bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Quality Improvement Initiative to Reduce Necrotizing Enterocolitis in Very Preterm Infants
Authors: Alshaikh Belal N. , Sproat Thomas D.R. , Wood Christel , Spence Jill-Marie , Knauff Megan , Hamilton Claire , Roy Meagan 
Published: November 2023

OBJECTIVE
To reduce the incidence of necrotizing enterocolitis (NEC) among very preterm infants in the Calgary Health Region to ≤2% within 2 years.

METHODS
A multidisciplinary team developed key drivers for NEC. Targeted interventions included strategies to increase mothers’ own milk (MOM), improve compliance with feeding regimens, standardize management of feeding intolerance, prevent intestinal microbial aberrations, and feed conservatively during blood transfusion and the treatment of patent ductus arteriosus. The outcome measure was NEC (≥ stage 2). Changes in NEC rates were examined among racial and ethnic groups. Process measures included MOM feeding at discharge, the difference between actual and expected time to reach full feeds, lowest hemoglobin, and the duration of empirical antibiotics. Growth, the rate of blood transfusion, and the duration of parenteral nutrition were balancing measures. The preintervention, intervention, and sustainment periods were January 2013 to June 2016, July 2016 to December 2018, and December 2018 to December 2021, respectively.

RESULTS
We included 2787 infants born at ≤326/7 weeks’ gestation (1105 preintervention, 763 during intervention, and 919 in sustainment). NEC decreased from 5.6% to 1.9%. Process measures indicated increased MOM feeding at discharge, improved compliance with feeding regimens, increased lowest hemoglobin levels, and shorter durations of empirical antibiotics. Balancing measures revealed improved weight Z-scores, shorter durations on parenteral nutrition, and increased rates of blood transfusion.

CONCLUSIONS
Quality improvement initiatives to increase MOM, improve compliance with feeding regimens, feed conservatively during blood transfusion and treatment of patent ductus arteriosus, and prevent intestinal microbial aberrations were associated with reduced NEC.
El encanto de la ilusión
Authors: Acosta Díaz Emilio 
Published: November 2023

La ilusión es una de esas realidades humanas que comprendida en su conjunto se convierte en la fuerza impulsora de los grandes logros humanos; está unida a la realidad fundamental del ser en el proceso de integración de la vida. La ilusión tiene que ver con todas las dimensiones del ser humano y especialmente con sus motivaciones internas, en ese sentido, ilusionarse es moverse hacia, ir en búsqueda hacia el mundo de la posibilidad.
El presente artículo pretende resaltar la importancia de la ilusión en el desarrollo biológico, psicológico y espiritual del ser humano por lo que el interés se centrará en saber en que consiste, su función en la vida y como cultivarla a fin de que mantenga el misterio y el encanto por la vida. Ilusionarse e imaginar son ingredientes propios de la inteligencia humana y cumplen un papel definitivo a la hora de sentir que la vida es una fuerza que fluye y a su paso genera rastros de alegría y satisfacción mientras emerge el camino de la felicidad.
En tiempos frágiles de cambios permanentes
Authors: Acosta Díaz Emilio 
Published: November 2023

La vida es movimiento de transformaciones continuas, de cambios externos e internos expresados en estados ánimo, ansiedad generalizada, conexiones y desconexiones con el contexto vital. En esta realidad dinámica y cambiante vale recuperar una visión global, cuyo énfasis contenga el cuidado de sí mismo, de los demás y de la naturaleza; la Ecopsicosofía, en su pretensión, se preocupa por restablecer relaciones y conexiones con el hábitat natural.
Incidencia del conflicto socioeconómico y migratorio en la educación de la subregión La Cordillera-Cumbitara, Nariño.
Authors: Enríquez Pantoja María Viviana , Córdoba López Edy Santiago 
Published: November 2023

El propósito de este artículo, en el marco de la investigación en educación y migración interna, parte de la percepción del docente en ciencias sociales, su experiencia sobre los conflictos socioculturales actuales y como estos inciden en la educación de los estudiantes de la subregión La Cordillera – Cumbitara, Nariño (Colombia). Se debe tomar en cuenta una aproximación al contexto donde se exponen las principales problemáticas presentes en la región y la correlación que estas guardan con el fenómeno a explicar, como esto ha devenido en una crisis y trasformación de la identidad campesina generando un déficit en la soberanía alimentaria de la región y un continuo tránsito de lugar de residencia de la población en busca de una mejor oportunidad de vida.
Multipath Transfer-Function Correction Method to Predict Site-Specific Amplification at City Scale
Authors: Hallo Miroslav , Bergamo Paolo , Fäh Donat 
Published: November 2023

Abstract
The site-specific amplification of seismic waves is an essential component of local seismic hazard assessment. It can be evaluated from empirical data, but measurements are feasible just in a limited number of locations. Hence, at the city scale, there is a need for the theoretical prediction and interpolation of the amplification. In this article, we introduce a physics-based method to predict the site-specific amplification and duration in a broad frequency range. The method is based on a novel energy-based concept of the multipath propagation of waves in viscoelastic media with random heterogeneities. The amplification is expressed by the surface-outcrop transfer function of the multipath wave propagation, which is defined by expected values of the energy spectral ratio. The method is applied to the near-surface 2D velocity model in the city of Zürich in Switzerland. The predicted amplification is validated by empirical data at a nearby seismic station, and it is compared with the soil class and other site-condition proxies. Finally, the method performance is demonstrated by the prediction of site-specific seismic waveforms and response spectra for the 2022 ML 4.7 Mulhouse earthquake.
Spatial and Temporal Evolution Patterns of Construction Waste Generation and Influencing Factors - China Case Study
Authors: Luo Zhenhua , Song Shubin , Pan Haize , Li Mingyang 
Published: November 2023

Abstract
The issue of construction waste reduction has become a global focus, and analyzing the spatial and temporal distribution pattern of construction waste production and the influencing factors is of great significance for different regions to adopt scientific and effective reduction measures according to their own development characteristics. In this paper, panel data of 31 provinces in China are selected from 2013 to 2021 to present the spatial and temporal evolution pattern of construction waste production, and the spatial lag model (SLM) is used to analyze the influencing factors and effects of construction waste production from the perspective of economic and social development. It aims to explore the optimization measures and promotion strategies for construction waste reduction, and to provide reference and assistance for the global construction waste reduction cause. The study shows that China's construction waste production is mainly clustered in the eastern coastal area, with obvious spatial autocorrelation, and the clustering effect shows a trend of rising and then falling, with the peak point appearing in 2018. In terms of the influence effect, the demographic and affluence factors have a more obvious impact on construction waste production than the technological factors. There is a clear spatial spillover effect in the influence of all three aspects on construction waste production, in which urbanization, the scale of the construction industry, the per capita consumption level, the population size and the gross domestic product per capita are the main reasons for the spatial aggregation of construction waste production. Among the construction waste reduction strategies, in addition to the improvement of labor efficiency, the level of technological application, and the requirements of building codes, other strategies need to be considered according to the characteristics and current situation of the socio-economic development of each region. This study is an important reference for countries to analyze the situation of construction waste production and adopt reasonable reduction strategies.
Randomized Controlled Trial of Intravenous Immunoglobulin for Autoimmune Postural Tachycardia Syndrome (iSTAND)
Authors: Vernino Steven , Hopkins Steve , Bryarly Meredith , Hernandez Roberto S. , Salter Amber 
Published: November 2023

Abstract
Objective: Assess response to intravenous immunoglobulin (IVIG) in presumed autoimmune postural orthostatic tachycardia syndrome (POTS)
Background: POTS predominantly affects young women and may be associated with systemic autoimmune disorders, serum autoantibodies or recent infection. Uncontrolled case studies suggest that IVIG is beneficial for treating autoimmune POTS. However, no previous randomized controlled trials have been conducted.
Methods: This single site randomized controlled clinical trial compared IVIG to intravenous albumin infusions. Albumin comparator ensured blinding and control for effects of volume expansion. Eligible POTS patients had COMPASS-31 score ≥ 40 and met pre-determined criteria suggesting autoimmunity. Over 12 weeks, participants received 8 infusions (0.4gm/kg each). Four infusions were given weekly followed by four infusions every other week. Primary outcome measure was improvement in COMPASS-31 two weeks after final infusion.
Results: 50 participants consented; 30 met inclusion criteria and received study drug (16 IVIG and 14 albumin; 29 female). Group baseline characteristics were well matched. 27 participants completed treatment protocol. Change in COMPASS-31 did not differ between groups (median change [IQR]; IVIG: -5.5 [-23.3, 2.5] vs. Albumin: -10.6 [-14.1, -4.7]; p-value = 0.629). Response rate was also not different between groups. Adverse events were common but usually mild and did not differ between treatment groups.
Conclusions: This first randomized controlled trial of IVIG in POTS found no difference in symptom response compared to albumin infusion. Both groups showed improvement possibly related to volume expansion obscuring other benefits. Future clinical trials may benefit from the use of POTS-specific clinical outcome measures sensitive to symptoms other than orthostatic intolerance.
Fractal Analysis of Mandible in Panoramic Radiographs of Patients Received Radiotherapy for Nasopharyngeal Carcinoma
Authors: Tepe Rabia Duman , Toraman Kubra Ozkaya , Kayhan Kivanc Bektas , Ozcan Ilknur , Karabas Hulya Cakir 
Published: November 2023

Abstract
Objectives
This study aimed to evaluate the effect of radiotherapy on mandibular cortical and trabecular bone internal structure complexity and to determine the recovery time to healthy values after radiotherapy.
Materials and Methods
In this study, panoramic radiographs obtained before and after radiotherapy of patients who received radiotherapy for nasopharyngeal carcinoma were evaluated. According to the duration of the radiography after radiotherapy, four groups were formed 0–6 months, 6–12 months, 12–24 months, and 24–36 months. A total of 61 cases and 122 radiographs were evaluated. On each radiograph, fractal analysis (FA) was performed on four bilateral regions (ROIs) selected from trabecular and cortical bone. In addition, inferior alveolar canal width (IACW) and mandibular cortical width (MCW) measurements were also performed. Also, the mean and maximum dose values that the mandible was exposed to as a result of radiotherapy were measured and the relationship of these dose values with the changes in FD, IACW, and MCW values was evaluated.
Results
FD values of ROI-1, ROI-2, and ROI-3 selected over trabecular bone were statistically significantly decreased in all groups. However, there was no statistically significant difference between the four groups. In ROI-4 selected from cortical bone, a statistically significant decrease was observed in FD values, except for the 0–6 month group. The amount of FD decrease was higher in the 12–24 and 24–36 month groups compared to the 0–6 month group. MCW and IACW values were found to be statistically significantly lower in all groups after radiotherapy, and this decrease was similar between the groups.
Conclusions
Internal complexity of trabecular and cortical bone structure decreases in mandible exposed to radiotherapy. The risk of osteoradionecrosis continues even in the 3rd year after radiotherapy, so it would be useful to approach interventional procedures on bone carefully.
Clinical Relevance:
The FA method in ORN risk assessment is a non-invasive, easy-to-apply and low-cost method.
Effectiveness of Self-Directed Learning in Undergraduate Medical Education: A Systemic Review and Meta-Analysis
Authors: Aulakh Jasmine , Wahab Hana , Richards Christine , Ramdass Prakash V. A.K. 
Published: November 2023

Abstract

Background
Self-Directed Learning (SDL) is a theory of andragogy in which adult learners take their own initiative to identify and tailor their individual learning process and outcomes. In undergraduate medical education, SDL aims to develop medical students into lifelong learners. This study aims to estimate the overall effectiveness of self-directed learning compared to traditional didactic learning.
Methods
We performed a systematic review and meta-analysis according to the PRISMA statement. A systematic search was used across PubMed, Scopus, Embase and Google Scholar to identify peer-reviewed articles spanning from inception through September 2023. Key words used were “self-directed learning” AND “undergraduate medical education.” Forest plots were generated with the Open Meta-analyst Software, comparing SDL and traditional didactic learning (TDL).
Results
A total of 509 articles were screened for eligibility, of which 95 articles met the eligibility criteria for full-text review. Following a more detailed screening, 7 articles met the inclusion criteria for the systematic review and 9 articles for the meta-analysis. The systematic review analyzed 2,772 students while the meta-analysis included 1,317 students. The pooled analysis for all studies demonstrates that SDL had a mean score of 1.91 [95% CI (0.75–3.06)] higher than TDL.
Conclusions
Self-directed learning is an effective learning strategy in medical undergraduate education and has the potential to aid in students’ learning and improve their cognitive performance.
‘Life became harder with COVID-19’: Impacts of COVID-19 on youth living in eThekwini district, South Africa, a qualitative analysis of responses to an online survey
Authors: Closson Kalysha , Dong Erica , Zulu Bongiwe , Dietrich Janan J. , Zharima Campion , Jesson Julie , Pakhomova Tatiana , Beksinska Mags , Kaida Angela 
Published: November 2023

Abstract
Background
In South Africa, pervasive age and gender inequities have been exacerbated by the COVID-19 pandemic and public health response. We aimed to explore the impacts of the COVID-19 pandemic on youth in eThekwini, South Africa.
Methods
Between December 2021-May 2022 we explored the impacts of the COVID-19 pandemic on youth aged 16–24 residing in eThekwini, South Africa using open-ended responses to an online survey focused on understanding multi-levelled health and social impacts of the pandemic. Inductive coding summarized open-ended responses to the question “Has the COVID-19 pandemic affected you in any other way you want to tell us about?” overall and by gender.
Results
Of 2,068 respondents, 256 (12.4%, median age = 22, 62.1% women or non-binary) completed the open-ended survey question (11% in isiZulu). Results were organized into three main themes encompassing 1) COVID-19-related overwhelming loss, fear, grief, and exacerbated mental and physical health concerns; 2) COVID-19-related intensified hardships, which contributed to financial, employment, food, educational, and relationship insecurities for individuals and households; and 3) positive impacts of the pandemic response, including the benefits of government policies and silver linings to government restrictions. South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic.
Conclusions
We found that South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic. Trauma-aware interventions that provide economic and educational opportunities must be included in post-COVID recovery efforts.
Toxicity of orange and neem oils at each stage of development of the coffee leaf miner, Leucoptera coffeella (Lepidoptera: Lynetiidae), and their side effects on predator Chrysoperla externa (Neuroptera: Chrysopidae)
Authors: Lima Vinícius de Oliveira , Braghini Agda , Paula Fabrícia Cristina , Souza Jonas Mendes Rodrigues , Figueiredo Gustavo Pincerato , Vacari Alessandra Marieli 
Published: November 2023

Abstract

Despite chemical control remaining the predominant strategy for pest management, the utilization of sustainable control tactics has been growing as a crucial approach to mitigate environmental impact and ensure safe food production. However, such strategies have seen limited exploration in the agricultural realm, particularly within intensive coffee cultivation. In this context, the application of botanical insecticides, such as orange and neem oils, exhibiting insecticidal activity against various lepidopteran pests, holds promise as efficient and effective control measures. The objective of this research was to investigate the efficacy of botanical insecticides based on orange oil and neem oil for managing Leucoptera coffeella (Lepidoptera: Lyonetiidae) infestations, while additionally assessing the side effects of these insecticides on predator Chrysoperla externa (Neuroptera: Chrysopidae), commonly found in coffee cultivation areas. To achieve this, we examined the impact of botanical insecticides on eggs, larvae, pupae, and adults of L. coffeella, as well as on eggs and larvae in the first, second, and third instars of C. externa. The results obtained from this research indicate that the application of botanical insecticides based on orange oil and neem oil led to a significant reduction in the hatching of coffee leaf miner larvae (75.0-97.6%). Furthermore, when applied to larvae of its predator, C. externa, these insecticides demonstrated compatibility with the survival of the natural enemy. Both neem oil and orange oil exhibited the ability to prevent larvae from hatching from L. coffeela eggs when applied to adults. In light of these findings, it is evident that botanical insecticides formulated from orange oil and neem oil could serve as viable alternatives for the sustainable management of the coffee leaf miner, a significant pest in coffee cultivation.
Madagascar In-Country Evaluation for Bioline™ Malaria Ag Pf/Pan and Bioline™ Malaria Ag
Authors: Rakotoarisoa MA , Rakotomanga TA , Fenomanana J , MUSANGO Laurent , Raobela Oméga , Salava J , Andrianarivelo AM , Kialozafy Maximilienne , Rakotondradriana Antsa , Razanatsila Armel , Rabarisoa Hajalalaina , Rakotosaona Rianasoambolanoro , Ratsimbasoa Arsene 
Published: November 2023

Abstract
Background: Malaria remains a significant public health challenge in Madagascar. The World Health Organization (WHO) recommends confirming the presence of parasites through parasitological methods before initiating malaria treatment. Microscopy and rapid diagnostic tests (RDTs) are primary diagnostic methods. This study aimed to evaluate the diagnostic performance of two RDTs: Bioline™ Malaria Ag Pf/Pan and Bioline™ Malaria Ag Pf/Pv by comparing them to microscopic diagnosis, with polymerase chain reaction (PCR) serving as the designated reference standard.
Methods:
Madagascar-based, from two malaria-endemic districts: Ifanadiana and Mandoto , prospective, diagnostic performance study. Included: anyone, symptomatic and symptomatic, between 3 - 81 years from local primary schools and health canters between 05/2023 and 07/2023. Excluded: patients with severe malaria. Diagnosis: Bioline™ Malaria Ag Pf/Pan and Bioline™ Malaria Ag Pf/Pv RDTs and PCR.
Results:
The kappa species index was computed using 442 PCR-confirmed positive samples. The sensitivity for P. falciparum detection was 98% (95% CI: 96-99) with Pf/Pan RDTs, yielding a kappa species index of 0.9. Similarly, the sensitivity for P. falciparum detection was 97% (95% CI: 95-99) with Pf/Pv RDTs, accompanied by a kappa species index of 0.9. Pf/PvRDTs demonstrated a sensitivity of 100% (95% CI: 99-100) for P. vivaxdetection, with a kappa species index of 1, indicating strong agreement. Pf/Pan RDTs identified a proportion of 36% of mixed infections.
Conclusions: Our findings emphasize the need for careful consideration of the appropriate use of RDTs based on local epidemiology and clinical context. both Ag Pf/Pan and Bioline™ Malaria Ag Pf/Pv RDTs could be used at the peripheral levels where Microscopy and PCR are not possible (CSB1 and CSB 2) and using them according to their availability. At the district level, we could initiate an assessment of geographical cartography which will guide the policy of the use of Ag Pf/Pan and Bioline™ Malaria Ag Pf/PvRDTs according to Plasmodium species identified in different districts.
Trial registration: This study is part of the monitoring of quality control of Rapid Diagnostic Test at the National Malaria control Program (NMCP). The clear consent from participating was systematically collected.
Strontium attenuates LPS-induced inflammation via TLR4/MyD88/NF-κB pathway in bovine ruminal epithelial cells
Authors: Tan Panpan , Yang Jiaqi , Yi Fanxuan , Mei Linshan , Wang Yazhou , Zhao Chenxu , Zhao Baoyu , Wang Jianguo 
Published: November 2023

Abstract
Subacute ruminal acidosis (SARA) is a common nutritional metabolic disease in ruminants that causes significant economic losses to dairy farming. Strontium (Sr) is known to be involved in bone metabolism and exhibits potent anti-inflammatory effects. To evaluate the effect of Sr on LPS-induced inflammation in bovine ruminal epithelial cells, a model of LPS-induced inflammation was established in this study, and the cell viability of bovine ruminal epithelial cells was measured using CCK-8. The production of pro-inflammatory cytokines was measured by ELISA and real-time PCR, respectively. The related protein of the TLR4/MyD88/NF-κB pathway was assayed through Western blotting, the fluorescence of p-p65 and p-IκB were assayed by immunofluorescence. Molecular docking of Sr and TLR4/MyD88/NF-κB pathway-related proteins was performed using MIB2 (http://bioinfo.cmu.edu.tw/MIB2/). Results showed that after treatment for 24 h, the cell viability was decreased at the high concentration of Sr (≥ 10 mmol/L). Sr significantly decreased the production of TNF-α, IL-1β, and IL-6, down-regulated the related protein expression of the TLR4/MyD88/NF-κB pathway, reduced the fluorescence levels of p-p65 and p-IκB. The NF-κB pathway inhibitor PDTC and molecular docking further revealed that Sr reduced LPS-induced pro-inflammatory cytokines production via the TLR4/MyD88/NF-κB pathway. These results suggest that Sr reduces LPS-induced pro-inflammatory cytokines production via the TLR4/MyD88/NF-κB pathway, thereby exerting an anti-inflammatory effect in bovine ruminal epithelial cells.