An Elastic Organic Crystal Enables Macroscopic Photoinduced Crystal Elongation.

Among the various types of photomechanical deformations of organic crystals, photoinduced elongation of millimeter-scale crystals has yet to be demonstrated. Here we report that the millimeter-sized crystalline rods of an anthracene-pentiptycene hybrid organic π-system (1) are highly elastic and able to elongate up to 21.6% or 0.40 mm without fragmentation upon undergoing [4 + 4] photodimerization reactions. Both the mechanical and photomechanical effects reveal a strong cohesion of the system, even at the interface of 1 and its photodimer 2 and under the conditions of randomized molecular packing, representing a new class of mechanically adaptive organic crystals.

Impact of a Multicomponent Educational Intervention on Community Pharmacy-Based Naloxone Services Implementation: A Pragmatic Randomized Controlled Trial.

BACKGROUND: Despite US naloxone access laws, community pharmacists lack training and confidence in providing naloxone. OBJECTIVE: To assess the impact of the Empowering Community Pharmacists program on pharmacists' knowledge, perceived barriers, attitudes, confidence, and intentions regarding naloxone services implementation, as well as naloxone prescriptions dispensed. METHODS: A 3-month pragmatic randomized controlled trial was conducted from December 2018 to March 2019. Alabama community pharmacists were recruited by mail, email, phone, and fax and randomized to intervention (monthly resources/reminders + educational webinar) or control (monthly reminders only). Outcome measures were assessed via online surveys at baseline (T1), immediately post-intervention (T2), and 3 months post-intervention (T3), including naloxone knowledge (%correct); perceived barriers, attitudes, confidence, and intention regarding naloxone services implementation (7-point Likert-type scale; 1 = strongly disagree, 7 = strongly agree); and number of naloxone prescriptions dispensed. Mean differences between control and intervention from T1 to T3 were assessed using 2-way mixed analysis of variance and adjusted analyses were conducted using generalized estimating equations with negative binomial distribution to assess associations between variables. RESULTS: Of 55 participants (n = 27 intervention, n = 28 control), most were female (80.3%), white (80.6%), in independently owned pharmacies (39.1%). Increases in mean [SD] confidence (5.52 [1.03]-6.16 [0.74], P < 0.0005) and intention (5.35 [1.51]-6.10 [0.96], P = 0.023) occurred from pre- to post-program within the intervention group and were statistically significant compared with control (confidence P = 0.016, intention P = 0.014). Confidence (exp(ß) = 1.46, P = 0.031) and perceived barriers (exp(ß) = 0.75, P = 0.022) were associated with number of naloxone prescriptions dispensed. CONCLUSION AND RELEVANCE: The Empowering Community Pharmacists program improved community pharmacists' confidence and intention regarding naloxone services implementation. Other states can adapt program elements according to their laws. CLINICALTRIALS.GOV IDENTIFIER: NCT05093309.

Exploring outcomes from an innovative, pediatric-focused intervention with undergraduate nursing students.

BACKGROUND: To adapt to COVID-19 restrictions, a virtual pediatric skills day was developed to provide nursing students with practical experience prior to entering the pediatric clinical setting. Student assessment before and after participation indicate a virtual skills day is helpful in building student confidence prior to pediatric clinicals. METHODS: This mixed-method study involved a cross-sectional approach with a six-item survey administered before and immediately after the virtual pediatric skills day intervention to undergraduate junior nursing students. Outcome measures included comfort and preparation for pediatrics and families of pediatric patients. FINDINGS: After exploring outcomes from 93 students complete pre and post intervention measures, we addressed comfort themes including excited, nervous, and readiness while preparedness themes highlighted concerns with parental interactions, upset children, and COVID-19 restrictions. DISCUSSION: It is beneficial for nursing students to have clinical experiences with children prior to visiting a pediatric clinical setting. Such experiences decrease student stress and anxiety and allow meaningful opportunities to occur.

Cellular and Molecular Biology of Cancer Stem Cells of Hepatocellular Carcinoma.

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer death globally. The cancer stem cells (CSCs) of HCC are responsible for tumor growth, invasion, metastasis, recurrence, chemoresistance, target therapy resistance and radioresistance. The reported main surface markers used to identify liver CSCs include epithelial cell adhesion/activating molecule (EpCAM), cluster differentiation 90 (CD90), CD44 and CD133. The main molecular signaling pathways include the Wnt/ß-catenin, transforming growth factors-ß (TGF-ß), sonic hedgehog (SHH), PI3K/Akt/mTOR and Notch. Patients with EpCAM-positive alpha-fetoprotein (AFP)-positive HCC are usually young but have advanced tumor-node-metastasis (TNM) stages. CD90-positive HCCs are usually poorly differentiated with worse prognosis. Those with CD44-positive HCC cells develop early metastases. Those with CD133 expression have a higher recurrence rate and a shorter overall survival. The Wnt/ß-catenin signaling pathway triggers angiogenesis, tumor infiltration and metastasis through the enhancement of angiogenic factors. All CD133+ liver CSCs, CD133+/EpCAM+ liver CSCs and CD44+ liver CSCs contribute to sorafenib resistance. SHH signaling could protect HCC cells against ionizing radiation in an autocrine manner. Reducing the CSC population of HCC is crucial for the improvement of the therapy of advanced HCC. However, targeting CSCs of HCC is still challenging.

Pre-service Teachers Perspectives of Google Expedition.

This article explores pre-service teachers' personal experiences as they implemented immersive virtual reality using Google Expedition during a summer STEM camp for primary students. The research is situated around semi-structured interviews conducted to determine how pre-service teachers view their experiences using Google Expedition in primary classrooms, and the pedagogical challenges they encountered during this process. The semi-structured interviews provided insight into the planning, the pedagogical applications, and the obstacles or challenges they encountered during the planning stage and execution of their lesson using a highly interactive, three-dimensional tool such as Google Expedition. The data indicated that pre-service teachers had confidence in implementing virtual reality lessons in the class and considered it a new horizon for teaching. Yet, it also identified pedagogical challenges associated with implementing virtual reality in a primary classroom.

Impact on social capital and learning engagement due to social media usage among the international students in the U.S.

International students who pursue their academic goals in United States are prone to difficulties when attempting to build social resources and adjust to the new culture. Social media is a practical means of connection due to its ease of use and accessibility. Previous research has indicated contradictory effects of social media use on academic engagement. In addition to the direct effect, this research examined social media use influences on international students' learning engagement by mediating social capital and cultural adjustment. A total of 209 international students completed a web-based survey distributed via e-mail and social media between November 2021 and May 2022. Data were analyzed using Structural Equation Model. Results showed that only purposely using social media to collaborate with learning counterparts or materials directly improves international students' learning engagement. Other uses of social media (e.g., expanding new resources, solidifying close relationships) have no significant direct effects. Nonetheless, they are essential to improving levels of learning engagement via the mediation of bridging capital (social resources attributed to expanding relationships) and students' cultural adjustment in the U.S. International students' bonding capital (social resources available through trustworthy relationships) and home cultural retention showed little direct or indirect effects on learning engagement. This study recognizes the importance of social resources and cultural adjustment for international students. Also, this study provides valuable information to educators and administrators, as there is a need to identify the underlying mechanisms to contribute feasible learning intervention approaches and alleviate negative effects for international students.

A classification algorithm to predict chronic pain using both regression and machine learning - A stepwise approach.

This secondary data analysis study aimed to (1) investigate the use of two sense-based parameters (movement and sleep hours) as predictors of chronic pain when controlling for patient demographics and depression, and (2) identify a classification model with accuracy in predicting chronic pain. Data collected by Oregon Health & Science University between March 2018 and December 2019 under the Collaborative Aging Research Using Technology Initiative were analyzed in two stages. Data were collected by sensor technologies and questionnaires from older adults living independently or with a partner in the community. In Stage 1, regression models were employed to determine unique sensor-based behavioral predictors of pain. These sensor-based parameters were used to create a classification model to predict the weekly recalled pain intensity and interference level using a deep neural network model, a machine learning approach, in Stage 2. Daily step count was a unique predictor for both pain intensity (75% Accuracy, F1 = 0.58) and pain interference (82% Accuracy, F1 = 0.59). The developed classification model performed well in this dataset with acceptable accuracy scores. This study demonstrated that machine learning technique can be used to identify the relationship between patients' pain and the risk factors.

Aspirin Modifies Inflammatory Mediators and Metabolomic Profiles and Contributes to the Suppression of Obesity-Associated Breast Cancer Cell Growth.

Breast cancer is the most common cancer among women. Adiposity generally accompanies immune cell infiltration and cytokine secretion, which is ideal for tumor development. Aspirin is a chemopreventive agent against several types of cancer. The aim of this study was to investigate whether aspirin inhibits the growth of 4T1 breast cancer cells by inhibiting the inflammatory response and regulating the metabolomic profile of 3T3-L1 adipocytes. 3T3-L1 adipocyte-conditioned medium (Ad-CM) was used to mimic the obese adipose tissue microenvironment in 4T1 cells. The results revealed that aspirin inhibited macrophage chemoattractant protein (MCP-1), interleukin (IL-6), IL-1ß, and plasminogen activator inhibitor (PAI-1) production in 3T3-L1 adipocytes stimulated by tumor necrosis factor-alpha (TNF-α) and lipopolysaccharide (LPS). In the obesity-associated model, Ad-CM significantly promoted 4T1 cell growth and migration, which were attenuated after aspirin treatment. The results of metabolic analyses using Ad-CM showed that amino acid metabolites and oxidative stress were increased in mature 3T3-L1 adipocytes compared to those in fibroblasts. Aspirin treatment modified metabolites involved in suppressing lipogenesis, oxidative stress, and neoplastic formation. In the relative fatty acid quantitation analysis of Ad-CM, aspirin diminished fatty acid contents of C16:1, C18:1, C18:2, C20:4, and C24:1. This study is the first to show that aspirin modifies the metabolomics and fatty acid composition of 3T3-L1 adipocytes and inhibits obesity-associated inflammation that contributes to obesity-related breast cancer cell growth and migration.

Liver Fibrosis and Inflammation under the Control of ERK2.

Chronic liver injury could lead the formation of liver fibrosis, eventually some would develop to hepatocellular carcinoma (HCC), one of the leading malignancies worldwide. The aim of the study is to dissect the role of extracellular signal-regulated kinase 2 (ERK2) signaling in liver fibrosis and inflammation. The choline-deficient, ethionine-supplemented (CDE) diet could lead to fatty livers and generate oval cells, activate hepatocyte stellate cell (HSC) and recruit immune cells as the liver fibrosis model mice. WT and ERK2 deficient (ERK2-/-) mice were compared in terms of liver weight/body weight, liver function, liver fibrosis markers and the differential gene expression in hepatotoxicity. ERK2-/- mice display the less degree of liver fibrosis when compared to WT mice. The protein level of alpha smooth muscle (α-SMA) was reduced and several hepatocellular carcinoma-related genes such as MMP9, FoxM1 were down-regulated. In addition, the cell proliferation and the percentages of activated T cells were reduced in ERK2-/- mice upon liver injury. Therefore, ERK2 plays an important role in regulating liver cirrhosis and inflammation.

Aspirin Disrupts the Crosstalk of Angiogenic and Inflammatory Cytokines between 4T1 Breast Cancer Cells and Macrophages.

The tumor microenvironment is rich in multiple cell types that influence tumor development. Macrophages infiltrate tumors, where they are the most abundant immune cell population and secrete a number of cytokines. Aspirin acts as a chemopreventive agent against cancer development. This study investigated whether aspirin regulates crosstalk between breast cancer cells and macrophages. To study these interactions in a tumor microenvironment, a conditioned media was employed using 4T1 breast cancer cells cultured in RAW 264.7 cell-conditioned medium (RAW-CM), and a cocultured model of both cells was used. When 4T1 cells were cultured in the RAW-CM, there were increases in cell viability and secretion of the cytokines VEGF, PAI-1, TNF-α, and IL-6. Treatment with aspirin inhibited 4T1 cell growth and migration and MCP-1, PAI-1, and IL-6 production. In the coculture of both cells, aspirin inhibited secretion of MCP-1, IL-6, and TGF-ß. Furthermore, aspirin significantly decreased the M2 macrophage marker CD206, but increased M1 marker CD11c expression. In summary, aspirin treatment inhibited the crosstalk of 4T1 and RAW 264.7 cells through regulation of angiogenic and inflammatory mediator production and influenced the M1/M2 macrophage subtype. This highlighted that aspirin suppresses the tumor favorable microenvironment and could be a promising agent against triple-negative breast cancer.

Glioma-Associated Oncogene Homolog Inhibitors Have the Potential of Suppressing Cancer Stem Cells of Breast Cancer.

Overexpression of Sonic Hedgehog signaling (Shh) pathway molecules is associated with invasiveness and recurrence in breast carcinoma. Therefore, inhibition of the Shh pathway downstream molecule Glioma-associated Oncogene Homolog (Gli) was investigated for its ability to reduce progression and invasiveness of patient-derived breast cancer cells and cell lines. Human primary breast cancer T2 cells with high expression of Shh signaling pathway molecules were compared with breast cancer line MDA-MB-231 cells. The therapeutic effects of Gli inhibitors were examined in terms of the cell proliferation, apoptosis, cancer stem cells, cell migration and gene expression. Blockade of the Shh signaling pathway could reduce cell proliferation and migration only in MDA-MB-231 cells. Hh pathway inhibitor-1 (HPI-1) increased the percentages of late apoptotic cells in MDA-MB-231 cells and early apoptotic cells in T2 cells. It reduced Bcl2 expression for cell proliferation and increased Bim expression for apoptosis. In addition, Gli inhibitor HPI-1 decreased significantly the percentages of cancer stem cells in T2 cells. HPI-1 worked more effectively than GANT-58 against breast carcinoma cells. In conclusion, HPI-1 could inhibit cell proliferation, reduce cell invasion and decrease cancer stem cell population in breast cancer cells. To target Gli-1 could be a potential strategy to suppress breast cancer stem cells.

Lunasin Attenuates Obesity-Associated Metastasis of 4T1 Breast Cancer Cell through Anti-Inflammatory Property.

Obesity prevalence is increasing worldwide and is accompanied by low-grade inflammation with macrophage infiltration, which is linked with a poorer breast cancer prognosis. Lunasin is a natural seed peptide with chemopreventive properties and multiple bioactivities. This is the first study to explore the chemopreventive effects of lunasin in the obesity-related breast cancer condition using 4T1 breast cancer cells, 3T3-L1 adipocytes, and conditioned media. An obesity-related environment, such as leptin-treatment or adipocyte-conditioned medium (Ad-CM), promoted 4T1 cell proliferation and metastasis. Lunasin treatment inhibited metastasis of breast cancer cells, partially through modestly inhibiting production of the angiogenesis-mediator vascular endothelial growth factor (VEGF) and significantly by inhibiting secretion in the Ad-CM condition. Subsequently, two adipocytes inflammation models, 3T3-L1 adipocytes were stimulated by tumor necrosis factor (TNF)-α, and RAW 264.7 cell-conditioned medium (RAW-CM) was used to mimic the obese microenvironment. Lunasin significantly inhibited interleukin (IL)-6 and macrophage chemoattractant protein (MCP)-1 secretion by TNF-α stimulation, and MCP-1 secretion in the RAW-CM model. This study highlights that lunasin suppressed 3T3-L1 adipocyte inflammation and inhibited 4T1 breast cancer cell migration. Interestingly, lunasin exerted more effective anti-metastasis activity in the obesity-related condition models, indicating that it possesses anti-inflammatory properties and blocks adipocyte-cancer cell cross-talk.

Teaching Nursing Leadership: Comparison of Simulation versus Traditional Inpatient Clinical.

Nurse educators claim accountability to ensure their students are prepared to assume leadership responsibilities upon graduation. Although front-line nurse leaders and nurse executives feel new graduates are not adequately prepared to take on basic leadership roles, professional nursing organizations such as the American Nurses Association (ANA) and the Association of Colleges of Nursing (AACN) deem leadership skills are core competencies of new graduate nurses. This study includes comparison of a leadership-focused multi-patient simulation and the traditional leadership clinical experiences in a baccalaureate nursing leadership course. The results of this research show both environments contribute to student learning. There was no statistical difference in the overall score. Students perceived a statistically significant difference in communication with patients in the traditional inpatient environment. However, the students perceived a statistical significant difference in teaching-learning dyad toward simulation.

Effects of Intermittent Harem Mating on Parturition-induced Stress and Success Rate of Weaning in C57BL/6JNarl Mice.

Improving the effectiveness of mating schemes for large-scale production of mice is an ongoing challenge in animal facilities. Continuous mating, which requires fewer breeding cages than intermittent mating, has traditionally been used to take advantage of postpartum estrus for efficient production. However, the continuous mating scheme lacks flexibility because it cannot immediately accommodate the reduced needs of mice when production levels are high. In this study, we compared reproductive performance, fecal corticosterone metabolite (FCM) level as a stress indicator, and mouse mortality between the continuous trio (CT) and intermittent quad (IQ) mating schemes. The weaning rates in the IQ scheme were higher than those in the CT scheme (98.8% compared with 85.3%). The FCM levels in IQ female breeders were lower during the first 5 d after parturition than those in CT female breeders. The FCM levels in postpartum females housed with 2 adult mice were significantly higher on days 1, 3, and 5 after giving birth than those of females housed alone. This suggests that the presence of cage mates may induce stress responses in postpartum females. Increasing the individual cage area did not reduce the FCM levels of female breeders when accompanied by cage mates after parturition. In addition, the incidence of dystocia and mortality was lower in IQ breeders than in CT breeders. In summary, this breeding trial suggests that compared with the continuous mating scheme, the intermittent mating scheme improves the welfare of postpartum females with normal breeding performance in the C57BL/6JNarl production colony.

Development and Fabrication of a Multi-Layer Planar Solar Light Absorber Achieving High Absorptivity and Ultra-Wideband Response from Visible Light to Infrared.

The objective of this study is to create a planar solar light absorber that exhibits exceptional absorption characteristics spanning from visible light to infrared across an ultra-wide spectral range. The eight layered structures of the absorber, from top to bottom, consisted of Al2O3, Ti, Al2O3, Ti, Al2O3, Ni, Al2O3, and Al. The COMSOL Multiphysics® simulation software (version 6.0) was utilized to construct the absorber model and perform simulation analyses. The first significant finding of this study is that as compared to absorbers featuring seven-layered structures (excluding the top Al2O3 layer) or using TiO2 or SiO2 layers as substituted for Al2O3 layer, the presence of the top Al2O3 layer demonstrated superior anti-reflection properties. Another noteworthy finding was that the top Al2O3 layer provided better impedance matching compared to scenarios where it was absent or replaced with TiO2 or SiO2 layers, enhancing the absorber's overall efficiency. Consequently, across the ultra-wideband spectrum spanning 350 to 1970 nm, the average absorptivity reached an impressive 96.76%. One significant novelty of this study was the utilization of various top-layer materials to assess the absorption and reflection spectra, along with the optical-impedance-matching properties of the designed absorber. Another notable contribution was the successful implementation of evaporation techniques for depositing and manufacturing this optimized absorber. A further innovation involved the use of transmission electron microscopy to observe the thickness of each deposition layer. Subsequently, the simulated and calculated absorption spectra of solar energy across the AM1.5 spectrum for both the designed and fabricated absorbers were compared, demonstrating a match between the measured and simulated results.

Improving Respiratory Infection Diagnosis with Deep Learning and Combinatorial Fusion: A Two-Stage Approach Using Chest X-ray Imaging.

The challenges of respiratory infections persist as a global health crisis, placing substantial stress on healthcare infrastructures and necessitating ongoing investigation into efficacious treatment modalities. The persistent challenge of respiratory infections, including COVID-19, underscores the critical need for enhanced diagnostic methodologies to support early treatment interventions. This study introduces an innovative two-stage data analytics framework that leverages deep learning algorithms through a strategic combinatorial fusion technique, aimed at refining the accuracy of early-stage diagnosis of such infections. Utilizing a comprehensive dataset compiled from publicly available lung X-ray images, the research employs advanced pre-trained deep learning models to navigate the complexities of disease classification, addressing inherent data imbalances through methodical validation processes. The core contribution of this work lies in its novel application of combinatorial fusion, integrating select models to significantly elevate diagnostic precision. This approach not only showcases the adaptability and strength of deep learning in navigating the intricacies of medical imaging but also marks a significant step forward in the utilization of artificial intelligence to improve outcomes in healthcare diagnostics. The study's findings illuminate the path toward leveraging technological advancements in enhancing diagnostic accuracies, ultimately contributing to the timely and effective treatment of respiratory diseases.

Characteristics of patients with myofascial pain syndrome of the low back.

The objective of this study is to determine characteristics of patients with myofascial pain syndrome (MPS) of the low back and the degree to which the low back pain in the patients examined can be attributed to MPS. Twenty-five subjects with myofascial trigger point(s) [MTrP(s)] on the low back participated in this cross-sectional study. The location, number, and type of selected MTrPs were identified by palpation and verified by ultrasound. Pain pressure threshold, physical function, and other self-reported outcomes were measured. Significant differences were found in Group 1 (Active), 2 (Latent), 3 (Atypical, no twitching but with spontaneous pain), and 4 (Atypical, no twitching and no spontaneous pain) of participants in the number of MTrPs, current pain, and worst pain in the past 24 h (p = .001-.01). There were interaction effects between spontaneous pain and twitching response on reports of physical function, current pain, and worst pain (p = .002-.04). Participants in Group 3 reported lower levels of physical function, and higher levels of current pain and worst pain compared to those in Group 4. Participants in Group 1 and 2 had similar levels of physical function, current pain, and worst pain. The number of MTrPs is most closely associated with the level of pain. Spontaneous pain report seems to be a decisive factor associated with poor physical function; however, twitching response is not.

Assessing nutrition literacy and nutrition counseling proficiency following an interdisciplinary culinary medicine elective.

CONTEXT: Culinary medicine (CM) is a growing field of education that aims to bridge the gap between the clinical need for nutritional counseling and the lack of education on the topic. Healthcare professionals can aid in nutrition-related noncommunicable disease (NCD) prevention by improving a patient's dietary behavior. However, the presence of nutrition education in healthcare curricula is lacking. Early evidence indicates that CM could address this gap. OBJECTIVES: The objectives of this study are to determine if the provision of an interdisciplinary CM elective will improve student knowledge and confidence with counseling on nutrition and culinary principles, and to improve personal dietary habits of students. METHODS: This was a one-group pretest-posttest quasi-experimental design. First- and second-year osteopathic medical students (OMS) and nurse practitioner students were recruited to participate in a CM elective via email. Participants were excluded if they were not in good academic standing at their respective institutions. Twelve individuals (n=8 medical; n=4 nursing) were enrolled in the course. Participants completed pre- and postcourse surveys to determine changes in nutrition literacy (Nutrition Literacy Assessment Instrument [NLit42]), nutrition counseling proficiency (Nutrition Survey for Family Practitioners), and dietary quality (Automated Self-Administered 24-h dietary assessment tool; ASA24®). A two-sided, paired t test was conducted to determine changes in outcome variables. RESULTS: All 12 participants completed the precourse assessments, and 8 participants completed the postcourse assessments. Culinary activity attendance was 94.5 %. Participants exhibited a statistically significant increase in their overall nutrition literacy scores after completing the CM elective (p=0.006). Literacy subcategories indicated that the improvement came from the participant's ability to understand household measurements (p=0.005) better. Increases in self-reported proficiency were observed for participants' confidence to counsel on nutrition and prevention/wellness (p=0.02) and macronutrients in health and food safety (p=0.01). No statistically significant changes in the personal dietary pattern or quality were observed. CONCLUSIONS: The interdisciplinary CM elective improved nutrition literacy and some aspects of counseling proficiency. Although small shifts in dietary variables were observed, the elective did not statistically improve participants' dietary pattern. However, some changes that were observed may lead to clinically relevant outcomes if maintained long-term. These findings are encouraging. Implementing CM as an educational tool could improve healthcare practitioners' ability to understand and counsel patients on nutrition to prevent the nutrition-related NCDs.

RDAG U-Net: An Advanced AI Model for Efficient and Accurate CT Scan Analysis of SARS-CoV-2 Pneumonia Lesions.

Background/Objective: This study aims to utilize advanced artificial intelligence (AI) image recog-nition technologies to establish a robust system for identifying features in lung computed tomog-raphy (CT) scans, thereby detecting respiratory infections such as SARS-CoV-2 pneumonia. Spe-cifically, the research focuses on developing a new model called Residual-Dense-Attention Gates U-Net (RDAG U-Net) to improve accuracy and efficiency in identification. Methods: This study employed Attention U-Net, Attention Res U-Net, and the newly developed RDAG U-Net model. RDAG U-Net extends the U-Net architecture by incorporating ResBlock and DenseBlock modules in the encoder to retain training parameters and reduce computation time. The training dataset in-cludes 3,520 CT scans from an open database, augmented to 10,560 samples through data en-hancement techniques. The research also focused on optimizing convolutional architectures, image preprocessing, interpolation methods, data management, and extensive fine-tuning of training parameters and neural network modules. Result: The RDAG U-Net model achieved an outstanding accuracy of 93.29% in identifying pulmonary lesions, with a 45% reduction in computation time compared to other models. The study demonstrated that RDAG U-Net performed stably during training and exhibited good generalization capability by evaluating loss values, model-predicted lesion annotations, and validation-epoch curves. Furthermore, using ITK-Snap to convert 2D pre-dictions into 3D lung and lesion segmentation models, the results delineated lesion contours, en-hancing interpretability. Conclusion: The RDAG U-Net model showed significant improvements in accuracy and efficiency in the analysis of CT images for SARS-CoV-2 pneumonia, achieving a 93.29% recognition accuracy and reducing computation time by 45% compared to other models. These results indicate the potential of the RDAG U-Net model in clinical applications, as it can accelerate the detection of pulmonary lesions and effectively enhance diagnostic accuracy. Additionally, the 2D and 3D visualization results allow physicians to understand lesions' morphology and distribution better, strengthening decision support capabilities and providing valuable medical diagnosis and treatment planning tools.

Shaken Baby Syndrome Education for Mothers Awaiting Appointments in Rural OB/GYN Office.

A partnership between a nursing program and a rural obstetric office provided education to pregnant and postpartum women about coping with infant crying and the dangers of shaking a baby. Undergraduate nursing students delivered the Period of PURPLE Crying (PURPLE) educational program to 148 mothers. Change in knowledge about infant crying and the community clinical experience was evaluated. Pre and post intervention data were collected. Descriptive statistics indicated higher scores on mothers' posttest for knowledge about normal newborn crying behaviors and coping strategies. Students further developed the role of educator and researcher. These findings suggest the intervention contributed to mothers' improved knowledge about infant crying. Results of the pilot study are encouraging because the intervention had a significant effect on mothers' knowledge about infant crying and Shaken Baby Syndrome (SBS).