bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging Trends in the U.S. Physician Workforce: Implications for Licensure and Professional Standards
Authors: Galbraith Robert M. , Clyman Stephen G.
Published: April 2021

During the past quarter century, demand for physicians has dramatically increased, yet the supply of trained allopathic United States medical graduates (USMG) has become fixed. Expansion of funded residency positions has allowed large-scale absorption of international medical graduates (IMG), but there is now growing competition for IMG from other Anglophone countries with developing shortages. Substantive expansion of allopathic USMG enrollment will have to overcome hard fiscal and political realities and an uncertain pool of additional qualified applicants. Although the numbers of osteopathic physicians and non-physician clinicians (NPC) have increased briskly over the last decade, particularly in primary care, their ability to address shortages of specialists appears limited. This conjunction of events could result in serious shortages of physicians, particularly of specialists and in areas that are traditionally victims of maldistribution. Although many corrective actions are theoretically possible, most are impractical, and increasing enrollment of allopathic USMG may be the most feasible immediate approach. There could also be important ripple effects on professional standards, procedures for licensure and the introduction of several important new initiatives in assessment relevant to licensure and certification.
Guidelines for Medical Board Investigators and Consultants Dealing with Distressed Pain Medicine Practices
Authors: Greenberg David G.
Published: April 2021

During the past decade, the federal government has approved the development and marketing of powerful oral and transdermal narcotic preparations whose unit dose amounts often contain a much greater amount of active ingredient than ever previously allowed in a single dose of such medication. Although these changes have been beneficial in allowing patients suffering from severe chronic pain syndromes to have better access to higher doses of narcotic analgesics, in a minority of cases substance abusing and drug diverting patients have contributed to increases in their own and the public’s morbidity and mortality. Medical and other related regulatory boards have experienced significant difficulties in adapting their regulatory activities to recent increases in the prescribing of high unit dose narcotic preparations. Complicating this problem is the fact that the vast majority of practicing physicians have had little or no formal training in the fields of chronic pain or addiction medicine; and that most physicians completed their training long before the fairly recent approval and marketing of high dosage narcotic medications. These and other factors can contribute to dangerous prescribing practices. The author wishes to assist medical board staff in conducting thorough, consistent and fair investigations of cases involving suspected inappropriate prescribing of chronic pain medications. The attempt has been made to provide a possible approach for adjudicating board members that incorporates accepted modern methods for the compassionate diagnosis, treatment and ongoing monitoring of chronic pain patients that also serves to protect patients, the public, prescribing physicians and the regulatory boards.
Identical Telemedicine-Enabled Clinics in Three Different Geographies: Our Learnings
Authors: Mankar Suchitra , Paradkar Nikhilesh
Published: April 2021

Background: Scarcity of primary care is felt most in underserved communities. Telemedicine (TM)-enabled clinics bridge the gap in such scenarios. There was a need to understand how the same TM model would work in different settings.
Aim: The aim was to study outcomes in three identical TM-enabled clinics in different geographies so as to understand how to scale up clinics in future.
Setting: Three totally different sites were chosen: a rural village with low socioeconomic status, a rurban (rural-urban) prosperous village, and an urban slum. The clinics planned was identical. The process of establishment, training, recruitment and treatment guidelines were the same. Any deviation was noted.
Methodology: Data were gathered through public health survey, interactions with villagers and local leaders, medical examination of individuals, feedback from patients, and household survey to understand the socioeconomic status of the community.
Main outcome measures: The article attempted to study how different social, cultural, and economic settings affected the outcome of identical TM clinics.
Results: TM, though accepted in different settings, was not sufficient to meet the healthcare needs of the community. These needs were related to the social and economic characteristics. Public health initiatives along with TM were most beneficial. In the underserved areas, infrastructure posed challenges to implementing TM, and ‘Last Mile Care Delivery’ was essential to create the full impact of TM.
Conclusion: TM-enabled clinics along with last mile care delivery are the key to improve healthcare in underserved communities. Further research into customized TM models for different geographies would help in providing the best care.
Limitations of the study: The study period was 4 months. The study was in one state of India, so the applicability of the findings to other states/countries may vary.
Application of a New Method for Simultaneous Phase and Baseline Correction of NMR Signals (SINC)
Authors: Steimers Ellen , Sawall Mathias , Behrens Richard , Meinhardt Denise , Simoneau Joël , Münnemann Kerstin , Neymeyr Klaus , von Harbou Erik
Published: April 2021

Recently, we presented a new approach for simultaneous phase and baseline correction of nuclear magnetic resonance (NMR) signals (SINC) that is based on multiobjective optimization. The algorithm can automatically correct large sets of NMR spectra, which are commonly acquired when reactions and processes are monitored with NMR spectroscopy. The aim of the algorithm is to provide spectra that can be evaluated quantitatively, for example, to calculate the composition of a mixture or the extent of reaction. In this work, the SINC algorithm is tested in three different studies. In an in‐house comparison study, spectra of different mixtures were corrected both with the SINC method and manually by different experienced users. The study shows that the results of the different users vary significantly and that their average uncertainty of the composition measurement is larger than the uncertainty obtained when the spectra are corrected with the SINC method. By means of a dilution study, we demonstrate that the SINC method is also applicable for the correction of spectra with low signal‐to‐noise ratio. Furthermore, a large set of NMR spectra that was acquired to follow a reaction was corrected with the SINC method. Even in this system, where the areas of the peaks and their chemical shifts changed during the course of reaction, the SINC method corrected the spectra robustly. The results show that this method is especially suited to correct large sets of NMR spectra and it is thus an important contribution for the automation of the evaluation of NMR spectra.
Method for Estimating Activity Coefficients of Target Components in Poorly Specified Mixtures
Authors: Jirasek Fabian , Burger Jakob , Hasse Hans
Published: April 2021

Mixtures that contain a known target component but are otherwise poorly specified 15 are important in many fields. Previously, the activity of the target component, which is needed e.g. to design separation processes, could not be predicted in such mixtures. A method was developed to solve this problem. It combines a thermodynamic group contribution method for the activity coefficient with NMR spectroscopy, which is used for estimating the nature and amount of the different chemical groups in the mixture. The knowledge of the component 20 speciation of the mixture is not required. Test cases that are inspired by bioprocess engineering applications show that the new method gives surprisingly good results.
A Molecular Dynamics Simulation Scenario for Studying Solvent-mediated Interactions of Polymers and Application to Thermoresponse of Poly (N-isopropylacrylamide) in Water
Authors: García Edder , Bhandary Debdip , Horsch Martin , Hasse Hans
Published: April 2021

Studying equilibrium properties of polymers in solution by atomistic simulations is a challenging task as the available computation time is often not sufficient to ensure representative sampling of the phase space. One approach to tackle this problem is to create a simulation scenario which is simple enough to enable adequate sampling of equilibrium states while it retains the essential parts of the physics of the polymer in solution. In this work, we present and test such a scenario, which is designed for studying whether a given polymer will aggregate or dissolve in a given solvent. Two periodic polymer molecules are simulated in the explicit solvent. The distance d between the polymer chains lends itself as an order parameter so that advanced sampling techniques, such as umbrella sampling, can be applied easily. A state corresponding to dissolved polymers (large d) and a state corresponding to aggregated polymers (small d) can be defined. The scenario misses the intramolecular collapse of the single chain, but it retains full atomistic detail regarding the polymer-solvent and the intermolecular polymer-polymer interactions. Thethermoresponsive behavior of PNIPAM in water is studied with the new scenario, and it is shown that quantitative predictions of the experimental equilibrium data can be obtained after adjusting a single state-independent parameter in the force field.
How Associative Thinking Influences Scene Perception
Authors: Baror Shira , Bar Moshe , Aminoff Elissa
Published: April 2021

Perception of our external environment is not isolated from the influence of our internal thoughts. Here, we investigate the nature of their interaction. We argue that a common associative mechanism underlies both the perception of scenes and our internal thoughts, and in three experiments hypothesize that there is a functional advantage to an associative thought pattern in the perception of scenes. Experiments 1 and 2 showed that associative thinking indeed facilitates scene perception, an effect that evolved over the course of the experiments. Experiment 3 showed that associative thinking hinders the perception of individual, isolated objects, in which associative information is minimized, but that object perception is facilitated when associative thinking is reduced. This double dissociation reveals that a match between the orientation of internal and external processing is key for perception, suggesting that an associative mind is more receptive of externally perceived associative information.
A quantitative evaluation of gender asymmetry in euphemism
Authors: Kapron-King Anna , Xu Yang
Published: April 2021

Gender has long been discussed as a possible factor in how people speak differently. One gender-based difference asserted by scholars is that women use euphemisms more than men. Although there have been a number of studies investigating gender differences in language, the claim about euphemism usage has not been tested comprehensively. Using four large text corpora of English, we evaluate the claim that women use euphemisms more than men do through a quantitative analysis. We assembled a list of 106 euphemism-taboo pairs to analyze their relative use by each gender in the corpora. Our results do not show that women use euphemisms with a higher proportion than men. We repeated the analysis using different, more selective subsets of the euphemism-taboo pairs list and found that our result was robust. Our study indicates that in a broad range of settings involving both spoken and written speech, and with varying degrees of formality, women do not use euphemisms more than men.
Constituent durations in English NNN compounds: A case of strategic speaker behavior?
Authors: Schebesta Annika , Kunter Gero
Published: April 2021

This paper investigates the effect of morphological embeddedness and lexical frequency on the duration of constituents in left- and right-branching NNN compounds from a corpus of spoken English (Boston University Radio Speech Corpus, Ostendorf et al. 1997). Theories assuming that the phonetic signal is not affected by the internal structure of multimorphemic words are opposed by empirical studies on the morpho-phonetic interface which provide evidence that the phonetic signal is sensitive to different morphological boundaries. The analysis of 465 NNN compounds reveals that morphological embeddedness alone does not have the expected effect on constituent durations, however, we detected a complex interplay of the morphological structure of NNN compounds and the two involved bigram frequencies. For instance, the duration of N2 in left-branching compounds is affected by the frequency of N2N3 even though these two constituents do not form a morphological unit in this type of NNN compound. This interplay may be interpreted as a strategic way employed by the speaker in order to resolve potential conflicts between the frequency of adjacent constituents and the morphological structure: In such an instance, speakers appear to use acoustic duration to signal the branching direction of the triconstituent compound.
Induction of acute stress through an internet-delivered Trier Social Stress Test as assessed by photoplethysmography on a smartphone
Authors: Harvie Helen , Jain Barbie , Nelson Benjamin W , Knight Erik L , Roos Leslie E , Giuliano Ryan Jeffrey
Published: April 2021

Recent studies have demonstrated the feasibility of administering the Trier Social Stress Test (TSST) through the internet, with major implications for promoting international inclusivity in research participation through extending typical sampling procedures beyond traditional geographical boundaries. However, online TSST studies to date are limited by the lack of a control group, which may be particularly problematic for studies administered through video mediated platforms, given evidence these interactions may be inherently stressful due to a minimization of nonverbal cues and overemphasis on facial expression. Furthermore, there is a need for biological measures of stress reactivity that can be fully implemented online, as extant research has relied upon laboratory measures that must be shipped back and forth between laboratory and participant. Here, we test smartphone-based photoplethysmography as a measure of heart rate reactivity to an online variant of the TSST. Results demonstrate significant acceleration in heart rate and self-reported stress and anxiety in the TSST condition relative to a placebo version of the TSST. The placebo procedures lead to a significant increase in self-reported stress and anxiety relative to baseline levels, but this increase was smaller in magnitude than that observed in the TSST condition. These findings highlight the potential for smartphone-based photoplethysmography in internet-delivered studies of cardiac reactivity and demonstrate that it is critical to utilize random assignment to a control or stressor condition when administering acute stress online.
Comparative Effectiveness of Training with Simulators Versus Traditional Instruction in Veterinary Education: Meta-Analysis and Systematic Review
Authors: Noyes Julie A. , Carbonneau Kira J. , Matthew Susan M.
Published: April 2021

One of the greatest challenges in veterinary education is adequately preparing students with the clinical skills they need to be successful health care providers. Integration of simulators, devices used to represent real world phenomena under test conditions, into the veterinary curriculum can help address challenges to clinical instruction. The use of simulators in veterinary education is increasing; however, their effectiveness remains unclear. This meta-analysis seeks to synthesize the evidence for simulator training in veterinary education to provide a consensus of effect, guide the integration of simulators into the curriculum, and direct the development of future simulation-based research in veterinary medicine. A systematic search identified 416 potential manuscripts from which 60 articles were included after application of inclusion criteria. Information was extracted from 71 independent experiments. The overall weighted mean effect size for simulator training was g = 0.49 for the random-effects model. The outcome measures of knowledge, time, process, and product all produced statistically significant mean effect sizes favoring simulation ( d = 0.41, 0.35, 0.70, 0.53, respectively). A moderator analysis revealed that study characteristics and instructional design features moderated the effectiveness of simulator training. Overall, the results indicate that simulator training in veterinary education can be effective for knowledge and clinical skill outcomes.
El factor humano del arte ginecológico
Authors: Hernández-Yépez Palmer J. , Talledo-Chávez Estuardo , Talledo-Chávez Erick
Published: April 2021

Sr. Editor. Es de esperar que la gran mayoría de artículos publicados profundicen la importancia de la calidad de atención por parte del personal de salud en el ambiente ginecológico mediante la innovación de nuevas técnicas, cuidados y manejos a seguir. De esta manera se enriquece la práctica ginecológica para establecer un ambiente de seguridad en la atención de los pacientes.
Manejo farmacológico de la hipertensión materna durante la lactancia: un reto terapéutico
Authors: Tutal Muñoz Luis Miguel , Martínez Rodríguez John Edward , Ruiz Dorado Lizeth Cristina , Erazo Moncayo Leidy Diana , Ponce Ayala Rodrigo , Caicedo Cabezas Yohana Katherine
Published: April 2021

Introducción. Los trastornos hipertensivos del embarazo pueden aparecer y persistir en el puerperio, pudiendo requerir tratamiento durante el periodo de lactancia. Actualmente, no existe consenso acerca del manejo farmacológico, y representa un reto terapéutico para el clínico. Objetivo. Revisar la literatura acerca del manejo farmacológico de la hipertensión materna durante la lactancia. Métodos. Se realizó una búsqueda estructurada de la literatura en las siguientes bases de datos: ScienceDirect, PubMed-Medline, Embase biomedical, SciELO y Cochrane Library, con los términos: ‘pregnancy induced hypertension, AND therapeutics’, ‘postpartum hypertension AND therapeutics’, ‘pregnancy induced hypertension AND treatment’, ‘postpartum hypertension AND treatment’. Resultados. Se encontró 44 artículos relevantes para llevar a cabo la presente revisión. Conclusiones. No existe evidencia suficiente para demostrar la seguridad de cualquiera de los fármacos utilizados en el tratamiento de la hipertensión materna durante la lactancia. La literatura sugiere que nifedipino, enalapril, captopril y metoprolol, son los fármacos empleados con seguridad relativa para el lactante.
Protocolo de transfusión masiva en obstetricia
Authors: La Rosa Mauricio
Published: April 2021

La hemorragia obstétrica es la causa más común de mortalidad materna en el mundo. Durante las últimas décadas, nuestro conocimiento de la fisiopatología y manejo del shock hemorrágico se ha incrementado de manera significativa. Una de las estrategias que más impacto ha tenido en la supervivencia de estas pacientes es la transfusión de productos sanguíneos. Debido a ello, es crucial contar con un protocolo de transfusión masiva en caso de hemorragia obstétrica masiva.
Cetoacidosis por empagliflozina post histerectomía
Authors: González León Claudia , Macia Ubierna Jorge , Mendieta Zerón Hugo
Published: April 2021

Paciente de sexo femenino de 42 años, con diagnóstico de diabetes mellitus tipo 2, de 3 años de evolución, era tratada con empagliflozina/metformina. Intervenida quirúrgicamente por miomatosis uterina, presentó en el postoperatorio inmediato deterioro neurológico y acidosis metabólica, sin hiperglicemia, pero con desequilibrio hidroelectrolítico. Fue ingresada a terapia intensiva, requiriendo manejo invasivo con hemodiálisis y diálisis peritoneal por acidosis refractaria. Egresó luego de 17 días de estancia intrahospitalaria, en buenas condiciones generales.
Hiperreacción luteínica durante el tercer trimestre del embarazo. Reporte de caso
Authors: Reyna-Villasmil Eduardo , Torres-Cepeda Duly , Rondon-Tapia Martha
Published: April 2021

La hiperreacción luteínica es una entidad poco frecuente del embarazo, que se caracteriza por aumento bilateral y funcional de los ovarios con presencia de quistes de paredes finas. Varias hipótesis sugieren que es causada por el aumento de las concentraciones o la sensibilidad ovárica a la gonadotropina coriónica. La mayoría no presenta síntomas o complicaciones del embarazo, y el diagnóstico se realiza en forma accidental por ecografía de rutina. Es una condición benigna rara, suele autolimitarse y se resuelve espontáneamente después del parto. Sin embargo, a veces no pueden ser diferenciados de los tumores malignos de ovario sin un examen histológico. La cirugía está indicada cuando existen complicaciones como torsión ovárica o peritonitis por hemorragia o rotura. Se presenta un caso de hiperreacción luteínica durante el tercer trimestre del embarazo.
Mola invasiva coexistente con feto vivo normal. Reporte de caso
Authors: Tipiani Rodríguez Oswaldo , Solís Sosa Carlos , Valdez Alegría Grace Elizabeth , Quenaya Rodríguez Roberth Jonathan , Escalante Jibaja Ricardo , Cevallos Pacheco Carlos , Ibarra Lavado Oscar , Bocanegra Becerra Yuliana Libet
Published: April 2021

Comunicamos el caso de una gestante referida por sospecha de mola parcial. Las imágenes ultrasonográficas mostraban un feto normal unido a placenta pequeña, adyacente a una masa tumoral en ‘panal de abejas’. Se realizó amniocentesis, con resultado de cariotipo normal. Debido a valores de hCG-β superiores a 800 000 UI y crecimiento de la masa de 11% a la resonancia magnética, se realizó biopsia tumoral percutánea guiada por ecografía, la cual alejó la posibilidad de coriocarcinoma. La paciente hizo síntomas de hipertiroidismo que requirieron tratamiento y, al superar la hCG-β el millón de unidades, se decidió dar un curso de quimioterapia. A las 29 semanas inició trabajo de parto; se realizó cesárea-histerectomía, obteniéndose recién nacido vivo, con Apgar 5 y 7. Al examen anatomopatológico, la masa placentaria resultó mola invasiva. De acuerdo con nuestra búsqueda, se comunica el primer caso en la literatura de coexistencia de mola invasiva con feto sano, y resaltamos la importancia de usar las herramientas diagnósticas y de manejo necesarias para lograr la viabilidad del producto de la concepción, sin incrementar el riesgo materno.
Índice cefálico/abdominal/femoral (C+A-F), herramienta antropométrica efectiva en la evaluación del crecimiento fetal y de sus desviaciones
Authors: Sosa-Olavarría Alberto , Álvarez-Moya Eulolio , Schenone Giugni Mauro H. , Pianigiani Edgardo C. , Zurita-Peralta Jesús , Schenone Giugni Claudio V.
Published: April 2021

Antecedentes. Lograr un método ideal que evalúe el potencial de crecimiento fetal es una aspiración incumplida en nuestra disciplina, e impone la necesidad de una evaluación individualizada, a través de nuevas herramientas y multiparámetros integrados. Objetivos. Evaluar la correlación y establecer valores de referencia del índice cefálico/abdominal/femoral (CAF) con la edad gestacional (EG) y el peso fetal estimado, para tipificar la evolución del crecimiento fetal como adecuado o no para la edad gestacional, y correlacionar con el peso del recién nacido a término. Pacientes y métodos. Se estudiaron 1 032 embarazos con embarazo simple y sin complicaciones, de 12 a 38 semanas de gestación, en el Centro Policlínico de Valencia, Venezuela, entre los años 2015 y 2017. Las medidas ecográficas y el peso fetal se estimaron a intervalos de 3 a 5 semanas. Los parámetros estudiados fueron circunferencia cefálica (CC), circunferencia abdominal (CA) y longitud del fémur (FL), integrados en la fórmula índice CAF = [(CC + CA) - FL]. Se aplicó el modelo de regresión cúbica y puntaje Z en 256 casos seguidos hasta el parto. Se establecieron tres grupos de CAF: a) CAF <50, b) CAF 50 a 57, y c) CAF ≥58, calculando la media ± desviación estándar de los pesos de los recién nacidos en cada grupo. Resultados. Según las semanas de gestación, el índice CAF reveló un R² = 0,96, p <0,05, mientras que para el peso fue R² = 0,92, p <0,05. En 256 casos seguidos hasta el parto, cuando el CAF tenía valor igual o superior a 58, el peso del recién nacido fue 3 361 ± 484 g, con diferencias estadísticamente significativas en relación al resto de grupos (prueba de student p <0,05). Conclusiones. El índice CAF es un método multiparméetrico que permite, a través de evaluaciones seriadas, determinar el potencial de crecimiento individual esperado y virtualmente también identificar sus desviaciones.
Vacuna del papilomavirus en el Perú
Authors: Venegas Rodríguez Gino , Jorges Nimer Alcedo , Galdos Kajatt Oscar
Published: April 2021

El cáncer de cuello uterino es un problema de salud pública. La vacuna contra el virus del papiloma humano (VPH) protege contra la infección por el VPH. Ha mostrado ser efectiva para prevenir lesiones premalignas y cáncer de cérvix, así como lesiones de la vulva, vagina, canal anal, pene y orofaringe. Forma parte del calendario nacional de vacunación, es costo efectiva en la introducción de la estrategia nacional de vacunación y es la herramienta ideal ante sistemas de salud donde la prevención secundaria no ha dado resultado a lo largo del tiempo. La implementación del programa de vacunación en Perú se inició en el 2011. Actualmente, la indicación de la vacunación es con la vacuna tetravalente a niñas del 5° grado de primaria de los colegios públicos y privados, en 2 dosis a los 0 y 6 meses. En el 2019, la cobertura fue de 87% (234 535 niñas) para la primera dosis y 78% (211 339) para la segunda dosis.
Sarcomas durante el embarazo: reporte de dos casos y revisión de la literatura
Authors: Ibargüengoitia-Ochoa Francisco , Lira-Plascencia Josefina , Gallardo- Gómez Fabiola , Mustre-Juarez Carlos Rubén , Sepúlveda-Rivera Sergio , Ruiz Beltrán Arturo Maximiliano , Sepúlveda Rivera Cintia María
Published: April 2021

Objetivo. Presentar los resultados perinatales de dos pacientes con diagnóstico de sarcoma de Ewing y rabdomiosarcoma alveolar. Metodología. Se revisaron dos casos de pacientes con diagnóstico de sarcoma atendidas en el Instituto Nacional de Perinatología de la Ciudad de México. Resultados. Caso 1 femenino de 22 años, con embarazo de 23,0 semanas y tumoración en región glútea izquierda de 20 cm, dolor y dificultad para deambular. La radiografía de tórax informó múltiples nódulos pulmonares y la resonancia magnética, tumor en región glútea con compromiso extenso. El diagnóstico fue sarcoma de Ewing metastático en etapa IV. El manejo consistió en tratamiento sintomático con resolución del embarazo a las 28 semanas. Caso 2 femenino de 22 años con embarazo de 12,0 semanas y diagnóstico de síndrome medular metastásico. Se realizó descompresión T9-11. Se evidenció ausencia de frecuencia cardiaca fetal, por lo que se realizó manejo médico de aborto diferido.
Manejo de neoplasias malignas raras durante el embarazo
Authors: Reyna-Villasmil Eduardo
Published: April 2021

El cáncer durante el embarazo ocurre en 0,07% a 0,1% de todos los embarazos. Debido al notable aumento en la edad materna al momento del parto, la incidencia de tumores malignos diagnosticados durante el embarazo ha aumentado. Aunque es una condición rara, debe ser identificada y tratada de inmediato, ya que el embarazo puede producir conflictos para el tratamiento materno y desarrollo fetal óptimo. Los casos de cáncer más frecuentes durante el embarazo son los de mama, cuello uterino, melanoma, leucemia y linfoma. Sin embargo, existen casos reportados en menor frecuencia de páncreas, riñón, glándulas suprarrenales, vejiga, pulmón, hepatobiliar, de vulva y sistema nervioso central. La falta de experiencia y conocimiento podría conducir a diagnóstico tardío, tratamiento impreciso y complicaciones materno-fetales. Las estrategias para el tratamiento del cáncer durante el embarazo no deberían diferir en forma significativa de los esquemas de tratamiento en mujeres no gestantes. La decisión sobre el inicio y la continuación del tratamiento debe ir precedida de análisis detallado de los posibles beneficios y riesgos. Por lo tanto, es necesario tener en cuenta las pautas diagnósticas y ponderar la seguridad fetal con un enfoque multidisciplinario para establecer las potenciales opciones terapéuticas.
Drug nanotargeting for treatment of neurodegeneration and aging
Authors:   Cavitation-Control Technology Inc., Farmington, CT 06032, USA., S. D'Arrigo Joseph
Published: April 2021

Microvascular endothelial dysfunction precedes, often by decades, the cognitive decline associated with Alzheimer’s disease. Accordingly, cerebrovascular risk factors (e.g., atherosclerosis, diabetes, aging) contribute to the pathogenesis of this common neurodegenerative disease. By incorporating appropriate drug(s) into biobased (lipid cubic phase) nanocarriers, one obtains a multitasking combination therapeutic which targets certain cell-surface scavenger receptors, mainly class B type I (i.e., SR-BI), and crosses the blood-brain barrier. This (intravenous) combination therapeutic, known to be a successful drug carrier, would make it possible for various cell types within the brain (all potentially implicated [see below] in Alzheimer’s disease) to be simultaneously nanotargeted for localized drug delivery via cell-surface SR-BI. Hence, such colloidal-nanocarrier targeting allows for various Alzheimer’s-related cell types to be simultaneously searched in a holistic integrative approach. This (colloidal-nanocarrier) targeting advantage, in vivo, may be particularly important when delivering pleiotropic natural substances (e.g., a flavonoid) or for repurposing an FDA-approved drug. For example, the described/proposed colloidal (nanoemulsion) nanocarrier is especially useful for the delivery of low-molecular-weight compounds having a significant degree of lipophilicity (i.e., low water solubility), such as various pleiotropic natural substances (e.g., the plant polyphenol known as “resveratrol”, commonly used as a dietary supplement).
O estágio supervisionado em ensino de ciências como espaço para a mobilização dos saberes docentes
Authors: Arrais Antonia Adriana Mota , Silva Delano Moody Simões da
Published: April 2021

O presente é dedicado a investigar indícios de mobilização/desenvolvimento dos saberes docentes nos licenciandos de Ciências Naturais a partir da disciplina de Estágio Supervisionado em Ensino de Ciências 1 da Faculdade UnB Planaltina (FUP/UnB).  Para o desenvolvimento da pesquisa, foram utilizados como instrumentos de coletas de dados os relatos de medos e expectativas quanto a realização do estágio e os portfólios elaborados pelos licenciandos, tais materiais constituíram o corpus da investigação e foram submetidos a Análise Textual Discursiva (ATD). Os resultados indicaram que ao longo do estágio foram mobilizados e desenvolvidos diversos saberes pelos licenciandos, influenciados pelas vivências e experiências no contexto da escola, mas também pelas trocas e reflexões provocadas pelos professores colaboradores e pelo supervisor de estágio na universidade. Esse contato entre jovens e experientes na profissão possibilita confrontar, validar, ressignificar e desenvolver diversos saberes.
دليل السلطة التنفيذية في تطبيق الفصل 49 من الدستور
Authors: Ghazala Shahriddin
Published: April 2021

أحدث الفصل ٤٩ من الدستور تغييراَ جذرياً في منظومة حماية حقوق الإنسان في تونس، إذ يكاد يكون المادة الجامعة الوحيدة في الدساتير العربية التي تضع الشروط والمعايير المتعلقة بتنظيم الحقوق والحريات وضبط إطار لتدخّل المشرع ومختلف السلط العمومية بالاستناد إلى مبدأ التناسب بين ضوابط تقييد الحقوق وموجباتها. فقد تم بمقتضى الفصل ٤٩ دسترة مبدأ قانوني هام وهو مبدأ التناسب باعتباره منهجاً واختباراً من الضروري إعماله من قبل كافة المتدخلين في هذا المجال حتى تتم عقلنة هذا التدخل وضمان حماية أنجع وأدق للحقوق والحريات. ولئن كان المشرع والقاضي الدستوري المخاطبان الأساسيان بالفصل ٤٩، فإن ضمان احترام الحقوق والحريات يستوجب استبطان جميع المتدخلين لهذا المنهج ولمختلف ضوابط الفصل ٤٩، ومن بينهم ممثلو السلطة التنفيذية. وفي هذا الإطار، تقدم المؤسسة الدولية للديمقراطية والانتخابات هذا الدليل لممثلي السلطة التنفيذية وخاصة منهم العاملين في المجال التشريعي لمساعدتهم على إيجاد الآليات الكفيلة بالتقيد بأحكامه باعتباره نصاً دستورياً ملزماً لجميع السلط العمومية، خاصة في ظل أهمية دور السلطة التنفيذية في إعداد النصوص التشريعية في إطار المبادرة التشريعية أو في إصدار المراسيم. كما يعرج الدليل على دور الفصل ٤٩ في تأطير عمل السلطة التنفيذية عند إصدار النصوص الترتيبية المندرجة في إطار ممارسة رئيس الحكومة للسلطة الترتيبية العامة أو المندرجة في إطار ممارسة الوزراء للسلطة الترتيبية الخاصة. ويقدم الدليل أمثلة تطبيقية حول كيفية إعمال الفصل ٤٩ ومبدأ التناسب خلال مسار إعداد النصوص القانونية ومقترحات عملية لضمان تحقيق انسجام هذه النصوص مع الدستور خلال كامل المسار التشريعي.
دليل الهيئات العمومية المستقلة في تطبيق الفصل 49 من الدستور
Authors: Al-Makki Abir
Published: April 2021

أحدث الفصل ٤٩ من الدستور تغييراَ جذرياً في منظومة حماية حقوق الإنسان في تونس، إذ يكاد يكون المادة الجامعة الوحيدة في الدساتير العربية التي تضع الشروط والمعايير المتعلقة بتنظيم الحقوق والحريات وضبط إطار لتدخّل المشرع ومختلف السلط العمومية بالاستناد إلى مبدأ التناسب بين ضوابط تقييد الحقوق وموجباتها. فقد تم بمقتضى الفصل ٤٩ دسترة مبدأ قانوني هام وهو مبدأ التناسب باعتباره منهجاً واختباراً من الضروري إعماله من قبل كافة المتدخلين في هذا المجال حتى تتم عقلنة هذا التدخل وضمان حماية أنجع وأدق للحقوق والحريات. ولئن كان المشرع والقاضي الدستوري المخاطبان الأساسيان بالفصل ٤٩، فإن ضمان احترام الحقوق والحريات يستوجب استبطان جميع المتدخلين لهذا المنهج ولمختلف ضوابط الفصل ٤٩، ومن بينهم الهيئات العمومية المستقلة. وفي هذا الإطار، تقدم المؤسسة الدولية للديمقراطية والانتخابات هذا الدليل إلى الهيئات العمومية المستقلة، سواء التي تم إنشاؤها بمقتضى الدستور أو القانون، والتي تضطلع بمهام تقريرية رقابية أو تعديلية أو استشارية في مسائل ومجالات متصلة بالحقوق والحريات. ويمثل الدليل أداة عملية تهدف إلى تعزيز إدراك القائمين على هذه الهيئات بأهمية الفصل ٤٩ من الدستور ومساعدتهم على الإلمام بمضامينه وتيسير تطبيقه وإعمال مبدأ التناسب الذي أصبح يكتسي صبغة دستورية، وذلك من خلال تقديم أمثلة عملية وجداول تفصيلية حول كيفية تطبيقه، بما يساهم في بلورة قراءة متناغمة ومندمجة لهذا المبدأ ولأحكام الفصل ٤٩ من الدستور في ضوء الممارسات الجيدة في التجارب المقارنة.
Vietnamese University Staffs’ Perceptions of Lecturer Professional Development During the CDIO-Based Curriculum Implementation
Authors: Tran Ngoc Hai
Published: April 2021

Lecturer professional development (LPD) plays an important part in promoting student achievement and education quality improvement. At Ha Tinh Univerisity (HTU), Vietnam, the CDIO - based curriculum has been implemented since 2016 in different study programs. In order to make it succeed, LPD is considered a key measure. This qualitative case-study research aims to investigate the perceptions of HTU managers and the lecturers on LPD related to the CDIO based curriculum implementation using the data from the interviews, questionnaires and the documents. Significance of LPD related closely to the CDIO-based curriculum implementation is highly appreciated by HTU managers and lecturers.
Asymptotic synchronization of a coupled system of wave equations on a rectangular domain with reflecting sides
Authors: Li Tatsien , Rao Bopeng
Published: April 2021

We show the sufficiency of Kalman’s rank condition for the uniqueness of solution to a coupled system of wave equations in a rectangular domain. The approach does not need any gap condition on the spectrum of the differential operator and the usual multiplier geometrical condition. Then, the study on the asymptotic synchronization by groups can be improved for the corresponding system.
Immediate effects of thoracic manipulation on cervical joint position sense in individuals with mechanical neck pain: A randomized controlled trial
Authors: Erdem Emin Ulas , Ünver Banu , Akbas Eda , Kinikli Gizem Irem
Published: April 2021

BACKGROUND: Performing thoracic manipulations for neck pain can result in immediate improvements in neck function. OBJECTIVE: The aim of this study was to investigate the immediate effects of thoracic manipulation on cervical joint position sense and cervical range of motion in individuals with chronic mechanical neck pain. METHODS: Eighty male volunteers between 18–25 years and having chronic or recurrent neck or shoulder pain of at least 3 months duration with or without arm pain were randomized into two groups: Thoracic Manipulation Group (TMG:50) and Control Group (CG:30), with a pretest-posttest experimental design. The TMG was treated with thoracic extension manipulation while the CG received no intervention. Cervical joint position error and cervical range of motion of the individuals were assessed at baseline and 5 minutes later. RESULTS: There was no difference in demographic variables such as age (p= 0.764), Body Mass Index (p= 0.917) and Neck Pain Disability Scale (NPDS) scores (p= 0.436) at baseline outcomes between TMG and CGs. Joint position error outcomes between the two groups following intervention were similar in all directions at 30 and 50 degrees. Differences in range of motion following intervention in neck flexion (p< 0.001) and right rotation (p= 0.004) were higher in TMG compared to CG. CONCLUSIONS: A single session of thoracic manipulation seems to be inefficient on joint position sense in individuals with mild mechanical neck pain. However, thoracic manipulation might be an effective option to increase flexion and rotation of the cervical region as an adjunctive to treatment.
Study on the cross-sectional area of the multifidus muscle at the L4-L5 level on ultrasound images of Olympic-style weightlifting and judo athletes
Authors: Erdağı Kenan , Poyraz Necdet
Published: April 2021

BACKGROUND: The multifidus muscle is located near the spine and controls the erection of the spine and stabilization during movements of the spine and extremities, and assists in all other spinal movements. Differences in paraspinal muscles between sides and levels, particularly in he multifidus, have been proposed as possible indicators of low back pain or spinal pathology. OBJECTIVE: This study aims to examine the cross-sectional area of the lumbar multifidus muscle at L4-L5 vertebral levels on ultrasound images of athletes in Olympic-style weightlifting, judo athletes and sedentary individuals. METHODS: This study included asymptomatic male athletes (athletes in Olympic-style weightlifting, n= 17, age: 19.24 ± 1.88, judo athletes, n= 17, age: 19.18 ± 1.23) and sedentary individuals (n= 17, age: 19.88 ± 1.31). The cross-sectional area of lumbar multifidus muscles was assessed bilaterally at the L4-L5 segments level in prone and using ultrasound imaging. RESULTS: Lumbar multifidus muscle cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes were larger than those of sedentary individuals (p< 0.004). No asymmetric development was observed in cross-sectional areas of right-left lumbar multifidus muscle at L4-L5 levels of athletes in Olympic-style weightlifting and sedentary individuals (p> 0.008). The cross-sectional areas of the right and left lumbar multifidus muscle at L5 segment of individuals in judo athletes was found to be asymmetrical (p< 0.008). CONCLUSION: Our study shows that the cross-sectional areas of athletes in Olympic-style weightlifting and judo athletes are larger than that of sedentary individuals. The difference in the cross-sectional area of the lumbar multifidus muscle of athlete and sedentary groups might be said to result from hypertrophic effect of trainings of these athletes on the cross-sectional area of the lumbar multifidus muscle.
Reference values and regression equations for predicting the 6-minute walk distance in Saudi adults aged 50–80 years: A cross- sectional study
Authors: AL-Ghamdi Nawal S. , Shaheen Afaf A.M.
Published: April 2021

BACKGROUND: The 6-minute walk test (6-MWT) is commonly used to measure functional capacity in clinical and research settings. The reference equations for predicting the 6-minute walk distance (6-MWD) in different populations have been established; however, there is a lack of information regarding healthy Saudi individuals over 50 years old. OBJECTIVES: This study aimed to establish the reference values of 6-MWD in a sample of healthy Saudi adults aged 50–80 years, develop regression equations for the established 6-MWD, and compare the measured 6-MWD in the present study with the predicted 6-MWD derived from the previously published regression equations. METHODS: In total, 210 healthy Saudi volunteers aged 50–80 years participated in this cross-sectional study. The 6-MWT was performed according to the American Thoracic Society (ATS) guidelines. Lung function, physical activity, blood pressure, heart rate, oxygen saturation, exertion level of leg fatigue, and sensation of dyspnea were measured. RESULTS: The mean 6-MWD was 396.2 ± 69.4 m. It was significantly correlated with age, sex, height, body mass index (BMI), and physical activity. The predictors of 6-MWD were age and BMI for men, while they were age, BMI, and height for women. They accounted for 25% and 35% of the total variance of 6-MWD for men and women, respectively. The measured 6-MWD was significantly shorter than the predicted 6-MWD. CONCLUSION: Saudi populations have significantly shorter 6-MWDs than those reported in other ethnic groups. The sex-specific equations developed in this study are expected to provide a useful measure of 6-MWT for Saudi adults. However, further investigation is required to validate the application of these equations to individuals living in different regions of Saudi Arabia.
TRIB3 promotes proliferation, migration, and invasion of retinoblastoma cells by activating the AKT/mTOR signaling pathway
Authors: Bao Xian-Yi , Sun Ming , Peng Ting-Ting , Han Dong-Mei
Published: April 2021

BACKGROUND: Tribbles pseudokinase 3 (TRIB3) is a member of the tribbles-related family, which has been determined in various cancers, including renal cell carcinoma, acute promyelocytic leukemia, colorectal cancer, endometrial cancer, and glioma. However, its role in retinoblastoma (RB) has not yet been explored. METHODS: The expression level of TRIB3 was detected in RB tissues and cell lines using qRT-PCR. The effects of TRIB3 on cell proliferation and invasion capacities were analyzed with MTT, crystal violet, and transwell assays. Western blot and rescue assays were conducted to explore the underlying mechanism. RESULTS: This study found that TRIB3 was upregulated in human RB tissues compared to adjacent normal tissues both at the mRNA and protein levels. Overexpression of TRIB3 significantly promoted cell proliferation and invasion of RB cells, while TRIB3 knockdown inhibited these processes. Moreover, the mechanism deciphering experiments showed that TRIB3 overexpression can increase AKT and mTOR phosphorylation. Conversely, TRIB3 knockdown decreased the phosphorylation of AKT and mTOR. Additionally, MK2206, a potent AKT inhibitor, blocked the promotive effects of TRIB3 in RB cells. CONCLUSION: This study demonstrated that TRIB3 acts as an oncogene and plays a crucial role in the proliferation and invasion of RB cells via regulating the AKT/mTOR signaling pathway. Therefore, TRIB3 may serve as a potential target in the diagnosis and/or treatment of RB.
RUNX2 promotes malignant progression in gastric cancer by regulating COL1A1
Authors: Li Yanlei , Sun Ran , Zhao Xiulan , Sun Baocun
Published: April 2021

BACKGROUND: Runt-related transcription factor 2 (RUNX2) is an important gene that has been implicated in the progression of human cancer. Aberrant expression of RUNX2 predicts gastric cancer (GC) metastasis. However, the molecular mechanism of RUNX2 remains unknown. OBJECTIVE: We hypothesize that RUNX2 promotes GC metastasis by regulating the extracellular matrix component collagen type I alpha 1 (COL1A1). METHODS: The GEPIA database and immunohistochemical staining of 60 GC tissues were used to analyse the correlations between RUNX2 or COL1A1 expression and clinicopathological features, and the Kaplan-Meier method was used to evaluate survival. RT-PCR, western blotting and immunofluorescence were used to detect RUNX2 and COL1A1 expression in GC cells. Migration and invasion assays were performed to assess the influence of RUNX2 and COL1A1 on metastasis. RESULTS: RUNX2 and COL1A1 were highly expressed at both the gene and protein levels in GC, and patients who were positive for RUNX2 and COL1A1 had shorter survival. RUNX2 and COL1A1 expression linearly correlated with each other (r= 0.15, p< 0.01) and with clinical stage and lymph node metastasis (p< 0.05). Overexpressing RUNX2in vitro enhanced COL1A1 expression and promoted GC cell invasion and migration, whereas COL1A1 knockdown inhibited the increase in cell metastatic capacity promoted by RUNX2. In vivo, GC cells overexpressing RUNX2 promoted lung metastasis, and the downregulation of COL1A1 reduced the metastasis promoted by RUNX2. CONCLUSIONS: RUNX2 may promote GC metastasis by regulating COL1A1. RUNX2/COL1A1 can be employed as a novel target for therapy in GC.
Genetic variants in STAT4 and their interactions with environmental factors for the incidence of hepatocellular carcinoma
Authors: Zhong Xuan , Luo Meihua , Wu Yanmei , Zhou Xinfeng , Yu Xinfa , Liu Li , Chen Sidong
Published: April 2021

BACKGROUND: A recent genome-wide association study (GWAS) has posed STAT4 as a promising susceptibility gene for hepatocellular carcinoma (HCC). However, the most significant variant in this GWAS, rs7574865, yielded inconsistent results. OBJECTIVE: This study, in a Southern Chinese population, was aimed to clarify the roles in HCC incidence of the rs7574865 and other two potentially functional variants, rs897200 and rs1031507 in STAT4. METHODS: This study enrolled 631 new HCC cases and 631 cancer-free controls. The genetic association was estimated using the multivariate logistic regression model. The pairwise gene-environment interactions were assessed using the multiplicative term in regression model and the “Delta” method for the additive scale. RESULTS: In the multivariate analysis, the rs7574865 TT genotype conferred a decreased risk of HCC compared to the GG genotype (adjusted OR = 0.62, 95%CI = 0.38∼0.99). The significant association of rs7574865 was also observed under the additive genetic model, with an adjusted OR of 0.81 (95%CI = 0.65∼0.99). Nevertheless, other two variants alone showed no significant association, as well as the haplotypes and genetic risk scores. Further analysis indicated a potential interaction between the rs897200 and alcohol drinking (P= 0.048 and 0.072 for additive and multiplicative interactions, respectively). Drinkers with the rs897200 CT+CC genotypes presented an increased disease-risk, as compared with non-drinkers carrying the TT genotype (adjusted OR = 1.68, 95%CI = 1.11∼2.54). CONCLUSIONS: The variant in STAT4, rs7574865, serves as a potential marker for predicting incidence of HCC. The rs897200 variant possibly interplays with alcohol drinking to alter HCC risk in the Southern Chinese, but warrants further investigation.