bluuebunny/crossref_metadata_2025 huggingface dataset:
La pedagogía crítica de Paulo Freire y sus aportes a la educación superior costarricense actual
Authors: Espinoza Arroyo Manuel Gerardo
Published: November 2021

Costa Rican higher education at present faces a series of challenges that attempt against its general autonomy and institutionality. Therefore, in this context, this paper has the main objective to analyze Paulo Freire´s pedagogical proposal and his educational contributions to Costa Rican higher education nowadays. Consequently, this essay seeks to deepen three aspects, which the Brazilian pedagogue contributes to public Costa Rican universities: dialogue, dialectical thought, and transformation. In addition, every single aspect will be explained from the Freirean viewpoint in addition to thinking about the enforcement of it in the Costa Rican context.
Effect of lignin-containing highly fibrillated cellulose on the adsorption behavior of an organic dye
Authors: Yan Zhongyu , Yi Caifu , Yang Jiawan , Ma Haizhu , Sha Lizheng , Guo Daliang , Zhao Huifang , Zhang Xiaoqin , Wang Wenjun
Published: November 2021

The morphological properties and particle size characteristics of micro- and nanofibrillated cellulose (NFC) and lignin-containing NFC (LNFC) produced by a microfluidizer processor were investigated. The effects mechanism of lignin-containing on the adsorption of NFC and the stable properties of organic dyes suspension were also studied. The results showed that the preparation process and final performance of NFC were affected by the key factors including lignin, homogenization pressure, and number of homogenization cycles. The increase in the homogeneity of the fibrillated cellulose was minor for the NFC samples, while LNFC samples showed a larger increase in the homogeneity of the particle size distribution. The influence of lignin was reflected both in improved fibrillation efficiency and in the final organic dye dispersion properties achieved by LNFC addition, primarily observed as deceased particle sizes and fibril dimensions. This study indicated that pollution-free dispersion of organic dyes can be realized through the application of lignin-containing NFC.
Evaluation of the capacity of laccase secretion of four novel isolated white-rot fungal strains in submerged fermentation with lignocellulosic biomass
Authors: An Qi , Shi Wen-Yi , He Yi-Xuan , Hao Wen-Yao , Ma Kai-Yue , Chen Xi , Yan Xun-You , Bian Lu-Sen , Li Cong-Sheng , Han Mei-Ling
Published: November 2021

The capacity of novel isolated white-rot fungi secreting laccase was evaluated for various kinds of lignocellulosic biomass in submerged fermentation. The laccase secreted by Neofomitella fumosipora Han 386 and Pleurotus pulmonarius Han 527 was significantly faster than that by Coriolopsis trogii Han 751 and Coriolopsis sanguinaria An 282. Maximum laccase from N. fumosipora Han 386 on the four kinds of lignocellulosic biomass tested appeared on the first day. This phenomenon indicated that N. fumosipora Han 386 secreted laccase rapidly compared with other tested strains in this study and showed the superiority in the rate of secreting laccase. Based on the maximum laccase activity, the ability of secreting laccase of C. sanguinaria An 282 was superior to other tested novel isolated strains. On the whole, N. fumosipora Han 386 and P. pulmonarius Han 527 preferred Toona sinensis to produce laccase, C. trogii Han 751 preferred to produce laccase on Populus beijingensis, and C. sanguinaria An 282 grown on Sorghum straw was more suitable for secreting laccase. The results will be helpful for developing bioprocesses using various kinds of lignocellulosic biomass for lignocellulolytic enzyme production and enlarging the number of laccase producing strains for industrial application.
Weathering performance of mulberry wood with UV varnish applied and its mechanical properties
Authors: Çavuş Vedat
Published: November 2021

Mulberry wood is used in carpentry, fences, turnery, and garden architecture. In this study, various mechanical properties (modulus of rupture, modulus of elasticity, Janka hardness, and screw holding resistance) of mulberry (Morus alba) wood and its weathering performance after applying 3- and 5-layer UV system parquet varnishes with different surface applications were investigated. The varnished materials were aged using UV lamps for 252 h and 504 h, and the aged specimens were compared with non-aged specimens. The results of the variance analyses found that all tests were significant. According to the results, it was found that while the yellow color (b*) tone value, lightness, and glossiness (perpendicular (⊥) and parallel (║) direction at 20°, 60°, and 85° angles) values decreased for both varnish applications, the pendulum hardness value increased. The adhesion strength (pull-off) test (MPa) to the surface first decreased and then increased.
Recycling and value-added design of discarded wooden furniture
Authors: Yang Danren , Zhu Jiangang
Published: November 2021

In the process of the “green revolution”, individuals have realized the importance of recycling waste materials. However, with ongoing individual changes in lifestyle, the huge resource of discarded wooden furniture is still considerably underutilized. This paper aims to provide new ideas for the recycling of discarded wooden furniture and to create added value to used furniture. Based on the summarization of existing recycling technology and methods, the diversified innovation and reuse of discarded wooden furniture integrating the current aesthetic and demand of people from multiple aspects are analyzed for the purpose of revealing the hidden value of waste materials. Waste recycling is of great importance to the country and enterprises in line with the concept of circular economy. For the sake of further excavating the hidden value of discarded wooden furniture products, the additional in-depth research in optimizing and upgrading green production and manufacturing in furniture industry is called for in the paper.
Abiding effects of phenolic antioxidants on oxidative behaviour of fatty acid methyl esters derived from waste cooking oil
Authors: Hossain Mosharof , Sujan Shah Mohammad Asaduzzaman , Jamal Mohammad Shah , Chowdhury Md. Shahariar , Techato Kuaanan , Fakhruddin Abu Naieum Muhammad
Published: November 2021

Fatty acid alkyl esters (FAMEs) derived from waste vegetable oils and non-edible oil sources are the most attractive alternative liquid biofuel in the energy field. Substitute methyl esters derived from waste cooking oil (WCO) have a lower induction period (3.12 h) and do not satisfy the Biodiesel EN 14214:2012 Standard (8 h). In this study, concentrations of 100, 250, 500, and 1000 ppm of four different types of phenolic antioxidants—butylated hydroxyanisole (BHA), butylated hydroxytoluene (BHT), tert-butyl hydroquinone (TBHQ), and propyl gallate (PG)—were used to examine oxidative stability and improve fuel quality. PG (250 ppm) showed the most effective result of 18 h to 12.17 h of the induction period of 6 months of storage. Antioxidant effectiveness increased with regard the oxidative stability of waste cooking oil methyl ester in the following order: BHT <TBHQ < BHA< PG. Acid value and kinematic viscosity of WCO biodiesel increase 564.3% and 10.3% respectively, which indicate degradation of fuel quality. But biodiesel with antioxidant, all the parameters changes dynamically. The acid value, kinematic viscosity, and density of all investigated samples increased. All results were within limits of EN 14214:2012 standard speciﬁcation for the 6 months of storage period.
Vibrational characteristics of four wood species commonly used in wood products
Authors: Hu Wengang , Li Shuang , Liu Yan
Published: November 2021

The effects of the moisture content, density, and striking direction of a hammer on the vibrational characteristics, i.e., the fundamental frequency and dynamic modulus of elasticity, of four wood species, i.e., poplar (Populus tomentosa), mahogany (Swietenia mahagoni), beech (Fagus orientalis), and ash (Fraxinus excelsior), commonly used in wood products were investigated, aiming to provide basic evidence for the nondestructive testing of wood materials. The results showed that the effect of the wood species on the fundamental frequency, dynamic modulus of elasticity, and static modulus of elasticity was statistically significant. The dynamic moduli of elasticity of the four wood species were higher than the corresponding static moduli of elasticity. The effect of the striking direction on the dynamic modulus of elasticity was not significant, indicating that no matter where the hammer struck, i.e., radial and tangential surfaces, the fundamental frequency was essentially constant. Negative relationships were found between the fundamental frequency and the density and moisture when the data of the four wood species were viewed as a population sample. The vibrational characteristics of each wood species varied, which can be applied to the nondestructive testing of wood.
Effects of wood flour and MA-EPDM on the properties of fused deposition modeling 3D-printed poly lactic acid composites
Authors: Bae Sang-U , Seo Young-Rok , Kim Birm-June , Lee Min
Published: November 2021

Fused deposition modeling (FDM) 3D printing technology is the most common system for polymer additive manufacturing (AM). Recent studies have been conducted to expand both the range of materials that can be used for FDM and their applications. As a filler, wood flour was incorporated into poly lactic acid (PLA) polymer to develop a biocomposite material. Composite filaments were manufactured with various wood flour contents and then successfully used for 3D printing. Morphological, mechanical, and biodegradation properties of FDM 3D-printed PLA composites were investigated. To mitigate brittleness, 5 phr of maleic anhydride grafted ethylene propylene diene monomer (MA-EPDM) was added to the composite blends, and microstructural properties of the composites were examined by scanning electron microscopy (SEM). Mechanical strength tests demonstrated that elasticity was imparted to the composites. Additionally, test results showed that the addition of wood flour to the PLA matrix promoted pore generation and further influenced the mechanical and biodegradation properties of the 3D-printed composites. An excellent effect of wood flour on the biodegradation properties of FDM 3D-printed PLA composites was observed.
Laccase activity from Pleurotus ostreatus and Flammulina velutipes strains grown on agro- and forestry residues by solid-state fermentation
Authors: An Qi , Liu Ze-Yang , Wang Chun-Rui , Yang Jing , Chen Si-Yu , Chen Xi , Zhang Yi-Jie , Bian Lu-Sen , Han Mei-Ling
Published: November 2021

Laccase activity from Pleurotus ostreatus and Flammulina velutipes strains was investigated with various agro- and forestry residues by solid-state fermentation. Different species or strains belonging to the same species had the unique capacity of secreting laccase on solid-state fermentation with various agro- and forestry residues. Overall, the capacity of secreting laccase for P. ostreatus strains was superior to F. velutipes strains due to the value of maximum activity on various agro- and forestry residues, except on the stalk of straw. Compared with Populus beijingensis, corncob, and stalk of straw, the presence of cottonseed hull was helpful to improve laccase activity for P. ostreatus strains because the maximum laccase activity from cottonseed hull was higher than that from the other three agro- and forestry residues. The presence of stalk of straw was more helpful to improve laccase activity for F. velutipes strains because of the maximum laccase activity from stalk of straw was higher that from Populus beijingensis, corncob, and cottonseed hull. These results indicated the importance of selecting suitable agro- and forestry residues for fungi producing laccase. These findings contributed to the selection of suitable strains to obtain an integrated application of low-cost laccase in the factory.
Concluding remarks on the Silent Critic. Dedicated to Bronius Raguotis
Authors: Vaišnys Andrius
Published: November 2021

Skiriama Broniui RAGUOČIUI prisiminti,humanitarinių mokslų daktarui, literatūros ir spaudos kritikui, žurnalistikos istorikui, Vilniaus valstybinio universiteto Istorijos fakulteto Spaudos žurnalistikos katedros vedėjui, Vilniaus universiteto Komunikacijos fakulteto Žurnalistikos instituto docentui, Rašytojų sąjungos nariui, Žurnalistų sąjungos nariui, „Žurnalistikos tyrimų“ žurnalo redakcinės kiolegijos nariui ir autoriui.
THE EFFECT OF THROMBIN IN THE SERUM-ADAPTED IONIC ENVIRONMENT ON THE INDUCTION OF EPILEPTIFORM FIRING ACTIVITY OF HIPPOCAMPAL CULTURED NEURONS
Authors:   O.O. Bogomolets Institute of Physiology of the NAS of Ukraine, Kyiv, Ukraine, Shypshyna M.S. , Savotchenko A.V. ,   O.O. Bogomolets Institute of Physiology of the NAS of Ukraine, Kyiv, Ukraine, Kuznetsov K.I. ,   O.O. Bogomolets Institute of Physiology of the NAS of Ukraine, Kyiv, Ukraine, Veselovsky M.S. ,   O.O. Bogomolets Institute of Physiology of the NAS of Ukraine, Kyiv, Ukraine
Published: November 2021

The mechanisms of epileptiform neuronal activity develop- ment under blood-brain barrier (BBB) dysfunction remains relevant in modern psychoneurology. In the present work we mimic some effects of BBB disruption in the culture of hip- pocampal neurons to examined the effect of serum-adapted ionic environment on the impulse activity of hippocampal neurons and the role of serum protein thrombin in induction of epileptiform neuronal activity. Using the whole-cell patch- clamp method under current-clamp mode we analyzed the spontaneous action potentials (AP) in the single hippocampal neurons. The changing of ionic extracellular neuronal environ- ment to such serum-adapted contributed to the development of epileptiform tonic activity of cultured hippocampal neurons and led to increase the average APs frequency by 65.1 ± 17.9% (n = 5) in neurons with spontaneous firing activity (FA) and to occurrence of tonic electrical activity (1.65 ± 0.4 s-1) in neurons without firing activity. Glutamate NMDA receptors significantly contribute to epileptiform tonic activity formation in neurons with FA, while their role in tonic activity providing in neurons without FA was insignificant. Thrombin (5 U/ml) in the serum-adapted ionic solution significantly enhanced of epileptiform activity in neurons with and without spontaneous FA: APs frequency increased in these neuronal groups by 117.3 ± 25.6% (n = 3) and by 61.8 ± 11.5% (n = 3), respective- ly, compared with that in the serum-adapted ionic solution only. Blockade of thrombin protease activated receptor 1 (PAR-1) by application of SCH 79797 (10 μm) canceled the thrombin’s effect in neurons without spontaneous FA, and significantly reduced such in neurons with FA. Therefore, the change of ionic extracellular neuronal environment to serum-adapted stimulates the occurrence of epileptiform activity in hippo- campal neurons, that is apparently associated with NMDA- receptors activation in neurons with FA. The proepileptiform action of thrombin was mostly mediated by PAR-1 activation. Thrombin-dependent regulation of the hippocampal single neurons firing activity involves the mechanisms different from the modulation of glutamate NMDA receptors in these cells.
THE CARBON MONOXIDE DONOR, TOPIRAMATE, AND BLOCKERS OF AQUAPORINE RECEPTORS DECREASE MYOCARDIAL ISCHEMIA-REPERFUSION INJIRY
Authors:   Kherson State University, Ukraine, Beschasnyi S.P. , Hasiuk O.M. ,   Kherson State University, Ukraine
Published: November 2021

We investigated the metabolism of mouse isolated heart under the influence of tricarbonyldichlorothenium (II)- dimer (CORM-2 and 2,3-4,5-bis-O-isopropylidene-βD-fructopyranose sulfamate (topiramate) as potential blockers of aquaporine channel (AQP3) of cardiac myocytes. The results were compared with those obtained from the group receiving anti-AQP3 monoclonal antibodies. A decrease in coronary flow was found during the period preceding ischemia (topiramate did not cause this effect). However, at the end of reperfusion, CORM-2 was responsible for its stabilization. This compound did not affect glucose intake (topiramate increased it only at the end of reperfusion), decreased Ca2+ deposition in cardiac muscle (AQP3-IgG antibodies and topiramate had similar effect), decreased creatinine release, AST (especially at the end of reperfusion). The action of CORM-2 increased the amplitude of the R waveform before ischemia and during reperfusion. At the end of reperfusion the R-wave amplitude decreased. The effect of topiramate caused an increase in amplitude only at the beginning of reperfusion. Administration of CORM-2, topiramate and antibodies resulted in prolongation of the interval before and during ischemia. At the same time, the effect of these drugs and antibodies reduced the development of ischemic damage. The results indicate that the released CO from CORM-2 has effects similar to those of anti-AQP3 antibodies. The action of topiramate had signs of calcium channel blocking.
THE ROLE OF IMMUNOGLOBULIN A IN THE INFLAMMATORY PROCESS INVOLVING NEUTROPHILS
Authors:   O.O. Bogomoletz Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine, Prudnikov O.O. , Prudnikov I.M. ,   O.O. Bogomoletz Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine, Tsyvkin V.M. ,   O.O. Bogomoletz Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine, Smirnov A.M. ,   O.O. Bogomoletz Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine, Yanchiy R.I. ,   O.O. Bogomoletz Institute of Physiology of the National Academy of Sciences of Ukraine, Kyiv, Ukraine
Published: November 2021

Neutrophils, as effector cells of acute inflammation, play a significant role in tissue homeostasis maintaining through participation in innate and adaptive immune responses. Class A immunoglobulins (IgA) are the most common antibodies in mucous membranes, as well as the second most abundant in the blood and are considered one of the powerful regulators of the functional activity of neutrophils. The review examines the effect of IgA on the inflammatory process involving neutrophils, which involves both the nonspecific innate immune response and the antigen-dependent response of the immunity. Depending on the situation, IgA is able to initiate both pro- and anti-inflammatory neutrophil response. Examples of diseases with IgA-dependent disorders in the regulation of neutrophil activity, as well as approaches to their correction are given. Particular attention has been paid to the possible association of some diseases in which neutrophils are overactivated by IgA immune complexes with female fertility disorders.
THE INFLUENCE OF BARIATRIC SURGERY ON THE COURSE OF CARDIOVASCULAR DISEASES
Authors:   Center of innovative medical technologies NAS of Ukraine, Kyiv, Ukraine, Gorbachova V.V. , Todurov I.M. ,   Center of innovative medical technologies NAS of Ukraine, Kyiv, Ukraine, Plegutsa O.I. ,   Center of innovative medical technologies NAS of Ukraine, Kyiv, Ukraine, Khorevina K.M. ,   Center of innovative medical technologies NAS of Ukraine, Kyiv, Ukraine, Kalashnikov О.О. ,   Center of innovative medical technologies NAS of Ukraine, Kyiv, Ukraine
Published: November 2021

Obesity is an established risk factor for cardiovascular diseases (CVD) such as hypertension (HD), coronary artery disease (CAD), heart failure (HF), arrhythmias and venous thromboembolism. Lifestyle modifications to reduce weight have been shown to be successful in the short term, however their long-term results are still equivocal likely due to modest weight reduction and high recurrence rates. Bariatric surgery has been recognized as the most effective strategy in achieving substantial sustained weight loss, and can prevent the development or reverse CVD, metabolic syndrome, diabetes mellitus, obstructive sleep apnea syndrome, cancer, and COVID-associated complications. Bariatric surgery results in rapid weight loss over several months that lasts for at least 12-18 months. The surgery lowers all-cause mortality risks, risks of myocardial infarction and stroke. Furthermore, bariatric surgery contributes to the reduction of urgent hospitalizations for heart failure, coronary artery disease, and hypertension. The article shows modern view on the impact of bariatric surgery on the pathogenesis of the CVD in patients with obesity, indications and contraindications of the surgery, tactics of management of patients with existing cardiovascular pathology before the bariatric surgery.
Identifying Practices to Promote Inpatient Adolescent and Influenza Vaccine Delivery
Authors: Mihalek Alexandra J. , Hall Matt , Russell Christopher J. , Wu Susan ,   for the Pediatric Research in Inpatient Settings (PRIS) Network
Published: November 2021

OBJECTIVES

Many hospitalized children are underimmunized. We assessed the association between hospital immunization practices and tetanus, diphtheria, and acellular pertussis (Tdap), meningococcal, human papillomavirus (HPV), and influenza vaccine delivery.

METHODS

An electronic survey regarding hospital vaccine delivery practices was distributed via the Pediatric Health Information System (PHIS) and Pediatric Research in Inpatient Settings networks to PHIS hospitals. Number of vaccines delivered and total discharges in 2018 were obtained from the PHIS database to determine hospital vaccine delivery rates; patients 11 to 18 years old (adolescent vaccines) and 6 months to 18 years old (influenza vaccine) were included. Vaccine delivery rates were risk adjusted by using generalized linear mixed-effects modeling and compared with survey responses to determine associations between the number or presence of specific practices and vaccine delivery. Adjusted HPV and meningococcal vaccine delivery rates could not be calculated because of low delivery.

RESULTS

Twenty-nine hospitals completed a survey (57%). 152 499 and 423 046 patient encounters were included for the adolescent and influenza vaccines, respectively. Unadjusted inpatient vaccine delivery rates varied. After adjustment, the number of practices was associated only with influenza vaccine delivery (P = .02). Visual prompts (P = .02), nurse or pharmacist ordering (P = .003), and quality improvement projects (P = .048) were associated with increased influenza vaccine delivery; nurse or pharmacist ordering had the greatest impact. No practices were associated with Tdap vaccine delivery.

CONCLUSIONS

The number and presence of specific hospital practices may impact influenza vaccine delivery. Further research is needed to identify strategies to augment inpatient adolescent immunization.
Weight Status and Risk of Inpatient Admission for Children With Lower Respiratory Tract Disease
Authors: Halvorson Elizabeth E. , Saha Amit , Forrest Christopher B. , Razzaghi Hanieh , Rao Suchitra , Phan Thao-Ly Tam , Magnusen Brianna , Mejias Asuncion , McCrory Michael C. , Wells Brian J. , Skelton Joseph A. , Poehling Katherine A. , Tieder Joel S.
Published: November 2021

OBJECTIVES

To identify associations between weight category and hospital admission for lower respiratory tract disease (LRTD), defined as asthma, community-acquired pneumonia, viral pneumonia, or bronchiolitis, among children evaluated in pediatric emergency departments (PEDs).

METHODS

We performed a retrospective cohort study of children 2 to <18 years of age evaluated in the PED at 6 children’s hospitals within the PEDSnet clinical research network from 2009 to 2019. BMI percentile of children was classified as underweight, healthy weight, overweight, and class 1, 2, or 3 obesity. Children with complex chronic conditions were excluded. Mixed-effects multivariable logistic regression was used to assess associations between BMI categories and hospitalization or 7- and 30-day PED revisits, adjusted for covariates (age, sex, race and ethnicity, and payer).

RESULTS

Among 107 446 children with 218 180 PED evaluations for LRTD, 4.5% had underweight, 56.4% had healthy normal weight, 16.1% had overweight, 14.6% had class 1 obesity, 5.5% had class 2 obesity, and 3.0% had class 3 obesity. Underweight was associated with increased risk of hospital admission compared with normal weight (odds ratio [OR] 1.76; 95% confidence interval [CI] 1.69–1.84). Overweight (OR 0.87; 95% CI 0.85–0.90), class 1 obesity (OR 0.88; 95% CI 0.85–0.91), and class 2 obesity (OR 0.91; 95% CI 0.87–0.96) had negative associations with hospital admission. Class 1 and class 2, but not class 3, obesity had small positive associations with 7- and 30-day PED revisits.

CONCLUSIONS

We found an inverse relationship between patient weight category and risk for hospital admission in children evaluated in the PED for LRTD.
Physician Perspectives on the Impact of the COVID-19 Pandemic on Family-Centered Rounds
Authors: Craddock Kirsten E.S. , Grilo Stephanie , McCann Teresa A. , Catallozzi Marina , Banker Sumeet L.
Published: November 2021

BACKGROUND

The coronavirus disease 2019 pandemic has required modifications to family-centered rounds (FCR), although the specific changes and the effects on patients, families, and providers are not well known. In this study, we explore physician perspectives on changes made to FCR during the initial wave of the coronavirus disease 2019 pandemic and recommendations for the future.

METHODS

Semistructured individual interviews were conducted with 20 pediatric attending and resident physicians who cared for hospitalized patients between March and May 2020 on pediatric hospital medicine and subspecialty services that typically perform FCR. Transcripts were reviewed by using principles of framework analysis to iteratively develop a codebook. Review of coded segments, with attention to code co-occurrences, was used to clarify themes in the data relating to the research objective and the conceptual framework.

RESULTS

The rounding format changed for all providers and varied on the basis of clinical service and phase of the pandemic. Themes highlighted specific areas of change: (1) the process of FCR, (2) reaching consensus with families, (3) collaboration with members of the medical team, and (4) resident education, modeling, and supervision. Participants offered recommendations, including standardization of rounds, intentional involvement of nursing staff, and inclusion of families through virtual or small-group bedside rounds.

CONCLUSIONS

The pandemic led to a variety of modifications to FCR, and these changes had varied effects on communication and education. These findings provide insight into the state of FCR during the pandemic and may frame future recommendations for the development of shared guidelines for circumstances requiring limited bedside rounding.
A Qualitative Analysis of Observed Behavior of Pediatric Rapid Response Team Performance
Authors: Levin Amanda B. , Cartron Alexander M. , Siems Ashley , Kelly Katherine Patterson
Published: November 2021

BACKGROUND AND OBJECTIVES

Pediatric rapid response teams (RRTs) enhance patient safety, reduce cardiorespiratory arrests outside the PICU, and detect deteriorating patients before decompensation. RRT performance may be affected by failures in communication, poor team dynamics, and poor shared decision-making. We aimed to describe factors associated with team performance using direct observation of pediatric RRTs.

METHODS

Our team directly observed 73 in situ RRT activations, collected field notes of qualitative data, and analyzed the data using conventional content analysis. To assess accuracy of coding, 20% of the coded observations were reassessed for interrater reliability. The codes influencing team performance were categorized as enhancers or threats to RRT teamwork and organized under themes. We constructed a framework of the codes and themes, organized along a spectrum of orderly versus chaotic RRTs.

RESULTS

Three themes influencing RRT performance were teamwork, leadership, and patient and family factors, with underlying codes that enhanced or threatened RRT performance. Novel factors that were found to threaten team performance included indecision, disruptive behavior, changing leadership, and family or patient distress. Our framework delineating features of orderly and chaotic RRTs may be used to inform training and design of RRTs to optimize performance.

CONCLUSIONS

Observations of in situ RRT activations in a pediatric hospital both verified previously described characteristics of RRTs and identified new characteristics of team function. Our proposed framework for understanding these enhancers and threats may be used to inform future interventions to improve RRT performance.
COVID-19 Impact on Intern Exposure to Common Inpatient Diagnoses
Authors: Yarahuan Julia Whitlow , Bass Lanessa , Hess Lauren M. , Singhal Geeta , Lo Huay-ying
Published: November 2021

OBJECTIVE

We sought to understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on the clinical exposure of pediatric interns to common pediatric inpatient diagnoses.

METHODS

We analyzed electronic medical record data to compare intern clinical exposure during the COVID-19 pandemic from June 2020 through February 2021 with the same academic blocks from 2017 to 2020. We attributed patients to each pediatric intern on the basis of notes written during their pediatric hospital medicine rotation to compare intern exposures with common inpatient diagnoses before and during the pandemic. We compared the median number of notes written per intern per block overall, as well as for each common inpatient diagnosis.

RESULTS

Median counts of notes written per intern per block were significantly reduced in the COVID-19 group compared with the pre–COVID-19 group (96 [interquartile range (IQR): 81–119)] vs 129 [IQR: 110–160]; P < .001). Median intern notes per block was lower in the COVID-19 group for all months except February 2021. Although the median number of notes for many common inpatient diagnoses was significantly reduced, they were higher for mental health (4 [IQR: 2–9] vs 2 [IQR: 1–6]; P < .001) and suicidality (4.5 [IQR: 2–8] vs 0 [IQR: 0–2]; P < .001). Median shifts worked per intern per block was also reduced in the COVID-19 group (22 [IQR: 21–23] vs 23 [IQR: 22–24]; P < .001).

CONCLUSIONS

Our findings reveal a significant reduction in resident exposure to many common inpatient pediatric diagnoses during the COVID-19 pandemic. Residency programs and pediatric hospitalist educators should consider curricular interventions to ensure adequate clinical exposure for residents affected by the pandemic.
Prototipe Elektrokardiograf Tiga Lead Berbasis Komputer Jinjing
Authors: Putra Aulia Eka , Prawiroredjo Kiki , Candra Henry , Julian Engelin Shintadewi , Tjahjadi Gunawan
Published: November 2021

Penyakit jantung masih menjadi ancaman di Indonesia, menurut Kementerian Kesehatan, pada tahun 2014 penyakit jantung koroner (PJK) merupakan penyebab kematian tertinggi setelah stroke. Persentase terbesar penyakit kardiovaskuler adalah pada gangguan irama jantung. Instrumentasi medik elektrokardiograf (EKG) digunakan untuk mendeteksi sinyal biopotensial yang dihasilkan jantung sehingga dapat didiagnosis oleh dokter spesialis jantung. Penelitian ini mengusulkan sebuah prototipe sistem rekam jantung EKG yang ekonomis, dengan memanfaatkan suatu program aplikasi menggunakan bahasa pemrograman C Sharp. Sistem menggunakan 3 buah surface electrodes, modul AD8232, dan modul Arduino Uno sebagai komponen pembentuk instrument elektrokardiograf. Surface electrodes berfungsi menangkap sinyal aktivitas listrik pada jantung yang dikondisikan oleh modul AD8232 dan diubah menjadi sinyal digital pada  Arduino.  Tampilan pada layar komputer memperlihatkan jumlah denyut jantung per menit (BPM) dan grafik gelombang EKG yang dapat dibaca nilai amplitudo dan lebar waktu gelombangnya. Berdasarkan hasil perbandingan pengujian antara prototype EKG terhadap Portable Easy ECG Monitor PC-08B didapati kesalahan rata-rata parameter gelombang jantung yaitu pada denyut jantung per menit 1,19%, pada interval R-R 2.44%, pada interval P-R 2,05 %, pada interval Q-T 1,16 %, pada interval waktu gelombang P 2,58 %, pada interval waktu gelombang QRS 2,07 %, pada interval waktu gelombang T 3,26 %, pada nilai amplitudo QRS 3,40 %, pada nilai amplitudo gelombang P  4 %, dan pada nilai amplitudo gelombang T 4,10 %. Heart disease was a threat in Indonesia, according to the Ministry of Health in 2014 coronary heart disease (CHD) was the highest cause of death after stroke. The largest percentage of cardiovascular disease was in heart rhythm disorders. Electrocardiograph (ECG) was used to detect biopotential signals generated by the heart. This research proposed a low cost electrocardiograph (ECG) prototype by utilizing an application using C Sharp. The system consisted of three surface electrodes, an AD8232 module, and an Arduino Uno module. Surface electrodes detected the electrical activity signal from the heart that was conditioned using AD8232 module and converted to digital signal in Arduino Uno. The bit per minute (BPM) of the heart and the ECG graph are displayed on the laptop screen with graticule to measure the amplitude and the width of the wave. Based on the test results of the ECG prototype compare to the Portable Easy ECG Monitor PC-08B, it is found that the average error of heartbeat per minute  is 1.19 %, the R-R time interval is 2.44 %, the P-R time interval is 2.05 %, the Q-T time interval is 1.16 %, the P wave time interval is 2.58 %, the QRS time interval is 2.07 %,  T wave time interval is 3.26 %, the QRS amplitude is 3.40 %, the P amplitude is 4 %, and the T amplitude is 4.10 %.
A role of streptokinase in experimental post-streptococcal glomerulonephritis
Authors: Burova L. A. , Gavrilov E. A. , Pigarevsky P. V. , Totolian Artem A.
Published: November 2021

Post-streptococcal glomerulonephritis (PSGN) refers to the sequela of the acute infection, caused by Streptococcus pyogenes (group A streptococcus, GAS). This pathology has been studied for a long time, and today attempts are being made to identify the products of their life activity, able to initiate an immunopathological process in kidneys. Most attention has been paid to streptokinase, the enzyme transforming blood plasminogen into plasmin, capable, together with the plasmin receptor (NAPlr), of damaging the glomerular tissue, as well as activating the complement system. The aim of the study was to consider two tasks: to study the ability of the GAS-obtained enzyme to transform plasminogen of different species into plasmin as well as to study its role in the development of PSGN in rabbits having subcutaneously implanted tissue chambers. The animals were infected by inoculating GAS cultures into the chambers. Materials and methods. GAS strains of M types 1, 12, 22 and their ska– isogenic mutants were used in the study. Purified plasminogen preparations were isolated from fresh human, rabbit or mouse plasma by using chromatographic column with Lysine Sepharose 4B. To reveal the ability of streptokinase to activate plasminogen into plasmin, its preparation at a concentration of 1 mg/ml was added to 10 ìg of purified human, rabbit or mouse plasminogen. The concentration of plasmin was defined photometrically using S-2251 (Chromogenix, USA). To reproduce PSGN, four chambers were implanted under the skin in each rabbit; after the complete wound healing animals were infected and observed for three weeks. On day 14, the animals were treated with benzylpenicillin. The kidneys from survived rabbits were subjected to immunohistology analysis. Results. During in vitro experiments, M1, M12 and M22 GAS streptokinase showed distinct functional activity on human plasminogen, transforming it into plasmin: optical density indicators at ë = 405 nm were 0.4–0.7 compared with the negative control (ОD 0.001). Streptokinase did not activate mouse plasminogen (ОD = 0.001) and exerted quite a weak effect on transformation of the rabbit plasminogen into plasmin (ОD = 0.002). In experiments on PSGN induction in rabbits, we failed to detect streptokinase involvement, because no differences between initiation of glomerulonephritis by wild strains or ska– isogenic mutants were identified. Mutant strains deficient in the gene responsible for streptokinase synthesis but retained ability to bind rabbit and human IgG, caused morphological changes in kidney tissue, specific for PSGN. In addition, a comparative analysis of PSGN “rabbit” and “mouse” models developed by the same technology, was carried out and led to opposing conclusions regarding a role of streptokinase in pathogenesis of experimental glomerulonephritis. The role of IgG Fc-binding activity of GAS in development of experimental PSGN is discussed.
El Tor cholera at the contemporary stage of the seventh pandemia: pathogen evolution, clinical and epidemiological features, laboratory diagnostics
Authors: Savelyeva I. V. , Kulichenko A. N. , Saveliev V. N. , Kovalev D. A. , Taran T. V. , Podoprigora E. I. , Vasilieva O. V. , Shapakov N. A.
Published: November 2021

The phenotypic and molecular genetic properties of 133 strains of genetically modified (genovariant) Vibrio cholerae O1 El Tor biovar isolated from patients in Dagestan (1993, 1994, 1998), and compared with 246 strains of a typical toxigenic cholera vibrio El Tor biovar isolated in 1970–1990 at the Caucasus Region. It was found that 48.7% of the studied genetically modified strain variants had mixed phenotypic properties of the El Tor and classic biovars that evidences about a need to include the marker genes of the classical biovar (ctxBCl+, rtxC–) and the El Tor biovar (ctxBEl+, rtxC+) into the existing biotyping scheme. The genes of the El Tor biovar, isolated from patients in Dagestan, contain in addition to the El Tor ones, the genes of the classical biovar (ctxBCl and/or rstRCl), as well as the typical toxigenic cholera vibrios of El Tor, islands of persistence (EPI), pathogenicity (VPI-1 and VPI-2) and pandemicity (VSP-I and VSP-II). However, only the El Tor biovar genovariants were found to bear an integrative and conjugative SXT element with antibiotic polyresistance genes. Epidemic cholera outbreaks caused by the El Tor biovar genovariants that occurred in 1993–1998 at the Caucasus Region, correspond to classical (Asian) cholera based on disease severity. The epidemiological features of modern cholera were studied: the main way for transmission via fecal-oral route for typical El Tor cholera vibrio is waterborne, whereas for the El Tor gene variant — household. Primary infections upon water drinking and using domestic water from surface water bodies infected with typical El Tor vibrios occur outside the family hearth. In case of cholera caused by hybrid El Tor variants, infection is transmitted among family members via domestic factors under low sanitary level. The development of laboratory diagnostics and epidemiological surveillance of modern El Tor cholera is based on the development of PCR test systems taking into account the evolutionary genome transformations.
Nationwide questionnaire data of 229 Williams-Beuren syndrome patients using WhatsApp tool
Authors: Pires Lucas Vieira Lacerda , Ribeiro Rogério Lemos , Sousa Adriana Modesto de , Linnenkamp Bianca Domit Werner , Pontes Sue Ellen , Teixeira Maria Cristina Triguero Veloz , Befi-Lopes Debora Maria , Honjo Rachel Sayuri , Bertola Debora Romeo , Kim Chong Ae
Published: November 2021

ABSTRACT Background: Williams-Beuren syndrome is a multisystemic disorder caused by a microdeletion of the 7q11.23 region. Although familial cases with autosomal dominant inheritance have been reported, the vast majority are sporadic. Objective: To investigate the main complaints and clinical findings of patients with Williams-Beuren syndrome. Methods: A total of 757 parents of patients registered in the Brazilian Association of Williams-Beuren Syndrome (ABSW) received a questionnaire via WhatsApp from March to July 2017. Results: In total, 229 parents answered the survey. Age of diagnosis ranged from 2 days to 34 years (median: 3 years). The main clinical findings reported by the parents were abdominal colic (83.3%), failure to thrive (71.5%), feeding difficulty in the first year (68.9%), otitis (56.6%), urinary tract infections (31.9%), precocious puberty (27.1%) and scoliosis (15.9%). Cardiac defects were present in 66% of patients, and the most frequent defect was supravalvular aortic stenosis (36%). Arterial hypertension was reported in 23%. Hypercalcemia was reported in 10.5% of patients, mainly during the first year of life. Hyperacusis and hypersociability were common complaints (both present in 89%). Other behavioral and neuropsychiatric symptoms reported by the parents included attention deficit (89%), anger crises (83%), excessive fear (66%), depression (64%), anxiety (67%) and hypersexuality (33%). The most common complaints were hypersensitivity to sounds, talkative personality, emotional dependence and learning difficulties. In 98.3%, the parents denied family history. Conclusions: Williams-Beuren syndrome requires close follow-up with different medical specialties due to their variable clinical comorbidities, including language and school learning difficulties, behavioral and psychiatric problems.
Assessment of therapeutic strategies for management of impulse control disorder in Parkinson’s disease
Authors: Rodríguez-Violante Mayela , Ríos-Solís Yazmín , Esquivel-Zapata Oscar , Herrera Fanny , López-Alamillo Susana , Sarabia-Tapia Cynthia , Cervantes-Arriaga Amin
Published: November 2021

ABSTRACT Background: Impulse control disorders (ICD) occur frequently in individuals with Parkinson's disease. So far, prevention is the best treatment. Several strategies for its treatment have been suggested, but their frequency of use and benefit have scarcely been explored. Objective: To investigate which strategy is the most commonly used in a real-life setting and its rate of response. Methods: A longitudinal study was conducted. At the baseline evaluation, data on current treatment and ICD status according to QUIP-RS were collected. The treatment strategies were categorized as “no-change”, dopamine agonist (DA) dose lowering, DA removal, DA switch or add-on therapy. At the six-month follow-up visit, the same tools were applied. Results: A total of 132 individuals (58.3% men) were included; 18.2% had at least one ICD at baseline. The therapeutic strategy most used in the ICD group was no-change (37.5%), followed by DA removal (16.7%), DA switch (12.5%) and DA lowering (8.3%). Unexpectedly, in 20.8% of the ICD subjects the DA dose was increased. Overall, nearly 80% of the subjects showed remission of their ICD at follow-up. Conclusions: Regardless of the therapy used, most of the subjects presented remission of their ICD at follow-up Further research with a longer follow-up in a larger sample, with assessment of decision-making processes, is required in order to better understand the efficacy of strategies for ICD treatment.
The evaluation of psychogenic non-epileptic seizures (PNES) cases with saline injection method in video-EEG monitorization unit
Authors: Bora İbrahim , Demir Aylin Bican , Ceylan Dursun
Published: November 2021

ABSTRACT Background: It has been reported that 10 to 30% of patients sent to epilepsy centers with a diagnosis of refractory epilepsy are diagnosed with psychogenic non-epileptic seizure (PNES). A wide variety of provocative methods are used to assist PNES diagnosis. Objective: To investigate the effect of seizure induction on the diagnosis and prognosis of PNES. Methods: We retrospectively examined 91 patients with PNES complaints in our video-EEG laboratory. Intravenous saline was administered to all patients for induction of seizures. Results: Saline injection was performed in 91 patients referred to our EEG lab with PNES initial diagnosis, 57 of whom were female and 34 male. Saline injection triggered an attack in 82 patients (90%). Conclusions: In this study we have concluded that provocative methods are practical, cheap and, most of all, effective for patient diagnosis. In clinical practice, explaining the diagnosis is the first and most important step of the treatment, and careful patient-doctor communication has a positive impact on patient prognosis.
Constantin von Economo´s 90th death anniversary
Authors: Teive Hélio Afonso Ghizoni , Tensini Fernando Spina , Lima Plínio Garcia , Camargo Carlos Henrique Ferreira
Published: November 2021

ABSTRACT The year of 2021 marks 90 year since the death of the neuroscientist Constantin von Economo, whose research in various areas was extremely relevant for the field of neurology. He described lethargic epidemic encephalitis, published an atlas of the cytoarchitecture of the human cerebral cortex, and conducted multiple studies in neuroanatomy, neurophysiology, and clinical neurology. Von Economo's genius extended into other nonmedical fields such as aeronautics, and he had renowned artistic skills.
Exame ocupacional periódico: oportunidade de diagnóstico e monitoramento de doença crônica não transmissível em homens
Authors: Donato Tamyres Araújo Andrade , Silva Roberta Mendes Abreu , Andrade Amanda Cristina de Souza , Kochergin Clávdia Nicolaevna , Medeiros Danielle Souto de , Soares Daniela Arruda , Louzado José Andrade , Silva Kelle Oliveira , Cortes Matheus Lopes , Mistro Sóstenes , Amorim Welma Wildes Cunha Coelho , Oliveira Márcio Galvão Guimarães de , Bezerra Vanessa Moraes
Published: November 2021

Objetivou-se estimar a prevalência de hipertensão arterial, como principal marcador de doença crônica não transmissível (DCNT), e identificar os fatores modificáveis associados, em trabalhadores homens. Foram utilizados dados da linha de base de um estudo longitudinal com uma amostra de 1.024 trabalhadores homens com 18 anos ou mais de um município do Nordeste do Brasil. O marcador de DCNT foi a hipertensão arterial, definida por pressão arterial sistólica ≥ 140mmHg e/ou pressão arterial diastólica ≥ 90mmHg e/ou diagnóstico prévio de hipertensão arterial e/ou uso de medicamentos anti-hipertensivos. Empregou-se a regressão de Poisson com variância robusta, adotando a entrada hierárquica de variáveis. Foram calculadas frações atribuíveis populacionais (FAP) para as variáveis de estilo de vida, a fim de dimensionar o impacto dos fatores modificáveis na saúde dos trabalhadores. A prevalência da hipertensão arterial nesta população foi de 28,6% (IC95%: 25,9-31,5), os fatores distais: idade > 40 anos, cor da pele preta e renda familiar ≥ 3 salários mínimos; fatores intermediários: consumo abusivo de álcool, consumo de tabaco, percepção de um consumo elevado de sal e inatividade física e o fator proximal: sobrepeso e obesidade associaram-se positivamente com a hipertensão arterial. O cálculo da FAP permitiu observar que se ocorresse a redução ou eliminação de hábitos e comportamentos relacionados ao estilo de vida deste público, reduziria em 56,1% a prevalência da DCNT estudada. A identificação de fatores modificáveis e como estes podem interferir negativamente na saúde de trabalhadores homens possibilita o planejamento de intervenções no próprio local de trabalho, a fim de alcançar o maior número de indivíduos, visando reduzir os efeitos deletérios das DCNT.