bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Nano-TiO2 and Polypropylene Fiber on Mechanical Properties and Durability of Recycled Aggregate Concrete
Authors: Wei Xiong , Xiaoqing Wang , Chunmei Li 
Published: May 2024

AbstractIn order to promote the engineering application of recycled concrete, the effects of PPF and nano-TiO2 dioxide on the mechanical properties and durability of recycled concrete were studied.Polypropylene fiber recycled concrete(PRAC) and nano-TiO2 recycled concrete(TRAC) were prepared by adding different volume contents of PPF and nano-TiO2. The experimental findings demonstrated that the PPF and nano-TiO2 improved the splitting tensile strength of RAC better than the compressive strength. When the volume content of nano-TiO2. and PPF is 0.8% and 1.0%, respectively, the corresponding splitting tensile strength of concrete reaches the maximum value(3.4 and 3.7 MPa). The contribution rates of nano-TiO2 and PPF with different volume contents to the mechanical properties of RAC have optimal values, which are 0.4 and 1.0%, respectively. The incorporation of nano-TiO2 and PPF can effectively inhibit the loss of RAC mass and the generation of pores under freeze–thaw conditions, and slow down the decrease of dynamic elastic modulus. When the volume content of PPF is 1.0% and the volume content of nano-TiO2 is 0.4%, the protection effect on the internal structure of RAC is better, and its carbon resistance is better. The results of RSM model analysis and prediction show that both PPF and nano-TiO2 can be used as admixture materials to improve the mechanical properties and durability of RAC, and the comprehensive improvement effect of PPF on RAC performance is better than that of nano-TiO2.
Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children
Authors: Murphy Suzanne , Bell Kerry , Cook Erica Jane , Crafter Sarah , Davidson Rosemary , Fairhurst Caroline , Hicks Kate , Joffe Victoria , Messer David , Robinson-Smith Lyn , Strachan Luke , Torgerson David , Welch Charlie 
Published: May 2024

Abstract
Background
A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention (‘E-PLAYS’) aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools.

Methods
The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools’ teaching assistants. Teachers will select suitable children (ages 5–7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual.
The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS.

Discussion
The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children.

Trial registration
ISRCTN 17561417, registration date 19th December 2022.
Protocol version: v1.1 19th June 2023.
Determinants of implanon discontinuation among women in Gedeo Zone, South Ethiopia: a case–control study
Authors: Bezabih Tihtina , Agidew Selamawit Dires , Kebede Selamawit Semagn , Belay Moges Mareg , Siyoum Ever , Ashenafi Eden , Birhane Mahlet 
Published: May 2024

Abstract
Background
The main public health problem that has a significant impact on the high fertility rate, unintended pregnancies, and induced abortion is Implanon cessation. In addition to Implanon being underutilized in Ethiopia, the rate of cessation is higher among women who started using it. Nevertheless, little is known about the factors that lead to Implanon cessation.

Objectives
The study was aimed to determine the factors that led women to discontinue Implanon in Gedeo Zone, Southern Nation Nationalities and Peoples Region, southern Ethiopia, 2019.

Method
A community-based unmatched case–control study design was carried out. Cases and controls were selected by a multi-stage sampling with a 1:2 case-to-control ratio. Data was entered into EPi-data version 3.1 and exported to Statistical Package for Social Sciences (SPSS) version 20 for analysis. A bivariate and multivariable logistic regression was used to identify the factors affecting Implanon discontinuation. The adjusted odd ratio (AOR) with 95% Confidence Interval (CI) was used to determine the precision of estimates, and statistical significance was declared at a p-value of 0.05.

Result
From 516 women included in to the study, 495 (cases = 166 and controls = 329) women have responded to the questionnaires making a response rate of 96%. Monthly income 500—1000 birr [AOR: 0.3; 95% CI (0.2–0.5)], above 1000 birr [AOR: 0.2; 95% CI (0.1–0.4)], history of abortion [AOR: 2.0; 95% CI (1.0–4.1)], birth spacing [AOR: 0.6; 95% CI (0.3–0.9)], partner objection [AOR: 2.4; 95% CI (1.4–4.2)] were significantly associated factors.

Conclusion
This study identified that monthly income, having abortion history, birth spacing, partner objection were the factors that affect Implanon discontinuation. To reduce implanon discontinuation, reducing abortion, involving partner and increasing the birth spacing, appropriate counseling before the insertion and appropriate follow-up by a health care practitioner are highly recommended.
Simultaneous determination of five plant hormones in cotton leaves using QuEChERS combined with HPLC‒MS/MS
Authors: Wang Wenhao , Song Xianpeng , Wang Dan , Ma Yajie , Shan Yongpan , Ren Xiangliang , Hu Hongyan , Wu Changcai , Yang Jun , Ma Yan 
Published: May 2024

Abstract
Background
Plant hormones profoundly influence cotton growth, development, and responses to various stresses. Therefore, there is a pressing need for an efficient assay to quantify these hormones in cotton. In this groundbreaking study, we have established QuEChERS-HPLC‒MS/MS method, for the simultaneous detection of multiple plant hormones in cotton leaves, allowing the analysis and quantification of five key plant hormones.

Results
Sample extraction and purification employed 0.1% acetic acid in methanol and C18 for optimal recovery of plant hormones. The method applied to cotton demonstrated excellent linearity across a concentration range of 0.05–1 mg·L−1, with linear regression coefficients exceeding 0.99. The limits of quantification (LOQs) were 20 μg·kg−1 for GA3 and 5 μg·kg−1 for the other four plant hormones. Recovery rates for the five plant hormones matrix spiked at levels of 5, 10, 100, and 1000 μg·kg−1 were in the range of 79.07% to 98.97%, with intraday relative standard deviations (RSDs) ranging from 2.11% to 8.47%. The method was successfully employed to analyze and quantify the five analytes in cotton leaves treated with plant growth regulators.

Conclusion
The study demonstrates that the method is well-suited for the determination of five plant hormones in cotton. It exhibits excellent selectivity and sensitivity in detecting field samples, thus serving as a robust tool for in-depth research into cotton physiology.
Fire regime attributes shape pre-fire vegetation characteristics controlling extreme fire behavior under different bioregions in Spain
Authors: Beltrán-Marcos David , Suárez-Seoane Susana , Fernández-Guisuraga José Manuel , Azevedo João C. , Calvo Leonor 
Published: May 2024

Abstract
Background
Designing effective land management actions addressed to increase ecosystem resilience requires us to understand how shifting fire regimes are shaping landscapes. In this study, we aim to assess the link between fire regime and pre-fire vegetation biophysical characteristics (type, amount, and structure) in controlling extreme fire behavior across Atlantic-Transition-Mediterranean bioregions in Spain marked by different summer drought conditions and dominant plant regenerative traits. We used remote sensing metrics to estimate fire severity and pre-fire vegetation characteristics in eight study areas recently affected by large and highly severe wildfires under different environmental contexts. Furthermore, to account for fire regime attributes, we retrieved, for each target wildfire, the perimeter of the past wildfires that occurred between 1985 and 2022 and calculated fire recurrence, the time the since last fire (TSLF), and fire severity of previous wildfires (FSPW). The effect of fire regime attributes on pre-fire vegetation was examined using generalized linear mixed models (GLMMs).

Results
During the study period, fire recurrence decreased significantly in all bioregions analyzed. Fire severity increased under Atlantic conditions and decreased under Mediterranean environmental context, where the time since the last fire was the highest. Pre-fire fuel type and amount were identified as primary drivers of fire severity, being both strongly modulated by fire regime but following distinct mechanisms depending on the environmental context of each bioregion. In Atlantic sites, more frequent past wildfires of low to moderate fire severity were associated with a greater dominance of fire-prone shrublands with moderate fuel amounts, which increases the risk of severe wildfires. Similar trends occurred in Transition and Mediterranean sites but under the previous occurrence of highly severe wildfires. Specifically, long times after highly severe wildfires (> 30 years) increased fuel amount in conifer-dominated ecosystems in all bioregions analyzed, heightening susceptibility to extreme fire behavior.

Conclusions
Our findings highlight that fire-prone ecosystems need adaptative management strategies to mitigate the effects of fire regime changes, but these actions should be specific to the climatic and ecological context.
Generalized Riskiness Index in Vehicle Routing Under Uncertain Travel Times: Formulations, Properties, and Exact Solution Framework
Authors: Zhang Zhenzhen , Zhang Yu , Baldacci Roberto 
Published: May 2024

We consider a vehicle routing problem with time windows under uncertain travel times where the goal is to determine routes for a fleet of homogeneous vehicles to arrive at the locations of customers within their stipulated time windows to the maximum extent while ensuring that the total travel cost does not exceed a prescribed budget. Specifically, a novel performance measure that accounts for the riskiness associated with late arrivals at the customers, called the generalized riskiness index (GRI), is optimized. The GRI covers several existing riskiness indices as special cases and generates new ones. We demonstrate its salient managerial and computational properties to motivate it better. We propose alternative set partitioning-based models of the problem. To obtain the optimal solution, we develop an exact solution framework combining route enumeration and branch-price-and-cut algorithms, in which the GRI is dealt with in route enumeration and column generation subproblems. We mainly reduce the solution space by exploiting the GRI and budget constraints’ properties without losing optimality. The proposed method is tested on a collection of instances derived from the literature. The results show that a new instance of the GRI outperforms several existing riskiness indices in mitigating lateness. The exact method can solve instances with up to 100 nodes to optimality. It can consistently solve instances involving up to 50 nodes, outperforming state-of-the-art methods by more than doubling the manageable instance size. Funding: This work was supported by the National Natural Science Foundation of China [Grants 72101187, 72371204, 72021002, and 71901180], the Qatar National Research Fund [Grant ARG01-0430-230029], Natural Science Foundation of Sichuan Province [24NSFSC6232], and Guanghua Talent Project of the Southwestern University of Finance and Economics. Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2023.0345 .
Delayed closure of ventricular septal defect with prolonged mechanical support
Authors: Shehzad Dawood , Shehzad Mustafa , Ahmad Muhammad , Wassey Abdul , Zara Noor , Younis Humna , Khan Haider Ali Babar 
Published: May 2024

Introduction: Ventricular septal defect (VSD) is a severe complication following acute myocardial infarction (MI) resulting from mechanical disruption of the interventricular septum due to extensive myocardial necrosis. Despite advances in management, the mortality rate approaches 50%. We report a case of a 58-year-old male with VSD following MI who was successfully treated with a delayed surgical approach after haemodynamic support using Impella. Case description: A 58-year-old man with type 2 diabetes mellitus and hypertension presented with three days of chest pain. Testing revealed late presenting acute anterior ischaemic infarction and left-to-right shunt in the apical ventricular septum. Urgent cardiac catheterisation showed near-total occlusion of the left anterior descending artery. An Impella CP® was placed before angioplasty with a drug-eluting stent to optimise haemodynamics. After a multidisciplinary discussion, the Impella CP® was upgraded to Impella 5.5®, and surgery was delayed allowing for scar formation. The patient remained in the intensive care unit, where he underwent physical therapy, showing improvements in exercise tolerance by the time of surgery. He underwent a left ventriculotomy with a successful repair via an endocardial patch 28 days after initial presentation. Post-operative recovery was uneventful, with the patient discharged five days later, reporting no physical limitations one month post-discharge. Conclusion: The successful management of VSD post-MI relies on interdisciplinary collaboration, careful timing of surgical intervention and the strategic use of mechanical support devices such as the Impella. This case highlights the potential for favourable outcomes when tailored treatment approaches are employed.
Pandemic effect on ischaemic burden and prehospital time in acute coronary syndrome
Authors: Steege Noah , Crandell Jamie , DeVon Holli A , Rosamond Wayne D , Wong Eugenia , Chronowski Kevin , Grover Joseph , Zègre-Hemsey Jessica K 
Published: May 2024

Background: Acute coronary syndrome (ACS) requires rapid identification and intervention. Early recognition of symptoms, detection of ischaemic markers in electrocardiograms (ECGs) and timely reperfusion therapy all reduce the total ischaemic time. In 2020, SARS-CoV-2 emerged as a new threat to people with cardiac disease: calls to emergency departments, emergency department visits and hospital admissions for acute cardiac conditions decreased, possibly because patients delayed seeking care because of fear of SARS-CoV-2 exposure. The hypothesis of this study was that patients presenting with ACS during the pandemic would have more ischaemic features and longer prehospital time intervals than those presenting before the pandemic. However, there were no significant differences between pre-pandemic and pandemic groups regarding incidence of ECG ischaemic markers, elevated troponin, adverse outcomes or prehospital time intervals. Non-ST-elevation myocardial infarction was significantly higher in the pandemic sample, which suggests that patients with less severe symptoms sought treatment during the pandemic.
Australian paramedic ECG interpretation in acute coronary syndrome
Authors: Wyld Luke , Clegg Lisa , Griffin Kristina 
Published: May 2024

Background: The paramedic use of electrocardiogram (ECG) is the gold standard for prehospital identification of acute myocardial infarction. Following an extension to their scope of practice, all paramedics have the capability to identify an ST-elevation myocardial infarction (STEMI). However, there have been no investigations into paramedic ECG interpretation. Aims: This study aimed to investigate paramedic accuracy regarding ECG interpretation and compare findings with international literature. Methods: Anonymous participants were voluntarily recruited to interpret 12 ECGs. A literature review was undertaken to compare results with previous studies. Findings: Paramedics correctly identified the ECGs with a mean score of 63%. Accuracy in ECG interpretation increased with a higher educational background and specialist training. Postgraduate mean accuracy was 83.33%, with specialist accuracy at 83.53%. Conclusions: Further education and research into interpreting difficult ECGs is necessary. Australian services may consider the implementation of modified cardiac protocols to include suspected non-STEMI.
TECNOLOGIA RECREATIVA EM UNIDADE PEDIÁTRICA E CIRÚRGICA: REVISÃO INTEGRATIVA
Authors: Valentim da Silva Moreira Italo , Da Silva Sabino Aderlaine , Andrade da cunha Marques Anne Grace , Véras Fontes Esteves Arinete 
Published: May 2024

Introdução: toda e qualquer criança, onde ela estiver, tem o direito de brincar. No entanto, quando a criança está doente, ela pode ser submetida a tratamento com internações e ações hospitalares que afetam sua rotina, afastando-a dos seus pares e podendo privá-la de brincar. Tal situação implica em pouco contato social com outras crianças, dificuldades emocionais e baixo nível de atividade física, o que pode acarretar prejuízos à criança. Objetivo: analisar nas evidências científicas a importância e benefício das tecnologias recreativas utilizadas em unidade cirúrgica pediátrica. Materiais e Método: estudo de revisão integrativa, com questão de pesquisa elaborada pela estratégia PICO, selecionando-se os descritores "Tecnologia Biomédica", "Recreação", "Centro Cirúrgico", "Sala de Cirurgia", "Bloco Cirúrgico", "Cirurgia", "Sala de Operações", “Enfermagem Pediátrica”, “Equipe de Enfermagem”, “Profissionais de Enfermagem”, “Enfermeiras”, “Saúde da Criança”, em português e inglês, e utilizou-se o operador booleano AND ou OR. Realizou-se a busca em quatro fontes de literatura científica, no período de setembro de 2020 a fevereiro de 2021. Aplicaram-se os critérios de inclusão e exclusão, bem como os dados extraídos por formulário próprio. Resultados: a amostra final quantificou doze estudos e seus resultados foram agrupados em duas categorias: Atividades lúdicas e seus benefícios para a criança hospitalizada; Percepção dos profissionais e de familiares na recreação do paciente. Conclusão: o estudo contribuirá para que profissionais da área da saúde tenham um olhar diferenciado no cuidado do paciente hospitalizado, levando em consideração que o brincar oferta subsídios primordiais na amenização da aflição.
RISCO DE SUICÍDIO ENTRE UNIVERSITÁRIOS DA ÁREA DA SAÚDE E OS FATORES ASSOCIADOS
Authors: Tinti de Andrade Maria Betânia , Vieira Coelho Ferreira Luana , Da Cruz Sequeira Carlos Alberto , Olímpia Barbosa Felipe Adriana , Guidorizzi Zanetti Ana Carolina , Alves Nogueira Denismar , Marilda Rodrigues Resck Zélia , Graziani Giacchero Vedana Kelly 
Published: May 2024

INTRODUÇÃO: O suicídio é apontado como a quarta causa de morte entre jovens na faixa etária de 15 a 29 anos. Nesta faixa etária encontram-se os universitários, que podem vivenciar em sua vida acadêmica um período marcado por angustias, incertezas, desafios e sofrimentos que somados a outros fatores podem favorecer o risco de suicídio. OBJETIVO: Identificar os fatores de risco para o suicídio em estudantes universitários da área da saúde. MATERIAIS E MÉTODO: Estudo de abordagem quantitativa, desenvolvido com estudantes universitários matriculados a partir do 5° período nos cursos de graduação em Biomedicina, Enfermagem, Farmácia, Fisioterapia, Medicina, Nutrição e Odontologia de uma instituição de ensino superior localizada no Sul de Minas Gerais. Foram autoaplicados cinco instrumentos: Questionário sociodemográfico, educacional e clínico; Avaliação do Risco de Suicídio; Escala de Esperança de Herth; Inventário de Depressão Maior e Escala de Autoestima de Rosenberg. RESULTADOS: Participaram do estudo 747 universitários, 27,6% apresentavam risco de suicídio. Os preditores de risco de suicídio foram ter sintomas depressivos, baixa autoestima, diagnóstico de transtorno mental, uso de psicofármacos e insatisfação com o apoio social. CONCLUSÃO: O estudo poderá subsidiar referencial para intervenções, investigações e políticas públicas para o apoio aos estudantes universitários e para a prevenção do suicídio nessa população.
AVALIAÇÃO DO PROGRAMA MAIS MÉDICOS DA PERSPECTIVA DOS USUÁRIOS
Authors: Souza Gleriano Josué , Conceição Martins Lourdes , Krein Carlise , Dias Pedreschi Chaves Lucieli 
Published: May 2024

Introdução: o Programa Mais Médicos (PMM) contribuiu para ampliar a cobertura da Atenção Primária à Saúde (APS). Objetivo: avaliar segundo a experiência de usuários o PMM. Método: pesquisa avaliativa de método misto concomitante realizada em Tangará da Serra – Mato Grosso, com usuários cadastrados na área de abrangência de unidades de saúde da família que tinham na sua equipe médicos do PMM, durante o período de 2016 a 2018. Para os dados quantitativos, a análise descritiva foi gerada por meio do software IBM SPSS®, versão 21. Para a análise temática dos dados qualitativos, utilizou-se o software Qualitative Solutions Research NVivo® 10 que oportunizou apresentação em duas categorias: “PMM: da desconfiança ao reconhecimento por meio da prática médica” e “Prática acolhedora ao usuário e o vínculo: via de mão dupla”. A mixagem dos dados explorou a completude das informações levantadas. Resultados: participaram 1036 usuários, em maior frequência a favor do Programa, que relataram superação quanto à comunicação do idioma e reconhecimento na melhoria do acesso à consulta médica com a diminuição do tempo de espera. Existe satisfação com a prática do profissional, desperta contribuições mútuas entre os usuários e o profissional, ampliando possibilidades de corresponsabilidade com a saúde no território. Conclusão: Revelam-se subsídios do PMM no município, que projetou a ampliação da cobertura com reconhecimento de seus usuários, maior possibilidade de efetivar atributos da APS e fomentar a organização de uma rede de atenção, ao mesmo tempo o desafio da sustentabilidade dessa proposta pela dependência de cooperação do Programa.