bluuebunny/crossref_metadata_2025 huggingface dataset:
Low genetic diversity of Treponema pallidum ssp. pertenue (TPE) isolated from patients’ ulcers in Namatanai District of Papua New Guinea: Local human population is infected by three TPE genotypes
Authors: Medappa Monica , Pospíšilová Petra , Madruga Maria Paula M. , John Lucy N. , Beiras Camila G. , Grillová Linda , Oppelt Jan , Banerjee Arka , Vall-Mayans Marti , Mitjà Oriol , Šmajs David
Published: January 2024

Yaws is an endemic disease caused by Treponema pallidum subsp. pertenue (TPE) that primarily affects children in rural regions of the tropics. The endemic character of yaws infections and the expected exclusive reservoir of TPE in humans opened a new opportunity to start a yaws eradication campaign. We have developed a multi-locus sequence typing (MLST) scheme for TPE isolates combining the previously published (TP0548, TP0488) and new (TP0858) chromosomal loci, and we compared this typing scheme to the two previously published MLST schemes. We applied this scheme to TPE-containing clinical isolates obtained during a mass drug administration study performed in the Namatanai District of Papua New Guinea between June 2018 and December 2019. Of 1081 samples collected, 302 (28.5%) tested positive for TPE DNA, from which 255 (84.4%) were fully typed. The TPE PCR-positivity in swab samples was higher in younger patients, patients with single ulcers, first ulcer episodes, and with ulcer duration less than six months. Non-treponemal serological test positivity correlated better with PCR positivity compared to treponema-specific serological tests. The MLST revealed a low level of genetic diversity among infecting TPE isolates, represented by just three distinct genotypes (JE11, SE22, and TE13). Two previously used typing schemes revealed similar typing resolutions. Two new alleles (one in TP0858 and one in TP0136) were shown to arise by intragenomic recombination/deletion events. Compared to samples genotyped as JE11, the minor genotypes (TE13 and SE22) were more frequently detected in samples from patients with two or more ulcers and patients with higher values of specific TP serological tests. Moreover, the A2058G mutation in the 23S rRNA genes of three JE11 isolates was found, resulting in azithromycin resistance.
Effects of acupuncture treatment for myasthenia gravis: A systematic review and meta-analysis
Authors: Xue Hua , Zeng Li , He Hongxian , Xu Dongxun , Ren Kaixin
Published: January 2024

Background

Randomized controlled trials (RCTs) of acupuncture for myasthenia gravis (MG) were searched and the efficacy of acupuncture in the treatment of MG was evaluated by meta-analysis.

Methods

We searched for RCTs in six main electronic databases, and collected RCTs of acupuncture treatment for MG from database creation to 28 February 2023. The main outcome was the effective rate and the secondary outcome was the Traditional Chinese Medicine (TCM) relative clinical score, absolute clinical score (ACS) of MG, Quantitive myasthenia gravis score (QMG), quality of life, and adverse events. Odds ratios (ORs) and weighted mean differences (WMD) and 95% confidence intervals (CI) were used to assess pooled effect estimates using Review Manager software.

Results

A total of 14 RCTs were included. Meta-analysis showed that the effective rate in the acupuncture group was significantly improved compared with conventional Western medicine alone [OR = 4.28, 95% CI (2.95, 6, 22), P<0.005]. The pooled WMDs revealed that TCM relative clinical score [WMD = -2.22, 95% CI = (-2.53, -1.90), P<0.005], ACS of MG [WMD = -3.14, 95% CI = (-3.67, -2.62), P<0.005], and QMG [WMD = -0.88, 95% CI = (-1.46, -0.29), P<0.005] in the acupuncture group was lower than the control group. Adverse reactions related to acupuncture and quality of life were less mentioned among included RCTs.

Conclusion

This meta-analysis demonstrated that acupuncture as an auxiliary may play a positive role in treating MG. It can improve the effective rate of treatment, and reduce TCM relative clinical score, ACS of MG, and QMG. However, the quality of included studies was generally low and caution should be exercised when considering this treatment option. In the future, more rigorous study designs and high-quality RCTs are needed to verify the efficacy of acupuncture in the treatment of MG, because the results of high-quality RCTs are more reliable and accurate.
Selection of forage grasses for cultivation under water-limited conditions using Manhattan distance and TOPSIS
Authors: de Oliveira Bruno Rodrigues , Queiroz Duarte Marco Aparecido , Zuffo Alan Mario , Steiner Fábio , González Aguilera Jorge , Filgueiras Dutra Alexson , de Alcântara Neto Francisco , Renan Lima Leite Marcos , Guedes da Silva Nágila Sabrina , Pumacallahui Salcedo Eliseo , Morales-Aranibar Luis , Mollinedo Chura Richar Marlon , Ccama Alejo Roger , Caviedes Contreras Wilberth
Published: January 2024

Extreme weather events, such as severe droughts, pose a threat to the sustainability of beef cattle by limiting the growth and development of forage plants and reducing the available pasture for animals. Thus, the search for forage species that are more tolerant and adapted to soil water deficit conditions is an important strategy to improve food supply. In this study, we propose utilizing the mathematical concept of the Manhattan distance to assess the variations in the morphological variables of tropical forage grasses under water-limited conditions. This study aimed to select genotypes of tropical forage grasses under different water stress levels (moderate or severe) at this distance and the Technique for Order Preference by Similarity to Ideal Solution (TOPSIS). Nine varieties from five species were examined. Forage grasses were grown in 12-L pots under three soil irrigation regimes [100% pot capacity–PC (well-irrigated control), 60% PC (moderate drought stress), and 25% PC (severe drought stress)] with four replicates. Drought stress treatments were applied for 25 days during the forage grass tillering and stalk elongation phases. After exposure to drought stress, the growth and morphological traits of forage plants were evaluated. The results show that the use of the Manhattan distance combined with TOPSIS helps in the genotypic selection of more stable tropical forage grass varieties when comparing plants exposed to moderate and severe drought conditions in relation to the nonstressful environment (control). The ‘ADR 300’, ‘Pojuca’, ‘Marandu’, and ‘Xaraés’ varieties show greater stability when grown in a greenhouse and subjected to water stress environments. The selected forage varieties can be used as parents in plant breeding programs, allowing us to obtain new drought-resistant genotypes.
Prevalence, clinical correlates and outcomes of cardiorenal anemia syndrome among patients with heart failure attending tertiary referral hospital in Dodoma, Tanzania: A protocol of a prospective observational study
Authors: Edwin Gidion , Alphonce Baraka , Meremo Alfred , Meda John Robson
Published: January 2024

Background

Cardiorenal anemia syndrome (CRAS) is a common complication among patients with heart failure and is associated with poor clinical outcomes. However, there is a paucity of published data concerning CRAS, despite of significant increase in heart failure patients attending medical services in developing countries. This study aims to assess the prevalence, clinical correlates, and outcomes of CRAS among patients with heart failure attending the Benjamin Mkapa Hospital in Dodoma, Tanzania.

Methodology

A prospective observational study is ongoing at the Benjamin Mkapa Hospital in Dodoma, Tanzania. Currently, 92 patients have been recruited into this study and process is not yet completed. The socio-demographic data, clinical correlates, and prevalence of CRAS will be determined at baseline meanwhile, the outcomes of CRAS will be determined during a follow-up period of six months from the date of enrollment. CRAS is the primary outcome of the study. Data will be categorized into CRAS and non-CRAS during statistical analysis. Mean and standard deviation will be used for normally distributed continuous variables while median and interquartile range will be used for skewed data. Frequencies and percentages will summarize categorical variables. Clinical correlates and outcomes of CRAS will be analyzed and compared by using univariate and multivariate logistic regression and Cox proportional hazards models. A two-tailed p-value of less than 0.05 will indicate statistical significance.
Atorvastatin before percutaneous coronary intervention: A systematic review and meta-analysis
Authors: García-Campa Mariano , Flores-Ramírez Ramiro , Rojo-Garza Sabrina , Carrizales-Sepúlveda Edgar Francisco , Regalado-Ceballos Diego , Reyes-Araiza Raúl , Álvarez-Villalobos Neri , Rodríguez-Gutiérrez Rene , Azpiri-López José Ramón
Published: January 2024

Atorvastatin is widely recommended for long-term secondary prevention in STEMI patients with no contraindication. Although high-dose atorvastatin has been shown to reduce important patient outcomes such as MACE, there is still doubt that high-dose atorvastatin could have the same protective effect in patients undergoing PCI in the short and long term. We searched the following electronic databases: Scopus, Web of Science, MEDLINE, EMBASE, and Cochrane Central considering studies that enrolled adult patients with a confirmed diagnosis of STEMI or NSTEMI undergoing PCI. The intervention must have been atorvastatin alone compared to a placebo, standard care, or a different atorvastatin dose. A total of (n = 11) studies were included in the quantitative analysis. Information on (N = 5,399) patients was available; 2,654 were assigned to receive high-dose atorvastatin therapy, and 2,745 comprised the control group. High-dose atorvastatin pre-loading significantly reduced MACE at one month of follow-up (RR: 0.78; 95% CI: 0.67–0.91; p = 0.014) in both STEMI and NSTEMI. All-cause mortality was reduced in patients with STEMI (RR: 0.28; 95% CI: 0.10–0.81; p = 0.029). The quality of the body of evidence was rated overall as moderate. Patients presenting with STEMI or NSTEMI benefit from high-dose atorvastatin pre-loading before PCI by reducing MACE at 30 days. The use of high-dose atorvastatin in STEMI patients reduced all-cause mortality. The beneficial effects of atorvastatin pre-loading are limited to 30 days post-PCI.
Benefits of a digital health technology for older nursing home residents. A de-novo cost-effectiveness model for digital health technologies to aid in the assessment of toileting and containment care needs
Authors: Abraham Katharina , Kanters Tim Andre , Wagg Adrian Stuart , Huige Nicole , Hutt Edward , Al Maiwenn Johanna
Published: January 2024

The aim of this study was first, to introduce a comprehensive, de-novo health economic (HE) model incorporating the full range of activities involved in toileting and containment care (T&CC) for people with incontinence, capturing all the potential benefits and costs of existing and future Digital Health Technologies (DHT) aimed at improving continence care, for both residential care and home care. Second, to use this novel model to evaluate the cost-effectiveness of the DHT TENA SmartCare Identifi in the implementation of person-centred continence care (PCCC), compared with conventional continence care for Canadian nursing home residents. The de-novo HE model was designed to evaluate technologies across different care settings from the perspective of several stakeholders. Health states were based on six care need profiles with increasing need for toileting assistance, three care stages with varying degrees of toileting success, and five levels of skin health. The main outcomes were incremental costs and quality-adjusted life years. The effectiveness of the TENA SmartCare Identifi was based primarily on trial data combined with literature and expert opinion where necessary. Costs were reported in CAD 2020. After 2 years, 21% of residents in the DHT group received mainly toileting as their continence care strategy compared with 12% in the conventional care group. Conversely, with the DHT 15% of residents rely mainly on absorbent products for incontinence care, compared with 40% with conventional care. On average, residents lived for 2.34 years, during which the DHT resulted in a small gain in quality-adjusted life years of 0.015 and overall cost-savings of $1,467 per resident compared with conventional care. Most cost-savings were achieved through reduced costs for absorbent products. Since most, if not all, stakeholders gain from use of the DHT-assisted PCCC, widespread use in Canadian residential care facilities should be considered, and similar assessments for other countries encouraged.
Recovery of neuropsychological function following abstinence from alcohol in adults diagnosed with an alcohol use disorder: Systematic review of longitudinal studies
Authors: Powell Anna , Sumnall Harry , Smith Jessica , Kuiper Rebecca , Montgomery Catharine
Published: January 2024

Background

Alcohol use disorders (AUD) associate with structural and functional brain differences, including impairments in neuropsychological function; however, reviews (mostly cross-sectional) are inconsistent with regards to recovery of such functions following abstinence. Recovery is important, as these impairments associate with treatment outcomes and quality of life.

Objective(s)

To assess neuropsychological function recovery following abstinence in individuals with a clinical AUD diagnosis. The secondary objective was to assess predictors of neuropsychological recovery in AUD.

Methods

Following the preregistered protocol (PROSPERO: CRD42022308686), APA PsycInfo, EBSCO MEDLINE, CINAHL, and Web of Science Core Collection were searched between 1999–2022. Study reporting follows the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis, study quality was assessed using the JBI Checklist for Cohort Studies. Eligible studies were those with a longitudinal design that assessed neuropsychological recovery following abstinence from alcohol in adults with a clinical diagnosis of AUD. Studies were excluded if participant group was defined by another or co-morbid condition/injury, or by relapse. Recovery was defined as function reaching ‘normal’ performance.

Results

Sixteen studies (AUD n = 783, controls n = 390) were selected for narrative synthesis. Most functions demonstrated recovery within 6–12 months, including sub-domains within attention, executive function, perception, and memory, though basic processing speed and working memory updating/tracking recovered earlier. Additionally, verbal fluency was not impaired at baseline (while verbal function was not assessed compared to normal levels), and concept formation and reasoning recovery was inconsistent.

Conclusions

These results provide evidence that recovery of most functions is possible. While overall robustness of results was good, methodological limitations included lack of control groups, additional methods to self-report to confirm abstinence, description/control for attrition, statistical control of confounds, and of long enough study durations to capture change.
Effect of self-management intervention on patients with chronic obstructive pulmonary diseases, Chitwan, Nepal
Authors: Sharma Kalpana , Subba Hem K. , Poudyal Sunita , Adhikari Shital
Published: January 2024

Background

Self-management skills are important for patients with Chronic Obstructive Pulmonary Disease (COPD) who are responsible for their day to day care. Poor self-management behaviours have a significant influence on symptoms, functional impairments and quality of life. Evidence has shown that self-management interventions support patients to respond to changing symptoms and thereby make appropriate decisions regarding their self-management.

Objective

This study aimed to find out the effect of self-management interventions in patients with COPD in terms of self-management practice, inhaler practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms.

Methods

Quasi-experimental pre-test post-test design was carried out among patients with COPD attending respiratory units of Chitwan Medical College Teaching Hospital (CMC-TH), Nepal. Convenience sampling technique was used to select the 70 patients with COPD for the study. Baseline data was collected from the participants using (i) Semi-structured interview schedule for socio-demographic and clinical variables, (ii) COPD Self-Management Practice Questionnaire, (iii) Borg Dyspnoea Scale, and (iv) Six Minute Walking Distance (6MWD) Test (v) Pulmonary Function Test (PFT) and (vi) Observation Checklist. Self-management Intervention given was 2 ½ hour sessions per week for 6 weeks along with information booklets distribution. Participants were re-evaluated after 3 months of intervention using same tools. Data analysis was performed using IBMSPSS version 20.0 for window. Wilcoxon signed-rank test was performed to find the effectiveness of the self-management interventions on outcome parameters.

Results

Self-management interventions (2 ½ hour session per week for 6 weeks) elicited a statistically significant change on self-management practice (z = -7.215, p<0.001), inhaler practice (DPI practice z = -6.731, p<0.001, MDI practice, z = -1.816, p = 0.005), functional ability (z = -4.243, p<0.001), self-perceived dyspnoea (z = -4.443, p<0.001), COPD symptom burden (z = -7.009, p<0.001) and emotional symptoms (depression, z = -6.856, p<0.001, anxiety, z = -6.675, p<0.001) of patients with COPD.

Conclusions

Self-management intervention acts as powerful equipment to improve self-management practice, COPD symptoms burden, functional ability, self-perceived dyspnoea and emotional symptoms of patients with COPD. Hence, clinician and policy maker need to plan and intervene the rehabilitation program for the patients with COPD to enhance the effectiveness of therapy, self-management practice and general longevity.
Real-world evaluation of care for type 2 diabetes in Malaysia: A cross-sectional analysis of the treatment adherence to guideline evaluation in type 2 diabetes (TARGET-T2D) study
Authors: Lim Lee-Ling , Hussein Zanariah , Noor Nurain Md , Raof Anis S. Abd , Mustafa Norlaila , Bidin Mohamed B. Long , Ghani Rohana Abdul , Samsuddin Syahrizan , Yong Sy-Liang , Foo Siew-Hui , Raghuram Kavitha , Suwannasri Payiarat , W. B. Wan Mohamad , Chiew Thiam-Kian , Chan Siew-Pheng
Published: January 2024

Aim

Given a lack of data on diabetes care performance in Malaysia, we conducted a cross-sectional study to understand the clinical characteristics, control of cardiometabolic risk factors, and patterns of use of guideline-directed medical therapy (GDMT) among patients with type 2 diabetes (T2D), who were managed at publicly-funded hospitals between December 2021 and June 2022.

Methods

Patients aged ≥18 years with T2D from eight publicly-funded hospitals in the Greater Kuala Lumpur region, who had ≥2 outpatient visits within the preceding year and irrespective of treatment regimen, were eligible. The primary outcome was ≥2 treatment target attainment (defined as either HbA1c <7.0%, blood pressure [BP] <130/80 mmHg, or low-density lipoprotein cholesterol [LDL-C] <1.8 mmol/L). The secondary outcomes were the individual treatment target, a combination of all three treatment targets, and patterns of GDMT use. To assess for potential heterogeneity of study findings, all outcomes were stratified according to prespecified baseline characteristics namely 1) history of atherosclerotic cardiovascular disease (ASCVD; yes/no) and 2) clinic type (Diabetes specialist versus General medicine).

Results

Among 5094 patients (mean±SD age 59.0±13.2 years; T2D duration 14.8±9.2 years; HbA1c 8.2±1.9% (66±21 mmol/mol); BMI 29.6±6.2 kg/m2; 45.6% men), 99% were at high/very high cardiorenal risk. Attainment of ≥2 treatment targets was at 18%, being higher in General medicine than in Diabetes specialist clinics (20.8% versus 17.5%; p = 0.039). The overall statin coverage was 90%. More patients with prior ASCVD attained LDL-C <1.4 mmol/L than those without (13.5% versus 8.4%; p<0.001). Use of sodium-glucose cotransporter-2 (SGLT2) inhibitors (13.2% versus 43.2%), glucagon-like peptide-1 receptor agonists (GLP1-RAs) (1.0% versus 6.2%), and insulin (27.7% versus 58.1%) were lower in General medicine than in Diabetes specialist clinics.

Conclusions

Among high-risk patients with T2D, treatment target attainment and use of GDMT were suboptimal.
Age and sex differences in comorbidities in adult temporomandibular disorders: A cross-sectional study using Korea National Health and Nutrition Examination Survey (KNHANES)
Authors: Park Hye-Ji , Auh Q-Schick
Published: January 2024

Objectives

To investigate the relationship between Temporomandibular disorder (TMD) and associated comorbidities in groups matched according to age and sex.

Methods

Using data from the cross-sectional fifth Korea National Health and Nutrition Examination Survey (KNHANES). Of the 25,534 eligible KNHANES, 17,762 adults aged ≥19 years who responded to survey questionnaire on TMD and comorbidities. Subjects were classified into eight groups according to age and sex. Logistic regression analyses were performed to evaluate the association between TMD and comorbidities according to age and sex.

Results

Of the enrolled participants, 2,107 (11.86%) complained of ≥1 TMD symptoms. In all groups, odds ratios (ORs) for prevalence of TMD were >1 in those with tinnitus. Rhinitis was closely associated with TMD in 6 groups. ORs for TMD with comorbidities according to age and sex were as follows: hypertension, men aged 50–64 years (OR 0.62; CI 0.41–0.94); ischemic heart disease, men aged 35–49 years (4.38; 1.54–12.47); osteoarthritis, women aged 50–64 years (1.38; 1.03–1.86); diabetes mellitus, men aged 35–49 years (0.21; 0.05–0.88); depression, men aged 50–64 years (1.68; 1.00–2.83), women aged 35–49 years (1.39; 1.05–1.85) and women aged 65–80 years (2.01; 1.46–2.77); migraine, men aged 50–64 years (1.60; 1.14–2.25), women aged d35-49 years (1.44; 1.14–1.81) and women aged 35–49 years (1.43; 1.07–1.90); cold hypersensitivity in the hands and feet, men aged 19–34 years (1.64; 1.05–2.58), men aged 35–49 years (1.68; 1.04–2.70), men aged 65–80 years (1.74; 1.09–2.75) and women aged 35–49 years (1.45; 1.15–1.84); olfaction disorder, men aged 50–64 years (2.49; 1.39–4.43); voice disorder, men aged 50–64 years (2.25; 1.28–3.96) and women aged 65–80 years (1.69; 1.09–2.63)

Conclusions

This study confirmed that the types and effects of comorbidities related to prevalence of TMD may differ according to the patient’s age and sex and this result will increase the predictability of the onset of TMD.
Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia
Authors: Jalali Rakesh , Romaszko Jerzy , Dragańska Ewa , Gromadziński Leszek , Cymes Iwona , Sokołowski Janusz Bernard , Poterała Magdalena , Markuszewski Leszek , Romaszko-Wojtowicz Anna Maria , Jeznach-Steinhagen Anna , Glińska-Lewczuk Katarzyna
Published: January 2024

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016–2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.
An analysis of the effectiveness of reflective learning through watching videos recorded with smart glasses—With multiple views (student, patient, and overall) in radiography education
Authors: Muroi Kenzo , Kyogoku Shinsuke , Sakano Yasuaki , Sakamoto Hajime , Nakazeko Kazuma , Koyama Kazuya , Fukunaga Issei , Hori Kensuke , Kotake Kumiko , Nojiri Shuko , Sekine Miwa , Nishizaki Yuji , Daida Hiroyuki
Published: January 2024

The Objective Structured Clinical Examination (OSCE) is designed to assess medical students’ skills and attitude competencies before clinical practice. However, no method of reflective learning using video-based content has been used in OSCE education. This study aimed to confirm whether using smart glasses-based educational content is effective for OSCE reflective learning using multiple views (patient, student, and overall). This educational intervention study included a control group exposed to the traditional learning method and an intervention group exposed to a learning method incorporating smart glasses. Participants were 117 (72 in the control group and 45 in the intervention group) third-year radiological technology students scheduled to take the OSCE and 70 (37 in the control group and 33 in the intervention group) who met the eligibility criteria. Mock OSCEs were administered before and after the educational intervention (traditional and smart glasses-based education) to investigate changes in scores. After the educational intervention, a self-reported comprehension survey and a questionnaire were administered on the effectiveness of the video-based content from different views for student reflective learning. Unexpectedly, the OSCE evaluation score after the preliminary investigation significantly increased for the smart glasses control group (0.36±0.1) compared to the intervention group (0.06±0.1) setting up the radiographic conditions (x-ray center and detector center; p = 0.042). The intervention group’s lower score in the mock OSCEs may have been due to the discomfort of wearing the smart glasses to perform the radiography procedure and their unfamiliarity with the smart glasses, which may have affected their concentration. The findings suggest that smart glasses-based education for OSCEs can be improved (e.g., being easy to handle and use and trouble-free).
Disease-related malnutrition in children and role of oral nutrition supplement
Authors: Sidiartha I Gusti Lanang , Pratiwi I Gusti Ayu Putu Eka , Subanada Ida Bagus
Published: January 2024

Background Disease-related malnutrition (DRM) is a common complication in chronic diseases. An oral nutrition supplement (ONS) is a formula with high energy density which is commonly used to treat malnutrition.

Objective To identify the prevalence of DRM in children with chronic disease and evaluate the benefits of ONS.

Methods A retrospective study was conducted at Prof. IGNG Ngoerah Hospital, Denpasar, Bali. Data were collected from medical records of patients who were admitted from January to December 2021. Inclusion criteria were patients aged 1-18 years  with chronic diseases. Patients with organomegaly, edema, and incomplete medical record data were excluded. Disease-related malnutrition was defined as weight-for-height (for < 5 years of age) or BMI-for-age < -2SD (for > 5 years of age), according to the WHO growth charts. Subjects who received ONS for more than 80% of total energy during hospitalization were classified as part of the ONS group and the rest as standard group. Several variables between ONS and standard group were analyzed and considered significant if P value < 0.05.

Results Of 313 subjects with chronic disease, 139 (44.4%) were diagnosed with DRM.  Among of 139 subjects with DRM, a total of 64 subjects were analyzed in the ONS and standard feeding groups. No significant difference was found between groups with regards to age, gender, weight, height, white blood cell count, and lymphocyte cell count. Subjects with severe malnutrition significantly more classified as an ONS group than subjects with moderate malnutrition (P=0.001). Mean length of hospital stay was significantly shorter in the ONS group [11.8 (SD 6.7) days] than in the standard group [16.1 (SD 6.6) days]; (P=0.012).

Conclusion Malnutrition related to chronic disease in children is prevalent. Use of ONS is associated with a shorter length of hospital stay. Thus, routine nutritional status assessment to identify malnutrition in children with chronic disease is needed to treat with ONS in order to improve prognoses.
Cortisol levels associated with mortality in children with critical illness: a systematic review
Authors: Tolibin Restu Triwulandani , Widiretnani Septin , Moelyo Annang Giri
Published: January 2024

Background Critically ill patients, including those with sepsis, have increased cortisol levels due to activation of the hypothalamic-pituitary-adrenal (HPA) axis or critical illness-related corticosteroid insufficiency (CIRCI).

Objective To evaluate for a possible association between cortisol levels and mortality from sepsis in pediatric patients by systematic review of the literature.

Methods A systematic review was conducted on studies involving critically ill children, including those with sepsis. We included studies published between 2011-2020 analyzing data on cortisol levels (total serum cortisol, serum-free cortisol, salivary cortisol, real-time free cortisol, basal serum cortisol and post-adrenocorticotropin hormone (ACTH) stimulation test, or basal salivary cortisol and post-ACTH stimulation test), the predictive score for mortality (Pediatric Logistic Organ Dysfunction/PELOD), Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), Vasotropic Inotropic Score (VIS), or Pediatric Critical Illness Score (PCIS)], mortality (non-survivor percentage), and CIRCI percentage as an outcome in patients with critical illness, sepsis, and septic shock.

Results Twenty-one observational studies were included in our systematic review, with a total of 2,212 subjects, 916 of whom had sepsis. Nineteen studies indicated a positive association between elevated cortisol levels and mortality in critically ill children, but 2 studies stated that there was no association with the CIRCI percentage of 32.3 and 84.3% respectively. The mortality percentage of critically ill patients with elevated cortisol levels and sepsis were 25.81 (2.7-60)% and 35.31 (6-60)%, respectively. The percentages of CIRCI in critically ill and sepsis patients were 21.91 (0-84.3)% and 21.35 (0-84.3)%, respectively.

Conclusion Cortisol levels may increase or decrease in critically ill children. Elevated cortisol levels are associated with mortality in septic children. The effect of CIRCI on mortality in critically ill children cannot be concluded.
Educação ambiental em tempos de crise ecológica e climática:
Authors: PenaVega Alfredo
Published: January 2024

Os jovens estudantes de hoje são a próxima geração que amanhã terá de suportar as consequências dos efeitos das alterações climáticas numa crise ecológica. Conscientes do imobilismo dos responsáveis políticos em matéria de clima e ambiente, estes jovens querem tomar as rédeas do seu próprio destino, comprometendo-se a agir contra os efeitos das alterações climáticas. Porém, o modelo educativo compartimentalizado, fragmentado, disjuntivo e disciplinar não está adaptado aos grandes desafios colocados pelas alterações climáticas e ambientais. Neste artigo, propomos uma reflexão sobre a ideia de transformação, na forma como o conhecimento está ligado, numa aprendizagem para a cidadania em que o ensino da condição humana colocará o pensamento crítico do aluno no centro da sua condição de cidadão consciente. Utilizamos o programa de pesquisa, pacto mundial de jovens pelo clima como base de nossa reflexão. Concluímos que sem uma transformação da educação ambiental, as complexidades e incertezas de um mundo em constante mudança ficarão sem resposta.
educação ambiental no contexto de emergência climática:
Authors: De Souza Moser Anderson , Andrade Torales Campos Marilia , Angel Meira Cartea Pablo
Published: January 2024

Este artigo trata da educação ambiental em um contexto de emergência climática e descreve o processo de adaptação e validação de um instrumento de pesquisa elaborado pelo Projeto RESCLIMA para pesquisas no contexto do Ensino Médio no Brasil. A validação envolveu uma análise semântica realizada por professores mestres e doutores, juntamente com um teste piloto com alunos de três colégios estaduais. As sugestões dos avaliadores foram analisadas e incorporadas ao instrumento, abordando questões específicas relacionadas ao contexto brasileiro. Dada a relevância das representações sociais sobre a emergência climática para orientar políticas públicas e desenvolver práticas de comunicação e educação ambiental mais efetivas, é fundamental investigar como elas estão sendo compartilhadas entre alunos do Ensino Médio. Neste estudo, o processo de validação evidenciou a consistência do questionário para entender como essas representações estão sendo construídas nesse grupo populacional e seu potencial para orientar estratégias pedagógicas educacionais mais sólidas para responder ao problema.
Educação Básica como promotora da Alfabetização Nutricional a partir da Educação Ambiental Crítica:
Authors: Brumaro Regina Fornazari Valéria
Published: January 2024

A alimentação humana compõe o conjunto de conteúdos escolares que objetiva a promoção de hábitos alimentares saudáveis. Porém, a escola acaba por fomentar práticas que corroboram uma ideologia carnista que se opõe à sustentabilidade e contribui para a perpetuação de um cenário ambiental que ameaça o futuro do planeta. Assim, esse trabalho objetivou, por meio de um estudo exploratório, tecer considerações de como a Educação Ambiental Crítica no ensino escolar pode contribuir para o debate do Carnismo e das mudanças climáticas, fomentando a Alfabetização em Nutrição, na perspectiva de ampliar a visão crítica da comunidade escolar sobre a formação de hábitos alimentares saudáveis e sustentáveis. Desta forma, contribuindo para a cidadania, pois a alimentação ultrapassa aquilo que colocamos no prato ou levamos a mesa, mas,também,se constitui em um posicionamento ético e políticoque cada indivíduo deve exercer na sociedade.
Apresentação
Authors: Kataoka Adriana Massaê , López Carelia Hidalgo , Giloni-Lima Patricia Carla
Published: January 2024

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Lightened Elements Made of High-Performance Concrete with Fiber Composite Reinforcement
Authors:   , Řepka Jakub
Published: January 2024

This doctoral thesis introduces and discusses experiments focused on lightened elements made of high-performance concrete (HPC) and their reinforcement as they collectively illustrate the continuous research process aimed at lightened HPC load-bearing elements with fiber composite reinforcement. Each experiment contributes to the understanding of materials properties and interactions through the evaluation of tensile, shear, and compressive characteristics of coffered HPC panels as well as hollow HPC beams and columns reinforced with fiber composite reinforcement. It also includes a study focused on mineral-impregnated carbon fibers (MCF) as an alternative to fiber-reinforced polymers (FRP) to improve resistance to elevated temperatures and make such reinforcement suitable for load-bearing elements. This thesis aims to propose a more efficient utilization of the high-performance materials and lay a foundation for the production of load-bearing elements with longer service life and lower environmental impact.
A Bundled Educational Solution to Reduce Incorrect Plaster Splints Applied on Patients Discharged from Emergency Department
Authors: Ting Chia Wei Jennifer , Ho Shu Fang , Lateef Fatimah
Published: January 2024

Purpose: Plaster splints are routinely performed in the Emergency Department (ED) and avoidable complications such as skin ulcerations and fracture instability arise mainly due to improper techniques. Despite its frequent use, there is often no formal training on the fundamental principles of plaster splint application for a medical officer rotating through ED. We aim to use Quality Improvement (QI) methodology to reduce number of incorrect plaster splint application to improve overall patient care via a bundled educational solution.Methods: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act (PDSA) cycles, to decrease the rate of incorrect plaster splint application. A bundled education solution consisting of three sequential interventions (practical teaching session, online video lecture and quick reference cards) were formulated to specifically target critical factors that had been identified as the cause of incorrect plaster splints in ED.Results: With the QI intervention, our overall rate of incorrect plaster splints was reduced from 84.1% to 68.6% over a 6-month period.Conclusion: Following the QI project implementation of the bundled educational solution, there has been a sustained reduction in incorrect plaster splints application. The continuation of the training program also ensures the sustainability of our efforts in ED.
Ancient Alaskan Fuel Selectivity Strategies
Authors: Crawford Laura J.
Published: January 2024

In ancient Alaska, people allocated wood, bone, and oil for both fuel and non-fuel purposes, which required careful management. By examining these resources through the lens of human behavioral ecology (HBE) and the principle of least effort (PLE), we can understand fuel use—especially woody fuel use—from the standpoint of selectivity, wherein ancient people considered energetic output, handling costs, and state when choosing fuel sources. At any given site, some degree of firewood selectivity, ranging from complete indifference to marked discrimination, would have been most advantageous. Accordingly, ancient Alaskans at Cape Espenberg, Gerstle River, Hungry Fox, and Walakpa would have employed different fuel management strategies tailored according to their evolving needs. Results suggest that firewood indifference was more common, and that selectivity was advantageous only at longer-term occupations where fuel was abundant. Otherwise, proximity and handling costs trumped the benefits of taxon-specific selectivity, which is a strategy meant to confer desired combustion outcomes. Detecting when and where it was beneficial for ancient Alaskans to be selective grants insight into how they categorized fuel and adapted their fuel selection behaviors to fit particular circumstances. Moreover, the restrictions imposed by finite fuel availability have general implications for settlement patterns and mobility that may help trace ancient migration routes as hunter-gatherers leap-frogged from one fuel patch to another.
A Case Study of the Short-Term Development of Body Composition and Substrate Utilization Following Prolonged Low-Intensity Ski Trekking with Inadequate Energy Intake in Svalbard
Authors: Jarstad Even , Felberg Helge Andreas , Mamen Asgeir
Published: January 2024

This case study aimed to examine the short-term development of body composition and substrate utilization (i.e., contribution of fat and carbohydrates to energy supply) following prolonged low-intensity ski trekking (LIST) with inadequate energy intake in an Arctic region. For 23 days, two highly aerobically fit, male recreational athletes (24 and 26 years) performed ~2 – 11 hours of LIST each day, while pulling supply sledges (initially ~80 kg) across the length of Svalbard’s largest island, Spitsbergen (~640 km). We estimated body composition using bioelectrical impedance analysis (BIA). For evaluation of substrate utilization, we analyzed pulmonary respiratory gas-exchange ratio (RER) using an ergospirometry system during treadmill trekking (ski trekking simulation). Results indicated that the energy intake of each participant during this unsupported expedition was ~21.4 MJ·day-1 (~5107 kcal·day-1), of which ~33% (~5.0 g·kg-1·day-1), ~51% (~3.4 g·kg-1·day-1), and ~16% (~2.4 g·kg-1·day-1) came from carbohydrates, fat, and proteins, respectively. Body mass decreased by 7.2 kg (8.4%) in Subject A, and 4.4 kg (5.2%) in Subject B. Absolute fat mass decreased by 5.4 kg (37%) and 4.7 kg (30%) in Subject A and Subject B, respectively, whereas the changes in fat-free mass (–1.8 kg in Subject A, and +0.3 kg in Subject B) were within the random measurement error of the BIA analyser. Changes in RER in Subject A (–0.01 to –0.02 units) were within the random measurement error, whereas the RER data in Subject B were not interpretable due to excessive fluctuations in ventilatory equivalent for oxygen. In conclusion, this study indicates that short-term, prolonged LIST, performed with an energy deficit corresponding to a weight loss of ~2 kg·week-1, can lead to leaner body composition without notable changes in fat-free mass in well-trained, male recreational athletes. Furthermore, substrate utilization does not appear to be affected by short-term, prolonged LIST in this subgroup of athletes.
Surveillance for Zoonotic Pathogens and Inuit Qaujimajatuqangit of Ringed Seals (nattiit) (Pusa hispida) in Frobisher Bay and Eclipse Sound, Nunavut, Canada
Authors: Sudlovenick Enooyaq , Simonee James , Jones Megan E.B. , L'Hérault Vincent , Hernández-Ortiz Adrián , Jenkins Emily , Parker Sarah , Mavrot Fabien , Schneider Angie , Kutz Susan , Saliki Jeremiah T. , Daoust Pierre-Yves
Published: January 2024

Ringed seals (Pusa hispida) (nattiq (s.), nattiit (pl.) [Inuktut]) provide an important food staple for Nunavummiut (Indigenous residents of Nunavut). We studied the health of nattiit harvested by hunters from Baffin Island, Nunavut, via Inuit Qaujimajatuqangit and veterinary science. We conducted serological surveys and polymerase chain reaction (PCR) for select zoonotic pathogens, including Brucella spp., Erysipelothrix rhusiopathiae, Leptospira interrogans, and Toxoplasma gondii, in 55 nattiit from Frobisher Bay (FB) and 58 nattiit from Eclipse Sound (ES). We used a digestion assay to determine the presence of Trichinella spp. larvae in muscle samples from these seals. We conducted interviews with nine Local Knowledge Holders (LKHs) from Iqaluit (FB) and nine from Pond Inlet (ES) to gather their observations about nattiq health. The hunters evaluated nattiq health through a combination of behavior, nutritional condition, and appearance of skin and organs. They rarely observed severely ill nattiit. Hunters from ES but not from FB observed declining nattiit population numbers. In both regions, they observed increased numbers of harp seals (Phoca groenlandica). Frequencies of natural exposure among nattiit from FB and ES, based on seroprevalence, were 20.5% and 37% for Brucella spp., 25% and 11% for E. rhusiopathiae, 93% and 100% for L. interrogans, and 10% and 27% for T. gondii, respectively; PCR was negative for these pathogens in organs and tissues of seropositive animals. We did not detect larvae of Trichinella spp. Knowledge and experience from the LKHs in assessing nattiq health, complemented by negative findings from direct detection methods, provide reassurance about the safety of nattiit as country food, despite their exposure to some zoonotic pathogens in their natural environment.
Synthesis and Characterization of Fe-doped Hydroxyapatite/ZnO Nanocomposites Using the Coprecipitation Method from Processed Limestone
Authors: Hardian Arie , Dewi Rosalinawati , Jasmansyah Jasmansyah , Syarif Dani Gustaman , Murniati Anceu
Published: January 2024

Hydroxyapatite (HAp) is the main inorganic component that forms teeth and bones. The abundant limestone reservoir in Indonesia can be utilized as a natural resource for the green synthesis of hydroxyapatite. The objective of synthesizing Fe-doped hydroxyapatite/ZnO nanocomposites is to enhance the magnetic properties of hydroxyapatite, facilitating its utilization as a biomaterial in drug delivery systems. This application proves valuable in regulating the timing and location of active substance decay in pharmaceuticals. The coprecipitation method was employed to synthesize Fe-doped hydroxyapatite (Fe-HAp) at varying concentrations of 0%, 2.5%, 5%, and 10% mol. Subsequently, Fe- HAp/ZnO nanocomposites were crafted with a weight ratio 4:1 through straightforward homogenization between nano Fe-HAp and nano ZnO, utilizing ethanol as a solvent. The analytical tools employed for characterization included X-ray fluorescence (XRF), X-ray diffraction (XRD), and Vibrating Sample Magnetometer (VSM). XRF analysis revealed that the Ca/P ratio in the Fe- HAp/ZnO nanocomposite decreased with increasing Fe dopant concentration, while the weight percentage of ZnO remained consistent across all nanocomposites. The XRD results demonstrated the presence of typical diffraction patterns of HAp and ZnO in the Fe-HAp/ZnO nanocomposite. However, secondary phases such as β-TCP, CaCO3, and Fe2O3 were observed in the Fe-HAp sample. The crystallite size of the Fe-HAp/ZnO nanocomposite generated in this study ranged from 29 to 38 nm. VSM characterization outcomes indicated that the substitution of Fe(III) can modify the diamagnetic properties of hydroxyapatite, rendering it ferromagnetic or superparamagnetic, depending on the dopant concentration employed.
Financial relationships and dependencies in Czech secondary school mathematics textbooks
Authors: Čechák Petr
Published: January 2024

This article analyses and compares four sets of Czech secondary school mathematics textbooks from the perspective of financial relationships and dependencies. We claim that understading of financial relationships and dependencies, such as inflation or relationship between potential return of an investment and its riskiness play an important role in financial literacy; this is why they are implicitly present in the Czech Financial Literacy Standard. The importance of the study lies in its focus on the connection between financial education and functional thinking, a link which has been missing in the literature we are familiar with. Functional thinking is an important prerequisite for understanding financial relationships and dependencies. On the other hand, financial topics  may also be motivating and suitable contexts for developing functional thinking. Our comparative analyses indicates that Czech secondary mathematics textbooks do not provide teachers and pupils with opportunities to gain insights into the relationships and dependencies in financial education and that potential of the tasks with financial context for developing pupils’ functional thinking  is not fully used in the analysed textbooks.
Karmelka Barić, Günther Tutschke. Deutsch-serbisches Wörterbuch: Verben mit Präfixen und Beispielsätzen. Beograd: AGM Knijga. 2021. S. 622
Authors: Kic-Drgas Joanna
Published: January 2024

Karmelka Barić, Günther Tutschke. Deutsch-serbisches Wörterbuch: Verben mit Präfixen und Beispielsätzen. Beograd: AGM Knijga. 2021. S. 622