bluuebunny/crossref_metadata_2025 huggingface dataset:
PEPPSI complexes as potential prodrugs: enzyme inhibition, antioxidant activity, electrochemical characterization, molecular docking analysis
Authors: Üstün Elvan , Çelebi Mutlu S. , Ayvaz Melek Ç. , Şahin Neslihan
Published: April 2021

In this study, enzyme inhibition and antioxidant activity analyzes of previously characterized pyridine-enhanced precatalyst preparation stabilization and initiation (PEPPSI)-type Palladium(II) complexes with benzimidazole-type ligands {dichloro[L]pyridine palladium(II), L1: 1-(2-methyl-2-propenyl)-3-[benzylbenzimidazole]-2-ylidene, L2: 1-(2-methyl-2-propenyl)-3-[4-chloro benzylbenzimidazole]-2-ylidene, L3: 1-(2-methyl-2-propenyl)-3-[3-methylbenzylbenzimidazole]-2-ylidene, L4: 1-(2-methyl-2-propenyl)-3-[3,4,5-thrimethoxybenzylbenzimidazole]-2-ylidene, L5: 1-(2-methyl-2-propenyl)-3-[3-naphthylbenzylbenzimidazole]-2-ylidene, L6: 1-(2-methyl-2-propenyl)-3-[anthracen-9-ylmethylbenzimidazole]-2-ylidene} were performed and evaluated as potential drugs for neurodegenerative disorders such as Alzheimer disease and Parkinson disease. Inhibition of tyrosinase enzyme of N-heterocyclic carbenes (NHC) complexes was determined for the first time in literature. Chelating activities of the complexes were determined and compared with EDTA. Electrochemical characterization was performed using cyclic voltammetry method. Moreover, global reactivity descriptors and electronic transitions were evaluated by DFT/TDDFT methods and molecular docking interactions with human acetylcholine esterase, human butyrylcholine esterase and oxidoreductase were studied.
Macro Thermogravimetric Analyzers: Versatile and Underutilized Analytical Instruments
Authors: Riley John T. , Marsh Mason
Published: April 2021

Thermogravimetric analysis (TGA) is an analytical technique in which changes in physical and chemical properties of materials are measured as a function of temperature or time or both. TGA is commonly used to determine selected characteristics of materials that exhibit either mass loss, or gain, because of decomposition, oxidation, reduction, or loss of volatile material, such as moisture. Common applications of TGA are materials characterization through analysis of characteristic decomposition patterns and determination of combustible materials and combustion residues from a sample. Macro thermogravimetric analyzer (macro TGA) systems that use gram-size samples have been used for almost four decades for routine laboratory measurements, especially those measurements that monitor industrial processes. The larger sample sizes allow more accurate mass measurements for characterization of materials. Larger sample sizes also reduce the effects of uneven particle sizes and uneven distribution of properties between particles. Macro TGAs are automatic multi-sample analyzers with a multi-position sample carousel. Widespread use of these systems has led to the development of at least four ASTM International standard test methods that use macro TGAs. Other standard test methods using macro TGAs are in the process of being developed by ASTM International. Some other countries have developed, or are in the process of developing, standard test methods that use macro TGA instrumentation.
Seawater intrusion assessment and prediction of sea-freshwater interface in Parangtritis coastal aquifer, South of Yogyakarta Special Province, Indonesia
Authors: Wilopo Wahyu , Risanti R , Susatio Raja , Putra Doni Prakasa Eka
Published: April 2021

The Parangtritis area is a tourist destination in Yogyakarta, Indonesia, consisting of dunes and plains. One of the essential parameters in tourist areas is the provision of water sources. The increase in tourist visits and the development of tourism facilities in this area have increased groundwater utilization. Therefore, this study aims to assess the potential of seawater intrusion in the Parangtritis Beach area and its surroundings, Indonesia. The research was carried out by surveying, field measurements, and groundwater samples to test major ions in the laboratory. Indications of seawater intrusion are based on TDS values, Cl-, Simpson ratio, Sodium Chloride ratio, BEX, and groundwater type. The results showed that the research area had a shallow groundwater level with groundwater flow relative to the south-southwest and composed of unconfined aquifers. Only two water samples indicate seawater intrusion from Parangwedang spring and its southern place based on the geochemical analysis. However, this spring was formed due to geological structure related to geothermal manifestation and not due to seawater intrusion. It has a lateral flow to the south and is mixed with shallow groundwater, thereby increasing the chloride concentration in the groundwater. The sea-freshwater interface has a depth from 52 meters to 284 meters from sea level, where the farther from the coastline, the more profound.
Rapid detection of land cover change in tropical savanna environment using conditional change vector analysis on remote sensing data in Moyo watershed, Sumbawa Regency, West Nusa Tenggara Province, Indonesia
Authors: Nugroho Gatot , Chulafak Galdita Aruba , Yulianto Fajar
Published: April 2021

In environmental management, land cover change is a crucial aspect. The area of tropical savanna environments is vulnerable to land degradation. This study aimed to rapidly detect land cover changes in a tropical savanna environment based on remote sensing data. Conditional change detection was performed using the Change Vector Analysis (CVA) with input parameters such as the Enhanced Vegetation Index (EVI) and Normalized Difference Soil Index (NDSI). The results showed that during the period 2015 to 2019, changes were detected in the Moyo watershed every year. From 2015 to 2016, the Moyo River Basin was dominated by changes with a change magnitude of less than 0.088, which was 63% of the Moyo River Basin area. From 2016 to 2017, the changes were dominated by the change magnitude value of 0.063, which was 58.6% of the Moyo River Basin area. From 2017 to 2018, changes were dominated by the change magnitude value of 0.084 of 55.26% of the Moyo watershed area. From 2018 to 2019, the change was dominated by the change magnitude value of 0.057, which was 47.57% of the Moyo watershed area. The direction of land cover change was dominated by Q2 in 2016, Q4 in 2017 and 2018, and Q2 and Q4 in 2019. These changes generally occurred in the Moyo watershed middle and downstream parts, which are grasslands. The use of the Conditional Change Vector Analysis (CCVA) approach in a tropical savanna environment can detect changes and the direction of change with an accuracy of about 70%.
The impact of anthropogenic activities on the physicochemical characteristics of Cheleleka peat, Ethiopia
Authors: Tesfaye Haymanot , Warkineh Bikila
Published: April 2021

Cheleleka peatland is located at the eastern side of Lake Hawassa and its biological communities face a variety of anthropogenic factors such as agricultural expansion, water diversion, settlement and subsequent peatland drainage and peat extraction. The decomposing products were influenced by various anthropogenic activities. This study aims to identify the impact of human activities on peat characteristics. The result indicates that the peat soil is acidic having a pH value ranging from 4.1-to-4.7 and containing humic acid due to excessive accumulation of organic matter and nutrients. The maturity level of the peat was almost similar in all study sites, except for the Daka site, and are classified under mostly decomposed. At Wesha, Werka, Wendo, Shalo, Cheffe, and Wendo, sites the maturity of the peat was classified under sapric soil. Exceptionally, at Daka Site, the peat maturity level was hemic. The percentage of sand, clay, and silt of the peatland range 40-50% clay, 30-40% silt and 10-20% sandy. The mean organic carbon content of Cheleleka peatland ranged from 4.48 to 38.65% and positively correlated with the thickness of the peat and negatively correlated with the ash content of the peat. The main effects of unsustainable landuse practice on peatland are peat reduction/complete loss, reduce water and nutrient retention capacity due to drainage and compaction of peat due to overgrazing. Changes in drainage, vegetation cover, and extraction of peat had resulted in differing outcomes from decomposition processes, and the properties of peats on the disturbed sites had changed.
Soil characteristic and shallot growth with gypsum and zeolite amendments in irrigated saline Alfisol and Inceptisol
Authors: Rahayu Rahayu , Syamsiyah Jauhari , Dewi Livia
Published: April 2021

Salinity of soil and irrigation is a factor that may cause a decrease in shallot productivity, so it requires efforts with amendments. This research aimed to determine the effect of gypsum and zeolite amendments on soil and shallot growth with saline irrigation. A pot experiment was conducted in the field using a completely randomized design with three factors. The first factor was two soil types (Alfisol and Inceptisol); the second factor was three shallot cultivars (Brebes, Purbalingga, and Pemalang); and the third factor was two types of soil amendments. The results showed that gypsum and zeolite reduced pH, sodium adsorption ratio (SAR), electric conductivity paste (ECp) and Na of the soils studied. Gypsum and zeolite increased the uptake of N, P and K by shallot plants. The increase of N uptake by applying gypsum on Inceptisol was more effective to Brebes and Purbalingga cultivars than Pemalang cultivar. Gypsum increased the diameter and number of bulbs in Inceptisol. Zeolite and gypsum increased bulb weight of Purbalingga cultivar in Alfisol.
Awards
Authors: Schattman Rachel E. , Trinity Luke , Clark Eric M. , Merrill Scott C.
Published: April 2021

There are many examples of nonmonetary awards which can serve as proxies for social recognition of good agricultural stewardship and conservation behavior. However, the degree to which these awards motivate implementation and sustained use of conservation practices (such as cover cropping) has not been adequately examined. In this study, we used a serious game approach to explore the effect of nonmonetary conservation awards on participants’ agricultural management decisions in an online experiment. Our results show that study participants were highly motivated to implement cover crops on a year-by-year basis by the fictional Ecobadge award, particularly when award thresholds were set at low levels. There was no difference between participants with prior agricultural experience and those without. Although participants who were not motivated to seek the Ecobadge achieved higher mean financial returns, they also had a wider variation in their financial performance as a group. Those who attained the Ecobadge were less risk-tolerant than those who did not. Achievement of the Ecobadge decayed over several rounds of game play, except among participants who planted cover crops on a high percentage (≥50%) of their land, suggesting these participants possessed high intrinsic motivation. This exploration suggests that nonmonetary awards have high potential to serve as motivational tools to increase adoption of cover crops and potentially other agricultural conservation practices, likely as part of a suite of motivational strategies. We suggest that organizations reconsider how they issue these awards. Better integration of awards with opportunities for peer-to-peer recognition among farmers is a promising approach to expand implementation of conservation practices.
Beyond the Binary: Why Gender Matters in the Recruitment and Use of Children
Authors: Kapur Nidhi , Thompson Hannah
Published: April 2021

Gender matters in conflict. Socio-cultural norms, attitudes and expectations related to gender dictate the causes, course and consequences of child soldiering. Despite international commitments, the recruitment and use of children in armed forces and groups persists. This paper summarizes existing quantitative data from the United Nations Monitoring and Reporting Mechanism, in light of complementary qualitative analysis from other sources, to highlight the ways in which gender norms can (a) drive recruitment, (b) determine roles and responsibilities, and (c) influence outcomes for children associated with armed forces or groups. The needs and experiences of girls and boys are explored, and where evidence allows, that of children of diverse sexual orientation, gender identity and expression, and sex characteristics (SOGIESC). Recommendations are made on potential actions that can further nuance the gender perspective proposed in the Vancouver Principles. Suggestions are made on how to ensure prevention and response interventions are (1) supported by consistently disaggregated data, (2) cognisant of the gender drivers behind recruitment, and (3) tailored to the distinct needs of children of diverse SOGIESC.
Effect of empagliflozin on albuminuria, eGFR and serum creatinine: updated results from the ABCD nationwide empagliflozin audit
Authors: Crabtree Thomas SJ , Bickerton Alex , Elliott Jackie , Raghavan Rajeev , Barnes Dennis , Sivappriyan Siva , Phillips Suzanne , Evans Alison , Sennik Devesh , Rohilla Anurita , Gallen Ian , Ryder Robert EJ , - ABCD Empagliflozin Audit Contributors
Published: April 2021

Introduction: Evidence from phase III and the EMPA-REG OUTCOME trials have demonstrated improvements in renal endpoints with empagliflozin use. The EMPA-KIDNEY trial is currently underway and is assessing whether there are benefits of empagliflozin in improving renal outcomes in people both with and without diabetes, and the mechanism has been suggested to be similar to that of ACE inhibitors with the haemodynamic effects of sodium-glucose co-transporter-2 inhibition reducing intraglomerular pressure.Aim: To assess the impacts of empagliflozin use on albuminuria and estimated glomerular filtration rate (eGFR) in a real-world UK-based audit.Methods: Data were collated via the ABCD nationwide audit programme, with analyses performed using either t-tests/ ANOVA or Wilcoxon signed rank/Kruskal–Wallis tests. Pre-specified stratified subgroup analyses by baseline eGFR and baseline albuminuria levels were also performed.Results: Our results demonstrated significant reductions in albuminuria across the population as a whole. When stratified by baseline albuminuria levels, those with microalbuminuria (30–300 μg/mg) or macroalbuminuria (>300 μg/mg) had significant improvements in urine albumin levels at 6-month (3–9-month) follow-up, with median changes of −17.7 μg/mg (p<0.0001; 95% CI −17.4 to −23.7) and 379.4 μg/mg (p=0.03; 95% CI −269.9 to −725.4), respectively. Across the population as a whole, eGFR reduced initially (at 6 months, −1.26 mL/min/1.73 m3; p<0.0001; 95% CI −0.87 to −1.64) before recovering to baseline by 24 months. When stratified by baseline eGFR, those with reduced renal function (eGFR <90) recovered quickest, with improvements in eGFR noted from baseline by 24 months.Conclusion: In this real-world analysis, the results are comparable to those in randomised controlled trials and are likely more generalisable to UK clinical practice. Unfortunately, we do not have clinical endpoints such as end-stage renal failure, renal death or dialysis as part of our dataset. Future audits could consider including these data to establish clinical as well as biochemical outcomes.
The Impact of Biodiesel Blend Variation Contamination to Engine Friction, Wear, Performance and Emission
Authors: Nyirenda G. , Tamaldin N. , Zakaria M.H.
Published: April 2021

Biodiesel can be utilised in diesel engines without major alteration to the engine; however, its use can lead to engine oil dilution through biodiesel leaking and scraping to the engine oil pan. The objective of this research is to investigate the contamination of biodiesel in engine lubricant oil, and determine the relationship between engine performance and emission for three different blends of palm methyl ester (B10, B20, and B30). To simulate the contamination, the engine oils were blended with biodiesel fuels at 5%, 10%, 15% and 20% by volume and these mixtures were tested on four-ball test equipment. An air-cooled diesel engine was used to analyse the influence of the three biodiesel blends on the output and emission of the diesel engine. The results show that both coefficient of friction and wear scar diameter increased with the increase of biodiesel percentage. The results of engine performance during both sweep test and step test showed that the variation of torque and power among the blends at a particular speed was within a very narrow range.
Giant bilateral adrenal lipoma in a patient with congenital adrenal hyperplasia
Authors: Kienitz Tina , Schwander Jörg , Bogner Ulrich , Schwabe Michael , Steinmüller Thomas , Quinkler Marcus
Published: April 2021

Apart from adrenal myelolipomas, adrenal lipomatous tumors are rare and only seldom described in the literature. We present the case of a 50-year-old man, with a classical form of congenital adrenal hyperplasia (CAH), which was well treated with prednisolone and fludrocortisone. The patient presented with pollakisuria and shortness of breath while bending over. On MRI, fat-equivalent masses were found in the abdomen (14 × 19 × 11 cm on the right side and 10 × 11 × 6 cm on the left side). The right adrenal mass was resected during open laparotomy and the pathohistological examination revealed the diagnosis of an adrenal lipoma. Symptoms were subdued totally postoperatively. This is the first report of a bilateral adrenal lipoma in a patient with CAH that we are aware of.

Learning points:

Macronodular hyperplasia is common in patients with congenital adrenal hyperplasia (CAH).

Solitary adrenal tumors appear in approximately 10% of adult CAH patients and are often benign myelolipomas.

The Endocrine Society Clinical Practice Guideline does not recommend routine adrenal imaging in adult CAH patients.

Adrenal imaging should be performed in CAH patients with clinical signs for an adrenal or abdominal mass.

Adrenal lipoma is rare and histopathological examinations should rule out a differentiated liposarcoma.
Leptin antagonism inhibits prostate cancer xenograft growth and progression
Authors: Philp Lisa K , Rockstroh Anja , Sadowski Martin C , Taherian Fard Atefeh , Lehman Melanie , Tevz Gregor , Libério Michelle S , Bidgood Charles L , Gunter Jennifer H , McPherson Stephen , Bartonicek Nenad , Wade John D , Otvos Laszlo , Nelson Colleen C
Published: April 2021

Hyperleptinaemia is a well-established therapeutic side effect of drugs inhibiting the androgen axis in prostate cancer (PCa), including main stay androgen deprivation therapy (ADT) and androgen targeted therapies (ATT). Given significant crossover between the adipokine hormone signalling of leptin and multiple cancer-promoting hallmark pathways, including growth, proliferation, migration, angiogenesis, metabolism and inflammation, targeting the leptin axis is therapeutically appealing, especially in advanced PCa where current therapies fail to be curative. In this study, we uncover leptin as a novel universal target in PCa and are the first to highlight increased intratumoural leptin and leptin receptor (LEPR) expression in PCa cells and patients' tumours exposed to androgen deprivation, as is observed in patients' tumours of metastatic and castrate resistant (CRPC) PCa. We also reveal the world-first preclinical evidence that demonstrates marked efficacy of targeted leptin-signalling blockade, using Allo-aca, a potent, specific, and safe LEPR peptide antagonist. Allo-aca-suppressed tumour growth and delayed progression to CRPC in mice bearing LNCaP xenografts, with reduced tumour vascularity and altered pathways of apoptosis, transcription/translation, and energetics in tumours determined as potential mechanisms underpinning anti-tumour efficacy. We highlight LEPR blockade in combination with androgen axis inhibition represents a promising new therapeutic strategy vital in advanced PCa treatment.
ДІЯЛЬНІСТЬ ЗАКЛАДІВ ДОШКІЛЬНОЇ ОСВІТИ В УМОВАХ СОЦІАЛЬНИХ ЗМІН
Authors: Marusynets Mariana , Palko Tetiana
Published: April 2021

У статті здійснено рефлексивно-аналітичний аналіз діяльності закладів дошкільної освіти в умовах соціальних змін, вказано на можливі аспекти розвитку та ефективності процесу управління. Закцентовано увагу на тому, що стратегічною метою системи освіти є якісні зміни, зумовлені соціальними та інформаційними запитами, які потребують впровадження компетентнісного підходу в процес управління як на рівні керівника, так і всього педагогічного персоналу. Такі зміни спонукають керівника до особистого цілепокладання, креативності та критичності, самоорганізації та самовдосконалення щодо управління персоналом та закладом загалом. Визначено труднощі, які виникають у відмінностях між новітніми моделями управління і стереотипами, що сформувались упродовж десятиліть і є традицією.За традиційного підходу основною метою освіти є формування гармонійно розвиненої, суспільно активної особистості, яка поєднує в собі духовне багатство, моральну чистоту та фізичну досконалість. Компетентнісний підхід передбачає переорієнтацію на створення умов для задоволення потреб у якісній освіті громадян, суспільства та ринку праці з метою оновлення структури та змісту освіти, формування системи неперервної освіти, освіти впродовж життя. Здійснено пілотне дослідження з оцінювання якості діяльності закладів освіти за критеріями: санітарно-гігієнічні умови, безпека життя, зміст стратегічного планування діяльності закладу дошкільної освіти, професійне зростання педагога, підвищення кваліфікації, надання допомоги педагогу керівником та вихователем-методистом, методична робота тощо. Констатовано, що керівництву закладу дошкільної освіти необхідно звернути увагу на матеріально-технічне оснащення закладу; зміст стратегічного планування діяльності ЗДО, оскільки не завжди приймаються колегіальні рішення спільно з педагогічним колективом з цього питання; можливість професійного зростання педагога, постійного підвищення кваліфікації, чергової та позачергової атестації; надання допомоги педагогу керівником та вихователем-методистом.Зроблено висновки, що управлінська діяльність керівника на засадах компетентнісного підходу потребує створення умов для неперервного розвитку професійної компетентності педагогів з урахуванням їх особистісних потреб, державних вимог та суспільного запиту; створення сприятливого психологічного клімату, атмосфери творчої співпраці в педагогічному колективі; обговорення з колективом необхідності розроблення та впровадження системи управління якістю у закладі, що має починатися із визначення компонентів, за якими здійснюватиметься процес безперервного вдосконалення якості освітньої діяльності.
Взаємозв’язок попередніх обертань молоту у кваліфікованих метальниць молоту
Authors: Рожков Владислав , Павленко Віктор , Павленко Єлена , Павленко Тетяна , Шутєєва Тетяна , Шутєєв Вячеслав
Published: April 2021

Мета: дослідити взаємозв’язок першого попереднього обертання молоту із другим у кваліфікованих металь-ниць молоту.

Матеріал і методи: досліджувалися 8 кваліфікованих метальниць молоту, фіналісток Чемпіонату світу та кубків Європи, упродовж сезонів 2016-2019 рр. У роботі були використані наступні методи: аналіз і узагальнення науково-методичної літератури, аналіз матеріалів відеозйомки, методи математичної статистики.

Результати: у результаті кореляційного аналізу найбільш тісний взаємозв’язок було зафіксовано між часом другого попереднього обертання молоту, лінійною, кутовою швидкостями молоту, відцентрованою силою молоту, які мали спортсменки наприкінці другого попереднього обертання молоту та показниками: кут у правому, ліво-му ліктьових суглобах, що мали метальниці наприкінці першого попереднього обертання молоту r=0,734-0,833. Результати дослідження показали, що із збільшенням кутів у ліктьових суглобах впродовж першого попереднього обертання молоту, у досліджуваних спортсменок буде спостерігатися підвищення швидкісних показників молоту, відцентрованої сили молоту наприкінці другого попереднього обертання молоту, а також збільшуватися час друго-го попереднього обертання молоту. Такі параметри техніки першого обертання молоту як: лінійна швидкість мо-лоту; кутова швидкість молоту; відцентрована сила молоту; тривалість першого попереднього обертання молоту – суттєвого впливу на показники техніки другого попереднього обертання молоту не мали.

Висновки: встановлено, що для ефективного виконання другого попереднього обертання молоту в технічній підготовці під час удосконалення техніки першого обертання молоту найбільше уваги слід приділяти кутам у лік-тьових суглобах, траєкторії руху кулі молоту, куту у правому колінному суглобі і висоті підйому п’ятки лівої ноги над опорою наприкінці першого попереднього обертання молоту.

Ключові слова: техніка, біомеханічні параметри, попередні обертання молоту, кваліфіковані спортсменки, метання молоту
Вдосконалення технічної підготовленості спортсменок художньої гімнастики засобами народно-сценічного танцю
Authors: Кизім Петро , Батєєва Наталія
Published: April 2021

Мета: експериментально обґрунтувати вдосконалення технічної підготовленості спортсменок художньої гімнастики віку 10-12 років засобами народно-сценічного танцю.

Матеріал і методи: теоретичний аналіз і узагальнення даних спеціальної науково-методичної літератури, педагогічне спостереження, педагогічне тестування, педагогічний експеримент, метод експертних оцінок, методи математичної статистики. У дослідженні бралии участь 14 гімнасток у віці 10-12 років. Поділено на дві групи: контрольну групу (КГ) 7 гімнасток та основну групу (ОГ) 7 гімнасток.

Результати: виявлено, що рівень технічної підготовленості більш відчутно зріс у гімнасток основної групи, де в навчально-тренувальному процесі застосовано засоби народно-сценічного танцю.

Висновки: встановлено позитивний вплив засобів народно-сценічного танцю на динаміку рівня технічної підготовленості спортсменок художньої гімнастики. Підтвердженням ефективності розробленої методики було статистично зміни у гімнасток основної групи. У гімнасток контрольної групи спостерігалася позитивна динаміка результатів, але статистично значущих змін не спостерігалося.

Ключові слова: художня гімнастика, спортсменки, технічна підготовленість, народно-сценічний танець
Invasive, minimally invasive and non-invasive hemodynamic monitoring in perioperative medicine
Authors: Manuel Alberto Guerrero Gutiérrez , Rubén Pérez Nieto Orlando , López Eder Iván Zamarrón , Sánchez Díaz Jesús Salvador , Diego Escarramán Martínez , Tomás Ernesto Deloya , Morales Lizbeth Franco , Villaseñor Luis Antonio Morgado , Ángel Martínez Camacho Miguel , Raúl Soriano Orozco , Alfredo Diaz Martínez Manuel
Published: April 2021

The hemodynamic monitoring is a fundamental part of the patient in the perioperative period, during the last decade the monitoring at the patient's bedside has grown at giant steps, from the emergency area, operating room, to the Intensive Care area. One of its most important advances is the decrease in the use of pulmonary artery catheter, which is being replaced by ultrasound and less invasive monitoring techniques, in this article we will review from the beginning of the monitoring to the most used less invasive monitors currently.
Pathophysiology of diabetes mellitus complications: Metabolic events and control
Authors: Ohiagu Franklyn O. , Chikezie Paul C. , Chikezie Chinwendu M.
Published: April 2021

Background: Diabetes mellitus (DM) is a metabolic disorder that is characterized by hyperglycemia and glucose intolerance, which is associated with impaired insulin secretion and peripheral sensitivity and eventual b-cell dysfunction. This review summarized the major metabolic pathways leading to both microvascular and macrovascular complications in DM, with a view of highlighting the enzymes involved and the possible inhibition of the enzymes facilitating these processes as a measure of diabetic control.

Methods: Data used in writing this review were sourced online from scientific search engines such as Google Scholar, Scopus, EMBASE, PubMed, ResearchGate, Mendeley, Medline, and SpringerLink, using keywords such as 'diabetic complications', 'hyperglycemia-induced diabetic mechanisms', 'diabetic enzymes' and 'diabetic enzyme inhibitors'. A total number of 109 references published online between 1990 and 2020 were generated and cited in this review.

Results: The most scourging and dilapidating effects of DM as well as associated vascular complications are classified into four categories viz.: nephropathy, retinopathy, neuropathy and cardiovascular disease. Hyperglycemia, which is associated with uncontrolled DM, elicits abnormal metabolism such that the enzymes involved in metabolic events leading to diabetic complications are expressed and amplified. The disorders associated with DM are linked to various metabolic pathways facilitated by enzyme activities of the polyol pathway, hexosamine biosynthetic pathway, glucose autoxidation as well as increased synthesis of advanced glycation end-products (AGEs), hexokinase-2 driven glycolytic overload, increased activities of the cyclooxygenase (COX), lipoxygenase (LOX) and pyruvate kinase (PKC) enzymes. The inhibition of the enzymes involved in these pathways could serve to mitigate and arrest diabetic complications.

Conclusion: Thus, suitable inhibitors for enzymes involved in DM metabolic events could serve as panaceas against DM complications, which will add to the growing list of new and more efficacious antidiabetic drugs.
Pediatric Interprofessional ICU Ethics Rounds: A Single-Center Study
Authors: Kana Lulia A. , Feder Katherine J. , Matusko Niki , Firn Janice I.
Published: April 2021

OBJECTIVES:

We sought to examine whether sociodemographic differences, such as race and socioeconomic status, existed between patients in the PICU, pediatric cardiothoracic ICU (PCTU), and NICU who were identified as having ethical issues during interprofessional ethics rounds and all other patients admitted to these units and to characterize the primary ethical issues identified in this context.

METHODS:

We compared sociodemographic factors among patients admitted to a quaternary academic children’s hospital between January 2017 and December 2018 who were identified as having ethical issues during PICU, PCTU, and NICU interprofessional ethics rounds (n = 122) with those of all other patients admitted to these units (n = 4971). χ2 tests or Fisher’s exact tests, Mann–Whitney U tests, and a multivariable logistic regression analysis were performed.

RESULTS:

With bivariate analyses, we detected significant differences by race, insurance type, and ventilator dependence, but no significant differences between the 2 groups existed on the basis of sex, ethnicity, religion, primary language, age, or a socioeconomic status metric. After we adjusted for confounders using a multivariable logistic regression analysis, only patients who were ventilator dependent were at significantly higher odds (odds ratio = 5.78; confidence interval = 3.69–9.04; P < .001) of being identified as having ethical issues. Goals of care was the most frequent ethical issue (44%).

CONCLUSIONS:

Except for ventilator dependence, patients with ethical issues during PICU, PCTU, and NICU interprofessional ethics rounds are demographically similar to overall patients admitted in these units. Future research should be used to assess whether proactive rounds impact the timing of ethics consultation requests as well as to determine if interprofessional ethics rounds influence volume and acuity in formal ethics consultation practices.
Obesity and Corticosteroid Dosing Guideline Adherence in Children Hospitalized With Asthma
Authors: Kyler Kathryn E. , Bettenhausen Jessica L. , Hall Matt , Glynn Earl F. , Hoffman Mark A. , Shakhnovich Valentina , Smolderen Kim , Davis Ann M.
Published: April 2021

OBJECTIVES:

Drug dosing recommendations for children with obesity remain limited. This may lead to variability in medication dosing among children with obesity. Therefore, our objective was to determine differences in the prevalence of guideline-nonadherent systemic corticosteroid orders by weight category in children hospitalized for asthma.

METHODS:

We performed a retrospective cross-sectional study of children aged 2 to 17 years hospitalized with asthma and prescribed systemic corticosteroids between January 1, 2010, and December 31, 2017, using the Cerner Health Facts deidentified database. Weight categories ranging from underweight to class III obesity were defined on the basis of BMI percentiles by using CDC guidelines. Corticosteroid orders were categorized as guideline adherent or nonadherent on the basis of total body weight–based dosing guidelines from the National Heart, Lung, and Blood Institute. χ2 test and multivariable logistic regression models were used to determine differences in guideline adherence between weight categories.

RESULTS:

We identified 21 488 children prescribed systemic corticosteroids during asthma hospitalizations. Most (54.2%) had a healthy weight, and 23.8% had obesity. Almost one-quarter received guideline-nonadherent orders (22.2%), with increasing prevalence among higher weight categories (19.4% of healthy weight children versus 36.0% of those with class III obesity; P < .001). After controlling for demographic and clinical covariates, weight category remained significantly associated with receiving a guideline-nonadherent order (P < .001).

CONCLUSIONS:

The prevalence of guideline-nonadherent corticosteroid orders for children hospitalized with asthma increases linearly with weight category, disproportionately affecting children with severe obesity. Standardization of drug dosing guidelines for children with obesity may help reduce variability in drug doses prescribed that may increase risk of harm.
Optimizing Oral Medication Schedules for Inpatient Sleep: A Quality Improvement Intervention
Authors: Mozer Christine L. , Bhagat Palak H. , Seward Sarah A. , Mason Noah R. , Anderson Samantha L. , Byron Maxx , Peirce Leah B. , Konold Victoria , Kumar Madan , Arora Vineet M. , Orlov Nicola M.
Published: April 2021

OBJECTIVES:

Hospitalized children experience frequent nighttime awakenings. Oral medications are commonly administered around the clock despite the comparable efficacy of daytime administration schedules, which promote sleep. With this study, we evaluated the effectiveness of a quality improvement initiative to increase the proportion of sleep-friendly antibiotic administration schedules.

METHODS:

Interprofessional stakeholders modified computerized provider order entry defaults for 4 oral antibiotic medications, from around the clock to administration occurring exclusively during waking hours. Additionally, care-team members received targeted education. Outcome measures included the proportion of sleep-friendly administration schedules and patient caregiver–reported disruptions to sleep. Pre- and posteducation surveys were used to evaluate education effectiveness. Balancing measures were missed antibiotic doses and related escalations of care.

RESULTS:

Interrupted time series analysis revealed a 72% increase (interceptpre: 18%; interceptpost: 90%; 95% confidence interval: 65%–79%; P < .001) in intercept for percentage of orders with sleep-friendly administration schedules (orders: npre = 1014 and npost = 649). Compared with preeducation surveys, care-team members posteducation were more likely to agree that oral medications scheduled around the clock cause sleep disruption (resident: 71% pre, 90% post [P = .01]; nurse: 63% pre, 79% post [P = .03]). Although sleep-friendly orders increased, patient caregivers reported an increase in sleep disruption due to medications (pre 28%, post 46%; P < .001).

CONCLUSIONS:

A simple, low-cost intervention of computerized provider order entry default modifications and education can increase the proportion of sleep-friendly oral antibiotic administration schedules for hospitalized children. Patient perception of sleep is impacted by multiple factors and often does not align with objective data. An increased focus on improving sleep during hospitalization may result in heightened awareness of disruptions.
Evaluation and Improvement of Intern Progress Note Assessments and Plans
Authors: Kelly Michelle M. , Sklansky Daniel J. , Nackers Kirstin A.M. , Coller Ryan J. , Dean Shannon M. , Eickhoff Jens C. , Bentley Nicole L. , Nacht Carrie L. , Shadman Kristin A.
Published: April 2021

OBJECTIVES:

Progress notes communicate providers’ assessments of patients’ diagnoses, progress, and treatment plans; however, providers perceive that note quality has degraded since the introduction of electronic health records. In this study, we aimed to (1) develop a tool to evaluate progress note assessments and plans with high interrater reliability and (2) assess whether a bundled intervention was associated with improved intern note quality without delaying note file time.

METHODS:

An 8-member stakeholder team developed a 19-item progress note assessment and plan evaluation (PNAPE) tool and bundled intervention consisting of a new note template and intern training curriculum. Interrater reliability was evaluated by calculating the intraclass correlation coefficient. Blinded assessors then used PNAPE to evaluate assessment and plan quality in pre- and postintervention notes (fall 2017 and 2018).

RESULTS:

PNAPE revealed high internal interrater reliability between assessors (intraclass correlation coefficient = 0.86; 95% confidence interval: 0.66–0.95). Total median PNAPE score increased from 13 (interquartile range [IQR]: 12–15) to 15 (IQR: 14–17; P = .008), and median file time decreased from 4:30 pm (IQR: 2:33 pm–6:20 pm) to 1:13 pm (IQR: 12:05 pm–3:59 pm; P < .001) in pre- and postintervention notes. In the postintervention period, a higher proportion of assessments and plans indicated the primary problem requiring ongoing hospitalization and progress of this problem (P = .0016 and P < .001, respectively).

CONCLUSIONS:

The PNAPE tool revealed high reliability between assessors, and the bundled intervention may be associated with improved intern note assessment and plan quality without delaying file time. Future studies are needed to evaluate whether these improvements can be sustained throughout residency and reproduced in future intern cohorts and other inpatient settings.
Changes in Pediatric Emergency Department Visits During the COVID-19 Pandemic
Authors: Haddadin Zaid , Blozinski Anna , Fernandez Kailee , Vittetoe Kelly , Greeno Amber L. , Halasa Natasha B. , Lovvorn Harold N.
Published: April 2021

OBJECTIVES:

Community mitigation measures were implemented to decrease the spread of severe acute respiratory syndrome coronavirus 2. In this study, we aimed to evaluate changes in pediatric emergency department (ED) visits, secondary to acute respiratory illnesses (ARIs) and trauma, before and during the pandemic. We hypothesized that the numbers of ED visits and ARIs would decrease, whereas the proportion of trauma visits would increase.

METHODS:

A retrospective study from 2018 to 2020 was performed on children 18 years and younger presenting to the ED either for ARI or trauma at a high-volume comprehensive pediatric hospital between March and May each year. International Classification of Diseases, 10th Revision, Clinical Modification admission diagnosis codes were used to identify ARI, trauma, and injury mechanisms. Pearson’s χ2 test was used to compare proportions between categorical variables.

RESULTS:

Overall, 6393 total ED visits occurred in 2020, compared with 11 758 and 12 138 in 2018 and 2019, respectively. In 2020, the total ARI number declined by 58%, and ARI frequency decreased significantly, whereas the total trauma number declined by 34%, and the proportion of trauma visits significantly increased. In addition, the number and proportion of recreational vehicle crashes increased, whereas the number and proportion decreased for all intentional and animal-related traumas.

CONCLUSIONS:

The total number of pediatric ED visits dropped precipitously in 2020, but the proportion of trauma visits increased significantly in 2020, accounting for greater than one-quarter of all ED visits. Injury mechanism varied significantly compared to previous years. Future studies are needed to confirm these findings and evaluate the benefits of community mitigation to decrease ARIs and strategies directed to reduce mechanism-specific trauma.
The Neonate with Ambiguous Genitalia
Authors: Lee Brian R. , Strobel Katie M. , Chu Alison
Published: April 2021

Neonates with ambiguous genitalia have various clinical presentations, etiologies, and outcomes, ranging from benign to life-threatening. This review provides a summary of these findings. Some diagnoses may lead to delayed sex assignment. A systematic approach to the evaluation of disorders of sex development can allow for timely treatment and family counseling.
Craniosynostosis: Neonatal Perspectives
Authors: Bautista Geoanna
Published: April 2021

Craniosynostosis is the premature fusion of 1 or more sutures that normally separate the bony plates of an infant’s skull and occurs in about 1 in 2,000 to 2,500 live births. Primary or congenital craniosynostoses represent the majority of cases and consist of single-suture and multisuture synostoses. Multisuture synostoses are typically associated with distinct craniofacial syndromes, including Muenke syndrome, Apert syndrome, Crouzon syndrome, and Pfeiffer syndrome, and are thus categorized under syndromic craniosynostoses. Secondary causes of craniosynostoses include metabolic or hematologic disorders that affect bone metabolism and typically present much later than primary synostoses. The severity of the deformity and the presence of increased intracranial pressure dictate the need for early surgical intervention, prompting the importance of early recognition and timely referral. Infants with craniosynostosis are also at increased risk for neurodevelopmental impairment and thus require close follow-up and monitoring. The early recognition and referral of craniosynostosis is imperative for the optimization of management and minimization of potential neurologic impairments that may develop.
Representation of Women Physicians in Heart Failure Clinical Practice
Authors: DeFilippis Ersilia M , Moayedi Yasbanoo , Reza Nosheen
Published: April 2021

Women have been integral in the development of advanced heart failure (HF) and transplantation as a clinical subspecialty of cardiovascular medicine. However, women remain underrepresented in leadership positions, senior academic ranks and as researchers in HF. In recent years, there have been accelerating efforts to examine sex differences in the clinical and research domains of HF. The purpose of this review is to discuss the representation of women in HF training programmes and clinical practice, the demographics of HF clinicians compared with other cardiology subspecialties, the persistent sex disparities in HF practice and research environments and potential strategies to promote equity and inclusion for women in the field.
Converting the Masses
Authors: Nichols Amanda M.
Published: April 2021

Drawing on the work of Naomi Wolf who described a transition in commercial advertising inspired by the feminist movement, I examine the ways commercial marketing strategies have changed in the wake of the election of Donald Trump and the #MeToo movement. This shift illuminates the ideological functions of advertisements with regard to understandings of gender and nature. Employing Benson Saler’s family resemblances approach, and further drawing on the work of David Chidester and Katheryn Lofton I show that advertisements function in religion-resembling ways in pop culture. By examining a number of corporate advertisements between 2004 and 2019, I show a shift in some corporations’ marketing strategies in light of political tensions concerning sexual harassment and climate change in the United States. These changing strategies also represent a call to action by forming community around shared causes, urging consumers to choose wisely and think about something bigger than themselves.
Design, Modeling and Control of Bionic Knee in Artificial Leg
Authors: Xie Hualong , Xie Yao , Li Fei
Published: April 2021

The biped robot with heterogeneous legs (BRHL) greatly facilitates the development of intelligent lower-limb prosthesis (ILLP). In the BRHL, the remaining leg of the amputee is simulated by an artificial leg, which provides the bionic leg with the precise gait following trajectory. Therefore, the artificial leg must closely mimic the features of the human leg. After analyzing the motion mechanism of the human knee, this paper designs a four-link bionic knee in light of the coexistence of rolling and sliding between the femur, the meniscus and the tibia. Drawing on the driving mechanism of leg muscles, two pneumatic artificial muscles (PAMs) were adopted to serve as the extensor and flexor muscles on the thigh. The two PAMs move in opposite direction, driving the knee motions in the artificial leg. To overcome the complexity of traditional PAM modelling methods, the author set up a PAM feature test platform to disclose the features of the PAMs, and built static and dynamic nonlinear mathematical models of the PAMs based on the test data. Next, a proportional-integral-derivative (PID) closed loop controller and sliding mode controller was designed for the bionic knee, referring to the kinetics equation of the knee. Through experimental simulation, it is confirmed that the proposed controller can accurately control the position of the four-link bionic knee, and that the designed bionic knee and PAM driving mode are both correct.
SDA-SM: An Efficient Secure Data Aggregation Scheme using Separate MAC across Wireless Sensor Networks
Authors: Elshrkawey Mohamed , Al-Mahdi Hassan
Published: April 2021

Securing the aggregated data of the wireless sensor networks (WSNs) is a vital issue to minimize energy consumption and face potential attacks. This paper presents a novel end to end encryption scheme defined as Aggregating Secure Data -Separate MAC (SDA-SM). The importance of the SDA-SM is twofold. First, it separates the secured aggregated data and the message authentication codes (MAC) into two different packets. Second, it transmits these packets in a random separate time-slot according to the scheduling of the TDMA. Moreover, the TDMA applied in the LEACH protocol is modified to adequate to the proposed SDA-SM scheme. The SDA-SM uses MACs to verify the integrity of the aggregated data and uses a sensor protected identifier to authenticate the source of data. The simulation results of the experiments assure the SDA-SM objectives can be achieved with less computation of the communication overheads than earlier techniques. Besides, SDA-SM will be able to accomplish the integrity and confidentiality of accurate aggregated data while saving the energy to prolong the network lifetime.
A Pervasive Computational Intelligence based Cognitive Security Co-design Framework for Hype-connected Embedded Industrial IoT
Authors: Tariq Usman , Ahamed Ahanger Tariq , Nusir Muneer , Ibrahim Atef
Published: April 2021

The amplified connectivity of routine IoT entities can expose various security trajectories for cybercriminals to execute malevolent attacks. These dangers are even amplified by the source limitations and heterogeneity of low-budget IoT/IIoT nodes, which create existing multitude-centered and fixed perimeter-oriented security tools inappropriate for vibrant IoT settings. The offered emulation assessment exemplifies the remunerations of implementing context aware co-design oriented cognitive security method in assimilated IIoT settings and delivers exciting understandings in the strategy execution to drive forthcoming study. The innovative features of our system is in its capability to get by with irregular system connectivity as well as node limitations in terms of scares computational ability, limited buffer (at edge node), and finite energy. Based on real-time analytical data, projected scheme select the paramount probable end-to-end security system possibility that ties with an agreed set of node constraints. The paper achieves its goals by recognizing some gaps in the security explicit to node subclass that is vital to our system’s operations.