bluuebunny/crossref_metadata_2025 huggingface dataset:
OVARIAN HYPERSTIMULATION SYNDROMEAS A COMPLICATION OF MOLAR PREGNANCY: CASE REPORT
Authors:   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Lemrabott E. , Mohamed Mahmoud B. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Mohammed Saoud K. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Mamouni N. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Errarhay S. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Bouchikhi C. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes., Banani A. ,   Service de Gynecologie Obstetrique I CHU Hassan II, Fes.Marco Universite Sidi Mohamed Ben Abdellah Fes.
Published: December 2020

The authors present an atypical case of complete hydatidiform mole.Woman, 27years old, who went to the emergency room for abdominal pain associated with 10 week pregnancy. Echography revealed the presence of hyper stimulated ovaries leading to diagnosisof spontaneous Ovarian Hyperstimulation Syndrome (OHSS). Blood sample revealed high levels of hCG (300000 U/L), which associated with the ultrasound finding of placenta with vesicular areas, led to the suspicion of CHM,Dilatation and evacuation (D&E) were performed at 11 weeks of gestation. The signs and symptoms of OHSS were the severest on day 4 after D&E, when hCGhad already decreased We must be aware that OHSS can occur duringmolar pregnancy, and can be exacerbated after D&E.
INVESTIGATION OF THE INTERACTION OF THE ROLLER AND THE STATIONARY KNIFE OF THE ROLLER GIN WITH COTTON FIBER
Authors:   Researcher, Namangan Institute of Engineering and Technology, Namangan, Uzbekistan., Hojimatov Ulugbek , Kayumov Juramirza ,   PhD, Associate Professor, Zhejiang Sci-Tech University, Hangzhou, China., Hojimatov Farhod ,   Researcher, Namangan Institute of Engineering and Technology, Namangan, Uzbekistan., Dadaboyev Farhod ,   Senior Lecturer, Namangan Institute of Engineering and Technology, Namangan, Uzbekistan., Hojimatov Rasuljon ,   Candidate of Technical sciences, Namangan Institute of Engineering and Technology, Namangan, Uzbekistan.
Published: December 2020

The work is devoted to one of the topical issues of the cotton ginning industry. The article discusses the dynamic and mathematical models of the process in the interaction of the working drum-stationary knife system with the fiber of the ginned fly and solutions are given that allow you to determine the necessary part of the surface of the working drum and knife, taking into account the dynamics of the system. This method of solving problems is relevant because leads to the intensification of the roller ginning process.
IMMUNOPHENOTYPIC PROFILE OF T ACUTE LYMPHOBLASTIC LEUKAEMIA IN A TERTIARY CARE CENTRE - OUR EXPERIENCE
Authors:   Senior Resident, Department of Hematopathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India., Shah Sumayya , Hussain Mir Saleem ,   Senior Resident, Department of Hematopathology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, India.
Published: December 2020

Background:Studying the immunophenotypic profile of T-ALL patients in Kashmir and correlation of various demographic factors. Methods: 36 patients of all age groups were registered for this study of which 35 were included in the analyses. Result: 82.86% were males and 17.14% were females. 51.43% had common thymocyte T-ALL, 28.57% had pro T-ALL and 20% had mature thymocyte T-ALL. The average age at presentation was 18.60 years. 51.43% were CD1a positive. CD2 was positive in 70.83%. 88.57% were CD5 positive while 100% were positive for CD7. 42.86% were CD34 positive. The average bone marrow blast percentage was 82.43%. The average peripheral blood TLC was 92.73 x 103 cells/cumm. Conclusion: This is the first study to report immunophenotypic and demographic profile of T-ALL in Kashmir with the aim to increase understanding of the disease and contributing to more suitable treatment options.
Formalised assessment of systemic thrombogenicity in patients with Polycythemia vera suffered an ischemic stroke
Authors: Roitman E. V. , Shabalina A. A. , Tanashyan M. M.
Published: December 2020

Introduction. Thrombosis diagnosis and prevention in patients with Polycythemia vera (PV) suffered an ischemic stroke (IS) are still open. The aim was to find the reasons for systemic thrombogenicity and to compare the applicability of the main scales assessing thrombosis risk in patients with PV suffered IS.Materials and methods. We followed up 127 people (42-75 y.o.), of which 68 were patients with PV suffered IS (group I) and 59 non-PV-patients with ischemic stroke (group II). Clinical study included common blood analysis, rheological properties of erythrocytes, coagulation and endothelial parameters, cytokines, inflammation markers, angiogenesis markers, and testing for the V617F mutation in the JAK2 gene. The follow up included common and neurological examinations as well, and the assesment of thrombosis risk factors with both Caprini scale and CHA2DS2-VASc scale. All patients were examined twice as in the acute period of IS as well as in 16-18 months.Results. Between the groups no significant differences were found for the NIHSS average score and for Bartel index as well.The Caprini score belonged to the “very high risk” (score > 6) in both groups in the acute period of IS. At the same time, the score “8-10 points” prevailed in group II (68%) whereas the score “11-12 points” prevailed in group I.In the acute time of IS the CHA2DS2-VASc score revealed 12% of patients from both groups who had a score of “3-4 points” (moderate risk of thrombosis).In group I thrombotic complications rate correlated significantly with the JAK2V617F gene allelicloading (r = 0.236; p < 0.05), and the development of recurrence cerebrovascular disorders correlated significantly with Caprini score (r = 0.241; p < 0.05), but not with CHA2DS2-VASc score.Aiming to predict thrombotic complications in PV-patients the threshold (cut off) points were established for those markers as factor VIII, factor VII, red blood cell deformability, thrombin activated fibrinolysis inhibitor (TAFI), red blood cell count, white blood cell count, t-PA, VEGF-A, p-thrombomodulin, and ADAMTS-13.This pattern of parameters showed the odds ratio of thrombotic complications 10.3 (95% CI 7.6-13.8) in PV-patients in thelong-term period.At the end of the follow up the Caprini score showed a trend towards a decreasing in total while the CHA2DS2-VASc score remained virtually unchanged.Conclusion. We assume the accurate assessment of thrombotic risk in patients with Polycythemia vera suffered an ischemic stroke requires a proposed pattern of parameters including the test for JAK2V617F allelicloading and the calculation of Caprini score but not CHA2DS2-VASc score. Final results may provoke to change standard antithrombotic therapy in those patients towards its intensification due to pathogenetic featues of cancer-associated thrombosis.
Aspects of anticoagulant therapy in patients with atrial fibrillation in the light of updated guidelines of the European society of cardiology 2020: the position of dabigatran
Authors: Kropacheva E. S. , Panchenko E. P.
Published: December 2020

This review focuses on some aspects of anticoagulant therapy in the updated clinical guidelines for atrial fibrillation of the European society of cardiology, published in 2020. Atrial fibrillation is a polymorbid continuously developing syndrome, and therefore the treatment strategy is based on a comprehensive assessment of the patient, including the risk of stroke, the presence and severity of symptoms, and an assessment of structural heart disease and comorbidities. The review describes the principles of the proposed integrated approach, abbreviated “ABC pathway”, as reflecting the three main directions of the treatment strategy. According to experts, the clinical picture of AF (i.e. first detected, paroxysmal, persistent, long-term persistent or permanent) should not determine the indications for the appointment of anticoagulant therapy. The CHA2DS2-VASc scale continues to be the basis for stratification of thromboembolic risk. The role of dabigatran in primary and secondary prevention of stroke and systemic embolism in patients with atrial fibrillation is described. Changes in the position of experts regarding the assessment of bleeding risk are highlighted in order to help identify unmodified and eliminate modifiable risk factors for bleeding, as well as to identify AF patients who are potentially at high risk of bleeding for more frequent monitoring and monitoring of their condition. Questions about the use of direct oral anticoagulants in the choice of rhythm control tactics are highlighted separately. The use of dabigatran in patients undergoing cardioversion and catheter ablation is justified. Practical questions about the continuous strategy of anticoagulant therapy during ablation are highlighted separately. Changes related to multicomponent therapy after percutaneous coronary intervention are highlighted. The main measure to improve the safety of combined antithrombotic therapy is to minimize the duration of triple therapy. The updated recommendations supportlimiting the duration of triple antithrombotic therapy to 1 month, and also provide for early discontinuation of aspirin (≤1 week) and continuation of double antithrombotic therapy in cases of uncomplicated stenting and low risk of thrombosis, or when the risk of bleeding exceeds the risk of thrombotic events.
Antithrombotic therapy in patients with atrial fibrillation and percutaneous coronary intervention: what has changed in the guidelines in 2020?
Authors: Panchenko E. P.
Published: December 2020

The article presents an analytical review of the studies aimed at determining the optimal antithrombotic therapy in patients with atrial fibrillation undergoing elective or emergency percutaneous coronary intervention (PCI) due to the development of acute coronary syndrome (ACS). The results of the WOEST study are analysed. This study was the first to demonstrate an opportunity to safely discontinue administration of aspirin as part of the multicomponent antithrombotic therapy that included warfarin as an anticoagulant. Three studies were analysed - PIONEER AF-PCI, RE-DUAL-PCI and AUGUSTUS, where direct oral anticoagulants (DOACs) - rivaroxaban, dabigatran and apixaban were used as anticoagulants as part of the multicomponent therapy. The results of these studies formed the backbone of the updated European guidelines for the diagnosis and treatment of atrial fibrillation, 2020. The guidelines offer to divide patients with AF and ACS, who require multicomponent antithrombotic therapy, into two categories. The first group includes AF patients with uncomplicated PCI without a high risk of stent thrombosis, as well as patients with a risk of bleeding that prevails over the risk of stent thrombosis. The second category of patients, in contrast, is characterized by a high risk of stent thrombosis, which prevails over the risk of bleeding. In the absence of contraindications, the patients of both categories should choose DOAC as an anticoagulant and be prescribed clopidogrel as a P2Y12 inhibitor for 12 months. In AF patients with uncomplicated PCI without a high risk of stent thrombosis, as well as in patients with a risk of bleeding, which prevails over the risk of stent thrombosis, the period of treatment with the second antiplatelet drug (aspirin) should belimited to the hospital stay. Patients at increased risk of stent thrombosis and reduced risk of bleeding can extend the aspirin therapy for 1 month. The approaches to the choice of the duration and composition of the multicomponent antithrombotic therapy in AF patients taking oral anticoagulants after elective PCI are similar to those in ACS patients, except for the duration of clopidogrel therapy, which is reduced to 6 months in all patients.
Regarding the choice of Р2У12 platelet receptor blocker in the early invasive approach to acute coronary syndrome treatment in patients without indications for long-term anticoagulant use
Authors: Yavelov I. S.
Published: December 2020

In case of early invasive approach to the treatment of acute coronary syndrome in patients without indications forlong-term anticoagulants, double antithrombocytic therapy is recommended - a combination of acetylsalicylic acid with one of the blockers of P2Y12 platelet receptor (clopidogrel, prasugrel or ticagrelor). In this case, patients who do not have an excessively high risk of bleeding, there is evidence in favor of the choice of prasugrel or ticagrelor. Which of them is preferable in cases where in the first hours after hospitalization it is planned to perform coronary stenting is not fully clarified.The drawbacks of the randomized open PRAGUE-18 study do not allow us to judge the comparative effectiveness and safety of prasugrel and ticagrelor in primary percutaneous coronary intervention.ц The ISAR-REACT 5 study was relatively small and has its strengths as well as weaknesses. However, the European expert community considers the results to be sufficient to change the practical approaches to acute coronary syndrome treatment. Thus, according to the recommendations of the European Society of Cardiology for the treatment of acute coronary syndrome without stable ST segment elevations on ECG, which were updated in September 2020, prasugrel is proposed to be considered as a preferred treatment for ticagrelor in cases where the patient is directed to percutaneous coronary intervention (class IIa recommendation, degree of evidence B).
From Strategic Planning to Territorial Resilience
Authors: Odintsova A. V.
Published: December 2020

The adoption of the Strategy for the Spatial Development of the Russian Federation marked a new stage in the development of the practice of territorial strategizing. However, the lack of terminological clarity is one of the factors limiting the potential of this institution. Thus, the sustainability of socio-economic development, which is somehow present as the main goal in most territorial strategies, raises a number of questions. Taking into account the accumulated domestic and world experience, there are several interpretations of this concept: sustainability as stable rates of economic growth; sustainability as a concept developed at the UNO, requiring a balanced account of the environmental, social and economic components of social development; resistance to counteraction to various challenges and shocks. This article attempts to outline the main problems that arise due to the lack of clarity in the “dilution” of these concepts. In the world scientific literature and practice, the territorial potential for resilience to disasters has long been described by the concept of “resilience”, the content of which is considered in the paper.
Instruments to Measure Perceptions in the Emergency Department Provider-Patient with Sickle Cell Disease Interaction: Findings of an Integrative Review from a Ph.D. Project
Authors: Maddray Aindrea B. , Phillips Shannon M.
Published: December 2020

Background & Purpose:

The purpose of this review is to examine instruments that measure providers' perceptions of adult patients with Sickle Cell Disease (SCD), examine instruments that measure adult patients with SCD perceptions of providers' behaviors, and determine optimal instruments to use in evaluating the perceptions of Emergency Department (ED) providers and adult patients with SCD of one another's behaviors after an interaction in the ED.

Methods:

An integrative review was conducted searching EBSCOhost and PubMed databases using the keywords: measure [OR] measure* [OR] assess* [OR] scale [OR] survey [OR] tool [AND] stigma* [OR] stereotype [OR] prejudice [OR] bias [OR] perception [OR] attitude [OR] discrimination [OR] racism [OR] behavior [AND] interaction [OR] relationship [OR] communication [AND] sickle cell. Initial search located 256 articles, but only 15 articles were included in the final review.

Results:

Fifteen articles reporting six instruments were reviewed. Four instruments evaluated a provider’s perceptions of patients with SCD behaviors, and two instruments evaluated how patients with SCD perceived provider behaviors. The two patient-focused instruments and three provider-focused instruments were found to be adequately reliable and valid according to the Psychometric Grading Framework (PGF).

Conclusions:

The findings suggest that the General Perceptions About Sickle Cell Disease Patients Scale would be an optimal instrument to evaluate ED providers' perceptions of adult patients with SCD behaviors. One patient-focused instrument, The Sickle Cell Health-Related Stigma Scale (SCD-HRSS), reported adequate reliability and validity but was not specific to measuring the patient's perceptions of ED providers' behaviors, nor was it administered in the ED environment. The SCD-HRSS Doctors subscale has potential adaptability for use in measuring patients with SCD perceptions of ED provider behaviors in the ED environment.
Molecular-based Survey of Rickettsia spp. and Coxiella burnetii in Mosquitoes (Diptera: Culicidae) from Fars Province, Southern Iran, during 2017-18
Authors: Hoseini Zahra , Alipour Hamzeh , Azizi Kourosh , Soltani Aboozar
Published: December 2020

Objectives:

Since there have not been any studies on the roles of the Iranian mosquitoes in the transmission of Rickettsia spp. and Coxiella burneti, the present study investigates the roles of mosquitoes in the transmission of the pathogens using the PCR techniques for the first time in Iran.

Methods:

The present study was conducted in Fars province during the activity seasons of mosquitoes in 2017-18. The primer design was done to investigate the probability of mosquito’s contamination with Rickettsia spp. and Coxiella burnetii. The conventional PCR was used after the extraction of DNA from mosquitoes to study the contamination.

Results:

A total of 1103 adult mosquitoes were collected and identified. Among them, 3 genera and 11 species were identified, including Anopheles (25.74%), Culex (51.84%) and Culiseta (22.39%) genera. All tested mosquitoes were negative in terms of contamination to Rickettsia spp. and Coxiella burnetii.

Conclusion:

Based on the results, mosquitoes are not considered as vectors of Rickettsia spp. and Coxiella burnetii in this part of the country currently. Further studies on a larger scale are needed to examine the exact role of mosquitoes (as a possible vector with high abundance and mobility) in the transmission of these pathogens in tropical areas of Iran.
Resistance Profile of Vibrio spp. Strains Collected from Lagoon Bays and Wastewater in the City of Abidjan, Côte d'Ivoire, from January to June 2017
Authors: Kalpy J. Coulibaly , Sabine Vakou N. , Aboubakar S. Diaby , lydie N. Amon , Allico J. Djaman , Mady N'Diaye , Mireille Dosso
Published: December 2020

Background:

Lagoons and wastewater constitute aquatics environments which receive or accounts for most domestic discharges. These waters constitute an important ecosystem for the proliferation of microorganisms. The microorganisms that harbor these waters can provide information on the persistence of certain diseases in the human population, including gastrointestinal infections such as Cholera. The genus Vibrio contains pathogenic aquatic bacteria found in lagoon bays and wastewater.

Objective:

The main objectives of this work were to confirm the presence of Vibrio spp. in lagoon bays and sewage of the city of Abidjan over the entire interepidemic period, and to evaluate their sensitivity to commonly used antibiotics.

Methods:

The isolation and identification of the microorganisms were carried out using classical bacteriological techniques (biochemical test, API 20E gallery). When necessary, serotyping was carried out using agglutination tests on slides. Antibiotic susceptibility testing was carried out using the Kirby-Bauer disk diffusion (KBDD) method.

Results:

This study identified 12 bacterial strains, 9/12 (75%) of which were Vibrio sp. strains. Two Vibrio species, namely Vibrio parahaemolyticus 2/9 (22%) and 7/9 Vibrio cholerae (78%) were identified.

V. cholerae was isolated from both sewage and lagoon waters with dominance of serotype O1. The V. cholerae O1 and non-O1 strains showed a high level of resistance to sulfonamides, quinolones, fluoroquinolones, and moderate sensitivity to penicillins and tetracyclines. Resistant V. parahaemolyticus strains were also identified.

Conclusion:

The increased resistance of these bacteria could pose potential problems in the treatment of epidemics and other communicable diseases. The emergence of these multi-drug resistant strains of the genus Vibrio should prompt the Ivorian health authorities to maintain an epidemiological surveillance network for waterborne diseases throughout the country and to continue bacteriological sampling to monitor Vibrio's sensitivity to antibiotics.
Magnetic Resonance Imaging Identification of Rotator Cuff Pathology: Inter-rater Realibilty
Authors: Logvinov A. N. , Makarieva O. V. , Ilʼin D. O. , Kadantsev P. M. , Zaripov A. R. , Frolov A. V. , Magnitskaya N. E. , Ryazantsev M. S. , Burtsev M. E. , Korolev A. V.
Published: December 2020

Background. The shoulder MRI is one of the main methods for the rotator cuff injuries diagnostics and determination of the further treatment tactics. The agreement in the MRI data interpretation among specialists regarding different types of shoulder ruptures is an integral part of diagnostic test validity evaluation. The purpose of this study was to assess the agreement in the MRI data interpretation in the patients with shoulder rotator cuff pathology among trauma surgeons, as well as between trauma surgeons and a radiologist. Materials and Methods. The study was a retrospective analysis of the MRI data and surgical reports regarding 57 patients with various shoulder pathologies undergone the shoulder MRI and arthroscopic shoulder revisions in the period from 2017 to 2019. There were 38 (67%) men and 19 (33%) women among the patients. The average age of the patients was 52.7±13.6 years. The sensitivity and specificity, as well as the shoulder MRI inter-rater reliability were assessed in the course of the study. Results. The rotator cuff pathology was revealed in 52 patients: supraspinatus tendon injury in 98% of cases, supraspinatus and infraspinatus tendon — in 26%, isolated subscapularis tendon injury — in 2%, supraspinatus and subscapularis tendon — in 39%. The maximal concordance in the MRI data interpretation was achieved in the patients with full-thickness supraspinatus tendon rupture, as well as with the supraspinatus tendon calcifications. However, significant disagreement was found between orthopedists with different work experience in determination of the presence and type of infraspinatus and subscapularis tendons pathology and supraspinatus tendon incomplete ruptures and tendinitis. Conclusion. The high agreement in the MRI data interpretation in determining the pathology of the shoulder rotator cuff among trauma surgeons, as well as between trauma surgeons and radiologists, was observed only regarding the supraspinatus tendon, calcifying tendonitis and full-thickness injury. The diagnosis of tendinitis and incomplete tendon rupture remains difficult. Their interpretation results vary greatly. It is also worth noting the heterogeneity of the results of diagnostics of the infraspinatus and subscapularis tendon pathology.
Periprosthetic Joint Infection after Primary Total Knee Arthroplasty With and Without Sinus Tract: Treatment Outcomes
Authors: Preobrazhensky P. M. , Bozhkova S. A. , Panteleev A. N. , Tikhilov R. M. , Kazemirsky A. V.
Published: December 2020

Background. Sinus tract appears up to 20% of patients with periprosthetic joint infection (PJI) after primary total joint arthroplasty (TJA). The adverse effect of different patient related risk factors is well known, but the role of the sinus tract in PJI recurrence wasn’t properly investigated. The purpose of the study was to analyze the influence of a sinus tract on the effectiveness of two-stage reimplantation in PJI. Material and Methods. In order to reduce the influence of known risk factors on effectiveness of infection eradication several including criteria were introduced: patients with PJI after primary total knee arthroplasty (TKA), without surgeries before TKA and after infection manifestation and without attempts of antibiotic suppression. Finally, 119 of 475 patients with PJI after primary TKA, treated with two-stage protocol, were retrospectively analyzed: 33 patients with presence of the sinus tract, 86 — without sinus tract. Pathogen type, comorbidities, PJI type, bone defects, duration of surgery, intraoperative blood loss and the effectiveness of twostage reimplantation were analyzed. Results. Pathogen structure in analyzed groups was comparable. Staphylococci were the leading cause of PJI in compared groups: 64.4% of patients without sinus tract and 59.1% of patients with sinus tract. Wherein S. aureus was more frequently isolated in case of active sinus tract while S. epidermidis played the leading role in compared group. Polymicrobial PJI was more likely to develop in patients with sinus tract (p = 0.09). Massive bone defects of femur and tibia (type 3 according AORI classification) were identified only in patients with sinus tract PJI, as well as significantly longer duration of the spacer implantation and higher intraoperative blood loss at this stage (p0.05). Infection eradication after spacer implantation stage was achieved in 98.8% (n = 79) of patients without sinus tract while only 81% (n = 17) of patients with sinus tract PJI successfully passed this stage of surgical treatment (p0.05), effectiveness of revision knee arthroplasty was 98.7% (n = 78) and 76.5% (n = 13) respectively (p0.05). Finally, complex effectiveness of twostage reimplantation in patients with sinus tract was significantly lower (61.9%) than in patients of compared group (97.5%), p0.05. Conclusion. Presence of the sinus tract in patients with PJI after primary TKA adversely effects on the effectiveness of two-stage reimplantation, this fact could be explained by aggressive development of infection, caused by more virulent pathogens and higher frequency of polymicrobial cases among this cohort of patients. The established patterns require further research to develop tactics for managing this category of patients in order to increase the effectiveness of two-stage reimplantation.
Gender Differences of the ACL Insertion Sites
Authors: Malanin D. A. , Volodin I. V. , Suchilin I. A. , Demeshchenko M. V.
Published: December 2020

Background. The modern principles of reconstruction of the anterior cruciate ligament (ACL) and well-known surgical techniques do not take into account the peculiarities of the anatomical structure of the female knee. This happens due to insufficient substantiation that these peculiarities could influence the results of the treatment. The purpose of this study was to obtain new data on the structure of the areas of the ACL attachment, taking into consideration patient’s gender and the surgical anatomy. Material and Methods. 40 unpaired “fresh” anatomical preparations of the human female and male knees were studied. After preparation of the knee joints, the morphometry of the distal femoral epiphysis and the proximal tibial epiphysis was carried out by a digital sliding caliper according to 16 parameters. The shape, size, area, and the distance of the ACL attachment center from individual bone structures were assessed. The obtained data were correlated with the gender type of the knee structure. Results. The distal femoral epiphysis of the “female” type knee joint compared with the “male” type revealed the significant differences (p0.05) in the following parameters: the width of the condyles at the level of the transepicondylar line, the width of the intercondylar fossa, the length and height of the lateral condyle, and the ratio of the condyles width at the level of the transepicondylar line to the height of the lateral condyle. The tibial proximal epiphysis showed the gender differences in the articular surface frontal and sagittal dimensions, the width of the intercondylar eminence and the posterior slope of the tibial epiphysis articular surface. These features determined the different proportions of the female knee structure. The area of the anterior cruciate ligament femoral attachment and its center in the “female” type of structure were located 3 mm distal and 1.5 mm posteriorly (anteriorly and downwardly in arthroscopic imaging). The area of the tibial attachment of the same ligament and its center were localized 2 mm anteriorly in comparison with the “male” type structure. Conclusion. The discovered anatomical differences made it possible to distinguish the “female” and “male” types of the knee structure. The topography of the anterior cruciate ligament attachment areas is gender specific. This should be taken into account in the anatomical reconstruction of the ligament.
Estrategias lúdicas para el desarrollo de la competencia de Resolución de Problemas Matemáticos en Entornos Escolares
Authors: Cuello Alean Angelica Maria , Mestra Montoya Marlon Mike , Robles González Juana Raquel
Published: December 2020

El contexto educativo actual exige implementar estrategias pedagógicas que dinamicen el aprendizaje y favorezcan el desarrollo de competencias en los estudiantes se investigó el efecto de una estrategia lúdica en el desarrollo de la competencia de resolución de problemas matemáticos. Para esto, se diseñó un cuasiexperimento, designando como grupo control a 30 estudiantes del grado sexto de la IE Antonio Nariño y como grupo experimental a 30 estudiantes de la IE Tres María. Se diseñó un instrumento valorado con un 82 % de confiabilidad que contenía 20 ítems referentes a la resolución de problemas aditivos, multiplicativos, de proporcionalidad y del uso de fracciones. Inicialmente se aplicó el pretest a ambos grupos y posteriormente para el grupo control se continuó con una metodología de enseñanza tradicional mientras que con el grupo experimental se desarrollaron seis guías que contenían actividades lúdicas; posteriormente, a los grupos control y experimental se les volvió a aplicar el instrumento (postest). Los resultados iniciales mostraron significativas falencias en los estudiantes para resolver problemas con las operaciones matemáticas básicas, ambos grupos tuvieron un desempeño insuficiente; luego de las clases, el grupo experimental superó muchas de las dificultades alcanzando un nivel mínimo, pero el grupo control se mantuvo en el nivel insuficiente. Con la investigación se lograron mejoras significativas en la competencia resolución de problemas matemáticos, los estudiantes aprendieron matemática de forma agradable y las actividades les permitieron incorporar, expresar, descubrir, construir e interiorizar los contenidos del área. Esta investigación representa un cambio de paradigma del modelo tradicional de enseñanza de las matemáticas y permitió a los estudiantes aprender sin miedos y predisposiciones negativas.
Representaciones Sociales: Abordaje sobre ser mujer y prácticas sexuales en adolescentes femeninas de una Escuela Normal
Authors: Montiel Macea Gloria Estela , Martínez Bonett Piedad De los Ángeles
Published: December 2020

En este artículo se estudian las representaciones sociales y los significados sobre ser mujer y las prácticas sexuales de adolescentes femeninas de la Institución Educativa Escuela Normal Superior del municipio de Sahagún (Córdoba). El trabajo se desarrolló bajo la lógica de las representaciones sociales, teoría propuesta por Serge Moscovici y tuvo un enfoque cualitativo utilizando el método fenomenológico; la técnica y el instrumento para recolectar los datos fue la entrevista semiestructurada a través de un guion de entrevista; la cual, se les aplicó a cuatro informantes claves: adolescentes femeninas entre 10 y 15 años de edad las cuales declararon mediante entrevistas tener experiencia sexual. Para el análisis de los informantes claves se empleó la metodología propuesta por Martínez (2010), la cual se basó en la categorización, estructuración, contrastación y teorización; finalmente, los hallazgos se estructuraron en dos categorías: ser mujer y las prácticas sexuales. Los resultados evidenciaron carencia de conocimiento acerca de lo que significa ser mujer, en algunos casos fue relacionado con la obligación sexual hacia su pareja y, la negación de las prácticas sexuales fue catalogada, en muchas ocasiones, como infidelidad, llegando al maltrato físico y verbal. Con esta investigación se generó una mayor comprensión de las representaciones sociales que tienen las adolescentes sobre ser mujer y sobre las prácticas sexuales, los resultados permitirán implementar otra forma de abordaje de la temática en la educación para la sexualidad y brindar conocimientos holísticos adaptados a las expectativas y necesidades de las adolescentes para la construcción de su sexualidad y así superar los tabúes existentes.
Detecting Miscoded Diabetes Diagnosis Codes in Electronic Health Records for Quality Improvement: Temporal Deep Learning Approach (Preprint)
Authors: Rashidian Sina , Abell-Hart Kayley , Hajagos Janos , Moffitt Richard , Lingam Veena , Garcia Victor , Tsai Chao-Wei , Wang Fusheng , Dong Xinyu , Sun Siao , Deng Jianyuan , Gupta Rajarsi , Miller Joshua , Saltz Joel , Saltz Mary
Published: December 2020

BACKGROUND

Diabetes affects more than 30 million patients across the United States. With such a large disease burden, even a small error in classification can be significant. Currently billing codes, assigned at the time of a medical encounter, are the “gold standard” reflecting the actual diseases present in an individual, and thus in aggregate reflect disease prevalence in the population. These codes are generated by highly trained coders and by health care providers but are not always accurate.

OBJECTIVE

This work provides a scalable deep learning methodology to more accurately classify individuals with diabetes across multiple health care systems.

METHODS

We leveraged a long short-term memory-dense neural network (LSTM-DNN) model to identify patients with or without diabetes using data from 5 acute care facilities with 187,187 patients and 275,407 encounters, incorporating data elements including laboratory test results, diagnostic/procedure codes, medications, demographic data, and admission information. Furthermore, a blinded physician panel reviewed discordant cases, providing an estimate of the total impact on the population.

RESULTS

When predicting the documented diagnosis of diabetes, our model achieved an 84% F1 score, 96% area under the curve–receiver operating characteristic curve, and 91% average precision on a heterogeneous data set from 5 distinct health facilities. However, in 81% of cases where the model disagreed with the documented phenotype, a blinded physician panel agreed with the model. Taken together, this suggests that 4.3% of our studied population have either missing or improper diabetes diagnosis.

CONCLUSIONS

This study demonstrates that deep learning methods can improve clinical phenotyping even when patient data are noisy, sparse, and heterogeneous.
GM Diabetes My Way: Digital interventions supporting self-care in people with type 2 diabetes across Greater Manchester. A study Protocol. (Preprint)
Authors: Goldthorpe Joanna , Allen Thomas , Brooks Joanna , Kontopantelis Evangelos , Holland Fiona , Moss Charlie , Wake Deborah J. , Brodie Doogie , Cunningham Scott , Kanumilli Naresh , Bishop Hannah , Jones Ewan , Milne Nicola , Ball Steve , Jenkins Mark , Huntriss Rosemary , Sparrowhawk Keiron , Morgan-Curran Michael , Johnson Gemma , Rutter Martin
Published: December 2020

BACKGROUND

Digital diabetes management systems have the potential to deliver cost-effective self-management support. DiabetesMyWay (DMW) is a platform for an open access website that includes a variety of multimedia resources including offering patients access to their clinical data in the form of an electronic personal health record. DMW aims to improve both the outcomes and experience of people with T2D, and provide them with a single care record which can be shared with their clinicians to support consultations, clinical decision making, care planning and self-management advice.

OBJECTIVE

The objective of this study is to evaluate the effectiveness of DMW and to explore acceptability to patients and clinicians

METHODS

A consensus approach to recruitment will be taken; all adults registered with type 2 diabetes, registered with a GP in the study area will be eligible. We will take a mixed methods approach to data collection analysis.

RESULTS

The primary outcome for effectiveness will be HbA1c value post intervention in participants and controls receiving usual care; a qualitative exploration of acceptability and a cost effectiveness evaluation.

CONCLUSIONS

Digital interventions have potential to transform self-management of T2D and deliver major clinical, psychological and economic benefits. This test bed project aims to assess the impact of a range of digital interventions delivered through DiabetesMyWay in an ethnically and socially diverse group of people with type two diabetes in Greater Manchester.
Effects of the Soluble Guanylate Cyclase Stimulator Praliciguat in Diabetic Kidney Disease
Authors: Hanrahan John P. , de Boer Ian H. , Bakris George L. , Wilson Phebe J. , Wakefield James D. , Seferovic Jelena P. , Chickering Jennifer G. , Chien Yueh-tyng , Carlson Kenneth , Cressman Michael D. , Currie Mark G. , Milne G. Todd , Profy Albert T.
Published: December 2020

Background and objectives

Impaired nitric oxide signaling through soluble guanylate cyclase has been implicated in the pathophysiology of diabetic kidney disease. Praliciguat, a soluble guanylate cyclase stimulator that amplifies nitric oxide signaling, inhibited kidney inflammation and fibrosis in animal models.

Design, setting, participants, & measurements

In a phase 2 trial, 156 adults with type 2 diabetes, eGFR 30–75 ml/min per 1.73 m2, and urine albumin-creatinine ratio 200–5000 mg/g treated with renin-angiotensin system inhibitors were randomly allocated 1:1:1 to placebo, 20 mg praliciguat, or 40 mg praliciguat daily for 12 weeks. The primary efficacy and safety outcomes were change from baseline to weeks 8 and 12 in urine albumin-creatinine ratio and treatment-emergent adverse events, respectively. Other outcomes assessed were 24-hour ambulatory BP and metabolic parameters.

Results

Of 156 participants randomized, 140 (90%) completed the study. The primary efficacy analysis demonstrated a mean change from baseline in urine albumin-creatinine ratio of −28% (90% confidence interval, −36 to −18) in the pooled praliciguat group and −15% (−28 to 0.4) in the placebo group (difference −15%; −31 to 4; P=0.17). Between-group decreases from baseline to week 12 for praliciguat versus placebo were seen in mean 24-hour systolic BP (−4 mm Hg; −8 to −1), hemoglobin A1c (−0.3%; −0.5 to −0.03), and serum cholesterol (−10 mg/dl; −19 to −1). The incidence of treatment-emergent adverse events was similar in the pooled praliciguat and placebo groups (42% and 44%, respectively). Serious adverse events, events leading to study drug discontinuation, and events potentially related to BP lowering were reported at higher frequency in the 40-mg group but were similar in 20-mg and placebo groups.

Conclusions

Praliciguat treatment for 12 weeks did not significantly reduce albuminuria compared with placebo in the primary efficacy analysis. Nonetheless, the observed changes in urine albumin-creatinine ratio, BP, and metabolic variables may support further investigation of praliciguat in diabetic kidney disease.

Clinical Trial registry name and registration number:

A Study to Evaluate the Soluble Guanylate Cyclase (sGC) Stimulator IW-1973 in Diabetic Nephropathy/Diabetic Kidney Disease as Measured by Albuminuria, NCT03217591
Influence of Woody Breast Myopathy on Sarcomere Length and Tensile Strength in Commercial Broiler Pectoralis major Muscle
Authors: Puolanne T. Eero J. , Costandache Cristina G. , Ertbjerg Per
Published: December 2020

Woody breast syndrome is characterized by degenerative changes at the muscle fiber level and accumulation of connective tissue between the fibers. This study explored effects of the syndrome on muscle properties by focusing on a comparison of the sarcomere lengths between normal and woody breast muscles, including cranial and middle parts, surface and deeper layers, electrically stimulated and nonstimulated muscles, and their combinations. Tensile strengths longitudinally and transversally to the muscle fiber direction in the cranial and middle parts of the muscles were determined. The overall sarcomere lengths of woody breasts were longer than normal muscles (1.93 μ m vs. 1.88 μm; P < 0.05). The surface layer had overall longer sarcomere lengths than the deeper layer (cranial surface vs. cranial deeper layer: 1.97 vs. 1.89 μ m; middle surface vs. middle deeper layer: 1.93 vs.1.84 μ m; P < 0.05). Compared with normal breast muscles, woody breast muscles had longer sarcomeres in the surface layer; however, sarcomere length did not differ in the deeper layer. Electrically stimulated chicken breasts generally had longer sarcomere lengths (2.00 vs. 1.82 μm; P < 0.001). There was no significant difference in tensile strength between normal and focal woody breast (mild local lesion, usually in the cranial end) samples when fiber direction or sample location was studied (P > 0.05), but there was a clear difference between normal and focal versus diffuse (severe woody breast lesion throughout the muscle) samples (P < 0.001). Tensile strength was much greater in diffuse woody breast muscles when extended longitudinally or transversely to the fiber direction. In conclusion, although this study did not show sarcomere lengths in living muscle, it suggests an imbalance in sarcomere lengths in different parts of the breast muscle, which may induce a reduction in the functionality and strength of the muscle.
Construção de um modelo de Avaliação Culturalmente Responsiva para as associações de artesanato de Santa Cruz de la Sierra – Bolívia
Authors: Nincevic Salles Zvonimir , Brazileiro Paixão Roberto
Published: December 2020

A associatividade no setor de artesanato tem se transformado numa prática comum, é uma alternativa de fortalecimento coletivo para os produtores de Santa Cruz de la Sierra – Bolívia. Esta pesquisa buscou construir e validar analiticamente um modelo de avaliação culturalmente responsivo da associatividade. Para atingir o objetivo foram feitos 4 grupos focais em 2 fases e foi aplicado o método e rigor do Discurso do Sujeito Coletivo para analisar os dados coletados. Na fase 1, descreve-se as características culturais das associações e identificam-se as categorias avaliativas da proposta inicial do modelo CRE; a fase 2 foi feita para validar analiticamente o modelo CRE e refinar os indicadores estabelecidos, sua hierarquia e peso. O resultado foi a obtenção e validação do modelo CRE onde estabeleceram-se 5 categorias com seus próprios parâmetros e indicadores, que permitem a aplicação prática do modelo.
Índice de Desenvolvimento da Educação Básica (Ideb): Revisão Sistemática da Literatura
Authors: Soares Denilson Junio Marques , Soares Talita Emídio Andrade , Dos Santos Wagner
Published: December 2020

Neste artigo, foi realizada uma revisão sistemática da literatura adequada às recomendações PRISMA, utilizando o descritor “Índice de Desenvolvimento da Educação Básica”. As buscas foram realizadas nas bases de dados SCOPUS, Web of Science e Scielo no período compreendido entre 2007 e 2018. Foram selecionados 20 artigos, classificados em duas categorias que discutem o Ideb como instrumento de avaliação de políticas públicas educacionais e fatores relacionados aos resultados de escolas e municípios no indicador. Constatou-se que suas limitações e a concepção de qualidade por ele adotada são amplamente criticadas. Destaca-se a necessidade de uma maior discussão acadêmica sobre os indicadores educacionais de qualidade e de se promover estudos considerando os resultados obtidos por estudantes do Ensino Médio.
Avaliação e engagement acadêmico na Educação Superior: anseios e expectativas de estudantes do primeiro ano da graduação
Authors: Rigo Rosa Maria , Moreira José António Marques , Dias-Trindade Sara
Published: December 2020

Promover o engagement no Ensino Superior, sobretudo, dos estudantes ingressantes, é um dos maiores desafios para professores e instituições educativas, conforme têm destacado vários estudos internacionais (KRAUSE, 2005; COATES, 2006). O presente artigo tem, pois, por objetivo analisar os fatores que mais contribuem para a promoção de engagement acadêmico no Ensino Superior, sendo um estudo que conjuga metodologicamente dois tipos de investigação: a qualitativa e a quantitativa. Os resultados revelam que os estudantes consideram que os fatores que mais promovem o engagement acadêmico são: Relações Interpessoais; Formação Acadêmica; Tecnologias Digitais; Infraestrutura; e Formação Pessoal. Neste sentido, concluiu-se que é necessário desenvolver práticas pedagógicas assentes na interatividade, na conectividade e no envolvimento com os pares em ambientes enriquecidos com tecnologias digitais.
A avaliação da pós-graduação no Brasil: resultados e determinantes da avaliação da Capes (2013-2016)
Authors: Marques Cesar Augusto , Veiga Alinne De Carvalho , Borges Letícia Maria Correia
Published: December 2020

No Brasil, a regulação e a avaliação da qualidade dos programas de pós-graduação são feitas pela Fundação de Coordenação de Aperfeiçoamento de Pessoal de Ensino Superior (CAPES). A avaliação é central para todo o sistema de pós-graduação, distribuindo recursos financeiros e legitimando os diferenciais entre os programas. Assim, avaliar a avaliação é crucial para aperfeiçoar os modelos e compreender os resultados vigentes. Com este escopo, o presente trabalho coletou, estruturou e analisou os resultados e determinantes do processo avaliativo da Quadrienal 2013-2016, realizado em 2017. Para isso foram utilizadas técnicas de Web Scraping para construção de uma base de dados única, contendo as informações das fichas de avaliação de todos os programas avaliados. A partir de tal base foi aplicado um modelo de regressão logística para estimação das relações dos quesitos da avaliação com as mudanças de nota dentre as grandes áreas do conhecimento. Destaca-se a importância da produção acadêmica cientifica, sendo os quesitos de Produção intelectual e do Corpo Discente, Teses e Dissertações os que apresentaram maior relevância na alteração das notas.
Avaliação formativa: o portfólio como instrumento de avaliação para o desenvolvimento do aprendizado reflexivo
Authors: Sartor Harada Andresa
Published: December 2020

Com o objetivo de medir o desenvolvimento do aprendizado reflexivo impulsionado pela avaliação de portfólios na Educação a Distância (EAD), partiu-se de uma pesquisa que trata das variáveis que influenciam os processos reflexivos, levando em consideração a diversidade, estudos prévios e as diferentes nacionalidades dos participantes. O estudo demonstrou as possibilidades da avaliação com portfólio como ferramenta para a formação de professores, tanto como registros dos resultados quanto para promoção da reflexão sobre a prática e possíveis melhorias nos processos de aprendizagem. As análises estatísticas e descritivas concluem que tanto a modalidade a distância quanto o uso do portfólio cooperam em processos reflexivos dos professores em formação, sustentados também pela interculturalidade.
Diasporas tīklošanās prakses un piesaistes faktori mūsdienās
Authors: Mieriņa Inta
Published: December 2020

Ir svarīgi piesaistīt kaut vai vienam pasākumam vai aktivitātei, kuras laikā jaunietis iepazīstas ar citiem vietējiem latviešiem, nonāk dažādās kontaktu listēs vai Facebook grupās
Īpašā sala Minsteres Latviešu ģimnāzija – bijušā skolēna piezīmes
Authors: Rozītis Ojārs J.
Published: December 2020

Sava veida spītīgs latviskums “minsteriešiem” piemita. Taču drīzāk saistījās ar skolas un internāta dzīves neformālo pusi. Spilgtāk atmiņā palikuši neoficiālie dziedāšanas vakari