bluuebunny/crossref_metadata_2025 huggingface dataset:
Doctors of osteopathic medicine (DO): a Canadian perspective
Authors: Evren Sevan , Yuzhong Bi Andrew , Talwar Shuchi , Yeh Andrew , Teitelbaum Howard
Published: April 2020

Background: Doctors of osteopathic medicine (DO) are one of the fastest growing segments of health care professionals in the United States. Although Canada has taken significant leaps in the acknowledgment of US trained DOs, there continues to be a lack of understanding of the profession by Canadian trained physicians. In this article, we provide a brief overview of osteopathic medical education and training in the United States.Method: Current information of osteopathic training by American Association of Colleges of Osteopathic Medicine (AACOM) and American Osteopathic Association (AOA) was presented. Data pertaining to Canadians enrolled in osteopathic colleges was compared with allopathic (MD) and international medical graduates (IMGs).Results: Doctors of osteopathic medicine programs provide an additional pathway for students interested in pursuing a medical education. Canadian applications to osteopathic colleges are expected to grow due to successful post-graduate US residency matching, increased difficulty of matriculating at Canadian medical schools, and a greater awareness of the profession in Canada.Conclusions: Given the increasing enrollment of Canadian students in US osteopathic medical schools, we expect that Canadian DOs will play a significant role in shaping health care in both the US and Canada.
miR-202 Suppresses Hepatocellular Carcinoma Progression via Downregulating BCL2 Expression
Authors: Zhuang Donghai , Liang Li , Zhang Hongzhan , Feng Xianguang
Published: April 2020

miRNAs play an important role in progression of hepatocellular carcinoma (HCC). In this work, we assessed the function of miR-202 in human HCC and identified BCL2 as its target. We found miR-202 expression was found significantly downregulated, while BCL2 expression was markedly upregulated
in HCC tissues and cell lines (HepG2, Hep3B, and HCCLM3). Both miR-202 and BCL2 were closely correlated with major vascular invasion and advanced TNM stage as well as overall survival of HCC patients. Overexpression of miR-202 significantly inhibited cell proliferation, induced apoptosis and
cell cycle arrest at the G0/G1 phase, and prevented tumor formation in a xenograft nude mouse model. Further, miR-202 dramatically inhibited migration, invasion, and epithelialmesenchymal transition. miR-202 bound to the 3-untranslated region (3-UTR) of BCL2 mRNA and
downregulated the expression level of BCL2 protein. Exogenous BCL2 overexpression weakened the inhibitory effects of miR-202, while inhibition of BCL2 enhanced the inhibitory effects of miR-202. In conclusion, miR-202 serves as a tumor suppressor in HCC progression by downregulating BCL2 expression,
indicating miR-202 might be a potential target for HCC.
Ilha de Aritingui:
Authors: Grünewald Rodrigo de Azeredo
Published: April 2020

Este artigo trata da sociogênese e da territorialização da comunidade tradicional ribeirinha da Ilha de Aritingui, situada no município de Rio Tinto (PB), examinadas a partir de uma perspectiva diacrônica e a partir de conflitos com empresas do ramo do agronegócio açucareiro e, mais recentemente, da carcinicultura. Fica aqui em evidência como, a partir de um alinhamento com os órgãos ambientalistas, a identidade de comunidade “tradicional” se alavanca como uma alternativa política e social no meio rural do litoral da Paraíba.
Gestão comunal de águas:
Authors: Alves Maria Odete , Bursztyn Marcel , Chacon Suely Salgueiro
Published: April 2020

Este artigo analisa a construção do sistema de regulação da água de uso comum em Lagoa dos Cavalos, na zona rural do município de Russas (Ceará). Trata-se de um sistema de abastecimento de água construído em mutirão pelos usuários a partir do Perímetro Irrigado Tabuleiro de Russas. Apoia-se na teoria dos recursos comuns em articulação com o conceito de ação coletiva. Optou-se pela pesquisa qualitativa, combinando o uso de fontes testemunhais, documentais e bibliográficas. Os entrevistados foram selecionados com o uso da amostragem não probabilística intencional. Conclui que as regras de uso da água, inicialmente flexíveis, sofrem mudanças para adaptação ao novo contexto de escassez provocado pela sobre-extração. A fixação de novas regras promove aprendizagem coletiva, que contribui para o aperfeiçoamento e a criação de outras regras, gerando um círculo virtuoso entre ambas.
Relações entre o meio ambiente natural e a ocupação do solo:
Authors: Giustina Carlos Christian Della , Franco José Luiz de Andrade
Published: April 2020

A busca do entendimento da influência do meio natural sobre o comportamento das sociedades humanas tem fomentado, nas últimas décadas, estudos sociológicos, geográficos e históricos que consideram variáveis ambien- tais em suas análises. Com o desenvolvimento de geotecnologias, como o sensoriamento remoto e os sistemas de informações geográficas, análises espaciais se tornaram mais precisas e menos onerosas. O presente estudo analisa, com base nessas geotecnologias, a relação entre componentes do meio físico, como geologia, geomorfologia e pe- dologia, e os padrões de uso e ocupação do solo, no estado de Goiás. A modificação da paisagem de áreas naturais se dá, em geral, em áreas planas, onde as condições naturais do meio físico são adequadas à mecanização agrícola e à ocupação urbana. Áreas de mineração, apesar de representarem impactos ambientais pontuais na integridade da vegetação nativa, são locais onde há maior probabilidade de ocorrência de endemismos. Tendo em vista que o meio físico influencia diretamente as tipologias vegetais, a expansão da fronteira sobre áreas planas com predominância do cerrado Sentido Restrito ou em áreas de mineração pode comprometer estratégias de conservação da biodiversidade no cerrado.
E-Learning como estrategia pedagógica en la educación superior
Authors: Mujica-Sequera Ruth
Published: April 2020

Las tecnologías de la información y la comunicación (TIC) en el momento presente han tomado un rol protagónico en la sociedad, que son indispensables en el ámbito pedagógico. Esta investigación se llevó a cabo en la plataforma educativa Docentes 2.0, con el fin de proponer recomendaciones para promover la plataforma. En la metodología se definieron indicadores de la plataforma E-Learning en tres dimensiones: organizacional, funcional y pedagógica. Además, fueron analizados registros históricos en las bases de datos de la plataforma. A través de esta investigación se detectó una baja tasa de utilización de las plataformas E-Learning por parte de los docentes, sin embargo, se observó una total aceptación de las plataformas existentes por parte de sus usuarios.
Herramientas de una aplicación móvil de mensajería instantánea para el fortalecimiento del proceso enseñanza – aprendizaje del Inglés.
Authors: Portilla Diego
Published: April 2020

El presente estudio busca optimizar el uso de los dispositivos móviles en el ambiente de aprendizaje (aula de clase), utilizando para ello una aplicación móvil de mensajería instantánea de uso masivo, aprovechando el envío de información en formato audio, vídeo, imágenes y texto, con el fin de fortalecer el aprendizaje del inglés en los aprendices de un programa de formación, en el Centro de Formación Agroindustrial “La Angostura”, del Servicio Nacional de Aprendizaje SENA (Colombia). El enfoque de esta investigación es de carácter mixto secuencial, con énfasis en lo cualitativo, por cuanto se describen las actividades realizadas con la aplicación móvil en cuatro fases. La aplicación a través del dispositivo móvil se evalúa a través del modelo FRAME de Koole y las capacidades de dispositivos o 4 C de Quinn. Se observan como resultados que se puede fortalecer el aprendizaje del inglés, motiva el trabajo autónomo, fomenta el trabajo colaborativo y mejora en la competencia digital.   Finalmente, el aprendizaje móvil se caracteriza porque “el estudiante desarrollará sus capacidades cognitivas mediante la interacción, al tener como soporte la tecnología y las herramientas que proporciona” (Gómez, 2016).
Las TIC como oportunidad para fortalecer el PEA en los estudiantes con discapacidad visual
Authors: Acosta Mayra , Betún Angie , Delgado Jorge , Iñiguez Mao
Published: April 2020

El presente artículo se basa en la influencia que tiene la Tecnología de Información y Comunicación para fortalecer el Proceso de Enseñanza Aprendizaje en estudiantes que poseen discapacidad visual, la investigación se fundamenta en las bases del conectivismo de Downes y Siemens permitiendo articular nuevas formas de conocimiento; las personas no videntes afrontan muchos retos día a día para desenvolverse solos, desde el espacio físico inadecuado para su traslado, así como en el desarrollo de actividades en la educación, es por ello que se pretende describir los aportes que brindan las nuevas tecnologías que existen en el medio y las bondades que generan en el proceso de enseñanza aprendizaje de las personas que presentan este tipo de discapacidad. La metodología que se utilizó correspondió a un enfoque cualitativo de corte documental, así como la aplicación de una entrevista para el proceso de recolección de datos. Los resultados obtenidos demostraron que existen una diversidad de recursos informáticos entre los que se puede mencionar Talkback, Nvda, Vocalizer, Jaws los cuales permitirían la independencia del estudiante en el proceso de aprendizaje, generando un nivel de autonomía para potenciar su desarrollo cognitivo. Por último, se puede aseverar que la inserción de las TIC en los procesos de inclusión educativa permite reducir las barreras que se presentan en el desarrollo de la formación de los dicentes, logrando aplicar actividades inclusivas con el uso de tecnología en el desarrollo de la clase, comprendiendo que existe una sociedad diversa con diferentes formas de pensar, aprender y actuar.
OS BENEFÍCIOS DO BRINCAR NA EDUCAÇÃO INFANTIL
Authors: Christina Brancovan Garcia Monica
Published: April 2020

Este trabalho integra os estudos da linha de pesquisa em educação e teve como objetivo principal destacar a importância do brincar  ara as crianças na Educação Infantil. A importância da temática escolhida justifica-se pelo fato que em relação ao conhecimento cientifico, todo estudo que tenha a preocupação de estudar a importância do brincar na educação infantil e que esta também  ssociada à aprendizagem como fator relevante no desenvolvimento infantil. O presente trabalho tem como objetivo mostrar os  enefícios do brincar na educação infantil. Conclui-se que as atividades lúdicas possibilitam que as crianças reelaborem criativamente  entimentos e conhecimentos e edifiquem novas possibilidades de interpretação e de representação do real.
Cataclysmic Variables in the First Year of the Zwicky Transient Facility
Authors: Szkody Paula , Dicenzo Brooke , Ho Anna Y. Q. , Hillenbrand Lynne A. , van Roestel Jan , Ridder Margaret , DeJesus Lima Isabel , Graham Melissa L. , Bellm Eric C. , Burdge Kevin , Kupfer Thomas , Prince Thomas A. , Masci Frank J. , Mróz Przemyslaw J. , Golkhou V. Zach , Coughlin Michael , Cunningham Virginia A. , Dekany Richard , Graham Matthew J. , Hale David , Kaplan David , Kasliwal Mansi M. , Miller Adam A. , Neill James D. , Patterson Maria T. , Riddle Reed , Smith Roger , Soumagnac Maayane T.
Published: April 2020

Using selection criteria based on amplitude, time, and color, we have identified 329 objects as known or candidate cataclysmic variables (CVs) during the first year of testing and operation of the Zwicky Transient Facility. Of these, 90 are previously confirmed CVs, 218 are strong candidates based on the shape and color of their light curves obtained during 3–562 days of observation, and the remaining 21 are possible CVs but with too few data points to be listed as good candidates. Almost half of the strong candidates are within 10 deg of the galactic plane, in contrast to most other large surveys that have avoided crowded fields. The available Gaia parallaxes are consistent with sampling the low mass transfer CVs, as predicted by population models. Our follow-up spectra have confirmed Balmer/helium emission lines in 27 objects, with four showing high-excitation He ii emission, including candidates for an AM CVn, a polar, and an intermediate polar. Our results demonstrate that a complete survey of the Galactic plane is needed to accomplish an accurate determination of the number of CVs existing in the Milky Way.
New names and status for Pacific spiny species of Solanum (Solanaceae, subgenus Leptostemonum Bitter; the Leptostemonum Clade)
Authors: McClelland Donald H. R. , Nee Michael , Knapp Sandra
Published: April 2020

Five new species of spiny solanums (Solanum subgenus Leptostemonum Bitter; the Leptostemonum Clade) are described from the islands of the Pacific. Two of the new species are from Fiji (S. pseudopedunculatum D.McClelland, sp. nov. and S. ratale D.McClelland, sp. nov.), two from New Caledonia (S. memoayanum D.McClelland, sp. nov. and S. semisucculentum D.McClelland, sp. nov.), one from Papua New Guinea (S. labyrinthinum D.McClelland, sp. nov.) and another from Vanuatu (S. vanuatuense D.McClelland, sp. nov.). A new status and combination is provided for the rare Hawaiian endemic S. caumii (F.Br.) D.McClelland, comb. et stat. nov. and a new type designated for S. peekelii Bitter of Papua New Guinea, for which a description is also provided. All species are illustrated with digitized herbarium specimens, mapped and have been assigned a preliminary conservation status using current IUCN guidelines. Details of all specimens examined are provided in a Suppl. materials 1: file SM1.
Carpinus gigabracteatus, a new species from southeast Yunnan, China
Authors: Lu Zhiqiang
Published: April 2020

Carpinus gigabracteatus Z. Qiang Lu, a new hornbeam species from southeast Yunnan of China, is described and illustrated in this study. It possesses extremely large bracts and is closely related to C. tsaiana Hu and C. tschonoskii Maxim., based on the characters of large bract size and bracts without lobes at the base of inner margins. Furthermore, morphological comparison suggested it was distinctly different from C. tschonoskii by a series of characters from leaf, infructescence, bract and nutlet and from C. tsaiana by its leaf length to width ratio (1.4–2.0 vs. 2.0–2.4), lateral veins significantly impressed adaxially, number of lateral veins on each side of midvein (9–14 vs. 14–17), bract length (3.9–4.8 vs. 2.5–3.2 cm) and bract length to width ratio (2.3–3.1 vs. 1.5–2.1). Therefore, this hornbeam, based on only one population from southeast Yunnan, is here erected as a new species, named as C. gigabracteatus.
Prepubertal and Adolescent Vulvovaginitis: What to Do When a Girl Reports Vaginal Discharge
Authors: Lanis Aviya , Talib Hina J. , Dodson Nancy
Published: April 2020

Vaginitis presents with vaginal discharge, odor, pruritis, and/or discomfort and affects up to 75% of girls and women over the course of their lifetimes, with most women experiencing their first episode during adolescence. Given the prevalence of this disorder, this article aims to provide an overview of vaginitis for the general pediatrician. We start with prepubertal etiologies of vaginitis, then discuss pubertal and normal physiologic discharge, and then focus on the most common etiologies of adolescent vulvovaginitis. The three most common microbial etiologies of vaginitis (bacterial vaginosis, vulvovaginal candidiasis, and trichomonas) are addressed, as well as their diagnosis and treatment in adolescents.

[
Pediatr Ann
. 2020;49(4):e170–e175.]
Painful Periods in the Adolescent Girl
Authors: Myszko Olga , Al-Husayni Noor , Talib Hina J.
Published: April 2020

Up to two-thirds of adolescent girls report painful periods but few seek medical care for their dysmenorrhea. Dysmenorrhea is associated with multiple physical and psychological symptoms, and the delayed evaluation and treatment of dysmenorrhea contributes to a poor quality of life and can result in lifelong health problems, including chronic pelvic pain and infertility. It is recommended that an assessment of patients' menstrual cycles be performed regularly, as identification of abnormally painful menstrual cycles may reveal potential health problems, including pelvic diseases such as endometriosis and adenomyosis. Visits to primary care providers offer an opportunity to assess and educate adolescents and their families on normal menstrual physiology. The purpose of this article is to review the evaluation and management of dysmenorrhea.

[
Pediatr Ann
. 2020;49(4):e176–e182.]
Heavy Menstrual Bleeding in Adolescent Girls
Authors: Davila Jennifer , Alderman Elizabeth M.
Published: April 2020

Heavy menstrual bleeding (HMB) is a common complaint among adolescent girls. It reflects an abnormal volume of blood loss during the menstrual cycle. Abnormal uterine bleeding can manifest as HMB but includes menstrual irregularity. In many cases, immaturity of the hypothalamic-pituitary-ovarian axis or hormonal conditions like polycystic ovarian syndrome leading to anovulatory cycles are the underlying cause for heavy menses. However, in girls with HMB, especially those not responding to the usual hormonal attempts to manage HMB, an underlying bleeding disorder should be considered. Up to 62% of adolescents with HMB have a bleeding disorder, many without anemia at presentation. Evaluation for HMB in an adolescent girl should include referrals to an adolescent medicine specialist or gynecologist and pediatric hematologist.

[
Pediatr Ann
. 2020;49(4):e163–e169.]
Generalised Single-Valued Neutrosophic Number and Its Application to Neutrosophic Linear Programming
Authors: Mahapatra Nirmal Kumar , Bera Tuhin
Published: April 2020

In this chapter, the concept of single valued neutrosophic number (SVN-Number) is presented in a generalized way. Using this notion, a crisp linear programming problem (LP-problem) is extended to a neutrosophic linear programming problem (NLP-problem). The coefficients of the objective function of a crisp LP-problem are considered as generalized single valued neutrosophic number (GSVN-Number). This modified form of LP-problem is here called an NLP-problem. An algorithm is developed to solve NLP-problem by simplex method. Finally, this simplex algorithm is applied to a real-life problem. The problem is illustrated and solved numerically.
Assessment of Pyrogenic Carbonaceous Materials for Effective Removal of Radiocesium
Authors: Pipíška Martin , Ballova Simona , Fristak Vladimir , Ďuriška Libor , Hornik Miroslav , Demcak Stefan , Holub Marian , Soja Gerhard
Published: April 2020

Pyrogenic carbonaceous materials produced by pyrolysis process of various waste feedstocks are increasingly used in non-soil applications such as water purification tools. Pyrogenic carbonaceous materials thermochemically converted from wood chips, corn cobs, garden green waste, cherry pits, walnut shells, pine cones and municipal sewage sludge in slow pyrolysis under N2 atmosphere, were characterized by total C analysis, specific surface area, volumes of micro- and mesopores and tested in batch experiments as potential radiocesium sorption materials. Cesium adsorption-desorption experiments were conducted using the 137Cs radioisotope. Although tested materials significantly differ in Cs removal, Cs+ ions uptake could be attributed to the mechanisms of Freundlich surface adsorption. The highest maximum sorption capacities were reached for pine cones, wood chips and garden waste pyrogenic materials and reached 95.9 to 126 μmol g-1. These results demonstrate suitability of selected Pyrogenic carbonaceous materials as Cs adsorbents potentially useable as reactive barriers for 137Cs contaminated effluents.
Reuse of Waste Materials from Sleeper Subsoil
Authors: Kučová Kateřina , Kučerová Radmila , Lyčková Barbora , Glogarová Veronika , Takač David , Tichá Monika
Published: April 2020

The paper is focused on the topic of phytoremediation. The experiment included planting chosen plants (perennial ryegrass, chives and garden cress) into mixed homogenised mixture which in all cases contained substrate, compost and contaminated soil (sleeper subsoil) in ratios 60 : 20 : 20. The soil mixtures were analysed after the end of flowering. The results show that the most suitable compost was vermicompost of the brand EKOVERMES. The plants included a convenient choice of perennial ryegrass and garden cress.
Biodegradation of Sleeper Subsoil
Authors: Kučerová Radmila , Lyčková Barbora , Geryková Jana , Glogarová Veronika , Takač David , Sobková Ivona
Published: April 2020

The paper deals with laboratory testing of PAHs biodegradation in samples of sleeper subsoil via two chosen microorganisms, bacteria Pseudomonas monteilii and Rhodococcus degradans. The obtained results show that the pure bacterial culture R. degradans removed 46 % PAHs in 28 days. Bacterium P. monteilii was far more successful in degrading PAHs, it managed to remove 74 % PAHs. The worst result was from the mixture of both bacteria which degraded only 34 % PAHs.
Evaluation of some Specific Effects of Pavement Kerbs Containing Cement Kiln Dust on Soil and Lawns - The First Experimental Phase
Authors: Prochazka Lukáš , Vojvodíková Barbara
Published: April 2020

This article deals with the evaluation of the effects on soil caused by leaching of materials from curbs, which were made using cement kinl dust from the cement plant Horné Srnie. Attention is also paid to a condition of the grass growing near the curbs. These laboratory curbs (bricks) were produced with addition of cement kiln dust and fly ash after denitrification by the SNCR method in alkaline activated materials based on blast furnace slag granules activated by anhydrous disodium metasilicate During the experiment the effects of laboratory curbs on grass growth in testing flower pots were investigated. The aim of the experiment was to obtain a product suitable for curbs with supposed direct contact with the soil. The experiment dealt with the properties of laboratory curbs stored in situ as well as with their influence on the soil and the effect of leached substances on the surrounding grass. The main part of the experiment was conducted in situ.
Physico-Mechanical Properties of Cellulose Fiber-Cement Mortars
Authors: Števulová Nadežda , Hospodarova Viola , Václavík Vojtěch , Dvorský Tomáš
Published: April 2020

This paper is aimed to investigate the total sand filler replacement by two types of cellulosic fibers (bleached wood pulp - WP and recycled fibers from waste paper - RF) in cement-based mortars. Two different types of cement mortar, one with addition of finely ground limestone and other with powdered granulated slag, were mixed with fibers. The changes in consistency of fresh fiber cement mortars and development of compressive and flexural strength of mortars in dependence on hardening time up to 90 days was studied. The development of compressive and flexural strength with increasing hardening time of cellulose fiber mortars and two binders with different properties confirmed that binder mixtures containing finely ground slag and recycled cellulose fibers achieved higher values of these strength parameters. Also adhesion testing of fiber cement mortars on two substrates (ceramic fitting and aerated concrete block) after 28 days of their application showed better adhesion of cement mortars with finely ground granulated slag on the ceramic fitting surface compared to the mortars containing finely ground limestone. However, any cracks have occurred on both substrates during the maturing of mortars with slag. Based on the above facts, it can be concluded that suitable plaster mixtures for their use in the interior appear the cement recipes with both cellulose fibers (wood pulp and fibers from recycled waste paper) and with finely ground limestone.
Trends in the Use of Cement Bypass Dusts for their Application in Construction
Authors: Terpakova Eva , Števulová Nadežda
Published: April 2020

With the innovations in the field of building materials production, some by-products or wastes are also generated. This is closely related to the need for adequate environmental treatment of these products. One such product is by-pass dust from cement production, which can be characterized as a fine-grained material consisting mainly of Ca, Mg, K, S and Cl oxides. Bypass dust has high alkaline reaction due to its composition; therefore careful research is needed to assess its properties and subsequent practical use in the construction industry. Preliminary results of composites prepared on the basis of bypass dusts and other selected fly ash are discussed. The main aim of the experiments was to verify the possibilities of bypass dust utilization as partial substitution of cement in the preparation of composites. The composites prepared with different water/cement coefficient were tested for compressive strength of 28 days of hardening. It has been shown that a mixture of bypass cement dust and selected ashes can be used as a partial binder substitution up to 33% weight of cement, which can represent considerable benefits for practice. Preliminary investigation at the same conditions revealed that water/cement coefficient will need to be optimized in further research.
Effect of Colour Pigment on Selected Properties of Fly Ash Concrete. Part 1: Compressive Strength and Water Absorption
Authors: Junak Jozef , Junáková Natália , Salkova Viola
Published: April 2020

Concrete has not only fulfilled the load-bearing function, but also its aesthetic function comes to the fore. It is precisely coloured concrete that performs this function best. The second phenomenon of today is "green concrete". In the paper, the properties of coloured concrete are compared with its "greener" alternative - coloured concrete with fly ash as a binder substitution. Experimental samples were measured for compressive strength and water absorption over a period of 7 days to 2 years. The results showed that the combination of coloured pigment and fly ash has an interesting synergistic effect, as evidenced by a 45MPa compressive strength and a 15% decrease of water absorption.
Application of Nanomaterials for Sustainable Concrete
Authors: Hrabová Kristýna
Published: April 2020

Green concrete is defined as a concrete which uses waste material as at least one of its components, or its production process does not lead to environmental destruction, or it has high performance and life cycle sustainability. Currently, cement and concrete production is at all-time high resulting in significant carbon dioxide emissions. Eight percent of the world's total CO2 emissions come from manufacturing cement. Nanomaterial concrete is new generation concrete formed of materials of the grain size of nanoscale. In the construction industry, nanomaterials has potentials, especially the functional characteristics such as increased tensile strength. The paper shows the dose dependence carbon nanotubes for the physico-mechanical properties of cement mixes.
Clinical and epidemiologic profile of the initial COVID-19 patients at a tertiary care centre in India
Authors: Gupta Nitesh , Agrawal Sumita , Ish Pranav , Mishra Suruchi , Gaind Rajni , Usha Ganapathy , Singh Balvinder , Sen Manas Kamal , COVID 2019 working group *Safdarjung Hospital
Published: April 2020

COVID-19 has now become a pandemic. It has spread from Wuhan, China, in December 2019 to a large number of countries within three months. The objective of this work is to report the initial experience with epidemiologic and clinical features, as well as with the management of COVID-19 patients in India. This is a descriptive case series of the first 21 COVID-19 infected patients confirmed with polymerase chain reaction (PCR) and admitted to a tertiary care centre in India from 01.02.2020 to 19.03.2020. Clinical, laboratory, and radiologic data were collected, including age, sex, nationality, travel history, symptoms, duration of stay, and comorbidities. The mean age of the population was 40.3 years with a male preponderance. Thirteen (62%) patients had recent travel history outside India in the previous 30 days, two thirds of whom had travelled to Italy. The most common symptoms were fever and cough (42.9%) followed by sore throat, headache and breathlessness. Vital and laboratory parameters were preserved in all patients and none of them required ventilatory support. Among the first 21 patients diagnosed with COVID-19 infection in India, the typical clinical presentation consisted in a mild upper respiratory tract infection predominantly affecting the young male population. One patient required supplemental oxygen. All patients recovered with no residual symptoms.

 

*The Safdarjung Hospital COVID 2019 working group: Nitesh Gupta, Sumita Agrawal, Pranav Ish, Suruchi Mishra, Rajni Gaind, Ganapathy Usha, Balvinder Singh, Manas Kamal Sen, Shibdas Chakrabarti (Consultant and Head, Pulmonary Medicine); NK Gupta (Professor, Pulmonary medicine); Dipak Bhattacharya (Consultant, Pulmonary medicine); Rohit Kumar (Assistant Professor, Pulmonary Medicine); Siddharth R. Yadav (Assistant Professor, Pulmonary Medicine); Rushika Saksena (Specialist, Microbiology); Rojaleen Das (Assistant Professor,Microbiology); Vikramjeet Dutta (Assistant Professor, Microbiology); Anupam Kr Anveshi (Senior Resident, Microbiology); Santvana Kohli (Assistant Professor, Anaesthesiology); Naveen KV (Assistant Professor,  Anaesthesiology); Amandeep Jaswal (Assistant Professor, Anaesthesiology).
Translation and cross-cultural adaptation into Italian of the self-administered FLARE-RA questionnaire for rheumatoid arthritis
Authors: Ughi N. , Schioppo T. , Scotti I. , Merlino V. , Murgo A. , De Lucia O. , Fautrel B. , Guillemin F. , Christensen R. , Ingegnoli F.
Published: April 2020

The aim was to provide a translation into Italian with cross-cultural adaptation of the French FLARE-Rheumatoid Arthritis (RA) questionnaire, and to test its acceptability, feasibility, reliability and construct validity in a single-centre cohort study. The French version of the FLARE-RA questionnaire was cross-culturally adapted and translated into Italian following an established forward–backward translation procedure, with independent translations and backtranslations. To validate the Italian version we tested the internal validity with Cronbach’s alpha, test-retest reliability with the intraclass correlation coefficient, agreement between assessments with Bland-Altman plots and construct validity with Spearman’s correlation coefficients. The questionnaire was tested on 283 consecutive RA outpatients (mean age 56.1±13.9 years, 226/283 females, median disease duration 12.6 years ranging from 0.2 to 70.6). For the global score (11 items) the Cronbach’s alpha coefficient was 0.94. The intraclass correlation coefficient was 0.87 (95% CI, 0.76-0.96). The correlation of FLARE-RA global score was 0.59 (95% CI, 0.50-0.66) with the Disease Activity Score on 28 joints, 0.63 (95% CI, 0.55-0.71) with the Simplified Disease Activity Index, 0.77 (95% CI, 0.71-0.83) with the RA Impact of Disease and 0.67 (95% CI, 0.59-0.73) with the Health Assessment Questionnaire. The Italian version of the FLARE-RA is feasible, brief and easy to administer. The translated and cross-cultural adapted showed accordingly to be valid and reliable. This questionnaire has some practical advantages, such as clarity, comprehensiveness, simplicity, and a minimum filling time. The development of cross-cultural adapted questionnaires in different languages is of pivotal importance to obtain standardized and comparable data across countries.
Gitelman syndrome associated with chondrocalcinosis and severe neuropathy: a novel heterozygous mutation in SLC12A3 gene
Authors: Conticini E. , Negro A. , Magnani L. , Ugolini R. , Atienza-Mateo B. , Frediani B. , Salvarani C.
Published: April 2020

Gitelman syndrome (GS) is an inherited salt-wasting tubulopathy characterized by hypocalciuria, hypokalemia, hypomagnesemia and metabolic alkalosis, due to inactivating mutations in the SLC12A3 gene. Symptoms may be systemic, neurological, cardiovascular, ophthalmological or musculoskeletal. We describe a 70 year-old patient affected by recurrent arthralgias, hypoesthesia and hyposthenia in all 4 limbs and severe hypokalemia, complicated by atrial flutter. Moreover, our patient reported eating large amounts of licorice, and was treated with medium-high dosages of furosemide, thus making diagnosis very challenging. Genetic analysis demonstrated a novel heterozygous mutation in the SLC12A3 gene; therefore, we diagnosed GS and started potassium and magnesium replacement. GS combined with chondrocalcinosis and neurological involvement is quite common, but this is the first case of an EMG-proven severe neuropathy associated with GS. Herein, we underline the close correlation between hypomagnesemia, chondrocalcinosis and neurological involvement. Moreover, we report a new heterozygous mutation in exon 23 (2738G>A), supporting evidence of a large genetic heterogeneity in this late-onset congenital tubulopathy.
Christian leadership in a South African township community: A reflection on nepotism and its impact on society
Authors: Kabongo Kasebwe T.L.
Published: April 2020

The author reflects on the reality of nepotism in Christian leadership as he has observed in the township of Soshanguve and many other African poverty-stricken communities he has lived in. The leadership of churches in those areas seems to run in the family. This model tends to have a disempowering effect on the other church members in terms of taking responsibility or initiating projects that could expand the impact of the church beyond the borders of its walls. This article recognises the positive impact of nepotism, but it mostly stresses on the negative impact of nepotism on the democratisation of power in the church and society. It uses music, a critical vehicle of knowledge acquisition in Africa, to stress upon the fact that Christian leaders should be equipped to participate in the common good, help in the empowerment of ordinary people around them, starting with their members and be altruistic, like Jesus, and work beyond the boundaries of their families.
Perspectives for repurposing drugs for the coronavirus disease 2019
Authors: Cherian Sarah S. , Agrawal Megha , Basu Atanu , Abraham Priya , Gangakhedkar Raman R. , Bhargava Balram
Published: April 2020

The newly emerged 2019 novel coronavirus (CoV), named as severe acute respiratory syndrome CoV-2 (SARS-CoV-2), like SARS-CoV (now, SARS-CoV-1) and Middle East respiratory syndrome CoV (MERS-CoV), has been associated with high infection rates with over 36,405 deaths. In the absence of approved marketed drugs against coronaviruses, the treatment and management of this novel CoV disease (COVID-19) worldwide is a challenge. Drug repurposing that has emerged as an effective drug discovery approach from earlier approved drugs could reduce the time and cost compared to de novo drug discovery. Direct virus-targeted antiviral agents target specific nucleic acid or proteins of the virus while host-based antivirals target either the host innate immune responses or the cellular machineries that are crucial for viral infection. Both the approaches necessarily interfere with viral pathogenesis. Here we summarize the present status of both virus-based and host-based drug repurposing perspectives for coronaviruses in general and the SARS-CoV-2 in particular.
Évaluation de la relation entre températures de l’air et températures de surface issues du satellite modis : application aux vignobles de la vallée de Waipara (Nouvelle-Zélande)
Authors: Morin Gwenaël , Le Roux Renan , Sturman Andrew , Quénol Herve
Published: April 2020

L’impact du changement climatique sur la viticulture nécessite d’élaborer des stratégies d’adaptation à l’échelle du vignoble. La variabilité climatique locale, notamment les effets sur la température, influence la croissance de la vigne et détermine les caractéristiques des vins. L’objectif, à travers l’analyse et la modélisation spatiale des températures, est de prendre en compte l’influence des facteurs environnementaux et topographiques sur les événements climatiques locaux. Cependant, cette méthode nécessite l’installation de réseau dense de data loggers enregistrant la température de l’air pour construire et valider les modèles statistiques climatiques locaux. L’imagerie thermique, issue de la télédétection, apparaît comme une donnée alternative afin de s’affranchir des réseaux de mesure. La température de l’air (Ta) peut être estimée à partir de données satellitaires dérivant la température de surface (LST) mesurée parMOderate-Resolution Imaging Spectroradiometer(MODIS) avec une résolution temporelle journalière et à 1 km de résolution spatiale. Une analyse comparée dans la vallée viticole de Waipara (Nouvelle-Zélande) durant la saison végétative 2017-2018 a mis en évidence de bonnes relations statistiques entre Ta et LST. Les analyses statistiques ont montré, pour les températures moyennes journalières, des résultats avec un RMSE moyen de 2,46°C et un coefficient R² > 0,7. A l’échelle diurne et nocturne, les températures minimales ont obtenu de meilleurs résultats, notamment avec le satellite Terra (RMSE ≈ 2,50°C et R2≈ 0,80), que les températures maximales (RMSE ≈ 4,90°C et R² ≈ 0,70).
Development of a Novel Polyherbal Formulation for Augmenting Milk Production in Healthy Dairy Cows
Authors: Bora Manajit , Srivastava Bhavana , Gaidhani Sudesh N , Sharma Himanshu , Gautam Manish K , Tiwari Rajesh K , Wanjari Manish M , Khanduri Shruti , Hazra Jayram
Published: April 2020

Aim:

The study was designed to develop and standardize a novel polyherbal formulation (PHF) for augmenting milk production in healthy dairy cattle.

Materials and methods:

Five raw plant drugs, viz., tubers of Asparagus racemosus Willd. (Shatavari), whole plant of Eclipta alba (L.) Hassk. (Bhringraj), seeds of Trigonella foenum-graecum L. (Methika), fruits of Foeniculum vulgare Mill. (Mishreya.), and Anethum sowa Roxb. ex Fleming (Shatapushpa) were used to prepare hydroalcoholic extracts using the Soxhlet method. Three in-house batches of PHF were prepared and standardized as per Ayurvedic Pharmacopoeia of India (API) methods. Pharmacognostic authentication and chemical identification were done by macroscopic and microscopic studies, phytochemical screening, physicochemical analysis, and high performance thin layer chromatography (HPTLC) fingerprinting. The safety studies of galactagogue preparation were performed through heavy metals, microbial contamination, aflatoxins, and pesticide residue analysis.

Results:

Organoleptic studies revealed that all the batches appeared as semisolid in nature, blackish-brown in color, with a pleasant odor and slight bitter taste. Phytochemical screening confirmed the presence of similar secondary metabolites in the different batches of both raw drugs and PHF. Physicochemical analysis and HPTLC fingerprints at different illuminations showed that all three batches were uniformly composed and complied the pharmacopeial limits. Results of safety parameters advocated that all the three batches were safe and complied as per the WHO and API guidelines.

Conclusion:

The present work first claims the standardization of this unique, cost-effective, nonhormonal, Ayurvedic galactagogue in-house preparation, i.e., PHF for augmenting milk yield in dairy herd. It proves that all the three batches have similar characteristics and uniformly composed. It serves as a reference for identification and distinguishing the galactagogue herbs.
Development and Standardization of Narayana Churna—A Polyherbal Ayurvedic Formulation
Authors: Mangal Anupam K , Tomer Rinku , Jindal Heena , Dutta Sreya , Sharma Himanshu , Sharma Bhagwan S , Srikanth Narayanam , Dhiman Kartar S
Published: April 2020

Aim:

The present study aims to develop pharmacognostical standards, standard operating procedure (SOP), and analytical profiling including physicochemical analysis of Narayana Churna, a polyherbal Ayurvedic formulation.

Materials and methods:

The pharmacognostical (macroscopy, microscopy and powder drug analysis), thin layer chromatography (TLC), and quantitative physicochemical analysis including loss on drying, alcohol and water-soluble extractive values, total and acid-insoluble ash, and pH value were performed as per the standard procedures described in the Ayurvedic Pharmacopoeia of India (API). The microbial limit, aflatoxins, heavy metals and pesticide residues were also analyzed.

Results and discussion:

Narayana Churna is of grayish-brown color with a slightly pungent taste. The powder microscopy revealed the presence of pentagonal/hexagonal/polygonal cork cells, polygonal pale green endosperm, oval/polygonal/irregular shaped stone cells, elongated and flat-shaped bordered pitted vessels, pitted tracheids, annular vessels, unicellular covering trichomes, prismatic crystals of calcium oxalate, starch grains and oil globules. The TLC fingerprint was developed using toluene:ethyl acetate:formic acid (6:4:1) as the solvent system. The standardized limits of the physicochemical parameters, microbial count, aflatoxins, heavy metals and pesticide residues were also laid down.

Conclusion:

This is the first ever attempt made in order to develop the SOP and standardized parameters of Narayana Churna. Thus, the present study would be useful as the standardized reference protocol for the identification and standardization of this formulation.
تقدير مخاطر استخدام أسلحة اليورانيوم المنضّ ب في العراق - الجزء الثاني
Authors: ناجي العزاوي سعاد
Published: April 2020

الملخص

لقد تم حساب الجرعة الفعالة الجماعية في مناطق الدراسة، واستُخدمت معاملات الخطورة المعتمدة من منظمات دولية متخصصة بالتلوث الإشعاعي، مثل اللجنة الدولية للوقاية من الإشعاع (ICRP) ولجنة الأمم المتحدة العلمية المعنية بآثار الإشعاع الذري (UNSCEAR) لتحديد إجمالي حالات الإصابة بالأمراض السرطانية المميتة وغير المميتة وسرطان الدم (اللوكيميا) والأمراض الأخرى ذات العلاقة بالتلوث الإشعاعي المحتمل حصولها بين سكان مناطق الدراسة. أشارت نتائج هذه الدراسة أن إجمالي حالات الإصابة بالأمراض السرطانية المميتة وغير المميتة وسرطان الدم (اللوكيميا) المتوقعة في مدينة صفوان بحدود 1930 حالة وتمثل ما نسبته 7.2% من مجموع السكان، وبحدود 9141 حالة في مدينة الزبير وتمثل ما نسبته 4.5% من مجموع نسبة السكان، وبحدود 4475 حالة إصابة لغرب مدينة البصرة وتمثل ما نسبته 4.5% من مجموع السكان. وقد أكدت دراسات سريرية نشرها أطباء اختصاصيون في جامعة البصرة خلال تسعينيات القرن الماضي وجود هذه الزيادات. كما أن إجمالي حالات الإصابة بالأضرار الصحية الأخرى والأمراض الوراثية التي تظهر كتشوهات خلقية متوقعة في الأجيال القادمة بحدود 1831 حالة في مدينة صفوان، أي بنسبة 6.9% من مجموع السكان، وبحدود 8648 حالة في مدينة الزبير، أي بنسبة 4.2% من مجموع السكان، وبحدود 4234 حالة في غرب مدينة البصرة، أي بنسبة 4.2% من مجموع السكان. كذلك سيعاني ما يقرب من 14350 من أفراد القوات المسلحة العراقية التي وُجدت في قواطع صفوان والزبير وغرب مدينة البصرة أمراضًا سرطانية مميتة، إضافة إلى اللوكيميا والاعتلالات الصحية الأخرى خلال السنوات القادمة، أي ما نسبته 11.5% من القوات المشاركة في العمليات الحربية ضمن منطقة الدراسة آنذاك.
Primary amelanotic melanoma of the male urethra: A rare entity and diagnostic challenge
Authors: Zeighami Shahryar , Soltani Mohammmdreza , Khajeh Fatemeh , Ariafar Ali , Jahanabadi Zahra , Miladpour Behnoosh , Naghdi-sede Nima
Published: April 2020

Malignant melanoma (melanoma) is a tumor of melanocytes that usually presents as cutaneous lesions. While melanoma can infrequently appear as a primary tumor elsewhere in the body, it is extremely rare in the urethra and even rarer as amelanotic malignant melanoma. We report the case of a 66-year-old male who presented with painless gross hematuria and lower urinary tract obstructive symptoms in the recent 2 weeks prior to his visit to our clinic. History and physical examination, including external genital examination, abdominopelvic sonography, and urine culture, were not conclusive. Cystourethroscopy revealed a creamy pink fragile mass located in the anterior proximal urethra that extended to the mid portion. Pathological examination of this lesion confirmed the diagnosis of amelanotic malignant melanoma using immunohistochemistry. Radical cystourethrectomy with ileal conduit was subsequently conducted. Although this tumor is extremely rare, urologists and pathologists should consider malignant melanoma as a diagnosis in patients with urethral tumor because of the likelihood of early metastasis and, consequently, poor prognosis. Complete surgical removal of the tumor and use of effective therapies can improve outcomes in these patients.
Community Acquired Urosepsis: A surgical intensive care Experience
Authors: Shaikh Nissar , Momin Umais , Atef Shible Ahmed , Al-Musalmani Muna , Ansari Abdulla
Published: April 2020

Urosepsis contributes significantly to the epidemiology of sepsis. Urosepsis can be classified as community acquired or hospital acquired, depending upon the origin of infection acquisition: either from the community or from a healthcare facility. A great deal of literature is available about nosocomial urosepsis, but the literature regarding community-acquired urosepsis (CAUs) is limited, and studies are underpowered. The aim of our study was to determine the epidemiology, bacteriology, severity, and outcome of CAUs. Methods and Patients: All patients admitted from the emergency department to the surgical intensive care unit (SICU) with urosepsis over a period of 10 years were identified and included retrospectively from the SICU registry. The study was retrospective. Data were entered into the SPSS program version 23, and groups were compared by using chi-square and t-tests. Results were considered statistically significant at p ≤ 0.05. Results: During the study period, 302 patients with CAUs were admitted to the SICU. The common etiology was obstructive uropathy (60%). The Local Arab population outnumbered the non-Arab population (164/54.3%), and there were equal numbers of patients of both genders. Diabetes mellitus and hypertension together were the common comorbidities. Seventy-five percent of patients had acute kidney injury (AKI). Thirty-eight percent of patients had percutaneous nephrostomy, and 24.8% of patients underwent endoscopic stent insertion to relieve the obstruction. Ninety-three percent of patients were admitted with septic shock, and 71.5% had bacteremia. The common bacteria (36.1%) was extended-spectrum beta-lactamase-(ESBL)-producing bacteria, with a predominance of Escherichia coli (31.5%). Fifty-four percent of patients required a change of antibiotics to carbapenem. Eighty-two percent of patients had acute respiratory distress syndrome (ARDS). Patients with bacteremia had a statistically significant AKI, ARDS, and septic shock (p < 0.001). Male patients had a significantly higher incidence of oliguria, intubation, and ARDS (p < 0.05). Eight patients died of urosepsis during the study period, giving a mortality rate of 2.6%. Conclusion: In our patients, obstruction of urine flow was the most common cause of CAUs. Our urosepsis patients had a higher bacteremia rate, which led to higher incidences of organ dysfunction and septic shock. ESBL bacteria were a frequent cause of urosepsis, requiring a change of the initial antibiotic to carbapenem. Male patients had a significantly higher rate of organ dysfunction. Mortality in our urosepsis patients was lower than mentioned in the literature.
Durability Characterisation of Glass Fibre Reinforced Concrete by Resistance to Freezing and Thawing
Authors: Moceikis Rimvydas , Kičaitė Asta , Sahmenko Genadijs , Selsekienė Aušra
Published: April 2020

Resistance to freezing and thawing of glass fibre reinforced concrete (GRC) modified with silica fume and metakaolin was tested according to scaling at freezing test method with de-icing salt after 112 cycles. Surface mass loss was obtained, flexural strain energies calculated from load- deformation curves and ductile/ brittle behavior of GRC composite explained. SEM micrograph analysis was used to identify possible flaws on the surface of filaments and fiber-matrix contact zone due to freeze-thaw influence.