Expert consensus on difficulty assessment of endodontic therapy

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

Construction of a nomogram model to predict technical difficulty in performing laparoscopic sphincter-preserving radical resection for rectal cancer

BACKGROUND Colorectal surgeons are well aware that performing surgery for rectal cancer becomes more challenging in obese patients with narrow and deep pelvic cavities.Therefore,it is essential for colorectal surgeons to have a comprehensive understanding of pelvic structure prior to surgery and anticipate potential surgical difficulties.AIM To evaluate predictive parameters for technical challenges encountered during laparoscopic radical sphincter-preserving surgery for rectal cancer.METHODS We retrospectively gathered data from 162 consecutive patients who underwent laparoscopic radical sphincterpreserving surgery for rectal cancer.Three-dimensional reconstruction of pelvic bone and soft tissue parameters was conducted using computed tomography(CT)scans.Operative difficulty was categorized as either high or low,and multivariate logistic regression analysis was employed to identify predictors of operative difficulty,ultimately creating a nomogram.RESULTS Out of 162 patients,21(13.0%)were classified in the high surgical difficulty group,while 141(87.0%)were in the low surgical difficulty group.Multivariate logistic regression analysis showed that the surgical approach using laparoscopic intersphincteric dissection,intraoperative preventive ostomy,and the sacrococcygeal distance were independent risk factors for highly difficult laparoscopic radical sphincter-sparing surgery for rectal cancer(P<0.05).Conversely,the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance was identified as a protective factor(P<0.05).A nomogram was subsequently constructed,demonstrating good predictive accuracy(C-index=0.834).CONCLUSION The surgical approach,intraoperative preventive ostomy,the sacrococcygeal distance,and the anterior-posterior diameter of pelvic inlet/sacrococcygeal distance could help to predict the difficulty of laparoscopic radical sphincter-preserving surgery.

Linking 24-h Movement Behavior Guidelines to Cognitive Difficulties,Internalizing and Externalizing Problems in Preterm Youth

Background:Given the heightened risk of developmental challenges associated with preterm birth,it is crucial to explore interventions that may ameliorate potential adverse outcomes.This study aimed to examine whether meeting the 24-h movement behavior(24-HMB)guidelines,which include recommendations on physical activity(PA),screen time(ST),and sleep(SL),is related to indicators of cognitive difficulties,internalizing problems(e.g.,depression and anxiety),and externalizing problems(e.g.,difficulties in making friends and arguing)in a sample of preterm youth(children and adolescents born preterm).Methods:In this cross-sectional study,data from 3410 preterm youth(aged 6 to 17 years)were included for data analyses.Multivariable logistic regression was used to investigate associations between meeting the 24-HMB guidelines and the above-mentioned health outcomes,while controlling for sociodemographic and health-related factors.Results:The prevalence of meeting 24-HMB guidelines varied across independent and integrated components of the 24-HMB guidelines.Meeting the ST guideline alone(p<0.05)and integrated guidelines(i.e.,ST+SL and ST+SL+PA)were associated with fewer cognitive difficulties and reduced internalizing and externalizing problems(p<0.05).Specifically,meeting the SL guideline alone and integrated guidelines(i.e.,SL+ST)were associated with lower odds of depression and anxiety(p<0.01).Additionally,meeting independent,and integrated(PA and/or ST)guidelines were associated with less pronounced difficulties in making friends and arguing(p<0.05).Meeting 24-HMB guidelines in an isolated and integrated manner are linked to better cognitive performance and fewer internalizing and externalizing problems in preterm youth.Conclusion:Results suggest that advocating for the implementation of the 24-HMB guidelines may reduce cognitive challenges and behavioral issues,which is of high relevance for improving public health.Future longitudinal studies in preterm youth should investigate how modifying specific 24-HMB behaviors,especially ST,influence cognitive difficulties,internalizing and externalizing problems in this vulnerable population.

Effect of Mouth Opening Training Stick Combined with Oral Massage on Mouth Opening Difficulty in Head and Neck Cancer Patients after Treatment

Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.

Text Difficulty,Working Memory Capacity and Mind Wandering During Chinese EFL Learners’Reading

This experimental study investigated how text difficulty and different working memory capacity(WMC)affected Chinese EFL learners’reading comprehension and their tendency to engage in task-unrelated thoughts,that is,mind wandering(MW),in the course of reading.Sixty first-year university non-English majors participated in the study.A two-factor mixed experimental design of 2(text difficulty:difficult and simple)×2(WMC:high/large and low/small)was employed.Results revealed that 1)the main and interaction effects of WMC and text difficulty on voluntary MW were significant,whereas those on involuntary MW were not;2)while reading the easy texts,the involuntary MW of high-WMC individuals was less frequent than that of low-WMC ones,whereas while reading the difficult ones,the direct relationship between WMC and involuntary MW was not found;and that 3)high-WMC individuals had a lower overall rate of MW and better reading performance than low-WMC individuals did,but with increasing text difficulty,their rates of overall MW and voluntary MW were getting higher and higher,and the reading performance was getting lower and lower.These results lend support to WM theory and have pedagogical implications for the instruction of L2 reading.

Ableism and (Neo)Racism in School Placement Processes in Quebec: School Personnel Interpretations of Immigrant Student Difficulties - A Secondary Publication

The school placement processes of students from immigrant backgrounds considered to be in“difficulty”is an international concern at the intersection of works relating to special education and those concerning the school experiences of students from immigrant backgrounds or racialized groups.The research problem of this article concerns the identification of these students as disabled or as having adjustment or learning difficulties.From a perspective anchored in Disability Critical Race Studies,this ethnographic study documents different interpretations of perceived difficulties made by school actors with regard to seven primary school students from immigrant backgrounds.Five interpretation types are presented:(1)medicalization by dismissal of cultural markers,(2)medicalization by professional constraint,(3)medicalization by cultural deficit,(4)precautionary wait,and(5)cultural differentialism.Our results help to shed light on the special education overrepresentation phenomenon regarding these students and to understand how ableism and(neo)racism contribute to it.

Teachers’ Perceptions of the Challenges and Strategies in Supporting Students with Reading Difficulties

The purpose of this study is to determine the teacher’s perceptions of the challenges and strategies in supporting students with reading difficulties.This study used qualitative method of research and descriptive approach as its research design,in addition to a set of structured interview questions administered through Google Forms to gather data from elementary teachers of Taal Central School,located at Taal Batangas.These structured interview questions were carefully designed to cover various dimensions of the study,including the types of challenges perceived by teachers,strategies employed,and possible solutions for addressing the problems encountered in the process of supporting students with reading difficulties.The results revealed that teachers faced several challenges when teaching students with reading difficulties such as emotional and motivational issues/factors,lack of resources or teaching aids,deficits in knowledge and skills,and problems with student engagement and participation.This study also showed common approaches utilized by the teachers in supporting students with reading difficulties,which were fostering a positive and supportive environment,adopting individualized and multifaceted approaches,and utilizing effective teaching tools and strategies.Lastly,teachers also concluded varied solutions in addressing the challenges perceived in teaching students with reading difficulties towards fostering reading proficiency.These include developing peer support,use of positive reinforcement,and parental involvement.Moreover,specialized resources,professional development for teachers,and specific teaching strategies are also highlighted as crucial components.By integrating these approaches,teachers concluded that it can create a supportive and effective learning environment tailored to the needs of students with reading difficulties.

Effects of Super Absorbent Polymers on Yield and Water-saving and Drought-escaping Mechanism in Spring Maize

The effects of super absorbent polymers （SAP） on yield as well as water-saving and drought-escaping mechanism in spring maize in the seasonal drought region were studied. As shown by the results, during the seasonal drought in southern China, SAP treatment promoted the soil moisture, improved the capability of absorption and transportation of roots, promoted physiological and biochemical functions, increased the chlorophyll content, photosynthetic rate and intercellular CO2 concentration, and reduced the stomatal conductance and transplre.tion rate. As a result, the economic characters of spring maize were improved, and the yield was increased.

Characteristics and Functions of Cooperative Economic Organizations for Water-saving Irrigation in Agricultural Development in Arid Areas

Agricultural cooperative economic organization for water-saving irrigation in arid areas is a new form of economic organization in production,operation and management during the application process of water-saving irrigation technologies.Currently,there are few researches on this cooperative economic organization.In this study,connotations of cooperative economic organizations for water-saving irrigation are specifically defined,and the characteristics and functions of this cooperative economic organization are analyzed.Based on that,several suggestions are proposed on the continuous development of cooperative economic organizations for water-saving irrigation.

Application of Automatic Water-saving Irrigation System in Roof Gardens

Based on the special site conditions of roof gardens,it was put forward to introduce automatic water-saving irrigation system into the roof garden constructions,such as the solar energy and microcomputer auto water-saving irrigation system,aiming to solve the photosynthetic noon break phenomenon of plants and relieve the stress from high temperature.

Design and Construction of Rainwater Harvesting and Water-saving Irrigation System of Toona sinensis on Mountain Slopes

In order to collect rainwater and resist drought to enhance the utilization rate of rainfall and water resources, through project rainwater harvesting measures, the total annual rainwater harvesting amount of the six greenhouses was calculated according to annual average precipitation 542.2 mm, up to 1 095.7 m^3. The upper natural slopes of cultivated land were as rainwater harvesting areas, and total annual rainwater harvesting amount was 49 242 m^3 on the mountain slopes with an area of 73.37 hm^2, while total water storage amount was 39 394 m^3 in theory, so it could meet water use for the irrigation of 26.28 hm^2 of T. sinensis land. To be convenient for rainwater harvesting, irrigation and supplying water to the water-saving cellars, one pert-cut and part-fill reservoir （which was 470 m^3 in volume） was built on the mountain slopes at the right rear of the greenhouses, and their altitude difference was 50 m. The reservoir was sealed and was built with reinforced concrete. Water-saving cellars were distributed in front and the middle and at the back of two rows of greenhouses, and they were connected with each other. The reservoir could supply water to the water-saving cellars and also collect water by mountain slopes, from the lower water-saving cellars or deep wells. Two rainwater hervesting ditches that were 1 650 m in length were at the lower edge of arable land in the upper reaches of slopes to intercept rainfall runoff and make it flow into channels and then the sedimentation tanks. The total annual rainwater harvesting amount of the reservoir and water-saving cellars was 1 222.5 m^3.

Effects of Water Stress on Economic Characters of Water-saving Rice Variety Luhan No.1

[Objective] This study aimed at exploring the utilization rate of water of the new water-saving rice variety ＂Luhan No.1＂ and providing references and basis for the further demonstration and extension.[Method] Water-saving rice variety ＂Luhan No.1＂ and original receptor ＂6527＂ were used for dry processing without aquifer,and rice under regular irrigation conditions was used as the control.[Result] Under conditions which had economized on 67.4% of water compared with the regular irrigation,decreasing rates of 1 000-seed weight,seed setting rate,plant height and effective panicles of ＂Luhan No.1＂ were relatively small and had not achieved a significant level,while the decreasing rates of production of the region,total grains per panicle,theoretical production and filled grains per panicle of the original receptor ＂6527＂ were all over 25% and had attained very significant levels（P0.01）.[Conclusion] ＂Luhan No.1＂ had shown stable production,energy conservation,reducing environmental pollution and other advantages under water-conservating cultivation conditions.

The Potential Contribution of Subsurface Drip Irrigation to Water-Saving Agriculture in the Western USA

Water shortages within the western USA are resulting in the adoption of water-saving agricultural practices within this region. Among the many possible methods for saving water in agriculture, the adoption of subsurface drip irrigation （SDI） provides a potential solution to the problem of low water use efficiency. Other advantages of SDI include reduced NO3 leaching compared to surface irrigation, higher yields, a dry soil surface for improved weed control, better crop health, and harvest flexibility for many specialty crops. The use of SDI also allows the virtual elimination of crop water stress, the ability to apply water and nutrients to the most active part of the root zone, protection of drip lines from damage due to cultivation and tillage, and the ability to irrigate with wastewater while preventing human contact. Yet, SDI is used only on a minority of cropland in the arid western USA. Reasons for the limited adoption of SDI include the high initial capital investment required, the need for intensive management, and the urbanization that is rapidly consuming farmland in parts of the western USA. The contributions of SDI to increasing yield, quality, and water use efficiency have been demonstrated. The two major barriers to SDI sustainability in arid regions are economics （i.e., paying for the SDI system）, including the high cost of installation; and salt accumulation, which requires periodic leaching, specialized tillage methods, or transplanting of seedlings rather than direct-seeding. We will review advances in irrigation management with SDI.

THE BALANCE BETWEEN SUPPLY AND DEMAND OF WATER RESOURCES AND THE WATER-SAVING POTENTIAL FOR AGRICULTURE IN THE HEXI CORRIDOR

The Hexi Corridor is an important base of agriculture development inNorthwest China. According to recent statistics, there are 65. 94 x 10~8m^3 of water resourcesavailable in the Hexi Corridor. At present, net consumption in development and utilization is 43. 33x 10~8m^3. Water supply and demand reach a balance on the recent level of production, but loss ofevaporation and evapotranspiration is as much as 25. 69 x 1010~8m^3. So net use efficiency of waterresources is 59% Based on analyzing balance between water and land considering ecologicalenvironment at present, there exists the serious water shortage in the Shiyang River system whereirrigation lands have overloaded. There is a comparative balance between supply and demand of waterresource in the Heihe River system; and the Sule River system has some surplus water to extendirrigation land. Use of agriculture water accounts for 83. 3% and ecological forest and grass for 6.9% . The Hexi Corridor still has a great potential for water saving in agriculture production.Water-saving efficiency of irrigation is about 10% by using such traditional technologies as furrowand border-dike irrigation and small check irrigation, and water-saving with plastic film cover andtechniques of advanced sprinkler and drip/micro irrigation etc. can save more than 60% of irrigatedwater. Incremental irrigation area for water-saving potential in the Hexi Corridor has beenestimated as 56% - 197% to original irrigation area. So the second water sources can be developedfrom water saving agriculture in the Hexi Corridor under Development of the Western Part of China inlarge scale. This potential can be realized step by step through developing the water-savingmeasures, improving the ecological condition of oasis agriculture, and optimizing allocation ofwater resources in three river systems.

The water-saving potential of using micro-sprinkling irrigation for winter wheat production on the North China Plain

The shortage of groundwater resources is a considerable challenge for winter wheat production on the North China Plain.Water-saving technologies and procedures are thus urgently required.To determine the water-saving potential of using micro-sprinkling irrigation(MSI)for winter wheat production,field experiments were conducted from 2012 to 2015.Compared to traditional flooding irrigation(TFI),micro-sprinkling thrice with 90 mm water(MSI1)and micro-sprinkling four times with 120 mm water(MSI2)increased the water use efficiency by 22.5 and 16.2%,respectively,while reducing evapotranspiration by 17.6 and 10.8%.Regardless of the rainfall pattern,MSI(i.e.,MSI1 or MSI2)either stabilized or significantly increased the grain yield,while reducing irrigation water volumes by 20–40%,compared to TFI.Applying the same volumes of irrigation water,MSI(i.e.,MSI3,micro-sprinkling five times with 150 mm water)increased the grain yield and water use efficiency of winter wheat by 4.6 and 11.7%,respectively,compared to TFI.Because MSI could supply irrigation water more frequently in smaller amounts each time,it reduced soil layer compaction,and may have also resulted in a soil water deficit that promoted the spread of roots into the deep soil layer,which is beneficial to photosynthetic production in the critical period.In conclusion,MSI1 or MSI2 either stabilized or significantly increased grain yield while reducing irrigation water volumes by 20–40%compared to TFI,and should provide water-saving technological support in winter wheat production for smallholders on the North China Plain.

Development Potentials and Benefit Analysis of Efficient Water-saving Irrigation in Lixin County

On the basis of analyzing water resources,crop planning structure,and irrigation mode in Lixin County,potentials and benefits of developing efficient water-saving irrigation in the county were explored to provide references for its future water-saving irrigation.

Development Prospect and Strategies of Water-saving and Drought-resistance Rice

Water-saving and drought-resistance upland rice has become a preferable choice for cotton farmlands ready for changing crops or paddy fields with water in short,because simplified and mechanical cultivation can be applied for the rice varieties of drought resistance and high yield.At present,it has been applied with an area of 400 000 hm2 in Hunan Province and the area continues growing.The research bred and introduced the relevant cultivation technology standard applicable to local water-saving and drought-resistance rice varieties in order to improve farmer＇s benefits.

Application Research of Water-saving and Drought-resistant Landscape Plants:A Case Study of Inner Mongolia Drought-resistant Mongolian Grasses

Construction of "water-saving landscape architecture" is a crucial content of building "conservation-minded society'',an important approach of ensuring the sustainable development of landscaping industry.It targets at exploring a reasonable means of using the nature,so as to improve ecological conditions and environment,save resources and energies,and promote the harmonious coexistence of man and nature.Landscape plant is a significant component of landscape architecture,it is a key section to choose proper drought-resistant plant species for the landscape construction.

Water-saving Technologies,Solar Green House and Ecological Rehabilitation in Minqin Oasis of Gansu Province,China

Land degradation and desertification have become severe environmental problems in arid areas due to excessive use of water resources. It is urgent to reduce agricultural water use for ecological rehabilitation, which may result in a decrease in agricultural production and farmer＇s welfare. This paper focused on the impacts of some main measures including extensions of watersaving irrigation, expanding solar green house and increasing off-farm employment, which are generally recognized to be important to alleviate water shortage and poverty. A bioconomic model is applied taking Minqin Oasis in Gansu Province as a case study site. Simulation results showed that the effect of expanding solar greenhouse was more positive than other ones so it drew more attention. On the view of the different effects between each irrigation zone, mixed policy patterns suitable for them are suggested. In Baqu, expanding solar greenhouse should be the most important, auxiliary with encouraging pipe irrigation. Inversely, with regard to Quanshan, the major attention should be paid to subsidy for pipe irrigation and it would be better to supply the off-farm employment opportunities to the households in Huqu, where the expanding of solar greenhouse should also be summoned. Finally, it should be noted that farmer＇s income would only resume to 90% of the current level in the short run by putting more effort into local policies. Thus, the ecological compensation is needed to ensure farmer＇s welfare.

Analysis on the Water-saving Irrigation Technique Based on the Perspective of Food Safety

The paper analyzed the important role of water saving in protecting the food safety,introduced the present development of agricultural water-saving technique,pointed out the potential risks of water resources,and proposed the future development of water-saving irrigation.