bluuebunny/crossref_metadata_2025 huggingface dataset:
Tidal Effects on the Radial Velocities of V723 Mon: Additional Evidence for a Dark 3 M
⊙ Companion
Authors: Masuda Kento , Hirano Teruyuki
Published: April 2021

Jayasinghe et al. identified a dark ≈3 M
⊙ companion on a nearly edge-on ≈60 day orbit around the red giant star V723 Monoceros as a black hole candidate in the mass gap. This scenario was shown to explain most of the data presented by Jayasinghe et al., except for periodic radial velocity (RV) residuals from the circular Keplerian model. Here we show that the RV residuals are explained by orbital phase-dependent distortion of the absorption line profile associated with changing visible fractions of the approaching and receding sides of the red giant star, whose surface is tidally deformed by and rotating synchronously with the dark companion. Our RV model constrains the companion mass M
• = 2.95 ± 0.17 M
⊙ and orbital inclination

(medians and 68.3% highest density intervals of the marginal posteriors) adopting the radius of the red giant 24.0 ± 0.9 R
⊙ as constrained from its SED and distance. The analysis provides independent support for the companion mass from ellipsoidal variations and the limits on the companion’s luminosity from the absence of eclipses, both derived by Jayasinghe et al. We also show that a common scheme to evaluate the tidal RV signal as the flux-weighted mean of the surface velocity field can significantly underestimate its amplitude for RVs measured with a cross-correlation technique, and present a modified prescription that directly models the distorted line profile and its effects on the measured RVs. The formulation will be useful for estimating the component masses and inclinations in other similar binaries.
Biotransformation of quercetin, kaempferol and apigenin to monoglycosylated derivatives by in vitro suspension cultures of Astragalus vesicarius ssp. carniolicus
Authors: Popova Pavlinka , Zarev Yancho , Ionkova Iliana
Published: April 2021

Biotransformation of exogenous substrates quercetin, kaempferol and apigenin by suspension cultures of Astragalus vesicarius ssp. carniolicus to their monoglycosylated derivatives was performed. The maximal enzymatic potential of cells of A. vesicarius ssp. carniolicus was evaluated by different concentrations of substrate exposure. According to quantitative ultra-high performance liquid chromatography-high resolution electrospray ionization mass spectrometry (UHPLC-HR-ESI-MS) analysis, the highest concentration of kaempferol O-glycoside (14.88 nmol/g dry weight, DW), apigenin O-glycoside (10.55 nmol/g DW) and quercetin O-glycoside (150.83 nmol/g DW) was achieved, when suspension cultures were treated with 4 mg/mL kaempferol, 4 mg/mL apigenin and 3 mg/mL quercetin, respectively. The glycosidic products of biotransformation were not detected in the untreated control.
Plastome analysis unveils Inverted Repeat (IR) expansion and positive selection in Sea Lavenders (Limonium, Plumbaginaceae, Limonioideae, Limonieae)
Authors: Darshetkar Ashwini M. , Maurya Satish , Lee Changyoung , Bazarragchaa Badamtsetseg , Batdelger Gantuya , Janchiv Agiimaa , Jeong Eun Ju , Choi Sangho , Choudhary Ritesh Kumar , Kim Soo-Yong
Published: April 2021

The genus Limonium, commonly known as Sea Lavenders, is one of the most species-rich genera of the family Plumbaginaceae. In this study, two new plastomes for the genus Limonium, viz. L. tetragonum and L. bicolor, were sequenced and compared to available Limonium plastomes, viz. L. aureum and L. tenellum, to understand the gene content and structural variations within the family. The loss of the rpl16 intron and pseudogenisation of rpl23 was observed. This study reports, for the first time, expansion of the IRs to include the ycf1 gene in Limonium plastomes, incongruent with previous studies. Two positively selected genes, viz. ndhF and ycf2, were identified. Furthermore, putative barcodes are proposed for the genus, based on the nucleotide diversity of four Limonium plastomes.
Systemic Sclerosis and Associated Interstitial Lung Disease in Ontario, Canada: An Examination of Prevalence and Survival Over 10 Years
Authors: Pope Janet E. , Quansah Kobina , Hassan Shazia , Seung Soo Jin , Flavin Jason , Kolb Martin
Published: April 2021

Objective

Systemic sclerosis (SSc) is a rare autoimmune disease. Pulmonary complications of SSc are some of the leading causes of morbidity and mortality. The objective of this study was to determine prevalence and survival estimates of SSc and SSc with interstitial lung disease (SSc-ILD) in the Canadian province of Ontario using administrative data over 10 years.

Methods

Using International Classification of Diseases, 10th revision codes adapted for Canada (ICD-10-CA), adult patients diagnosed with SSc and SSc-ILD between April 1, 2008, and March 31, 2018, were identified from the National Ambulatory Care Reporting System and the Discharge Abstract Database administrative databases. SSc was identified first, and ILD was included if presence occurred after SSc diagnosis. Prevalence estimates were determined for both SSc and SSc-ILD. For survival rates, Kaplan-Meier survival curves were generated.

Results

At the start of the 2017/18 fiscal year (final year of the cohort), there were 2114 prevalent SSc cases for a cumulative prevalence of 19.1 per 100,000 persons, as well as 257 prevalent cases of SSc-ILD that generated a prevalence of 2.3 cases per 100,000 persons. Mean ages were 57 and 58 years with 84% and 80% females for patients with SSc and SSc-ILD, respectively. One-, 5-, and 10-year survival rates were 85.0%, 64.5%, and 44.9% for the SSc group and 77.1%, 44.4%, and 22.0% for the SSc-ILD group, respectively.

Conclusion

To our knowledge, this study provides the first population-based estimates of SSc and SSc-ILD in Canada for prevalence and survival. Results confirm that the prevalence estimates of SSc-ILD fall within the Canadian threshold for rare disease. It also demonstrates the poor survival in SSc, especially when ILD is also present.
Treatment With Tofacitinib in Refractory Psoriatic Arthritis: A National Multicenter Study of the First 87 Patients in Clinical Practice
Authors: Galíndez-Agirregoikoa Eva , Prieto-Peña Diana , Martín-Varillas José Luis , Joven Beatriz , Rusinovich Olga , Melero-González Rafael B. , Ortiz-Sanjuan Francisco , Almodóvar Raquel , Alegre-Sancho Juan José , Martínez Ángels , Sellas-Fernández Agustí , Méndez Lara , García-Vicuña Rosario , Atienza-Mateo Belén , Gorostiza Iñigo , González-Gay Miguel Ángel , Blanco Ricardo
Published: April 2021

Objective.

Tofacitinib (TOF) is the first Janus kinase (JAK) inhibitor approved for psoriatic arthritis (PsA). It has shown efficacy in patients refractory to anti–tumor necrosis factor-α in randomized controlled trials (RCTs). Our aim was to assess efficacy and safety of TOF in clinical practice.

Methods.

This was an observational, open-label multicenter study of PsA patients treated with TOF due to inefficacy or adverse events of previous therapies. Outcome variables were efficacy, corticosteroid dose-sparing effect, retention rate, and safety. A comparative study of clinical features between our cohort of patients and those from the OPAL Beyond trial was performed.

Results.

There were 87 patients (28 women/59 men), with a mean age of 52.8 ± 11.4 years. All patients were refractory to biologic disease-modifying antirheumatic drugs (DMARDs) and/or to conventional synthetic DMARDs plus apremilast. TOF was started at 5 mg twice daily after a mean follow-up of 12.3 ± 9.3 years from PsA diagnosis. At first month, Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS28-ESR) decreased from median 4.8 (IQR 4.1–5.4) to 3.7 (IQR 2.8–4.7,P< 0.01), Disease Activity Index for Psoriatic Arthritis from median 28 (IQR 18.4–34.1) to 15.5 (IQR 10.1–25.7,P< 0.01), and C-reactive protein from median 1.9 (IQR 0.3–5.0) to 0.5 (IQR 0.1–2.2) mg/dL (P< 0.01). Also, TOF led to a significant reduction in prednisone dose. Mild adverse effects were reported in 21 patients (24.13%), mainly gastrointestinal symptoms. TOF retention rate at Month 6 was 77% (95% CI 65.2–86.3). Patients in clinical practice were older with longer disease duration and received biologic agents more commonly than those in the OPAL Beyond trial.

Conclusion.

Data from clinical practice confirm that TOF seems to be effective, rapid, and relatively safe in refractory PsA despite clinical differences with patients in RCTs.
Quelques Réflexions sur les savoirs implicites
Authors: Savoyant Alain
Published: April 2021

L’analyse des activités de travail accorde aujourd’hui une place importante aux savoirs dits « implicites », qualifiés aussi de savoirs tacites, informels ou non-formels. On défend ici l’idée que le caractère difficilement énonçable et non formalisable de ces savoirs, ne suffit pas à les constituer en tant que savoirs spécifiques du travail. Ce sont avant tout des savoirs d’activité, constitués dans et pour l’activité dont ils assurent l’orientation, qu’il faut distinguer des savoirs de la tâche, constitués en disciplines académiques et technologiques, utilisés dans la conception des systèmes et des processus de production et qui fondent les tâches de ces processus. On examine brièvement quelques conditions (niveau de prescription, nature et degré de développement de l’activité) qui déterminent les formes et les contenus de ces savoirs d’activité.
Analyse de l’activité d’apprentissage : le point de vue de la didactique professionnelle
Authors: Pastré Pierre
Published: April 2021

Le dossier qu’on présente, outre cette introduction, est constitué de 4 chapitres. Les trois premiers chapitres portent chacun sur un chantier de recherche, réalisé auprès de stagiaires de l’Afpa : montage de télérupteur pour des électriciens, soudage de bandes plastiques pour des constructeurs de piscines, conduite d’entretien pour des formateurs. Le dernier chapitre développe une analyse comparative des trois chantiers. Le cadre théorique utilisé est celui de la didactique professionnelle.
L’apprentissage du soudage de membranes armées par les pisciniers
Authors: Michel Georges , Berry-Deschamps Pascaline
Published: April 2021

Ce texte porte sur, d’une part l’analyse de l’activité de soudage de membranes armées chez les pisciniers (constructeurs et réparateurs de piscines), et d’autre part l’analyse du processus d’apprentissage de cette activité, à l’éclairage de la didactique professionnelle. Il s’agit ici d’une compétence demandant une coordination sensorimotrice fine que peu d’apprenants (15 %) parviennent à acquérir. Ces deux niveaux d’analyse nous ont permis d’identifier la structure conceptuelle de cette activité et d’en décrire le schème sensorimoteur. Les étapes de construction des compétences (passage du concept de collage au concept de soudage, préalables au soudage, soudage avec exigence d’étanchéité puis d’esthétique) que nous avons pu faire émerger de nos analyses de l’apprentissage ont été indispensables pour la transposition didactique (par découpage, découplage et focalisation) qui nous a permis de proposer des situations facilitant cet apprentissage complexe.
Les formes de didactisation des instruments de travail en formation professionnelle initiale : une approche comparatiste
Authors: Filliettaz Laurent
Published: April 2021

Cet article s’ancre dans le champ de la recherche en formation professionnelle initiale. Elle s’intéresse à la manière dont des jeunes issus de la scolarité obligatoire apprennent à utiliser des outils dans des activités de travail en entreprise. Elle vise à mieux comprendre le rôle des collectifs de travail dans cette rencontre des apprentis avec les instruments de leur activité : comment les experts aménagent-ils (ou pas) l’activité des novices autour de l’usage des instruments ? Comment médiatisent-ils leurs rapports à ces instruments ? En quoi ces médiations prennent-elles des formes didactisées ? Pour répondre à ces questions, cette contribution adopte une double approche comparatiste. Sur le plan empirique, elle propose une analyse de trois situations de formation fortement contrastées observées dans deux entreprises formatrices distinctes. Et sur le plan épistémologique ou théorique, elle contribue à questionner les apports des didactiques disciplinaires et de la linguistique appliquée au champ de la recherche en formation professionnelle.
Vegetable biocholine as a hepatoprotectant in laying hens fed with diet contaminated with aflatoxin B1
Authors: Dazuk V. , Boiago M.M. , da Rosa G. , Alba D.F. , Souza C.F. , Baldissera M.D. , Vedovatto M. , Mendes R.E. , Santurio J.M. , Deolindo G.L. , Da Silva A.S.
Published: April 2021

The aim of the study was to determine whether the addition of vegetable biocholine (VB) in laying hens feed minimises the effects of daily intake of aflatoxin B1 (AFB1). We allocated Hy-line Brown line laying hens into four groups with four replications/group and four birds/repetition. The treatments were as follows: Afla0Bio0: basal feed without aflatoxin and VB (natural contamination: 0.026 mg AFB1/kg), Afla0Bio800, basal feed supplementation of 800 mg VB/kg (natural contamination: 0.024 mg AFB1/kg); Afla2.5Bio0, basal feed contaminated experimentally with aflatoxin (2.51 mg/kg); Afla2.5Bio800, basal feed contaminated with aflatoxin (2.50 mg/kg) and supplemented with 800 mg VB/kg. The experiment took place over a period of 42 days, divided into two cycles of 21 days each. Significance was indicated byP≤0.05. The inclusion of aflatoxin reduced egg production after 42 days of consumption of contaminated feed. VB supplementation in the tested dose was insufficient to minimise the negative effects of the toxin on the laying rate. There was a lower percentage of yolk in Afla2Bio0 than in Afla0Bio0, and a higher percentage of albumen and specific gravity in Afla2.5Bio0 than in Afla0Bio0. Ingestion of aflatoxin in the feed increased lipoperoxidation (LPO) and decreased antioxidant capacity in the egg yolk; however, when VB was added, LPO was similar to the control. Lower total bacterial count (TBC) in the eggshell was observed when the birds consumed VB, as well as higher TBC in the eggshell of the birds was challenged with aflatoxin. In the blood of birds that consumed aflatoxin (Afla2.5Bio0) there was an increase in the activity of alkaline phosphatase and a reduction in the activities of glutathione S-transferase and glutathione peroxidase (GPx). In the birds that consumed VB without aflatoxin challenge, we observed that there was a stimulation of GPx activity. We conclude that the consumption of VB had positive effects on the health of the laying hens and improved the quality of the eggs.
Blanding's Turtle Demography and Population Viability
Authors: King Richard B. , Golba Callie K. , Glowacki Gary A. , Kuhns Andrew R.
Published: April 2021

In anticipation of U.S. federal status classification (warranted, warranted but precluded, not warranted), scheduled for 2023, we provide population viability analysis of the Blanding's turtle Emydoidea blandingii, a long-lived, late-maturing, semi-aquatic species of conservation concern throughout its range. We present demographic data from long-term study of a population in northeastern Illinois and use these data as the basis for viability and sensitivity analyses focused on parameter uncertainty and geographic parameter variation. We use population viability analysis to identify population sizes necessary to provide population resiliency to stochastic disturbance events and catastrophes, and demonstrate how alternative definitions of ‘foreseeable future' might affect status decisions. Demographic parameters within our focal population resulted in optimistic population projections (probability of extinction = 0% over 100 y) but results were less optimistic when catastrophes or uncertainty in parameter estimates were incorporated (probability of extinction = 3% and 16%, respectively). Uncertainty in estimates of age-specific mortality had the biggest impact on population viability analysis outcomes but uncertainty in other parameters (age of first reproduction, environmental variation in age-specific mortality, percent of females reproducing, clutch size) also contributed. Blanding's turtle demography varies geographically and incorporating this variation resulted in both mortality- and fecundity-related parameters affecting population viability analysis outcomes. Possibly, compensatory variation among demographic parameters allows for persistence across a wide range of parameter values. We found that extinction risk decreased and retention of genetic diversity increased rapidly with increasing initial population size. In the absence of catastrophes, demographic conservation goals could be met with a smaller initial population size than could genetic conservation goals; ≥20–50 adults were necessary for extinction risk <5%, whereas ≥50–110 adults were necessary to retain >95% of existing genetic diversity over 100 y. These thresholds shifted upward when catastrophes were included; ≥50–200 adults were necessary for extinction risk <5% and ≥110 to >200 adults were necessary to retain >95% of existing genetic diversity over 100 y. Impediments to Blanding's turtle conservation include an incomplete understanding of geographic covariation among demographic parameters, the large amount of effort necessary to estimate and monitor abundance, and uncertainty regarding the impacts of increasingly frequent extreme weather events.
L’artiste pantocrator : le créateur de jeu vidéo au travail
Authors: Krajewski Pascal
Published: April 2021

Si le jeu vidéo est bien un nouveau médium artistique, il tire ses spécificités du régime d’interaction qu’il noue avec son spectateur et de la place particulière qu’il lui octroie dans le déploiement de l’œuvre. Dès lors, les enjeux artistiques de la création vidéoludique devront s’analyser non plus comme un travail autour de la représentation et de l’expression, mais selon leur versant technologique, à savoir la simulation et l’inspiration. Ces deux nouvelles voies visent respectivement à inventer des mondes habités que le joueur peut expérimenter et à lui insuffler de véritables émotions en se focalisant sur l’effet induit par le système et l’univers du jeu. Le nouvel artiste créateur ne se retrouve plus dans la notion de pensée plastique mais met en œuvre une nouvelle forme de pensée créatrice, toute numérique et réticulaire, algorithmique, modulaire. Le game designer se rêve artiste pantocrator, tout puissant, capable de tout créer par la seule puissance du code et des appareils.
Nœuds. Figures de l’essentiel
Authors: Ossola Carlo
Published: April 2021

Du Moyen Âge à l’époque moderne, du moins jusqu’à Érasme, la tradition latine repose sur le principe des universels. Au temps de la mondialisation et de la globalisation, ce legs nous invite, plus que jamais, à renouer avec des valeurs fondamentales qui puissent être reconnues par tous et partout – l’universel – et partagées – l’essentiel.

Dans cet ouvrage issu de sa leçon de clôture, Carlo Ossola déroule le fil de ses vingt ans d’enseignement au Collège de France. Mais plus encore, il suggère quelques points à partir desquels notre condition humaine d’abalietas (« abaliété »), constitutive de chacun de nous, peut nous montrer la voie à suivre en lui donnant un sens qui soit véritablement orienté vers autrui.
Le corps en exil
Authors: Barbisan Léa
Published: April 2021

La philosophie du langage, l’esthétique et la philosophie de l’histoire de Walter Benjamin ont fait l’objet de travaux conséquents, qui ont assuré la reconnaissance et balisé l’interprétation de textes essentiels. La pensée anthropologique, en revanche, reste un champ insuffisamment exploré, bien que central dans l’œuvre de Benjamin. Elle trouve sa source dans une réflexion approfondie sur la question du corps, qui captive le philosophe du milieu des années 1910 jusqu’à la fin de sa vie et ouvre des perspectives inédites sur la théorie de la connaissance, l’éthique et la théorie politique. Ce livre tisse ensemble les différents fils qui constituent cette pensée du corps et relève l’ampleur des enjeux que ce questionnement soulève. Les textes de Benjamin rendent remarquablement compte du défi que doit relever la philosophie européenne à l’aube du xxe siècle : prendre en considération le caractère corporel de l’expérience et, ce faisant, l’historicité de la connaissance, la relation constitutive à l’altérité, l’expérience de la vulnérabilité, l’engagement matériel et affectif dans le monde social. Suivre l’évolution du questionnement sur le corps met en lumière la cohésion de l’œuvre de Benjamin, tout en en éclairant la position singulière qu’elle occupe au sein de son contexte théorique d’émergence. Si la réflexion de Benjamin sur la corporéité ouvre des perspectives sur le paysage philosophique de l’Europe du tournant du siècle, elle entre aussi en résonance avec des questionnements qui animent la philosophie contemporaine.
Le partenariat en éducation relative à l’environnement : pertinence et défis
Authors: Sauvé Lucie
Published: April 2021

En cette époque de « restructuration » et d’« intégration », le partenariat apparaît souvent comme une stratégie salvatrice dans différents secteurs d’activité humaine. Est-ce dans la foulée de cette tendance contemporaine que le mouvement des réformes éducatives en cours valorise le partenariat entre l’école et les autres acteurs de la « société éducative » ? Quel sens le partenariat prend-il en éducation et plus spécifiquement, dans le domaine de l’éducation relative à l’environnement ? S’agit-il de promouvoir des alliances utilitaires et instrumentales, ou de mettre en place des processus de coopération solidaire favorisant l’apprentissage et le développement mutuel de ses acteurs ? Cet article explore sommairement les caractéristiques, la pertinence et les défis du partenariat en éducation relative à l’environnement. Il propose des critères d’évaluation pour la qualité d’un processus partenarial.
Navigating Mentorship, Scholarship, Teaching, and Service
Authors: Rausch Meredith A.
Published: April 2021

There will be an abundance of new and unique experiences for a new faculty member during their first years in the academy. Understanding the expectations for scholarship, teaching, and service is a major portion of this experience; however, there are additional policies, procedures, opportunities, and expectations for junior faculty. Developing relationships for mentoring will be imperative to the successful navigation of each of these areas. This chapter will provide ideas for obtaining a mentor; developing as a responsible and successful mentee; ideas for navigating scholarship, teaching, and service requirements in the university setting; as well as provide voices from the field to offer additional perspectives.
A Framework for Navigating Post-Doctoral Career Opportunities for PK-12 Educators Post-COVID-19 Pandemic
Authors: Nelson Valerie Luckey , Moffett Noran L. , Wilson-Jones Linda
Published: April 2021

The field of education is constantly changing, and with the current COVID-19 pandemic, it will undoubtedly change the way education systems operate in the future. This chapter covers several key topics related to navigating post-doctoral career opportunities for PK-12 educators. Educators are in a unique position to contribute to research in the field in which they have a plethora of experiences. With a major focus on student outcomes, there is a critical need to understand factors that directly impact learning such as parent involvement, socio-economic status, technology, and student behavior. Using an ethnographic approach, the authors provide insight into challenges post-doctoral professionals may face in attempts to enhance their professional identity. These narrative accounts shed light on not only the role of mentors but the desire to contribute to the body of research through the development of research agendas.
Study of Indian Customer Mobile Banking Adoption
Authors: Bhattacharyya Som Sekhar , Choudhary Rohit , Punewar Piyush
Published: April 2021

The banking landscape in India has been changing rapidly due to advent of emerging technologies. Consumers have adopted technology in their everyday banking transactions. These changes have been evident because of the advent of electronic channels like mobile banking (MB), internet banking, payments banking, fintech applications, and such others. Given the burgeoning Indian population, the brick and mortar model of banking hasn't been able to keep up with the increased and enhanced customer needs. This has led to bankers harping on adoption of mobile banking. The authors in this study applied a sequential mixed method quant-qual to better comprehend customer perceptions towards adoption of mobile banking services. The research was carried out in two phases: quantitative survey followed by qualitative interviews. The findings from the study helped gauge the user perception towards MB. These were concerns regarding security, internet availability, simplified user interface experience of MB, customer convenience for core banking services, and transactions with minimum number of clicks.
Blockchain-Based Transparent and Traceable Halal Food Supply Chain Management Systems
Authors: Junejo Aisha Zahid , Hashmani Manzoor Ahmed , Alabdulatif Abdullah A.
Published: April 2021

Halal food is gaining attention among Muslims and non-Muslims alike due to its nature of ensuring food is free from any impurities or contamination and hygienically prepared. The growing demand for Halal food has resulted in several food-producing companies to certify their products as Halal. However, with existing supply chains, there is no authenticity of these products being Halal. To ensure Halal food authenticity, the technology of blockchain is proposed as a viable solution. In this chapter, the applicability and usability of blockchain technology in food supply chain management systems is studied and highlighted. The study depicts that how trackability and traceability of the blockchain networks can effectively aid in maintaining the Halal integrity of food products by presenting various use cases. Technological shift for food supply chains over blockchains will result in more transparent, secure, and resilient supply chains. This will bring variety of health and economic benefits to food producing business and consumers.
Cognitive Stimulation in an Intensive Care Unit: A Qualitative Evaluation of Barriers to and Facilitators of Implementation
Authors: Parker Ann M. , Aldabain Louay , Akhlaghi Narges , Glover Mary , Yost Stephanie , Velaetis Michael , Lavezza Annette , Mantheiy Earl , Albert Kelsey , Needham Dale M.
Published: April 2021

Background

Delirium in the intensive care unit is associated with poor patient outcomes. Recent studies support nonpharmacological therapy, including cognitive stimulation, to address delirium. Understanding barriers to cognitive stimulation implemented by nurses during clinical care is essential to translating evidence into practice.

Objective

To use qualitative methods through a structured quality improvement project to understand nurses’ perceived barriers to implementing a cognitive stimulation intervention in a medical intensive care unit.

Methods

Data were collected through semistructured interviews with nurses in a medical intensive care unit. Data were categorized into themes by using thematic analysis and the Consolidated Framework for Implementation Research. During cognitive stimulation, nurses reviewed with patients a workbook of evidence-based tasks (focused on math, alertness, motor skills, visual perception, memory, problem-solving, and language).

Results

The 23 nurses identified 62 barriers to and 26 facilitators of cognitive stimulation. These data were summarized into 12 barrier and 9 facilitator themes corresponding to the following Consolidated Framework for Implementation Research domains: Intervention Characteristics, Outer Setting, Inner Setting, and Characteristics of Individuals. Nurses also identified several facilitators within the Process domain. Patient-specific variables, including sedation, were the most frequently reported barriers. Other barriers included cognitive stimulation not being prioritized, nursing staff–related issues, documentation burden, and a lack of understanding of, or appreciation for, the evidence supporting cognitive stimulation.

Conclusions

Implementation of cognitive stimulation requires a multidisciplinary approach to address perceived barriers arising from the organization, context, and individuals associated with the intervention, as well as the intervention itself.
Pain Associated With Continuous Intravenous Infusion of Bumetanide: A Case Series
Authors: Herges Lori B. , Jentzer Jacob C. , Brighton Diane D. , Herges Joseph R. , Ou Narith N.
Published: April 2021

Introduction

Bumetanide can induce generalized musculoskeletal pain when administered as a continuous infusion, an effect that may be underrecognized. The purpose of this case series is to educate health care providers about the incidence and presentation of pain associated with bumetanide infusions, adding to the existing literature describing this adverse event.

Clinical Findings

Of 40 critically ill patients, 15 (38%) had increased pain scores after initiation of a continuous infusion of bumetanide, with symptoms commonly occurring 12 to 24 hours after initiation of the infusion. Reported descriptions of the pain included generalized aching, soreness, burning, allodynia, headaches, and exacerbation of underlying pain in localized areas. Increases in patient-reported pain correlated directly with initiation of the continuous infusion of bumetanide.

Diagnosis

Four of the 15 bumetanide-associated pain events (27%) were recognized as such by the health care team.

Interventions

Bumetanide was promptly discontinued in the 4 identified cases. The 11 patients (73%) whose pain was not recognized as related to bumetanide remained on a continuous infusion of bumetanide and received pain medications including opioids. Infusions were stopped when patients transitioned to dialysis (n = 8 [53%]), began receiving comfort care (n = 5 [33%]), or completed diuresis therapy (n = 2 [13%]).

Outcomes

For all patients, pain symptoms resolved within 24 to 48 hours after discontinuation of bumetanide infusion with no significant electrolyte abnormalities.

Conclusion

Bumetanide-induced pain is more common than previously described. Early recognition of this adverse event can prevent patient discomfort and escalation of treatment.
A Bundle-Based Approach to Prevent Catheter-Associated Urinary Tract Infections in the Intensive Care Unit
Authors: Shadle Holly N. , Sabol Valerie , Smith Amanda , Stafford Heather , Thompson Julie A. , Bowers Margaret
Published: April 2021

Background

Catheter-associated urinary tract infections are the second most common health care–associated infections, occurring most frequently in intensive care units. These infections negatively affect patient outcomes and health care costs.

Local Problem

The targeted institution for this improvement project reported 13 catheter-associated urinary tract infections in 2018, exceeding the hospital’s benchmark of 4 or fewer such events annually. Six of the events occurred in the intensive care unit. Project objectives included a 30% reduction in reported catheter-associated urinary tract infections, 20% reduction in urinary catheter days, and 75% compliance rating in catheter-related documentation in the intensive care unit during the intervention phase.

Methods

This project used a pre-post design over 2 consecutive 4-month periods. The targeted population was critically ill patients aged 18 and older who were admitted to the intensive care unit. A set of bundled interventions was implemented, including staff education, an electronic daily checklist, and a nurse-driven removal protocol for indwelling urinary catheters. Data were analyzed using mixed statistics, including independent samples t tests and Fisher exact tests.

Results

No catheter-associated urinary tract infections were reported during the intervention period, reducing the rate by 1.33 per 1000 catheter days. There was a 10.5% increase in catheter days, which was not statistically significant (P = .12). Documentation compliance increased significantly from 50.0% before to 83.3% during the intervention (P = .01).

Conclusions

This bundled approach shows promise for reducing catheter-associated urinary tract infections in critical care settings. The concept could be adapted for other health care–associated infections.
Are women safe in disaster? Competency in handling gender-based violence by public health staff in Galle district
Authors: De Silva E. P. M. , Ponnamperuma T. T.
Published: April 2021

Introduction: Gender-based violence (GBV) is a human right issue that is common but under reported. It is noted that GBV incidence increases in disaster situations. As the public health staff is the key responsible personnel in post-disaster health management, their competencies in managing GBV in crisis situation are extremely important. Methods: A descriptive cross-sectional study was conducted in conveniently selected 8 Medical Officer of Health (MOH) areas in Galle district. All four categories of public health workers (medical officers, nursing sisters, public health inspectors and midwives) working at selected MOH offices were assessed by a selfadministrated questionnaire regarding knowledge on identification, prevention and management of GBV victims in disaster situations. Results: Among 200 public health workers, only 23.5% had training on disaster management. Among the trained MOH staff, only 34.0% were taught on handing GBV in disaster situation. Knowledge on GBV was average in the staff (mean = 72.3, SD = 7.7). There was no significant difference observed in identification, prevention and management of GBV between different employment categories of the MOH staff (all ps > 0.05). Knowledge on GBV showed no difference between the trained and untrained staff (t (198,200) = 0.8, p = 0.4) on disaster management. Conclusions and Recommendations: Knowledge on identification, prevention and management of GBV in disaster situations among the public health staff was average, and was not sufficient. Only a minority have obtained training and all these programmes have not addressed GBV management. Thus, it is recommended to hold regular training programmes to the public health staff in GBV management in disaster situations.
Modern surgery; dynamic frontiers and blurring boundaries
Authors: Goonesinghe Satish K. , Waidyarathne Eisha I.
Published: April 2021

No abstract available
Laparoscopic resection and Roux-en-Y reconstruction of a hilar cholangiocarcinoma
Authors: Jayathilake A. B. , Darmapala A. , Dasanayake B. , Agalawatta A. S. M. G. B. B. , Madushanka U. D. P. , Udupihilla J. , Pinto V. , Galketiya K. B.
Published: April 2021

No abstract available
Node-Dependent Kinematics and Multidimensional Finite Elements for the Analysis of Single/Double Swept, Composite Helicopter Blades
Authors: Filippi M. , Carrera E. , Giusa D. , Zappino E.
Published: April 2021

This paper deals with finite element analysis of helicopter blades with single and double swept geometries made by metallic and composite materials. First, classical and refined beam theories are combined at the element level via a nodedependent kinematic (NDK) concept, which was recently
introduced by the authors. Such an NDK approach enables the accuracy/efficiency ratio of the solution to be tuned according to the level of fidelity required by the design phase. Second, one-dimensional NDK models are combined with the possibility to introduce solid elements in those regions
of the blade with a sharp variation of the geometries. The numerical examples consider a swept-tip rectangular beam and a doubleswept helicopter blade with a realistic airfoil. Natural frequencies and through-the-layer stress distributions are reported to demonstrate the flexibility and computational
efficiency of the proposed methodology.
Prevalence and risk factors of diabetic kidney disease in north eastern Nigeria
Authors: Chiroma Ijuptil , Sulaiman Mohammad Maina , Mubi Bilkisu Mohammed , Ndahi Akilahyel Auta , Mamza Ahidiyu Anaryu , Lawan Mustapha , Loskurima Umar , Shettima Jummai , Amali Abdullahi Oteikwu , Ummate Ibrahim
Published: April 2021

Diabetic Kidney Disease (DKD) is a leading cause of chronic kidney disease and end stage renal disease. In northeastern Nigeria the epidemiology and risk factors have not been fully studied. This study aimed at evaluating the prevalence and risk factors of DKD in Maiduguri, north eastern Nigeria. The study population consisted of adult diabetic patients recruited consecutively at the diabetic clinic of University of Maiduguri Teaching Hospital Maiduguri. Socio-demographic variables including age, sex, weight, BMI, as well as laboratory parameters, were obtained from each patient. Glomerular filtration rate was derived from CKD-EPI formula using serum creatinine. Two hundred and sixty-one diabetic patients were recruited. The prevalence of DKD among them was 42.9%. Classification based on eGFRshowed that 35(13.4%) patients had hyperfiltration; 48 (18.4%) stage I; 66 (25.3%) stage II; 68 (26.1%) stage III; 36 (13.8%) stage IV; 8 (3.1%) stage V. One hundred and seventeen (44.8%) had proteinuria. Low eGFR <60ml/1.73M2 was associated with age >50 years (r=1.039, p=0.011); male sex (r=-0.899, p=0.008); hyperuricaemia (r=1.010, p=0.000); low PCV (r=1.276, p=0.000); HbA1C (r=1.127, p=0.030); proteinuria (r=2.011, p=0.004).This study has shown that chronic kidney disease is common among diabetic patients in northeastern Nigeria. Age, male sex, hyperuricaemia, low PCV, high HbA1C levels and proteinuria were found to be associated with development of DKD.
Table of Contents Vol 87, No 1 (2020)
Authors: Office Editorial
Published: April 2021

No abstract available.
Gut Microbiota, Metabolites, and Cardiovascular Diseases
Authors: Zhang Yi-Qiong , Hua Yi-Ming , Li Chen-Xing , Lan Bei-Di , Wang Xiao-Ke , Wang Qi , Yuan Zu-Yi , Ma Lu , Wu Yue
Published: April 2021

Abstract

Numerous studies unveiled the interactions between intestinal flora and the host and how these affect human health and disease. The gut microbiota and its metabolites, such as trimethylamine N-oxide (TMAO), short-chain fatty acids, and secondary bile acids, are related to human metabolism, immunity, and diseases. An increasing number of studies has indicated that intestinal flora and its metabolites contribute to cardiovascular diseases (CVDs) development. Revealing the role of intestinal flora and its metabolites in cardiovascular pathogenesis may provide novel strategies for preventing and treating CVDs. However, the specific mechanisms are unclear, and more research is warranted. Here, we reviewed the most recent research progress on the relationship between intestinal flora, its metabolites, and CVDs.
The Heart Valves
Authors: Ho Siew Yen
Published: April 2021

Abstract

The four heart valves are arranged in different planes from each other. The aortic valve is most centrally located being related to all four cardiac chambers. Similar in construction to the pulmonary valve in possessing semilunar leaflets, neither valve has a ring-like annulus. Instead, the semilunar insertions of the leaflets form a crown-like arrangement. The semilunar valves are complexes comprising not only of leaflets but their attachments to arterial walls and adjoining ventricular structures at the ventriculo-arterial junction. The mitral and tricuspid valves guarding the atrioventricular junctions comprise of leaflets hinged to the junction, and have tendinous cords mainly anchored to papillary muscles that are inserted into ventricular walls to the support apparatus. A complete fibrous annulus is lacking, especially in the tricuspid valve and along the hinge line of the posterior mitral leaflet. This article also reviews the relationships of each valvar component and to adjacent cardiac structures.
Pretransplant Histocompatibility Testing Algorithm
Authors: Aziz Feroz , Tiwari Aseem K. , Patel Himanshu V. , Chauhan Rajni
Published: April 2021

Remarkable advances in histocompatibility testing have immensely improved the safety of transplantation and have decreased the incidence of rejections. Human leukocyte antigen (HLA) typing and crossmatches by complement-dependent cytotoxicity or flow cytometer-based methods are the vital tests involved in pretransplant histocompatibility testing. Continuous development in these testing technologies since the 1960s has refined these methodologies that can be used to predict graft rejection. Advancements from polymerase chain reaction-based methods to sequence based in HLA typing, and from cell-based cross-matches to virtual cross-matches using advanced solid-phase platforms, have enhanced our understanding about the donor-specific antibodies (DSAs) and have challenged the concept that the presence of DSA is an absolute contraindication to transplantation. Despite various developments, it is very difficult to perform a plethora of tests for pretransplant workup due to cost constraints in a developing country like India. In this review, we would discuss the advantages, limitations, and cost involved in the pretransplant immunologic workup along with an algorithmic approach for physicians that may help in decision-making amidst multiple information from different platforms.
Pattern of Injuries Sustained during Training
Authors: Maheshwari Vikas , Porwal Neerav , Gadhavi Rushikesh , Kushwaha Arvind , Yadav Arun Kumar
Published: April 2021

Background:

Physical injuries constitute a major health problem in the training institutes. The present study was undertaken with the aim to analyze the injury pattern in a training institute.

Materials and Methods:

This study was carried out on male trainees of a premier training academy. Trainees with all forms of injuries were included in the study. This was a descriptive record-based study carried out at a tertiary-level hospital. The records were extracted from January 2011 to December 2016. These trainees were assessed in terms of their age, term, activity causing the injury, anatomical part injured, and their final disposal.

Results:

Out of a total of 5400 trainees, 1536 trainees with various forms of injuries were assessed (28.4%; 95% confidence interval [CI]: 27.2–29.7). Their mean age was 18.62 years (standard deviation: 0.9 years). The lower limbs were most commonly injured (n = 1167, 75.91%; 95% CI: 73.7%–78.0%). There were 865 (56.3%) cases of soft-tissue injuries in comparison to 671 (43.69%) cases of bony injuries. Injuries due to physical training outnumbered to those sustained during sporting activities. Majority of the cases were managed conservatively (n = 1445, 94.07%), and only 85 trainees required surgical intervention (5.53%). Loss of man-days ranged from 1 to 309 days (mean: 38.18 days).

Conclusion:

Injuries are an integral part of training, resulting in morbidity and loss of man-days. The descriptive epidemiology of the injuries may help in formulating preventive and promotive measures for injuries.
Gaseous Pollutants in Indian EKM and SSK Class Submarines
Authors: Verma Vivek , Tarway Nimesh , Pinninti Anil
Published: April 2021

Introduction:

Once a submarine dives, the captive atmosphere inside keeps changing due to release of various pollutant gases. The gases are produced by machinery, cooking, human, paints, batteries, cooking etc. The study was envisaged to measure these gaseous pollutants on surface and in prolonged dive onboard EKM and SSK class submarines.

Methods and Material:

Detector tubes and pumps were used to measure the concentration of twenty gaseous pollutants in harbour on surface & during sailing in dived condition. In harbour, readings were taken early morning and before secure in the evening. During sailing readings were taken on surface, just after diving and thereafter every four hrs. The readings were recorded in excel sheet and correlated with activities on board at time of taking reading.

Results:

Only Ammonia and Hydrogen Sulphide were detected at the beginning of the day in harbour, however by the end of the day all other gases were detected except Mercury, Oil mist, Nitrogen Dioxide, Ozone & Arsine. At Sea none of the gases were detected at the beginning of sailing. At 12h post dive all gases were detected except Mercury, Oil mist, Nitrogen Dioxide, Ozone, Halogenated Hydrocarbons & Arsine.

Recommendations and Conclusion:

The gas concentration values obtained by using detector tubes and pumps were found to be within recommended Permitted Exposure Levels (PEL) for human for continuous exposure. No gas was found to be above the recommended PEL. There was no significant difference in the gas concentration levels in the EKM & SSK Class submarines. Pump and detector tube is a convenient, reasonably accurate and efficient method to measure gaseous pollutants on board Submarines.
Study of Blood Pressure and its Relationship with Anthropometric Variables among School Children
Authors: Mookkiah Ilankumaran , Singh Mahendra Vikram , Bobdey Saurbah , Neelakandan Anand , Maramraj Kiran Kumar
Published: April 2021

Introduction:

Hypertension is a global public health issue. Blood pressure (BP) has been shown to track (or persist) from childhood to adulthood. Obese and overweight children have a higher prevalence of elevated BP than normal weight children. Hence, the prevention of childhood obesity is one of the cardinal strategies for the prevention of hypertension and cardiovascular risks later in life.

Materials and Methods:

It was a cross-sectional study conducted among school children of age 10 years and above. BP and anthropometric measurements such as height and weight were measured using standard methods for 1620 children. The data were compiled and statistical analysis was done to assess the relationship between BP and anthropometric parameters.

Results:

A total of 990 boys and 630 girls were examined. The mean age for boys was 14 years (range 10–18 years) and mean age of girls was 13.8 years (range 10–18 years). The mean systolic BP and diastolic BP of the study participants increased uniformly with the increase in weight, height, and body mass index (BMI). A significant positive correlation was observed between anthropometric parameters and BP.

Conclusion:

This study reinforces the evidence of significant correlation between BP and anthropometric parameters in school children. Enhancing awareness and institution of good lifestyle habits at an early age hold the key to the prevention of lifestyles diseases in adults. Hence, school children with increased weight and BMI are to be counseled regarding their diet and they should be encouraged to undertake regular physical activity.