bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical students in distress: The impact of gender, race, debt, and disability
Authors: Rajapuram Nikhil , Langness Simone , Marshall Megan R. , Sammann Amanda
Published: December 2020

Background

In 2012, over half of US medical students experienced burnout and depression. Since that time, there have been many changes to student demographics, school resources and awareness of burnout in the medical field altogether. New tools are also available to screen for student distress, a condition that correlates with low mental quality-of-life, suicidal ideation and serious thoughts of dropping out. Despite increased attention on wellbeing and improved screening methods, no large-scale studies have evaluated student distress in the modern era of medical education. The objective of this study was to determine the current prevalence of medical student distress and contributing risk factors.

Methods

Student wellbeing from a national cohort of US medical students was measured with an electronic survey in a prospective, observational survey study from 2019–2020. Medical student distress was defined as a Medical Student Wellbeing Index (MS-WBI) of ≥4. Demographic details including age, race, gender, marital status, disability, desired specialty, and debt burden were evaluated in a multivariate logistic regression model to determine possible risk factors for the development of distress.

Results

A total of 3,162 students responded to the survey, representing 110 unique medical schools. Of these respondents, 52.9% met criteria for distress and 22% had either taken or considered taking a leave of absence for personal wellbeing. Independent risk factors for distress included involvement in the clinical phase of medical school (OR 1.37); non-male gender (OR 1.6); debt burden >$20,000 (OR 1.37), >$100,000 (OR 1.81), and >$300,000 (OR 1.96); and disability status (OR 1.84).

Conclusions

Medical student wellbeing remains poor in the modern era of medical education despite increased attention to wellbeing and increased availability of wellbeing resources. Disability status is a novel risk factor for distress identified in this study. The persistence of previously identified risk factors such as non-male gender, debt burden and clinical phase of school suggest that efforts to curb medical student distress have been inadequate to date.
Deep learning based automatic segmentation of metastasis hotspots in thorax bone SPECT images
Authors: Lin Qiang , Luo Mingyang , Gao Ruiting , Li Tongtong , Man Zhengxing , Cao Yongchun , Wang Haijun
Published: December 2020

SPECT imaging has been identified as an effective medical modality for diagnosis, treatment, evaluation and prevention of a range of serious diseases and medical conditions. Bone SPECT scan has the potential to provide more accurate assessment of disease stage and severity. Segmenting hotspot in bone SPECT images plays a crucial role to calculate metrics like tumor uptake and metabolic tumor burden. Deep learning techniques especially the convolutional neural networks have been widely exploited for reliable segmentation of hotspots or lesions, organs and tissues in the traditional structural medical images (i.e., CT and MRI) due to their ability of automatically learning the features from images in an optimal way. In order to segment hotspots in bone SPECT images for automatic assessment of metastasis, in this work, we develop several deep learning based segmentation models. Specifically, each original whole-body bone SPECT image is processed to extract the thorax area, followed by image mirror, translation and rotation operations, which augments the original dataset. We then build segmentation models based on two commonly-used famous deep networks including U-Net and Mask R-CNN by fine-tuning their structures. Experimental evaluation conducted on a group of real-world bone SEPCT images reveals that the built segmentation models are workable on identifying and segmenting hotspots of metastasis in bone SEPCT images, achieving a value of 0.9920, 0.7721, 0.6788 and 0.6103 for PA (accuracy), CPA (precision), Rec (recall) and IoU, respectively. Finally, we conclude that the deep learning technology have the huge potential to identify and segment hotspots in bone SPECT images.
COVID-19 misinformation: Mere harmless delusions or much more? A knowledge and attitude cross-sectional study among the general public residing in Jordan
Authors: Sallam Malik , Dababseh Deema , Yaseen Alaa , Al-Haidar Ayat , Taim Duaa , Eid Huda , Ababneh Nidaa A. , Bakri Faris G. , Mahafzah Azmi
Published: December 2020

Since the emergence of the recent coronavirus disease 2019 (COVID-19) and its spread as a pandemic, media was teeming with misinformation that led to psychologic, social and economic consequences among the global public. Probing knowledge and anxiety regarding this novel infectious disease is necessary to identify gaps in knowledge and sources of misinformation which can help public health efforts to design and implement more focused interventional measures. The aim of this study was to evaluate the knowledge, attitude and effects of misinformation about COVID-19 on anxiety level among the general public residing in Jordan. This cross-sectional study was conducted using an online-based questionnaire that took place in April 2020, which targeted people residing in Jordan, aged 18 and above. The questionnaire included items on the following: demographic characteristics of the participants, knowledge about COVID-19, anxiety level and misconceptions regarding the origin of the pandemic. The total number of participants included in final analysis was 3150. The study population was predominantly females (76.0%), with mean age of 31 years. The overall knowledge of COVID-19 was satisfactory. Older age, males, lower monthly income and educational levels, smoking and history of chronic disease were associated with perceiving COVID-19 as a very dangerous disease. Variables that were associated with a higher anxiety level during the pandemic included: lower monthly income and educational level, residence outside the capital (Amman) and history of smoking. Misinformation about the origin of the pandemic (being part of a conspiracy, biologic warfare and the 5G networks role) was also associated with higher anxiety levels. Social media platforms, TV and news releases were the most common sources of information about the pandemic. The study showed the potential harmful effects of misinformation on the general public and emphasized the need to meticulously deliver timely and accurate information about the pandemic to lessen the health, social and psychological impact of the disease.
The impact of funding for federally qualified health centers on utilization and emergency department visits in Massachusetts
Authors: Myong Catherine , Hull Peter , Price Mary , Hsu John , Newhouse Joseph P. , Fung Vicki
Published: December 2020

Importance

Federally qualified health centers (FQHCs) receive federal funding to serve medically underserved areas and provide a range of services including comprehensive primary care, enabling services, and behavioral health care. Greater funding for FQHCs could increase the local availability of clinic-based care and help reduce more costly resource use, such as emergency department visits (ED).

Objective

To examine the impact of funding increases for FQHCs after the ACA on the use of FQHCs and EDs.

Methods

Retrospective study using the Massachusetts All Payer Claims Database (APCD) 2010–2013 that included APCD enrollees in 559 Massachusetts ZIP codes (N = 6,173,563 in 2010). We calculated shift-share predictions of changes in FQHC funding at the ZIP code-level for FQHCs that received Community Health Center funds in any year, 2010–13 (N = 31). Outcomes were the number of ZIP code enrollees with visits to FQHCs and EDs, overall and for emergent and non-emergent diagnoses.

Results

In 2010, 4% of study subjects visited a FQHC, and they were more likely to be younger, have Medicaid, and live in low-income areas. We found that a standard deviation increase in prior year FQHC funding (+31 percentage point (pp)) at the ZIP code level was associated with a 2.3pp (95% CI 0.7pp to 3.8pp) increase in enrollees with FQHC visits and a 1.3pp (95% CI -2.3pp to -0.3pp) decrease in enrollees with non-emergent ED visits, but no significant change in emergent ED visits (0.3pp, 95% CI -0.8pp to 1.4pp).

Conclusions

We found that areas exposed to greater FQHC funding increases had more growth in the number of enrollees seen by FQHCs and greater reductions in ED visits for non-emergent conditions. Investment in FQHCs could be a promising approach to increase access to care for underserved populations and reduce costly ED visits, especially for primary care treatable or non-emergent conditions.
Rates, costs and determinants of lumbar spine imaging in population-based women born in 1973–1978: Data from the Australian Longitudinal Study on Women’s Health
Authors: Wang Yuanyuan , Hussain Sultana Monira , Wluka Anita E. , Lim Yuan Z. , Urquhart Donna M. , Mishra Gita D. , Teede Helena , Doust Jenny , Brown Wendy J. , Cicuttini Flavia M.
Published: December 2020

Objective

There are concerns that lumbar spine imaging represents low value care. Our aim was to examine the use of lumbar spine imaging [radiography, computed tomography (CT), magnetic resonance imaging (MRI)] over 20 years, and costs and person-level characteristics of imaging in a large cohort of Australian women.

Methods

The Australian Longitudinal Study on Women’s Health (ALSWH) is a longitudinal population-based survey of women randomly selected from national health insurance scheme (Medicare) database. This study examined 13458 women born in 1973–1978 who consented to link their ALSWH and Medical Benefits Scheme records. Self-reported data on demographics, body mass index, depression, physical and mental health, and back pain were collected in each survey performed in 1996, 2000, 2003, 2006, 2009, 2012, and 2015. Data on lumbar spine imaging from 1996 to 2015 were obtained from the Medical Benefits Scheme database.

Results

38.9% of women underwent some form of lumbar spine imaging over 20 years. While radiography increased from 1996 to 2011 and decreased thereafter, CT and MRI continued to increase from 1996 to 2015. In women with self-reported back pain, depression and poorer physical health were associated with imaging, with no significant differences in types of imaging. Based on imaging rates in ALSWH, the estimated costs for Australian women aged 30–39 years were AU$51,735,649 over 2011–2015.

Conclusions

Lumbar spine imaging was common in population-based Australian women, with rates increasing over 20 years. Depression and poor physical health were associated with lumbar spine imaging. Raising awareness of this in clinicians is likely to result in significant cost savings if clinical guidelines are followed, with the potential of freeing resources for high value care and health outcomes.
Using the SNAP-Tag technology to easily measure and demonstrate apoptotic changes in cancer and blood cells with different dyes
Authors: Woitok Mira , Grieger Elena , Akinrinmade Olusiji A. , Bethke Susanne , Pham Anh Tuan , Stein Christoph , Fendel Rolf , Fischer Rainer , Barth Stefan , Niesen Judith
Published: December 2020

In vitroandex vivodevelopment of novel therapeutic agents requires reliable and accurate analyses of the cell conditions they were preclinical tested for, such as apoptosis. The detection of apoptotic cells by annexin V (AV) coupled to fluorophores has often shown limitations in the choice of the dye due to interference with other fluorescent-labeled cell markers. The SNAP-tag technology is an easy, rapid and versatile method for functionalization of proteins and was therefore used for labeling AV with various fluorophores. We generated the fusion protein AV-SNAP and analyzed its capacity for the specific display of apoptotic cells in various assays with therapeutic agents. AV-SNAP showed an efficient coupling reaction with five different fluorescent dyes. Two selected fluorophores were tested with suspension, adherent and peripheral blood cells, treated by heat-shock or apoptosis-inducing therapeutic agents. Flow cytometry analysis of apoptotic cells revealed a strong visualization using AV-SNAP coupled to these two fluorophores exemplary, which was comparable to a commercial AV-Assay-kit. The combination of the apoptosis-specific binding protein AV with the SNAP-tag provides a novel solid method to facilitate protein labeling using several, easy to change, fluorescent dyes at once. It avoids high costs and allows an ordinary exchange of dyes and easier use of other fluorescent-labeled cell markers, which is of high interest for the preclinical testing of therapeutic agents in e.g. cancer research.
PolyFold: An interactive visual simulator for distance-based protein folding
Authors: McGehee Andrew J. , Bhattacharya Sutanu , Roche Rahmatullah , Bhattacharya Debswapna
Published: December 2020

Recent advances in distance-based protein folding have led to a paradigm shift in protein structure prediction. Through sufficiently precise estimation of the inter-residue distance matrix for a protein sequence, it is now feasible to predict the correct folds for new proteins much more accurately than ever before. Despite the exciting progress, a dedicated visualization system that can dynamically capture the distance-based folding process is still lacking. Most molecular visualizers typically provide only a static view of a folded protein conformation, but do not capture the folding process. Even among the selected few graphical interfaces that do adopt a dynamic perspective, none of them are distance-based. Here we present PolyFold, an interactive visual simulator for dynamically capturing the distance-based protein folding process through real-time rendering of a distance matrix and its compatible spatial conformation as it folds in an intuitive and easy-to-use interface. PolyFold integrates highly convergent stochastic optimization algorithms with on-demand customizations and interactive manipulations to maximally satisfy the geometric constraints imposed by a distance matrix. PolyFold is capable of simulating the complex process of protein folding even on modest personal computers, thus making it accessible to the general public for fostering citizen science. Open source code of PolyFold is freely available for download athttps://github.com/Bhattacharya-Lab/PolyFold. It is implemented in cross-platform Java and binary executables are available for macOS, Linux, and Windows.
Retinal changes in COVID-19 hospitalized cases
Authors: Lani-Louzada Rafael , Ramos Carolina do Val Ferreira , Cordeiro Ricardo Mello , Sadun Alfredo A.
Published: December 2020

The main objective of this study was to evaluate the retinas of severely or critically ill COVID-19 patients during their hospital stay, at varying time points after symptoms onset. This was a case series observed during May 2020 in two referral centers for COVID-19 treatment in Rio de Janeiro, Brazil. 47 eyes from 25 hospitalized patients with severe or critical confirmed illness were evaluated. A handheld retinal camera was used to acquire bilateral fundus images at several time points after symptoms onset. Electronic health records were retrospectively analyzed and clinical data collected. Severe and critical diseases were noticed in 52% (13/25) and 48% (12/25) of enrolled patients, respectively. Retinal changes were present in 12% (3/25) of patients: a 35 year-old male demonstrated bilateral nerve fiber layer infarcts and microhemorrhages in the papillomacular bundle, but required mechanical ventilation and developed severe anemia and systemic hypotension, acute kidney injury and neurologic symptoms during the course of the disease (critical illness); a 56 year-old male, who required full enoxaparin anticoagulation due to particularly elevated D-dimer (>5.0 mcg/mL), demonstrated unilateral and isolated flame-shaped hemorrhages; and a 49 year-old hypertensive male showed bilateral and discrete retinal dot and blot microhemorrhages. The other 22 patients evaluated did not demonstrate convincing retinal changes upon examination. There was no correlation between disease severity and admission serum levels of CRP, D-dimer and ferritin. This was the first study to show that vascular retinal changes may be present in not insignificant numbers of severe or critical COVID-19 inpatients. These retinal changes, only seen after morbid developments, were likely secondary to clinical intercurrences or comorbidities instead of a direct damage by SARS-CoV-2, and may be important and easily accessible outcome measures of therapeutic interventions and sentinels of neurologic and systemic diseases during COVID-19 pandemic.
The Hospital Anxiety and Depression Scale (HADS) applied to Ethiopian cancer patients
Authors: Wondie Yemataw , Mehnert Anja , Hinz Andreas
Published: December 2020

Psychological distress is a common problem associated with cancer. The main objective of the present study was to test the Hospital Anxiety and Depression Scale (HADS) in a sample of Ethiopian cancer patients and to compare the results with those obtained from a sample in Germany. Data were collected from 256 cancer patients who visited the University of Gondar Hospital between January 2019 and June 2019 using the HADS, the European Organization for Research and Treatment of Cancer Quality of Life questionnaire (EORTC QLQ-C30), and the Multidimensional Fatigue Inventory MFI-20. The reliability of the HADS was good, with Cronbach’s α coefficients of 0.86 (anxiety), 0.85 (depression), and 0.91 (total scale). The Ethiopian cancer patients were more anxious (M = 7.9) and more depressed (M = 9.3) than the German patients (M = 6.8 for anxiety and M = 5.5 for depression). Only a weak level of measurement invariance was detected between the Ethiopian and the German sample. In the Ethiopian sample, anxiety and depression were associated with tumor stage (high levels in stage 4) and treatment (high levels for patients not receiving surgery and chemotherapy). Both anxiety and depression were significantly associated with all of the EORTC QLQ-C30 and MFI-20 scales. The HADS proved to be applicable for use with Ethiopian cancer patients. The high level of anxiety and depression present in that group indicates a need for psychosocial care.
DSAVE: Detection of misclassified cells in single-cell RNA-Seq data
Authors: Gustafsson Johan , Robinson Jonathan , Inda-Díaz Juan S. , Björnson Elias , Jörnsten Rebecka , Nielsen Jens
Published: December 2020

Single-cell RNA sequencing has become a valuable tool for investigating cell types in complex tissues, where clustering of cells enables the identification and comparison of cell populations. Although many studies have sought to develop and compare different clustering approaches, a deeper investigation into the properties of the resulting populations is lacking. Specifically, the presence of misclassified cells can influence downstream analyses, highlighting the need to assess subpopulation purity and to detect such cells. We developed DSAVE (Down-SAmpling basedVariationEstimation), a method to evaluate the purity of single-cell transcriptome clusters and to identify misclassified cells. The method utilizes down-sampling to eliminate differences in sampling noise and uses a log-likelihood based metric to help identify misclassified cells. In addition, DSAVE estimates the number of cells needed in a population to achieve a stable average gene expression profile within a certain gene expression range. We show that DSAVE can be used to find potentially misclassified cells that are not detectable by similar tools and reveal the cause of their divergence from the other cells, such as differing cell state or cell type. With the growing use of single-cell RNA-seq, we foresee that DSAVE will be an increasingly useful tool for comparing and purifying subpopulations in single-cell RNA-Seq datasets.
Corneal thickness evaluation in healthy eyes: Comparison between two different Scheimpflug devices
Authors: Rosa Nicola , De Bernardo Maddalena , Pepe Angela , Vitiello Livio , Marotta Giuseppe , Imparato Roberto , Capasso Luigi
Published: December 2020

Purpose

To evaluate the correlation between corneal thickness (CT) measurements obtained with two Scheimpflug devices, Pentacam HR and Precisio, and to elaborate, if necessary, a regression formula which could make these results comparable.

Design

Retrospective, Comparative, Observational study.

Setting

Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana” University of Salerno, Italy

Methods

One hundred twenty four healthy eyes of 124 volunteers (65 males; range: 20–32 years; mean age of 24.8 ± 1.7) were included in this study. CT was measured using Pentacam HR and Precisio in three different points: the pupil center (PC), the corneal apex (CA) and the thinnest point (TP).

Results

CT obtained with both devices at the PC, at the CA and at the TP showed a good correlation (r = 0.97, r = 0.97, r = 0.97, respectively), but Pentacam HR measurements were significantly thicker than those provided by Precisio (p < 0.01). The differences between Pentacam HR and Precisio were 21.9 ± 8.8 μm at the PC, 21.9 ± 8.9 μm at the CA, 19.1 ± 9.0 μm at the TP. The calculated regression formulas were: y = 0.9558x + 2.3196 for the PC, y = 0.9519x + 4.5626 for the CA, y = 0.9364x + 15.436 for the TP, where x is the CT measured with Pentacam HR and y is the Precisio measurement.

Conclusions

The findings provided by this study highlight that Precisio measures thinner corneas compared to Pentacam HR. The identified regression formulas could be utilized to make interchangeable the results obtained with these two devices.
Expression analysis of microbial rhodopsin-like genes in Guillardia theta
Authors: Konno Masae , Yamauchi Yumeka , Inoue Keiichi , Kandori Hideki
Published: December 2020

The CryptomonadGuillardia thetahas 42 genes encoding microbial rhodopsin-like proteins in their genomes. Light-driven ion-pump activity has been reported for some rhodopsins based on heterologousE.colior mammalian cell expression systems. However, neither their physiological roles nor the expression of those genes in native cells are known. To reveal their physiological roles, we investigated the expression patterns of these genes under various growth conditions. Nitrogen (N) deficiency induced color change in exponentially growingG.thetacells from brown to green. The 29 rhodopsin-like genes were expressed in native cells. We found that the expression of 6 genes was induced under N depletion, while that of another 6 genes was reduced under N depletion.
El cine comercial como medio de aprendizaje de la Farmacología
Authors: Pérez-Mañá Clara , Farré Magí , Papaseit Esther , Baños Josep-Eladi
Published: December 2020

Las películas comerciales se utilizan cada vez más como método de enseñanza en muchas disciplinas universitarias. En medicina son un recurso importante para enseñar algunos aspectos médicos al ser ilustrados usando el lenguaje cinematográfico. La relación médico-paciente, los dilemas éticos o el profesionalismo son alguno de los temas más presentes en las películas comerciales. En el presente manuscrito tratamos del interés del cine comercial en el campo de la farmacología, cuyo conocimiento está en la frontera de los campos básicos y clínicos. Revisamos el uso de películas para mejorar la enseñanza y aprendizaje de la farmacología y la farmacología clínica. Por ello describimos algunas películas que son especialmente útiles para este propósito, como Awakenings / Despertares de 1990, Lorenzo’s oil / El aceite de Lorenzo de 1992, The constant gardener / El jardinero fiel de 2005 y más recientemente Dallas Buyers Club (2013). Se incluyen algunas recomendaciones para su uso óptimo en la enseñanza de farmacología y farmacología clínica.
Recent Advances in Apricot Dehydration
Authors: T.A Saufishan. , S Harimuthiah. , Arokiyaraj.A Ajay , C Arshiya. , G Aravind. , S S.Sangeetha Gandhi, Gowthami.
Published: December 2020

Fruits like apricot have high water activity and they are highly heat sensitive and easily degradable. About 50% of the apricot fruit produced in a year getting wasted due to the short harvest season and the sensitivity to storage even at refrigerated conditions. For that drying methods are used and dehydration must not only be efficient and economic but also yield high-quality products based on flavour, nutrients, colour, rehydration, uniformity, appearance, and texture.
Translumbosacral Neuromodulation Therapy Is a Promising Option for Fecal Incontinence
Authors: Bharucha Adil E. , Oblizajek Nicholas R.
Published: December 2020

Fecal incontinence is a common symptom that can significantly impair quality of life. The treatment options range from conservative measures (e.g., Kegel exercises, pelvic floor biofeedback therapy, fiber supplementation, or medications) to noninvasive nerve stimulation (e.g., posterior tibial nerve stimulation and transcutaneous tibial nerve stimulation), implanted neurostimulation (i.e., sacral nerve stimulation), perianal injection of dextranomer, and anal sphincteroplasty. In this issue of the journal, a promising, uncontrolled study suggests that noninvasive, repetitive magnetic stimulation of the lumbosacral nerves significantly improved symptoms, increased anal squeeze pressure, and increased rectal compliance in patients with fecal continence. Sham-controlled studies are necessary to confirm these findings.
Clinical Course of Chronic Pancreatitis During Pregnancy and its Effect on Maternal and Fetal Outcomes
Authors: Mahapatra Soumya Jagannath , Midha Shallu , Teja Gadella Varun , Vajpai Tanmay , Singh Nilanchali , Sahoo Sushree Monika , Pandey Shivam , Elhence Anshuman , Sethia Rahul , Garg Pramod Kumar
Published: December 2020

Introduction:

There are limited data on the effect of chronic pancreatitis (CP) on pregnancy outcomes and vice versa. Our aim was to evaluate the clinical trajectory of CP during pregnancy and its effect on pregnancy outcomes.

Methods:

All female patients of child-bearing age (≥15 years) diagnosed with CP were studied from January 2004 to July 2019. The change in frequency of painful episodes was assessed before, during, and after pregnancy. Maternal and fetal outcomes were compared between pregnant women (early onset) and women presenting with CP after completion of all pregnancies (late onset).

Results:

Of 187 women with CP, pregnancy outcomes and clinical course were assessed in 99 patients. The frequency of painful exacerbations was significantly lower during pregnancy compared with prepregnancy and postpregnancy periods (P < 0.001). The median pain score decreased significantly to 0 (0–2) during pregnancy from 3 (0–6) before conception and increased to 4 (0–8) after pregnancy (P = 0.002). Women with early onset CP (n = 57) had their first child later and had fewer pregnancies compared with those with late onset CP (n = 42). There was no difference in maternal outcomes such as gestational diabetes, hypertension, and preterm delivery, and fetal outcomes such as abortion, low birth weight, and still birth between the groups. There was no reported congenital anomaly.

DISCUSSION:

Younger patients with CP had later and fewer pregnancies, but there was no increased risk of adverse maternal and fetal outcomes. The clinical course of CP was usually benign during pregnancy with decreased frequency and severity of pain.
Short-term outcomes of treatment of active stage of Charcot foot in outpatient setting
Authors: Demina Anastasia G. , Bregovskiy Vadim B. , Karpova Irina A.
Published: December 2020

Background: Treatment options in patients with an acute Charcot foot is not well standardized and still challenging.

Aims: To evaluate the results of the non-operative treatment of patients with active stage of diabetic charcot arthropathy in outpatient foot clinic and to identify factors influenced on treatment results.

Materials and methods: Medical files of 141 patients with unilateral ulcer-free active charcot arthropathy were reviewed. 78 patients agreed for treatment (total contact cast or walker), 63 patients refused of treatment (follow-up only). The time of resolution of the acute stage, severity of final deformities and foot-related complications were evaluated. Refusers were asked about the cause of their decision.

Results: Mean delay of the diagnosis was 3,2±2,8 months. Main causes of the refuse were: mistrust to doctor - 38%, problems with employment - 33%, home/family problems - 18%, medical reasons - 11%. Median healing times (months) in the treatment group vs controls: 9 (6 - 19) 15 (13 - 25) (p=0,001) and progression of the initial deformity: 14% and 35%, respectively (p=0,01). Foot-related complications: 17,5% in the treatment group and in 55,6% of controls (including 6 amputations) (p=0,001). Frequency of breaking the cast/walker - 32%/16,6%. Foot lesions due to cast/walker: 13,6%/41,7% (p<0,01). Median healing times (months) with walkers - 13 (11 - 19), with casts - 9 (6 - 15) months (р=0,02). The use of crutches shortened healing time.

Conclusions: The significant delay of diagnosis was revealed. The refuse rate in our cohort was high and main causes of the refuse were social and psychological. Neglect of treatment leads to high frequency and severity of foot-related complications. We noticed high rate of breaking of walkers and casts and device-related foot lesions. Total contact casts were more effective and safe compared with walkers.
Urate-lowering effects of dipeptidyl peptidase-4 inhibitors
Authors: Panevin Taras S. , Zhelyabina Olga V. , Eliseev Maxim S. , Shestakova Marina V.
Published: December 2020

Hyperuricemia is an increase of uric acid (UA) concentration in blood serum >420 pmol/L in men or >360 pmol/L in women and is considered to be a common biochemical abnormality. This condition shows that the extracellular fluid is oversaturated with urates, which concentration exceeds the limit of their solubility. This fact predisposes to the formation of crystals of sodium salt of UA and results in gout, urolithiasis, and other diseases. The frequent combination and relationship between purine and carbohydrate metabolism were noted in previous studies. In this regard, the choice of drugs for correcting these disorders should consider the possibility of a combined positive effect on the UA and serum glucose levels. The hypoglycemic drugs with pleiotropic effects on several metabolic syndrome components are considered to be of particular interest. Currently, one of the most frequently prescribed groups of drugs in the treatment of diabetes mellitus type 2 are dipeptidyl peptidase-4 inhibitors, which affect the level of incretins (gliptins). These drugs can be potentially attractive in patients with purine metabolism disorders since the available data indicate that these drugs affect UA level.
Current data on the effectiveness of gliclazide and molecular mechanisms of action of the drug
Authors: Petunina Nina A. , Kuzina Irina A. , Nedosugova Ludmila V.
Published: December 2020

With the growing prevalence of type 2 diabetes mellitus (T2DM) the possibility of treating it with available drugs is one of the main issues. Although glycemic control and reduction of micro- and macrovascular outcomes remain important aspects of treatment, the main limiting factors are the availability and cost of oral hypoglycemic agents. Although newer agents, such as sodium -glucose cotransporter 2 inhibitors, dipeptidyl peptidase-4 inhibitors and glucagon-like peptide 1 receptor agonists, potentially being valuable for patients with insulin resistance and cardiovascular complications, they are relatively expensive and have limited availability. Second-generation sulfonylureas effectively reduce glycated hemoglobin and contribute to the prevention of micro- and macrovascular complications of T2DM The review substantiates the role of Gliclazide MR as a more affordable drug for the treatment of T2DM, the safety of which has been confirmed by many studies; cardio-and nephroprotective effects are shown, as well as mechanisms for influencing в-cells of the pancreas and extrapancreatic effects through activation of phospholipase C and the G-protein-сoupled-receptors (GPCR) are analyzed. The latest data on the assessment of adverse events of Gliclazide MR are presented in comparison with both other sulfonylureas and glucose-lowering drugs of other classes.
El programa de tutorias: canal de acompañamiento a las trayectorias educativas en medicina veterinaria
Authors: FASCENDINI Paola Y. , GUAITA María L. , OJEDA Norberto
Published: December 2020

El propósito del presente trabajo es socializar el impacto del Programa de Tutorías en la trayectoria educativa de los ingresantes a la carrera de medicina veterinaria de la Universidad Nacional del Litoral. El Programa de tutorías data del año 2010 cuando mediante el plan de mejoramiento de la carrera se instaura la necesidad de iniciar una labor de acompañamiento dirigida a los estudiantes ingresantes. Dicho programa se lleva a cabo mediante la labor profesional realizada desde la cátedra de Introducción a la Veterinaria, el Director de carrera y el Servicio de Orientación Educativa (S.O.E) de la Facultad de Ciencias Veterinarias siendo los co-responsables de dicha ejecución. El desafío constante del programa es responder a la construcción continua de alternativas que permitan a los estudiantes apropiarse de las habilidades necesarias para alcanzar el éxito académico. Teniendo en cuenta los resultados se observa que el Programa de Tutorías es recomendado por el 98% de los tutorados, debido a que el mismo es favorecedor de los procesos de afiliación universitaria. La novedad del programa es que se lleva a cabo por estudiantes avanzados, quienes luego de un proceso de selección y capacitación realizan la tarea orientativa.
Scholars and Literati at the University of Jena (1558–1800)
Authors: De la Croix David , Stelter Robert
Published: December 2020

This note is a summary description of the set of scholars and literati who taught at the University of Jena from its inception in 1558 to the eve of the Industrial Revolution (1800).
Strict Liability Principle Application in the Management of Straits Marine Pollution for International Navigation according to the Indonesia Sea Convention Law
Authors: SUDINI Luh Putu , RAKA Anak Agung Gede , HERAWAN Tutut
Published: December 2020

Congested crossings going vessels in the strait used for international navigation such as the Malacca Strait, allowing the serious pollution of the sea water in the strait. How does the application of the principle of strict liability in the management of marine pollution in the Straits used for international navigation under the Convention on Law of the Sea 1982 in Indonesia? This research is a normative law, the main approach in legislation (statute approach), with the source material through the law library research. Indonesia has ratified the Convention on the Law of the Sea 1982 through Law no. 17 In 1985 the Indonesian government should establish laws that regulate a legal product on the management of marine pollution in particular in the straits used for international shipping considering Indonesia as an archipelago crowded waters traversed by large foreign ships in an easy and highly probable do pollution at sea. The application of the principle of strict liability is appropriate and relevant use in marine pollution liability for damages in the Straits used for international shipping as Idi Indonesian waters in the Strait of Malacca and the weapon system of archipelagic sea-groove Indonesia because Indonesia as favorable to the State Island Countries. compensated by the mean absolute responsibility, obligations to pay compensation to the beach arises immediately upon the oil spill in the sea without regard to guilt or innocence tanker or ship traffic in the Strait of Malacca done by using the right of transit passage and responsibility for compensation is associated with a number of limited liability or the ceiling or ceiling system.
Public–Private Partnerships in Ecotourism Development in Protected Areas: A Case Study of Tunkinsky National Park in Russia
Authors: MAKSANOVA Lyudmila , IVANOVA Sembrika , BUDAEVA Darima , ANDREEVA Alyona
Published: December 2020

This paper discusses the opportunities offered by public–private partnerships in developing ecotourism infrastructure in protected areas. The paper also addresses the issues contributing to threats and conflicts while implementing infrastructure projects. In order to fulfil research objectives, the authors employ a sociological instrument. Using a snowball method, the authors selected 34 experts with professional competencies in tourism development, natural resource management, protected area management, and public-private partnerships. The results of this study demonstrate a potential demand for the mechanisms of public-private partnerships when developing ecotourism infrastructure. Using the case study of Tunkinsky National Park, the authors identified potential threats and conflicts in the process of preparation and delivery of public-private partnership projects for ecotourism infrastructure development.
The Effect of Paracetamol and Codeine Analgesic Combination on Creatinine Levels in Male Wistar Rats
Authors: Natasaputra Vianney , Nugroho Taufik Eko
Published: December 2020

Background :  Pain is one of the most common complaint in patients. Combination of paracetamol and codeine is an alternative analgesic combination in chronic pain management. They belong to different group of analgesic and have different mechanism of action. Combination of these drugs give a better potential in pain management.  However, these drugs also have potential side effect on the kidney.Methods : An experimental study of post-test only control group design. The sample were 20 Wistar rats, randomized into 4 groups: control group, a group receiving paracetamol 32 mg/kg body weight, a group receiving codeine 1,9 mg/kg body weight, and a group receiving paracetamol 32 mg/kg body weight and codeine 1,9 mg combination, administered 4 times a day orally using gastric instillation for 28 days. At the 29th day, blood is collected from retro orbital vessel to measure the serum creatinine levels. Statistical analysis was conducted using ANOVA TestResult : Obtained from statistical analysis there is no significant difference in serum creatinine levels in Wistar rats given all treatment group (p > 0,05).Conclusion : There is no significant difference in serum creatinine levels between administration of paracetamol and codeine combination compared to the control group.
Splątany świat, czyli teorii sekret trzeci
Authors: Krajewska Anna
Published: December 2020

This introductory article presents the act of editing an issue of a scientific journal as a kind of interface through which the act of writing and reading is entangled, a process that produces a theory in a performative way. The author considers anamorphosis, synaesthesia and entanglement (which she considers with reference to the category of a secret) to be the basis of contemporary literary and literary discourses.
Dynamic Mechanical and Dielectric Properties of Fly Ash/(Polystyrene/Low-Density Polyethylene) Composites
Authors: Nasr Gamal , Mohamed Taqwa , Khalil Rania
Published: December 2020

By using the melt mixing method, polystyrene (PS), low-density polyethylene (LDPE), and a PS/LDPE blend have been prepared. Fly ash was used as filler embedded in the PS/LDPE blend to form composites. The dynamic mechanical analysis (DMA) showed that the storage modulus (E′) decreases as the temperature increases. E′ increases clearly with fly ash loading, and the maximum E′ value was found for the composite loaded with 30 % fly ash content. The mean-field theory developed by Kerner was used to predict the dynamic mechanical properties of the composites from their pure components. A good agreement was investigated between the deduced theoretical values via iteration method and the experimental results. The dielectric constant (ε′), dielectric loss, and dielectric loss tangent (tan δ) have been measured at different constant frequencies. The ε′ and tan δ commence to decrease by increasing the applied frequency.
Supercomplex formation boosts respiration
Authors: den Brave Fabian , Becker Thomas
Published: December 2020

Mitochondrial respiratory chain complexes associate in supercomplexes, but the physiological role of these assemblies remains controversial. Recent studies in EMBO Reports reveal that supercomplexes promote metabolic fitness. Berndtsson et al (2020) demonstrate that supercomplex formation enhances electron transport by reducing the distance for diffusion of cytochrome c between cytochrome bc1 complex and cytochrome c oxidase and thereby increases competitive fitness in yeast. Similarly, Garcia‐Poyatos et al (2020) report that zebrafish lacking the supercomplex assembly factor SCAF1 display a reduced growth and decreased female fertility.
Metformin use is associated with a lower risk of osteoporosis/vertebral fracture in Taiwanese patients with type 2 diabetes mellitus
Authors: Tseng Chin-Hsiao
Published: December 2020

Objectives

To investigate the metformin effect on the risk of osteoporosis (OS) and/or vertebral fracture (VF).

Methods

We enrolled 14 611 pairs of metformin ever and never users matched on propensity score (PS) from Taiwan’s National Health Insurance database. All patients had new-onset type 2 diabetes mellitus (T2DM) during 1999–2005 and were free from OS and/or any fracture at the start of follow-up on January 1, 2006. They were followed up until December 31, 2011 for the incidence of OS/VF. Cox regression incorporated with the inverse probability of treatment weighting using PS was used in the main analyses.

Results

New-onset OS/VF was diagnosed in 1757 never users (median follow-up 5.0 years) and 1143 ever users (median follow-up 5.3 years). The respective incidence rates were 2870.97 and 1713.20 per 100 000 person-years. Two-thirds of the incident cases had OS without VF and the other third had VF. In main analyses, the hazard ratio for ever vs never users was 0.592 (95% CI: 0.550–0.638). In either sex, a dose–response pattern was noted and metformin therapy > 2 years was consistently associated with a lower risk. The protective effect attenuated with increasing age but remained significant in patients aged ≥ 80 years. In sensitivity analyses, metformin significantly reduced the risk of both OS and VF (with or without a prior OS) by 30–40%. Additional analyses showed a null association for other antidiabetic drugs, but significant interactions between metformin and insulin, sulfonylurea and pioglitazone, respectively, were noted.

Conclusion

Metformin use is associated with a lower risk of OS/VF.
Características morfofuncionales de una muestra de futbolistas profesionales chilenos de primera B según posición de juego
Authors: Velásquez-González Hugo , Peña-Troncoso Sebastián Enrique , Hernández-Mosqueira Claudio , Cresp Barría Mauricio , Espinoza Cortez José Antonio
Published: December 2020

Objective: to analyze the morphofunctional profile of Chilean professional soccer players according to their playing position. Method: the study design was non-experimental, with a descriptive-correlational scope. Twenty-nine professional soccer players belonging to the Valdivia Sports Club of Chile were evaluated. Fat percentage was established by measuring four skin folds and applying the Durnin and Womersley equation. For the physical variables, the maximum squat repetition test was applied, and the Brzycki method was used to project the maximum force in one repetition. In explosive force, the Bosco Test was performed; this test evaluates the squat jump (SJ). The level 1 recovery Yoyo Test was used for the aerobic resistance, with heart rate (HR) measurement at the end and in recovery (1 minute). Results: Only significant differences in height are observed between goalkeepers and midfielders (F = 4.491; p = 0.012); this implies that age, weight, and Σ4 folds do not affect in the playing position. Conclusions: it is observed that, in each game position, the players present a different morphofunctional configuration, which allows inferring that the work must be differentiated.
Herencia Institucional y desarrollo
Authors: Rodríguez-Soto Jorge
Published: December 2020

El objetivo de este artículo se centra en estudiar la relación histórica institucional de un grupo de países seleccionados y su estadio de desarrollo. Se parte de la premisa de que el proceso del desarrollo institucional debe ser comprendido como un continuo devenir, no como algo futuro, no como algo concluido. Losfenómenos observados hoy son resultado de su continua evolución, su pasado e historia. Desde la segunda mitad del siglo XX al presente suele simplificarse el desarrollo institucional en prescripciones de política y transformaciones institucionales que obvian la complejidad del proceso. Para abordar este planteamiento, metodológicamente se proponen cuatro categorías de análisis, a saber: países protestantes, católicos, colonias católicas subdivididas en españolas y francesas, y “nuevas Europas”. Estas se comparan a través de tres indicadores que son: el índice del desarrollo humano, la tasa de crecimiento del producto interno bruto, y el ranking de doing business. Este artículo demuestra cómo el desarrollo histórico de los países puede determinar la institucionalidad que poseen en el presente y su desempeño, tomando en consideración los antecedentes de la Edad Media y los inicios de la modernidad en el siglo XVI. Este concluye que las herencias institucionales se hacen patentes de facto en los resultados presentes de varias economías, y que deberían ser tomadas en cuenta a la hora de planear e implementar política pública.
Drainage and retention enhancement of a wheat straw-containing pulp furnish using microparticle retention aids
Authors: Vishtal Alexey , Rousu Päivi , Hultholm Tom , Turku Kati , Paananen Petteri , Käyhkö Jari
Published: December 2020

The usage of non-wood pulps in furnishes for the production of various paper grades is a real alternative for the substitution of wood pulp in papermaking. In terms of the papermaking process, the main limiting factor for non-wood pulp utilization is poor dewatering. This problem can be partially solved by means of retention aids, and the modern microparticle-based retention aids are very promising for this application. In this study the main aim was to characterize how the microparticle retention systems affect the retention, dewatering, and formation of a non-wood pulp furnish and how these effects and mechanisms differ when compared to normal wood pulp. The performance of several commercially available retention aids was studied by making dynamic sheet forming tests for reference and an organosolv wheat straw furnish. The emphasis in the experiments was on drainage enhancement. The maximum drainage gain obtained with the bentonite-CPAM retention aid system was about 5%. Despite the improved drainage, dewatering of the reference furnish was better than for the non-wood containing furnish.