bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimated Effect of Restarting Renin-Angiotensin System Inhibitors after Discontinuation on Kidney Outcomes and Mortality
Authors: Hattori Koki , Sakaguchi Yusuke , Oka Tatsufumi , Asahina Yuta , Kawaoka Takayuki , Doi Yohei , Hashimoto Nobuhiro , Kusunoki Yasuo , Yamamoto Satoko , Yamato Masafumi , Yamamoto Ryohei , Matsui Isao , Mizui Masayuki , Kaimori Jun-Ya , Isaka Yoshitaka 
Published: June 2024

Key Points

Restarting renin-angiotensin system inhibitor after discontinuation was associated with a lower risk of kidney outcomes and mortality but not related to hyperkalemia.Our findings support a proactive approach to restarting renin-angiotensin system inhibitor among patients with CKD.

Background
While renin-angiotensin system inhibitors (RASi) have been the mainstream treatment for patients with CKD, they are often discontinued because of adverse effects such as hyperkalemia and AKI. It is unknown whether restarting RASi after discontinuation improves clinical outcomes.

Methods
Using the Osaka Consortium for Kidney disease Research database, we performed a target trial emulation study including 6065 patients with an eGFR of 10–60 ml/min per 1.73 m2 who were followed up by nephrologists and discontinued RASi between 2005 and 2021. With a clone-censor-weight approach, we compared a treatment strategy for restarting RASi within a year after discontinuation with that for not restarting RASi. Patients were followed up for 5 years at maximum after RASi discontinuation. The primary outcome was a composite kidney outcome (initiation of KRT, a ≥50% decline in eGFR, or kidney failure [eGFR <5 ml/min per 1.73 m2]). Secondary outcomes were all-cause death and incidence of hyperkalemia (serum potassium levels ≥5.5 mEq/L).

Results
Among those who discontinued RASi (mean [SD] age 66 [15] years, 62% male, mean [SD] eGFR 40 [26] ml/min per 1.73 m2), 2262 (37%) restarted RASi within a year. Restarting RASi was associated with a lower hazard of the composite kidney outcome (hazard ratio [HR], 0.85; 95% confidence intervals [CIs], 0.78 to 0.93]) and all-cause death (HR, 0.70; 95% CI, 0.61 to 0.80) compared with not restarting RASi. The incidence of hyperkalemia did not differ significantly between the two strategies (HR, 1.11; 95% CI, 0.96 to 1.27).

Conclusions
Restarting RASi after discontinuation was associated with a lower risk of kidney outcomes and mortality but not related to the incidence of hyperkalemia.
APRENDIZAGEM BASEADA EM PROBLEMAS: UMA PERSPECTIVA DO ENSINO DA MATEMÁTICA PARA O ENEM
Authors: Mello da Silva Matheus , Afonso Etges Hélio , Adriana de Oliveira Marcia 
Published: June 2024

O presente artigo busca ressaltar a importância da Matemática, do seu ensino e a aplicação de metodologias ativas para a preparação de alunos do Ensino Médio que desejam realizar o Exame Nacional do Ensino Médio (ENEM). Para isso foi realizada uma oficina a partir do projeto Conexões UNISC, setor vinculado à Pró-Reitoria Acadêmica da Universidade de Santa Cruz do Sul. O curso de Matemática Licenciatura Plena, inserido no Projeto, realiza a oficina A Matemática para o ENEM. Ela objetiva identificar as dificuldades apresentadas pelos estudantes nos conteúdos cobrados no Exame Nacional do Ensino Médio. O desenvolvimento do trabalho está centralizado em materiais didático-pedagógicos elaborados pelo bolsista e professores, ancorado em recursos tecnológicos como vídeos para a aplicação de atividades da oficina e na resolução de problemas. Fundamentada em uma proposta de modelo teórico-prático de atividades, a oficina apropria-se de uma das metodologias ativas, que é a de aprendizagem baseada em problemas. Com seu uso junto a turmas de alunos do Ensino Médio em 8 escolas da região de Santa Cruz do Sul, notou-se a mudança na compreensão e resolução de questões de Matemática no ENEM. Também o papel do docente e a diversificação na metodologia adotada para suas aulas garante uma melhora na participação dos discentes e estimula a autoaprendizagem.
ONLINE LEARNING MODEL TO IMPROVE THE STUDENTS’ ACHIEVEMENT IN DESIGN OF INFORMATION AND COMMUNICATION TECHNOLOGY
Authors: Zuhairi Zuhairi , Andayani Sutrisni , Jarudin Jarudin 
Published: June 2024

The rapid advancement of technology and the growing demand for ICT skills have necessitated innovative educational approaches to improve student achievement. Traditional classroom-based teaching often struggles to keep pace with the dynamic and evolving nature of ICT education. The variability in student learning styles and the increasing requirement for digital skills necessitate a flexible and scalable educational model. This study focuses on developing an effective online learning model tailored to enhance student performance in the field of Design of Information and Communication Technology (ICT). The study employed a mixed-methods approach, combining quantitative and qualitative data. Participants included undergraduate students enrolled in an ICT Design course. They were given access to an online learning platform offering interactive video lectures, multimedia resources, assessments, and collaborative projects. Data collection included pre- and post-tests to measure academic performance, surveys to gauge student satisfaction, and focus group discussions to gather qualitative insights into their learning experience. The findings indicated a significant improvement in student achievement, with post-test scores consistently higher than pre-test scores across all participants. The model's flexibility allowed students to learn at their own pace, leading to a deeper understanding of key concepts. Interactive resources and collaborative projects enhanced engagement and fostered critical thinking. Moreover, the majority of students expressed high satisfaction with the online learning experience, citing the variety of resources, self-paced learning opportunities, and collaborative forums as significant contributors.
PROFESSORAS DO CICLO DA ALFABETIZAÇÃO E SEUS CONHECIMENTOS ACERCA DE MATERIAIS MANIPULÁVEIS EM GEOMETRIA
Authors: Ciríaco Klinger Teodoro , Síveris Fabiane Pittas 
Published: June 2024

Compreender os conhecimentos de professoras do ciclo da alfabetização acerca da utilização de materiais manipuláveis nas aulas de Geometria constituiu-se objetivo desta investigação. Para tanto, a produção de dados ocorreu no contexto das reuniões de um grupo de práticas colaborativas em Educação Matemática, cuja temática eleita para estudos e reflexões, no momento da investigação, fora a Geometria. O referencial teórico possibilitou discutir questões sobre a formação para o ensino desta área do conhecimento, causas e consequência de seu "abandono" no ensino básico, como também as contribuições dos materiais manipuláveis para abstração de conceitos geométricos. Em termos metodológicos, adotou-se a pesquisa qualitativa, de caráter descritivo-analítico, ao construir itinerários de recolha de informações por meio das observações dos encontros com o grupo, catalogação dos materiais existentes nas escolas em que as docentes atuavam e o desenvolvimento de um roteiro de entrevista semiestruturada. Ao concluir o trabalho de campo, é possível fazer a inferência de que os conhecimentos sobre os materiais manipuláveis ainda são insuficientes, uma vez que na teoria as professoras reconhecem a relevância e contribuição deste recurso à aprendizagem de seus alunos, mas, na prática, sua adoção tem sido realizada de forma descontextualizada, o que acarreta na incompreensão das propriedades matemáticas existentes e possíveis de serem compreendidas a partir de sua exploração.
Investigation of the Relationship Between Mothers’ Perceived Husband Support and Paternal–Infant Attachment in Turkey
Authors: Kaya İffet Güler , Kocatürk Asiye 
Published: June 2024

OBJECTIVE:This study was conducted in a descriptive cross-sectional design to investigate the impact of spousal support provided to expectant mothers during pregnancy on paternal bonding.DESIGN AND METHODS:Both longitudinal and cross-sectional analyses are presented in this article. An information form, the Perceived Spousal Support Among Women in the Early Postpartum Period Scale (PSSSEPPP), and the Paternal–Infant Attachment Scale (PIAS) were used to collect data.FINDINGS:The mean PSSSEPPP score of mothers was 57.93 ± 13.86, and fathers’ second- and fourth-month PIAS scores were 63.32 ± 13.76 and 66.73 ± 13.66, respectively. There was a statistically positive correlation between PSSSEPPP and PIAS. A directional and significant relationship was found (r= 0.714,p= .001).CONCLUSION:Supporting expectant mothers during pregnancy and in the early postpartum period has positively affected paternal–infant attachment.
Swab Testing to Optimize Pneumonia treatment with empiric Vancomycin (STOP-Vanc): study protocol for a randomized controlled trial.
Authors: Freiberg Jeffrey A , Siemann Justin K , Qian Edward T , Ereshefsky Benjamin J , Hennessy Cassandra , Stollings Joanna L , Rali Taylor M , Harrell Frank E , Gatto Cheryl L , Rice Todd W , Nelson George E 
Published: June 2024

Abstract

Background: Vancomycin, an antibiotic with activity against Methicillin-resistant Staphylococcus aureus (MRSA), is frequently included in empiric treatment for community-acquired pneumonia (CAP) despite the fact that MRSA is rarely implicated in CAP. Conducting polymerase chain reaction (PCR) testing on nasal swabs to identify the presence of MRSA colonization has been proposed as an antimicrobial stewardship intervention to reduce the use of vancomycin. Observational studies have shown reductions in vancomycin use after implementation of MRSA colonization testing, and this approach has been adopted by CAP guidelines. However, the ability of this intervention to safely reduce vancomycin use has yet to be tested in a randomized controlled trial.
Methods: STOP-Vanc is a pragmatic, prospective, single center, non-blinded randomized trial. Adult patients with suspicion for CAP who are receiving vancomycin and admitted to the Medical Intensive Care Unit at Vanderbilt University Medical Center will be screened for eligibility. Eligible patients will be enrolled and randomized in a 1:1 ratio to either receive MRSA nasal swab PCR testing in addition to usual care (intervention group), or usual care alone (control group). PCR testing results will be transmitted through the electronic health record to the treating clinicians. Primary providers of intervention group patients with negative swab results will also receive a page providing clinical guidance recommending discontinuation of vancomycin. The primary outcome will be vancomycin-free hours alive, defined as the number of hours alive and free of the use of vancomycin within the first seven days following trial enrollment estimated using a proportional odds ratio model. Secondary outcomes include 30-day all-cause mortality and time alive off vancomycin.
Discussion: STOP-Vanc will provide the first randomized controlled trial data regarding the use of MRSA nasal swab PCR testing to guide antibiotic de-escalation. This study will provide important information regarding the effect of MRSA PCR testing and antimicrobial stewardship guidance on clinical outcomes in an intensive care unit setting.
Trial registration: This trial was registered on ClinicalTrials.gov on February 22, 2024. (ClinicalTrials.gov identifier: NCT06272994)
Identifying and tuning coordinated water molecules for efficient electrocatalytic water oxidation
Authors: Zhang Qiuyu , Zhang Geng , Guo Wei , Zheng Hong , Li Xiang , Wang Jinxin 
Published: June 2024

Abstract

Coordination complexes are promising candidates for powerful electrocatalytic oxygen evolution reaction (OER) but challenges remain in favoring the kinetics behaviors through local coordination regulation. Herein, by refining the synergy of carboxylate anions and multiconjugated tripodal benzimidazole ligands, we tailor a series of well-defined and stable coordination complexes (CCs), Ni-tPBA0~3, with three-dimensional (3D) supramolecular/coordinated structures. The coordinated water as potential open coordination sites (OCSs) can directly become intermediates, while the metal center easily achieves re-coordination with water molecules in the pores to resist lattice oxygen dissolution. Specifically, nickel centers with mono-coordinated water undergo the intermolecular oxygen coupling while those with neighboring coordinated water molecules follow an intramolecular oxygen coupling mechanism (IOM) with a low thermodynamic energy barrier. With more coordinated water introduced, an optimized IOM process appears with the synergy of potential OCSs, enabling fast generation of –Ni–(OH)x intermediate and synchronizing the re-coordination of water molecules with the deprotonation of active –OH for enhanced kinetics. As such, a low overpotential of 265 mV at 10 mA cm–2 and long-term stability of 150 h at 100 mA cm–2 was achieved, superior to most single transition metal-based molecular electrocatalysts. This study underscores the potential of crafting the coordinated water molecules for efficient electrocatalysis applications.
Seismic clusters and fluids diffusion: a lesson from the 2018 Molise (Southern Italy) earthquake sequence
Authors: Gentili Stefania , Brondi Piero , Rossi Giuliana , Sugan Monica , Petrillo Giuseppe , Zhuang Jiancang , Campanella Stefano 
Published: June 2024

Abstract

The identification of seismic clusters is essential for many applications of statistical analysis and seismicity forecasting: an incorrect cluster identification leads to incorrect results. However, there are several methods to identify clusters, and their results are not always compatible. We tested different approaches to analyze the clustering: a traditional window-based approach, a complex network-based technique (Nearest Neighbor - NN), and a novel approach based on fractal analysis. The case study is the increase in seismicity observed in Molise, southern Italy, from April to November 2018. To analyze the seismicity in detail with the above-mentioned methods, an improved template-matching catalog was created. A stochastic declustering method based on the Epidemic Type Aftershock Sequence (ETAS) model was also applied to add probabilistic information. We explored how the significant discrepancies in these methods’ results affect the result of NESTORE (NExt STrOng Related Earthquake) algorithm – a method to forecast strong aftershocks during an ongoing cluster – previously successfully applied to the whole Italian territory. We performed a further analysis of the spatio-temporal pattern of seismicity in Molise, using the principal component analysis (PCA), the ETAS algorithm, as well as analyses, aimed at detecting possible migration and diffusion signals. We found a relative quiescence of several months between the main events of April and August, the tendency of the events to propagate upwards, and a migration of the seismicity consistent with a fluid-driven mechanism. We hypothesize that these features indicate the presence of fluids, which are also responsible for the long duration of the sequence and the discrepancies in cluster identification methods. Such results add to the other pieces of evidence of the importance of the fluid presence in controlling the seismicity in the Apennines. Moreover, this study highlights the importance of refined methods to identify clusters and encourages further detailed analyses of anomalous sequences.
Restorative seeding controls annual invasive species, but perennials can thrive in the long term despite treatments in sand grassland restoration
Authors: Saradi Nora , Reis Bruna Paolinelli , Csákvári Edina , Csonka Anna Cseperke , Vörös Márton , Verebényiné Krisztina Neumann , Török Katalin , Halassy Melinda 
Published: June 2024

Abstract

Biodiversity loss caused by invasive alien species is a major problem in planetary perspective. Ecological restoration is an important tool to counteract invasions, but invasive species may negatively affect restoration if present in the landscape. We investigated long-term changes in annual and perennial invasive alien species abundance in three sandy grassland restoration experiments. We evaluated the dependence of annual and perennial invasive species abundance on initial restoration intervention, invasive species propagule pressure from the surrounding landscape, and time since interventions. Restoration interventions (seeding, mowing and carbon amendment) were conducted at a total of eight sites in the Kiskunság region of Hungary. The interventions took place between 1995 and 2003 and were monitored for 17–25 years. To assess invasive propagule pressure around the experimental sites, total shoot numbers in adjacent 1 m by 1 m plots along 100-meter-long transects were counted in 2020–2021 from the center of the eight experimental sites. Invasive propagule pressure within a 100-meter buffer did not explain changes in the abundance of annual and perennial invasive species. The cover of annual invasive species has mostly decreased over time, and treatment (mainly seeding) could accelerate this process. The cover of perennial invasive species increased over time irrespective of applied treatments and landscape invasive propagule pressure. Our research showed that seeding with native species is an effective tool for restoring sandy grasslands and preventing the spread of annual invasive species, but our toolbox for preventing perennial invasion in grassland restoration is limited.
Novel Metrics for Tracking Blood Pressure Changes in Continuous Cuffless Blood Pressure Estimations
Authors: He Shan , Bolic Miodrag 
Published: June 2024

Abstract

Recent studies revealed the importance of tracking continuous blood pressure (BP) changes in monitoring and controlling hypertension and diagnosing cardiovascular diseases. However, current evaluation protocols utilize distance measures as primary metrics, which cannot properly evaluate the ability of the estimation model to track BP change. This paper proposes a comprehensive evaluation framework which evaluates the distance and trend similarity metrics, and the composite metric of both between the reference and estimated BPs. The results of applying both widely used conventional metrics and the new proposed metrics for BP estimations are demonstrated in an example of comparing the reference with a set of different BP estimations.Then, the metrics are applied to BP estimations obtained using state-of-the-art (SOTA) algorithms. It is shown that even though SOTA algorithms have a low mean and standard deviation of absolute difference, they are not capable of tracking short-termblood pressure changes. Therefore, we suggest that the proposed evaluation framework should be used regularly in evaluating continuous BP monitoring systems.
“I will take part in the revolution with our people”: A qualitative study of healthcare workers' experiences of violence and resistance after the 2021 Myanmar coup d’etat
Authors: Haar Rohini J. , Crawford Katerina , Fast Larissa , Win Than Htut , Rubenstein Leonard , Blanchet Karl , Lillywhite Louis , Tint-Zaw Nicholus , Mon Myo-Myo 
Published: June 2024

Abstract

Background
In Myanmar, ongoing conflict since the 2021 military coup d’etat has been characterized by targeted violence against health workers (HWs), particularly those participating in the pro-democracy movement. Existing knowledge about the challenges faced by health workers in Myanmar is scant, including their perspectives on mitigating their suffering and the broader impact on community health. This knowledge gap prompted our study to assess the extent of the violence, its impact on the workers and the community, and identify resource priorities.
Methods
This qualitative study employed purposive and snowball sampling to recruit health workers affiliated with the Civil Disobedience Movement (CDM). We interviewed 24 HWs in Myanmar between July and December 2022, predominantly physicians and nurses. We used a semi-structured interview guide and conducted interviews remotely due to the security situation. We adopted content analysis to understand participation in the CDM movement, experiences of violence, personal and professional impacts, the sequelae to community health, how HWs responded as well as their ongoing needs.
Results
Thematic content analysis revealed that violence was both individually targeted and widespread. Health workers faced professional, financial, and personal impacts as a result. The health system as a whole has been severely diminished. Health workers have had to adapt to continue to provide care, for example some fled to rural areas and worked clandestinely, exchanging their services for food and shelter. In those settings, they continued to face insecurity from airstrikes and arrests. Health workers have also experienced moral distress and burden due to their resistance and protest against the regime.
Conclusion
The coup and ensuing violence severely disrupted the healthcare system, resulting in shortages of supplies, reduced quality of care, and exacerbated challenges during the COVID-19 pandemic. Despite facing significant hardships, HWs remained resilient, engaging in resistance efforts within the CDM and seeking support from local communities and international organizations. They expressed a need for increased awareness, financial assistance, and concrete support for the health system to address the crisis.
Factors associated with deer vehicle collisions in South Carolina (SC), USA
Authors: Sharma Sanjeev , Khanal Puskar 
Published: June 2024

Abstract

Every year in the United States, approximately 1.5 million deer–vehicle collisions (DVCs) occur, resulting in >200 human fatalities, >29,000 human injuries, 1.3 million deer fatalities, and >1 billion dollars’ worth of property damage. However, there was a lack of studies implementing machine learning techniques from the state level to evaluate the factors affecting DVCs. Data on DVCs on roads are valuable to reduce the occurrence of DVCs and to assist in planning. We utilized the data from 2018 to 2021 provided by Department of Transportation and Safety. The finding suggests that DVCs occurred more frequently near the developed areas, cultivated land and woody wetland and in October, from 8:00 PM to 10:00 PM and 6:00 AM to 8:00 AM. The accuracy scores 0.56 and 0.63 were obtained from machine learning and artificial neural network, opening the door for future research on more factors that affect DVCs.