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Abstract Air pollution is associated with morbidity and mortality worldwide. We investigated the impact of improved air quality during the economic lockdown during the SARS-Cov2 pandemic on emergency room (ER) admissions in Germany. Weekly aggregated clinical data from 33 hospitals were collected in 2019 and 2020. Hourly concentrations of nitrogen and sulfur dioxide (NO2, SO2), carbon and nitrogen monoxide (CO, NO), ozone (O3) and particulate matter (PM10, PM2.5) measured by ground stations and meteorological data (ERA5) were selected from a 30 km radius around the corresponding ED. Mobility was assessed using aggregated cell phone data. A linear stepwise multiple regression model was used to predict ER admissions. The average weekly emergency numbers vary from 200 to over 1600 cases (total n = 2,216,217). The mean maximum decrease in caseload was 5 standard deviations. With the enforcement of the shutdown in March, the mobility index dropped by almost 40%. Of all air pollutants, NO2 has the strongest correlation with ER visits when averaged across all departments. Using a linear stepwise multiple regression model, 63% of the variation in ER visits is explained by the mobility index, but still 6% of the variation is explained by air quality and climate change.

Cognitive and psychomotor are two aspects that play an important role in children's development, especially at the preschool age. This study aims to create and test products in the form of learning methods with song and movement to improve children's cognitive and psychomotor aspects. This research is a research and development using 4D theory from Thiagarajan, Semmel, and Semmel. There are four phases in this research, namely the define phase, product design, product development, and dissemination. Data analysis used in this study was a qualitative and quantitative approach using instruments in the form of questionnaires, product validation sheets, and learning observation sheets. The collected data is then analyzed using two analytical techniques: (1) qualitative data with content analysis techniques and (2) quantitative data analyzed statistically with the help of SPSS. The results showed that this learning method was proven to have a level of validity, practicality, and effectiveness above the standard to improve children's cognitive and psychomotor aspects.

This study evaluates masticatory efficiency in orthodontic patients with craniofacial disorders compared to controls without, considering the effect of an orthodontic appliance and malocclusion. A total of 119 participants (7–21 years), divided into a craniofacial disorder and control group (n = 42 and n = 77; mean age 13.5 ± 5.2 and 14.2 ± 3.3 years) were included. Masticatory efficiency was evaluated using a standard food model test, where masticated test food bodies were analyzed, and parameters like particle number (n) and area (mm2) were recorded. This study newly introduced the masticatory efficiency index (MEI), which encompasses the above terms (number and area), with a high MEI being an indicator of high masticatory ability. Younger orthodontic patients with a craniofacial disorder had a significantly decreased MEI (0.50 ± 0.25 n/mm2) compared to patients without (1.10 ± 0.48 n/mm2; p = 0.02). The presence of a crossbite significantly decreased masticatory efficiency, particularly in craniofacial disorder patients (0.69 ± 1.44 n/mm2) versus controls (0.89 ± 1.00 n/mm2, p = 0.04). As treatment progressed with age and fixed appliances, mastication group differences became non-significant, suggesting that patients with a craniofacial disorder were catching up to healthy controls in the rehabilitation of their masticatory function. Considering an early diagnosis of malocclusion during orthodontic therapy in combination with speech therapy can avoid negative malocclusion effects with growth, caused by muscle imbalances.

Abstract Objective Critical illness is often accompanied by elevated blood glucose, which generally correlates with increased morbidity and mortality. Prehospital blood glucose (PBG) level might be a useful and easy‐to‐perform tool for risk assessment in emergency medicine. This retrospective single‐center cohort study was designed to analyze the association of prehospital glucose measurements with hospitalization rate and in‐hospital mortality. Methods Records of 970 patients admitted to a university hospital by an emergency physician were analyzed. Patients with a PBG ≥140 mg/dL (G1, n = 394, equal to 7.8 mmol/L) were compared with patients with a PBG

Abstract Background The study evaluates the position and displacement tendency of unerupted maxillary canines in orthodontic patients with non-syndromic craniofacial disorders (CD) compared to a control (C) group. Methods Canine position and displacement tendency were evaluated using panoramic radiographs (PAN) examined with parameters such as sector classification (sectors 1–5) and inclination angles (α and β). The displacement tendency was defined as the positioning of the tip in sectors 1 or 2, as well as its combination with increased angles (α > 30° and β > 39°). In addition, the correlation of the tooth position and agenesis, cleft side, and sex was assessed. Results A total of 116 pre-treatment PAN, divided into the CD group (n = 50; mean age 8.32 ± 2.27 years) and the C group (n = 66; mean age 10.80 ± 2.82 years), were evaluated in this study. The sector classification showed no displacement tendency in both groups. Inclination angles α/β showed a statistically significant higher displacement tendency (p = 0.01) of the CD group (n = 5) on the right side, compared to healthy subjects (n = 1). Male CD patients had a statistically significant higher displacement tendency on the right side (p = 0.03). A statistically significant correlation between cleft and non-cleft-side (p = 0.03) was found. Conclusion Patients with CD showed a statistically significant higher displacement tendency of the maxillary canine affected by the cleft side. The inclination angle was found to be the better predictor compared to the sector classification which should be considered in the orthodontic treatment planning.

(Series Information) European Papers - A Journal on Law and Integration, 2023 8(1), 81-84 | European Forum Highlight of 16 May 2023 | (Abstract) German-speaking scholarship on EU law is coined, to a significant extent, by relevant decisions of constitutional courts in German-speaking countries. The translation of these decisions into other languages contributes strongly to broaden the legal discourse, as it allows also non-German-speaking members of the scientific community or of courts in other Member States to read and to reflect upon them. Against this background, in this Highlight we take a look at the translation policy of the German Bundesverfassungsgericht (BVerfG) and the Austrian Verfassungsgerichtshof (VfGH). For the sake of comparison, we also take a look at how the French Conseil constitutionnel (CC) – as an example for a constitutional court of a non-German-speaking Member State – approaches this question. While in all three cases the number of provided translations has increased considerably over the past 25 years, it turns out that the BVerfG and the VfGH translate mostly into English. The CC, however, does not only translate (proportionally) more decisions, but also it translates them into different languages, very prominently into German, thereby inviting German-speaking scholarship and German-speaking judges to take account of it. The provision of translations by courts seems to be more than a service to ‘interested third parties’. It turns out to be a tool to pursue the specific interests of a court as well.

BackgroundSevere left-sided cardiac obstructions are associated with high morbidity and mortality if not detected in time. The correct prenatal diagnosis of coarctation of the aorta (CoA) is difficult. Fetal cardiac magnetic resonance imaging (CMR) may improve the prenatal diagnosis of complex congenital heart defects. Flow measurements in the ascending aorta could aid in predicting postnatal CoA, but its accurate visualization is challenging.ObjectivesTo compare the flow in the descending aorta (DAo) and umbilical vein (UV) in fetuses with suspected left-sided cardiac obstructions with and without the need for postnatal intervention and healthy controls by fetal phase-contrast CMR flow. A second objective was to determine if adding fetal CMR to echocardiography (echo) improves the fetal CoA diagnosis.MethodsProspective fetal CMR phase-contrast flow in the DAo and UV and echo studies were conducted between 2017 and 2022.ResultsA total of 46 fetuses with suspected left-sided cardiac obstructions [11 hypoplastic left heart syndrome (HLHS), five critical aortic stenosis (cAS), and 30 CoA] and five controls were included. Neonatal interventions for left-sided cardiac obstructions (n = 23) or comfort care (n = 1 with HLHS) were pursued in all 16 fetuses with suspected HLHS or cAS and in eight (27%) fetuses with true CoA. DAo or UV flow was not different in fetuses with and without need of intervention. However, DAo and UV flows were lower in fetuses with either retrograde isthmic systolic flow [DAo flow 253 (72) vs. 261 (97) ml/kg/min, p = 0.035; UV flow 113 (75) vs. 161 (81) ml/kg/min, p = 0.04] or with suspected CoA and restrictive atrial septum [DAo flow 200 (71) vs. 268 (94) ml/kg/min, p = 0.04; UV flow 89 vs. 159 (76) ml/kg/min, p = 0.04] as well as in those without these changes. Adding fetal CMR to fetal echo predictors for postnatal CoA did not improve the diagnosis of CoA.ConclusionFetal CMR-derived DAo and UV flow measurements do not improve the prenatal diagnosis of left-sided cardiac obstructions, but they could be important in identifying fetuses with a more severe decrease in blood flow across the left side of the heart. The physiological explanation may be a markedly decreased left ventricular cardiac output with subsequent retrograde systolic isthmic flow and decreased total DAo flow.

(1) Background: To identify reasons for the persistence of surgical ligation of the patent ductus arteriosus (PDA) in premature infants after the 2019 Food and Drug Administration (FDA) approval of transcatheter device closure; (2) Methods: We performed a 10-year (2014–2023) single-institution retrospective study of premature infants (n = 94 before, n = 26 after FDA approval). Unfavorable PDA morphology, active infection, and recent abdominal pathology were the most common reasons for surgical ligation over device occlusion in epoch 2. There were no differences in demographics, age at closure, or outcomes between infants who received surgical ligation in the two epochs; (4) Conclusions: Despite increasing trends for transcatheter PDA closure in premature infants, surgical ligation persists due to unfavorable ductal morphology, active infection, or abdominal pathology.

This article draws on existing communication research and praxes to share the best practices for retaining students enrolled in the introductory public speaking course. Among the many important pedagogical practices that communication scholars have documented, this article highlights the value of 10 best practices: instructor use of immediacy and confirmation; instructor inclusion of written prescriptive feedback, peer feedback workshops, low-stakes assignments, applied assignments, and individual speech preparation tools; and instructor participation in out-of-class communication, online office hours, and classroom-connectedness.

Due to dental diseases, anatomical restrictions, and mixed dentition, the reduction in the number of teeth and the displacement of tooth germs pose challenges in orthodontic treatment, limiting anchorage options. The presented case demonstrates an advanced treatment solution using digital CAD/CAM-technologies and medical imaging for the creation of a mini-implant template. A 12-year-old male patient experiencing delayed tooth eruption, multiple impacted germs, and maxillary constriction underwent intraoral scanning and CBCT. Utilizing coDiagnostiXTM Version 10.2 software, the acquired data were merged to determine the mini-implant placement and to design the template. The template was then manufactured through stereolithography using surgical-guide material. Mini-implants were inserted using the produced appliance, enabling safe insertion by avoiding vital structures. Surgically exposed displaced teeth were aligned using a Hyrax screw appliance anchored on the mini-implants for rapid palatal expansion (RPE) and subsequently used as fixed orthodontics to align impacted teeth. The screw was activated daily for 10 weeks, resulting in a 7 mm posterior and 5 mm anterior maxillary transversal increase. Skeletal anchorage facilitated simultaneous RPE and tooth alignment, ensuring accuracy, patient safety, and appliance stability. The presented case shows a scenario in which computer-aided navigation for mini-implant positioning can enhance precision and versatility in challenging anatomical cases.

There are three main types of atonement, namely the ‘classic’ type where Christ is a Victor, the ‘Latin’ type where Christ is satisfaction and the type of ‘humanism’ in which God is Love. These three types contain language of violence. However, the most striking language of violence is the ‘Latin’ type, where God is seen as the Angry one, who is thirsty for blood and asking to be satisfied. The sacrifice of redemption is seen as the idea of ‘bribe to God’. Some theologians reject this idea and look for other alternatives. This article aims to find other alternatives while maintaining the idea of redemption sacrifice. The author uses a Jewish perspective in reading the Bible. From the entire Bible metanarrative, the authors construct the theory of atonement by focusing on the idea of Besorat Hageulah, the Gospel of redemption. On the cross is the sacrifice for redemption that expresses God’s justice and love. The bloodshed on the cross is not to satisfy God, who is angry, but as a sign of God’s love for humans according to the demands of justice ‘life shall go for life’ (KJV, Dt 19:21). Contribution: This article is interdisciplinary in the sense that it touches on issues such as redemption, mercy and peace. In this article, the author has shown how redemption brings peace and love. The implication is in the life of the nation and state as God’s creatures.

In faith and practice, Pentecostals put emphasis on practical issues as well as spiritual experience in their theological understanding and doctrinal teachings. The Pentecostals take their doctrine from certain empirical events. One of the spiritual experiences often underlined is the baptism of the Holy Spirit. In interpreting the Book of Acts, Pentecostals tend to emphasise the theological character of the narratives and seldom their historical uniqueness. That is why Pentecostals stress the normative theological intent of the historical record for contemporary Christian experience. This article therefore examines critically Pentecostal paradigm of the baptism of the Holy Spirit, deriving examples from the Acts of the Apostles. It is concluded that the practice of the baptism of the Holy Spirit carried out by Christians today, arguably, has no biblical basis. This is because, there is nowhere the Bible commands people to seek baptism in the Holy Spirit. The observation is that, all the events or experiences of Christians baptised in the Holy Spirit in Acts are not necessarily universal normative for every Christian and for this reason, there is no need to be dogmatic. Contribution: This article challenges the practice of the baptism of the Holy Spirit in church today. This study supports the fact that the baptism of the Holy Spirit is not a universal experience for every Christians and there is no need to be dogmatised.

Abstract Background Phelan-McDermid syndrome (PMS) is caused by haploinsufficiency of the SHANK3 gene and is characterized by global developmental delays and autism spectrum disorder (ASD). Based on several converging lines of preclinical and clinical evidence supporting the use of insulin-like growth factor-1 (IGF-1) in PMS, this study aims to follow-up a previous pilot study with IGF-1 to further evaluate this novel therapeutic for core symptoms of ASD in children with PMS. Methods Ten children aged 5–9 with PMS were enrolled. Participants were randomized to receive IGF-1 or placebo (saline) using a 12-week, double-blind, crossover design. Efficacy was assessed using the primary outcome of the Aberrant Behavior Checklist—Social Withdrawal (ABC-SW) subscale as well as secondary outcome measures reflecting core symptoms of ASD. To increase power and sample size, we jointly analyzed the effect of IGF-1 reported here together with results from our previous controlled trail of IGF-1 in children with PMS (combined N = 19). Results Results on the ABC-SW did not reach statistical significance, however significant improvements in sensory reactivity symptoms were observed. In our pooled analyses, IGF-1 treatment also led to significant improvements in repetitive behaviors and hyperactivity. There were no other statistically significant effects seen across other clinical outcome measures. IGF-1 was well tolerated and there were no serious adverse events. Limitations The small sample size and expectancy bias due to relying on parent reported outcome measures may contribute to limitations in interpreting results. Conclusion IGF-1 is efficacious in improving sensory reactivity symptoms, repetitive behaviors, and hyperactivity in children with PMS. Trial registration NCT01525901.

Covid-19 provides lessons for society, especially believers. The real fellowship must be limited, and online worship held, making believers enter a new atmosphere. The challenge is not whether it can or not, but financial issues and including the internet are a concern in the Indonesian context. The purpose of this article is to show the church around the ministry during the pandemic. The research method used is a qualitative interview of individuals involved in worship, both online and offline. This study reveals that each church has differences in managing religious life because the existing tradition and ecclesiology make it difficult for the church to accomplish the ministry. The church tries to communicate with the congregation using modern technology or go straight to the houses while still following the government's recommendations, namely social distancing and attention to health. The church must begin to think about the pattern of fellowship today.

The Tübingen Palatal Plate (TPP) is a minimally invasive yet highly effective functional orthodontic treatment for upper airway obstruction in infants with Robin Sequence (RS). It consists of a palatal plate to cover the cleft and a velar extension that shifts the root of the tongue forward. We review our practical experience with this approach. First, upon admission, our local orthodontists perform an (3-D) intraoral scan of the maxilla. Based on the scan data, the TPP is manufactured in a semi-digital workflow. The length and angulation of its extension is checked via awake laryngoscopy and the effectiveness confirmed by a sleep study. Plates are kept in place by adhesive cream. When inserting the TPP, the tip of the tongue must be visible. Next, metal fixation bows should be secured to the forehead using tape and elastic bands. Plates are removed daily for cleaning, and the oral mucosa is then checked for pressure marks. Feeding training (initially only via finger feeding) may even start before plate insertion. Breathing often normalizes immediately once the plate is inserted. For isolated RS, we have never had to perform a tracheostomy. This has largely been possible through our highly dedicated and competent team, particularly the nursing staff, and the early involvement of parents.

Background: Monitoring the vital signs of delirious patients in an intensive care unit (ICU) is challenging, as they might (un-)intentionally remove devices attached to their bodies. In mock-up scenarios, we systematically assessed whether a motion detector (MD) attached to the bed may help in identifying emergencies. Methods: We recruited 15 employees of the ICU and equipped an ICU bed with an MD (IRON Software GmbH, Grünwald, Germany). Participants were asked to replay 22 mock-up scenes of one-minute duration each: 12 scenes with movements and 10 without movements, of which 5 were emergency scenes (“lying dead-still, with no or very shallow breathing”). Blinded recordings were presented to an evaluation panel consisting of an experienced ICU nurse and a physician, who was asked to assess and rate the presence of motions. Results: Fifteen participants (nine women; 173 ± 7.0 cm; 78 ± 19 kg) joined the study. In total, 286 out of 330 scenes (86.7%) were rated correctly. Ratings were false negative (FN: “no movements detected, but recorded”) in 7 out of 180 motion scenes (3.9%). Ratings were false positive (FP: “movements detected, but not recorded”) in 37 out of 150 scenes (24.7%), more often in men than women (26 out of 60 vs. 11 out of 90, respectively; p < 0.001). Of note, in 16 of these 37 FP-rated scenes, a vibrating mobile phone was identified as a potential confounder. The emergency scenes were correctly rated in 64 of the 75 runs (85.3%); 10 of the 11 FP-rated scenes occurred in male subjects. Conclusions: The MD allowed for identifying motions of test subjects with high sensitivity (96%) and acceptable specificity (75%). Accuracy might increase further if activities are recorded continuously under real-world conditions.

We present overall specifications and science goals for a new optical and near-infrared (350 - 1650 nm) instru- ment designed to greatly enlarge the current Search for Extraterrestrial Intelligence (SETI) phase space. The Pulsed All-sky Near-infrared Optical SETI (PANOSETI) observatory will be a dedicated SETI facility that aims to increase sky area searched, wavelengths covered, number of stellar systems observed, and duration of time monitored. This observatory will offer an "all-observable-sky" optical and wide-field near-infrared pulsed tech- nosignature and astrophysical transient search that is capable of surveying the entire northern hemisphere. The final implemented experiment will search for transient pulsed signals occurring between nanosecond to second time scales. The optical component will cover a solid angle 2.5 million times larger than current SETI targeted searches, while also increasing dwell time per source by a factor of 10,000. The PANOSETI instrument will be the first near-infrared wide-field SETI program ever conducted. The rapid technological advance of fast-response optical and near-infrared detector arrays (i.e., Multi-Pixel Photon Counting; MPPC) make this program now feasible. The PANOSETI instrument design uses innovative domes that house 100 Fresnel lenses, which will search concurrently over 8,000 square degrees for transient signals (see Maire et al. and Cosens et al., this conference). In this paper, we describe the overall instrumental specifications and science objectives for PANOSETI.

We propose a novel instrument design to greatly expand the current optical and near-infrared SETI search pa- rameter space by monitoring the entire observable sky during all observable time. This instrument is aimed to search for technosignatures by means of detecting nano- to micro-second light pulses that could have been emitted, for instance, for the purpose of interstellar communications or energy transfer. We present an instru- ment conceptual design based upon an assembly of 198 refracting 0.5-m telescopes tessellating two geodesic domes. This design produces a regular layout of hexagonal collecting apertures that optimizes the instrument footprint, aperture diameter, instrument sensitivity and total field-of-view coverage. We also present the optical performance of some Fresnel lenses envisaged to develop a dedicated panoramic SETI (PANOSETI) observatory that will dramatically increase sky-area searched (pi steradians per dome), wavelength range covered, number of stellar systems observed, interstellar space examined and duration of time monitored with respect to previous optical and near-infrared technosignature finders.

We present overall specifications and science goals for a new optical and near-infrared (350 - 1650 nm) instru- ment designed to greatly enlarge the current Search for Extraterrestrial Intelligence (SETI) phase space. The Pulsed All-sky Near-infrared Optical SETI (PANOSETI) observatory will be a dedicated SETI facility that aims to increase sky area searched, wavelengths covered, number of stellar systems observed, and duration of time monitored. This observatory will offer an "all-observable-sky" optical and wide-field near-infrared pulsed tech- nosignature and astrophysical transient search that is capable of surveying the entire northern hemisphere. The final implemented experiment will search for transient pulsed signals occurring between nanosecond to second time scales. The optical component will cover a solid angle 2.5 million times larger than current SETI targeted searches, while also increasing dwell time per source by a factor of 10,000. The PANOSETI instrument will be the first near-infrared wide-field SETI program ever conducted. The rapid technological advance of fast-response optical and near-infrared detector arrays (i.e., Multi-Pixel Photon Counting; MPPC) make this program now feasible. The PANOSETI instrument design uses innovative domes that house 100 Fresnel lenses, which will search concurrently over 8,000 square degrees for transient signals (see Maire et al. and Cosens et al., this conference). In this paper, we describe the overall instrumental specifications and science objectives for PANOSETI.

This study examines the shame that drives the rite of confession of guilt and sin in the Toraja tradition and then dialogues with the Christian faith. In this study, a qualitative research method was used with an ethnographic approach. Observations and interviews were conducted with figures who knew the topic. The results show that Toraja people experience collective shame when community members commit moral violations. A sense of shame before others or social shame is felt. However, spiritual shame is an aspect that cannot be ignored. Behind the social violations, there are efforts to interpret the relationship with God (Toraja language, Puang Matua), which needs to be brought back to lead people to repentance. Contribution: This article combines tradition and theology, particularly missional and contextual theology. The results of this study are expected to increase the efforts of each respondent to interpret God in every social violation committed to lead people to repentance.

This paper is sniffing out the atmosphere and reputation of the Old Town of the Polish city of Lublin throughout the twentieth century. Nosing into the sensory experiences with Lublin’s historical city centre as recalled by its inhabitants, the contribution takes a closer look at the complex emotional relationality of Lublin’s inhabitants and the Old Town neighbourhood, triggered by sensory encounters, and analyses the sensory and mental mapping of a no-go area.

Pulmonary vasodilator therapy is still often an off‐label treatment for pulmonary hypertension in children. The aim of this nationwide register‐based study was to assess patient characteristics and strategies for pulmonary vasodilator therapy in young Swedish children. Prescription information for all children below seven years of age at treatment initiation, between 2007 and 2017, was retrieved from the National Prescribed Drug Register, and medical information was obtained by linkage to other registers. All patients were categorized according to the WHO classification of pulmonary hypertension. In total, 233 patients had been prescribed pulmonary vasodilators. The treatment was initiated before one year of age in 61% (N = 143). Sildenafil was most common (N = 224 patients), followed by bosentan (N = 29), iloprost (N = 14), macitentan (N = 4), treprostinil (N = 2) and riociguat (N = 2). Over the study period, the prescription rate for sildenafil tripled. Monotherapy was most common, 87% (N = 203), while 13% (N = 20) had combination therapy. Bronchopulmonary dysplasia (N = 82, 35%) and/or congenital heart defects (N = 156, 67%) were the most common associated conditions. Eight percent (N = 18) of the patients had Down syndrome. Cardiac catheterization had been performed in 39% (N = 91). Overall mortality was 13% (N = 30) during the study period. This study provides an unbiased overview of national outpatient use of pulmonary vasodilator therapy in young children. Few cases of idiopathic pulmonary arterial hypertension were found, but a large proportion of pulmonary hypertension associated with congenital heart defects or bronchopulmonary dysplasia. Despite treatment, mortality was high, and additional pediatric studies are needed for a better understanding of underlying pathologies and evidence of treatment effects.

The challenge of online learning for students is the lack of direct interaction between students and lecturers, causing students to have difficulty learning. In addition, unstable internet network constraints cause the learning process not to run optimally. This paper aims to develop online learning in universities. The type of research is a descriptive survey. The research respondents were 96 students. This study examines the effectiveness of the online learning process. Data were analyzed and compared with research results in journal articles. The online learning evaluation analysis from the side of the first student showed that students were more interested in face-to-face learning than online. Second, most students plan to study now for future use. Third, the main obstacles faced by students are internet access and internet quota. Lecturers have an essential role in helping students learn online. Third, students need groups to share the happy learning process. Thus, the readiness of lecturers and students in online learning needs to be improved with the support of learning technology devices.