bluuebunny/crossref_metadata_2025 huggingface dataset:
Tibial Tubercle Apophyseal Stage to Determine Skeletal Age in Pediatric Patients Undergoing ACL Reconstruction: A Validation and Reliability Study
Authors: Dekhne Mihir S. , Kocher Isabelle D. , Hussain Zaamin B. , Feroe Aliya G. , Sankarankutty Saritha , Williams Kathryn A. , Heyworth Benton E. , Milewski Matthew D. , Kocher Mininder S.
Published: September 2021

Background:

Anterior cruciate ligament (ACL) injuries demand individualized treatments based on an accurate estimation of the child’s skeletal age. Wrist radiographs, which have traditionally been used to determine skeletal age, have a number of limitations, including cost, radiation exposure, and inconvenience.

Purpose:

To evaluate the reliability and validity of a radiographic staging system using tibial apophyseal landmarks as hypothetical proxies for skeletal age to use in the preoperative management of pediatric ACL tears.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

The study included children younger than 16 years of age who underwent ACL reconstruction between July 2008 and July 2018 and received both skeletal age radiography and knee radiography within 3 months of each other. Skeletal age was calculated from hand and wrist radiographs using the Greulich and Pyle atlas. Tibial apophyseal staging was categorized into 4 stages: cartilaginous stage (stage 1), apophyseal stage (stage 2), epiphyseal stage (stage 3), and bony/fused stage (stage 4). Data were collected by 2 independent assessors. The analysis was repeated 1 month later with the same assessors. We calculated descriptive statistics, measures of agreement, and the correlation between skeletal age and apophyseal stage.

Results:

The mean chronological age of the 287 patients included in the analysis was 12.9 ± 1.9 years; 164 (57%) of the patients were male. The overall Spearman r between skeletal age and tibial apophyseal staging was 0.69 (0.77 in males; 0.60 in females). The interrater reliability for the tibial apophyseal staging was substantial (Cohen κ = 0.66), and the intrarater reliability was excellent (Cohen κ = 0.82). The interrater reliability for skeletal age was excellent (intraclass correlation coefficient [ICC] = 0.93), as was the intrarater reliability (ICC = 0.97).

Conclusion:

The observed correlation between skeletal age and tibial apophyseal staging as well as observed intra- and interrater reliabilities demonstrated that tibial apophyseal landmarks on knee radiographs may be used to estimate skeletal age. This study supports the validity of knee radiographs in determining skeletal age and provides early evidence in certain clinical presentations to simplify the diagnostic workup and operative management of pediatric knee injuries, including ACL tears.
Effect of COVID-19 on Ulnar Collateral Ligament Reconstruction in Major League Baseball Pitchers
Authors: Paul Ryan W. , Omari Ali , Fliegel Brian , Bishop Meghan E. , Erickson Brandon J. , Alberta Frank G.
Published: September 2021

Background:

The coronavirus disease of 2019 (COVID-19) pandemic led to the suspension and shortening of the 2020 Major League Baseball (MLB) season from 162 to 60 regular season games. The effect of this disruption on injury rates, specifically injury to the ulnar collateral ligament (UCL), has not been quantified.

Purpose/Hypothesis:

The purpose of this study was to compare the rate of UCL reconstruction (UCLR), surgery timing, and pitching workload in MLB pitchers from before and after the COVID-19 pandemic lockdown. We hypothesized that UCLR rates relative to games played would be increased and pitching workload would be decreased in 2020 compared with previous seasons.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

An extensive online search using publicly available data was conducted to identify all MLB pitchers who underwent UCLR between January 1, 2017, and December 31, 2020. Only pitchers who were competing at the MLB level when undergoing reconstruction were included. Player characteristics and surgery date, as well as career and season of surgery pitching workload, were collected for all included pitchers. All data were compared as a pooled sample (2017-2019 vs 2020).

Results:

A similar number of pitchers underwent UCLR during or after the 2020 regular season (n = 18) compared with the 2017-2019 seasons (n = 16, 20, and 16, respectively). However, after accounting for the decrease in games played during the 2020 regular season, an MLB pitcher was 2.9 times more likely to undergo surgery per game after the COVID-19 lockdown compared with the previous years ( P < .001). MLB pitchers who underwent surgery in 2020 threw fewer preseason innings than did pitchers who underwent surgery between 2017 and 2019 (5.98 vs 9.39; P = .001).

Conclusion:

MLB pitchers were almost 3 times more likely to undergo UCLR per game after the COVID-19 lockdown. A decreased preseason pitching workload because of the COVID-19 lockdown may have had an effect on per game UCLR rates.
Comparison of magnitude and summated vector mean of surgically induced astigmatism vector according to incision site after phakic intraocular lens implantation
Authors: Kamiya Kazutaka , Ando Wakako , Takahashi Masahide , Shoji Nobuyuki
Published: September 2021

Background

To compare the arithmetic mean (M-SIA) and the summated vector mean of surgically induced astigmatism (SVM-SIA) according to the incision site after phakic intraocular lens (Visian implantable collamer lens (ICL), STAAR Surgical) implantation.

Methods

This study comprised 121 eyes of 121 consecutive patients undergoing ICL surgery through a 3.0-mm temporal or superior clear corneal incision. The magnitude and the axis of corneal astigmatism preoperatively and 3 months postoperatively were measured using an automated keratometer. The M-SIA and the SVM-SIA were determined according to the incision site.

Results

The magnitude of corneal astigmatism significantly increased from 1.23 ± 0.59 D preoperatively to 1.46 ± 0.72 D postoperatively in the temporal incision group (Wilcoxon signed-rank test, P < 0.001), but it significantly decreased from 1.09 ± 0.36 D preoperatively to 0.86 ± 0.41 D postoperatively in the superior incision group (P < 0.001). The M-SIA was 0.48 ± 0.30 D, and the SVM-SIA was 0.23 ± 0.52 D at a meridian of 82° in the temporal incision group. The M-SIA was 0.57 ± 0.30 D, and the SVM-SIA was 0.47 ± 0.45 D at a meridian of 1° in the superior incision group.

Conclusions

ICL implantation induces the M-SIA by approximately 0.5 D, but the SVM-SIA decreased to 50% and 80% of the M-SIA in magnitude through temporal and superior incisions, respectively. The direction of the SVM-SIA showed a tendency toward corneal flattening to the incisional site. It should be noted that the M-SIA is somewhat different from the SVM-SIA according to the incision site.

Trial registration University Hospital Medical Information Network Clinical Trial Registry (000044269)
Association between suicide, external-cause and all-cause mortality and irregular mental health discharge among the US veteran population
Authors: Riblet Natalie B. , Gottlieb Daniel J. , Watts Bradley V. , Levis Maxwell , Shiner Brian
Published: September 2021

Background

Irregular hospital discharge is highly prevalent among people admitted to hospital for mental health reasons. No study has examined the relationship between irregular discharge, post-discharge mortality and treatment setting (i.e. mortality after patients are discharged from acute in-patient or residential mental health settings).

Aims

To understand the relationship between irregular discharge and mortality among patients discharged from acute in-patient and residential settings.

Method

A retrospective study was conducted in members of the US veteran population discharged from acute in-patient or residential settings of the US Department of Veterans Affairs between 2003 and 2018. Multivariate Cox proportional hazards were used to evaluate associations between irregular discharge and suicide, external-cause (as defined by ICD-10 Codes: V01-Y98) and all-cause mortality in the first 30-, 90- and 180-days post-discharge.

Results

There were over 1.5 million mental health discharges between 2003 and 2018. Patients with an irregular discharge were at increased risk for suicide, external-cause and all-cause mortality in the first 180 days after discharge. In the first 30 days after discharge, patients with irregular discharge had more than three times greater suicide risk than patients with regular discharge (adjusted hazard ratio (HR) = 3.41, 95% CI 2.21–5.25). Suicide risk was higher among patients with irregular discharge in the first 30 days after acute in-patient discharge (adjusted HR = 1.55, 95% CI 1.11–2.16). In both settings, the mortality risk associated with irregular discharge attenuated but remained elevated within 90 and 180 days.

Conclusions

Irregular discharge after an acute in-patient or residential stay poses a large risk for mortality soon after discharge. Clinicians must identify effective interventions to mitigate harms associated with irregular discharge in these settings.
NICE shared decision making guidelines and mental health: challenges for research, practice and implementation
Authors: Zisman-Ilani Yaara , Chmielowska Marta , Dixon Lisa B. , Ramon Shulamit
Published: September 2021

The National Institute for Health and Care Excellence (NICE) initiated an ambitious effort to develop the first shared decision making guidelines. The purpose of this commentary is to identify three main concerns pertaining to the new published guidelines for shared decision making research, practice, implementation and cultural differences in mental health.
Young, Empowered and Strong: A Web-Based Education and Supportive Care Intervention for Young Women With Breast Cancer Across the Care Continuum
Authors: Sella Tal , Snow Craig , Freeman Hannah , Poorvu Philip D. , Rosenberg Shoshana M. , Partridge Ann H.
Published: September 2021

PURPOSE

Patient-centered digital interventions may help empower young women to self-manage symptoms and psychosocial concerns and support informational needs often unaddressed in clinic.

METHODS

Young, Empowered and Strong (YES) is an interactive web-based intervention designed to engage young women with personalized education and symptom self-management resources on the basis of responses to patient-reported outcome–based questionnaires. We piloted YES among young women (< 45 years) with newly diagnosed early breast cancer (EBC) or metastatic breast cancer (MBC) and breast cancer survivors (BCSs). Assessments were deployed weekly (EBC and MBC) or every 4 weeks (BCSs) over 12 weeks. At study completion, use, feasibility, and acceptability of YES were evaluated via a survey and semistructured interview.

RESULTS

Thirty women were enrolled between April and June 2019: 10 EBC, 10 BCSs, and 10 MBC. The mean age at diagnosis and enrollment was 36 (range 25-44) and 39 (range 31-44) years, respectively. Most participants were actively treated (96%, 27 of 28) with endocrine therapy (54%, 15 of 28) or chemotherapy (43%, 12 of 28). Overall, 61% (180 of 296) of assessments were completed (EBC: 70%, BCSs: 63%, and MBC: 52%). Of 37 patient-reported outcome and need domains, the most frequently triggered were sexual health (EBC: 90%, BCSs: 90%, and MBC: 90%), anxiety (EBC: 80%, BCSs: 90%, and MBC: 90%), stress and mindfulness (EBC: 80%, BCSs: 90%, and MBC: 90%), and fatigue (EBC: 90%, BCSs: 80%, and MBC: 90%). On postpilot survey, participants reported that YES helped them to learn (50%, 7 of 14), monitor (43%, 6 of 14), and manage (57%, 8 of 14) their symptoms.

CONCLUSION

YES is a feasible and acceptable digital intervention to support young women across the breast cancer care continuum. The nearly universal triggering of sexual and mental health needs suggests suboptimal management in the clinical setting and the potential for self-management through a digital platform.
Nivolumab Versus Gemcitabine or Pegylated Liposomal Doxorubicin for Patients With Platinum-Resistant Ovarian Cancer: Open-Label, Randomized Trial in Japan (NINJA)
Authors: Hamanishi Junzo , Takeshima Nobuhiro , Katsumata Noriyuki , Ushijima Kimio , Kimura Tadashi , Takeuchi Satoshi , Matsumoto Koji , Ito Kimihiko , Mandai Masaki , Nakai Hidekatsu , Sakuragi Noriaki , Watari Hidemichi , Takahashi Nobutaka , Kato Hidenori , Hasegawa Kosei , Yonemori Kan , Mizuno Mika , Takehara Kazuhiro , Niikura Hitoshi , Sawasaki Takashi , Nakao Sari , Saito Toshiaki , Enomoto Takayuki , Nagase Satoru , Suzuki Nao , Matsumoto Takashi , Kondo Eiji , Sonoda Kenzo , Aihara Satomi , Aoki Yoichi , Okamoto Aikou , Takano Hirokuni , Kobayashi Hiroshi , Kato Hisamori , Terai Yoshito , Takazawa Akira , Takahashi Yusuke , Namba Yoshinobu , Aoki Daisuke , Fujiwara Keiichi , Sugiyama Toru , Konishi Ikuo
Published: September 2021

PURPOSE

This phase III, multicenter, randomized, open-label study investigated the efficacy and safety of nivolumab versus chemotherapy (gemcitabine [GEM] or pegylated liposomal doxorubicin [PLD]) in patients with platinum-resistant ovarian cancer.

MATERIALS AND METHODS

Eligible patients had platinum-resistant epithelial ovarian cancer, received ≤ 1 regimen after diagnosis of resistance, and had an Eastern Cooperative Oncology Group performance score of ≤ 1. Patients were randomly assigned 1:1 to nivolumab (240 mg once every 2 weeks [as one cycle]) or chemotherapy (GEM 1000 mg/m2 for 30 minutes [once on days 1, 8, and 15] followed by a week's rest [as one cycle], or PLD 50 mg/m2 once every 4 weeks [as one cycle]). The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), overall response rate, duration of response, and safety.

RESULTS

Patients (n = 316) were randomly assigned to nivolumab (n = 157) or GEM or PLD (n = 159) between October 2015 and December 2017. Median OS was 10.1 (95% CI, 8.3 to 14.1) and 12.1 (95% CI, 9.3 to 15.3) months with nivolumab and GEM or PLD, respectively (hazard ratio, 1.0; 95% CI, 0.8 to 1.3; P = .808). Median PFS was 2.0 (95% CI, 1.9 to 2.2) and 3.8 (95% CI, 3.6 to 4.2) months with nivolumab and GEM or PLD, respectively (hazard ratio, 1.5; 95% CI, 1.2 to 1.9; P = .002). There was no statistical difference in overall response rate between groups (7.6% v 13.2%; odds ratio, 0.6; 95% CI, 0.2 to 1.3; P = .191). Median duration of response was numerically longer with nivolumab than GEM or PLD (18.7 v 7.4 months). Fewer treatment-related adverse events were observed with nivolumab versus GEM or PLD (61.5% v 98.1%), with no additional or new safety risks.

CONCLUSION

Although well-tolerated, nivolumab did not improve OS and showed worse PFS compared with GEM or PLD in patients with platinum-resistant ovarian cancer.
Insulin Resistance and Cardiometabolic Risk Profile Among Nondiabetic American Young Adults: Insights From NHANES
Authors: Parcha Vibhu , Heindl Brittain , Kalra Rajat , Li Peng , Gower Barbara , Arora Garima , Arora Pankaj
Published: September 2021

Background

The burden of insulin resistance (IR) among young American adults has not been previously assessed. We evaluated (1) the prevalence and trends of IR and cardiometabolic risk factors and (2) the association between measures of adiposity and IR among adults 18 to 44 years of age without diabetes and preexisting cardiovascular disease.

Methods

Cross-sectional survey data from six consecutive National Health and Nutrition Examination Survey (2007-2008 to 2017-2018) cycles were analyzed. IR was defined by the homeostatic model assessment for IR (HOMA-IR) of ≥2.5. The temporal trends of IR, cardiometabolic risk factors, and the relationship between IR and measures of adiposity were assessed using multivariable-adjusted regression models.

Results

Among 6247 young adults 18 to 44 years of age, the prevalence of IR was 44.8% (95% CI: 42.0%-47.6%) in 2007-2010 and 40.3% (95% CI: 36.4%-44.2%) in 2015-2018 (P for trend = 0.07). There was a modest association of HOMA-IR with higher body mass index (BMI), waist circumference, total lean fat mass, and total and localized fat mass (all Ps < 0.001). Participants with IR had a higher prevalence of hypertension [31.3% (95% CI: 29.2%-33.5%) vs 14.7% (95% CI: 13.2%-16.2%)], hypercholesterolemia [16.0% (95% CI: 12.4%-19.5%) vs 7.0% (95% CI: 5.8%-8.5%)], obesity [56.6% (95% CI: 53.9%-59.3%) vs 14.7% (95% CI: 13.0%-16.5%)], and poor physical activity levels [18.3% (95% CI: 16.4%-20.2%) vs 11.7% (95%CI: 10.3–13.1%)] compared to participants without IR (all Ps < 0.05).

Conclusions

Four-in-10 young American adults have IR, which occurs in a cluster with cardiometabolic risk factors. Nearly half of young adults with IR are nonobese. Screening efforts for IR irrespective of BMI may be required.
Circadian Rhythms in Resting Metabolic Rate Account for Apparent Daily Rhythms in the Thermic Effect of Food
Authors: Ruddick-Collins Leonie C , Flanagan Alan , Johnston Jonathan D , Morgan Peter J , Johnstone Alexandra M
Published: September 2021

Context

Daily variation in the thermic effect of food (TEF) is commonly reported and proposed as a contributing factor to weight gain with late eating. However, underlying circadian variability in resting metabolic rate (RMR) is an overlooked factor when calculating TEF associated with eating at different times of the day.

Objective

This work aimed to determine whether methodological approaches to calculating TEF contribute to the reported phenomena of daily variation in TEF.

Methods

Fourteen overweight to obese but otherwise healthy individuals had their resting and postprandial energy expenditure (EE) measured over 15.5 hours at a clinical research unit. TEF was calculated for breakfast, lunch, and dinner using standard methods (above a baseline and premeal RMR measure) and compared to a method incorporating a circadian RMR by which RMR was derived from a sinusoid curve model and TEF was calculated over and above the continuously changing RMR. Main outcome measures were TEF at breakfast, lunch, and dinner calculated by different methods.

Results

Standard methods of calculating TEF above a premeal measured RMR showed that morning TEF (60.8 kcal ± 5.6) (mean ± SEM) was 1.6 times greater than TEF at lunch (36.3 kcal ± 8.4) and 2.4 times greater than dinner TEF (25.2 kcal ± 9.6) (P = .022). However, adjusting for modeled circadian RMR nullified any differences between breakfast (54.1 kcal ± 30.8), lunch (49.5 kcal ± 29.4), and dinner (49.1 kcal ± 25.7) (P = .680).

Conclusion

Differences in TEF between morning and evening can be explained by the underlying circadian resting EE, which is independent of an acute effect of eating.
Adrenal Cortex Development and Maintenance: Knowledge Acquired From Mouse Models
Authors: Abou Nader Nour , Boyer Alexandre
Published: September 2021

The adrenal cortex is an endocrine organ organized into concentric zones that are specialized to produce specific steroid hormones essential for life. The development and maintenance of the adrenal cortex are complex, as a fetal adrenal is first formed from a common primordium with the gonads, followed by its separation in a distinct primordium, the invasion of the adrenal primordium by neural crest-derived cells to form the medulla, and finally its encapsulation. The fetal cortex is then replaced by a definitive cortex, which will establish zonation and be maintained throughout life by regeneration relying on the proliferation, centripetal migration, and differentiation of several stem/progenitor cell populations whose activities are sex-specific. Here, we highlight the advances made, using transgenic mouse models, to delineate the molecular mechanisms regulating these processes.
The Role of Mitochondria-Linked Fatty-Acid Uptake-Driven Adipogenesis in Graves Orbitopathy
Authors: Zhang Lei , Rai Pavandeep , Miwa Satomi , Draman Mohd Shazli , Rees D Aled , Haridas Anjana S , Morris Daniel S , Tee Andrew R , Ludgate Marian , Turnbull Doug M , Dayan Colin M
Published: September 2021

Context

Depot-specific expansion of orbital adipose tissue (OAT) in Graves orbitopathy (GO; an autoimmune condition producing proptosis, visual impairment and reduced quality of life) is associated with fatty acid (FA)-uptake–driven adipogenesis in preadipocytes/fibroblasts (PFs).

Objective

This work sought a role for mitochondria in OAT adipogenesis in GO.

Methods

Confluent PFs from healthy OAT (OAT-H), OAT from GO (OAT-GO) and white adipose tissue in culture medium compared with culture medium containing a mixed hormonal cocktail as adipogenic medium (ADM), or culture-medium containing FA-supplementation, oleate:palmitate:linoleate (45:30:25%) with/without different concentration of mitochondrial biosubstrate adenosine 5′-diphosphate/guanosine 5′-diphosphate (ADP/GDP), AICAR (adenosine analogue), or inhibitor oligomycin-A for 17 days. Main outcome measures included oil-red-O staining and foci count of differentiated adipocytes for in vitro adipogenesis, flow cytometry, relative quantitative polymerase chain reaction, MTS-assay/106 cells, total cellular-ATP detection kit, and Seahorse-XFe96-Analyzer for mitochondria and oxidative-phosphorylation (OXPHOS)/glycolysis-ATP production analysis.

Results

During early adipogenesis before adipocyte formation (days 0, 4, and7), we observed OAT-specific cellular ATP production via mitochondrial OXPHOS in PFs both from OAT-H and OAT-GO, and substantially disrupted OXPHOS-ATP/glycolysis-ATP production in PFs from OAT-GO, for example, a 40% reduction in OXPHOS-ATP and trend-increased glycolysis-ATP production on days 4 and 7 compared with day 0, which contrasted with the stable levels in OAT-H. FA supplementation in culture-medium triggered adipogenesis in PFs both from OAT-H and OAT-GO, which was substantially enhanced by 1-mM GDP reaching 7% to 18% of ADM adipogenesis. The FA-uptake–driven adipogenesis was diminished by oligomycin-A but unaffected by treatment with ADP or AICAR. Furthermore, we observed a significant positive correlation between FA-uptake–driven adipogenesis by GDP and the ratios of OXPHOS-ATP/glycolysis-ATP through adipogenesis of PFs from OAT-GO.

Conclusion

Our study confirmed that FA uptake can drive OAT adipogenesis and revealed a fundamental role for mitochondria-OXPHOS in GO development, which provides potential for therapeutic interventions.
Marginal Performances by Late Medieval Pigs and Blind Men
Authors: Carlson Marla
Published: September 2021

In 1425, Parisians under Anglo-Burgundian rule during the Hundred Years War enjoyed the spectacle of blind men in armor attempting to club a pig to death, in the process clubbing one another. Marginal images in Oxford, Bodleian Library, MS Bodley 264, a Flemish Romance of Alexander copied and illuminated roughly eighty years earlier, closely resemble this so-called game, and a dozen cities recorded iterations beginning in the thirteenth century and continuing into the fifteenth. The repetition suggests the workings of a scenario, which performance studies theorist Diana Taylor defines as a condensation of embodied practice and knowledge reactivated in multiple times and places to transmit culture from person to living person. Reading through the Bodley 264 Romance of Alexander in order to clarify the scenario's specific function in its Parisian context, this article argues that the strategic battering of marginal beings served to transmit a hierarchically ordered culture while forcefully expelling the Armagnac faction from the hierarchy's highest rank. Within this stark example of public violence that performatively materialized political division, the bodies of pigs and blind men resonated with multiple identity categories, and the dominant group whose power and cohesion the entertainment reinforced both ignored and enjoyed their trauma.
Redundant enhancers in the iab-5 domain cooperatively activate Abd-B in the A5 and A6 abdominal segments of Drosophila
Authors: Postika Nikolay , Schedl Paul , Georgiev Pavel , Kyrchanova Olga
Published: September 2021

The Abdominal-B (Abd-B) gene belongs to Bithorax complex and its expression is controlled by four regulatory domains, iab-5, iab-6, iab-7 and iab-8, each of which is thought to be responsible for directing the expression of Abd-B in one of the abdominal segments from A5 to A8. A variety of experiments have supported the idea that BX-C regulatory domains are functionally autonomous and that each domain is both necessary and sufficient to orchestrate the development of the segment they specify. Unexpectedly, we discovered that this model does not always hold. Instead, we find that tissue-specific enhancers located in the iab-5 domain are required for the proper activation of Abd-B not only in A5 but also in A6. Our findings indicate that the functioning of the iab-5 and iab-6 domains in development of the adult cuticle A5 and A6 in males fit better with an additive model much like that first envisioned by Ed Lewis.
Nutrition for Consumers
Authors:   University of North Texas, Connors Priscilla
Published: September 2021

This book is an introduction to everyday nutrition and its application to healthy living. It opens with a chapter on food safety and security that describes nutritious foods as safe to eat, available where people live, and easily accessed. The following chapter on nutrition recommendations introduces the reader to healthful eating practices and online food and nutrition resources such as U.S. Department of Agriculture and Food and Drug Administration. The third chapter describes how food and drink is transformed into nutrients that are absorbed and utilized. Chapters four through nine introduce six nutrient categories: Carbohydrates in Grains, Fruits, & Vegetables (4) , Lipids and Fats (5), Protein in Health and Food Sources (6), Vitamins in Health and Disease (7), Minerals Inorganic Nutrients (8), and Water in Health (9). Chapter 10 Nutrition in Healthy Living reviews the role that nutrition plays in promoting good health and reducing chronic disease risk.
Satisfacción del profesorado con la formación en servicio online: aproximaciones desde la usabilidad pedagógica
Authors: Turpo Gebera Osbaldo , Hurtado Mazeyra Alejandra , Delgado Sarmiento Yvan , Pérez Postigo Gerber Sergio
Published: September 2021

En los escenarios formativos, la usabilidad resulta fundamental para avanzar con mayor seguridad en la aprehensión de los contenidos formativos. La usabilidad pedagógica indica la satisfacción con la formación recibida, a partir de la valoración del diseño, la navegabilidad y los contenidos brindados por la plataforma virtual. Este estu-dio presenta una experiencia formativa evaluada por 152 docentes de educación superior participes de un curso ofertado por una universidad peruana. Se sigue un diseño metodológico combinado, de encuesta y entrevista. Los resultados obtenidos avalan el alto novel de satisfacción de los docentes respecto a la usabilidad de los recursos online. Este aspecto evidencia la importancia de considerar las características y motivaciones de los participantes en la planificación formativa a fin de contribuir a las re-flexiones que posibilitan la continuidad formativa en dichos entornos. De la misma forma, la valoración satis-factoria con la formación recibida en línea indica no solo una adaptación pertinente de los recursos a sus necesidades, sino también la adquisición de mayores niveles de madurez en el dominio de competencias digitales. Por este motivo, se reclama la interacción constructiva de la práctica pedagógica, así como la transferencia de la propuesta a otros contextos similares.
Percepción docente del uso de las TIC en la Educación Inclusiva
Authors: Vega-Gea Esther , Calmaestra Juan , Ortega-Ruiz Rosario
Published: September 2021

Las Tecnologías de la Información y la Comunicación juegan un papel clave en el proceso de inclusión, y claramente en la educación inclusiva. Es necesario tener en cuenta la percepción que los docentes tienen sobre el uso de las TIC en sus clases. Para ello se propusieron dos objetivos: confirmar la estructura factorial del cuestionario utilizado; y analizar el papel que determinadas variables como sexo, edad, nivel educativo y especialización tenían en la percepción del uso de las TIC que tenía el profesorado. Participaron 99 docentes de Educación Infantil, Primaria y Secundaria. Se utilizó el cuestionario sobre percepciones docentes hacia las TIC en el desarrollo de prácticas inclusivas (Pegalajar, 2015). Se realizaron análisis descriptivos, análisis factorial confirmatorio (AFC) y análisis de contraste de rangos. Los resultados del AFC confirmaron una estructura de cuatro factores y la idoneidad del instrumento. La percepción que los docentes tienen de la aplicación de las TIC en la educación inclusiva en general es positiva. Sin embargo, son los docentes especialistas quienes presentan una percepción más positiva. Este trabajo supone un avance científico en el análisis y profundización del estudio de la percepción docente sobre el uso que hacen de las TIC en sus prácticas inclusivas.
Tajwan: Dylematy rozwoju
Authors: Trojnar Ewa
Published: September 2021

TAIWAN: DILEMMAS OF DEVELOPMENT The primary research objective of the book is a comprehensive analysis of the evolution of Taiwan’s position in the international system. The specific objectives are related to the recognition of the potential of the island in the political, military, economic and social sectors; the dynamics of the relationship between them, as well as their evolution since 1949, so from the time when the ROC authorities were established on the island for a period of authoritarian regime in this country, to the present, already with the democratic government. The turning point summarizing the analysis is year 2013, the period of the second term of President Ma Ying-jeou (2012–2016) of the Nationalist Party (Kuomintang – the KMT) and the government of this party. The key to the problem is also the determination of the international environment of Taiwan, entering with its system in important interactions, and therefore identification of the area which integrates multi-level activity in Taiwan. The analysis will also concern the evaluation of the use of the potentials owned by Taiwan in shaping and implementation of strategic interests. Particular attention will be paid to Taiwan’s activity in the area of its natural neighborhood. Description and explanation of the position of Taiwan in the international system is accompanied by a research question about the type and nature of the interactions conditioning the achievement of a defined status.
Digital transformation in community nursing
Authors: Brown Antonia , Hartley Karen
Published: September 2021

Digital transformation has been making its mark on organisations in healthcare and beyond over the last few years, with no signs of stopping. In the NHS, much of the focus has been on acute services until recently, but this focus is now shifting towards community services, with Sussex Community Foundation Trust (SCFT) being named as the first community Digital Aspirant Trust by NHSx. This article explores what digital transformation is and uses SCFT's experiences to illustrate how this can provide benefits for community nurses. It considers what the future of digital transformation might look like and how clinicians can help to ensure patients remain central to any change.
Chronic obstructive pulmonary disease, exacerbation and self-management: a literature review
Authors: Boyer Paula
Published: September 2021

Chronic obstructive pulmonary disease (COPD) is being increasingly diagnosed in the UKs on the rise, and is expected to continue to rise due to an ageing population with multiple co-morbidities and exposure to risk factors, such as cigarette smoke, noxious gases and air pollutants. The prevalence of this disease is high is areas of socioeconomic deprivation and among high industrial areas. The use of self-management plans in COPD is recommended by the National Institute for Health and Care Excellence (NICE), to enable to patients with this disease to be competent and confident in taking part in managing their own health condition and recognising signs and symptoms of an exacerbation. The aim of this article is to discuss self-management of COPD and the clinical guidance surrounding exacerbation of disease. A follow-up literature review will focus on the effectiveness of self-management plans in COPD.
Lower limb wounds in diabetes: the challenges of wound healing
Authors: Gohil Krishna
Published: September 2021

Managing ulceration in the lower limb for a patient with diabetes can be complex and challenging, requiring a multiprofessional, patient-centred, holistic approach with early referral for specialist review as key. Any delay in referral and intervention can be catastrophic, as time is tissue. Peripheral arterial disease and neuropathy both contribute significantly to the delays in wound healing, and it is important to rapidly recognise the problems with an informed assessment and understand the possible reasons for delayed wound healing, so that management is appropriate, rapid referrals are made and patient outcomes are optimised. This article discusses some of the reasons why wound healing is complicated in those with diabetes as a comorbidity.
Wound bed preparation: an overview
Authors: Shamsian Negin
Published: September 2021

Wound bed preparation is the management of a wound in order to optimise healing and/or facilitate other therapeutic measures. It is the most pivotal step in healing wounds. Early referral to a specialist wound clinic can markedly improve the wound healing process. This overview will discuss the techniques involved in the preparation of the wound bed that will effectively accelerate the healing process. The process begins with a correct diagnosis of the wound and optimising the patient's medical condition. The TIMERS framework is discussed. Wound dressings, including the use of negative-pressure wound therapy, are discussed, along with debridement techniques and agents. The timing of wound intervention and evaluating progress will also be discussed, and wound bed preparation strategies will be included. There has been an added challenge of wound care in the community as a result of the COVID-19 pandemic. The present article provides an overview of how to prepare a wound bed in the community.
Chronic kidney disease in adult horses: causes, diagnosis and management
Authors: Gough Rachel , McGovern Kate
Published: September 2021

Chronic kidney disease is a rare disease in horses, unlike humans and companion animals where it is frequently encountered. There are multiple causes, although, since the disease typically presents late in the disease process, the instigating factor is often not ascertained. Clinical signs most commonly include weight loss, ventral oedema and polyuria-polydipsia. There is a need for more sensitive markers of renal damage or dysfunction so that the disease can be detected earlier in its course. Serum symmetric dimethylarginine and neutrophil gelatinase-associated lipocalin are potential biomarkers that are being investigated in this regard. Currently, once the diagnosis has been made, treatment is supportive only, with no options to halt the progression of the disease. Although this is a terminal condition, horses can be maintained with an adequate quality of life for several years after diagnosis in some cases.
Esomeprazole in the treatment of equine glandular gastric disease
Authors: Sundra Tania
Published: September 2021

Background:

Equine glandular gastric disease is a highly prevalent disease, for which there is no universally effective treatment. Given the widespread use of esomeprazole in the treatment of peptic ulcer disease in humans, its use in horses warrants further investigation.

Objective:

To assess rates of healing of equine glandular gastric disease using oral esomeprazole.

Study design:

Retrospective case series.

Methods:

Medical records and gastroscopy images of horses diagnosed with equine glandular gastric disease and treated with esomeprazole by Avon Ridge Equine Veterinary Services were reviewed.

Results:

Out of four horses treated with esomeprazole for 28 days, 75% (three) healed and 25% (one) did not improve. Out of three horses treated with esomeprazole for 14 days, 67% (two) healed and 33% (one) did not improve.

Main limitations:

The study was limited by its retrospective nature and small sample size.

Conclusions:

Esomeprazole may be a valid first-line treatment option for equine glandular gastric disease. Larger and more robust studies of esomeprazole are warranted.
Synthesis and Spectral studies of Ru (II) complexes with Macrocyclic Ligands
Authors: Rajak Ashish , Srivastava Arpit , Shrivastava Subhash Chandra , Chauhan Ranjeet Singh , Patel Uday Singh , Srivastava Shekhar
Published: September 2021

Fifteen Ru (II) complexes of the type [RuCl2(L)] (where L= N4 donor macrocyclic ligands) have been synthesised by reaction of [(RuCl2(DMSO)4] with fifteen macrocyclic Schiff base ligands containing N4 donors groups. The prepared fifteen [RuCl2(L)] complexes were characterised by elemental analysis, molar conductivity, UV-visible, IR, X- ray photoelectron spectra (XPS) and magnetic susceptibility measurementsand an octahedral geometry was proposed for all these complexes.
Role of Adsorbents in Treatment of Pollutants from Aqueous Medium
Authors: Laiq Esmat , Jabin Shagufta , Gupta Priti
Published: September 2021

This paper will provide an outline of the dissolved pollutants and their removal techniques from water and wastewater. Dissolved impurities are omnipresent in all kinds of water like ground water, surface water and other industrial sewage. Many methods are available for the treatment of dissolved pollutants. Rather than the conventional methods such as membrane technology, coagulation- flocculation method, electro dialysis, and ion exchange method for removing dissolved impurities from a different kind of water, the applicability of the adsorption technique is a simple, economical and the most potential one. Adsorbents may be conventional and non-conventional. Activated carbon and silica gel are included in conventional materials. Activated carbon is preferred material for removing pharmaceutical waste, heavy metals, and dyes from an aqueous medium. They can remove larger and smaller particles from water and wastewater due to their porosity. Among non-conventional methods, clay minerals and zeolites are used in both natural and modified forms as potential adsorbents. Bio-sorbents like industrial waste, agro waste, and chitosan have unique properties to be used as adsorbents to remove dissolved impurities from an aqueous medium. It also outlines mechanism of adsorption and complex relation between adsorbents and adsorbates. Considering the applicability of different adsorbents discussed here for the removal of heavy metals, pharmaceutical waste, dyes, and organic waste, it is expected that this technique can be helpful in further treatment in variety of water and wastewater.
New Reagent of Coupling Reaction for Spectrophotometric Determination of Paracetamol in Pharmaceutics
Authors: Azeez Kurdistan F. , Tahir Tara F. , Kokhasmail Dashne M.
Published: September 2021

New reagent 2- hydroxybenzaldehydewas used in a coupling reaction for determination of paracetamol via spectrophotometric method. The proposition of simplicity, inexpensive, rapidity and sensitivity were conducted via spectrophotometric procedure. The method was based on diazotization of paracetamol and coupling with 2-hydroxybenzaldehyde in alkaline medium. Linear concentration range (0.50 - 12.00) µg/ml was comply Beer’s law at maximum wavelength 444 nm and detection limit (LOD) 0.05 µg/ml. The molar absorptivity and regression coefficient of (R2) were 1.2032×104 l/mol.cm, 0.9995, respectively. The suggested method was profitablyadapted for the determination of paracetamol in pharmaceutics. The results attained were in good agreement with thatone by standard method high performance liquid chromatography (HPLC).
Development of a Validated High-Performance Liquid Chromatographic Method in Reverse Phase for Simultaneously Determining Triamcinolone Acetonide and Benzyl Alcohol in Injectable Suspension.
Authors: Tiwari Vivek , Mishra S.K.
Published: September 2021

A high-performance liquid chromatographic stability-indicating assaymethod in reverse-phase has been developed and validated for the simultaneous qualitative and quantitative measurement of triamcinolone acetonide and benzyl alcohol content in injectable suspension. The reverse-phase method was developed by using Inertsil ODS-2 column(100 x 4.6mm),5μm. with a mobile phase ratio comprised of water and acetonitrile mixed in 70:30 v/v ratio and pumped at a flow rate of 1.5 ml/min where the temperature of the column oven controlled at 40°C and sample compartment at 5°C with 10μL injection volume. Benzyl Alcohol and Triamcinolone Acetonide had retention times of 1.80 and 5.60 minutes, respectively with UV detection for benzyl alcohol at 215 nm and triamcinolone acetonide at 254 nm. The guidelines of the International Conference on Harmonization were used for the validation of this novel method. During validation, the developed approach was shown to be exact, accurate, linear, robust, rugged, and stable. The detector was showing linear response in a range of 10 µg/mlto 120 µg/ml and 2.5 µg/ml to 30 µg/ml for triamcinolone Acetonide and benzoyl alcohol respectively.
A Study on Groundwater Quality Based on Major Ion Chemistry of Jharkhand State in India: A Review
Authors: Pramanik Arun Kumar , Das Sandip Kumar , Chatterjee Abhik
Published: September 2021

Groundwater is prime and major source of drinking water in our world. Groundwater in Jharkhand is also used for drinking, domestic, irrigation, mining and industrial etc. purposes. In Jharkhand some population are suffering from scarcity of pure drinking water and some population have partial facility with drinking water as groundwater of many area of Jharkhand are contaminated with fluoride, arsenic, heavy metals and iron etc. dangerous chemicals. This review paper focuses on current status of groundwater and contamination of different water quality parameters based on major ion chemistry in Jharkhand. The discussed water quality parameters in this study are water temperature, pH, electrical conductivity, total dissolved solid, total hardness, calcium, magnesium, iron, sodium, potassium, chloride, fluoride, arsenic, carbonate, bicarbonate, phosphate, nitrate and sulphate.
hERG Channel-Related Cardiotoxicity Assessment of 13 Herbal Medicines
Authors: Ha Hyekyung , Lee Sion , Kim Dong-Hyun , Seo Chang-Seob , Shin Hyeun-kyoo
Published: September 2021

Objectives: As the use of herbal medicinal products (HMPs) increases worldwide, systematic verification of the safety of HMPs is required. The induction of cardiotoxicity is one of the major factors in post-approval withdrawal of medicinal products, and drug-induced cardiotoxicity assessment is emerging as an important step in drug development. In the present study, we evaluated human ether-à-go-go-related gene (hERG) potassium channel-related cardiotoxicity to predict the risk of cardiac arrhythmia in thirteen herbal medicines known to have cardiac toxicity. Methods: We measured the inhibition rate of hERG potassium channel activity of 13 medicinal herbal extracts in hERG-expressing HEK 293 cells using an automated patch-clamping system. Quinidine was used as a positive control for inhibition of hERG activity. Results: Extracts of Evodiae Fructus, Strychni Semen, and Corydalis Tuber potently inhibited the activity of hERG, and IC50 values were 3.158, 19.87, and 41.26 μg/mL, respectively. Cnidi Fructus, Ephedra Herba, Lithospermi Radix, Polygoni Multiflori Radix, Visci Ramulus et Folium, Asiasari Radix et Rhizoma, and Scolopendra weakly inhibited hERG activity, and the IC50 value for each herbal medicine was more than 400 μg/mL. Aconiti Kusnezoffii Tuber and two types of Aconiti Lateralis Radix Preparata (Po and Yeom) had weak inhibitory activity against hERG, and the IC50 values were more than 700 μg/mL. The IC50 value of quinidine against hERG was 1.021 μM. Conclusion: Evodiae Fructus, Strychni Semen, and Corydalis Tuber acted as potent inhibitors against hERG. These herbal medicines may cause cardiac arrhythmia through QT prolongation, so care should be taken when taking them.
A Retrospective Study of Traffic Accident Inpatients in a Korean Medicine Hospital: Correlation of STAI-Ⅰ, STAI-Ⅱ, BDI, and CSEI-s scores with Pain Improvement
Authors: Lee Seung Min , Lee Cham Kyul , Lee Eun Yong , Roh Jeong Du
Published: September 2021

Objectives: The objective of this study was to investigate the correlation of the scores on the State-Trait Anxiety Inventory-Ⅰ (STAI-Ⅰ), State-Trait Anxiety Inventory-Ⅱ (STAI-Ⅱ), Beck’s Depression Inventory (BDI), and Core Seven Emotions Inventory-short form (CSEI-s) scales with pain improvement. Methods: We retrospectively investigated the medical records of 66 traffic accident inpatients who satisfy the selection criteria. They had received Korean medical treatment including acupuncture, electroacupuncture, pharmacopuncture, herbal medicine, and Chuna during hospitalization. STAI-Ⅱ, BDI, and CSEI-s scores on hospital day 1, and STAI-Ⅰ and numerical rating scale(NRS) scores on hospital day 1, 4, 7, and 10 were used for analysis. Pain improvement was evaluated by difference in NRS scores between hospital day 1 and hospital day 4, 7, 10. Results: The STAI-Ⅰ, BDI, and CSEI-s scores showed significant correlations with pain or pain improvement. Conclusions: This study may be used in the research on psychological state and pain management of traffic accident patients and for patient education. Large-scale, well-designed studies need to be conducted in future to strengthen the results in this regard.
3.5  kW narrow-linewidth monolithic fiber amplifier at 1064  nm by employing a confined doping fiber
Authors: Huang Zhimeng , Shu Qiang , Luo Yun , Tao Rumao , Feng Xi , Liu Yu , Lin Honghuan , Wang Jianjun , Jing Feng
Published: September 2021

A high-power monolithic continuous-wave fiber amplifier at 1064 nm has been demonstrated based on a piece of confined ytterbium-doped fiber, which generated 3.5 kW narrow-linewidth laser with near-diffraction-limited beam quality. By tailoring the diameter of gain dopant across the fiber core, and optimizing the profile of refractive index and doping concentration, the confined doping fiber works making the fundamental mode more dominant in transverse mode competition, while suppressing the high-order mode. In a kilowatt-level narrow-linewidth fiber master oscillator power amplifier (MOPA) system, the threshold of mode instability (MI) is about 2.2 times as much as that of the conventional fiber amplifier. Then, by increasing seed power and utilizing a MOPA configuration with four amplifier stages, up to 3.57 kW signal output, a slope efficiency of 61% without any sign of MI or stimulated Raman scattering for a spectral dynamic range of higher than

−

50

d
B

is obtained. A further increase of the output power was only limited by the available laser-diode pump power. To the best of our knowledge, this is the highest narrow-linewidth laser power generated from the confined doping monolithic fiber amplifier.
Effect of noisy channels on the transmission of mesoscopic twin-beam states
Authors: Allevi Alessia , Bondani Maria
Published: September 2021

Quantum properties of light, which are crucial resources for quantum technologies, are quite fragile in nature and can be degraded and even concealed by the environment. We show, both theoretically and experimentally, that mesoscopic twin-beam states of light can preserve their nonclassicality even in the presence of major losses and different types of noise, thus suggesting their potential usefulness to encode information in quantum communication protocols. We develop a comprehensive general analytical model for a measurable nonclassicality criterion and find thresholds on noise and losses for the survival of entanglement in the twin beam.