Reference Guidelines Research Articles

Assessment of Potentially Toxic Elements and Their Risks in Water and Sediments of Kitengure Stream, Buhweju Plateau, Uganda

Artisanal and small-scale gold mining (ASCGM) provides a livelihood for many communities worldwide, but it has profound environmental impacts, especially on the quality of nearby water resources. This study assessed the impacts of ASCGM on the physicochemical quality of water and sediments from Kitengure stream, Buhweju Plateau, Western Uganda. Surface water (n = 94) and superficial sediments (n = 36) were sampled between October 2021 and January 2022 from three different sections of Kitengure stream (upstream, midstream around the ASCGM area, and downstream). The samples were analyzed for various physicochemical parameters and selected potentially toxic elements (PTXEs), namely: zinc (Zn), cadmium (Cd), lead (Pb), copper (Cu), and arsenic (As). A health risk assessment was performed using the hazard index and incremental life cancer risk methods. Pearson’s bivariate correlation, geoaccumulation, and pollution indices were used to establish the sources and potential risks that PTXEs in sediments could pose to aquatic organisms. The results indicated that water in Kitengure stream draining the ASCGM site was highly colored (1230.00 ± 134.09 Pt-co units; range = 924.00–1576.00 Pt-co units) and turbid (194.75 ± 23.51 NTU; range = 148–257 NTU). Among the five analyzed PTXEs, only Cd (0.082 ± 0.200–0.092 ± 0.001 mg/L) and Cu (0.022 ± 0.004–0.058 ± 0.005 mg/L) were detected in water, and Cd was above the permissible limit of 0.003 mg/L for potable water. Upon calculating the water quality index (WQI), the water samples were categorized as very poor for upstream samples (WQI = 227) and unfit for use (WQI = 965 and 432) for midstream and downstream samples, respectively. In sediments, the mean concentration ranges of Zn, Cd, Pb, Cu, and As were 0.991 ± 0.038–1.161 ± 0.051, 0.121 ± 0.014–0.145 ± 0.025, 0.260 ± 0.027–0.770 ± 0.037, 0.107 ± 0.017–0.422 ± 0.056, and 0.022 ± 0.002–0.073 ± 0.003 mg/kg, respectively, and they were all below their average shale, toxicity reference, and consensus-based sediment quality guidelines. Geoaccumulation indices suggested that there was no enrichment of the elements in the sedimentary phase and the associated ecological risks were low. However, there were potential non-carcinogenic health risks that maybe experienced by children who drink water from Kitengure stream. No discernable health risks were likely due to dermal contact with water and sediments during dredging or panning activities. It is recommended that further studies should determine the total mercury content of water, sediments, and crops grown along the stream as well as the associated ecological and human health risks.

The measurement of tire-road noise: how does standardization contribute to the development of low noise pavements in Europe

Low-noise road pavements are among the most effective solutions for reducing road traffic noise emission at the source. There was a significant international effort over the past years for developing and standardizing methods for measuring tire-road noise emission, essentially Statistical Pass-By (SPB) and Close ProXimity (CPX) methods. The dedicated Working Group of the European Committee for Standardization (CEN/TC227/WG5) recently investigated how these standards are used in practice and how they contribute to the implementation of low-noise pavements. For this, a survey was launched and 14 European countries responded on their practices. The survey showed a large diversity of use, although all refer to the measurement methods SPB, CPX. Based on these methods, some countries have developed national regulations or reference guidelines to specify and assess the acoustic performance of road surfaces. These procedures are, however, significantly different and lead to varying definitions of low-noise pavements, which prevents sharing knowledge, experience and data. This context justifies the ongoing development within CEN/TC227/WG5 of a standard procedure for the acoustic characterization of road pavements based on existing measurement methods. The paper will present and analyze the results of the survey, then will present the ongoing work in CEN.

Working in a relational way is everything: Perceptions of power and value in a drug policy-making network

BackgroundThe development of drug policies has been a major focus for policy-makers across North America in light of the ongoing public health emergency caused by the overdose crisis. In this context, the current study examined stakeholders’ experiences and perceptions of power and value in a drug policy-making process in a North American city using qualitative, questionnaire, and social network data.MethodsWe interviewed 18 people who participated in the development of a drug policy proposal between October 2021 and March 2022. They represented different groups and organizations, including government (n = 3), people who use drugs-led advocacy organizations (n = 5), other drug policy advocacy organizations (n = 5), research (n = 3) and police (n = 2). Most of them identified as men (n = 8) and white (n = 16), and their ages ranged between 30 and 80 years old (median = 50). Social network analysis questionnaires and semi-structured qualitative interviews were administered via Zoom. Social network data were analysed using igraph in R, and qualitative data were analysed using thematic analysis. The analyses explored perceptions of value and power within a drug policy-making network.ResultsThe policy-making network showed that connections could be found across participants from different groups, with government officials being the most central. Qualitative data showed that inclusion in the network and centrality did not necessarily translate into feeling powerful or valued. Many participants were dissatisfied with the process despite having structurally advantageous positions or self-reporting moderately high quantitative value scores. Participants who viewed themselves as more valued acknowledged many process shortcomings, but they also saw it as more balanced or fair than those who felt undervalued.ConclusionsWhile participation can make stakeholders and communities feel valued and empowered, our findings highlight that inclusion, position and diversity of connections in a drug policy-making network do not, in and of itself, guarantee these outcomes. Instead, policy-makers must provide transparent terms of reference guidelines and include highly skilled facilitators in policy discussions. This is particularly important in policy processes that involve historical power imbalances in the context of a pressing public health emergency.

Osteoporosis-Definition, risk assessment, diagnosis, prevention and treatment (update 2024) : Guidelines of the Austrian Society for Bone and Mineral Research

Austria is among the countries with the highest incidence and prevalence of osteoporotic fractures worldwide. Guidelines for the prevention and management of osteoporosis were first published in 2010 under the auspices of the then Federation of Austrian Social Security Institutions and updated in 2017. The present comprehensively updated guidelines of the Austrian Society for Bone and Mineral Research are aimed at physicians of all specialties as well as decision makers and institutions in the Austrian healthcare system. The aim of these guidelines is to strengthen and improve the quality of medical care of patients with osteoporosis and osteoporotic fractures in Austria. These evidence-based recommendations were compiled taking randomized controlled trials, systematic reviews and meta-analyses as well as European and international reference guidelines published before 1June 2023 into consideration. The grading of recommendations used ("conditional" and "strong") are based on the strength of the evidence. The evidence levels used mutual conversions of SIGN (1++ to 3) to NOGG criteria (Ia to IV). The guidelines include all aspects associated with osteoporosis and osteoporotic fractures, such as secondary causes, prevention, diagnosis, estimation of the 10-year fracture risk using FRAX®, determination of Austria-specific FRAX®-based intervention thresholds, drug-based and non-drug-based treatment options and treatment monitoring. Recommendations for the office-based setting and decision makers and institutions in the Austrian healthcare system consider structured care models and options for osteoporosis-specific screening. The guidelines present comprehensive, evidence-based information and instructions for the treatment of osteoporosis. It is expected that the quality of medical care for patients with this clinical picture will be substantially improved at all levels of the Austrian healthcare system.

Clinical practice guidelines and expert consensus statements on rehabilitation for patients with COVID-19: a systematic review

ObjectivesTo appraise the quality of clinical practice guidelines (CPGs) and expert consensus statements on rehabilitation for patients with COVID-19, summarise recommendations of rehabilitation assessments and interventions and evaluate the heterogeneity...

A Reconfigurable Soft Helical Actuator with Variable Stiffness Skeleton.

Due to their exceptional adaptability, inherent compliance, and high flexibility, soft actuators have significant advantages over traditional rigid actuators in human-machine interaction and in grasping irregular or fragile objects. Most existing soft actuators are designed using preprogramming methods, which schedule complex motions into flexible structures by correctly designing deformation constraints. These constraints restrict undesired deformation, allowing the actuator to achieve the preprogrammed motion when stimulated. Therefore, these actuators can only achieve a certain type of motion, such as extension, bending, or twisting, since it is impossible to adjust the deformation constraints once they are embedded into the structures. In this study, we propose the use of variable stiffness materials, such as shape memory polymer (SMP), in the structural design of soft actuators to achieve variable stiffness constraints. A reconfigurable soft helical actuator with a variable stiffness skeleton is developed based on this concept. The skeleton, made of SMP, is encased at the bottom of a fiber-reinforced chamber. In its high-stiffness state, the SMP constrains the deformation toward the skeleton when the actuator is pressurized. This constraint is removed once the SMP skeleton is heated, endowing the actuator with the ability to switch between bending and helical motion in real-time. A theoretical model is proposed to predict the behavior of the actuator when driven by pressure, and experiments are conducted to verify the model's accuracy. In addition, the influence of different design parameters is investigated based on experimental results, providing reference guidelines for the design of the actuator.

Geochemical indices and sedimentation rates in the Pardo River basin, São Paulo state, Brazil

Sediment geochemical indices and sedimentation rates data from the Pardo River watershed, São Paulo State, Brazil, provide relevant reference guidelines for stakeholders to plan future actions aiming to achieve the appropriate management of that hydrographic basin. The watershed includes 20 municipalities where about 650,000 inhabitants are living and whose waters after withdrawal and treatment supply ∼300,000 people in that region. Six sediment cores provided the geochemical and radiometric dataset, which was obtained from sampling sites located in the following cities: Ourinhos, Santa Cruz do Rio Pardo, Águas de Santa Bárbara, Avaré, Botucatu, and Pardinho. The concentration data for some metals were compared with the reference values established by the Brazilian environmental legislation for sediment dredging because currently there is a lack of specific quality guidelines for marine or fluvial sediment in Brazil. Also, the entire dataset was used in the calculation of two traditional geochemical indices, i.e., the enrichment factor (EF) and contamination factor (CF). In some cores, both indices provided insight revealing possible anthropogenic inputs of magnesium oxide (MgO), potassium oxide (K2O), sulfur trioxide (SO3), vanadium oxide (V2O5), copper (II) oxide (CuO), and other constituents due to development of activities related to the crop production. The constant rate of supply (CRS) of the unsupported/excess lead 210 (210Pb) model has been successfully applied to the obtained a radiometric 210Pb dataset, yielding mean values of the mass accumulation rate (MAR) between 0.86 and 7.23 g/(cm2·y) and linear sedimentation rates (LSR) ranging from 2.9 to 7.1 cm/y. Both of these rates exhibited a significant correlation, representing physical weathering processes occurring in the basin. Chemical weathering rates reported in the literature indicate values much lower than the physical weathering rates and such findings have also been confirmed in the current study when the obtained data were compared with results from previous investigations in the Pardo River watershed. The CRS 210Pb chronological model was useful to track historical changes in the MgO and CuO concentration in the sediment cores, allowing curves to be plotted exhibiting major peaks in core 1 (1980–2010) and core 3 (2000–2010), a continuous increase from 1970 onwards until 2010 (core 4), and a sharp increase at the end of the monitoring period, 2017 (cores 5 and 6). Data available for the harvested area at a municipality located within the basin for the period 1990–2022 have indicated a more pronounced increase over the last years in the production of sugar cane, soybeans, and oranges, implying an increasing use of fertilizers and agricultural correctives for crop production, whose chemical composition would justify the trends observed for MgO and CuO concentrations in the sediment cores. The current study also revealed a wide range of significant relations involving the concentration of ferric oxide (Fe2O3) and other analyzed constituents, with iron tending to accumulate in the finer grain sizes (from 0.125 to <0.037 mm) of the sediment. The CRS 210Pb chronological model permitted evaluation of the history of the iron flux up to the present, which could represent baseline guidance levels for indicating future anthropic inputs in the basin.

The Stability Performance of Indoor Environmental Quality (IEQ) Parameters: Emphasize the Strategies of Sustainable Comforts in the Learning Environment in a Tropical Climate

Implementing sustainable construction practices in higher educational facilities in Malaysia would enhance the quality of learning activities. Students in higher education predominantly utilize learning areas. The objective of this study is to evaluate indices of indoor environmental quality (IEQ) that prioritise sustainability in educational environments. The major indicators comprised four significant key terms: Indoor Air Quality (IAQ), Thermal Comfort (TC), Visual Comfort (VC), and Acoustic Comfort (AC). The study utilized data from previous studies published between 2021 and 2023 to determine the present issue that emerged inside Malaysian higher educational facilities. This was achieved by a critical assessment of the parameters' findings via fieldwork measurement. This leads to a spectrum that falls within a satisfactory threshold to attain the desired degree of user comfort. The findings demonstrate that students' comfort level is enhanced by their preference for a stable level of IEQ parameters. According to this study, on average standards of IEQ parameters for a sustainable learning environment; temperature (27°C), humidity (40%), air flow (0.30 m/s), illuminate (400lux) and acoustic (40dB). The strategic framework has been recommended to enhance learning environments and act as a reference guideline for future evaluations of indoor environmental quality.

Rational Use of Proton Pump Inhibitors among Patients Admitted in a Tertiary Care Hospital

Background: The prevalent usage of proton pump inhibitors (PPIs) is a testament to the effectiveness of this class of medications, but it also introduces risk associated with inappropriate prescriptive and consumptive practices. Because of the negative effect of incorrect usage and overdose of PPIs, it is very important for physicians to only prescribe these drugs when needed. However, recent studies showed some concerns about long-term PPIs consumption. The rational prescription of medications is vital to ensuring the optimal use of medical resources, providing effective therapy and minimizing adverse drug reactions. Methods: This observational study was conducted in the department of Pharmacology and therapeutics, Sylhet M.A.G. Osmani medical college, Sylhet, in collaboration with the department of Medicine, Surgery, Gastroenterology, Obstetrics and gynaecology, Sylhet M.A.G. Osmani medical college hospital, Sylhet, from July 2022 to June 2023. The sample size for this study was 600. Usage of PPIs was considered to be appropriate on the basis NICE guidelines and recommendations by Scarpignato et al. (2016) committees on behalf of three Italian scientific societies. Result: For 600 PPIs prescriptions, total 705 case sheets were reviewed. The mean age of the study patients was 42.94±17.16 years. Female were found more 359(59.8%) than male 241(40.2%). Out of 600 patients, based on the indications of PPI usage, 287 (47.8%) of prescriptions were found appropriate, whereas inappropriate prescriptions were found in 313 (52.2%) cases. Out of 287 patients who were prescribed PPIs in an appropriate indication, 175 (61%) patients were given PPIs in an appropriate dose, whereas inappropriate dose was found in 112 (39%) of patients. Again, among 175 patients who were prescribed PPIs for appropriate dose, 24 (13.7%) patients were given PPIs in an appropriate frequency, whereas inappropriate frequency was found in 151 (86.3%) of patients. Finally, 24/600 (4%) patients were prescribed in an appropriate indication with an appropriate dose and frequency, whereas inappropriate prescription were found in 576/600 (96%) patients. PPIs were used as prophylaxis for NSAIDs in highest number 147(51.2%) of patients. Oral was the most common 348(58%) route of prescribing PPIs. Omeprazole was the highest 577(96.2%) prescribed PPIs. Conclusion: Based on this study result, it could be concluded that in most of the patients PPIs prescriptions were not following appropriate indications, dose and frequency recommended by reference guidelines. Like any other drugs, PPIs should be prescribed for a clear indication, the minimum dose needed for the expected effect and medication halted when no longer necessary upon re-evaluation.

Study on Building Types and Fire and Evacuation Safety Reference Guidelines for Quarantine Hotels in Taiwan

&lt;p&gt;國內目前對於防疫旅館之防火避難安全尚未有明確可供依循的規範或指引，本研究以「申請即排序與規劃」的源頭控管概念出發，將防疫旅館進行建築類型化與排序，再配合疫情狀況彈性收斂為「優先組」、「次優組」與「候補組」，並依各群組特性擬訂其所需之申請審查要項。建議防疫旅館以獨棟型為優先、低層型次之，如為單梯應注意要規劃兩方向逃生動線；為複合中高層型時，其他樓層用途單純者為佳，且須確實執行共同防火管理；複合中高層（閒置）則為最不建議之類型。除建築類型評估外，尚應考量設備與消防救助之條件是否符合基本條件，並依據建築類型分組之特性訂定防疫旅館的申請評估要項。最後以「申請即排序與規劃」、 「使用要維護管理與自主評核」、「查核有專業檢查與稽查」三個核心概念出發，研擬「防疫旅館防火避難安全參考指引」。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;This study starts with the concept of &amp;quot;application, namely ranking and planning&amp;quot;. After separating by building type, group the types into &amp;ldquo;Priority Group&amp;rdquo;, &amp;ldquo;Sub-Prime Group&amp;rdquo;, and &amp;ldquo;Alternative Group&amp;rdquo; according to the current COVID-19 situation, and plan the required application review items based on the features of each group. It is recommended that quarantine hotels prioritize independent buildings and then lower-floor hotels. For multi-purpose medium-high floor, other floors are better for simple purposes, and common fire escape management must be implemented. Multi-purpose medium-high floor (vacant) are the least recommended type. In addition, due to the complex fire protection and evacuation features of quarantine hotels, it is important to consider whether the conditions for equipment and fire rescue are met. Finally, start with the three core concepts of &amp;quot;application, namely ranking and planning&amp;quot;, &amp;quot;maintenance, management, and self-assessment are needed during use&amp;quot;, and &amp;quot;inspection, with professional checking and auditing&amp;quot;, to research and plan the &amp;quot;Reference Guideline for Fire Evacuation Safety of Quarantine Hotels&amp;quot;.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Exploring the factors influencing evidence-based approaches to advanced chronic kidney disease: a qualitative study involving nurses and physicians

BackgroundAdvanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care.ObjectiveTo analyse attitudes, subjective norms, and perceived behavioural control among primary care professionals related to the implementation of an evidence-based approach for individuals with ACKD in primary care.MethodologyThis was a qualitative study using an interpretative phenomenological approach based on the theory of planned behaviour. Two aspects of the evidence-based approach were explored: the implementation of clinical practice guidelines and the utilisation of electronic kidney disease records within the scope of this study. Primary care nurses and physicians participated in a previous pilot interview and five focus groups. Subsequently, a thematic analysis of the gathered data was conducted.FindingsThirty-three primary care professionals participated. The emerging themes included: experiences in the management of ACKD (highlighting a distinct profile of older, frail patients with comorbidities masking CKD and a CKD follow-up primarily focused on analytical monitoring and drug adjustment); factors in the professional environment influencing the use of scientific evidence (such as time constraints, excessive electronic health records, and unfamiliar reference guidelines); attitudes towards the application of recommendations on ACKD (recognising limitations of computer systems despite considering them as guidance); and capacities to implement evidence-based recommendations (acknowledging formative needs and challenges in coordinating care with nephrology services).ConclusionsSeveral psychological elements identified through the TBP hinder the adequate implementation of an evidence-based approach for individuals with CKD. Attitudes have been identified as factors modulating the use of standardised electronic records. Instead, subjective norms (influences from the professional environment) and perceived behavioral control (perception of capabilities) acted as barriers to the proper application of clinical practice guidelines and standardised records.Implications for practiceStrategies aimed at optimising the management of people with ACKD should focus not only on training but also on improving attitudes, organisational structures, IT systems and coordination between primary care and nephrology.

Development and evaluation of the inactivated vaccine against Aeromonas schubertii in hybrid snakehead

Aeromonas schubertii is a global pathogen of fish that causes internal nodular diseases and death in severe cases. In the present study, we isolated nine pathogenic strains from diseased hybrid snakehead (Channa argus♂ × Channa maculata♀) which were formally identified as A. schubertii by molecular identification, including 16S rRNA and gyrB gene sequencing. Subsequently, we determined the extracellular enzyme activity of six isolates and compared pathogenicity to investigate potential relationships with geographic characteristics. Two highly pathogenic strains, AS-14 and AS-16, were finally identified as inactivated vaccine candidates. Subsequently, we evaluated different concentrations of the antigen for each vaccine by performing experiments in hybrid snakehead; fish were inoculated with inactivated vaccine via the intraperitoneal route and a booster injection was administered 14 days later. Relative percent survival (RPS) for fish immunized with high doses of the two vaccines (1 × 108 CFU/fish) were 54.4% and 57.4%, respectively; these values were higher than other groups of fish receiving different doses (1 × 106 and 1 × 107 CFU/fish). The bacterial load of tissues harvested from the fish immunized with high doses of the vaccine groups were significantly lower than those of fish immunized with low doses. Titers of specific antibodies against A. schubertii in fish immunized with a high dose of AS-16 vaccine were maintained at high levels when tested six weeks after the booster injection. Furthermore, immune-related genes in the spleen, including MHC I, MHC II, CD4, CD8α and IgM, all exhibited high levels of expression, thus suggesting that hybrid snakehead underwent an adaptive immune response post-vaccination. Collectively, our findings enrich our understanding of the specific causative agents underlying nodular diseases in hybrid snakehead and provide scientific reference guidelines for the development of vaccines against A. schubertii. The development of such vaccines will be conducive to the sustainable development of hybrid snakehead in commercial aquaculture.

Improving the Mathematical Problem-Solving Ability of Junior High School Students through Two Stay Two Stray Learning Based on a scientific learning approach on Cube and Block Material

Education is the initial foundation for humans to be able to walk in this life. Since the beginning of human creation, education has become a part of life to be able to adapt to the environment, this pre-experimental research with a one group pretest-posstest research design, the population in this study is all grade VIII students of SMP Negeri 7 Ternate City. The sample of this study was class VIII-i students consisting of 20 students. The data collection of this study used a mathematical problem-solving ability test instrument in the form of an essay. The data were analyzed using descriptive statistics, namely the Benchmark Reference Guidelines (PAP) based on the category of students' mathematical problem-solving ability and normalized N-Gain calculations and inferential statistics using the t-Test for abnormal distribution data. The results showed that: the mathematical problem solving ability of grade VIII-i students of SMP Negeri 7 Ternate City. the application of the Two Stay Two Stray learning model Based on the Scientific Learning Approach can significantly improve students' mathematical problem solving skills on cube and block material.

Anthropogenic activities dominated the spatial and temporal changes of normalized difference vegetation index (NDVI) in the Hehuang valley in the northeastern Qinghai Province between 2000 and 2020

The Hehuang Valley (HV) is a key development area in the Qinghai Province; understanding changes in the vegetation within this area is of great significance if we are to maintain the ecological quality of this regional environment. Based on the 30 m spatial resolution Normalized difference vegetation index (NDVI) time series dataset, this paper analyzes the spatial and temporal characteristics and evolutionary trends of NDVI in the HV from 2001 to 2020 under the influences of climate change and human activities, by applying Mann-Kendall trend analysis, the Hurst index, and residual analysis. Analysis showed that firstly, high NDVI values (&amp;gt;0.5) were distributed in the low elevation areas of the HV except for towns and cropland, while the low NDVI values (&amp;lt;0.5) were mainly distributed in the high elevation regions; the NDVI exhibited an increasing trend over the study period. Second, human activities promoted NDVI growth in the HV by changing land-use types, although there is a risk of vegetation degradation in the future. Third, the proportion of NDVI changes affected by climate change and human activities was determined to be 87.24% of the HV; furthermore, the contribution of human activities was three-fold higher than that of climate change. Fourth, managers should scientifically manage grasslands and forests and implement specific anthropogenic interventions based on the characteristics of regional NDVI degradation, to improve ecosystem resilience. These results can be used to quantitatively analyze the relative contributions of natural and anthropogenic factors to the ecological changes in the HV, and provide reference guidelines for the management of ecological environments.

Laboratory weathering studies to evaluate the water quality impact of a lithium mining in Portugal

Lithium mining driven by the growing demand for lithium-ion batteries, has environmental consequences linked to soil and water pollution. Nevertheless, research on the environmental impacts of lithium extraction still needs to be improved, highlighting the imperative for additional research. The article addresses the potential impact of the C57 lithiniferous feldspar mine on water quality, specifically focusing on surface, groundwater and spring water samples collected at the mining site and surrounding area in Gonçalo (Guarda, Portugal). The objective is to evaluate the environmental consequences of mining activities, with particular emphasis on mineral leaching. This study aims to evaluate the water quality around the C57 mine and the potential environmental impacts of mining operations. Water samples were collected from different sources, such as surface, underground, and spring waters, and chemical analyses were carried out to determine concentrations of different parameters, which were later compared with national and international reference guidelines. In addition to analysing the water samples, weathering tests were carried out using the Soxhlet extractor method to simulate the leaching of minerals over a shorter period (about 125 days). The concentrations of the analysed elements by atomic absorption spectroscopy (Al, Ca, Cd, Cr, Cu, Fe, K, Li, Mg, Mn, Na, Ni, Pb and Zn) in the weathering solutions were generally low and decreased throughout the testing period, with significant concentrations of aluminium and chromium exceed Canadian environmental quality guidelines for surface waters. The detected lithium concentrations are quite different, ranging from 8.7 to 19.8 μg/L in surface waters, from 6.9 to 74.1 μg/L in groundwater, and from 25.6 to 35.4 μg/L in spring waters, but are all below the US EPA (2021) recommendations threshold of 0.7 mg/L. Based on the findings, the article concludes that there is currently no clear evidence to indicate the environmental impact of mining activities on water quality in the analysed samples. However, weathering tests suggest potential long-term implications regarding the leaching of specific chemical elements, particularly aluminium and chromium.

The effects of gestational age on neonatal cholestasis: A retrospective cohort study.

Reference guidelines for neonatal conjugated hyperbilirubinemia (cholestasis) management use a uniform approach regardless of gestational age (GA). We hypothesize that the clinical pattern of neonatal cholestasis is tightly related to GA. The aim of this study was to describe the effects of GA on neonatal cholestasis. A retrospective 4-year cohort study in a 70-bed neonatal care unit. Neonates with conjugated bilirubin≥34.2μmol/L (2 mg/dL) were identified. The incidence, clinical characteristics, etiology, treatment, and prognosis were compared between infants <32 and≥32 weeks GA. Overall incidence of cholestasis was 4% (125/3402). It was >5 times higher and the mean duration was >1.5 times longer in neonates <32 weeks GA (10% versus 1.8%, p <0.01 and 49 versus 31 days, p <0.01, respectively). The onset of cholestasis was later in neonates <32 weeks (22 versus 10 days of life, p <0.001). This later onset of cholestasis was associated with parenteral nutrition, whereas the earlier onset was associated with other causes. Treatment using fish oil lipids was more frequently administrated to infants <32 weeks GA, whereas Ursodeoxycholic acid was administrated more frequently in≥32 weeks GA. Cholestasis resolved during hospitalization in 73% of <32 versus 38% in≥32 weeks GA infants (p <0.01). The incidence, clinical presentation, etiology, treatment, and clinical evolution of neonatal cholestasis were all significantly affected by GA. Our results support the use of a GA-oriented approach for the management of neonatal cholestasis.

Impact of Artificial Intelligence Development on Taiwan's Legal System and Legislation in the Post-Pandemic Era

In the post-pandemic era, AI development has entered a new phase, driven by the emergence of generative AI and the increasing prevalence of information and communication technologies represented by 5G. In the dawn of the AI age, significant shifts are underway, heralding a new era of transformation. This article explores the impact of AI advancement on Taiwan's legal framework during this era. It delves into both historical developments and prospective transformations and begins with a retrospective analysis of Taiwan's AI-related legislation before the post-pandemic era. Subsequently, it focuses on a critical aspect of Taiwan's AI legal framework during this era, including two pivotal documents in Taiwan: the "AI Basic Act" and the " Reference Guidelines for the Use of Generative AI in the Executive Yuan and its Subordinate Agencies and Affiliated Institutions”. Both have recently garnered widespread attention, marking a crucial step towards navigating the evolving landscape of artificial intelligence. Finally, this article offers insights into the prospective evolution of Taiwan's legal landscape pertaining to AI. The formulation of the "AI Basic Act" is pivotal in setting fundamental norms for AI development in Taiwan. This draft is significant with its 24 articles aimed at fostering a trustworthy environment and promoting diverse AI utilization. It ensures that Taiwan's high-tech advancements align with global standards. On the other side, the “Reference Guidelines for the Use of Generative AI” are designed to regulate the administrative agencies in response to the widespread application of generative AI. Furthermore, since 2023, the Personal Data Protection Act and Criminal Code, among others, have all been amended to include provisions related to AI technology, reflecting the apparent impact of AI on the legal system. Given the novelty of AI in society, prioritizing the creation of a basic act is crucial. Such legislation defines AI in Taiwan, establishes ethical principles, outline development directions, and provides fundamental norms. It will serve as a cornerstone for shaping and revising other policies and laws to navigate the evolving landscape of AI.

Digital transformation, entrepreneurship, and disruptive innovation: evidence of corporate digitalization in China from 2010 to 2021

The year 2010 was an important turning point for China’s economy, and the digital economy has become its new feature. In the digital economy wave, digital transformation and innovation are two essential starting points for enterprise development. Few studies have examined the effect of companies’ digital transformation on disruptive innovation, neglecting the role of entrepreneurship. This study aims to address this research gap by developing an analytical framework for digital transformation, entrepreneurship, and disruptive innovation. Based on China’s A-listed firms from 2010 to 2021, we use Python to create indicators for digital transformation and examine its impact on disruptive innovation and the role of entrepreneurship using a double fixed-effects model. The results demonstrate that digital transformation significantly promotes disruptive innovation, and entrepreneurship positively moderates this relationship. Furthermore, heterogeneity analyses show that digital transformation’s positive effects of disruptive innovation and entrepreneurship are more pronounced in non-SOEs, companies in growth and decline stages, and nonmanufacturing companies. However, in SOEs and manufacturing firms, entrepreneurship was unable to moderate this relationship. The conclusions reflect the exploration of the realization mechanism and micro-foundations of the current, in-depth digital transformations, and the findings provide reference guidelines for enabling enterprises to realize digital transformation and disruptive innovation and, relevant experiences.

Application and research progress of single cell sequencing technology in leukemia.

Leukemia is a malignant tumor with high heterogeneity and a complex evolutionary process. It is difficult to resolve the heterogeneity and clonal evolution of leukemia cells by applying traditional bulk sequencing techniques, thus preventing a deep understanding of the mechanisms of leukemia development and the identification of potential therapeutic targets. However, with the development and application of single-cell sequencing technology, it is now possible to investigate the gene expression profile, mutations, and epigenetic features of leukemia at the single-cell level, thus providing a new perspective for leukemia research. In this article, we review the recent applications and advances of single-cell sequencing technology in leukemia research, discuss its potential for enhancing our understanding of the mechanisms of leukemia development, discovering therapeutic targets and personalized treatment, and provide reference guidelines for the significance of this technology in clinical research.

Automated information extraction model enhancing traditional Chinese medicine RCT evidence extraction (Evi-BERT): algorithm development and validation.

In the field of evidence-based medicine, randomized controlled trials (RCTs) are of critical importance for writing clinical guidelines and providing guidance to practicing physicians. Currently, RCTs rely heavily on manual extraction, but this method has data breadth limitations and is less efficient. To expand the breadth of data and improve the efficiency of obtaining clinical evidence, here, we introduce an automated information extraction model for traditional Chinese medicine (TCM) RCT evidence extraction. We adopt the Evidence-Bidirectional Encoder Representation from Transformers (Evi-BERT) for automated information extraction, which is combined with rule extraction. Eleven disease types and 48,523 research articles from the China National Knowledge Infrastructure (CNKI), WanFang Data, and VIP databases were selected as the data source for extraction. We then constructed a manually annotated dataset of TCM clinical literature to train the model, including ten evidence elements and 24,244 datapoints. We chose two models, BERT-CRF and BiLSTM-CRF, as the baseline, and compared the training effects with Evi-BERT and Evi-BERT combined with rule expression (RE). We found that Evi-BERT combined with RE achieved the best performance (precision score = 0.926, Recall = 0.952, F1 score = 0.938) and had the best robustness. We totally summarized 113 pieces of rule datasets in the regulation extraction procedure. Our model dramatically expands the amount of data that can be searched and greatly improves efficiency without losing accuracy. Our work provided an intelligent approach to extracting clinical evidence for TCM RCT data. Our model can help physicians reduce the time spent reading journals and rapidly speed up the screening of clinical trial evidence to help generate accurate clinical reference guidelines. Additionally, we hope the structured clinical evidence and structured knowledge extracted from this study will help other researchers build large language models in TCM.