bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk severity moderated effectiveness of pain treatment in adolescents
Authors: Vuorimaa Hanna , Leppänen Leena , Kautiainen Hannu , Mikkelsson Marja , Hietanen Maiju , Vilen Heli , Pohjankoski Heini
Published: November 2018

Background and aims

A targeted pain program may prevent the progression and subsequent occurrence of chronic pain in adolescents. This study tested the effectiveness of a new acceptance and commitment therapy -based pain management intervention, using physical and psychological functions as the outcomes. The objective was also to determine whether Pediatric Pain Screening Tool risk profiles function as outcome moderator in the current sample. A valid screening tool would enable the program development.

Methods

Thirty-two consecutive adolescent patients (13–17 years old) with idiopathic recurrent musculoskeletal pain completed the study. The intervention comprised acceptance and commitment therapy-oriented multidisciplinary treatment. Pediatric Pain Screening Tool, pain frequency, functional disability, school attendance, physical endurance, depressive symptoms, and catastrophizing coping style were measured before treatment (baseline) and again at 6 and 12 months after the initiation of treatment. To test the effectiveness of the new program, we also determined whether the original risk classification of each patient remained constant during the intervention.

Results

The intervention was effective for high-risk patients. In particular, the pain frequency decreased, and psychosocial measures improved. In post-intervention, the original risk classification of seven patients in the high-risk category changed to medium-risk. PPST classification acted as a moderator of the outcome of the current program.

Conclusions

The categorization highlighted the need to modify the program content for the medium-risk patients. The categorization is a good tool to screen adolescent patients with pain.

Implications

The results support using the Pediatric Pain Screening Tool in developing rehabilitation program for pediatric musculoskeletal pain patients. According to the result, for adolescent prolonged musculoskeletal pain patients the use of ACT-based intervention program is warranted.
Selenium analogs of phenoxypropionic and phenoxyacetic herbicides
Authors: Zakrzewski Jerzy , Huras Bogumiła , Kiełczewska Anna , Krawczyk Maria
Published: November 2018

Selenium analogs of phenoxyacetic herbicides, namely 2-(2,4-dichlorophenoxy)propionic acid (2,4-DP), 2-(2,4-dichlorophenoxy)acetic acid (2,4-D), 2-(4-chloro-2-methylphenoxy)propionic acid (MCPP), 2-(4-chloro-2-methylphenoxy)acetic acid (MCPA), 2-(2,4,5-trichlorophenoxy)propionic acid (2,4,5-TP), and 2-(2,4,5-trichlorophenoxy)acetic acid (2,4,5-T), were synthesized in two steps. Iodo aryl derivatives were dimerized with elemental selenium in the presence of CuO as catalyst to the corresponding diselenides. Diselenides were reduced with NaBH4 to a selenide anion and condensed with either propionic or chloroacetic acid to achieve the selenium analogs of phenoxyacetic herbicides. These selenium analogs show moderate herbicidal and fungistatic activity.
Bis-heterocycles. Part I: tetrahydro-5,5′- bi(1,2,4-triazin-6-ones)
Authors: Mohammad Hanan H. , El-Abadelah Mustafa M. , Sabri Salim S. , Awwadi Firas F. , Voelter Wolfgang
Published: November 2018

Selected sets of tetrahydro-5,5′-bi(1,2,4-triazines) (1–3) appended with acetyl, benzoyl, and ester moieties at C-3 position and N-1 (p-substituted)phenyl ring have been prepared and characterized by spectral (IR, NMR, MS) data and X-ray diffraction for compound 3a. Their synthesis was achieved in high yield via the reaction of diethyl aminomalonate with various N-(aryl)hydrazonoyl chlorides in the presence of triethylamine.
Long-Term Potentiation and Excitability in the Hippocampus Are Modulated Differently by θ Rhythm
Authors: Law Clayton S. H. , Leung L. Stan
Published: November 2018

Oscillations in the brain facilitate neural processing and cognitive functions. This study investigated the dependence of long-term potentiation (LTP), a neural correlate of memory, on the phase of the hippocampal θ rhythm, a prominent brain oscillation. Multichannel field potentials and current source-sinks were analyzed in hippocampal CA1 of adult male rats under urethane anesthesia. A single burst (five pulses at 200 Hz) stimulation of stratum oriens (OR) induced LTP of the basal dendritic excitatory sink (ES), which was maximal when the burst was delivered at ∼340° and ∼160° of the distal dendritic θ rhythm. Apical dendritic sink evoked by stratum radiatum (RAD) stimulation also showed biphasic maxima at ∼30° and ∼210° of the distal dendritic θ rhythm, about 50° phase delay to basal dendritic LTP. By contrast, maximal population spike (PS) excitability, following single-pulse excitation of the basal or mid-apical dendrites, occurred at a θ phase of ∼140°, and maximal basal dendritic ES occurred at ∼20°; γ (30–57 Hz) activity recorded in CA1 RAD had maximal power at ∼300° of the distal dendritic θ rhythm, different from the phases of maximal LTP. LTP induced during the rising θ phase was NMDA receptor sensitive. It is suggested that the θ phase modulation of CA1 PS excitability is mainly provided by θ-rhythmic proximal inhibition, while dendritic LTP is also modulated by dendritic inhibition and excitation, specific to basal and apical dendrites. In summary, basal and apical dendritic synaptic plasticity and spike excitability are facilitated at different θ phases in a compartmental fashion.
Histamine H1 Receptor Contributes to Vestibular Compensation
Authors: Chen Zhang-Peng , Zhang Xiao-Yang , Peng Shi-Yu , Yang Zhong-Qin , Wang Yan-Bo , Zhang Yang-Xun , Chen Xi , Wang Jian-Jun , Zhu Jing-Ning
Published: November 2018

Vestibular compensation is responsible for the spontaneous recovery of postural, locomotor, and oculomotor dysfunctions in patients with peripheral vestibular lesion or posterior circulation stroke. Mechanism investigation of vestibular compensation is of great importance in both facilitating recovery of vestibular function and understanding the postlesion functional plasticity in the adult CNS. Here, we report that postsynaptic histamine H1 receptor contributes greatly to facilitating vestibular compensation. The expression of H1 receptor is restrictedly increased in the ipsilesional rather than contralesional GABAergic projection neurons in the medial vestibular nucleus (MVN), one of the most important centers for vestibular compensation, in unilateral labyrinthectomized male rats. Furthermore, H1 receptor mediates an asymmetric excitation of the commissural GABAergic but not glutamatergic neurons in the ipsilesional MVN, which may help to rebalance bilateral vestibular systems and promote vestibular compensation. Selective blockage of H1 receptor in the MVN significantly retards the recovery of both static and dynamic vestibular symptoms following unilateral labyrinthectomy, and remarkably attenuates the facilitation of betahistine, whose effect has traditionally been attributed to its antagonistic action on the presynaptic H3 receptor, on vestibular compensation. These results reveal a previously unknown role for histamine H1 receptor in vestibular compensation and amelioration of vestibular motor deficits, as well as an involvement of H1 receptor in potential therapeutic effects of betahistine. The findings provide not only a new insight into the postlesion neuronal circuit plasticity and functional recovery in the CNS, but also a novel potential therapeutic target for vestibular disorders.

SIGNIFICANCE STATEMENTVestibular disorders manifest postural imbalance, nystagmus, and vertigo. Vestibular compensation is critical for facilitating recovery from vestibular disorders, and of great importance in understanding the postlesion functional plasticity in the adult CNS. Here, we show that postsynaptic H1 receptor in the medial vestibular nucleus (MVN) contributes greatly to the recovery of both static and dynamic symptoms following unilateral vestibular lesion. H1 receptor selectively mediates the asymmetric activation of commissural inhibitory system in the ipsilesional MVN and actively promotes vestibular compensation. The findings provide not only a new insight into the postlesion neuronal circuit plasticity and functional recovery of CNS, but also a novel potential therapeutic target for promoting vestibular compensation and ameliorating vestibular disorders.
Epithelial Shaping by Diverse Apical Extracellular Matrices Requires the Nidogen Domain Protein DEX-1 in Caenorhabditis elegans
Authors: Cohen Jennifer D , Flatt Kristen M , Schroeder Nathan E , Sundaram Meera V
Published: November 2018

The body’s external surfaces and the insides of biological tubes, like the vascular system, are lined by a lipid-, glycoprotein-, and glycosaminoglycan-rich apical extracellular matrix (aECM). aECMs are the body’s first line of defense against infectious agents and promote tissue integrity and morphogenesis, but are poorly described relative to basement membranes and stromal ECMs. While some aECM components, such as zona pellucida (ZP) domain proteins, have been identified, little is known regarding the overall composition of the aECM or the mechanisms by which different aECM components work together to shape epithelial tissues. In Caenorhabditis elegans, external epithelia develop in the context of an ill-defined ZP-containing aECM that precedes secretion of the collagenous cuticle. C. elegans has 43 genes that encode at least 65 unique ZP proteins, and we show that some of these comprise distinct precuticle aECMs in the embryo. Previously, the nidogen- and EGF-domain protein DEX-1 was shown to anchor dendrites to the C. elegans nose tip in concert with the ZP protein DYF-7. Here, we identified a new, strong loss-of-function allele of dex-1, cs201. dex-1 mutants die as L1 larvae and have a variety of tissue distortion phenotypes, including excretory defects, pharyngeal ingression, alae defects, and a short and fat body shape, that strongly resemble those of genes encoding ZP proteins. DEX-1 localizes to ZP-containing aECMs in the tissues that show defects in dex-1 mutants. Our studies suggest that DEX-1 is a component of multiple distinct embryonic aECMs that shape developing epithelia, and a potential partner of multiple ZP proteins.
LA INTEGRACIÓN DE MODALIDADES ALTERNATIVAS DE CAPACITACIÓN A LA PRESENCIALIDAD PARA EL SECTOR ADMINISTRATIVO EN LA UNIVERSIDAD NACIONAL DE COSTA RICA
Authors: Alfaro Salas Marly Yisette , Salas Ocampo Luis Diego
Published: November 2018

El mundo de trabajo actual, las actividades programadas y no programadas, laatención de plazos inmediatos, así como la incorporación de la tecnología estáobligando a las instituciones públicas y privadas a renovar las modalidades enlas que sus sectores trabajadores pueden estar capacitados y actualizadosde forma eficaz. Para ello, la incorporación de las metodologías novedosas,que permitan la transmisión del conocimiento de forma más accesible, esuna necesidad imperante para cumplir este objetivo. En este campo, las capacitaciones en las que predomina la presencialidad están siendo relegadas por otras metodologías que incorporan los entornos virtuales, se convierten en un referente de liderazgo tecnológico en la gestión de la capacitación. Se evidencia, en este trabajo, la necesidad de que la universidad genere metas que orienten el desarrollo de un enfoque de e-learning a nivel de capacitación y realice los cambios para llegar a ese nivel. Al menos, debe ubicar el tema dentro de la estrategia institucional, cambiar los mecanismos de formación de docentes y promover planes de internacionalización con los programas que inicien este tipo de cambios. Es clave que la estructura administrativa de la universidad tenga su propia estrategia de capacitación que apunte a estos insumos que se plantean.
Diseño de una red de monitoreo como herramienta de gestión participativa: calidad física y química del agua subterránea en tres subcuencas del Valle Central, Costa Rica
Authors: Madrigal-Solís Helga , Fonseca-Sánchez Alicia , Calderón-Sánchez Hazel , Gómez-Cruz Alicia , Núñez-Solís Christian
Published: November 2018

El agua de los acuíferos Barva, Colima Superior y Colima Inferior, ubicados en el sector oeste del Valle Central de Costa Rica, representa la principal fuente de abastecimiento de agua potable en esta región. El propósito de este estudio fue diseñar una red de monitoreo o vigilancia para la calidad del agua de estos acuíferos en las subcuencas de los ríos Bermúdez, Ciruelas y río Segundo, así como fomentar la participación de actores sociales para el funcionamiento de cada red de vigilancia. De los sitios propuestos, cinco sobrepasaron, de dos a cuatro ocasiones, el Valor Alerta de 25 mg/l de nitratos como NO3-. Estos sitios, los cuales captaron agua del acuífero Barva, se encontraban en zonas donde predominaba el uso urbano y cultivos de café. Los lugares que captaron agua de este acuífero con las menores concentraciones, por debajo de los 2 mg/l, se encontraban en las zonas altas de las subcuencas, en donde predomina el bosque y los pastos, mientras que los que captaron agua de los Colima mostraron concentraciones por debajo de los 20 mg/l. Se recomienda la vigilancia semestral de al menos conductividad eléctrica, pH, temperatura, nitratos y cloruros. El funcionamiento de estas redes ofrece una oportunidad para la vigilancia de la calidad del agua subterránea por parte de actores clave en el nivel de cuenca, como uno de los primeros pasos en el desarrollo de un manejo sostenible de este recurso.
Improving Emergency Department Care for Pediatric Victims of Sexual Abuse
Authors: Hoehn Erin F. , Overmann Kevin M. , Fananapazir Nafeh , Simonton Kirsten , Makoroff Kathi L. , Bennett Berkeley L. , Duma Elena M. , Murtagh Kurowski Eileen
Published: November 2018

BACKGROUND AND OBJECTIVE:

Evidence-based medical care of sexual abuse victims who present to the pediatric emergency department (PED) is necessary to facilitate forensic evidence collection and prevent pregnancy and sexually transmitted infections. Adherence to testing and treatment guidelines remains low in PEDs, despite recommendations from the American Academy of Pediatrics and Centers for Disease Control and Prevention. We aimed to increase the proportion of patient encounters at a PED for reported sexual abuse that receive algorithm-adherent care from 57% to 90% within 12 months.

METHODS:

Our team of PED and child abuse pediatricians outlined our theory for improvement, and multiple plan-do-study-act cycles were conducted to test interventions that were aimed at key drivers. Interventions included the construction of a best practice algorithm derived from published guidelines, targeted clinician education, and integration of an electronic order set. Our primary outcome was the proportion of patient encounters in which care adhered to algorithm recommendations. Data were abstracted from the records of all patient encounters evaluated in the PED for reported sexual abuse.

RESULTS:

We analyzed 657 visits between July 2015 and January 2018. The proportion of patient encounters with algorithm-adherent care improved from 57% to 87% during the study period. This improvement has been sustained for 13 months. Failure to test for hepatitis and syphilis constituted the majority of nonadherent care.

CONCLUSIONS:

Using improvement methodology, we successfully increased algorithm-adherent evaluation and management of patients presenting for sexual abuse. Targeted education and an electronic order set were associated with improved adherence to a novel care algorithm.
Heart Rate Variability: An Old Metric with New Meaning in the Era of Using mHealth technologies for Health and Exercise Training Guidance. Part Two: Prognosis and Training
Authors: Singh Nikhil , Moneghetti Kegan James , Christle Jeffrey Wilcox , Hadley David , Froelicher Victor , Plews Daniel ,   Department of Medicine, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA,   Department of Medicine, St Vincent’s Hospital, University of Melbourne, Australia,   Division of Cardiovascular Medicine, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA,   Division of Cardiovascular Medicine, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA,   Cardiac Insight Inc, Seattle, USA,   Division of Cardiovascular Medicine, Department of Medicine, Stanford School of Medicine, Stanford, CA, USA,   Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
Published: November 2018

It has been demonstrated that heart rate variability (HRV) is predictive of all-cause and cardiovascular mortality using clinical ECG recordings. This is true for rest, exercise and ambulatory HRV clinical ECG device recordings in prospective cohorts. Recently, there has been a rapid increase in the use of mobile health technologies (mHealth) and commercial wearable fitness devices. Most of these devices use ECG or photo-based plethysmography and both are validated for providing accurate heart rate measurements. This offers the opportunity to make risk information from HRV more widely available. The physiology of HRV and the available technology by which it can be assessed has been summarised in Part 1 of this review. In Part 2 the association between HRV and risk stratification is addressed by reviewing the current evidence from data acquired by resting ECG, exercise ECG and medical ambulatory devices. This is followed by a discussion of the use of HRV to guide the training of athletes and as a part of fitness programmes.
Contribution of local peasant innovations to the re-configuration of endogenous rural development
Authors: Acevedo-Osorio Álvaro , Rivas G. Álvaro
Published: November 2018

In Colombia, Rural Development Institutional programs have made of local agents imperceptible since their trajectories have not been considered in the search for solutions to the problems in their territories. The present work introduces an innovative system to the production of the leaves of the plantain variety ‘Cachaco’ (Musa ABB S). This improvement, which was developed independently by indigenous communities of southern Tolima (Colombia), has been studied in detail throughout the technical, economic and social aspects of the productive and commercial processes of some plantain leaves producing farms. Based on their relation with their natural and socio-cultural environments, these communities have prompted their own process of re-peasantization. This productive innovation improves the life quality of the families involved, ensures their permanence in the territory and favors its cultural appropriation.
Toxicity evaluation of two insecticides on Tetragonisca angustula and Scaptotrigona xanthotricha (Hymenoptera: Apidae)
Authors: Quiroga Murcia Daniel Estiven , Zotti Moisés João , Zenner de polania Ingeborg , Pech-Pech Esdras Elías
Published: November 2018

Stingless bees (Hymenoptera: Apidae, Meliponini) have crucial roles in the ecosystem, offering pollination service and contributing to genetic diversity of species, and also providing honey and wax to humankind. Tetragonisca angustula and Scaptotrigona xanthotricha are species that have been used since ancient times for beekeeping. Currently these and other species have been exposed to agronomic practices, among which the use of synthetic pesticides used for crop protection stands out. The aim of this study was to evaluate the toxicity of the insecticides thiamethoxam and fipronil, which are used in agriculture in several countries in the tropical and subtropical belt in order to establish the risk that these products represent to the survival of these two species. The oral and topical LD50 was obtained by Probit analysis. Comparisons with the LD50s of other stingless bees and Apis mellifera were realized. Although further studies are required to calculate the real risk of the two compounds, the results showed an evident susceptibility of both species. We concluded that it is essential to use tools and practices that reduce the risk, and perform toxicological evaluations of new and existing pesticides on stingless bees.
Combined effect of green-colored covers and shading on the growth of sisal (Furcraea hexapetala) plants
Authors: Casierra-Posada Fánor , Portilla-Fuentes Fernando , Molano-Díaz Julián
Published: November 2018

Plants have the ability to respond in different ways to the quality of light, its intensity, and the combination of both. In addition, chlorophyll absorbs light in the blue and red bands of the spectrum, but green and infrared light are poorly absorbed or not absorbed, yet they affect plant morphogenesis. An experiment was carried out in Tunja, Colombia, in which the influence of shading on sisal plants (Furcraea hexapetala) was evaluated. The plants were placed under green polypropylene filters that induced 55.4, 85.8 and 90.1% light reduction and were compared with open exposure plants in a greenhouse. As a consequence of shading, the values of the following variables were reduced: chlorophyll content index by between 52.2 and 55.0%, dry mass by between 80.8 and 94.0%, water uptake by between 40.9 and 44.9%, water use efficiency by between 23.0 and 53.7% and relative growth rate by between 35.1 and 58.4%, as compared to the control, while the values for the root to shoot ratio, specific leaf area and leaf area ratio were increased by ranges of 24.2 to 73.5%, 107.5 to 132.4% and 116.6 to 174.9%, respectively. The shading with green filters induced a reduction in the red/far red ratio of light. Based on these results, it was possible to infer that the sisal plants presented low plasticity for tolerating the abiotic stress induced by green-filter shading.
Genetic divergence of Heliconiaceae species in the Central West Brazil region
Authors: Da Silva Cintia Graciele , Dalbosco Edneia Zullian , Baptista Da Luz Petterson , Krause Willian , Loges Vivian , Silva Celice Alexandre
Published: November 2018

The purpose of this study was to describe morphological traits and estimate genetic divergence and parameters between accessions of the genus Heliconia sp. from different municipalities in the state of Mato Grosso, Brazil. A set of 25 traits, 15 quantitative and 10 qualitative were evaluated. The genetic divergence was estimated based on Mahalanobis' distance, with the clustering methods known as Unweighted Pair Group Method using Arithmetic Averages (UPGMA). Genetic variability was observed for all assessed quantitative traits and the accessions were grouped in different classes. The traits with highest relative contribution to variability were longevity of flower stems and inflorescence length. The results indicated the existence of genetic variability among accessions of the Heliconiasp. germplasm bank, which can be used in breeding programs.
Editorial
Authors: Parra Quijano Héctor Mauricio
Published: November 2018

Abrimos este nuevo número de la revista Agronomía Colombiana, con una distinción especial a una de las personas que hizo de este proyecto editorial un importante y significativo medio de difusión científicotécnico del sector agrícola del país. Este reconocimiento y admiración es para el profesor Gerhard Fischer, quien durante más de 10 años estuvo a cargo de la dirección de la revista Agronomía Colombiana; pero ¿Quién es Gerhard Fischer?
First capture of Diclidurus albus Wied-Neuwied, 1820 (Mammalia, Chiroptera, Emballonuridae) from Nicaragua
Authors: Loza Julio , Sunyer Javier , Reid Fiona A. , Martínez-Fonseca José Gabriel
Published: November 2018

We report on the first capture and photographs of the Northern Ghost Bat, Diclidurus albus Wied-Neuwied, 1820, from Nicaragua, based on one individual from the Reserva Silvestre Privada Refugio Bartola, department of Río San Juan, southeastern Nicaragua. We provide basic morphological measurements of the individual as well as a distribution map of previous visual sightings and acoustic recordings of this species from Nicaragua.
Taxonomic notes on the species of the genus Micrasterias (Desmidiaceae, Conjugatophyceae) from the Metropolitan Region of Salvador, Bahia, Brazil
Authors: Santos Maria A. , Bicudo Carlos E. M. , Moura Carlos W. N.
Published: November 2018

We present the results of a taxonomic survey of the genus Micrasterias in the Metropolitan Region of Salvador (MRS), Bahia, northeastern Brazil during 2007–2010 and 2014–2015. A total of 275 phytoplanktonic and periphytic samples from 11 municipalities were analyzed. The samples were collected using a plankton net with 20 µm mesh or squeezed from macrophytes. Twenty-nine taxa were identified, which 20 have their geographic distributions expanded. Only M. pinnatifida was considered frequent, occurring in 9 municipalities, while we classified 21 species as rare in the study area. Our results emphasize the importance of the conservation of aquatic bodies in the MRS for the maintenance of biological diversity of desmids and other aquatic organisms.
Progress in the engineering profession: A Canadian perspective
Authors: Madsen Lynnette D.
Published: November 2018

To be a practicing engineer in Canada, a license is required from a provincial or territorial association within the national organization of Engineers Canada/Ingénieurs Canada.1The gateway to engineering for early-career Canadians is through four-year accredited programs at universities.
Medical curriculum reform in the disruptive technology era
Authors: Dharmasaroja Permphan
Published: November 2018

This article was migrated. The article was not marked as recommended.
Can research participation positively impact medical student research self-efficacy?
Authors: DeVoe Pamela , Hess Michael L.
Published: November 2018

This article was migrated. The article was not marked as recommended. Background: Mentored research experiences during medical school can establish a scholarly foundation for residency, as well as deepen student's confidence and practical knowledge in evidence-based clinical practice. Despite these positive outcomes, many students begin medical school without prior research experience, thus creating the potential for stress, discomfort, and procrastination in pursuing research experiences during training. Purpose: To determine the impact of a required research project on student gains in research self-efficacy, and to identify factors facilitating medical student research success. Methods: A cross-sectional survey design was used to collect data on medical student self-reported confidence to complete 13 specific research tasks. Surveys were distributed and collected from students in four medical school classes (MSI, MSII, MSIII, and MSIV). Results: The number of research projects completed was a significant indicator for increased confidence and self-efficacy for research participation; for writing a literature review; computing a power and sample size analysis; and summarizing and presenting project results. Significant differences were found between genders on constructing a dataset, choosing statistical analyses, describing and summarizing the meaning of results, with males showing greater confidence. Conclusions: Research self-efficacy can develop and increase for medical students through exposure to research methods training, mentoring, and successful completion of research projects.
FORMACIÓN DOCENTE Y DESARROLLO PROFESIONAL SITUADO PARA LA ENSEÑANZA DEL LENGUAJE Y MATEMÁTICAS EN COLOMBIA - Teacher Training And Professional Development Located For The Teaching Of Language And Mathematics In Colombia
Authors: González Alfredo , Díaz Alex Mauricio
Published: November 2018

Este artículo tiene como propósito presentar un rastreo bibliográfico de las tendencias actuales en Colombia acerca de la formación docente y desarrollo profesional situado para la enseñanza del Lenguaje y Matemáticas en los niveles de educación básica primaria y media académica. Se pretende focalizar en tres categorías de análisis: comunidades de aprendizaje, desarrollo profesional situado y práctica pedagógica, demostrando de manera concreta cómo se ha impactado en la calidad de la educación del país, desde el sector oficial, mediante el análisis de los resultados obtenidos en las investigaciones realizadas en este campo educativo. Estas categorías desarrollan algunas dimensiones que permiten resolver el interrogante de cuáles son los cambios que se dan en la práctica pedagógica de los docentes luego de aplicar un entrenamiento en la metodología del estudio de clases. El análisis de este sistema de categorías y dimensiones se ha realizado bajo el proceso de la enseñanza del Lenguaje y Matemáticas, y de cómo este contribuye significativamente en el mejoramiento de los procesos de comprensión de lectura y resolución de problemas matemáticos. Los estudios abordados demuestran un efecto positivo sobre la enseñanza e instrucción orientada por los docentes, especialmente en sus metodologías, estrategias didácticas, desarrollo profesional situado y las prácticas evaluativas, así como en el aprendizaje de los estudiantes.
Characterization of Comorbidities Limiting the Recruitment of Patients in Early Phase Clinical Trials
Authors: Duma Narjust , Kothadia Sejal M. , Azam Tariq U. , Yadav Siddhartha , Paludo Jonas , Vera Aguilera Jesus , Gonzalez Velez Miguel , Halfdanarson Thorvardur Ragnar , Molina Julian R. , Hubbard Joleen M. , Go Ronald S. , Mansfield Aaron S. , Adjei Alex A.
Published: November 2018

Background

Early phase clinical trials evaluate the safety and efficacy of new treatments. The exclusion/inclusion criteria in these trials are usually rigorous and may exclude many patients seen in clinical practice. Our objective was to study the comorbidities limiting the participation of patients with breast, colorectal, or lung cancer in clinical trials.

Materials and Methods

We queried ClinicalTrials.gov on December 31, 2016. We reviewed the eligibility criteria of 1,103 trials. Logistic regression analyses were completed, and exclusion was studied as a binary variable.

Results

Out of 1,103 trials, 70 trials (6%) excluded patients >75 years of age, and 45% made no reference to age. Eighty-six percent of trials placed restrictions on patients with history of prior malignancies. Regarding central nervous system (CNS) metastasis, 416 trials (38%) excluded all patients with CNS metastasis, and 373 (34%) only allowed asymptomatic CNS metastasis. Regarding chronic viral infections, 347 trials (31%) excluded all patients with human immunodeficiency virus, and 228 trials (21%) excluded all patients with hepatitis B or C infection. On univariate analysis, chemotherapy trials were more likely to exclude patients with CNS metastasis and history of other malignancies than targeted therapy trials. Multivariate analysis demonstrated that industry-sponsored trials had higher odds of excluding patients with compromised liver function.

Conclusion

Many clinical trials excluded large segments of the population of patients with cancer. Frequent exclusion criteria included patients with CNS metastasis, history of prior malignancies, and chronic viral infections. The criteria for participation in some clinical trials may be overly restrictive and limit enrollment.

Implications for Practice

The results of this study revealed that most early phase clinic trials contain strict exclusion criteria, potentially excluding the patients who may be more likely to represent the population treated in clinical settings, leaving patients susceptible to unintended harm from inappropriate generalization of trial results. Careful liberalization of the inclusion/exclusion criteria in clinical trials will allow investigators to understand the benefits and drawbacks of the experimental drug for a broader population, and possibly improve recruitment of patients with cancer into clinical trials.
Relevance of Reference Centers in Sarcoma Care and Quality Item Evaluation: Results from the Prospective Registry of the Spanish Group for Research in Sarcoma (GEIS)
Authors: Martin-Broto Javier , Hindi Nadia , Cruz Josefina , Martinez-Trufero Javier , Valverde Claudia , De Sande Luis M. , Sala Angeles , Bellido Lorena , De Juan Ana , Rubió-Casadevall Jordi , Diaz-Beveridge Roberto , Cubedo Ricardo , Tendero Oscar , Salinas Diego , Gracia Isidro , Ramos Rafael , Baguè Silvia , Gutierrez Antonio , Duran-Moreno José , Lopez-Pousa Antonio
Published: November 2018

Background

Reference centers (RCs) are a key point for improving the survival of patients with soft-tissue sarcomas (STS). The aim of this study was to evaluate selected items in the management of patients with STS, comparing results between RC and local hospitals (LHs).

Materials and Methods

Diagnostic and therapeutic data from patients diagnosed between January 2004 and December 2011 were collected. Correlation with outcome was performed.

Results

A total of 622 sarcomas were analyzed, with a median follow-up of 40 months. Imaging of primary tumor preoperatively (yes vs. no) correlated with a higher probability of free surgical margins (77.4% versus 53.7%; p = .006). The provenance of the biopsy (RC vs. LH) significantly affected relapse-free survival (RFS; 3-year RFS 66% vs. 46%, respectively; p = .019). Likewise, 3-year RFS was significantly worse in cases with infiltrated (55.6%) or unknown (43.4%) microscopic surgical margins compared with free margins (63.6%; p < .001). Patients managed by RCs had a better 3-year overall survival compared with those managed by LHs (82% vs. 70.4%, respectively; p = .003). Perioperative chemotherapy in high-risk STS, more frequently administered in RCs than in LHs, resulted in significantly better 3-year RFS (66% vs. 44%; p = .011). In addition, patients with stage IV disease treated in RCs survived significantly longer compared with those in LHs (30.4 months vs. 18.5 months; p = .036).

Conclusion

Our series indicate that selected quality-of-care items were accomplished better by RCs over LHs, all with significant prognostic value in patients with STS. Early referral to an RC should be mandatory if the aim is to improve the survival of patients with STS.
Immune Checkpoint Inhibitors and the Risk of Allograft Rejection: A Comprehensive Analysis on an Emerging Issue
Authors: Aguirre Luis E. , Guzman Maria E. , Lopes Gilberto , Hurley Judith
Published: November 2018

Background

It is well known that the state of immune tolerance induced by broad immunosuppression to prevent allograft rejection leads to an increased risk of the development of cancer. One of the most promising new areas of cancer treatment has been the development of immune checkpoint inhibitors that target the cytotoxic T-lymphocyte-associated antigen 4 and programmed cell death protein 1/programmed death-ligand 1 (PD-L1) pathways. As a logical consequence, growing interest in these agents translated into their implementation in patients with transplant-related malignancies. Because of overlapping and perhaps mutually exclusive mechanisms of action of transplant immunosuppression and cancer immunomodulation, it is critical to examine these interactions.

Materials and Methods

We carried out a systematic search for review articles and case reports published between July 2014 and November 2017 using three engines: Usearch, PubMed, and Up-to-date.

Results

Overall, there were 20 cases with 12 allograft rejections. The rejection rate associated with nivolumab was 73% (8/11) and with pembrolizumab it was 100% (2/2). The use of ipilimumab did not lead to rejection in any instance (0/4, 0%). Of the two patients treated with the sequential use of ipilimumab/nivolumab, one lost his allograft, yielding a rejection rate of 50%. The sequential use of ipilimumab/pembrolizumab led to a rejection rate of 100% (1/1, 100%).

Conclusion

The use of agents that act on the PD-L1 pathway are contraindicated in the face of solid organ allografts because of unacceptably high rates of irreversible allograft rejection. It appears that the use of ipilimumab may be tolerated as the mechanism is different from that of the PD-L1 agents.

Implications for Practice

Transplant rejection is a complex process that puts stress on patients and their families and can lead to tragic results. Significant advancements in the field of immunosuppression have led to the engenderment of agents devised to extend the survival of transplant recipients. The advent of immunomodulators in cancer therapy has been paradigm-shifting; however, because of their mechanism of action, their use must be carefully considered in patients with allografts and concomitant cancer. It appears that ipilimumab can be administered safely in these patients but that agents acting on the programmed death-ligand 1 pathway are contraindicated because of high rates of irreversible rejection.
“As Long as You Ask”: A Qualitative Study of Biobanking Consent—Oncology Patients’ and Health Care Professionals’ Attitudes, Motivations, and Experiences—the B-PPAE Study
Authors: Yip Sonia , Fleming Jennifer , Shepherd Heather L. , Walczak Adam , Clark Jonathan , Butow Phyllis
Published: November 2018

Introduction

Consent to biobanking remains controversial, with little empirical data to guide policy and practice. This study aimed to explore the attitudes, motivations, and concerns of both oncology patients and health care professionals (HCPs) regarding biobanking.

Materials and Methods

Qualitative interviews were conducted with oncology patients and HCPs purposively selected from five Australian hospitals. Patients were invited to give biobanking consent as part of a clinical trial and/or for future research were eligible. HCPs were eligible if involved in consenting patients to biobanking or to donate specimens to clinical trials.

Results

Twenty-two patients participated, with head and neck (36%) and prostate (18%) the most common cancer diagnoses; all had consented to biobanking. Twenty-two HCPs participated, from across eight cancer streams and five disciplines. Themes identified were (a) biobanking is a “no brainer”; (b) altruism or scientific enquiry; (c) trust in clinicians, science, and institutions; (d) no consent—just do it; (e) respecting patient choice (“opt-out”); (f) respectful timing of the request; (g) need for emotional/family support; (h) context of the biobanking request matters; and (i) factors for biobanking success.

Discussion

These findings reinforced previous findings regarding high public trust in, and support for, biobanking. An initial opt-in consent approach with the option of later opt-out was favored by patients to respect and recognize donor generosity, whereas HCPs preferred an upfront opt-out model. Factors impacting biobanking success included the context of the request for use in a trial or specific research question, pre-existing patient and HCP rapport, a local institution champion, and infrastructure.
Age and the Risk of Paclitaxel-Induced Neuropathy in Women with Early-Stage Breast Cancer (Alliance A151411): Results from 1,881 Patients from Cancer and Leukemia Group B (CALGB) 40101
Authors: Barginear Myra , Dueck Amylou C. , Allred Jacob B. , Bunnell Craig , Cohen Harvey J. , Freedman Rachel A. , Hurria Arti , Kimmick Gretchen , Le-Rademacher Jennifer G. , Lichtman Stuart , Muss Hyman B. , Shulman Lawrence N. , Copur M. Sitiki , Biggs David , Ramaswamy Bhuvaneswari , Lafky Jacqueline M. , Jatoi Aminah
Published: November 2018

Purpose

A few previous studies report a direct relationship between older age and chemotherapy-induced neuropathy. This study further evaluated this adverse event's age-based risk.

Methods

CALGB 40101 investigated adjuvant paclitaxel (80 mg/m2 once per week or 175 mg/m2 every 2 weeks) in patients with breast cancer and served as a platform for the current study that investigated age-based differences in neuropathy. Grade 2 or worse neuropathy, as per Common Terminology Criteria for Adverse Events version 4, was the primary endpoint; patients were assessed at baseline, every 6 months for 2 years, and then annually for 15 years.

Results

Among these 1,881 patients, 230 were 65 years of age or older, 556 were 55–64 years, and 1,095 were younger than 55; 1,226 neuropathy events (commonly grade 1 or 2) were reported in 65% of the cohort. The number of grade 2 or worse events was 63 (27%), 155 (28%), and 266 (24%) within respective age groups (p = .14). In univariate analysis, only motor neuropathy had a higher age-based incidence: 19 (8%), 43 (8%), and 60 (5%), respectively (p = .04); in multivariate analyses, this association was no longer statistically significant. Other endpoints, such as time to onset of neuropathy (time from trial enrollment to neuropathy development) and time to improvement (time from maximal grade sensory neuropathy to a one-category improvement), showed no statistically significant age-based differences. In contrast, obesity was associated with neuropathy, and every 2-week paclitaxel was associated with trends toward neuropathy.

Conclusion

Although paclitaxel-induced neuropathy is common, older age is not an independent risk factor. Clinical trial identification number. NCT00041119 (CALGB 40101).
Physical properties and microstructure of nickel slag/metakaolin-based geopolymer with different contents of nickel slag
Authors: Zhang Changsen , Zhu Baogui , Wu Qisheng , Li Yang , Feng Zhenzhe , Wang Yu , Hu Zhichao
Published: November 2018

Geopolymer pastes based on nickel slag/metakaolin (NS/MK) were prepared and their physical properties and microstructure as a function of NS content were studied. The results showed that the addition of NS in an appropriate proportion not only enhanced the compressive strength but also led to volume-expansive behaviour of the hardened pastes. Analysis of the pore size distribution indicated that increasing the NS content reduced the total pore volume and increased the average pore size. The silicate species dissolved from the NS participated in the geopolymerisation and influenced the mineralogical composition and microstructure of the gel phase. The addition of NS had no detrimental effect on the concentrations of alkali metals and pH of the leaching solution obtained from the geopolymer samples. In addition, the addition of NS had no detrimental effect on the dissolution behaviour of MK. This work presents a further step in the development of alternative ‘low-carbon’ binders for the construction industry.
Shear behaviour of Canadian marine clay/geomembrane interface under freeze–thaw cycles
Authors: Li Ling , Fall Mamadou
Published: November 2018

The influence of the number of freeze–thaw (F–T) cycles on the interface shear behaviour of a compacted marine clay (Leda clay)/smooth high-density polyethylene (HDPE) geomembrane is investigated in this paper. Shear tests are performed on samples subjected to various numbers of F–T cycles: zero, one, two, three, five and ten. The test results show that the interface shear strength of the Leda clay/smooth HDPE geomembrane is lower than that of Leda clay. The interface shear strength of the Leda clay/smooth HDPE geomembrane decreases with increasing number of F–T cycles. Furthermore, the interface shear friction angles of the Leda clay/smooth HDPE geomembrane are significantly reduced within the first three F–T cycles. The reduction in strength beyond the three F–T cycles is negligible. The total decrease in the shear strength of the samples that are not subjected to an F–T cycle compared to that of samples subjected to ten F–T cycles is 18·3, 17·6 and 13·6% under a vertical stress of 150, 250 and 350 kPa, respectively.
A mass-flux method to estimate pollutants in groundwater
Authors: Chapuis Robert P
Published: November 2018

Groundwater contamination is difficult to define and quantify. It may be easy or not to define who did the contamination and which contaminant was released, but it is hard to assess how much, where and when a contaminant was released. Second, concentrations fluctuate with space and time in groundwater. Third, it is difficult to assess the total mass of dissolved contaminant and the annual mass discharged into surface water or reaching pumping wells. These issues are documented with an example from Canada where the fluctuations in concentrations, over time and space, spanned four orders of magnitude within the plume. All data were examined using a quality control process, which examined all reasons for poor quality and revealed contradictory pieces of information and also poor procedures or field protocols for water sampling. An annual mass-flux method for the aquifer contaminants reaching a river was developed. It takes into account the contaminant concentration in the river and the dilution by the river water. This method helped to reconcile field and laboratory data for the mean concentrations in the plume and clarify the situation.
Waste-composition-dependent ‘HBM’ model parameters based on degradation experiments
Authors: Datta Sampurna , Zekkos Dimitrios , Fei Xunchang , McDougall John
Published: November 2018

Municipal solid waste (MSW) is biodegradable in landfills under anaerobic conditions. The evolution of the hydro-biochemical-mechanical (HBM) processes during degradation is investigated first through experiments and subsequently through modelling. Three well-characterised MSW specimens from US landfill sites with significantly different waste compositions ranging from ‘waste-rich’ to ‘soil-rich’ were degraded in large-scale experimental set-ups that enabled simultaneous characterisation of the processes with time. The closely monitored processes are subsequently modelled using a two-stage anaerobic degradation model which is incorporated in the HBM model. This allows an assessment of model performance as a function of waste composition and derivation of waste-composition-dependent model parameters. The model performed fairly well in capturing the biochemical and physical behaviours. An increase in biodegradable material in waste specimen corresponds to an increase in anaerobic activity (volatile fatty acids and methanogenic biomass accumulation), a higher rate of organic fraction depletion, an increase in settlement and an increase in methane production. However, the model is found to significantly overpredict methane production for all the specimens.
Orphan breakwaters – what protection is given when they collapse?
Authors: Allsop Nigel William Henry , Pearson Adrian N. , Bruce Tom
Published: November 2018

Many old coastal harbours in the UK are protected by blockwork breakwaters, but the original streams of income for maintaining or refurbishing these structures have largely diminished. Their breakwaters may, however, still protect harbour-side properties against wave overtopping, and thus flooding. This paper presents results from an exploratory study to identify how the blockwork breakwaters common in many smaller UK coastal harbours may collapse due to storm action and how much wave protection is given by collapsed breakwaters.
Effects of installation location on the in-service wind load of a tower crane
Authors: Chen Wei , Qin Xianrong , Yang Zhigang
Published: November 2018

Tower cranes are usually attached to buildings, which affects the crane's aerodynamic configuration, and therefore the wind loads on the tower crane are changed. In this study, a numerical simulation using computational fluid dynamics was carried out to investigate the mean force and moment coefficients of an in-service tower crane at five different locations. A single unattached tower crane was taken as the reference counterpart. The results showed that the building played an important role in reducing the along-wind load of the tower crane. In comparison with the reference tower crane, the average reductions of the along-wind load on the tower crane under longitudinal and transverse arrangements were 53·4% and 52·7%, respectively. For 90° to 180° wind directions, the torsion moments were smaller than those of the reference. The closer the crane was to the building, the smaller was the torsion moment. Among the five locations investigated, longitudinal distance was found to have less effect on the along-wind, across-wind and torsion moment loads on the tower crane than the transverse distance. However, the transverse distance had a great influence for 0° to 90° wind directions. The closer the tower crane was to the corner of the building, the more severe the wind direction deviated from the original direction.