bluuebunny/crossref_metadata_2025 huggingface dataset:
Imposter phenomenon in physical therapists: A cross‐sectional observational study
Authors: Anderson Alexandra R. , LaPenna Jamie , Willis Dustin , Simpson Khyrah , Chang Alison H.
Published: March 2024

Background and Aims

Imposter phenomenon (IP), or perceived fraudulence, describes an ongoing fear of exposure as a fraud or imposter, despite objective successes and accomplishments. Although there is a growing interest of IP in medicine, IP in the physical therapy profession has been minimally examined. We aimed to determine the prevalence and predictors of IP among licensed physical therapists in the United States.

Methods

This cross‐sectional observational study utilized an online survey to assess levels of IP using the Clance Imposter Phenomenon Scale. We assessed degrees of emotional exhaustion and job satisfaction and collected professional and demographic information. A multivariable logistic regression model examined factors associated with IP presence.

Results

The mean IP score was 60.3 (SD: 15.1, range: 19–95). Fifty‐five respondents (10.7%) had low IP, 196 (38.1%) moderate, 215 (41.8%) frequent, and 48 (9.3%) intense IP. The prevalence of IP, defined as frequent or intense IP, was 51.2%. Having manager/supervisor experience (odds ratio [OR] = 0.55, 95% confidence interval [CI] = 0.34–0.90) was associated with a reduced odds of IP presence. Holding a bachelor's or master's degree (vs. Doctor of Physical Therapy (DPT); OR = 2.31, 95% CI = 1.07–5.00), a history of or current mental health diagnosis (OR = 2.77, 95% CI = 1.69–4.54), and emotional exhaustion (moderate vs. low: OR = 5.37, 95% CI = 2.11–13.69; high vs. low: OR = 14.13, 95% CI = 5.56–35.89) were each associated with an increased odds of IP presence.

Conclusions

IP is highly prevalent among licensed physical therapists. Seasoned clinicians with managerial roles seemed to be less susceptible to IP, whereas those with mental health diagnoses, emotional exhaustion, and those without a DPT degree may be more susceptible. Given its high prevalence and potential negative impact on burnout and career advancement, it is crucial to increase IP awareness and provide education on management strategies.
Spatial distribution characteristics and influencing factors of shallow and deep soil moisture under ecological restoration in the loess plateau, China
Authors: Wen Yongfu , Li Mengzhen , Xu Ruirui , Qiu Dexun , Gao Peng , Mu Xingmin
Published: March 2024

Deep soil moisture is one of the primary factors restricting vegetation growth on the Loess Plateau (LP) of China. Investigating the spatial variations and influencing factors of shallow and deep soil moisture is of great significance for ecological restoration on the LP. In this study, we sampled disturbed soil up to a depth of 10 m with a soil drill. A 200 × 200 m grid was superimposed on a digital topographic map, and 78 sampling sites were selected across the Zhifanggou (ZFG) watershed. According to the results, the vertical profile of soil could be subdivided into four layers: the shallow active layer (SAL; 0–0.5 m), the shallow rainfall recharge layer (SRL; 0.5–2.2 m), the deep excessive layer (DEL; 2.2–4 m), and the deep stable layer (DSL; 4–10 m). The horizontal distribution characteristics of soil moisture in various soil layers were similar, with a generally high concentration in the south and a low concentration in the north. In addition, a relatively low soil moisture content (SMC) occurred in the center of the SRL. Soil moisture was negatively correlated with slope and slope aspect between 0 and 2.2 m (p < 0.05), whereas slope and slope aspect had no significant effects on deep soil moisture (>2.2 m). The SMCs of the four soil layers, from lowest to highest, were as follows: forestland, shrubland, and grassland. The SMC of forestland was negatively correlated with restoration age, whereas the SMC of grassland was positively correlated with restoration age. This study deepens our understanding of shallow and deep soil moisture distribution characteristics and the corresponding ecological restoration on the LP and provides a reference for the rational use of deep soil moisture.
Constructing brain functional networks with adaptive manifold regularization for early mild cognitive impairment
Authors: Fu Xidong , Shan Shengchang , Liu Chun , Lu Yu , Jiao Zhuqing
Published: March 2024

Brain functional network (BFN) has emerged as a practical path to explore biomarkers for early mild cognitive impairment (eMCI). Currently, most of BFNs only considered the topology structure between two brain regions and ignored the high‐order information among multiple brain regions. We proposed an adaptive manifold regularization method to construct a new BFN. Firstly, a traditional hypergraph was constructed through a low‐order BFN. Then, an adaptive hypergraph was obtained by updating the traditional hypergraph weight and structure through adaptive hypergraph learning. An adaptive hypergraph manifold regularization term was constructed by the Laplacian matrix of the adaptive hypergraph. Finally, the low‐order BFN was optimized through the adaptive hypergraph manifold regularization and sparse regularization. The experimental results confirmed that the proposed method outperformed other state‐of‐the‐art methods in classification performance and stability. This study revealed the causes of changes in topological properties and provided a reference for the clinical diagnosis of eMCI.
Feasibility analysis of photovoltaic systems for kiwifruit irrigation: A case study in Shaanxi province, China
Authors: Zhao Hang , Zhu Delan , Ge Maosheng , Khudayberdi Nazarov , Liu Changxin
Published: March 2024

Although photovoltaic (PV) irrigation systems are widely used in China, feasibility assessment of these systems is important because of differences in the distribution characteristics of solar resources and crops. In this study, kiwifruit planting in Shaanxi province was considered, and a calculation model for PV irrigation system evaluation was developed. Based on the geographical distribution of kiwifruit planting, as well as the spatial and temporal distributions of solar energy in Shaanxi province, the application potential of PV irrigation for kiwifruit was investigated comprehensively from the perspectives of technology, economy and irrigation feasibility. The results showed that the proportion of the PV module scale to the irrigation scale in all the kiwifruit planting areas in Shaanxi province was far less than 1.5%, and there were no technical obstacles. In Baoji, Weinan, Hanzhong and Ankang, the annual cost of the PV irrigation system was greater than that of the diesel pump irrigation system. Regarding irrigation feasibility, farmlands with a slope of 0%–8.75% were considered highly suitable for installing a PV irrigation system. The results revealed 32,269 ha of farmland appropriate for PV irrigation among the 66,371 ha of kiwifruit in Shaanxi province.
The effect of crop insurance on agricultural loan delinquencies
Authors: Lee Daemyung , Chen Le , Rejesus Roderick M. , Aglasan Serkan , Dinterman Robert , Connor Lawson
Published: March 2024

This study addresses how participation in the Federal crop insurance program influences agricultural loan delinquencies. To achieve this objective, we use 1994–2015 county‐level panel data for corn production in the Midwestern United States (US). Traditional linear fixed effect (FE) models, instrumental variable‐based FE estimation, and several robustness checks are used in the empirical analysis. Estimation results suggest that counties with higher levels of crop insurance participation tend to have statistically lower rates of agricultural loan delinquency. This is evidence that the US crop insurance program helps reduce financial stress and facilitates the continued viability of the agricultural credit system.
Evaluation of rabbit adipose derived stem cells fate in perfused multilayered silk fibroin composite scaffold for Osteochondral repair
Authors: Zadegan Sara , Vahidi Bahman , Nourmohammadi Jhamak , Shojaee Asiyeh , Haghighipour Nooshin
Published: March 2024

Development of osteochondral tissue engineering approaches using scaffolds seeded with stem cells in association with mechanical stimulations has been recently considered as a promising technique for the repair of this tissue. In this study, an integrated and biomimetic trilayered silk fibroin (SF) scaffold containing SF nanofibers in each layer was fabricated. The osteogenesis and chondrogenesis of stem cells seeded on the fabricated scaffolds were investigated under a perfusion flow. 3‐Dimethylthiazol‐2,5‐diphenyltetrazolium bromide assay showed that the perfusion flow significantly enhanced cell viability and proliferation. Analysis of gene expression by stem cells revealed that perfusion flow had significantly upregulated the expression of osteogenic and chondrogenic genes in the bone and cartilage layers and downregulated the hypertrophic gene expression in the intermediate layer of the scaffold. In conclusion, applying flow perfusion on the prepared integrated trilayered SF‐based scaffold can support osteogenic and chondrogenic differentiation for repairing osteochondral defects.
Accuracy of point‐of‐care ultrasound in the diagnosis of acute appendicitis in a pediatric emergency department
Authors: Balbo Stefano , Pini Cecilia Maria , Raffaldi Irene , Delmonaco Angelo Giovanni , Castagno Emanuele , Guanà Riccardo , Di Rosa Gianpaolo , Bondone Claudia
Published: March 2024

Purpose

To investigate the accuracy of point‐of‐care ultrasound (PoCUS) in diagnosing acute appendicitis in children; to evaluate the concordance between PoCUS performed by a pediatric emergency physician (PedEm) and ultrasonography (US) performed by a radiologist; to draw a “learning curve.”

Methods

We prospectively enrolled children aged 0–14 years old led to the Emergency Department of Regina Margherita Children's Hospital, from January 2021 to June 2021, with suspected acute appendicitis. PoCUS was performed by a single trained PedEm, blindly to the radiologist's scan. A “self‐assessment score” and the “time of duration of PoCUS” were recorded for each patient. Final diagnosis of appendicitis was made by a pediatric surgeon.

Results

We enrolled 62 children (2–14 years). Overall sensitivity of PoCUS was 88%, specificity 90%; PPV 90.6%, and NPV 86.6%. Global concordance between the PedEm and the radiologist was good/excellent (k 0.74). The mean duration of PoCUS significantly decreased during the study period, while the self‐assessment score increased.

Conclusion

This is a preliminary study that shows the effectiveness of PoCUS in diagnosing acute appendicitis; furthermore, it shows how the PedEm's performance may improve over time. The learning curve showed how the experience of the PedEm affects the accuracy of PoCUS.
Clinical and immunological features of COVID‐19 in patients with anti‐MDA5 dermatomyositis during the omicron wave in Chongqing, China
Authors: Wu Na , Chen Zhiwei , Zha Guanhua , Deng Zhiling , Huang Wenhan , Cai Dachuan , Peng Mingli , Hu Peng , Tang Lin , Ren Hong
Published: March 2024

Patients with anti‐melanoma differentiation‐associated gene 5 (anti‐MDA5) dermatomyositis (DM) have a higher risk of coronavirus disease 2019 (COVID‐19) infection. In this longitudinal observational study, we aimed to investigate the clinical and immunological features of these patients after COVID‐19 infection. A total of 73 patients with anti‐MDA5 DM were recruited from the Second Affiliated Hospital of Chongqing Medical University during the Omicron wave epidemic. Clinical data were collected by questionnaire survey and electronic medical records. Blood samples were used to determine the immunity responses. From December 9, 2022 to March 31, 2023, 67 patients were eligible for final analysis; 68.7% of them were infected with COVID‐19. The most common symptoms observed in COVID‐19 were upper respiratory symptoms, most cases were mild or moderate (97.8%). The clinical laboratory indexes were relativity stable in patients after infection (all p > 0.05). Vaccination is not a protective factor against the Omicron infection (odds ratio: 2.69, 95% confidence interval: 0.81–8.93, p = 0.105). Both wildtype (WT) neutralizing antibodies titer and BA.5‐specific immunoglobulin G titer were significantly enhanced after infection (all p < 0.01), which was as high as healthy controls (HCs). The memory B‐cell responses were similar between the patients with anti‐MDA5 DM and HCs (p > 0.05). However, both the WT‐specific CD8+ T cells and CD4+ T cells were reduced in patients with anti‐MDA5 DM (all p < 0.05). In conclusion, patients with anti‐MDA5 DM did not deteriorate the COVID‐19, in turn, COVID‐19 infection did not increase the risk of anti‐MDA5 DM exacerbation. The humoral responses were robust but the cellular responses were weakened after COVID‐19 infection.
Osseointegration of minimally invasive sacroiliac joint fixation implants—A human retrieval study
Authors: Randers Engelke , Kibsgård Thomas , Nogueira Liebert P. , Kjensjord Trygve , Röhrl Stephan M. , Nordsletten Lars , Stuge Britt
Published: March 2024

Minimally invasive sacroiliac joint fusion has become increasingly prevalent and is described to reduce pain and improve function. In some patients, pain can recur several months after primary surgery. Lack of early implant osseointegration might be a cause of pain and hence an indication for revision surgery. Triangular titanium implants are the most documented implant for minimally invasive sacroiliac joint fusion. There is, however, no knowledge of how triangular titanium implants osseointegrate in humans and whether fusion is induced over the sacroiliac joint. During planned revision surgery due to recurrent pain, six triangular titanium implants were retrieved from six different patients at median 9 months from primary surgery. All six implants were scanned using microcomputed tomography. The presence or absence of bone in‐growth, on‐growth, and through‐growth of the implants was evaluated as an indication of implant osseointegration. Three of six implants showed no or minor signs of osseointegration. Of the three remaining implants, one showed partial osseointegration and two implants showed high degrees of osseointegration. This study showed that triangular titanium implants can osseointegrate into host bone in humans. When osseointegration occurs, triangular titanium implants can give fusion across the sacroiliac joint.
How revegetation reinforces soil at early stage of restoration: A 6‐year field study in southwest China
Authors: Zhu Jinqi , Wang Yujie , Zheng Bofu , Langendoen Eddy J. , Wang Yunqi
Published: March 2024

Background and aims

Restoring vegetation on hillslopes has been found to increase soil strength, thereby reducing the risk of soil erosion and shallow landslides. However, limited information is available on the temporal changes in root biomechanical traits and increased soil shear strength related to vegetation growth following restoration with different species.

Methods

In 2012, Symplocos setchuensis, Buxus megistophylla, and Cynodon dactylon were replanted in a forest gap in Jinyun Mountain, Beibei District, China, and studied over a 6‐year period. We measured root traits (root tensile strength, Young's modulus, cellulose content, and root density) and soil traits (cohesion and internal friction angle) at two soil depths (0–20 and 20–40 cm) for undisturbed and reconstituted samples.

Results

S. setchuensis was found to have the highest tensile strength and resistance to failure for root diameters <2 mm. With elapsed time, tensile strength and cellulose content decreased. Cohesion and root mechanical reinforcement of topsoil generally increased with time (+10% per year). Root chemical and mechanical effects contributed approximately 50% to soil reinforcement. C. dactylon had the fastest growth rate and reinforced the topsoil soil rapidly, whereas S. setchuensis exhibited a consistent increase in soil reinforcement during the study period and provided more deep roots that could reinforce subsoil.

Conclusion

Chemical and mechanical effects almost equally contributed to soil reinforcement. Although the relative contributions varied for different species, the variation in each contribution sheds new light on the sustainable use of vegetation for mitigating shallow landslides in mountainous areas.
Non‐oxidized and oxidized flaxseed orbitides differently induce HepG2 cell apoptosis: involvement of cellular uptake and membrane death receptor DR4
Authors: Peng Changmei , Li Jing , Zhao Aixiu , Yu Shaoqing , Zheng Liufeng , Deng Ze‐Yuan
Published: March 2024

BACKGROUND

Flaxseed orbitides have health‐promoting properties, particularly potent anti‐cancer activity. However, flaxseed orbitides containing a methionine structure, such as [1‐9‐NαC]‐linusorb B2 (CLB), are easily oxidized to sulfoxide ([1‐9‐NαC],[1‐Rs,Ss‐MetO]‐linusorb‐B2 (CLC)) and sulfone ([1–9‐NαC], [1‐MetO]‐linusorb B2 (CLK)), with CLC having less anti‐cancer ability than CLB. It is unclear why oxidized flaxseed orbitides are less effective against cancer than non‐oxidized flaxseed orbitide.

RESULTS

Non‐oxidized ([1‐9‐NαC]‐linusorb‐B3 (CLA) and CLB) and oxidized (CLC and CLK) flaxseed orbitides were found to significantly upregulate the levels of pro‐apoptotic proteins, including Bax/Bcl‐2, CytoC, caspase‐3, and caspase‐8, in a dose‐dependent manner, with non‐oxidized flaxseed orbitides being more effective than oxidized flaxseed orbitides. Mechanically, the cellular absorption of non‐oxidized flaxseed orbitides was higher than that of oxidized flaxseed orbitides. Moreover, the significant fluorescence quenching of DR4 protein by flaxseed orbitides (especially non‐oxidized orbitides) indicated the formation of a DR4–orbitide complex. Molecular docking demonstrated that non‐oxidized orbitides could easily dock into the active cavity of DR4 protein. Further blocking DR4 significantly reduced the ability of non‐oxidized flaxseed orbitides to stimulate caspase‐3 expression, whereas oxidized flaxseed orbitides retained this ability.

CONCLUSION

Non‐oxidized flaxseed orbitides are more effective against cancer than oxidized flaxseed orbitides due to higher cellular uptake and activation of the DR4‐mediated death receptor signaling pathway. © 2024 Society of Chemical Industry.
Game changers or money pits? Asymmetric impact of sports facilities investment on football revenue
Authors: Tang Wanxia , Zhang Xiaolin
Published: March 2024

Our investigation explores the asymmetric association between sports facilities investment and football revenue in the top 10 nations with the highest sports facilities investment. This study employs a distinctive methodology, “Quantile‐on‐Quantile,” to probe the interconnectedness of time series within each country. The findings reveal that investments in sports facilities have a predominantly positive impact on football revenue in the selected economies, particularly in various segments of the data distribution. It underscores the importance of implementing policies that maximize the effect of sports facilities investment on football revenue and inform public policy decisions.
Genetic diagnosis of Alport syndrome in 16 Chinese families
Authors: Xiao Tangli , Zhang Jun , Liu Li , Zhang Bo
Published: March 2024

Background

Alport syndrome (AS) is a genetically heterogeneous disorder resulting from mutations in the collagen IV genes COL4A3, COL4A4, and COL4A5. The genetic diagnosis of AS is very important to make precise diagnosis and achieve optimal outcomes.

Methods

In this study, 16 Chinese families with suspected AS were recruited after pedigree analysis, and the clinical presentations were analyzed by a nephrologist. The genetic diagnosis was performed by whole‐exome sequencing (WES) and the disease‐causing variants were confirmed by Sanger sequencing.

Results

The cohort of probands included seven men and nine women, with a mean age of 19.9 years. Pathological analysis showed slight‐to‐moderate mesangial proliferation, and thin basement membrane was the main findings. Pathogenic variants were revealed by WES in each family, and the co‐segregation with renal presentation was confirmed by PCR. In addition, RT‐PCR analysis showed that the intronic variant led to aberrant splicing.

Conclusion

Our findings expand the spectrum of AS gene variation, which will inform genetic diagnosis and add to the theoretical basis for the prevention of AS.
Alterations of functional brain activity and connectivity in female nurses working on long‐term shift
Authors: Dong Yujie , Wu Xiaohong , Dong Yuqin , Li Yuwei , Qiu Ke
Published: March 2024

Aim

To investigate the alterations of functional brain activity and connectivity in female nurses working on long‐term shifts and explore their correlations with work‐related psychological traits.

Design

An exploratory cross‐sectional study.

Methods

Thirty‐five female nurses working on long‐term shifts (shift nurses) and 35 female nurses working on fixed days (fixed nurses) were enrolled. After assessing the work‐related psychological traits, including burnout, perceived stress, anxiety, and depression of nurses, the fractional amplitude of low‐frequency fluctuations (fALFF) and region of interest (ROI)‐based functional connectivity (FC) analyses were performed to investigate the differences of brain spontaneous activity and functional connectivity between these two groups of nurses. Thereafter, correlations between the functional brain parameters (fALFF and FC) and clinical metrics were investigated among the shift nurses.

Results

Compared to fixed nurses, shift nurses had higher burnout, perceived stress and depression scores, lower fALFF in the right dorsolateral prefrontal cortex (dlPFC), left and right superior parietal lobule (SPL), bilateral anterior cingulate cortex (ACC), and higher fALFF in the right superior/middle temporal gyrus, as well as decreased FC between the right dlPFC (the selected ROI) and bilateral ACC, left and right inferior frontal/orbitofrontal gyrus (IFG/IOFG), right SPL, and left middle occipital gyrus (voxel‐level p < 0.001, cluster level p < 0.05, GRF correction). Correlation analyses demonstrated that the fALFF value of the right dlPFC was significantly correlated with the burnout and anxiety scores, the FC value of the right dlPFC‐right SPL was correlated with the perceived stress and burnout scores, the FC value of the right dlPFC‐right IFG/IOFG was correlated with the burnout score in shift nurses (p < 0.05).

Conclusion

Shift nurses had work‐related altered functional activity and connectivity in the right frontoparietal network, which provided objective and visualised evidence to clarify the hazards of long‐term shift work on female nurses.

Patient or Public Contribution

Seventy nurses participated deeply as subjects in this study. These findings are expected to draw managers' attention to the harmful influences of shift work on nurses.
The preparation of children for day surgery from the parent's viewpoint: A mixed methods study
Authors: Kerimaa Heli , Hakala Mervi , Haapea Marianne , Serlo Willy , Pölkki Tarja
Published: March 2024

Aim

The purpose of the study was to describe the preparation of children for day surgery from the parent's viewpoint.

Design

Empirical Research Mixed Method.

Methods

The research applied a mixed‐methods study design. The study was conducted at the Paediatric Day Surgical Department of one REDACTED between 2018 and 2020 at the same time as an associated randomised controlled conduct trial. Parents of 41 children (ages 2–6 years) completed measures assessing their preparation for day surgery and satisfaction with the procedure. Semi‐structured interviews were conducted with 15 parents to better understand their experiences.

Results

According to the results, most of the parents (95%) told their children about the upcoming day surgery procedure. The child was prepared for the surgery with cognitive and sensory information, and the preparation usually started at home well before the surgery. The parents' experiences with the most critical aspects of preparing their child included three main categories: (1) usability of the preparation method; (2) content and timing of the preparation method and (3) consideration of the family perspective.
Efficacy and safety of azacitidine in pediatric patients with newly diagnosed advanced myelodysplastic syndromes before hematopoietic stem cell transplantation in the AZA‐JMML‐001 trial
Authors: Locatelli Franco , Strålin Karin Belander , Schmid Irene , Sevilla Julián , Smith Owen P. , van den Heuvel‐Eibrink Marry M. , Zecca Marco , Zwaan Christian M. , Gaudy Allison , Patturajan Meera , Poon Jennifer , Simcock Mathew , Niemeyer Charlotte M.
Published: March 2024

Here we report efficacy, pharmacokinetics, and safety data obtained in treatment‐naive, pediatric patients with newly diagnosed advanced MDS receiving azacitidine in the AZA‐JMML‐001 study. The primary endpoint was response rate (proportion of patients with complete response [CR], partial response [PR], or marrow CR, sustained for ≥4 weeks). Of the 10 patients enrolled, one had an unconfirmed marrow CR and none had confirmed responses after three cycles; the study was therefore closed after stage 1. Azacitidine was well tolerated. The lack of efficacy of azacitidine in pediatric patients with newly diagnosed advanced MDS highlights the need for effective new treatments in these patients.
Segregation and well‐being in Sweden: Geographies of well and ill‐being
Authors: Westra Gijs Harm
Published: March 2024

Well‐being is rarely considered in studies of residential segregation. This paper explores the spatial distribution of well‐being and its relationship to various forms of residential segregation. External well‐being indices are obtained for Swedish individuals through register data. The mean well‐being of 13 scales of bespoke neighbourhoods is classified into 12 clusters. Similar to previous findings, a strongly polarised pattern of neighbourhood well‐being is found. Neighbourhood well‐being is found to strongly correlate with more traditional measures of segregation. Areas in cities found in more traditional segregation studies have lower well‐being. Half of the working population lives in areas that have homogenised levels of well‐being; 14% live in a well‐being‐deprived neighbourhood. Low‐scoring areas are deprived in most well‐being dimensions, while middle and high‐scoring neighbourhoods vary in the domains they excel in. The paper is one of the first to connect segregation studies to explore the causes of the spatial sorting of well‐being. Moreover, it is one of the few that explores well‐being on scales below the regional level.
Differential effects of subject‐based and integrated curriculum approaches on students' learning outcomes: A review of reviews
Authors: Kreijkes Pia , Greatorex Jackie
Published: March 2024

There is no general agreement about the best way of organising the curriculum. Debates often pitch a subject‐based curriculum against an integrated curriculum although there is great variation among integrated approaches. Numerous claims have been made regarding the comparative merits of different approaches, but many scholars have noted the lack of a strong evidence base to support these. This article reports a review of reviews to examine how the learning outcomes of students following more subject‐based or more integrated curriculum approaches compare based on empirical research that uses control groups. The literature from 1990 to mid‐2022 was systematically searched. A final sample of nine reviews was included and critically appraised using the AMSTAR 2. The evaluation found that all reviews were of critically low quality. Within the reviews, relatively few primary studies concerned the primary school or secondary school level and had control groups. There was variation in outcomes reported between studies, but these tended to either find positive effects of integrated approaches or no differences between groups. Very few primary studies found detrimental effects of interventions involving integrated approaches. Various methodological issues as well as complexities of integration need to be considered when interpreting the findings. Overall, we conclude that based on the limitations of the current evidence, neither strictly subject‐based nor more integrated approaches can be regarded as superior for students' learning outcomes. Implications for theory, research and practice are discussed.

Context and implications

Rationale for this study

There is a need for understanding the current evidence for comparative effects of subject‐based and integrated curriculum approaches on students' learning experiences and outcomes.

Why the new findings matter

The findings can inform the long‐lasting, international debates regarding the best ways of structuring the curriculum.

Implications for practitioners, curriculum designers and researchers

This review of reviews demonstrates that it is crucial for all stakeholders to move away from the false dichotomy of ‘subjects’ versus ‘integration’ and to recognise the various ways in which subjects can be integrated. Based on the reviewed evidence, neither strictly subject‐based nor integrated approaches are superior for students' learning. A well‐implemented approach drawing on the best of both worlds is likely required in practice, but more research is needed to explore this. The findings can inform researchers about what studies are needed to move the debate forward, including studies that use adequate control groups and consider affective outcomes.
Atomic Imaging of Multi‐Dimensional Ruddlesden–Popper Interfaces in Lead‐Halide Perovskites
Authors: Liu Yusheng , Liu Suya , Xu Liang , Ma Mengmeng , Zhang Xuliang , Chen Xiao , Wei Fei , Song Bin , Cheng Tao , Yuan Jianyu , Shen Boyuan
Published: March 2024

Ruddlesden–Popper (RP) interface with defined stacking structure will fundamentally influence the optoelectronic performances of lead‐halide perovskite (LHP) materials and devices. However, it remains challenging to observe the atomic local structures in LHPs, especially for multi‐dimensional RP interface hidden inside the nanocrystal. In this work, the advantages of two imaging modes in scanning transmission electron microscopy (STEM), including high‐angle annular dark field (HAADF) and integrated differential phase contrast (iDPC) STEM, are successfully combined to study the bulk and local structures of inorganic and organic/inorganic hybrid LHP nanocrystals. Then, the multi‐dimensional RP interfaces in these LHPs are atomically resolved with clear gap and blurred transition region, respectively. In particular, the complex interface by the RP stacking in 3D directions can be analyzed in 2D projected image. Finally, the phase transition, ion missing, and electronic structures related to this interface are investigated. These results provide real‐space evidence for observing and analyzing atomic multi‐dimensional RP interfaces, which may help to better understand the structure‐property relation of LHPs, especially their complex local structures.
Long‐term cardiovascular assessment of women with previous pregnancy complicated by hypertensive disorder
Authors: Dimopoulou S. , Neculcea D. , Papastefanou I. , Galan A. , Nicolaides K. H. , Charakida M.
Published: March 2024

Objectives

Women with a hypertensive disorder of pregnancy (HDP) are at increased risk of developing hypertension and cardiovascular disease later in life. However, from previous studies, it is difficult to define whether this association reflects pre‐existing maternal cardiovascular risk or a potentially causal relationship between HDP and later cardiovascular risk. In this study, we performed detailed cardiovascular assessment in women in midgestation, prior to development of HDP, and at 2 years postpartum, aiming to identify cardiovascular changes prior to development of HDP and to assess persistent cardiovascular alterations long after the HDP event.

Methods

This was a prospective observational study in which we performed detailed cardiovascular assessment in midgestation and at a median of 2.3 (interquartile range, 2.1–2.4) years postpartum. We examined 112 women who developed HDP and 451 women whose pregnancy was not complicated by hypertension. We used conventional and more advanced (i.e. speckle tracking) echocardiographic techniques to determine accurately left ventricular systolic and diastolic function. We used M‐mode measurements to determine left ventricular remodeling and estimate left ventricular mass. Maternal vascular status was assessed using ophthalmic artery Doppler and by calculating peak systolic velocity (PSV) ratio, as a marker of peripheral vascular resistance.

Results

In midgestation, women who subsequently developed HDP had increased ophthalmic artery PSV ratio. These women also had mild cardiac functional and morphological alterations, which were accounted for mostly by maternal cardiovascular risk factors. At 2 years postpartum, women who had experienced HDP, compared to those who did not, had cardiovascular abnormalities with reduction in left ventricular systolic and diastolic function, which remained after multivariable analysis. Longitudinal analysis demonstrated that the evolution of cardiovascular changes in the HDP and non‐HDP groups was similar.

Conclusions

Mild cardiac functional and morphological alterations precede the development of HDP and such changes persist for at least 2 years postpartum. The cardiac changes are likely to be the consequence of pre‐existing maternal cardiovascular risk factors rather than an adverse consequence of HDP. © 2024 International Society of Ultrasound in Obstetrics and Gynecology.
Comparative study of fresh phosphogypsum treatment by sulfuric acid and neutralization with NaOH and CO2
Authors: Phuong Dang Ngoc , Chi Ngo Kim , Lam Tran Dai
Published: March 2024

The newly formed, fresh phosphogypsum (PG) at the filter cake of the Dinh Vu Diamoni photphate DAP fertilizer factory was studied and treated with dilute sulfuric acid. The impurities were removed by sulfuric acid treatment and the carbonatation by NaOH and CO2 to create calcium carbonate. The results showed that fresh PG at filter cake contained the P2O5 total of 1.38%, and the phosphorus pentoxides effectively were removed at 69.32%. The acid‐treated PG was neutralized by NaOH and CO2 aeration, creating CaCO3 in situ nano‐microparticles identified by scanning electron microscopy (SEM) images and CaCO3 intensity by X‐ray diffraction (XRD). In this study, the cement mortar test, which used treated PG from both sulfuric treatment and NaOH neutralization within CO2 aeration, has better compressive strength properties and hydration supported by SEM images, XRD results, and thermogravimetric analysis.
Chemical constituents of Syzygium cerasiforme leaves and their nitric oxide inhibitory activity in LPS‐activated RAW264.7 cells
Authors: Ninh Bui Hai , Dung Duong Thi , Van Tuyen Nguyen , Tai Bui Huu , Van Kiem Phan
Published: March 2024

A phytochemical study of the methanolic extract of Syzygium cerasiforme leaves led to the isolation of seven compounds (1–7). Their chemical structures were identified as benzyl‐6ʹ‐O‐galloyl‐β‐d‐glucopyranoside (1), 3‐methoxy‐4‐hydroxyphenol 1‐O‐β‐D‐(6ʹ‐O‐galloyl)‐glucopyranoside (2), betulonic acid (3), 3‐epi‐betulinic acid (4), 7α‐methoxy‐stigmast‐5‐en‐3β‐ol (5), dihydrodehydrodiconiferyl alcohol (6), and secoisolariciresinol (7), by HR‐ESI‐MS, 1D‐ and 2D NMR spectra, and by comparison with the previously published data. Compounds 1–7 exhibited NO production inhibitory activity in LPS‐activated RAW264.7 cells with IC50 values of 33.17, 25.51, 51.09, 54.17, 39.54, 6.98, and 58.12 µm, respectively, compared to that of the positive control compound, L‐NMMA, which showed an IC50 of 32.5 µm. This is the first report on these compounds from S. cerasiforme.
Design, synthesis, and biological evaluation studies of novel thiophene substituted thiazolidinones scaffold as promising antimicrobial agents
Authors: Godhani Dinesh R. , Mehta Umang P. , Mehta Jignasu P. , Saiyad Anwar H.
Published: March 2024

Global public health is profoundly imperiled by antimicrobial resistance (AMR) and has made it extremely difficult to effectively control infectious diseases which are connected to it, so a new series of 5‐benzylidene‐2‐(thiophen‐2‐yl)‐3‐(4H‐1,2,4‐triazol‐4‐yl)thiazolidin‐4‐ones (5a–o) is synthesized. Spectral techniques have been utilized to characterize and confirm the structures of targeted molecules. The outcomes are to be compared with typical drugs given that compounds are examined against gram‐positive and gram‐negative strains of bacteria and fungus. Against bacterial strains, products with nitro, methyl, and bromo substituents in the p‐position of the benzene ring, as well as products with the nitro group at the m‐position, showed very excellent activities against bacterial strains, while compounds with chloro substituent at p‐position and m‐position demonstrated good activity against the fungal strains Aspergillus niger and Fusarium javanicum.
Investigating the photosensitized reaction of methylene blue with toluidines: A spectroscopic and kinetic analysis
Authors: Trivedi Pranav , Pand Umeshchandra , Sharma Kuldeep , Sharma Chandramauly
Published: March 2024

The photosensitized reaction of isomeric Toluidines was investigated in an alkaline medium under visible light, utilizing methylene blue (MB) as a photosensitizer. The reaction starts with an exciplex forming between nitrogen and the dye, and when it is exposed for a while, it breaks apart, creating photoproducts. UV–visible spectroscopy was used to study the reaction. To see how oxygen affects it, the reaction was conducted without oxygen, and methanol was added to check if it removes harmful particles. Additionally, factors like pH, the amount of dye, the amount of the substance under study, and the brightness of the light were examined for their impact on the reaction rate. The efficiency of the reaction in using light was calculated. Finally, a possible explanation of how the reaction works was formulated in the proposed mechanism.
CLPC1 protein inhibition, antimycobacterial, and anti‐inflammatory properties of the metabolite from Streptomyces wuyuanensis collected in Nghe An province, Vietnam
Authors: Ni Huynh Thi Ngoc , Ninh Pham Thi , Dung Nguyen Thi , Van Chien Tran , Uyen Nguyen Quynh , Anh Ho Ngoc , Suh Joo‐Won , Cheng Jinhua , Thao Nguyen Kim Nu , Duc Nguyen Minh , Thao Tran Thi Phuong
Published: March 2024

Streptomyces wuyuanensis A79 was isolated from the soil samples collected in Quynh Luong mangrove forest, Quynh Luu district, Nghe An province, Vietnam. This strain demonstrated antimycobacterial activity against Mycobacterium smegmatis. Compound 1 (indole‐3‐carboxylic acid) was isolated from the culture extract of S. wuyuanensis (A79). This compound displayed the affection of ATPase activity of the recombinant ClpC1 protein, a regulatory protein of Mycobacterium tuberculosis. In addition, compound 1 exhibited anti‐inflammatory activity through the inhibition of TNF‐α on LPS‐stimulated macrophage RAW264.7. This is the first time compound 1 (indole‐3‐carboxylic acid) has been isolated from S. wuyuanensis. Indole‐3‐carboxylic acid was also reported for the first time its inhibition of M. tuberculosis ClpC1 protein.
Reporting Standards, Certification/Accreditation, and Reproducibility
Authors: Simon Gyorgy , Aliferis Constantin
Published: March 2024

This chapter covers the interrelated topics of (a) enhancing the quality, safety and reproducibility of clinical AI/ML via reporting standards frameworks; (b) recent efforts for accrediting health care provider organizations for AI readiness and maturity; (c) professional certification; and (d) education and related accreditation in the space of educational programs of data science and biomedical informatics specific to AI/ML.
Synthesis of Recommendations, Open Problems and the Study of BPs
Authors: Aliferis Constantin , Simon Gyorgy
Published: March 2024

This chapter assembles a list of all best practices (BPs), and pitfalls, discussed in the previous chapters. These are codified in a single hierarchical structure and assistive checklists intended to make them operationally useful. We differentiate between macro-, meso- and micro-levels of pitfalls and corresponding best practices-roughly corresponding to high-level principles, concrete differentiations of the above and granular/detailed tools and techniques for implementation. The recommended BPs are cross-referenced across the volume and key corresponding literature and other sources. Several open problems remain and the evolution of BPs for biomedical AI/ML is certain to become in the years to come a field of inquiry with explosive growth and value.
Foundations and Properties of AI/ML Systems
Authors: Aliferis Constantin , Simon Gyorgy
Published: March 2024

The chapter provides a broad introduction to the foundations of health AI and ML systems and is organized as follows: (1) Theoretical properties and formal vs. heuristic systems: computability, incompleteness theorem, space and time complexity, exact vs. asymptotic complexity, complexity classes and how to establish complexity of problems even in the absence of known algorithms that solve them, problem complexity vs. algorithm and program complexity, and various other properties. Moreover, we discuss the practical implications of complexity for system tractability, the folly of expecting Moore’s Law and large-scale computing to solve intractable problems, and common techniques for creating tractable systems that operate in intractable problem spaces. We also discuss the distinction between heuristic and formal systems and show that they exist on a continuum rather than in separate spaces. (2) Foundations of AI including logics and logic based systems (rule based systems, semantic networks, planning systems search, NLP parsers), symbolic vs. non-symbolic AI, Reasoning with Uncertainty, Decision Making theory, Bayesian Networks, and AI/ML programming languages. (3) Foundations of Computational Learning Theory: ML as search, ML as geometrical construction and function optimization, role of inductive biases, PAC learning, VC dimension, Theory of Feature Selection, Theory of Causal Discovery. Optimal Bayes Classifier, No Free Lunch Theorems, Universal Function Approximation, generative vs. discriminative models; Bias-Variance Decomposition of error and essential concepts of mathematical statistics.
The Development Process and Lifecycle of Clinical Grade and Other Safety and Performance-Sensitive AI/ML Models
Authors: Aliferis Constantin , Simon Gyorgy
Published: March 2024

This chapter introduces the notion of “clinical-grade” and other sensitive, mission-critical models and contrasts such models with more fault-tolerant feasibility, exploratory, or pre-clinical ones. The steps outlined span from requirements engineering to deployment and monitoring and also emphasize a number of contextual factors determining success such as clinical and health economic considerations. AI’s “knowledge cliff” is discussed and the need to operationalize AI/ML “self-awareness” and overcome its limitations to ensure generality and safe use. This chapter introduces many core pitfalls and best practices. The overarching concepts, pitfalls and BPs of the chapter will be elaborated further and implementation will be presented across the book and especially in chapters “Foundations and Properties of AI/ML Systems,” “An Appraisal and Operating Characteristics of Major ML Methods Applicable in Healthcare and Health Science,” “Foundations of Causal ML”, “Model Selection and Evaluation”, and in chapter “Overfitting, Underfitting and General Model Overconfidence and Under-Performance Pitfalls and Best Practices in Machine Learning and AI”.
Data Preparation, Transforms, Quality, and Management
Authors: Johnson Steven G. , Simon Gyorgy , Aliferis Constantin
Published: March 2024

Data preparation and feature engineering transform source data elements into a form that can be used by analytic and machine learning methods. Raw source data elements are transformed into data design features that are specified in the data design through an iterative process of mapping data elements to concepts, value sets, and phenotype expressions. Data that meet the data design criteria are extracted into a data mart where the quality of the data can be assessed. Once data are of sufficient quality and meet expectations, ML features are developed for use in machine learning models.
Removal of fiber posts using conventional versus guided endodontics: a comparative study of dentin loss and complications
Authors: Krug R. , Schwarz F. , Dullin C. , Leontiev W. , Connert T. , Krastl G. , Haupt F.
Published: March 2024

Objectives

To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro.

Material and methods

Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group. After treatment, the prepared access cavities were volumetrically assessed by micro-CT. Statistical significance was evaluated by one-way analysis of variance followed by post hoc comparisons with Tukey's HSD test and Pearson's chi-squared test for independence.

Results

Both CONV and GE resulted in dentin loss and residual resin material. CS resulted in more dentin loss and less residual resin material than CG and GE (p < .05). All groups had some deviations from the original root canal but no perforations. The shortest working time was observed in the GE group.

Conclusions

Compared to the conventional freehand technique, GE resulted in significantly less radicular dentin loss, a few deviations but no perforations.

Clinical relevance

Guided endodontics can improve the speed and safety of fiber post removal without root perforation.
Immersive virtual reality for complex skills training: content analysis of experienced challenges
Authors: Laine Joakim , Rastas Elisa , Seitamaa Aino , Hakkarainen Kai , Korhonen Tiina
Published: March 2024

This study aimed to examine the challenges that adult participants experienced in immersive virtual reality (I-VR). Practitioners have indicated that some challenges persist from trainee to trainee and scholars have called for the design and development of virtual reality (VR) applications based on learning theories. Thus, we examined challenges immersed learners experienced during self-discovery of game mechanics and assembly task within an early-development I-VR program. We clarified the immersive learning phenomenon by studying the self-reported problem statements from 168 university students and staff. They used an HTC Vive Pro Eye device and a custom-built software. Through an iterative content analysis of post-survey and video-stimulated recall interviews, we retrieved 481 problem statements from the participants. As a result, we derived and detailed 89 challenges, 22 component features, 11 components, and 5 principal factors of immersive learning. The most cited components that the participants found challenging were the use of controllers and functions, reciprocal software interaction, spatial and navigational constraints, relevance realisation, and learner capabilities. Closer inspection of the quantified data revealed that the participants without digital gaming experience reported relatively more hardware-related problem statements. The findings regarding the constraints of immersive learning helped clarify the various actants involved in immersive learning. In this paper, we provide a design implication summary for VR application developers. Further research on theory-based development and design implications in various immersive training settings is needed.