of the left common carotid artery and the brachiocephalic trunk in the occurrence of unexplained bilateral stroke. In the absence of traditional risk factors and other evidence, cerebral infarction in the blood supply area of malformed vessels should be considered vascular malformation related, but its exact pathogenesis remains unclear. Antiplatelet therapy, lipid lowering, and plaque stabilization are effective methods to prevent new infarction in such patients.
Development of ultrafine nanofiber from polyacrylonitrile/ethylene co-vinyl alcohol precursor using solution electrospinning
Authors: Karim Md. Razaul , Hasan Saeed , Nakane Koji , Zakaria Mohammad
Published: September 2023

Ultrafine nanofiber from polyacrylonitrile (PAN)/ethylene co-vinyl alcohol (EVOH) with a diameter of a few hundred nanometers was prepared through solution electrospinning. In this study, EVOH was employed as a precursor for the purpose of decreasing the diameter of electrospun fibers. The effect of different EVOH content in weight percentages incorporated with PAN on the fiber diameters was investigated. A successive and drastic reduction in fiber diameter was observed with the increase of EVOH in the blend. Moreover, the fiber diameter was further reduced after isopropanol (IPA) treatment. Scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and Fourier transform infrared (FTIR) spectroscopy were used to investigate the fiber morphology, thermal attributes, degradation behavior, and the chemistry of electrospun nanofiber respectively. The diameter of PAN/EVOH nanofibers found ranged from 47 nm to 880 nm, and after IPA treatment observed from 41 nm to 719 nm. The diameter of PAN/EVOH blend fiber was found to be 514 nm, 319 nm, and 116 nm for the EVOH content of 25%, 50%, and 75% correspondingly. After IPA treatment (at the content of 75%), the lowest PAN nanofiber diameter was discovered to be 102 nm. In the DSC heat flow, melting temperature (Tm) of electrospun nanofibers manufactured from pure PAN, pure EVOH, PAN/EVOH blend, and IPA treated were detected at 290 0C, 182 0C, 301 0C, and 271 0C separately. The blend nanofiber (50/50) exhibited a distinctive single melting peak in DSC and the Tm was shifted upward from 290°C (as observed in pure PAN) to 301°C. In addition, on the TGA curve
the degradation temperature of blend nanofiber (50/50) extended up to 289°C which surpasses the pure PAN's value of 280°C. Both DSC and TGA analyses demonstrated the enhancement of the thermal properties of blend nanofiber. Due to its smaller diameter and improved thermal properties, the developed nanofiber may find use in air filtration and protective clothing.
Computed tomography enterography radiomics and machine learning for identification of Crohn’s disease
Authors: Shi Qiao , Hao Yajing , Liu Huixian , Liu Xiaoling , Yan Weiqiang , Mao Jun , Chen Bihong T.
Published: September 2023

Background: Crohn’s disease (CD) is a severe chronic and relapsing inflammatory bowel disease. Contrast-enhanced computed tomography (CT) enterography (CTE) has been used frequently to evaluate CD. However, imaging findings of CD are not always specific and may overlap with other bowel diseases. Recent researches have shown that radiomics-based machine learning algorithms have been used to assist in the diagnosis of medical images. In this study, we aim to develop a non-invasive method for detecting bowel lesions from Crohn’s disease using computed tomography (CT) enterography (CTE) radiomics and machine learning algorithms.
Methods: Patients (n=139) with pathologically confirmed Crohn’s disease were retrospectively enrolled into the study. Radiomics features were extracted from both the arterial- and venous-phase CTE images for both the bowel lesions with Crohn’s disease and segments of normal bowel. A machine learning classification system was built combining 6 selected radiomics features and 8 classification algorithms. The models were trained with leave-one-out cross-validation and were evaluated for accuracy.
Results: The classification model showed robust performance and high accuracy, with the area under the curve (AUC) reaching 0.981 and 0.978 for the arterial- and venous-phase CTE images, respectively. The model achieved an accuracy of 0.9375, and 0.9615 for the arterial-phase and venous-phase image, respectively.
Conclusions: Our study identified a CTE radiomics machine learning method that could be used to differentiate Crohn’s disease bowel lesions from normal bowel. Future studies with a larger sample size and external cohorts should be performed to validate our results.
Nurturing the Future: Examining Breastfeeding Practices and Nutritional Health Among Amazonian Kichwa Mothers and Infants
Authors: Orellana-Manzano Andrea , Maldonado-Lino Diana , Valencia Luz , Lopez Andres , Santillan Dellanara , Ortiz-Ulloa Johana , Cevallos Juan , Gonzalez-Narvaez Mariela , Manzano Patricia , Vizcaino Maria , Gavin Karina , Zurita-Benavides Maria , Berghe Wim Vanden
Published: September 2023

This study examines the knowledge, attitudes, and practices of Amazonian Kichwa (AK) breastfeeding mothers and infants, focusing on cultural influences on early nutrition patterns. Using a descriptive, observational, and cross-sectional approach, thirty women self-identified as AK women and their infants from two rural and one urban area in Ecuador were studied. The study found that 89% of mothers practiced exclusive breastfeeding and showed promising signs of attachment and breastfeeding techniques. However, 81% were unaware of the "exclusive" breastfeeding practice scope and its benefits. Nutritional status was determined using Z scores, with the median BMI for age within the normal range. This study highlights the need to consolidate knowledge and promote breastfeeding practices to later generations, despite increased exposure to urbanization and modernization in the Amazonia region of Ecuador.
A systematic comparison of the association between father- and mother-child interactions and the development of adaptive behaviour in toddlers with Down syndrome and typical development
Authors: Robledo Juan-Pablo , Tenorio Marcela , Arango Paulina , Aparicio Andrés
Published: September 2023

This study assessed the association between Parent-Child Interactions and the development of Adaptive Behaviour, and systematically compared mother-child vs father-child interactions, and toddlers with Down Syndrome versus typically developing ones. 30 toddlers with Down Syndrome and 30 typically developing counterparts paired by developmental age from Santiago de Chile (12–24 months-old), were recorded interacting with each of their parents separately. Fathers were overall equally sensitive than mothers, and parents of toddlers with Down syndrome were overall more directive. Maternal directivity showed the highest association with adaptive development— albeit only in toddlers with typical development. Paternal overall sensitivity was– with only a few exceptions –systematically associated to adaptive development, regardless of the assessed group. The present study strongly suggests that paternal sensitivity during playtime is just as relevant for the adaptive behaviour of toddlers as is maternal sensitivity, particularly in the case of toddlers with Down syndrome.
In vitro performance of an autocured universal adhesive system in bonding to dentin
Authors: Kibe Kota , Hatayama Takashi , Shimada Yasushi
Published: September 2023

Background
The successful integration of resin-based dental adhesives significantly impacts restorative dentistry, providing efficient and aesthetically pleasing caries treatments. Among various adhesives, one-step self-etching adhesives (1-SEAs) have gained popularity due to their simplicity and short application time. However, concerns have been raised regarding their bonding performance and marginal adaptation characteristics, which differ from two-step self-etching adhesives (2-SEAs) and three-step etch-and-rinse adhesives. Additionally, light-cured bonding materials may encounter challenges in deep cavities and inaccessible areas, necessitating extended light irradiation time. Autocured bonding materials are a potential solution, but limited comparative studies have been conducted on their performance.
Methods
In this in vitro study, we evaluated a new autocured universal bonding material (Bondmer Lightless 2) and compared the results with recent light-cured bonding materials. Microshear bond strength (µSBS) tests were performed on 25 human molars using five different combinations of adhesives and composite resins: Bondmer Lightless 2 with Estelite Bulk Fill Flow (BE group), Bondmer Lightless 2 with a prototype composite resin (BO group), Prime&Bond Universal with SDR flow+ (PS group), Scotchbond Universal with Filtek Bulk Fill (SF group), and G-Premio Bond with Gracefil BulkFlo (GG group). The bond strengths and failure modes were assessed using a universal testing machine and scanning electron microscope (SEM), respectively. Marginal adaptation was evaluated using swept-source optical coherence tomography (SS-OCT) and confocal laser scanning microscopy (CLSM) on 40 sound bovine maxillary incisors.
Results
The µSBS test showed no significant differences in bond strength among the tested groups. Most failure modes were observed at the bond interface between the adhesive and the dentin. The autocured bonding material demonstrated significantly higher marginal adaptation (SI%) than PS, SF, and GG. The CLSM images corresponded with gaps observed in the SS-OCT images, indicating improved marginal sealing in the autocured group.
Conclusions
The new autocured universal bonding material exhibited comparable bond strength to a conventional light-cured material while demonstrating a superior marginal adaptation level. This finding suggested that the autocured material could be a valuable alternative, especially when extended light irradiation would pose a challenge. Further clinical studies would be warranted to evaluate the performance of the autocured bonding material in actual restorative dental practice.
Research on Price-Based Autonomous Group Robot Resource Allocation Strategy in Emergency Scenarios
Authors: Yi Sun , Xiao Zhang
Published: September 2023

In unknown and dynamic emergency scenarios, achieving the collaboration of autonomous group robots for search and rescue operations can be regarded as resource allocation among robots at the micro-level. The resource allocation problem for autonomous group robots can be abstracted as a non-cooperative game, and in a dynamically changing environment, pricing becomes a critical factor for effective resource allocation.This paper starts from the perspectives of uniform pricing strategy and differential pricing strategy, respectively. It establishes master-slave game models for these two pricing strategies to describe resource allocation between resource providers and resource consumers. Furthermore, the paper utilizes game theory to model the competition for computational resources between resource-providing robots and resource-consuming robots, and solves for their Nash equilibrium solution, demonstrating its existence and uniqueness.Additionally, performance analysis and numerical analysis are conducted on both the uniform pricing model and the differential pricing model, thereby highlighting the advantages and disadvantages of different pricing models for dynamic adjustment of pricing strategies. Meanwhile, the differential pricing model introduces a fairness factor to enhance collaboration between robots and prevent resource accumulation. Simulation results indicate that under the same CPU cycle, the average processing time is shorter in the uniform pricing model, while in the differential pricing model, the resource-providing robots yield higher profits. Hence, the suitable pricing strategy can be chosen based on specific requirements.Simultaneously, as the CPU cycle increases, the cost for resource-consuming robots decreases, average processing time reduces, and the payment enthusiasm of resource-consuming robots increases. Therefore, the CPU cycle is related to the overall well-being of the autonomous group robot system.
Diverse Forms of Denticles Facilitate the Evolutionary Success of Sharks
Authors: Shen Sheng-Feng , Dahl Rikke , Ghimire Ashish , Iizuka Yoshiyuki , Huang Jen-Pen , Lin Wei-Chen , Yang Cheng-Chun , Huang Tsung-Hui , Mai Guan-Shuo , Møller Peter , Chen Po-Yu
Published: September 2023

The ground sharks Carcharhiniformes are the most specious order of modern sharks, and although occupying ecologically diverse habitats, they share a common feature of having a variety of ridges on the crown of their skin teeth (dermal denticles). For the first time, we objectively quantify dermal denticle disparity using deep learning on scanning electron microscopy images, concluding ten morphogroups across modern sharks (Selachii). Seven of the ten morphogroups display these ridged denticles. Through nanoindentation, electron probe micro-analysis, and computational fluid dynamics, we establish mechanical properties, elemental composition, and swimming performance, and find that denticle ridges are highly variable and present a spectrum of functional properties beyond drag reduction. Further, we found a radiation event within the ground sharks around 170 MYA, resulting in the enormous diversity of the clade, for which ridged dermal denticles may have been key.
The Effects of Working Memory versus Language Learning Aptitude on L2 Listening Learning: A Comparison of Chinese and Non-Chinese Cultural Circles in Asia
Authors: chen yu
Published: September 2023

Many previous studies have discussed the interactions between two of the most important human cognitive functions, memory and language, and have pointed out that the listening comprehension of L2 learners is profoundly affected by memory and language backgrounds. Therefore, this study explores the relationship among working memory (WM) and language aptitude (LA) components that represent the phonological memory of 129 Asian international students from two different cultural circles: the Chinese and Non-Chinese-character cultural circle countries (abbreviated as 4C and N4C) in Chinese listening proficiency (CLP). The statistical results show that first, after learning Chinese as an L2 for the same amount of time, L2 learners with disparate backgrounds were found to have significantly different levels of Chinese listening proficiency (CLP), with the 4C cohort showing higher CLP levels. Second, the cognitive ability factors that can successfully predict learners’ CLP are different. Specifically, phonetic coding ability (PCA) is the best predictor, although with different predictive power for both N4C and 4C primary Chinese L2 learners. In regard to N4C learners, the explanatory power of executive functioning of working memory (EWM) is added. In conclusion, from the perspective of language-historical background, the predictive cognitive ability related to memory required by L2 learners is dynamic; in addition, EWM, as a general cognitive factor independent of LA, plays a significant role in L2 learners’ listening comprehension.
KESPKSR: A Blind Image Super-resolution Network Combined Kernel Estimation and Structural Prior Knowledge
Authors: Zhang Jiajun , Zhou Yuanbo , Bi Jiang , Xue Yuyang , Deng Wei , He Wenlin , Zhao Tao , Sun Kai , Tong Tong , Zhang Qing , Gao Qinquan
Published: September 2023

The goal of blind image super-resolution (BISR) is to recover the corresponding high-resolution image from a given low-resolution image with unknown degradation. Prior related research has primarily focused effectively on utilizing the kernel as prior knowledge to recover the high-frequency components of image. However, they overlooked the function of structural prior information within the same image, which resulted in unsatisfactory recovery performance for textures with strong self-similarity. To address this issue, we propose a two stage blind super-resolution network that is based on kernel estimation strategy and is capable of integrating structural texture as prior knowledge. In the first stage, we utilize a dynamic kernel estimator to achieve degradation presentation embedding. Then, we propose a triple path attention groups consists of triple path attention blocks and a global feature fusion block to extract structural prior information to assist the recovery of details within images. The quantitative and qualitative results on standard benchmarks with various degradation settings, including Gaussian8 and DIV2RK, validate that our proposed method outperforms the state-of-the-art methods in terms of fidelity and recovery of clear details. The relevant code is made available on this link as open source.
Volumetric changes in brain MRI of infants with abnormal development who had Hypoxic-ischemic Encephalopathy and underwent therapeutic hypothermia
Authors: Im Soo-Ah , Kim Sae-Yun , Kang Hyun Mi , Youn Young-Ah
Published: September 2023

Background
Hypoxic-ischemic encephalopathy (HIE) is a severe neonatal complication that can result in 40–60% of long-term morbidity. MRI is a noninvasive method which is usually performed before discharge to visually assess acquired cerebral lesions associated with HIE and severity of lesions possibly providing a guide for detecting adverse outcomes. This study aims to evaluate the impact of HIE on brain volume changes observed in MRI scans performed at a mean 10 days of life, which can serve as a prognostic indicator for abnormal neurodevelopmental (ND) outcomes at 18–24 months among HIE infants.
Methods
We retrospectively identified a cohort of HIE patients between June 2013 and March 2017. The inclusion criteria for TH were a gestational age ≥ 35 weeks, a birth weight ≥ 1,800 g, and the presence of ≥ moderate HIE. Brain MRI was performed at a mean 10 days of life and brain volumes (total brain volume, cerebral volume, cerebellar volume, brain stem volume, and ventricle volume) were measured for quantitative assessment. At 18–24 months, the infants returned for follow-up evaluations, during which their cognitive, language, and motor skills were assessed using the Bayley Scales of Infant and Toddler Development III.
Results
The study recruited a total of 240 infants between 2013 to 2017 for volumetric brain MRI evaluation. Among these, 83 were normal control infants, 107 were TH-treated HIE infants and 37 were HIE infants who did not receive TH due to contraindications. Clinical evaluation was further proceeded among the 107 TH-treated HIE infants. We grouped according to brain MRI findings; 33.6% (36/107) infants had normal or minimal lesions of brain MRI and 66.4% (71/107) had abnormal MRI findings. At 18–24 months, 31 of 107 infants (29.0%) had delayed neurodevelopment and 76 of 107 infants (71.0%) were normal in their neurodevelopmental stages. When comparing brain volumes between the normal control infants (n = 83) and the abnormal ND group at the corrected 18–24 months of age (n = 31) in the 107 TH -treated HIE group, abnormal ND group exhibited a significant reduction in brain stem volume and larger ventricular volume (p < 0.001). This observation was consistent when we regrouped the HIE infants according to severe brain MRI group who did not receive TH due to contraindications.
Conclusion
In addition to location of brain injury in MRI assessment, brain stem volume reduction accompanied by larger ventricular volume in HIE infants may serve as a biomarker indicating severe HIE and adverse long-term neurodevelopmental outcomes among HIE infants who were treated with TH.
Exploring Perceptions Of Women And Couples Of Childbearing Age To Improve Preconception Care Visits At Public Health Centre
Authors: Luh Seri Ani , Arya Utami Ni Wayan , Herry Purnama I Gede , Luh Mertasari , Luh Sawitri
Published: September 2023

Visiting preconception care (PCC) can prevent poor pregnancy outcomes. However, only a tiny percentage of couples of childbearing age use this service at the Public Health Centre (PHC). This study aims to explore the perceptions of women and couples of childbearing ages in the use of preconception care in PHC. This research is an exploratory qualitative study. The subjects of the study were women and couples of childbearing age. Purposively selected informants consist of the Dean of PHC, General Physicians, Obstetrics and Gynecology Specialists, women, and couples of childbearing age who have and never used PCC. The criteria for informants who participate include being willing to be informants and coordinators. Data were collected by an in-depth interview method at an agreed location. Data were analyzed thematically. Only a few informants claimed to have used PCC. The perceptions of women and fertile couples about PCC are grouped into three themes, namely, the themes of culture, knowledge, and means of service. They visit the PCC only to qualify for administration and want to become pregnant or want a child of a specific gender. Conversely, those who had never been to a service were associated with low awareness and perception of shame. Low awareness and perceptions of shame from women and couples of childbearing age contribute to low preconception healthcare visits. This study suggests increasing health care coverage through socialization about the benefits of visiting PCCs to prevent poor pregnancy outcomes.
Responsible coordination of municipal health and care services: Café dialogues as a method for responsible innovation
Authors: Skjærpe Jorunn Nærland , Iakovleva Tatiana Aleksandrovna , Storm Marianne
Published: September 2023

Background
Care coordination is crucial to ensure and improve the health of individuals with mental illness. This study aimed to describe and analyze an inclusive innovation process that could contribute to the responsible coordination of municipal health and care services.
Method
Café dialogues were performed to explore the perspectives of professionals and service users regarding care coordination. Further, we used a responsible innovation framework to analyze the innovation process.
Results
Factors supporting responsible coordination at the individual level comprised service users knowing the professionals working with them, personalized healthcare services, and access to meaningful activities. At the provider level, key factors were effective coordination routines, communication, information exchange, and professionals being familiar with each other. Results reflect professionals' and service users' perspectives on efficient care coordination, existing challenges, and measures to improve care coordination.
Conclusion
Café dialogues can be an inclusive method for innovation and can inform responsible coordination of municipal health and care services for individuals with mental illness. The impact of these measures on the improvement and responsible coordination of municipal health and care services should be explored.
Study on the characteristics of ecological network and critical areas of ecological restoration in Hebei-Tianjin coastal wetlands
Authors: Wang Feng , Liu Jintong , Fu Tonggang , Gao Hui , Qi Fei , Gao Yue , Zhao Liang
Published: September 2023

Coastal wetlands are crucial ecosystems at the interface between land and sea. In the context of economic development and urbanization, these wetlands face challenges such as reduction in area and fragmentation. Ecological networks can connect fragmented habitats, creating corridors for material, information, and energy transmission. This is vital for maintaining biological and landscape diversity and ensuring the healthy development of ecosystems. However, there is currently no research on the ecological networks in the Hebei-Tianjin coastal wetlands. In this study, the morphological spatial pattern analysis (MSPA) method is employed to identify wetlands sources, while the minimum cumulative resistance (MCR) model is used to extract potential ecological corridors. By combining these with existing river corridors, the ecological network of coastal wetlands in Hebei and Tianjin is constructed, and regional network characteristics are analyzed. Critical areas of ecological protection and restoration are determined, including important ecological corridors, ecological pinch points, and ecological breakpoints. The results showed that: (1) The ecological network of Hebei-Tianjin coastal wetlands consisted of 38 ecological sources, 171 potential ecological corridors, and 399 river corridors, with a total area of 851.31 km2. (2) Key ecological protection and restoration areas were proposed, including 35 crucial potential wetlands ecological corridors, 343 ecological pinch points, and 99 ecological breakpoints. Targeted restoration of these critical areas could significantly improve the connectivity of wetlands ecological networks. (3) At present, priority should be given to protecting critical ecological corridors and existing river corridors with high similarity to potential ecological corridors. The findings of this study can provide a scientific basis for the network construction and protection of Hebei-Tianjin coastal wetlands.
Changes in Temperature and CO2 Concentration Induced by El Niño
Authors: Nishioka Masaharu
Published: September 2023

We compared satellite-based UAH Earth surface temperature, NOAA ENSO index, and Earth-surface CO2 change rate in detail. These three variables were well correlated over the observed 40 years. The temperature changed approximately one year after the ENSO index changed, and the CO2 change rate followed the temperature change by several months. CO2 emission and absorption at the Earth’s surface responded to temperature changes. It was like Earth’s breathing. CO2 emission due to higher temperature was related to plant respiration or decomposition processes.
Neurological intervention transition model for dynamic prediction of good outcome in spontaneous subarachnoid haemorrhage
Authors: Luo Yiming , Payne Stephen John
Published: September 2023

Deterioration of neurovascular conditions can be rapid in patients with spontaneous subarachnoid haemorrhage (SAH) and often lead to poor outcomes. Therefore, it is crucial to promptly assess and continually track the progression of the disease. This study incorporates baseline clinical conditions, repeatedly measured neurological grades and biomarkers for dynamic outcome prediction of patients with spontaneous SAH. Neurological intervention, mainly aneurysm clipping and endovascular embolisation, was also incorporated as an intermediate event in developing neurological intervention transition (NIT) joint model. A retrospective cohort study was performed on 701 patients with spontaneous SAH with a study period of 14 days from the MIMIC-IV dataset. Dynamic prognostic model predicting outcome of patients was developed based on combination of Cox model and piecewise linear mixed-effect models to incorporate different types of prognostic information. Clinical conditions on admission as baseline covariates, including cerebral oedema, cerebral infarction, respiratory failure, hydrocephalus and vasospasm, as well as repeated measured GCS score, glucose and white blood cell (WBC) levels were covariates contributing to the optimal model. Incorporation of neurological intervention as an intermediate event increases the prediction performance compared with baseline joint modelling approach. The average AUC of the optimal model proposed in this study is 0.7783 across different starting points of prediction and prediction intervals. The model proposed in this study can provide dynamic prognosis for spontaneous SAH patients and significant potential benefits in critical care management for clinical practice.
Evaluation of Complications of Root Canal Treatment Performed by Residents and Endodontic Specialists Using Contemporary Techniques: A Retrospective Study
Authors: Shao Tongfei , Guan Rui , Zhang Chen , Hou Benxiang
Published: September 2023

Objectives: Endodontic treatment has benefited from the development of new techniques and equipment. Few clinical studies have been published on the complications associated with root canal preparations performed by doctors with different working experiences using contemporary techniques. This study aimed to analyze the complications of endodontic treatment performed by residents and endodontic specialists in a teaching stomatology hospital using contemporary techniques.
Materials and Methods: Cases of root canal treatment (RCT) and root canal retreatment (ReRCT) performed by residents and endodontic specialists were collected from the electronic medical system of the Beijing Stomatology Hospital. The cases were examined in terms of patient age, sex, type of tooth, diagnosis, treatment plan, number of appointments, whether a rubber dam and operating microscope were used, type of irrigation used, presence of ledges, canal transportation, perforations, missed canals, separated instruments, clinical incidence of second mesiobuccal (MB2) root canal in the maxillary molars, and occurrence of flare-ups.
Results: In total, 859 patients were included in the analysis. The overall incidence of complications in the resident group were significantly higher than in the specialist group. More ledges and flare-ups were observed in the resident group. There were no significant differences in root canal transportation, perforation, or instrument separation between the two groups. The findings of MB2 in the maxillary molars were significantly higher in the specialist group. Univariate analysis showed that the incidence of root canal preparation complications was related to operator experience and tooth type.
Conclusion: Operator experience influenced ledges, flare-ups, and finding MB2, but did not affect root canal transportation, perforation, or instrument separation with contemporary techniques.
Clinical Relevance: With the development of new techniques and equipment of endodontics therapy, whether clinical experience has an effect on the complications of root canal treatment.
Rich2 inhibits the NLRP3 inflammasome in epilepsy formation by regulating autophagy
Authors: Guo Hao-Kun , Xu Tao , Xie Xiao-Yong , Zhang Hui , Hu Li-Qin , Tang Feng-Lin , Zhao Yu-Ping , Luo Jing , Ma Yuan-Lin
Published: September 2023

Background
The intricate pathophysiology of epilepsy has hindered the advancement of efficacious therapies. Despite the existence of a dozen antiseizure drugs (ASDs) with favorable effects on seizure management globally, approximately 30% of patients continue to exhibit resistance to ASDs. Neuroinflammation seems to play a pivotal role in the disease's progression. Rich2 (Rho GTP enzyme-activated protein 44) is a protein-coding gene, the functions of which include participation in the RAC1 GTP enzyme cycle and the RHOC GTP enzyme cycle. Recent studies have found that the dysfunction of Rac 1-autophagy-related pathways not only hinders the clearance of pathogens or nonorganicparticles but also participates in the dysfunction of T cells and macrophages and that the activation of Rac 1 or mTOR can reverse ibandronate (IBAN)-induced autophagy. It has been shown that autophagy can regulate the activation of the NLRP3 inflammasome, which is significantly enhanced after the inhibition of autophagy. However, the role of Rich2 in epilepsy remains unclear. This study aimed to investigate the mechanism of Rich2 in epilepsy.
Methods
Adult male C57BL/6 mice were intracranially administered kainic acid (KA) to establish an epilepsy model and were pretransfected with adeno-associated virus (AAV) three weeks prior to KA injection. Additionally, SH-SY5Y cells were transfected with AAV for 48 hours and subsequently treated with KA for 6 hours. Immunoblot analysis, immunofluorescence staining, seizure video monitoring, LFP (local field potential) recording, and Nissl staining were performed individually. VX 765 was orally administered 30 minutes prior to KA induction (at 10 am and 4 pm) for a duration of 7 days until the mice were euthanized.
Results
In the KA-induced temporal lobe epilepsy (TLE) model, Rich2 expression was reduced in the hippocampus, and it was lowest at 3 days after KA injection. Overexpression of Rich2 significantly attenuated epileptic activity, reduced neuronal damage after status epilepticus (SE), and downregulated IL-1β, IL-18 and pyrin domain protein 3 (NLRP3) inflammasome expression through activation of autophagy, while downregulation of Rich2 hadthe opposite effects. Inhibition of cysteine-aspartic-specific proteinase-1 (caspasase-1) by VX765 reversed the effect of Rich2 knockdown.
Conclusion
Rich2 influences seizure activity and impacts neuronal viability in a mouse model of temporal lobe epilepsy induced by KA. Additionally, Rich2 governs neuroinflammation in epileptic subjects through the regulation of NLRP3/Caspase-1/IL-1β signaling via autophagy activation.
Crop Rotations and Changes in Saskatchewan Fertilizer Use: 1991-94 and 2016-19
Authors: Lika Elisabeta , Sutherland Chelsea , Gleim Savannah , Smyth Stuart J.
Published: September 2023

Over the past 30 years, Saskatchewan, which holds over 40% of Canada’s cropland, has seen a shift in dryland crop production. Previously, fields were often left fallow with tillage as the primary weed control. The 1995 introduction of herbicide-tolerant canola transformed this, leading to continuous crop rotations and increased nitrogen-fixing pulse crops. This research, based on a 2020–2021 online survey, aimed to assess the impact of these changes on fertilizer use. Findings showed that while pulses positively impacted crop rotations, their effect on nitrogen fertilizer requirements varied. Additionally, GMHT canola required fewer fertilizers compared to the conventional canola in the 1991–1994 period. These changes highlight improved fertilizer efficiency, suggesting that expanding the pulse crop industry could further enhance prairie agriculture’s environmental sustainability.
A wetland condition assessment to consider ecological relationships of a Maya cultural keystone species within the Lake Atitlan, Guatemala littoral zone
Authors: Garcia-Polo Jorge , Diemont Stewart A.W. , Falkowski Tomasz B. , Leopold Donald J.
Published: September 2023

Littoral wetland plant species such as Typha domingensis and Schoenoplectus californicus (both locally called tul) in Lake Atitlan provide diverse ecosystem services (ES). These ES include removal of pollutants, oxygenation, and raw material for handicrafts. Human communities, most of whom are Indigenous Maya, actively steward littoral wetlands informed by their traditional ecological knowledge (TEK). Our goal was to assess the wetland condition in four Maya Tz'utujil communities (Santiago Atitlan, San Pedro, San Juan and San Pablo La Laguna), each with different Indigenous uses and management practices. We used a three-level wetland condition assessment: 1) littoral vegetation extent measured with remote Sentinel-2 and Google Earth photographs, 2) field plant survey to measure vegetation structure and plant diversity, and 3) wetland stressor assessment. Stressors analyzed were land use, non-native macrophyte (Hydrilla verticillata) and lake-level fluctuations. In Santiago, where wetland plant TEK is most intact, remote sensing results showed the highest tul concentrations (81% of the overall 5 ha of S. californicus and 98% of the 5.2 ha for T. domingensis), and the highest structure and diversity indices (first-order Jackknife and Shannon index). San Juan showed higher plant structure (number of stalks, diameter, and cover) than San Pablo and San Pedro. Santiago and San Juan were however, the most vulnerable to water-level reduction. Traditional Tulero practice in Santiago, including planting and cutting tul and removing invasive macrophytes, has sustained these wetlands. Ecological value embedded in Indigenous resource management suggests the need to include these practices in governmental environmental management and policy.