bluuebunny/crossref_metadata_2025 huggingface dataset:
Alkaloids of narrow-leaved lupine as a factor determining alternative ways of the crop’s utilization and breeding
Authors: Vishnyakova M. A. , Kushnareva A. V. , Shelenga T. V. , Egorova G. P.
Published: October 2020

Narrow-leaved lupine (Lupinus angustifolius L.), a valuable leguminous crop adapted to a wide range of climatic conditions, has a very short history of domestication. For many centuries it was used mainly as a green manure, since the success and prospects of the multi-purpose use of the species depend on its breeding improvement, in particular, on a particular concentration of alkaloids in seeds and green mass. The first varieties of scientific breeding were created only in the 1930s after the appearance of low-alkaloid mutants. Despite wide prospects for use in various areas of the national economy, unstable productivity and susceptibility to diseases hinder the production of this crop. Obviously, breeders deal only with a small part of the gene pool of the species and limited genetic resources, using mainly low-alkaloid (sweet) genotypes to create new varieties. The genetic potential of the species can be used more efficiently. At the same time, it is rational to create highly alkaloid (bitter) varieties for green manure, while food and feed varieties should not lose their adaptive potential, in particular, resistance to pathogens, due to the elimination of alkaloids. In this regard, it seems to be a productive idea to create ‘bitter/sweet’ varieties combining a high content of alkaloids in the vegetative organs and low in seeds, which can be achieved by regulating the synthesis/transport of alkaloids in the plant. The paper discusses the current state of use of the species as a green manure, fodder, food plant. Information is given on the quantity and qualitative composition of narrow-leaved lupine alkaloids, their applied value, in particular, fungicidal, antibacterial, insecticidal, the use of lupine alkaloids as active principles of drugs. Along with promising breeding considerations, the possibility of using technologies for processing raw high-alkaloid materials with the accompanying extraction of valuable ingredients for pharmaceuticals is discussed. Information is briefly presented about the genomic resources of the species and the prospects for their use in marker-assistant selection and genome editing.
Regions enriched for DNA repeats in chromosomes of Macrostomum mirumnovem, a species with a recent Whole Genome Duplication
Authors: Zadesenets K. S. , Rubtsov N. B.
Published: October 2020

The free-living flatworm Macrostomum mirumnovem is a neopolyploid species whose genome underwent a recent Whole Genome Duplication (WGD). In the result of chromosome fusions of the ancient haploid chromosome set, large metacentric chromosomes were formed. In addition to three pairs of small metacentrics, the current karyotype of M. mirumnovem contains two pairs of large metacentric chromosomes, MMI1 and MMI2. The generation of microdissected DNA libraries enriched for DNA repeats followed by DNA probe preparation and fluorescent in situ hybridization (FISH) were performed. The DNA probes obtained marked chromosome regions enriched for different DNA repeats in the M. mirumnovem chromosomes. The size and localization of these regions varied in different copies of large chromosomes. They varied even in homologous chromosomes, suggesting their divergence due to genome re-diploidization after a WGD. Besides the newly formed chromosome regions enriched for DNA repeats, B chromosomes were found in the karyotypes of the studied specimens of M. mirumnovem. These B chromosomes varied in size and morphology. FISH with microdissected DNA probes revealed that some Bs had a distinct DNA content. FISH could paint differently B chromosomes in different worms and even in the same sample. B chromosomes could carry a bright specific fluorescent signal or could show no fluorescent signal at all. In latter cases, the specific FISH signal could be absent even in the pericentromeric region of the B chromosome. Possible mechanisms of B chromosome formation and their further evolution are discussed. The results obtained indicate an important role that repetitive DNAs play in genome re-diploidization initiating a rapid differentiation of large chromosome copies. Taking together, karyotype peculiarities (a high level of intraspecific karyotypic diversity associated with chromosome number variation, structural chromosomal rearrangements, and the formation of new regions enriched for DNA repeats) and some phenotypic features of M. mirumnovem (small body size, short lifecycle, easy maintenance in the laboratory) make this species a perspective model in the studies of genomic and karyotypic evolution in species passed through a recent WGD event.
La cerámica provincial inca como producto y como expresión de estatus en la población mitmaquna de Pueblo Viejo-Pucará
Authors: Castillo Mayra Carmen , Makowski Hanula Krzysztof
Published: October 2020

Continuando la línea de investigaciones iniciada hace quince años por los integrantes del Programa Arqueológico – Escuela de Campo «Valle de Pachacamac», los autores del presente artículo discuten los resultados del análisis de cerámica que corresponden a imitaciones de estilos imperiales inca que han sido seleccionados entre varios estilos en uso durante el Horizonte Tardío en el valle bajo de Lurín. La muestra proviene de pisos y de contextos excavados en dos  residencias palaciegas del asentamiento Pueblo Viejo-Pucará, a 15 km de Pachacamac, fundado por los mitmaquna procedentes de Huarochirí por iniciativa de la administración imperial inca. Los resultados de análisis de pastas y acabados por medio de microscopía digital fueron confrontados con los estudios previos sobre la procedencia de las fuentes de arcilla, que implicaron el análisis LA-TOF-ICP-MS y el estudio de la variedad de alfares. Este enfoque permite revisar, de manera crítica, dos supuestos ampliamente difundidos en las investigaciones sobre la relación entre el estilo inca y las tradiciones locales en el contexto de debate sobre las identidades cultural, étnica y política del productor y del usuario: 1) El hipotético control que ejerce el Estado Inca sobre los ceramistas, que se expresaría en la imposición de cánones morfo-estilísticos y tecnológicos cuzqueños a los alfareros locales y 2) La supuesta relación directaentre la identidad étnica y las preferencias estilísticas del usuario local de cerámica, verbigracia el estilo Ychsma o Puerto Viejo. La validez de ninguno de estos supuestos pudo ser confirmada en la producción de la cerámica Inca provincial a cargo de alfareros locales y probables mitmaquna norteños; asimismo en su uso, se refleja un complejo proceso de construcción de identidades nuevas en el contexto cosmopolita del imperio, no sin que algunos aspectos de la identidad de origen se hayan racionalizado, afirmado y materializado.
¿Gestión de la distancia o reajuste de jurisdicciones? La propuesta de fundación de un tribunal del Santo Oficio en las Filipinas por el jesuita Francisco Velho (1658)
Authors: Rodrigues Lourenço Miguel
Published: October 2020

Este artículo tiene como objetivo analizar la labor del hermano jesuita Francisco Velho como procurador general de la provincia de Filipinas en Madrid. Durante su estancia en la corte, Velho presentó un conjunto de tres memoriales que pretendían resolver la difícil cuestión de la dependencia espiritual de las islas Molucas. Su iniciativa le llevó a proponer al Consejo de Indias y al Consejo de la Suprema Inquisición la creación de un tribunal del Santo Oficio en Manila. En este estudio, analizaremos el rol que desempeñó el Santo Oficio en la estrategia del procurador general de la provincia de Filipinas. De la misma manera, consideraremos las razones que posteriormente resultaron en el fracaso del proyecto.
Los proyectos de instauración de tribunales de la Inquisición en la frontera urbana colonial de la región «platina»: Tucumán y Río de la Plata (siglos XVII-XVIII)
Authors: Vassallo Jaqueline
Published: October 2020

Este trabajo aborda las propuestas de creación de tribunales de la Inquisición, que generaron autoridades inquisitoriales, reales y eclesiásticas a lo largo de los siglos XVII y XVIII, para contrarrestar la enorme extensión territorial que tenía la jurisdicción del tribunal de Lima y los problemas que derivaban de ello. El estudio se enfoca especialmente en las gobernaciones del Tucumán y el Río de La Plata, como integrantes de la llamada «región platina»; es decir, un espacio que vinculó núcleos poblacionales de la frontera urbana colonial en los que convivieron portugueses, castellanos, hispano-criollos y lusoamericanos.
Contra los gravísimos males que combaten la Religión y el Estado: Inquisición e Iglesia en Cuba a inicios del siglo XIX
Authors: Fernández Mellén Consolación
Published: October 2020

Entre 1810 y 1824, las Antillas españolas fueron testigos de cómo el territorio de la América continental iniciaba, maduraba y culminaba su proceso de independencia y de una España que, a partir de la invasión francesa de la península Ibérica en 1808, vivió sus dos primeras experiencias liberales. Ambos desarrollos históricos supusieron la subversión del orden que representaba la monarquía absoluta, al momento en la persona de Fernando VII, y sus consecuencias se dejaron sentir en las islas. Tras el restablecimiento del absolutismo, en Cuba surgieron voces que buscaron adaptar la actividad inquisitorial a una nueva realidad que, impuesta por acontecimientos externos, condicionó el desarrollo y la efectividad de la actuación de los ministros de la Inquisición en la isla. El presente artículo se propone rescatar un proyecto de establecer un nuevo tribunal de Inquisición en La Habana, que fue presentado como un instrumento para el control de las ideas, la defensa de la religión y contra la herejía.
Directrices que influyen en el «Programa de Segregación en la Fuente y Recolección Selectiva de Residuos Sólidos» de las Municipalidades de San Martín de Porres y Ate, Perú (2011-2017)
Authors: Gallegos Blas Keth Lee Jacob , Nieto Medina Patricia Alejandra , Torpoco Beltrán Elias Eric
Published: October 2020

El objetivo del presente estudio fue analizar las directrices que influyen en el Programa de Segregación en la Fuente y Recolección Selectiva de los distritos de San Martín de Porres y Ate, así como la comparación de su evolución de 2011 a 2017 bajo un enfoque descriptivo. Se presenta la descripción de la situación actual del aprovechamiento de residuos sólidos en el país, su manifestación en dispositivos legales y la descripción de los programas de segregación de ambos distritos. Asimismo, un análisis de la cantidad de residuos sólidos recolectados, convenios de gestión y valorización de beneficios ambientales en kg de CO2 evitados de ambos programas. Como conclusión, se evidencia que Ate mostró una mayor cantidad de residuos sólidos recolectados que San Martín de Porres para el año 2017 en 254,4 toneladas. Asimismo, Ate presentó tres convenios más que San Martín de Porres, lo cual representa una ventaja para adquirir mayores beneficios para el programa. En cuanto a la valorización de beneficios ambientales, Ate superó a San Martín de Porres por 400.543 kg de CO2. Los resultados meritorios de las tres directrices lograron que Ate se presentara como una municipalidad ejemplar con un programa que tiene una base estratégica con vistas a la sostenibilidad.
Necesidades de formación percibidas por los egresados de Utopía relacionadas con la educación comunitaria y de extensión
Authors: Fierro Guarnizo Frank Isneider
Published: October 2020

Este estudio evaluó la percepción de los egresados del programa Utopía de los años 2014 a 2017, respecto a las necesidades de capacitación percibidas. La recolección de datos ocurrió en dos fases: la primera a través de una encuesta electrónica y la segunda por medio de una entrevista. Los resultados muestran que la mayoría de los egresados trabajó en áreas relacionadas con extensión rural y afirmaron tener competencias ‘moderadas’ y de ‘alto nivel’ en este campo. Entre las principales responsabilidades laborales resaltaron ‘asistencia técnica’ y ‘transferencia de tecnología’. Sus principales fuentes de conocimiento fueron ‘Internet’ y ‘otros colegas’. Las metodologías más utilizadas para transferir conocimiento fueron ‘enseñanza presencial’ y ‘reuniones’. En cuanto a necesidades de capacitación percibidas para el trabajo como agente de extensión, la mayoría afirmó tener deficiencias relacionadas con las metodologías de extensión rural (planificación, implementación y evaluación de programas, y métodos de enseñanza), por el contrario, afirmaron suficiencia en el conocimiento técnico. La competencia técnica es esencial, pero se hace necesario profundizar en temas como métodos de enseñanza, difusión de innovaciones y liderazgo, los cuales deberían incluirse en el currículo
School polytechnization in the Central Black Earth Region in 1931–1933
Authors: Zlobin Andrey N.
Published: October 2020

We examine various aspects of the introduction of polytechnic education in educational institutions of the Central Black Earth Region. The relevance of the study is justified primarily by the fact that this aspect of the development of domestic education has not been previously studied, and also by novelty of archival documents introduced into scientific circulation for the first time. We focus on the legislative consolidation of the principles of polytechnism in the framework of the educational reform in the early 30s of 20th century, as well as on the theoretical understanding of the technological aspect of the educational process. The purpose of this research is to study the state policy aimed at developing labor training and education in lower and secondary educational institutions and implementing its aspects in the Central Black Earth Region. The study analyzes the measures taken by the regional authorities within the framework of implementing the party’s policy on education polytechnization: increasing the number of workshops and workrooms, purchasing equipment, assigning household plots to schools, organizing clubs and competitions, conducting excursions to enterprises, improving the skills of school employees and librarians, helping them establish contacts with enterprises and allocating them experienced engineers and technicians to work in schools. We examine the difficulties that accompanied school polytechnization. They included: poor equipment of workshops, low qualifications of instructors and teachers, unwillingness of managers of a number of organizations to meet halfway with schools, formalism in organizing socialist competitions and contracts with enterprises, underestimation by school administrators and teachers of the importance of technical training. In conclusion, we summarize the achievements and shortcomings of the polytechnic aspect of the educational process in the Central Black Earth Region of the early 1930s, and outline further prospects for labor training in Soviet schools.
Self-development of youth in the social and cultural conditions of functioning student scientific society
Authors: Grigorieva Elena I. , Pankova Elena I. , Gabdiyev Mukhaddas
Published: October 2020

We consider the process of self-development of student youth in the context of the functioning of student scientific society, which is a space for self-identification, self-determination and self-development of youth in the structure of civil society. The basic mechanisms of self-development are revealed: self-understanding, self-awareness, self-determination, self-government, self-improvement and self-realization. It is noted that they are all interconnected and interact with each other, their consistent implementation forms a kind of algorithm for moving to higher forms of self-improvement. The characteristic is given to the principles under which the social and cultural conditions for students’ self-development will be most vividly realized (subjectivity, motivational orientation of self-development, effectiveness of cultural activity, facilitation, focus, coherence, consistency and continuity in the content of the educational process, the connection of upbringing with life, the democracy of the upbringing system, interactivity, individualization, differentiation and tolerance of the education system, integrity and structure, variability and competitiveness of the activity of self-developing personality). Particular attention is paid to social and cultural activities, which are aimed at self-realization of the personality, self-development of personal spiritual and physical potential of students. Personal self-development connected with integration into the internal and external activities of the individual for self-designing and self-creation at the level of self-awareness, motivational, value and emotional spheres, behavior in accordance with the requirements of the social and normative space and the tasks of research, social organizational and social and cultural activities of student scientific society.
Potencial erosivo de jugos de frutas amazónicas
Authors: Acuña Flores Shareen Melannie , Tay-Chu Jon Lidia Yileng , Ccahuana-Vasquez Renzo Alberto , Delgado-Cotrina Leyla
Published: October 2020

La erosión dental es la pérdida irreversible de la superﬁcie del esmalte o dentina, debido a exposición frecuente de ácidos de origen no bacteriano. A pesar de que ciertos jugos de frutas presentan potencial erosivo in vitro, no existe una evidencia conclusiva al respecto. Objetivos: Evaluar in situ el potencial erosivo de jugos de frutas amazónicas sobre el esmalte dental. Material y métodos: Se evaluó in situ la microdureza superﬁcial Vickers (MSV) del esmalte dental luego de la exposición a las bebidas Physalis Peruviana (aguaymanto), Averrhoa Carambola (carambola), Myrciaria Dubia (camu camu), Coca cola (control positivo) y agua destilada (control negativo). Participaron quince voluntarios (18 a 30 años) quienes utilizaron placas palatinas para reproducir el medio de almacenamiento. Se colocaron 6 fragmentos por placa. Las placas fueron expuestas a las diferentes bebidas 4 v/d (9:00 am, 11:00 am, 13:00 pm y 15:00 pm) durante 5 minutos por 5 días. Por cada ciclo erosivo se expuso a dos bebidas, inmediatamente los dispositivos palatinos fueron recolocados en la boca de los participantes. Hubo un periodo de washout de 8 días entre cada ciclo. Se calculó la diferencia de MSV antes y después de la exposición. El análisis de ANOVA/Tukey se utilizó para determinar las diferencias entre las bebidas en el programa SPSS 19, con un nivel de signiﬁcancia de 0,5%. Resultados: Las cuatro bebidas evaluadas disminuyeron la MSV del esmalte (p<0,05) sin diferencia signiﬁcativa entre ellas. Conclusiones: Los jugos a base de camu camu, aguaymanto y carambola son potencialmente erosivos.
Desórdenes orales potencialmente malignos. Lo que el odontólogo debe conocer
Authors: Iparraguirre Nuñovero Marcos Felipe , Fajardo Ximena , Carneiro Everdan , Couto-Souza Paulo Henrique
Published: October 2020

Objetivo: El objetivo de este estudio es actualizar los conocimientos sobre Desordenes Orales Potencialmente Malignos, dando énfasis a datos epidemiológicos, apariencia clínica, sintomatología, diagnóstico diferencial y manejo terapéutico, así como también resaltar el rol del odontólogo general en el examen clínico. Material y métodos: Fue realizada una búsqueda de la literatura en las bases de datos cientíﬁcas “Medline”, “Pubmed” y “SciELO”, utilizando las palabras clave “Leukoplakia”, “Erythroplasia”, “Cheilitis”, “Nevus, Pigmented”, “Oral Submucous Fibrosis”, “Lichen Planus”. La búsqueda fue orientada hacia artículos de revisión, estudios clínicos y reportes de caso, priorizando los artículos publicados en los últimos 5 años y sin hacer distinciones por el idioma. Resultados: Como resultado de la búsqueda se obtuvieron 165 artículos, los cuales fueron revisados cuidadosamente para conservar solo aquellos que se dedicaran a describir, comparar o tratar desordenes con potencial de malignidad, incluyendo datos de relevancia como epidemiología, apariencia clínica, sintomatología, diagnóstico diferencial y manejo terapéutico. De esta manera, el estudio se limitó a 41 artículos. Conclusiones: Al adoptar medidas preventivas, así como un meticuloso examen clínico sobre tejidos blandos, se puede facilitar la detección temprana de Desordenes Orales Potencialmente Malignos. La eliminación de lesiones sospechosas o un control de las condiciones cancerígenas puede evitar en gran mayoría el desarrollo de tumores malignos.
Colony relocation of Greater Crested Terns Thalasseus bergii in Bass Strait, south-eastern Australia
Authors:   School of Life and Environmental Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia, Fromant Aymeric ,   Centre d’Etudes Biologiques de Chizé (CEBC), UMR 7372 du CNRS-La Rochelle Université, 79360 Villiers-en-bois, France, Eizenberg Yonina ,   School of Life and Environmental Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia, Jessop Rosalind ,   3Victorian Wader Study Group, P.O. Box 1088, Cowes VIC 3922, Australia, Lec’hvien Arnaud ,   School of Life and Environmental Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia, Geeson Johanna ,   School of Life and Environmental Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia, Arnould John ,   School of Life and Environmental Sciences, Deakin University, 221 Burwood Highway, Burwood VIC 3125, Australia
Published: October 2020

A newly established Greater Crested Tern Thalasseus bergii colony was observed on Kanowna Island, northern Bass Strait, in December 2019 and was monitored through January 2020. A maximum of 532 ± 28 nests was counted,representing ~15–20% of the known northern Bass Strait breeding population. Resightings of 69 leg-banded individuals (from 3 to 24 years of age) demonstrated that founding individuals originated from colonies in Victoria [The Nobbies on Phillip Island (54%), Corner Inlet Barrier Islands (39%), Mud Islands in Port Phillip Bay (6%)] and one individual from South Australia. Breeding began 2 months later than usual for northern Bass Strait, perhaps because the birds only moved to Kanowna Island after failed nesting attempts elsewhere (Corner Inlet and Phillip Island). Individuals were observed to mainly feed their chicks with Barracouta Thyrsites atun and Jack Mackerel Trachurus declivis, contrasting with the usual predominance of Australian Anchovy Engraulis australis in the diet of this species in the Bass Strait region. This relocation may result from local changes in prey availability and/or a combination of potential human disturbance, predation and storm events. The recent 50% decrease in the number of breeding Greater Crested Terns in Victoria suggests substantial changes in the regional environmental conditions, highlighting the importance of understanding the impact of environmental variations on seabird species.
Envelhecimento populacional e financiamento público: análise do Rio Grande do Sul utilizando um modelo multissetorial
Authors: Fochezatto Adelar , Correa Petry Guilherme , Braatz Jacó , Martinez Paolo Mazzoncini , Da Rocha Mariana Mariano
Published: October 2020

Os efeitos econômicos do envelhecimento populacional é um tema ainda pouco estudado em países em desenvolvimento. No contexto brasileiro, o Rio Grande do Sul é um dos estados com maiores taxas de envelhecimento populacional. Esta mudança demográfica altera o perfil do consumo da economia, influenciando outras variáveis relacionadas. O objetivo deste trabalho é analisar os impactos das mudanças demográficas na arrecadação de impostos sobre consumo no Rio Grande do Sul. Para isso, é utilizado um modelo de insumo-produto regional. Os resultados mostram que o envelhecimento populacional gera um perfil de consumo que reduz a carga destes impostos na economia.
El cuerpo instrumentalizado bajo la dinámica macroeconómica y territorial de la marginalidad avanzada
Authors: Delgado Torres Enrique
Published: October 2020

El artículo es un análisis del modo en que la dinámica estructural de la marginalidad avanzada consolida una forma de instrumentalización del cuerpo, fundada en el desarrollo tecnológico. En este sentido, se asume que el individuo para poder ser integrado a un proyecto de ciudad, requiere de ser imbuido por instrumentos como la figura de la “ciudadanía”, para consolidar una estructura corporal asociada a la pertenencia, y a la capacidad de acción sobre las ciudades para su conformación. La macroestructura económica y territorial, de la cual depende la marginalidad avanzada también ha reformado otros ámbitos, como la producción de la tecnología y la ciencia, alineándolas bajo su lógica operativa. La denuncia que hace Javier Echeverría en este contexto toma relevancia para entender esta cuestión, cuando se refiere a las “tecnociencias” como aquel desarrollo tecnológico y científico cooptado por las grandes corporaciones, que controlan los movimientos del capital a gran escala, direccionando la instrumentalización del individuo y su cuerpo para su funcionamiento más adecuado con respecto a los flujos del capital; de este modo llega a la denominación de tecnopersonas. Todo esto obliga a repensar las formas en que se ha instrumentalizado al individuo y su cuerpo en distintos ámbitos, pero a su vez, en sincronía con la marginalidad avanzada, y de este modo reconocer el desarrollo tecnológico como parte de su composición.
Exponential Synchronization of Inertial Cohen–Grossberg Neural Networks with Time-Varying Delays via Periodically Intermittent Control
Authors: Ding Qing , Song Yinfang
Published: October 2020

This paper deals with the exponential synchronization problem of inertial Cohen–Grossberg neural networks with time-varying delays under periodically intermittent control. In light of Lyapunov–Krasovskii functional method and inequality techniques, some sufficient conditions are attained to ensure the exponential synchronization of the master-slave system on the basis of p-norm. Meanwhile, the periodically intermittent control schemes are designed. Finally, in order to verify the effectiveness of theoretical results, some numerical simulations are provided.
Application of a Customized Total Talar Prosthesis for Revision Total Ankle Arthroplasty
Authors: Morita Shigeki , Taniguchi Akira , Miyamoto Takuma , Kurokawa Hiroaki , Tanaka Yasuhito
Published: October 2020

Background:

The rate of revision surgery for total ankle arthroplasty (TAA) is higher than for hip and knee arthroplasties. Tibiotalocalcaneal arthrodesis is widely used; however, it requires a large allograft. Thus, the use of a customized total talar prosthesis in combination with the tibial component of TAA (combined TAA) may be an effective strategy for talar component subsidence. This study aimed to evaluate the clinical and radiographic effectiveness of the combined TAA in such revision cases.

Methods:

Between 2000 and 2015, 10 patients (10 women; 10 ankles) were treated using the combined TAA for revision after standard TAA or combined procedures that included the use of a talar body prosthesis. In 6 patients, the tibial component was concurrently replaced. The median follow-up period was 49 months (interquartile range [IQR], 24.5 to 90 months). The Japanese Society for Surgery of the Foot (JSSF) ankle-hindfoot scale score, a numerical rating scale (NRS) pain score, passive range of motion of the ankle, and the presence of osteophytes and degenerative changes in the adjacent joints were assessed preoperatively and at final postoperative follow-up.

Results:

The median NRS pain score improved significantly, from 7 (IQR, 6.25 to 8.75) to 2 (IQR, 1 to 3). The median JSSF ankle-hindfoot scale total score improved significantly, from 64 (IQR, 56.25 to 71.5) to 88.5 (IQR, 79.75 to 96). In the subcategories of this scale, the median pain score improved from 20 (IQR, 20 to 27.5) to 35 (IQR, 30 to 40), and the median function score improved from 34 (IQR, 26.5 to 37) to 43.5 (IQR, 39.75 to 46). The median range of motion improved from 29° (IQR, 25.5° to 35°) to 35° (IQR, 31.25° to 43.75°). No significant difference in osteophyte formation was found. Degenerative changes in the adjacent joint were found only in the talonavicular joint.

Conclusions:

The combined TAA, used in revision for postoperative complications after standard TAA or combined procedures including the use of a talar body prosthesis, was associated with improved objective JSSF ankle-hindfoot scale scores, subjective pain assessment, and range of motion in the ankle.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Pore-water chemistry: A proxy for tracking the signature of ongoing silica diagenesis
Authors: Varkouhi Shahab , Tosca Nicholas J. , Cartwright Joseph A.
Published: October 2020

Silica diagenesis leads to dramatic petrophysical variations in the host sediment across the depth of an opal-A to opal-CT transition zone. Predicting the present-day diagenetic status of opal-A to opal-CT transition zones, i.e., active versus fossilized fronts, is essential to constraining the drivers that control abrupt changes in the physical state of sediment. This study assesses whether there are modern signatures of ongoing silica diagenesis in the sediment pore water, and demonstrates the potential for pore-water-chemistry profiles for distinguishing between active opal-CT precipitation and fossil transition zones. Pore-water chemistry, mineralogy, and thermodynamic analyses of the Ocean Drilling Program Wells 794 and 795 indicate that solubility equilibrium has been reached with respect to opal-CT in the transition zones captured by the Neogene biosilica in the Sea of Japan. Even though silica dissolution might be triggering a reverse-weathering process, the equilibrium reached with respect to diagenetic opal strongly suggests that the silica drop across the transition zones is mainly influenced by active opal-A to opal-CT transformation. Owing to abrupt petrophysical variations associated with opal-CT formation, other interstitial profiles—major ions and primary parameters—have been influenced by silica diagenesis. The extremely low silica diffusion fluxes in the sediment, the low permeability of host sediment, and the occurrence of considerable pore-water loss at the depth of the transition zone all support this conclusion that the dissolved species have not been diffused in the sediment at rates comparable to those by pore-water advection. Advection and diffusion, however, appear to have ceased recently because they have failed to smooth the signature of ongoing silica diagenesis. The porosity drop during opal-A to opal-CT diagenesis at Sites 794 and 795 is principally attributed to chemically induced anomalous compaction, causing the sediment framework to lose its strength under fragmentation and extensive opal-A dissolution.
Cause and Predictors of Neonatal Mortality among Neonates admitted to Neonatal Intensive Care Units of Public Hospitals in eastern Ethiopia: Facilities based Prospective follow-up study
Authors: Desalew Assefa , Sintayehu Yitagesu , Teferi Nardos , Amare Firehiwot , Geda Bifitu , Worku Teshager , Abera Kebebush , Asefaw Abiyot
Published: October 2020

Background: The first month is the most crucial period for child survival. Neonatal mortality is stagnated in sub-Saharan Africa including Ethiopia. And the trend in reduction is slower than infant and child mortality. The facilities-based cause and predictor of neonatal death in the neonatal intensive care unit were not well documented in this study setting. Hence the aim of this study was to determine the cause and predictors of neonatal mortality among neonates admitted in neonatal intensive care units in eastern Ethiopia. Method: Facilities-based prospective follow-up study was conducted among neonates admitted in neonatal intensive care units of public hospitals in eastern Ethiopia from November to December 2018. Data were collected using pre-tested, structured questionnaire and follow-up checklist. The main outcomes, cause of death was set by senior pediatricians and residents. Epi-Data 3.1 and SPSS 25 version software were used for entry and analysis. Binary logistic regression was used to find out the predictors of facilities-based neonatal mortality.Result: The proportion of facilities-based neonatal mortality was 20%. The top five cause of death was a complication of prematurity 49%, birth asphyxia 37.8%, infection 32.6%, meconium aspiration syndrome 17.3% and congenital malformation 6.1%. Low birth weight, preterm births, length of stay, low 5thminutes Apgar score, hyperthermia and initiation of feeding were predictors of neonatal death among Neonates admitted in neonatal intensive care units in public hospitals, eastern Ethiopia.ConclusionIn summary, the proportion of facilities-based Neonatal death was unacceptably high. The main causes of death were preventable and treatable. Hence, early detection, anticipating high-risk newborns and timely intervention is very essential. Furthermore, early initiation of feeding and a better referral linkage to tertiary facilities could contribute for reduction of neonatal death in this setting.
Gender Differences in the Effect of Medical Humanities Program on Medical Students' Empathy: A Prospective Longitudinal Study 
Authors: Lwow Michal , Canetti Laura , Muszkat Mordechai
Published: October 2020

Background: Previous studies have suggested that Medical students' empathy declines during medical school, especially during the clinical studies. The aim of this study was to examine. changes in medical students' empathy during their first clinical experience, and to determine the impact of gender and humanities curriculum on empathy changes. Methods: In this prospective longitudinal study, 262 4th year students from three consecutive classes were assessed. Empathy was assessed before and at 4th-year-end, using the Jefferson Scale of Physician Empathy-Student Version (JSPE-S). The three classes differed in humanities curriculum [limited Medical Humanities (MH(lim)) vs. extended Medical Humanities (MH(ext))], and in admission system [Personal Interview (PI) vs. multiple mini interviews (MMI)]. Results: Overall, there was a small but significant decrease in JSPE-S during the fourth year (114.40±11.32 vs. 112.75±14.19, p= 0.034). Among men there was a statistically significant decline in JSPE-S during the fourth year, and the MH(ext) (but not the MH(lim)) was associated with the decline (t(35) = 2.38, p = 0.023). Women students showed no decline in empathy during the fourth-year of studies, regardless of type of humanities program. In addition, women who participated in MH(ext) had a higher JSPE-S scores during the 4th -year as compared to women who participated in MH(lim). Conclusion: Pre-clinical humanities program was associated with a decline in empathy among men medical students during the fourth-year of medical studies. Gender differences in response to medical humanities programs require further study.
Assessing immune infiltration and the tumor microenvironment for the diagnosis and prognosis of sarcoma
Authors: Zhu Naiqiang , Hou Jingyi
Published: October 2020

Background: Sarcomas, cancers originating from mesenchymal cells, are comprehensive tumors with poor prognoses, yet their tumorigenic mechanisms are largely unknown. In this study, we characterize infiltrating immune cells and analyze immune scores to identify the molecular mechanism of immunologic response to sarcomas.Method: The “CIBERSORT” algorithm was used to calculate the amount of L22 immune cell infiltration in sarcomas. Then, the “ESTIMATE” algorithm was used to assess the “Estimate,” “Immune,” and “Stromal” scores. Weighted gene co-expression network analysis (WGCNA) was utilized to identify the significant module related to the immune therapeutic target. Gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were performed using the “clusterProfiler” package in R for annotation and visualization. Results: Macrophages were the most common immune cells infiltrating sarcomas. The number of CD8 T cells was negatively associated with that of M0 and M2 macrophages, and positively associated with M macrophages in sarcomas samples. The clinical parameters (disease type, gender) significantly increased with higher Estimate, Immune, and Stromal scores, and with a better prognosis. The blue module was significantly associated with CD8 T cells. Functional enrichment analysis showed that the blue module was mainly involved in chemokine signaling and the PI3K-Akt signaling pathway. CD48, P2RY10 and RASAL3 were identified and validated at the protein level.Conclusion: Based on the immune cell infiltration and immune microenvironment, three key genes were identified, thus presenting novel molecular mechanisms of sarcoma metastasis.
Reducing burden from respiratory infections in refugees and immigrants: a systematic review of interventions in OECD, EU, EEA and EU-applicant countries
Authors: Lambert Jan-Frederic , Stete Katarina , Balmford James , Bockey Annabelle , Kern Winfried , Rieg Siegbert , Boeker Martin , Lange Berit
Published: October 2020

Background: Respiratory diseases are a major reason for refugees and other immigrants seeking health care in countries of arrival. The burden of respiratory diseases in refugees is exacerbated by sometimes poor living conditions characterised by crowding in mass accommodations and basic living portals. The lack of synthesised evidence and guideline-relevant information to reduce morbidity and mortality from respiratory infections endangers this population.Methods: A systematic review of all controlled and observational studies assessing interventions targeting the treatment, diagnosis and management of respiratory infections in refugees and immigrants in OECD, EU, EEA and EU-applicant countries published between 2000 and 2019 in MEDLINE, CINAHL, PSYNDEX and Web of Science.Results: Nine of 5779 identified unique records met our eligibility criteria. Seven studies reported an increase in vaccine coverage from 2% – 52% after educational multilingual interventions for respiratory-related childhood diseases (4 studies) and for influenza (5 studies). There was limited evidence in one study that hand sanitiser reduced rates of upper respiratory infections and when provided together with face masks also the rates of influenza-like-illness in a hard to reach migrant neighbourhood. In outbreak situations of vaccine-preventable diseases, secondary cases and outbreak hazards were reduced by general vaccination strategies early after arrival but not by serological testing after exposure (1 study). We identified evidence gaps regarding interventions assessing housing standards, reducing burden of bacterial pneumonia and implementation of operational standards in refugee care and reception centres.Conclusions: Multilingual health literacy interventions should be considered to increase uptake of vaccinations in refugees and immigrants. Immediate vaccinations upon arrival at refugee housings may reduce secondary infections and outbreaks. Well-designed controlled studies on housing and operational standards in refugee and immigrant populations early after arrival as well as adequate ways to gain informed consent for early vaccinations in mass housing is required to inform guidelines.
The impacts and unintended consequences of the nationwide pricing reform for drugs and medical services in the urban public hospitals in China
Authors: Zhang Xiaoxi , Lai Hongyu , Zhang Lidan , He Jiangjiang , Fu Bo , Jin Chunlin
Published: October 2020

Background Since 2015, China has been rolling out the pricing reform for drugs and medical services (PRDMS) in the urban public hospitals in order to reduce drug expenditures and to relieve financial burdens of patients. This study aims at evaluating the effectiveness of the reform and investigating its positive impacts and unintended consequences to provide evidence basis for further policy making.Methods The Difference-in-difference (DID) approach was employed to analyze the reform impacts on the 31 provincial administrative areas in China based on data abstracted from China Statistics Yearbooks and China Health Statistics Yearbooks from 2012 to 2018.Results The reform resulted in a decrease of 7.59% in drug cost per outpatient visit, a decrease of 5.73% in drug cost per inpatient admission, a decrease of 3.63% in total cost per outpatient visit and an increase of 9.10% in surgery cost per inpatient admission in the intervention group. However, no significant change in examination cost was found. The reduction in the medical cost per inpatient admission was not yet demonstrated, nor was that in the total outpatient/ inpatient expenses. The nationwide pricing reform for drugs and medical services in urban public hospitals (PRDMS-U) in China is demonstrated to be effective in cutting down the drug expenditures. However, the revealed unintended consequences indicate that there are still significant challenges for the reform to reach its ultimate goal of curbing the medical expenditures.Conclusion We conclude that the pricing reform alone may not be enough to change the profit-driven behavior of medical service providers as the root cause lies in the unchanged incentive scheme for providers in the service delivery. This holds lessons for policy making of other low- and middle-income countries (LMICs) with similar health systems set up in the achievement of Universal Health Coverage (UHC).
Comparison of Health Care Utilization Among Patients Affiliated and Not Affiliated with Healthcare Professionals in China
Authors: Si Yafei , Zhou Zhongliang , Su Min , Hu Han , Yang Zesen , Chen Xi
Published: October 2020

Background Doing “more” in healthcare can be a major threat to the delivery of high-quality health care. It is important to identify the supplier-induced demand (SID) of health care. This study aims to test SID hypothesis by comparing health care utilization among patients affiliated with healthcare professionals and their counterpart patients not affiliated with healthcare professionals.Methods We used coarsened exact matching to compare the health care utilization and expenditure between patients affiliated and not affiliated with healthcare professionals. Using the cross-sectional data of the China Labour-force Dynamics Survey (CLDS) in 2014, we identified 806 patients affiliated with healthcare professionals and 22788 patients not affiliated with healthcare professionals. The main outcomes were outpatient proportion and expenditure as well as inpatient proportion and expenditure.Results The matched outpatient proportion of patients not affiliated with healthcare professionals was 0.6% higher (P=0.754) than that of their counterparts, and the matched inpatient proportion was 1.1% lower (P=0.167). Patients not affiliated with healthcare professionals paid significantly more (680 CNY or 111 USD, P<0.001) than their counterparts did per outpatient visit (1126 CNY [95% CI 885-1368] vs. 446 CNY [95% CI 248-643]), while patients not affiliated with healthcare professionals paid insignificantly less (2061 CNY or 336 USD, P=0.751) than their counterparts did per inpatient visit (15583 CNY [95% CI 12052-19115] vs. 17645 CNY [95% CI 4884-30406]).Conclusion Our results lend support on supplier-induced demand hypothesis and highlight the need for policies to address the large outpatient care expenses of patients not affiliated with healthcare professionals. Our study also suggests that as the public becomes more informed, the demand of health care may persist while heath care expenditure per outpatient visit may decrease sharply due to the decline in supplier-induced demand. As significant misbehaviors performed by providers, it’s important to create right incentives to offer less avoidable healthcare service during outpatient visits may work to reduce healthcare costs.
The effect of 3D-printed plastic teeth on scores in a tooth morphology course in a Chinese university
Authors: Wang Helin , Xu Haokun , Zhang Junhua , Yu Shibin , Wang Meiqing , Qiu Jun , Zhang Mian
Published: October 2020

Background: The tooth morphology course is an important basic dental course. However, it is difficult to fully reflect the three-dimensional (3D) morphological characteristics of tooth structure in two-dimensional pictures in traditional textbooks. The aim of this study was to assess the effect of 3D-printed plastic model teeth in the teaching of tooth morphology. Methods: Twenty-two undergraduate students who matriculated at the School of Stomatology, the Fourth Medical University, in 2014 and 23 who matriculated in 2016 participated in the study. Each student who matriculated in 2016 was given a full set of fourteen standard 3D-printed plastic model teeth for use during the learning process, and an anonymous questionnaire was used to evaluate the usefulness of the 3D-printed plastic model teeth from the perspective of the students. Results: There was no significant difference between the two groups in the scores of the theoretical examination or the total score. However, for the score of the sculpted gypsum teeth, the students who used the 3D-printed plastic model teeth in their studies scored significantly higher (P=0.002). More than 90% of the students thought that the 3D-printed plastic model teeth were of great help or were very helpful for mastering the anatomy of teeth and for carving the gypsum teeth. Conclusion: Standard 3D-printed plastic teeth can effectively assist students in learning tooth morphology by transforming two-dimensional pictures and descriptions in the textbook into a 3D conformation, effectively promoting students' learning and mastery of tooth morphology and structure. Additionally, the results suggest that 3D-printed plastic model teeth are of great help to the students in mastering and improving their carving skills.
Impact of a theory-informed and user-centered stroke information campaign on the public’s behaviors, attitudes, and knowledge when facing acute stroke: a controlled before-and-after study. Cover title: Impact of the ReACT stroke campaign
Authors: Haesebaert Julie , Laude C. , Termoz A. , Bravant E. , Perreton N. , Bony T. , Trehard H. , Porthault S. , Derex L. , Nighoghossian N. , Schott AM.
Published: October 2020

Background: Public awareness of stroke symptoms is a key factor to ensure access to reperfusion strategies in due time. We designed and launched a regional theory-informed and user-centered information campaign and assessed its impact on emergency medical services (EMS) calls for stroke suspicion, time-to-call, and public attitudes and awareness concerning stroke.Methods: A controlled before-and-after study was conducted during 3 sequential time-periods in 2 separate counties. Key messages of the campaign were underpinned by stroke representations and the theory of planned behavior, and focused on recognition of stroke warning signs and the need to call EMS urgently. The campaign included posters, leaflets, adverts and films displayed in bus and subway stations, internet, social networks, and local radio. Outcome measures on behavior, attitudes, and knowledge were assessed before the launch of the campaign, at 3 months, and 12 months.Results: The number of EMS calls for stroke suspicion increased by 21% at 12 months in the intervention county and this change was significantly different to that observed in the control county (p=0.02). No significant changes were observed regarding self-reported attitudes in case of stroke. An 8% significant increase in recognizing at least 2 stroke warning signs was observed in the intervention county (p=0.04) at 3 months, while it did not change significantly in the control county (p=0.6). However, there was no significant difference in warning sign recognition between both counties (p=0.16).Conclusion: The campaign significantly improved public’s behavior of calling EMS, although stroke knowledge was not improved as much as expected. Repeating these campaigns over time might further help improve timeliness and access to reperfusion strategies.Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT02846363.