bluuebunny/crossref_metadata_2025 huggingface dataset:
Program-modular approach to the coordination of interests of participants of regional water markets (the case of southern regions of Russia)
Authors:   Southern Federal University, Rostov-on-Don, Russian Federation, Matveeva Lyudmila G. ,   Russian Information, Analytical and Scientific Research Water Management Center, Rostov-on-Don Russian Federation, Chernova Olga A. ,   Southern Federal University, Rostov-on-Don, Russian Federation,   Russian Information, Analytical and Scientific Research Water Management Center, Rostov-on-Don Russian Federation, Kaplyuk Ekaterina V. ,   Southern Federal University, Rostov-on-Don, Russian Federation
Published: August 2021

Relevance. The efficiency of water management is determined by the quality of managerial decision-making. These decisions should ensure the balance of interests of all the actors in regional water markets. At present, in Russia, however, the balance of interests is considered only in macro-level strategies, which leads to the inefficiency of water distribution in regions. The study of the issues of rational distribution of water resources and their use in various industries and spheres of activity is, therefore, particularly relevant. Research objective. This article aims to propose methodology for maintaining the optimal balance between the interests of economic actors in regional water markets. Data and methods. This article proposes a program-modular approach to building a more efficient water management system. It is shown how the proposed methodology based on the incremental model of management can be used for balancing the interests of economic agents (suppliers and consumers of water resources). Results. It is proved that the plurality and divergence of interests of economic agents makes it difficult to manage them and thus precludes social and economic development of territories. The structural-functional analysis of the incremental model reveals various types of connections between the water-retaining capacity of gross regional product and indexes of industrial production for regions of the South Federal District. Conclusions. The prospects of development of water management in regions are associated with ensuring the balance of interests of the water market’s participants. The program-modular approach proposed by the authors combines the administrative and resource potential of regional water management and aligns the goals on the regional level with the more general goals of hydropower modernization. The novelty of our research is that it relies on the incremental model, which, unlike other models of management, leads to an incremental achievement of the desired through certain iterations.
FORMAÇÃO DOCENTE: A ESCRITA DE SI NA APRENDIZAGEM DE PSICOLOGIA E SOCIOLOGIA
Authors: Costa Elis Regina da , Araújo Juliana Pereira
Published: August 2021

RESUMO No processo do fazer docente e fazer-se docente, a escrita de si nas disciplinas de Psicologia e Sociologia da Educação constitui um campo fecundo de intervenção, investigação e formação inicial de futuros professores. Alunos do curso de Pedagogia trouxeram à luz episódios que potencializaram um exercício de significar e ressignificar sua trajetória de vida, sua inserção nos grupos, sua subjetividade e singularidade, que foi dispositivo reflexivo valioso na aprendizagem significativa de conceitos da Psicologia e da Sociologia da Educação. Participaram alunos do Curso de Pedagogia de uma Universidade pública. A metodologia proposta consistiu em produções narrativas autobiográficas fundamentadas nas teorias estudadas no transcorrer das disciplinas de Psicologia e Sociologia da Educação. Concluiu-se que há na autobiografia, a presença pouco considerada de elementos que influem na formação alicerçando visões, aceites e recusas teóricas e necessita ser considerada na formação inicial.
A FORMAÇÃO DOCENTE DIANTE DE PROJETOS SIGNIFICATIVOS PARA ALUNAS DO ENSINO MÉDIO
Authors: Ofugi Fabrício
Published: August 2021

RESUMO Este artigo tem como objetivo apresentar o relato de uma prática profissional de um professor que resultou em uma apresentação musical de estudantes do Ensino Médio junto a um renomado grupo musical. A realização dessa prática aconteceu no contexto de reflexão sobre a prática docente entre professores do Ensino Médio no Instituto Federal de Brasília. Diante da reflexão, inspirados pela teoria fundamentada, buscou-se a geração de dados a partir de escutas em sala de aula que contribuíram para a realização de projetos que trouxessem significados para os alunos. O relato traz as etapas para a realização desses projetos. O resultado dessa experiência evidenciou a necessidade de abordagens efetivas da Psicologia na formação docente no contexto da interação com estudantes do Ensino Médio.
Fatores sociodemográficos e clínicos de casos de hanseníase associados ao desempenho da avaliação de seus contatos no Ceará, 2008-2019
Authors: Soares Gerlania Maria Martins de Melo , Souza Eliana Amorim de , Ferreira Anderson Fuentes , García Gabriela Soledad Márdero , Oliveira Maria Leide Wand-Del-Rey de , Pinheiro Aquiléa Bezerra de Melo , Santos Maria Aldenisa Moura dos , Ramos Junior Alberto Novaes
Published: August 2021

Resumo Objetivo Analisar o efeito de características sociodemográficas e clínicas de casos novos (CNs) de hanseníase como determinantes no desempenho da avaliação dos contatos. Métodos Estudo transversal, com abordagem temporal do indicador de avaliação de 100% dos contatos examinados de CNs registrados no Ceará, Brasil, via Sistema de Informação de Agravos de Notificação (Sinan), em 2008-2019. Empregou-se regressão logística para estimar razão de chances-odds ratio (OR) com intervalos de confiança de 95% (IC95%). A tendência temporal baseou-se em regressão joinpoint. Resultados Foram analisados 23.675 CNs, 65,4% com contatos examinados. Verificou-se maior chance para não avaliação de 100% dos contatos registrados com CN multibacilar (OR=1,19 - IC95% 1,11;1,28) e com exame de contatos como modo de entrada (OR=1,71 - IC95% 1,35;2,18). A tendência temporal do indicador foi de aumento (variação percentual anual: 2,1 - IC95% 1,2;3,0). Conclusão Dimensões distintas de vulnerabilidade individual e social de CNs de hanseníase influenciam o persistente desempenho insatisfatório da avaliação de contatos.
Boletim COVID-PA: relatos sobre projeções baseadas em inteligência artificial no enfrentamento da pandemia de COVID-19 no estado do Pará
Authors: Souza Jr. Gilberto Nerino de , Braga Marcus de Barros , Rodrigues Luana Lorena Silva , Fernandes Rafael da Silva , Ramos Rommel Thiago Jucá , Carneiro Adriana Ribeiro , Brito Silvana Rossy de , Dolácio Cícero Jorge Fonseca , Tavares Jr. Ivaldo da Silva , Noronha Fernando Napoleão , Pinheiro Raphael Rodrigues , Diniz Hugo Alex Carneiro , Botelho Marcel do Nascimento , Vallinoto Antonio Carlos Rosário , Rocha Jonas Elias Castro da
Published: August 2021

Resumo Objetivo: Relatar o produto de pesquisa e extensão universitária denominado Boletim COVID-PA, que apresentou projeções sobre o comportamento da pandemia no estado do Pará, Brasil. Métodos: Utilizou-se da técnica de inteligência artificial conhecida como ‘redes neurais artificiais’, para geração de 13 boletins com projeções de curto prazo baseadas nos dados históricos do sistema da Secretaria de Estado de Saúde Pública. Resultados: Após oito meses de projeções, a técnica gerou resultados confiáveis, com precisão média de 97% (147 dias observados) para casos confirmados, 96% (161 dias observados) para óbitos e 86% (72 dias observados) para ocupação de leitos de unidade de terapia intensiva. Conclusão: Esses boletins tornaram-se um instrumento útil para a tomada de decisão de gestores públicos, auxiliando na realocação de recursos hospitalares e otimização das estratégias de controle da COVID-19 nas diversas regiões do estado do Pará.
La pospandemia y políticas públicas para enfrentarla
Authors: González Chacón Diana Alexandra , González Segovia Octavio Miguel , Corredor González Luz Rocío , Bonilla Montenegro Julián Darío , Pedraza Álvarez Lilibeth Patricia , Pérez Correa Kethy Luz , Miranda Terraza Luis Francisco , Viloria Escobar Javier , Cuesta Tamayo Kelly Daniela , Pérez Suescun Leonardo Fabio , Piedrahita-Bustamante Pedro , Restrepo-Echavarría Néstor Julián , Santos Pinho Carlos Eduardo , Santos Flores Israel , Gutiérrez Ossa Jahir Alexander
Published: August 2021

Este libro tiene el objetivo de analizar las alternativas de política pública necesarias para la preservación de la salud de la población, la reactivación de la economía y la definición de un marco institucional que facilite las relaciones entre individuos en un contexto pospandémico, mediante un enfoque multidimensional. En ese sentido, se analizan los antecedentes de las pandemias de carácter universal, el rol de las organizaciones internacionales, el papel de los bienes públicos globales, los modelos de gobernanza global desde un contexto glocal, las tendencias en investigación acerca de pandemias y sostenibilidad, los nuevos retos del Estado, el financiamiento de las pequeñas y medianas empresas, los incentivos fiscales a la innovación en inteligencia artificial y la utilidad de los modelos matemáticos para la toma de decisiones de política pública. De esta manera, se presenta un análisis ordenado de los retos que enfrenta la sociedad en la actualidad, con su explicación y atención mediante alternativas de acción pública. Por lo tanto, es una guía sobre el rol y la capacidad que deben desarrollar coordinadamente los funcionarios nacionales, junto a las organizaciones internacionales, para influir la definición de políticas que reorganicen el equilibrio mundial.
Pulmonary Cystic Adenomatoid Malformation, Prenatal Diagnosis and Case Management
Authors: EL González , AS Castillo
Published: August 2021

The Cystic Adenomatous Malformation (CAM) is a rare fetal lung lesion. Its frequency is about 1 in 4000 births and is characterized by an overgrowth of terminal respiratory bronchioles that forms cysts of various sizes. It can be associated with polyhydramnios and pulmonary hypoplasia. We describe here a case of Adenoid Cystic Pulmonary Malformation type II with prenatal diagnosis at 20 weeks of gestational age, as well as its subsequent management. Morphological ultrasound describes multiple small cysts associated with a slight mediastinal deviation. The prognosis depends mainly on the associated injuries. Prenatal ultrasound allows early diagnosis and follow-up of CCAM to monitor the appearance of possible pathophysiological complications that may worsen its prognosis.
Rebalancing Roman Archaeology: from disciplinary inertia to decolonial and inclusive action
Authors: Kamash Zena
Published: August 2021

This article analyses the current state of our discipline, particularly its decoloniality and inclusivity. This is investigated via two lenses: data from Roman Archaeology Conferences and Theoretical Roman Archaeology Conferences from 1991 to 2019; and data from the 2019 Roman Archaeology Teaching Survey. These two lenses provide ways into thinking about whose voices are heard in the discipline, current barriers to more diverse voices, and biases within the topics and regions of the Roman world in our research and teaching. The article argues that these data demonstrate a need for change within our discipline, across research and teaching, in order to promote a healthier, decolonial, and more inclusive discipline for the future. As a consequence, this article also makes numerous recommendations and suggestions for action to bring about positive change.
Sistemas de apareamiento y de cruza en Echeveria strictiflora y Echeveria subalpina (Crassulaceae) para su conservación y propagación ex situ
Authors: Álvarez-Álvarez Jonathan , Vázquez-Santana Sonia , García-Campusano Florencia
Published: August 2021

Antecedentes: Los atributos florales y reproductivos inciden sobre la capacidad de producir gametos, la transferencia de polen, el desarrollo de semillas viables y reclutamiento de nuevos individuos. Este conocimiento es clave para el establecimiento de estrategias de conservación, manejo y propagación de las especies.
Pregunta: ¿Qué atributos morfológicos caracterizan a los verticilos sexuales de E. strictiflora y E. subalpina ? ¿Qué impacto tienen los sistemas de cruza intra e interespecíficos en la producción y germinación de semillas?
Especies: Echeveria strictiflora y Echeveria subalpina .
Sitio de estudio: Estudio ex situ en la ciudad de México durante 2018-2020.
Métodos: Se describió la posición espacial y arreglo de los verticilos sexuales. Se caracterizó la morfología de granos de polen y óvulos por microscopía óptica y electrónica de barrido. Se determinaron los sistemas de apareamiento y de cruza intra e interespecíficos, así como la producción y germinación de semillas bajo condiciones controladas.
Resultados: E. strictiflora y E. subalpina son hercógamas, con sistema de cruza mixto y producen semillas viables por hibridación recíproca. Producen abundante polen viable y óvulos. Son autocompatibles, aunque la autocruza impacta en la producción y capacidad germinativa de las semillas, lo que sugiere un efecto por depresión endogámica.
Conclusiones: E. strictiflora y E. subalpina producen frutos y semillas por autocruza y entrecruza intra e interespecífica, pero la depresión endogámica es una limitante para el reclutamiento, lo que muestra la importancia de conservar poblaciones con individuos suficientes para mantener la diversidad, así como sus áreas de distribución natural.
The species of Mentzelia (Loasaceae) in Mexico, part 1: Sectional diversity
Authors: Schenk John , Granados Mendoza Carolina , Estrada-Castillón Andres Eduardo
Published: August 2021

Background: Mentzelia (Loasaceae) is a genus of approximately 95 species that are largely distributed in western North America; however, much ambiguity remains regarding species in Mexico.
Questions: What species of Mentzelia occur in Mexico and how can they be distinguished?
Study species: Mentzelia
Methods: Fieldwork, herbarium studies and scanning electron microscopy were carried out to determine the diversity of Mentzelia species in Mexico.
Results: Twenty-five species of Mentzelia occur in Mexico, of which four taxa are endemic to the country. Five of the six sections of Mentzelia occur in Mexico. Mentzelia section Mentzelia was the most species rich in Mexico (8 spp.), followed by section Trachyphytum (7 spp.), section Bartonia (6 spp.), section Bicuspidaria (3 spp.), and section Dendromentzelia (1 sp.). The sections have different distribution patterns, with some restricted to few areas and one widespread across most of Mexico.
Conclusions: This study is the first treatment of Mentzelia that encompasses all species and regions of Mexico, which includes approximately 26 % of the worldwide Mentzelia species. In-depth studies of the species in the region are needed to abate gaps in our knowledge on the extent of species distributions and to clarify species boundaries among some problematic species complexes.
Visually guided aspiration of fluorescently labelled single neurons from acute midbrain slices followed by Smart-seq2 v1
Authors: Pavon Arocas Oriol , F. Olesen Sarah , Branco Tiago
Published: August 2021

To link the expression of ion channels, receptors, and molecular effectors to specific brain areas and their subdivisions, it is necessary to perform single-cell RNA-sequencing while preserving the anatomical origin of each neuron. Here we describe a protocol to perform visually guided aspiration of fluorescently labelled single neurons from acute midbrain slices of transgenic mice, followed by Smart-seq2 and deep sequencing. This protocol enables researchers to obtain detailed transcriptomic profiles from any cell-type labelled using transgenic lines - and potentially other methods like viral injections - located in a brain area of interest.
TMA-TNP Section Map and Slide Processing - Phase 1 v1
Authors: S Feiler Heidi , Chin Koei
Published: August 2021

Human Tumor Atlas Tissue MicroArrary TNP (TMA-TNP) The Tissue MicroArray (TMA) TNP will extend the SARDANA-TNP characterization and analytics methodologies for evaluation and validation on a large array of breast tumor samples that provide a broad spectrum of disease state and subtype. A commercially available anonymized breast tumor TMA was purchased and sections distributed to participating HTAN Centers. Some deidentified basic clinical data will also be provided. The participating HTAN Centers will characterize the FFPE specimens (e.g. by imaging) and generate a spatially resolved cell type/state census using each Center’s method of choice. Data will then be recorded in a common repository to enable joint analysis. This TNP has two specific Aims focused on (i) Data Collection and (ii) Data Coordination and Analysis. Individual Centers can participate in one or both aims. The custom TMA design for this project was generated by Dr. Koei Chin (OHSU) and sent to Pantomics for custom TMA FFPE block generation and sectioning. The TMA design and clinical sample descriptions can be found here: dx.doi.org/10.17504/protocols.io.bn2fmgbn This protocol describes the procedure by which the OHSU OMS Atlas HTAN Center distributed TMA sections for TMA-TNP Phase 1 analysis.
cDNA Synthesis Using SuperScript III First-Strand Synthesis System for RT-PCR v1
Authors: Doran Lynn
Published: August 2021

The SuperScript® III First-Strand Synthesis System for RT-PCR is used to synthesize first-strand cDNA from purified total RNA. RNA targets from 100 bp to >12 kb can be detected with this system. The procedure follows the manufacturer's instructions but includes lab specific template and reagent amounts and specifies primers and equipment for use in our lab to prepare total RNA samples for qPCR analysis of gene expression. The original protocol is attached below: Kit: Script™ III First-Strand Synthesis System, ThermoFisher Catalog number:18080051
High-quality reference genome of Fasciola gigantica: Insights into the genomic signatures of transposon-mediated evolution and specific parasitic adaption in tropical regions v1
Authors: Luo Xier
Published: August 2021

Fasciola gigantica and Fasciola hepatica are causative pathogens of fascioliasis, with the widest latitudinal, longitudinal, and altitudinal distribution; however, among parasites, they have the largest sequenced genomes, hindering genomic research. In the present study, we used various sequencing and assembly technologies to generate a new high-quality Fasciola gigantica reference genome. We improved the integration of gene structure prediction, and identified two independent transposable element expansion events contributing to (1) the speciation between Fasciola and Fasciolopsis during the Cretaceous-Paleogene boundary mass extinction, and (2) the habitat switch to the liver during the Paleocene-Eocene Thermal Maximum, accompanied by gene length increment. Long interspersed element (LINE) duplication contributed to the second transposon-mediated alteration, showing an obvious trend of insertion into gene regions, regardless of strong purifying effect. Gene ontology analysis of genes with long LINE insertions identified membrane-associated and vesicle secretion process proteins, further implicating the functional alteration of the gene network. We identified 852 predicted excretory/secretory proteins and 3300 protein-protein interactions between Fasciola gigantica and its host. Among them, copper/zinc superoxide dismutase genes, with specific gene copy number variations, might play a central role in the phase I detoxification process. Analysis of 559 single-copy orthologs suggested that Fasciola gigantica and Fasciola hepatica diverged at 11.8 Ma near the Middle and Late Miocene Epoch boundary. We identified 98 rapidly evolving gene families, including actin and aquaporin, which might explain the large body size and the parasitic adaptive character resulting in these liver flukes becoming epidemic in tropical and subtropical regions.
Protocol for Safe, Affordable, and Reproducible Isolation of SARS-CoV-2 RNA from Wastewater v2
Authors: Trujillo Monica , Cheung Kristen , Gao Anna , Hoxie Irene , Kannoly Sherin , Myat San Kaung , S. Smyth Davida , Dennehy John
Published: August 2021

The following protocol describes our workflow for processing wastewater with the goal of detecting the genetic signal of SARS-CoV-2. The steps include pasteurization, virus concentration, RNA extraction, and quantification by RT-qPCR. We include auxiliary steps that provide new users with tools and strategies that will help troubleshoot key steps in the process. This protocol is one of the safest, cheapest, and most reproducible approaches for the detection of SARS-CoV-2 RNA in wastewater. Furthermore, the RNA obtained using this protocol can be sequenced both using a targeted approach sequencing specific regions or the whole genome. The protocol was adopted by the NYC Department of Environmental Protection in August 2020 to support their efforts in monitoring SARS-CoV-2 prevalence in wastewater in all five boroughs of the city. Owing to the pasteurization step, it is safe for use in a BSL1+facility. This step does not reduce the genetic signal of the virus while making the protocol safe for the personnel involved. This protocol could be used to isolate a variety of other clinically relevant viruses from wastewater and serve as a foundation of a wastewater surveillance strategy for monitoring community spread of known and emerging viral pathogens.
Approaches to the Analysis Performance Indicators Multiservice Telecommunication Networks Based on SDN Technology
Authors:   Institute of Control Systems of the ANAS, Baku, Republic of Azerbaijan, Humbatov R. T. , Ibrahimov B. G. ,   Azerbaijan Technical University, Baku, Republic of Azerbaijan, Alieva A. A. ,   Mingechevir State University, Baku, Republic of Azerbaijan, Ibrahimov R. F. ,   Institute of Control Systems of the ANAS, Baku, Republic of Azerbaijan
Published: August 2021

The quality of functioning multiservice telecommunication networks based on the architectural concept Next Generation Network (NGN) and Future Networks (FN) using modern innovative technologies has been analyzed. Based on the study, a new approach to the construction model for assessing performance indicators multiservice telecommunication networks based on SDN (Software Defined Networking) technologies, taking into account the property self-similarity traffic is proposed. On the basis of the proposed approach, complex indicators MTS were investigated, taking into account the requirement QoS (Quality of Service) and QoE (Quality of Experience). The mathematical apparatus and the results of the study throughput software and hardware complexes, the probabilistic-time characteristics of the network and the management physical resources in the provision multimedia services are presented. Models have been investigated and analytical expressions have been obtained for the assessment complex indicators of the quality offunctioning MTS in the provision multimedia services with the necessary parameters. А numerical analysis is carried out and a graphical dependence of the maximum network throughput on the total number software and hardware systems for a given system load factor is built.
Stochastic Assessment of the Development of the Epidemic in Local Population Clusters
Authors:   Moscow, Fedosov V. V. , Fedosova A. V. ,   National University, Bogota, Colombia (Universidad Nacional de Colombia), Buitrago O. ,   Military University of New Granada, Bogota, Colombia (Universidad Militar Nueva Granada)
Published: August 2021

A mathematical model is proposed for stochastic assessment of the intensity of infection with highly active viruses in places with a high concentration of the population — closed (shopping and sports centers) or open (celebrations, rallies) spaces. Using a heuristic algorithm, the number of infected people is calculated depending on the observance or violation of the selected parameters: safe distances, personal immunity and protection standards. The initial conditions contain the total number of individuals in the clusters, the initial number of virus carriers, and the size of the space. Dispositions are introduced into the model that simulate the dynamics of changes in the coordinates of individuals in clusters. Programming, numerical experiments and graphics are done in MATLAB. A sharp jump was found in the number of those who had been initiated in case of non-observance of social distancing and frequent change of dispositions. The algorithm by fairly simple means allows you to quickly assess situations that are classified as poorly predictable. Introduces control elements into the complex problem of the development of an epidemic in local population clusters. The model is open to additions and improvements and may be of interest to support decision-making by healthcare or administrative authorities.
Etiology of acute intestinal infections of viral character in the Altai territory
Authors: Nikonorova Marina A. , Karbysheva Nina V. , Shevtsova Ekaterina A. , Beskhlebova Olga V.
Published: August 2021

BACKGROUND: The Incidence of acute intestinal infections (AII) is generally maintained at a high level. Significant progress made in the field of laboratory diagnostics allowed us to proceed to a detailed study of the etiological structure of AII, and as a result, it was found that in recent years the role of pathogens of a viral nature has significantly increased, but a detailed study of the characteristics of these infections requires further research. AIMS: To study the structure and clinical and laboratory features of intestinal infections of viral etiology in adult hospitalized patients in the Altai Territory. MATERIAL AND METHODS: From 2017 to 2020, a single-stage study was conducted of 67 patients of an infectious hospital with AII of viral etiology, aged from 18 to 76 years, hospitalized in the infectious departments of the City Hospital No. 5, Barnaul. In order to determine the structure of AII, the polymerase chain reaction (PCR) method with hybridization-fluorescence detection AmpliSens AII screen-FL, bacteriological and serological methods were used. Taking into account the results of laboratory examination (molecular-genetic, bacteriological and serological), all patients were divided into 3 groups: group 1 ― 45 patients with viral monoinfection (67.2%), group 2 ― 9 patients with viral mixed infection (13.4%) and group 3 ― 13 patients with combined viral ― bacterial etiology (19.4%). Data processing and graphical representation were performed using computer programs Statistica 10.0 (Russian version) (Russia), Excel 2010 (Windows 10). RESULTS: As a result of the study, it was found that among the AII of viral etiology, 67.2% had monoviral AII and 32.8% had mixed AII-mixed viral (13.4%) and viral-bacterial etiology (19.4%). Among monoviral AII dominated norovirus infection (in 52,9%). Noted that the differences of clinical and laboratory parameters of the monoviral and mixed-viral infections have not been found, and there were no differences in groups of monoviral infections: rotavirus, adenovirus and norovirus, which is consistent with earlier data. As well as co-infection of salmonellosis, in combination with one and/or several viruses, more often occurred with febrile syndrome, watery diarrhea and abdominal pain. CONCLUSION: Thus, in adult patients in the conditions of an infectious hospital, mono-and mixed-virus infection (in combination with two or more viruses or bacteria) was detected in the structure of viral AII by PCR. There was no statistically significant difference in clinical and laboratory parameters in the study groups due to the insufficient sample size and the feasibility of conducting further studies using a similar protocol with a larger number of patients.
Transarterial chemoembolization using drug-eluting bead compared with radiofrequency ablation for treatment of single small hepatocellular carcinoma: a pilot non-randomized trial
Authors: Kim Tae Hoon , Kim Na Hye , Kim Jin Dong , Kim Young Nam , Kim Yu Jin , Kim Eun Jung , Yoo Ki Deok , Ryu Choong Heon , Song Ha Hun , Kim Hyun
Published: August 2021

Background/Aims: Surgical resection, transplantation, and radiofrequency ablation (RFA) are generally accepted as amenable treatments for small hepatocellular carcinoma (HCC). Recently drug-eluting beads (DEB) which had several treatment advantages were introduced for transarterial chemoembolization (TACE). The aim of this study was to evaluate feasibility and safety of DEB-TACE compared with RFA for the treatment of single small HCC.Methods: In this pilot non-randomized trial, we assessed retrospective data of 40 patients who underwent DEB-TACE (n=21) or RFA (n=19) for single small (≤3 centimeter in greatest dimension) HCC. The primary outcomes were tumor response and time to recurrence. The secondary outcome was treatment-related complications.Results: Complete response rate to DEB-TACE and RFA after first follow-up assessment was 90.5% and 94.7%, respectively (P=1.000). During mean follow-up of 87.6 months (95% confidence interval: 74.4-102), 7 patients experienced local recurrence. The 6- and 12-month cumulative local recurrence rate was 5.0% and 21.8% in DEB-TACE vs. 11.1% and 17.0% in RFA group (P=0.877). A total 14 distant intrahepatic recurrences were developed and 12- and 24-month cumulative distant intrahepatic recurrence rate was 20.6% and 42.7% in DEBTACE vs. 17.2% and 36.3% in RFA group (P=0.844). Two patients experienced gangrenous cholecystitis after DEB-TACE requiring cholecystectomy as treatment-related adverse event.Conclusions: Tumor response and recurrence rate after single session of DEB-TACE or RFA were similar. DEB-TACE could be applied selectively in patients with a single small HCC if the other therapeutic modality is unfeasible.
The advent of elastic stable intramedullary nailing for the treatment of long bone fractures in skeletally immature patients
Authors:   Vittore Buzzi Children’s Hospital, Milano, Italy, Andreacchio A. , Alberghina F. ,   Regina Margherita Children’s Hospital, University of Torino, Torino, Italy, Canavese F. ,   Lille University Center, Jeanne de Flandre Hospital, Nord-de-France University, Lille, France
Published: August 2021

Introduction Management of pediatric long bones fractures is a complex and rapidly evolving field. Traditionally, casting and conservative techniques played a key-role in the management of fractures in skeletally immature patients. However, the surgical approach has evolved steadily over the past four decades or so and increasing evidence has been published supporting the advantages of fixation techniques over conservative methods. The purpose of this narrative review is to outline how innovations in orthopedic surgery have changed the rationale of treating long bones fractures in children and adolescents with focus on surgical techniques, particularly elastic stable intramedullary nailing (ESIN). Material and methods We aimed to describe the main trends in pediatric long bones fractures management and to identify its specificities and difficulties as well as the best standard of care. Results The introduction of ESIN has profoundly influenced the management of pediatric upper and lower extremity fractures. Overall, in comparison to conservative techniques, advantages of ESIN include minimally invasiveness, short hospital stay, primary bone union, early mobilization and progressive weight bearing, and good outcome with low complication rate. Moreover, the flexible nail can be used as a closed reduction tool itself. Conclusions Irrespective of the technique performed, the key-concepts remain 1) the proper understanding of the injury to treat; 2) the identification the main characteristics of the patient; 3) the pros and cons of each technique; and 4) the potential complications.
Use of flexible nails in children diaphyseal fractures. Five questions and answers
Authors:   University of Nancy, France, Lascombes P. ,   Geneva University Hospitals, Geneva, Switzerland, Journeau P. ,   Children hospital, Nancy, France, Popkov D.A. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation
Published: August 2021

Introduction More than 40 years after the launch of elastic stable intramedullary nailing (ESIN) as a golden standard of the treatment of some fractures in children and adolescents. Material and methods This review is based on answers to five essential questions: The position of ESIN compared with other methods of treatment; The choice of the implants; The indications for ESIN today; How to avoid complications as much as possible? Do we remove the implants or not? Results The aspects of biomechanics, design, indications for ESIN in comparison to other treatment, surgical techniques depending on fractured bones, complications are presented in the article. Conclusion ESIN is an excellent method to fix long bone fractures in children and adolescents. Top one is definitively the fractures of both bones of the forearm, then the diaphyseal fractures of the femur and the tibia before the age to be eligible for a locking nail. However, some unstable fractures cannot be treated conservatively or with a locking nail, and an ESIN remains unstable. In these cases, we are allowed to propose to add an external fixator for 4 to 6 weeks, waiting for a good stabilisation of the fracture.
Knee meniscus suturing techniques in children and indications for their use
Authors:   Mozorov Children's Clinical Hospital, Moscow, Russian Federation, Pavlova D.D. , Sharkov S.M. ,   Mozorov Children's Clinical Hospital, Moscow, Russian Federation,   Sechenov First Moscow State Medical University, Moscow, Russian Federation, Petrov M.A. ,   Pirogov Russian National Research Medical University, Moscow, Russian Federation
Published: August 2021

Relevance The problem of meniscus injuries in children has acquired a particular relevance. The growth in their incidence has been caused not only by an active sports- and lifestyle of pediatric patients but also by improved diagnosis due to magnetic resonance and arthroscopic techniques. Aim To formulate indications for the use of various methods of meniscus suturing in children and to evaluate the results of treatment of meniscus injuries in children, depending on the location of the tears. Materials and methods Our study included 74 patients who underwent meniscus suturing from March 2018 to December 2020. The age of the children ranged from 10 to 17 years. Time since the injury ranged from one day to 3 years. Before surgery, they underwent instrumental examination; knee joint radiography was performed in all patients, knee MRI was performed in 66 patients. Results Meniscus sutures were evaluated clinically and instrumentally at 6 months after the operation (MRI). One year after the meniscus repair, X-rays of the knee were taken to assess osteoarthritis. There was no pain after surgery in 68 children (91.9 %). There were no blocks of the knee joint after surgery in all children. Full recovery of the range of motion in the knee joint was observed in 69 children (93.2 %). Complications were noted in five children. Conclusion Poor results after meniscectomy has led to the emergence of several methods that allow meniscus repair and avoid meniscectomy that impairs knee functions. In children, the potential for restoration of menisci after their reconstruction is higher than in adults. It is possible to repair lesions not only in the white zone but after periods of more than three months since the injury. The choice of the meniscus suture technique used is determined by the location of the tear, taking into account possible complications. The use of a combination of methods allows reconstruction of the damaged meniscus regardless of the location of the tear and the complexity of the injury. Good clinical results, absence of complaints and return to usual physical activities in the immediate postoperative period should be regarded as positive outcomes subjected to further study.
Reconstructive surgery in recurrent deformity (clubfoot relapse)
Authors:   University of Nancy, France, Lascombes P. ,   Geneva University Hospitals, Geneva, Switzerland, Popkov D.A. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation, Leonchuk S.S. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation
Published: August 2021

Introduction Recurrent clubfoot deformity may be due to either an imperfect initial correction, or a natural history of a severe disease. In the later, idiopathic clubfoot is uncommon. In the review we describe reconstructive surgery in recurrent deformity of idiopathic clubfoot. Material and methods Surgery may be justified at different age and according to the type of deformity. Different surgical approaches and their indications are exposed in the article. Results After Ponseti’s method application additional surgeries may be considered in recurrent clubfoot deformity which may represent 10 to 20 % of cases: second Achilles tenotomy, postero-lateral relapse, complete antero-medial and postero-lateral relapse, transfer of the anterior tibial tendon, correction of sequelae: metatarsus varus, residual equinus, residual rotation of the calcaneopedal unit. Conclusion Idiopathic equine varus clubfoot is a frequent condition. Well-codified management should lead to extremely favorable functional results. Unfortunately, some cases lead to a recurrence of the deformity. Surgical procedures are sometimes required. The goal is to avoid as much as possible arthrodesis and secondary degenerative arthritis.
Chondromas and multiple enchondromatosis
Authors:   University of Nancy, France, Lascombes P. ,   Geneva University Hospitals, Geneva, Switzerland, Mainard-Simard L. ,   Paediatric Radiology, Hôpital d'Enfants, CHU de Nancy, Vandoeuvre les Nancy, France
Published: August 2021

Introduction The chondromas are a cartilaginous proliferation of mature appearance and moderate size, reason why these tumors are regarded more like hamartomas than real benign tumor. Chondromas represent 10 to 12 % of benign bone tumors. Any bone of an enchondral ossification may be involved. Several bones can be involved, and the disease is called “chondromatosis”. In the review we describe clinical and radiological findings of this pathology as well as indications for reconstructive surgery. Material and methods The review is dedicated to isolated chondromas, periosteal and extraskeletal chondromas, chondromatosis. Results The aspects of epidemiology, clinical presentation, radiology, MRI, prognosis, indications and methods of surgical treatment have been described in the article for each types of chondroma and enchondromatosis. Conclusion Chondromas are benign bone tumors which may be responsible of pathologic fractures. Their surgical treatment consists in curettage and bone grafting or bone-cement filling with or without osteosynthesis. Multiple enchondromatosis should be considered as an osteochondrodysplasia. Its treatment is not the treatment of the multiple chondromas themselves, but of the bone deformities and length discrepancy induced by the disorder. The transformation of some tumors in chondrosarcomas in adolescence or adulthood needs a strict follow up of these patients.
Musculoskeletal anomalies in children with Mucopolysaccaridoses
Authors:   CHU de Nancy, Hôpital d’enfants de Brabois, Nancy, France, Müller F. , Alomar K. ,   CHU de Nancy, Hôpital d’enfants de Brabois, Nancy, France, Journeau P. ,   CHU de Nancy, Hôpital d’enfants de Brabois, Nancy, France
Published: August 2021

Introduction The accumulation of glycosaminoglycan (GAGs) in the tissues in Mucopolysaccharidoses (MPS) can lead to skeletal anomalies (DYSOSTOSIS MULTIPLEX) and to soft tissue impairments (neural or medullar compression, joint stiffness, tenosynovitis). Here is a review of orthopedic issues frequently encountered in patients with MPS. Material and methods Surgery may be justified at different age and according to the type of MPS. Different surgical approaches and their indications are exposed in the article. Results The article exposes indications and techniques for orthopedic issues in MPS children: cervical stenosis, cervical instability, kyphosis, hip dysplasia and hip dislocation, genu valgum. Conclusion Various musculoskeletal anomalies can be found in patients with mucopolysaccharidoses. Neurological impairments are frequently seen due to cervical stenosis or instability and should be early detected with regular MRI of the cervical spine. Well-codified management should lead to favorable functional results and maintain functional and walking abilities.
Treatment of idiopathic increased femoral anteversion in children and adolescents – a perspective
Authors:   University of Oslo, Norway, Horn J. ,   Oslo University Hospital, Oslo, Norway
Published: August 2021

Rotational problems of the lower extremities affect a vast number of infants and children, whereas increased femoral anteversion (inward rotation) is the most frequent cause of intoeing in school-aged children. Femoral anteversion is defined by the angle of the femoral neck in relation to the femoral shaft in the coronal plane, whereas the degree of anteversion is greatest in infancy and gradually decreases towards skeletal maturity in most children. In about 15 % of all children increased femoral anteversion persists into adulthood. In cases of excessive anteversion gait problems, hip and/or knee pain are common. Derotational osteotomy of the femur is an established treatment for the condition. However, there is a lack of knowledge and clear evidence when to perform surgery and how this affects function and pain in these patients. The current paper is not based on a complete literature review and, therefore, does not fulfill the criteria of a review article. However, the article is based on the authors’ in-depth knowledge and a rapid review of the literature, and it can be defined as a scholarly article providing a perspective on the condition.
Multilevel orthopaedic surgery in children with spastic cerebral palsy
Authors:   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation, Popkov D.A. , Chibirov G.M. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation, Kozhevnikov V.V. ,   Federal Center for Traumatology, Orthopedics and Endoprosthetics, Barnaul, Russian Federation, Gvozdev N.S. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation
Published: August 2021

Introduction The purpose of the article was to review the modern literature on the role of multilevel single-stage interventions in the surgery of secondary orthopaedic complications in children with cerebral palsy. Material and methods The review was done using the databases of the current sources of scientific information including PubMed, Scopus, ResearchGate, RSCI and Elsevier, Springer publishing products. A report made for the first educational meeting of the European Pediatric Orthopaedic Society held in Russia at the Ilizarov Center in 2021 was used for the contribution. Results and discussion The article discusses terminology, indications, particular techniques and early postoperative period, long-term outcomes of multilevel orthopaedic interventions and aspects of iatrogenic orthopaedic conditions in children with cerebral palsy. Conclusion Multilevel intervention is the surgical procedure of choice for the correction of secondary orthopaedic complications in patients with cerebral palsy. The success of the surgery would depend on adequately identified indications and quantitative values of the correction to be performed on the basis of 3D gait analysis, the compliance with specific technical requirements for the procedure and an early rehabilitation program. The strategy of multilevel interventions suggests the greatest possible reduction in the number of orthopaedic surgeries and can be considered successful if the patient undergoes a maximum of two multilevel reconstructive interventions in the childhood.
The results of the survey among the parents of patients with achondroplasia on the role of vosoritide therapy
Authors:   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation, Popkov D.A. , Nesterova Ju.V. ,   Russian Association of Dwarfism, Moscow, Russian Federation, Aranovich A.M. ,   Ilizarov National Medical Research Centre for Traumatology and Orthopedics, Kurgan, Russian Federation
Published: August 2021

Introduction Achondroplasia (ACP) is a common skeletal dysplasia. Vozoritide is the first drug that has an effect on the pathogenesis of impaired enchondral growth in achondroplasia. Clinical trials of the second and third phases have shown its effectiveness according to the latest literature data presented. After providing scientifically grounded information, a questionnaire was completed by parents of children with ACP to have their opinion before the introduction of the drug into medical practice. Materials and methods The survey was conducted on June 21-24, 2021 at the Ilizarov Center supported by the patient’s organization Small People Support Center for Patients with Achondroplasia and Other Bone Dysplasias and Their Families. The questionnaire included 5 questions, compiled by the first author of this study. 65 completed questionnaires were received for the analysis. Results and discussion The overwhelming majority of parents have confidence in the use of vozoritide as a means of achieving targeted growth which may allow to avoid surgical treatment. However, the parallel use of this drug and surgical treatment for incomplete growth of a child is not excluded if the growth graphs show that the required parameters have not been achieved by the time the growth zones are closed. Despite the fact that at present only the influence of vozoritide on the growth of a child with ACP has been reliably proven, parents feel confident with the information about the possible effect of the drug on other problems associated with impaired enchondral growth, and are ready to start therapy at an earlier age and for a longer period. Parents do not oppose the pharmacological treatment to surgical treatment. Vozoritide is seen as the main component of treatment, and surgery as a complementary one that follows (if necessary). This reasonable combination increases the parents' confidence in the predicted favorable treatment outcome.
Perceptions regarding an ‘effective medical teacher’ among undergraduate students of a medical college in Puducherry
Authors: Arumugam Arulkavi , Anandan Velavan , Purty Anil J.
Published: August 2021

Background: To find the characteristics of an effective medical teacher, as perceived by the under graduate medical students who are at different stages of the MBBS course.Methods: A cross sectional study was done among all the undergraduate medical students studying in a medical college and hospital in Puducherry. The undergraduate students were visited in batches and students were explained regarding objectives and those who consented for the study were administered with a validated and pretested questionnaire in line with the objective of the study. The results are expressed in the form of proportions and percentages and the chi-square-test was used to test the significance of difference observed between different batches of studentResults: The most important qualities perceived by the students for being an effective medical teacher are creating interest in the subject, having good communication skills, providing good resource material, inspiring and motivating students, being easily approachable, respecting students/ patients / other staff, being enthusiastic, energetic and good listener. There is a significant difference in the perceived importance among different batch of students in the domain of teaching skills of a medical teacherConclusions: This study identified qualities of medical teachers related to their teaching skills, usage of teaching learning methods, approach towards students and their personal qualities that are perceived to be more important by medical students.