bluuebunny/crossref_metadata_2025 huggingface dataset:
A scoping review of literature assessing the impact of the learning assistant model
Authors: Barrasso Anthony P. , Spilios Kathryn E.
Published: February 2021

Much of modern education reform is focused on implementation of evidenced-based teaching, but these techniques are sometimes met with trepidation from faculty, due to inexperience or lack of necessary resources. One near-peer teaching model designed to facilitate evidenced-based teaching in Science, Technology, Engineering, and Mathematics classrooms is the Learning Assistant (LA) model. Here, we describe the details of the LA model, present a scoping review of literature using the four original goals of the LA model as a framework, and suggest future areas of research that would deepen our understanding of the impact that the LA model may have on education. We summarize how the LA model improves student outcomes and teacher preparation and identify a relative deficiency of literature that addresses how the LA model impacts faculty and departmental/institutional change. Additionally, of the 39 papers reviewed, 11 are strictly pre-experimental study designs, 28 use quasi-experimental designs or a combination of quasi and pre-experimental, and none of them included a true experimental design. Thus, we conclude that current studies suggest that LA model positively impacts education, but more refined assessment would improve our understanding of the model. Furthermore, despite the encouraging research on the impact of the LA model and the proliferation of LA programs at institutions across the world, the study of the LA model has been, for the most part, limited to a small group of education researchers. Therefore, a major objective of this review is to introduce the LA model to a new group of instructors and researchers who can further our understanding of this promising model.
Mapping regional forest management units: a road-based framework in Southeastern Coastal Plain and Piedmont
Authors: Yang Di , Fu Chiung-Shiuan
Published: February 2021

Management practices are one of the most important factors affecting forest structure and function. Landowners in southern United States manage forests using appropriately sized areas, to meet management objectives that include economic return, sustainability, and esthetic enjoyment. Road networks spatially designate the socio-environmental elements for the forests, which represented and aggregated as forest management units. Road networks are widely used for managing forests by setting logging roads and firebreaks. We propose that common types of forest management are practiced in road-delineated units that can be determined by remote sensing satellite imagery coupled with crowd-sourced road network datasets. Satellite sensors do not always capture road-caused canopy openings, so it is difficult to delineate ecologically relevant units based only on satellite data. By integrating citizen-based road networks with the National Land Cover Database, we mapped road-delineated management units across the regional landscape and analyzed the size frequency distribution of management units. We found the road-delineated units smaller than 0.5 ha comprised 64% of the number of units, but only 0.98% of the total forest area. We also applied a statistical similarity test (Warren’s Index) to access the equivalency of road-delineated units with forest disturbances by simulating a serious of neutral landscapes. The outputs showed that the whole southeastern U.S. has the probability of road-delineated unit of 0.44 and production forests overlapped significantly with disturbance areas with an average probability of 0.50.
Seismic hazard microzonation of Bengkulu City, Indonesia
Authors: Mase Lindung Zalbuin , Sugianto Nanang , Refrizon
Published: February 2021

It has been known that Bengkulu City (Indonesia) is vulnerable to undergo seismic damage. This study is initiated by measuring horizontal to vertical spectral ratio (H/V) to sites in Bengkulu City using microtremor. The inversion analysis is performed to generate shear wave velocity profile. Hundreds of sites are investigated in this study. The results show that observedH/Vis consistent with the theoreticalH/V. National Earthquake Hazard Reduction Program code is adopted to classify the site class. The results also exhibit that Bengkulu City is dominated by Site Classes C and D. In general, this study could lead local government to consider seismic hazard mitigation for spatial plan.
Biomaterial-based cell delivery strategies to promote liver regeneration
Authors: Ali Maqsood , Payne Samantha L.
Published: February 2021

Chronic liver disease and cirrhosis is a widespread and untreatable condition that leads to lifelong impairment and eventual death. The scarcity of liver transplantation options requires the development of new strategies to attenuate disease progression and reestablish liver function by promoting regeneration. Biomaterials are becoming an increasingly promising option to both culture and deliver cells to support in vivo viability and long-term function. There is a wide variety of both natural and synthetic biomaterials that are becoming established as delivery vehicles with their own unique advantages and disadvantages for liver regeneration. We review the latest developments in cell transplantation strategies to promote liver regeneration, with a focus on the use of both natural and synthetic biomaterials for cell culture and delivery. We conclude that future work will need to refine the use of these biomaterials and combine them with novel strategies that recapitulate liver organization and function in order to translate this strategy to clinical use.
Developing a Canadian evaluation framework for patient and public engagement in research: study protocol
Authors: L’Espérance Audrey , O’Brien Nadia , Grégoire Alexandre , Abelson Julia , Canfield Carolyn , Del Grande Claudio , Dogba Maman Joyce , Fancott Carol , Levasseur Mary Anne , Loignon Christine , Majnemer Annette , Pomey Marie-Pascale , Rasiah Jananee , Salsberg Jon , Santana Maria , Tremblay Marie-Claude , Urquhart Robin , Boivin Antoine
Published: February 2021

Background

Patient and public engagement (PPE) in research is growing internationally, and with it, the interest for its evaluation. In Canada, the Strategy for Patient-Oriented Research has generated national momentum and opportunities for greater PPE in research and health-system transformation. As is the case with most countries, the Canadian research community lacks a common evaluation framework for PPE, thus limiting our capacity to ensure integrity between principles and practices, learn across projects, identify common areas for improvement, and assess the impacts of engagement.

Objective

This project aims to build a national adaptable framework for the evaluation of PPE in research, by:

Building consensus on common evaluation criteria and indicators for PPE in research;

Defining recommendations to implement and adapt the framework to specific populations.

Methods

Using a collaborative action-research approach, a national coalition of patient-oriented research leaders, (patient and community partners, engagement practitioners, researchers and health system leaders) will co-design the evaluation framework. We will develop core evaluation domains of the logic model by conducting a series of virtual consensus meetings using a nominal group technique with 50 patient partners and engagement practitioners, identified through 18 national research organizations. We will then conduct two Delphi rounds to prioritize process and impact indicators with 200 participants purposely recruited to include respondents from seldom-heard groups. Six expert working groups will define recommendations to implement and adapt the framework to research with specific populations, including Indigenous communities, immigrants, people with intellectual and physical disabilities, caregivers, and people with low literacy. Each step of framework development will be guided by an equity, diversity and inclusion approach in an effort to ensure that the participants engaged, the content produced, and the adaptation strategies proposed are relevant to diverse PPE.

Discussion

The potential contributions of this project are threefold: 1) support a national learning environment for engagement by offering a common blueprint for collaborative evaluation to the Canadian research community; 2) inform the international research community on potential (virtual) methodologies to build national consensus on common engagement evaluation frameworks; and 3) illustrate a shared attempt to engage patients and researchers in a strategic national initiative to strengthen evaluation capacity for PPE.
Malawian children with fast-breathing pneumonia with and without comorbidities
Authors: Ginsburg Amy Sarah , Mvalo Tisungane , Hwang Jun , Phiri Melda , McCollum Eric D. , Maliwichi Madalitso , Schmicker Robert , Phiri Ajib , Lufesi Norman , May Susanne
Published: February 2021

Background

Due to high risk of mortality, children with comorbidities are typically excluded from trials evaluating pneumonia treatment. Understanding heterogeneity of outcomes among children with pneumonia and comorbidities is critical to ensuring appropriate treatment.

Methods

We explored whether the percentage of children with fast-breathing pneumonia cured at Day 14 was lower among those with selected comorbidities enrolled in a prospective observational study than among those enrolled in a concurrent randomized controlled trial evaluating treatment with amoxicillin in Lilongwe, Malawi.

Results

Among 79 children with fast-breathing pneumonia in the prospective observational cohort, 57 (72.2%) had HIV infection/exposure, 20 (25.3%) had malaria, 2 (2.5%) had severe acute malnutrition, and 17 (21.5%) had anemia. Treatment failure rate was slightly (not significantly) lower in children with comorbidities (4.1%, 3/73) compared to those without comorbidities (4.5%, 25/552) similarly treated. There was no significant difference in clinical cure rates by Day 14 (95.8% with vs 96.7% without comorbidity).

Conclusions

Children with fast-breathing pneumonia excluded from a concurrent clinical trial due to comorbidities did not fare worse. Children at higher risk whose caregivers seek care early and who receive appropriate risk assessment (e.g., pulse oximetry, hemoglobin, HIV/malaria testing) and treatment, can achieve clinical cure by Day 14.

Trial registration

ClinicalTrials.govNCT02960919; registered November 8, 2016.
High neutrophil-to-lymphocyte ratio predicts early neurological deterioration in spontaneous intracerebral hemorrhage patients
Authors: Mohamed Wafaa S. , Kamel Amr E. , Abdelwahab Ahmed H. , Mahdy Mohamed E.
Published: February 2021

Background

Intracerebral hemorrhage (ICH) is caused by bleeding, primarily into parenchymal brain tissue, and accounts for 9 to 27% of all strokes worldwide. Higher neutrophils, lower lymphocytes, and higher neutrophil-to-lymphocytes ratio (NLR) values predict worse outcomes after spontaneous intracranial hemorrhage (sICH) and could aid in the risk stratification of patients.

Methods

Eighty patients with sICH within the first 24 h of stroke onset and admitted into the neurology intensive care unit of an Egyptian university hospital and were assessed by GCS for consciousness level and NIHSS for stroke severity assessment, complete blood count, and special attention to NLR. Patients were reevaluated by GCS and NIHSS on the 7th day of the stroke. Early neurological deterioration (END) was defined as four points or a greater increase in the NIHSS score or two points or a greater decrease in GCS or death.

Results

END was recorded in 21.25% of patients while non-END was recorded in 78.75%. END was highly significantly associated with a low grade of GCS, high grade of NIHSS, elevated absolute lymphocyte count (ALC), and elevated NLR. Lower GCS score, higher NIHSS score, larger hematoma volume, and higher NLR values were independent predictors for END. The best cutoff of NLR in END prediction was > 9.1.

Conclusion

NLR is a trustworthy early predictor of sICH outcome.
The effect of pyrolysis temperature and feedstock on date palm waste derived biochar to remove single and multi-metals in aqueous solutions
Authors: Sizirici Banu , Fseha Yohanna Haile , Yildiz Ibrahim , Delclos Thomas , Khaleel Abbas
Published: February 2021

In this study, leaf and frond date palm waste as feedstock was used to derive biochars. The effects of pyrolysis temperatures on their physical and chemical properties, and their capacity to remove copper, iron, nickel and zinc from single and multi-metal solutions at various pH values were investigated. Analytical and spectroscopic techniques such as scanning electron microscopy, energy dispersive X-ray, Fourier transform infrared spectroscopy, X-ray diffraction, carbon, hydrogen, nitrogen, sulfur elemental analysis, Brunauer Emmett Teller analysis were conducted for characterization. The pore volume, surface area, pH, and total carbon content of date palm leaf and frond biochar increased while functional groups and hydrogen, nitrogen and oxygen content of biochar decreased with increasing pyrolysis temperature compared to feedstock. The removal efficiencies and sorption capacity for single and mixed metal ions were found between 98 and close to 100% and 2.4 and 3.0 mg g− 1 by leaf and frond biochar samples at pH > 6, respectively. Biochar obtained from different feedstock at different pyrolysis temperature did not show any statistically significant improvements on the removal of single or mixed metals from aqueous solutions. The date palm leaf or frond biochar obtained at low pyrolysis temperature is as effective to remove metals as the ones obtained at high pyrolysis temperatures. Therefore, to consume less energy to produce biochar at lower temperature which exhibits same effective removal efficiency will be a win-win solution in terms of sustainability and economy. As a result, date palm waste biochar can be effectively used to remove metals in water and wastewater.
Longitudinal damage of cable-stayed bridges subjected to near-fault ground motion pulses
Authors: Yi Jiang , Yu De’en
Published: February 2021

This paper investigated the nonlinear seismic performance of an existing cable-stayed bridge longitudinally subjected to a set of simulated near-fault ground motion pulses. An elaborated non-linear finite element model of the bridge was established which particularly considered cable sag effect, material nonlinearity of the tower and the deck. Through non-linear dynamic response analyses, seismic responses of the tower, deck and cables were evaluated at the yield and ultimate state of the structure. In particular, the yield and ultimate state of the structure were defined in the text based on damage levels of the structure and structural integrity requirement. It is revealed that the pulse period (Tp), by determining the relative contribution of multiple modes of the structure, strongly affected the damage process of the structure. AsTpwas close to the period of first vertical vibration of the deck, the responses of the deck and cables were largely excited so that the deck might yield prior to yield of the tower, the cables failed prior to the ultimate state of the tower, and the deck suffered most of the damage despite of the yielding of the tower.
Migration deconvolution using domain decomposition
Authors: Osorio Luana Nobre , Pereira-Dias Bruno , Bulcão André , Landau Luiz
Published: February 2021

Least-squares migration (LSM) is an effective technique for mitigating blurring effects and migration artifacts generated by limited data frequency bandwidth, incomplete coverage of geometry, source signature, and unbalanced amplitudes caused by complex wavefield propagation in the subsurface. Migration deconvolution (MD) is an image-domain approach for LSM that approximates the Hessian operator using a set of precomputed point spread functions. We have developed a new workflow by integrating the MD and domain decomposition (DD) methods. DD techniques aim to solve large and complex linear systems by splitting problems into smaller parts, facilitating parallel computing, and providing a higher convergence in iterative algorithms. We suggest that instead of solving the problem in a unique domain, as conventionally performed, splitting the problem into subdomains that overlap and solve each of them independently. We accelerate the convergence rate of the conjugate-gradient solver by applying the DD methods to retrieve better reflectivity, which is mainly visible in regions with low amplitudes. Moreover, using the pseudo-Hessian operator, the convergence of the algorithm is accelerated, suggesting that the inverse problem becomes better conditioned. Experiments using the synthetic Pluto model demonstrate that our algorithm dramatically reduces the required number of iterations while providing a considerable enhancement in image resolution and better continuity of poorly illuminated events.
Neural effects of antidepressant medication and psychological treatments: a quantitative synthesis across three meta-analyses
Authors: Nord Camilla L. , Barrett Lisa Feldman , Lindquist Kristen A. , Ma Yina , Marwood Lindsey , Satpute Ajay B. , Dalgleish Tim
Published: February 2021

Background

Influential theories predict that antidepressant medication and psychological therapies evoke distinct neural changes.

Aims

To test the convergence and divergence of antidepressant- and psychotherapy-evoked neural changes, and their overlap with the brain's affect network.

Method

We employed a quantitative synthesis of three meta-analyses (n = 4206). First, we assessed the common and distinct neural changes evoked by antidepressant medication and psychotherapy, by contrasting two comparable meta-analyses reporting the neural effects of these treatments. Both meta-analyses included patients with affective disorders, including major depressive disorder, generalised anxiety disorder and panic disorder. The majority were assessed using negative-valence tasks during neuroimaging. Next, we assessed whether the neural changes evoked by antidepressants and psychotherapy overlapped with the brain's affect network, using data from a third meta-analysis of affect-based neural activation.

Results

Neural changes from psychotherapy and antidepressant medication did not significantly converge on any region. Antidepressants evoked neural changes in the amygdala, whereas psychotherapy evoked anatomically distinct changes in the medial prefrontal cortex. Both psychotherapy- and antidepressant-related changes separately converged on regions of the affect network.

Conclusions

This supports the notion of treatment-specific brain effects of antidepressants and psychotherapy. Both treatments induce changes in the affect network, but our results suggest that their effects on affect processing occur via distinct proximal neurocognitive mechanisms of action.
Longitudinal Investigation of Pubertal Milestones and Hormones as a Function of Body Fat in Girls
Authors: Ortega Madison T , McGrath John A , Carlson Lauren , Flores Poccia Vanessa , Larson Gary , Douglas Christian , Sun Bob Z , Zhao Shanshan , Beery Breana , Vesper Hubert W , Duke Lumi , Botelho Julianne C , Filie Armando C , Shaw Natalie D
Published: February 2021

Context

Epidemiologic studies have demonstrated that overweight/obese girls (OW/OB) undergo thelarche and menarche earlier than normal weight girls (NW). There have been no longitudinal studies to specifically investigate how body weight/fat affects both clinical and biochemical pubertal markers in girls.

Objective

To investigate the effect of total body fat on reproductive hormones and on the maturation of estrogen-sensitive tissues during puberty in girls.

Methods

Ninety girls (36 OW/OB, 54 NW), aged 8.2 to 14.7 years, completed 2.8 ± 1.7 study visits over 4 years. Visits included dual-energy x-ray absorptiometry to calculate total body fat (TBF), Tanner staging, breast ultrasound for morphological staging (BMORPH; A-E), pelvic ultrasound, hormone tests, and assessment of menarchal status. The effect of TBF on pubertal markers was determined using a mixed, multistate, or Cox proportional hazards model, controlling for baseline BMORPH.

Results

NW were older than OW/OB (11.3 vs 10.2 years, P < .01) at baseline and had more advanced BMORPH (P < .01). Luteinizing hormone, estradiol, and ovarian and uterine volumes increased with time with no effect of TBF. There was a time × TBF interaction for follicle-stimulating hormone, inhibin B, estrone, total and free testosterone, and androstenedione: Levels were initially similar, but after 1 year, levels increased in girls with higher TBF, plateaued in girls with midrange TBF, and decreased in girls with lower TBF. Girls with higher TBF progressed through BMORPH stage D more slowly but achieved menarche earlier than girls with lower TBF.

Conclusion

In late puberty, girls with higher TBF demonstrate differences in standard hormonal and clinical markers of puberty. Investigation of the underlying causes and clinical consequences of these differences in girls with higher TBF deserves further study.
Dual Oxidase System Genes Defects in Children With Congenital Hypothyroidism
Authors: Wang Fengqi , Xiaole Li , Ma Ruixin , Zhao Dehua , Liu Shiguo
Published: February 2021

Purpose

The objectives of this study were to analyze the distribution of dual oxidase (DUOX) system genes (containing DUOX2, DUOX1, DUOXA2, and DUOXA1) variants in children with congenital hypothyroidism (CH) and their phenotypes.

Methods

Target region sequencing technology was performed on DUOX system genes among 606 CH subjects covering all the exon and intron regions. Detailed clinical data were collected for statistical analysis.

Results

A total of 95 suspected pathogenic variants were detected in the DUOX system genes, showing a 39.11% rate in variant carrying (237/606). DUOX2 had the highest rate in this study. There were statistical differences in maximum adjusted dose and current dose of levothyroxine between the DUOX system genes nonmutated group with the mutated group (both Ps < 0.001). The cases in the DUOX system genes mutated group were more likely to develop into transient CH (χ 2 = 23.155, P < 0.001) and more likely to manifested as goiter or gland-in-situ (χ 2 = 66.139, P < 0.001). In addition, there was no significant difference in clinical characteristics between DUOX system genes monoallelic and non-monoallelic. Although 20% of the variants affected the functional domain regions (EF hand, flavin adenine dinucleotide and nicotinamide adenine dinucleotide binding sites), there was no significant effect on the phenotype severity whether the variation is located in the functional domain regions.

Conclusions

Our results showed the high variation rate of DUOX2 in the DUOX system genes among Chinese CH patients. The complex genotype-phenotype relationship of DUOX system genes broadened the understanding of CH phenotype spectrum.
Corroboration of Height Velocity Prediction Markers for rhGH With an Oral GH Secretagogue Treatment in Children With GHD
Authors: Blum Werner F , Bright George M , Do Minh-Ha T , McKew John C , Chen Haiying , Thorner Michael O
Published: February 2021

Context

Recombinant human growth hormone (rhGH) is approved for treatment of pediatric growth hormone deficiency (GHD), with greatest growth responses observed in those with severe GHD. Orally administered GH secretagogues (GHS) may be useful treatment in patients with moderate GHD. Distinguishing children with severe vs moderate GHD could identify children who would be better treated with rhGH or GHS.

Objectives

Evaluate baseline insulin-like growth factor-I (IGF-I) and stimulated peak GH response as predictors of 12-month height velocity (HV) in children with GHD.

Design

Data on children with GHD were analyzed in a legacy data base (GeNeSIS data).

Participants

514 naïve to rhGH-treatment, prepubertal children with idiopathic isolated GHD for whom stimulated GH, baseline serum IGF-I, and first-year HV during rhGH treatment data are available.

Outcome Measures

Children with severe or moderate GHD were categorized based on GH and IGF-I data and evaluated based on baseline auxologic and hormone profiles and first-year growth response to rhGH.

Results

Cohorts of severe and moderate GHD were 81/514 (15.8%) and 433/514 (84.2%). Cohorts differed significantly with regard to indicators of GHD [eg, baseline height SD score (SDS), height SDS minus target height SDS, HV, HV SDS, and change in height SDS during rhGH treatment]. Multiple regression analysis showed IGF-I and stimulated GH were significant predictors of HV independent of other known variables. Expected first-year HV in moderate GHD was 8.3 cm/y.

Conclusions

The combination of peak GH to GH stimulation testing and baseline IGF-I concentration are predictive enrichment markers for annualized HV responses to rhGH therapy.
Obituary: Friedrich Bonhoeffer (1932-2021)
Authors: Drescher Uwe
Published: February 2021

Summary: Uwe Drescher commemorates the life and work of Friedrich Bonhoeffer, whose pioneering work – including the development of innovative in vitro assays – led to important discoveries in the field of axon guidance and neural development.
Stark trade-offs and elegant solutions in arthropod visual systems
Authors: Meece Michael , Rathore Shubham , Buschbeck Elke K.
Published: February 2021

Vision is one of the most important senses for humans and animals alike. Diverse elegant specializations have evolved among insects and other arthropods in response to specific visual challenges and ecological needs. These specializations are the subject of this Review, and they are best understood in light of the physical limitations of vision. For example, to achieve high spatial resolution, fine sampling in different directions is necessary, as demonstrated by the well-studied large eyes of dragonflies. However, it has recently been shown that a comparatively tiny robber fly (Holcocephala) has similarly high visual resolution in the frontal visual field, despite their eyes being a fraction of the size of those of dragonflies. Other visual specializations in arthropods include the ability to discern colors, which relies on parallel inputs that are tuned to spectral content. Color vision is important for detection of objects such as mates, flowers and oviposition sites, and is particularly well developed in butterflies, stomatopods and jumping spiders. Analogous to color vision, the visual systems of many arthropods are specialized for the detection of polarized light, which in addition to communication with conspecifics, can be used for orientation and navigation. For vision in low light, optical superposition compound eyes perform particularly well. Other modifications to maximize photon capture involve large lenses, stout photoreceptors and, as has been suggested for nocturnal bees, the neural pooling of information. Extreme adaptations even allow insects to see colors at very low light levels or to navigate using the Milky Way.
The Efficiency of Race-Neutral Alternatives to Race-Based Affirmative Action: Evidence from Chicago’s Exam Schools
Authors: Ellison Glenn , Pathak Parag A.
Published: February 2021

Several K-12 and university systems have adopted race-neutral affirmative action in place of race-based alternatives. This paper explores whether these plans are effective substitutes for racial quotas in Chicago Public Schools (CPS), which now employs a race-neutral, place-based affirmative action system at its selective exam high schools. The CPS plan is ineffective compared to plans that explicitly consider race: about three-quarters of the reduction in average entrance scores at the top schools could have been avoided with the same level of racial diversity. Moreover, the CPS plan is less effective at adding low-income students than was the previous system of racial quotas. We develop a theoretical framework that motivates quantifying the inefficiency of race-neutral policies based on the distortion in student preparedness they create for a given level of diversity and use it to evaluate several alternatives. The CPS plan can be improved in several ways, but no race-neutral policy restores minority representation to prior levels without substantially greater distortions, implying significant efficiency costs from prohibitions on the explicit use of race. (JEL H75, I21, I28, J15)
Assessment of burnout and associated factors among medical educators
Authors: Akram Zareena , Sethi Ahsan , Khan Aabish Mehreen , Zaidi Fatima Zia
Published: February 2021

Objective: To assess burnout in medical educators and to identify factors associated with it.

Methods: A sequential mixed methods research study was conducted over eight months from July 2018 until February 2019. Participants included medical educators, who are studying for or graduated with a postgraduate qualification in medical education. An online questionnaire was developed using Maslach Burnout Inventory to collect quantitative data. The findings were explored in-depth qualitatively. Descriptive and inferential statistics were calculated for the quantitative data using SPSS 20. For qualitative data, we performed thematic analysis.

Results: Of total 160 medical educationists, 101 responded giving 63.1% response rate. Mean age was 41.4 years and majority 53.5% were females. Overall aggregate mean burnout level was 12.34 ± 7.36 whereas sub-domains of Maslach burnout inventory( MBI) like i) emotional exhaustion, ii) depersonalization and iii) personal accomplishment were found out to be 19.59, 10.42 and 11.21 respectively. Most respondents had moderate 71 (70.3%) emotional exhaustion and 8 (8.9%) had severe emotional exhaustion. Average level of depersonalization was suffered by 73 (72.3%) respondents and severe level was observed in 20 (19.8%) respondents. Personal accomplishment was found low in all 101 (100.0%) respondents. Selective in-depth interviews revealed that coping mechanisms like social gatherings, indoor and outdoor game facilities and outings and leisure time should be strategized for faculties.

Conclusion: In this study medical educators were found to have quite high level of burnout. The early career medical educators feels emotionally exhausted, with low sense of personal accomplishment.

doi: https://doi.org/10.12669/pjms.37.3.3078

How to cite this:Akram Z, Sethi A, Khan AM, Zaidi FZ. Assessment of burnout and associated factors among medical educators. Pak J Med Sci. 2021;37(3):827-832. doi: https://doi.org/10.12669/pjms.37.3.3078

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia
Authors: Jamal Saba , Meraj Fatima , Mansoor Neelum , Parveen Sadia , Shaikh Ameerah , Jabbar Naeem
Published: February 2021

Objectives: Acute leukaemia is the most common and highly curable childhood malignancy; subtyping and identification of antigens via immunophenotyping helps in treatment plan as well as minimal residual disease monitoring.

Methods: This retrospective study was conducted at the Haematology section of the clinical laboratories of Ziauddin University Hospital and The Indus Hospital, Karachi conducted at January 1st, 2012 to December 31st, 2017. The study included 1379 cases of de novo acute leukemia from 2012 to 2017. Among these, 80% were diagnosed by using four color flowcytometry (FACS Calibur), 9% and 11% via immunohistochemistry on bone marrow trephine biopsy samples and morphological examination respectively.

Results: The mean age of patients was 7.4 ± 4.3 years while male to female ratio was 1.75:1. Lymphoblastic leukaemia accounted for 77.2% and myeloid leukaemia 21.2%. Amongst lymphoblastic lineage, B-ALL was 80.4% while T-ALL was 19.6%. Among the phenotypic expression of B-ALL, CD79a (99.8%) had the highest positivity. In B-ALL, CD13 (29.8%) was the most common aberrant myeloid marker. Aberrant expression of CD79a observed in 11.1% of T-ALL cases. In non APL AML, aberrant expression of CD79a and CD19 was observed in 6.6% and 5.5% of cases respectively.

Conclusion: Overall immunophenotypic profile, expression of aberrant phenotypes and subtype distribution in our patients was similar to international literature except for a relatively high frequency of T-ALL which was discordant from the western data.

doi: https://doi.org/10.12669/pjms.37.3.3552

How to cite this:Jamal S, Meraj F, Mansoor N, Parveen S, Shaikh A, Jabbar N. Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia. Pak J Med Sci. 2021;37(3):805-811.  doi: https://doi.org/10.12669/pjms.37.3.3552

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Respiratory concerns of gabapentin and pregabalin: What does it mean to the pharmacovigilance systems in developing countries?
Authors: Shrestha Sunil , Palaian Subish
Published: February 2021

Gabapentin and pregabalin, commonly known as gabapentinoids, have been widely used globally. This paper highlights the serious breathing problems due to using gabapentin and pregabalin which was warned by the United States Food and Drug Administration on December, 2019. In this article, we tried to recommend suggestions for controlling these adverse drug reactions (ADRs). Safety reports of gabapentin and pregabalin should be obtained from concerned manufacturers and reviewed for respiratory depression effects. There should be strict prescription monitoring and drug use evaluation studies. Concurrent use of gabapentin and pregabalin with other respiratory depressants such as opioids should be strictly monitored. Educating patients can help in the early detection of ADRs due to gabapentin and pregabalin. Anecdotal reports on these medications should be encouraged.
Personalisation of treatment pathways – analysis of chances and barriers by the implementation of digital technologies under the conditions of the German Health System
Authors: Töpfer Armin , Brabänder Georg
Published: February 2021

Background: The potential of digital technologies is far from being exhausted for patients. The regulatory framework becomes a brake on innovation due to digitalisation, but also due to the trend towards individualisation. Strategies, corporate culture and processes, which are necessary for the design of high-quality and cost-effective healthcare services, are still lacking in many healthcare providing organisations.

Health Services 4.0 and patient integration as leverage: With Health Services 4.0 it is possible to improve the outcome of the individual healthcare service and meet the regulatory requirements. This requires the capabilities of the provider to dynamically balance exploitation and exploration. The challenges are to develop innovations in a continuously changing working environment and/or to adapt (medical) technical innovations into their own service processes.

Conclusion: This article is focused on hypotheses of cause-and-effect analyses formulated as scenarios, related to the implementation of digital technologies in order to improve efficiency and effectiveness for a high medical expertise as well as for a higher level of service quality.

The output is a more detailed analysis of key value drivers, success factors as well as internal and external value generators for the design of Health Services 4.0. Up to now many issues regarding the use of digital technologies are still only partly analysed and not yet proved for a more efficient care on high-quality level.

The company's capacity for ambidexterity is becoming an important dynamic capability, with on one hand flexibility for new developments and on the other hand stability for hard factors in physical value chains and soft factors in value-oriented attitudes and behaviour based on empathy.

This article was previously published in German in "Monitor Versorgungsforschung" under the original title " Personalisierung von Behandlungspfaden – Das Potenzial digitaler Technologien". This translated version faithfully reflects the authors, data, and interpretations of the original.
Interdigitating Dendritic Cell Sarcoma in Upper Arm Misdiagnosed as Ruptured Epidermal Inclusion Cyst
Authors: Chun Jae Young , Roh Si-Gyun , Kim Jong-Lim , Shin Jin Yong , Chang Suk Choo , Lee Nae-Ho
Published: February 2021

Interdigitating dendritic cell sarcoma (IDCS) is an extremely rare neoplasm that usually arises in lymph nodes, but also can exist in extranodal sites. This report is about a case study of IDCS in the upper arm skin with axillary lymph node metastasis. A 66-year old woman had a slowly growing mass with tenderness sensation on her right upper arm that was being injected triamcinolone acetonide at local clinic. The presumptive diagnosis was a ruptured epidermal inclusion cyst, and empiric antibiotic therapy was done; however, she had poor respondence to antibiotic therapy. Therefore, magnetic resonance imaging, incisional biopsy, positron emission tomography-computed tomography, and bone scan were performed and a malignant tumor was diagnosed. She received surgical resection and lymph node dissection of the right axilla. No adjuvant chemotherapy was done. Although extremely rare, this case suggests that extranodal IDCS should be considered in differential diagnosis of untreated atypical skin mass and early biopsy should be performed.
Minibatch Forward-Backward-Forward Methods for Solving Stochastic Variational Inequalities
Authors: Boţ Radu Ioan , Mertikopoulos Panayotis , Staudigl Mathias , Vuong Phan Tu
Published: February 2021

We develop a new stochastic algorithm for solving pseudomonotone stochastic variational inequalities. Our method builds on Tseng’s forward-backward-forward algorithm, which is known in the deterministic literature to be a valuable alternative to Korpelevich’s extragradient method when solving variational inequalities over a convex and closed set governed by pseudomonotone Lipschitz continuous operators. The main computational advantage of Tseng’s algorithm is that it relies only on a single projection step and two independent queries of a stochastic oracle. Our algorithm incorporates a minibatch sampling mechanism and leads to almost sure convergence to an optimal solution. To the best of our knowledge, this is the first stochastic look-ahead algorithm achieving this by using only a single projection at each iteration.
Using machine learning to predict the number of alternative solutions to a minimum cardinality set covering problem
Authors: Emerick Brooks , Lu Yun , Vasko Francis J.
Published: February 2021

Although the characterization of alternative optimal solutions for linear programming problems is well known, such characterizations for combinatorial optimization problems are essentially non-existent. This is the first article to qualitatively predict the number of alternative optima for a classic NP-hard combinatorial optimization problem, namely, the minimum cardinality (also called unicost) set covering problem (MCSCP). For the MCSCP, a set must be covered by a minimum number of subsets selected from a specified collection of subsets of the given set. The MCSCP has numerous industrial applications that require that a secondary objective is optimized once the size of a minimum cover has been determined. To optimize the secondary objective, the number of MCSCP solutions is optimized. In this article, for the first time, a machine learning methodology is presented to generate categorical regression trees to predict, qualitatively (extra-small, small, medium, large, or extra-large), the number of solutions to an MCSCP. Within the machine learning toolbox of MATLAB®, 600,000 unique random MCSCPs were generated and used to construct regression trees. The prediction quality of these regression trees was tested on 5000 different MCSCPs. For the 5-output model, the average accuracy of being at most one off from the predicted category was 94.2%.
denúncias e pronúncias: estudos afroperspectivistas sobre infâncias e educação das relações étnico-raciais
Authors: Noguera Renato
Published: February 2021

This brief Afroperspectivist study explores the articulation between the education of ethnic-racial relations and childhood studies. The generational issues of childhood are not dissociated from racialization. Therefore, racism is a phenomenon that needs to be tackled in children's contexts. This essay makes some complaints about situations of racism that afflict children in Brazil, and offers what we call pronouncements. We postulate that it is important to propose anti-racist paths. Afro-perspectivist philosophy operates on the assumption that childhood – approached as a philosophical concept - is the existential and political key to the promotion of afrotopia, which the Senegalese economist Felwine Sarr understands as a real historical possibility. We argue that the Western project promotes adulthood, which implies the colonization of life and the world. Our hypothesis is that through the promotion of childhood we can create the necessary conditions for anti-racist societies, and offer an afro-perspectivist understanding of childhood as a proactive indicator of the possibility other realities.
Developing a nursing dependency scoring tool for children's palliative care: the impact on hospice care
Authors: Tatterton Michael , Martin Catherine , Moore Clare , Walker Charlotte
Published: February 2021

Background:

Occupancy is commonly used to measure bed management in hospices. However, the increasing complexity of children and young people and growing dependence on technology mean that this is no longer effective.

Aim:

To develop a dependency tool that enables the hospice to safely and effectively manage the use of beds for planned short breaks (respite care), preserving capacity for children requiring symptom management and end-of-life care.

Methods:

A comprehensive literature review and existing tools were used to inform the development of the Martin House Dependency Tool Framework. Training was provided to staff and the tool was piloted before applying it across the hospice caseload.

Findings:

The tool has been used on 431 children (93.1% of caseload). The tool enabled consistency of assessment and more effective management of resources, due to a contemporaneous understanding of the clinical needs of those on the caseload.

Conclusion:

The tool has enabled consistent and transparent assessment of children, improving safety, effectiveness and responsiveness, and the management of the workforce and resources.
Incorporating regenerative medicine into rehabilitation programmes: a potential treatment for ankle sprain
Authors: Gan Quan Fu , Foo Chai Nien , Leong Pooi Pooi , Cheong Soon Keng
Published: February 2021

Ankle sprain has a great effect on morbidity and complications of chronic diseases. Experts have come to a consensus where ankle sprain can be managed by rest, ice, compression and elevation, non-steroidal anti-inflammatory drugs, immobilisation, functional support such as the use of an ankle brace, exercise, surgery and other therapies that include physiotherapy modalities and acupuncture. However, the time required for healing is still relatively long in addition to post-operative complications. Because of the challenges and setbacks faced by interventions to manage ankle sprains and in view of the recent trend and development in the field of regenerative medicine, this article discusses future treatments focusing on a personalised and holistic approach for ankle sprain management. This narrative review provides a novel idea for incorporating regenerative medicine into conventional therapy as an intervention for ankle sprain based on theoretical concepts and available evidence on regenerative medicine involving ligament injuries.
Influence of inspiratory muscle strength on exercise capacity before and after cardiac rehabilitation
Authors: dos Santos Tamires Daros , Pereira Sergio Nunes , Portela Luiz Osório Cruz , Pereira Marisa Bastos , Pasqualoto Adriane Schmidt , da Silveira Aron Ferreira , Martins de Albuquerque Isabella
Published: February 2021

Background/Aims

Coronary artery bypass grafting is a complex procedure that triggers a series of clinical and functional complications. The reduction of inspiratory muscle strength that persists during the late postoperative period has been suggested as an important determinant of functional capacity after coronary artery bypass grafting. The aim of this study was to investigate whether inspiratory muscle strength, functional capacity and quality of life are determinants of exercise capacity before and after a short-term phase II cardiac rehabilitation programme in patients who have had coronary artery bypass graft surgery.

Methods

A prospective quasi-experimental study was undertaken with 20 patients who had recevied coronary artery bypass surgery. All patients completed a short-term, moderate-to-high intensity inspiratory muscle training programme, followed by aerobic and resistance exercise, two times a week for 12 weeks, totalling 24 sessions, under the direct supervision of a physical therapist.

Results

Pre-intervention, peak oxygen consumption (peak VO2) was associated with maximum inspiratory pressure (β=0.037; 95% confidence interval 0.01–0.06; P=0.002). Post-intervention, peak VO2 was associated with maximum inspiratory pressure (β=0.03; 95% confidence interval 0.007–0.053; P=0.014) and the 6-Minute Walk Test (β=0.007; 95% confidence interval, 0.001–0.013; P=0.024).

Conclusions

Inspiratory muscle strength influences exercise capacity before and after a short-term cardiac rehabilitation programme in patients who have had coronary artery bypass graft surgery.
‘Resistant to change?’: using critical reflection to analyse positionality within a neoliberal academic environment
Authors: Robinson Kim , Macfarlane Selma
Published: February 2021

A growing body of literature has outlined the deleterious impacts of neoliberalism on higher education in the Western world. These critiques are far-ranging and include effects on students, curriculum, educators and the purpose of higher education itself. Some of this literature has focused specifically on social work education, highlighting ways in which neoliberal agendas run counter to the profession’s focus on social justice and a critical approach to education. In this article, as social work academics based in Australia, we use a structured process of critical reflection to deconstruct and reconstruct a challenging incident that embodies and reflects key tenets of neoliberal discourse. The authors draw on a combination of theories that inform critical social work, such as feminism, critical theory and postmodern thinking. We argue that critical reflection can enable us to name and unpack the discourses and power dynamics at play within academic and other settings in order to more clearly and consciously resist managerial processes and to generate alternative discourses based on social work values. The endeavour is aimed not at prescribing practices of resistance, but rather at considering possibilities for creative responses in subtle spaces.