bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing different doses of dexmedetomidine in attenuating extubation response in chronic smokers undergoing total extraperitoneal laparoscopic inguinal hernia repair: a randomized prospective study
Authors: Singha Dheeraj , Thakur Aman , Guleria Aryan , Chaudhary Vivek , Singh Jai , Sharma Abhishek
Published: September 2022

Background

During the process of emergence from general anesthesia, tracheal extubation is a very critical step. Tracheal extubation is not just a reversal of intubation, as during extubation we encounter a change of state from controlled conditions to an uncontrolled environment. We have aimed our study at evaluating the attenuating effect on the extubation response using three different doses of dexmedetomidine on patients who are smokers and undergoing total extraperitoneal laparoscopic inguinal hernia repair under general anesthesia. This randomized, controlled, triple-blinded study included 90 smokers aged between 40 and 60 years. These patients were randomized to receive dexmedetomidine 0.5 μg/kg (group A), 0.75 μg/kg (group B), and 1 μg/kg (group C) prepared as a 10 ml infusion started 10 min before patients were extubated. Extubation quality, hemodynamic changes, oxygen saturation, sedation, and postoperative complications were evaluated.

Results

The extubation quality became better, sedation and incidence of bradycardia in the post-operative period increased with a higher dose of dexmedetomidine. Attenuation of hemodynamic parameters was observed after 4 min of starting infusion and during extubation in each group and was found to be significant (P < 0.001).

Conclusions

It was concluded that dexmedetomidine when used at a dose of 0.75 μg/kg provided excellent extubation conditions with stable hemodynamic parameters in chronic smokers with minimal sedation and no other adverse effects.
Semi-quantitative analysis of cannabinoids in hemp (Cannabis sativa L.) using gas chromatography coupled to mass spectrometry
Authors: De Prato Luca , Timmins Matthew , Ansari Omid , Ruthrof Katinka X. , Hardy Giles E. St. J. , Howieson John , O’Hara Graham
Published: September 2022

Background

Hemp (Cannabis sativa L.) is a producer of cannabinoids. These organic compounds are of increasing interest due to their potential applications in the medicinal field. Advances in analytical methods of identifying and quantifying these molecules are needed.

Method

This study describes a new method of cannabinoid separation from plant material using gas chromatography-mass spectrometry (GC-MS) as the analytical tool to detect low abundance cannabinoids that will likely have implications for future therapeutical treatments. A novel approach was adopted to separate trichomes from plant material to analyse cannabinoids of low abundance not observed in raw plant extract. Required plant sample used for analysis was greatly reduced compared to other methods. Derivatisation method was simplified and deconvolution software was utilised to recognise unknown cannabinoid compounds of low abundance.

Results

The method produces well-separated spectra and allows the detection of major and minor cannabinoids. Ten cannabinoids that had available standards could be identified and quantified and numerous unidentified cannabinoids or pathway intermediates based on GC-MS spectra similarities could be extracted and analysed simultaneously with this method.

Conclusions

This is a rapid novel extraction and analytical method from plant material that can identify major and minor cannabinoids using a simple technique. The method will be of use to future researchers seeking to study the multitude of cannabinoids whose values are currently not understood.
Perception, awareness, and attitude toward digital dentistry among pre-dental students: an observational survey
Authors: Sharab Lina , Adel Mohamed , Abualsoud Rahaf , Hall Brandi , Albaree Suheil , de Leeuw Reny , Kutkut Ahmad
Published: September 2022

Background

Pre-dental students’ perception and awareness about current technology in dentistry can influence their motivation and maturity during the learning experience and affect their dental education outcome. This observational survey aimed to examine pre-dental student's cognitive and behavioral traits as perception measures toward digital dentistry. The survey covered areas that the authors believed to impact dental education and future investments in institutional decision making. The survey was distributed over all pre-dental students representing two US dental schools in the state of Kentucky. The survey included four main categories: (1) career vision, (2) perception of digital dentistry, (3) prior knowledge of digital dentistry, and (4) personal intelligence.

Results

The feedback was positive toward the future use of digital dentistry. The findings are discussed in light of the implications of pre-dental students' perception to support teaching and learning in dental education.

Conclusions

Despite the expected enthusiasm of pre-dental students toward digital technology, the results highlight the need to emphasize structured self-learning, self-evaluation, and a deeper understanding of research within the dental curricula.
On solution and perturbation estimates for the nonlinear matrix equation $$X-A^{*}e^{X}A=I$$
Authors: Chacha Chacha S.
Published: September 2022

This work incorporates an efficient inversion free iterative scheme into Newton’s method to solve Newton’s step regardless of the singularity of the Fr$${\acute{\text {e}}}$$

e
´

chet derivative. The proposed iterative scheme is constructed by extending the idea of the foundational form of the conjugate gradient method. Moreover, the resulting scheme is refined and employed to obtain a symmetric solution of the nonlinear matrix equation  $$X-A^{*}e^{X}A=I.$$

X
-

A

∗

e
X

A
=
I
.

Furthermore, explicit expressions for the perturbation and residual bound estimates of the approximate positive definite solution are derived. Finally, five numerical case studies provided confirm both the preciseness of theoretical results and the effectiveness of the propounded iterative method.
Exercise training and cardiac autonomic function following coronary artery bypass grafting: a systematic review and meta-analysis
Authors: Kushwaha Purnima , Moiz Jamal Ali , Mujaddadi Aqsa
Published: September 2022

Background

Exercise training improves cardiac autonomic function is still debatable in patients with coronary artery bypass grafting (CABG). The aim of the present review is to assess the effect of exercise on CABG patient’s heart rate variability (HRV) and heart rate recovery (HRR) parameters.

Main body

Databases (PubMed, Web of Science and PEDro) were accessed for systematic search from inception till May 2022. Eleven potential studies were qualitatively analyzed by using PEDro and eight studies were included in the quantitative synthesis. Meta-analysis was conducted by using a random-effect model, inverse-variance approach through which standardized mean differences (SMDs) were estimated. The analysis of pooled data showed that exercise training improved HRV indices of standard deviation of the R–R intervals (SDNN) [SMD 0.44, 95% CI 0.17, 0.71,p = 0.002], square root of the mean squared differences between adjacent R–R intervals (RMSSD) [SMD 0.68, 95% CI 0.28, 1.08,p = 0.0008], high frequency (HF) [SMD 0.58, 95% CI 0.18, 0.98,p = 0.005] and low frequency-to-high frequency (LF/HF) ratio [SMD − 0.34, 95% CI − 0.65, − 0.02,p = 0.03].

Conclusions

Exercise training enhances cardiac autonomic function in CABG patients. Owing to the methodological inconsistencies in assessing HRV, the precise effect on autonomic function still remains conflicted. Future high-quality trials are needed focusing on precise methodological approach and incorporation of various types of exercise training interventions will give clarity regarding autonomic adaptations post-exercise training in CABG.

Trial registrationCRD42021230270, February 19, 2021.
Presence of peritumoral edema on T2w MRI: a poor non-invasive prognostic marker in breast cancer patients
Authors: Kushvaha Suchana , Renganathan Rupa
Published: September 2022

Background

The purpose of the study was to assess the correlation between peritumoral edema (PE) seen on magnetic resonance imaging (MRI) in breast cancer and the established pathological prognostic factors like tumor histology and molecular subtype, grade, Ki67 index, lymphovascular invasion (LVI) and nodal stage. The breast MRI and pathological data of post-surgery specimen of 126 breast cancer patients over a period of 18 months were retrospectively studied. Those who received neoadjuvant therapy, had non-invasive, locally advanced, inflammatory and bilateral breast cancers were excluded. Patients were divided into two groups based on finding of peritumoral edema on T2w MRI images: Group A with PE (n = 88) and Group B without PE (n = 38). Pathological results for the two groups were analyzed and compared using Chi square test. p values of < .05 were considered as significant.

Results

Statistically significant correlation was found between the PE and molecular subtype (p value of < .01), high grade (p value of .001) and High Ki-67 index (p value of .001). No significant correlation was present for the histological type and LVI pathological nodal stage (pN).

Conclusions

We concluded that presence of PE on MRI is associated with poor pathological prognostic factors in breast cancer. It can serve as an additional non-invasive marker to assess prognosis in breast cancer patients especially in those receiving neoadjuvant therapy where the whole tumor may not be available for pathological analysis post-therapy.
Kinetic study in the extraction of xanthones from Securidaca longepedunculata roots by microwave-assisted-extraction
Authors: Djiobie Tchienou Gertrude Eléonore , Tsatsop Tsague Roli Karole , Dongmo Sokeng Séléstin , Ngassoum Martin Benoît
Published: September 2022

Background

Extraction of active compounds from plants using microwave can be utilized as an alternative solution for conventional extraction. To well understand this technology, the study of the modelization and kinetics mechanism of the extraction method is necessary. This study aimed to evaluate the suitable kinetics models for MAE of the Xanthones from Securidaca longepedunculata Fresen roots.

Results

The experimental data (xanthones versus time, power and ratio, respectively) were fitted to three-parameter empirical kinetics models. The second-order models appear to be the best fit to explain kinetics study of MAE than the first model. The second-order model was acceptable, with elevated value of the correlation coefficient (R2 = 0.9861), showing that it perfectly relates the process.

Conclusion

Based on the results obtained, the extraction of xanthones from roots of S. longepedunculata is done successively in two steps, washing and diffusion of compounds from matrices as described by second-order kinetics model. The latter could report the kinetics model of extraction process from S. longepedunculata Fresen using microwave technology.
Role of nuclear factor kappa B, interleukin-19, interleukin-34, and interleukin-37 expression in diabetic nephropathy
Authors: Esam Doaa , Abdel-Moneim Adel , Mahmoud Basant , Abdel-Gabbar Mohamed
Published: September 2022

Background

The long-term effects of diabetes mellitus (DM) can impair several organs, including the kidney, resulting in serious health problems. Diabetic nephropathy (DN), a primary contributor in end-stage renal failure worldwide, affects 20–30% of patients with type 2 DM (T2DM). This study was designed to assess the contribution of nuclear factor kappa B (NF-κB) and interleukin (IL)-6, IL-19, IL-34, and IL-37 in the development of DN.

Methods

The study included 160 participants, of which 130 were allocated into the patients with diabetes group, patients with chronic kidney disease (CKD), and patients with diabetic chronic kidney disease (DCKD), and 30 were healthy controls.

Results

The obtained data revealed a significant (p < 0.05) increase in IL-19, IL-34, and NF-κB mRNA expression and serum IL-6 levels in patient groups (CKD and DCKD) compared with the healthy control group, whereas IL-19, IL-34, and NF-κB mRNA expression showed a marked elevation in the DCKD group when compared with patients with CKD. Conversely, IL-37 mRNA expression and serum superoxide dismutase (SOD) activity were significantly (p < 0.05) decreased in both groups relative to the healthy controls, whereas the decrease was markedly higher in the DCKD group when compared with the CKD group.

Conclusion

The obtained results could indicate the potential implication of NF-κB, IL-19, IL-34, and IL-6 levels, along with the decrease in IL-37 expression and serum SOD activity, in the pathophysiology of kidney disease in diabetes. Moreover, designing drugs targeting these cytokines and/or their signal pathways may prevent or alleviate the progression of kidney disease.
Outcomes for Children With Type II and Type III Pleuropulmonary Blastoma Following Chemotherapy: A Report From the International PPB/DICER1 Registry
Authors: Schultz Kris Ann P. , Harris Anne K. , Nelson Alexander T. , Watson Dave , Lucas John T. , Miniati Doug , Stewart Douglas R. , Hagedorn Kelly N. , Mize William , Kamihara Junne , Mitchell Sarah G. , Wilson David B. , Gettinger Katie , Rangaswami Arun A. , Harney Laura A. , Rodriguez Galindo Carlos , Bisogno Gianni , Dehner Louis P. , Hill D. Ashley , Messinger Yoav H.
Published: September 2022

PURPOSE

Pleuropulmonary blastoma (PPB) is the most common primary lung neoplasm of infancy and early childhood. Type II and type III PPB have historically been associated with a poor prognosis.

METHODS

Patients with known or suspected PPB were enrolled in the International PPB/ DICER1 Registry. Medical records were abstracted with follow-up ascertained annually. All PPB diagnoses were confirmed by central pathology review. Beginning in 2007, the IVADo regimen (ifosfamide, vincristine, actinomycin-D, and doxorubicin) was recommended as a potential treatment regimen for children with type II and type III PPB. This regimen was compared with a historical control cohort.

RESULTS

From 1987 to 2021, 314 children with centrally confirmed type II and type III PPB who received upfront chemotherapy were enrolled; 132 children (75 with type II and 57 with type III) received IVADo chemotherapy. Adjusted analyses suggest improved overall survival for children treated with IVADo in comparison with historical controls with an estimated hazard ratio of 0.65 (95% CI, 0.39 to 1.08). Compared with localized disease, distant metastasis at diagnosis was associated with worse PPB event-free survival and overall survival with hazard ratio of 4.23 (95% CI, 2.42 to 7.38) and 4.69 (95% CI, 2.50 to 8.80), respectively.

CONCLUSION

The use of IVADo in children with type II and type III PPB resulted in similar-to-improved outcomes compared with historical controls. Inferior outcomes with metastatic disease suggest the need for novel therapies. This large cohort of uniformly treated children with advanced PPB serves as a benchmark for future multicenter therapeutic studies for this rare pediatric tumor.
Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly—A Prospective Study
Authors: Ilie Mirela-Diana , Tabarin Antoine , Vasiljevic Alexandre , Bonneville Jean-François , Moreau-Grangé Lucile , Schillo Franck , Delemer Brigitte , Barlier Anne , Figarella-Branger Dominique , Bisot-Locard Ségolène , Santos Alexandre , Chanson Philippe , Raverot Gérald
Published: September 2022

Context

Somatostatin receptor ligands (SRLs) are the cornerstone medical treatments for acromegaly; however, many patients remain unresponsive to SRLs. Well-established predictive markers of response are needed.

Objective

We aimed to explore the relationship between responsiveness to SRLs relative to somatostatin (SST)2A and 5 receptor expression, adenoma granularity, and T2-weighted magnetic resonance imaging (MRI) signal intensity (T2WSI).

Methods

We conducted a multicentric, prospective, observational cohort study, in France. Forty-nine naïve patients (ie, patients without preoperative SRL treatment) with active acromegaly following surgery were treated with octreotide (group 1; n = 47), or pasireotide if uncontrolled under first-generation SRLs (group 2; n = 9). Data were collected at baseline and months 3 and 6. Biochemical measurements, immunohistochemistry studies, and MRI readings were centralized.

Results

In group 1, IGF-I decrease from baseline to month 6 positively correlated with SST2A immunoreactive score (IRS), P = 0.01. Densely granulated/intermediate adenomas had a greater IGF-I and GH decrease under octreotide compared with sparsely granulated adenomas (P = 0.02 and P = 0.006, respectively), and expressed greater levels of SST2A (P < 0.001), coupled with lower levels of SST5 (P = 0.004). T2WSI changed between preoperative MRI and month 6 MRI in one-half of the patients. Finally, SST5 IRS was higher in preoperative hyperintense compared with preoperative hypointense adenomas (P = 0.04), and most sparsely granulated and most hyperintense adenomas expressed high SST5 levels.

Conclusion

We prospectively confirm that SST2A and adenoma granularity are good predictors of response to octreotide. We propose the IRS for scoring system harmonization. MRI sequences must be optimized to be able to use the T2WSI as a predictor of treatment response.
Hospitalized Patients With COVID-19 Have Higher Plasma Aldosterone-Renin Ratio and Lower ACE Activity Than Controls
Authors: Parikh Nisha I , Arowolo Folagbayi , Durstenfeld Matthew S , Nah Gregory , Njoroge Joyce , Vittinghoff Eric , Long Carlin S , Ganz Peter , Pearce David , Hsue Priscilla , Wu Alan H S , Hajizadeh Negin , Liu Kathleen D , Lynch Kara L
Published: September 2022

Context

SARS-CoV-2 infects cells via the angiotensin converting enzyme 2 (ACE2) receptor, whose downstream effects “counterbalance” the classical renin angiotensin aldosterone system (RAAS).

Objective

We aimed to determine to what extent circulating RAAS biomarker levels differ in persons with and without COVID-19 throughout the disease course.

Methods

We measured classical (renin, aldosterone, aldosterone/renin ratio [ARR], Ang2, ACE activity) and nonclassical (ACE2, Ang1,7) RAAS biomarkers in hospitalized COVID-19 patients vs SARS-CoV-2 negative controls. We compared biomarker levels in cases with contemporaneous samples from control patients with upper respiratory symptoms and a negative SARS-CoV-2 PCR test. To assess RAAS biomarker changes during the course of COVID-19 hospitalization, we studied cases at 2 different times points ∼ 12 days apart. We employed age- and sex-adjusted generalized linear models and paired/unpaired t tests.

Results

Mean age was 51 years for both cases (31% women) and controls (50% women). ARR was higher in the first sample among hospitalized COVID-19 patients vs controls (P = 0.02). ACE activity was lower among cases at their first sample vs controls (P = <0.001). ACE2 activity, Ang 1,7, and Ang2 did not differ at the 2 COVID-19 case time points and they did not differ in COVID-19 cases vs controls. Additional adjustment for body mass index (BMI) did not change our findings.

Conclusions

High ARR, independent of BMI, may be a risk marker for COVID-19 hospitalization. Serum ACE activity was lower in patients with COVID-19 vs controls at the beginning of their hospitalization and then increased to similar levels as controls, possibly due to lung injury, which improved with inpatient disease management.
Age-Stratified Propofol Dosage for Pediatric Procedural Sedation and Analgesia
Authors: van Dijk Huib , Hendriks Mark P. , van Eck-Smaling Marga M. , van Wolfswinkel Leo , van Loon Kim
Published: September 2022

Background:

Procedural sedation and analgesia (PSA) for diagnostic and minimally invasive therapeutic procedures has become common practice in children of all ages. Based on our clinical experience, we suspected an inverse relation between age and dosage. However, a schedule for age-stratified propofol induction and maintenance dosage for PSA was not available and could be helpful to many anesthesiologists as a reference.

Methods:

We performed a retrospective cohort study of children who received procedural sedation at the Wilhelmina Children’s Hospital (WKZ), a tertiary pediatric hospital part of the University Medical Center Utrecht (UMCU), between June 2007 and December 2020. We studied whether the induction (mg·kg−1) and maintenance (mg·kg−1·h−1) dosage is age-dependent using linear regression models.

Results:

A total of 6438 pediatric procedures were retrieved from Anesthesia Information Management Systems (AIMS). A total of 5567 records were available for induction dose analysis and 5420 records for analysis of the maintenance dose. After adjustment for sex, American Society of Anesthesiologists (ASA) physical status classification, opioid administration, and diagnostic or interventional, we obtained a coefficient of −0.11 (95% confidence interval [CI], −0.12 to −0.11) for age (years) from a multivariable linear regression model for propofol induction dosage (mg·kg−1) and a coefficient of −0.36 (95% CI, −0.39 to −0.34) for age (years) for propofol maintenance dosage.

Conclusions:

We found a noteworthy inverse age-effect on propofol dosage for both induction and maintenance of pediatric procedural sedation. Furthermore, our study revealed that remarkably higher propofol sedation doses were needed for infants and toddlers than previously expected and reported.
Hypobaric Unilateral Spinal Anesthesia Versus General Anesthesia for Hip Fracture Surgery in the Elderly: A Randomized Controlled Trial
Authors: Simonin Marine , Delsuc Claire , Meuret Pascal , Caruso Liana , Deleat-Besson Robert , Lamblin Antoine , Huriaux Laetitia , Abraham Paul , Bidon Cyril , Giai Joris , Riche Benjamin , Rimmelé Thomas
Published: September 2022

BACKGROUND:

Hypotension during surgery is frequent in the elderly population and is associated with acute kidney and myocardial injury, which are, themselves, associated with increased 30-day mortality. The present study compared the hemodynamic effects of hypobaric unilateral spinal anesthesia (HUSA) to general anesthesia (GA) in patients ≥70 years of age undergoing hip fracture surgery.

METHODS:

We conducted a single-center, prospective, randomized study. In the HUSA group, patients were positioned with the operated hip above, and the hypobaric anesthetic solution was composed of 9 mg ropivacaine, 5 µg sufentanil, and 1 mL of sterile water. Anesthesia was adjusted for the GA group. Mean arterial pressure (MAP) was measured with a noninvasive blood pressure upper arm cuff every 3 minutes. Hypotension was treated with a bolus of ephedrine and then a continuous intravenous of norepinephrine to obtain a MAP ≥65 mm Hg. Primary outcome was the occurrence of severe hypotension, defined as a MAP <65 mm Hg for >12 consecutive minutes.

RESULTS:

A total of 154 patients were included. Severe hypotension was more frequent in the GA group compared to the HUSA group (odds ratio, 5.6; 95% confidence interval, 2.7–11.7; P < .001). There was no significant difference regarding the short-term outcomes between the HUSA and GA groups: acute kidney injury (respectively, 5.1% vs 11.3%; P = .22), myocardial injury (18.0% vs 14.0%; P = .63), and 30-day mortality (2.4% vs 4.7%; P = .65).

CONCLUSIONS:

HUSA leads to fewer episodes of severe intraoperative hypotension compared to GA in an elderly population undergoing hip fracture surgery.
Consumer Engagement in Perioperative Clinical Trials
Authors: Wallace Sophie K. A. , Bucknall Tracey K. , Myles Paul S.
Published: September 2022

Consumer engagement (patient and public involvement) in perioperative medicine research is in its infancy. The patient experience and family/carer perspectives can provide an extra layer of insight to give more understanding as to what, why, and how we do research. Patients who have undergone surgery have a unique understanding of the issues, concerns, wants, and needs that they learned as a patient—they, therefore, can be considered as a professional given their experience(s)—thus warranting recognition as a partner in research. Knowledge of the consumer engagement literature and availability of resources should support anesthesia researchers aiming to include these perspectives in their research. This includes several existing engagement frameworks and assessment tools. We provide a framework for consumer engagement for adoption into anesthesia and other perioperative research.

By incorporating the patient or caregiver into the design, funding application(s), data collection, and interpretation of the findings can be beneficial to all. This includes promoting knowledge and access to clinical trials, the wording of participant consent and information forms, methods of data collection, selection of important outcomes, and dissemination of results.
Online mentoring: Challenges and strategies
Authors: Jan Sadiq , Mehboob Usman
Published: September 2022

Objectives: To gain insights into the e-mentoring experience, needs of the stakeholders (mentors and mentees) challenges and strategies to overcome the challenges.

Methods: Qualitative exploratory study was conducted in Islamic International Medical College, from February 2021 to July 2021. The study duration was six months. Six ‘Semi-structured interviews’ of mentors and two ‘focus group discussions’ with mentees were conducted. A purposeful sampling technique was employed to select the respondents. Data were audio taped and transcribed verbatim. After that analysis of data was done by inductive content analysis. Data were coded line by line. Open codes were combined to form categories, which were combined to form themes through abstraction.

Results: Data was analyzed by using Atlas.ti. After analyzing data from mentors and mentees, 21 open codes sorted into 15 categories and abstracted to from five major themes. Participants talked about the problems of online sessions like; connectivity issues, impaired interaction, nonspecific goals, unaware of MS Teams use. They suggested strategies to make these sessions more practical; like workshops for training, face to face sessions before online mode, blended approach, careful selection of mentors and mentees. All were satisfied with security and witnessed anonymity and privacy.

Conclusion: Online mentoring can help students feel less lonely through social contact. E-mentoring provides flexibility to those who would usually deal with discrimination to being mentored because of their gender, ethnicity, disability or geographical location.

doi: https://doi.org/10.12669/pjms.38.8.5804

How to cite this:Jan S, Mahboob U. Online mentoring: Challenges and strategies. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5804

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The new educational paradigm in the COVID-19 era: Can Blackboard replace physical teaching in EFL writing classrooms?
Authors: Aljafen Bandar
Published: September 2022

Background: Many changes are evident in classrooms in the COVID-19 times, but the most drastic perhaps has been the scramble to find substitutes for physical classrooms, a truly solemn challenge for the foreign language learning paradigm. In the meantime, many customized learning apps came to the educationists’ rescue: Blackboard being one of them. This study endeavors to investigate the effectiveness of Blackboard as an alternative to face-to-face writing instruction during the COVID-19 crisis and in the following period of precautionary distancing and other norms.

Methods: The study used the final grades of Saudi male and female EFL undergraduates across two terms and with the Blackboard and face-to-face approaches in three compulsory English writing courses, and statistical tests were conducted on them.

Results: The findings showed that female students (M=83.24, Std= 10.627) significantly outperform the male students (M=73.62, Std=16.011) in the final writing test (P=. 000). Furthermore, in face-to-face teaching (M=84.34, Std=10.752) was more statistically effective than when using Blackboard (M=75.65, Std=14.545) with the Sig value scored (P=. 000). Findings also showed that third level scored higher than the second and the first in writing (83.83, 78.17, 77.89) respectively. All the differences were significant (P=. 000).

Conclusion: The implications of the study have a major bearing on curriculum and pedagogy planning for the coming times which may see more comebacks of the COVID-19 variants and warrant innovative teaching-learning tools and methods.
Case Report: Angio Behçet in a child
Authors: Chamtouri Ikram , Besbes Habib , Abdelali Mabrouk , Chouchene Slaheddine
Published: September 2022

Behçet’s disease (BD) is rare in children. Herein, we report a case of 12-year-old male child with a history of left superficial femoral vein thrombosis and bilateral pulmonary embolism, admitted for multiple thrombosis located in the inferior vena cava, right atrium and ventricle associated with multiple pulmonary artery aneurisms and fissurations concomitant to oral aphthosis, which was suggestive of BD. Despite corticoids and immunosuppressive therapy, the child had a massive hemoptysis resulting in his death. The association between intracardiac thrombosis, pulmonary aneurism and venous thrombosis should raise suspicion of angio-Behçet, which could be lethal.
Circadian signatures of anterior hypothalamus in time-restricted feeding
Authors: Zhou Meiyu , Chen Jianghui , Huang Rongfeng , Xin Haoran , Ma Xiaogen , Li Lihua , Deng Fang , Zhang Zhihui , Li Min-Dian
Published: September 2022

Background: Meal timing resets circadian clocks in peripheral tissues, such as the liver, in seven days without affecting the phase of the central clock located in the suprachiasmatic nucleus (SCN) of the hypothalamus. Anterior hypothalamus plays an essential role in energy metabolism, circadian rhythm, and stress response. However, it remains to be elucidated whether and how anterior hypothalamus adapts its circadian rhythms to meal timing.

Methods: Here, we applied transcriptomics to profile rhythmic transcripts in the anterior hypothalamus of nocturnal female mice subjected to day- (DRF) or night (NRF)-time restricted feeding for seven days.

Results: This global profiling identified 128 and 3,518 rhythmic transcripts in DRF and NRF, respectively. NRF entrained diurnal rhythms among 990 biological processes, including ‘Electron transport chain’ and ‘Hippo signaling’ that reached peak time in the late sleep and late active phase, respectively. By contrast, DRF entrained only 20 rhythmic pathways, including ‘Cellular amino acid catabolic process’, all of which were restricted to the late active phase. The rhythmic transcripts found in both DRF and NRF tissues were largely resistant to phase entrainment by meal timing, which were matched to the action of the circadian clock. Remarkably, DRF for 36 days partially reversed the circadian clock compared to NRF.

Conclusions: Collectively, our work generates a useful dataset to explore anterior hypothalamic circadian biology and sheds light on potential rhythmic processes influenced by meal timing in the brain (www.circametdb.org.cn).
Mental health problems of asymptomatic or mildly symptomatic COVID-19 patients in hospitel in Thailand: A cross-sectional study
Authors: Kerdcharoen Nitchawan , Kirdchok Pantri , Wonglertwisawakorn Chayut , Naviganuntana Yingrat , Polruamngern Nongnuch , Chinvararak Chotiman
Published: September 2022

Background

There is evidence that patients with COVID-19 have a higher prevalence of mental health problems than the normal population. This study aimed to investigate the prevalence of mental health problems and their associated factors in patients with asymptomatic or mildly symptomatic in the hospitel in Thailand.

Methods

Mental health problems were evaluated using the Depression, Anxiety, and Stress Scale - 21 items, and Patient Health Questionnaire-9. The prevalence of mental health problems was presented by frequency and percentage. McNemar's test was used to compare the prevalence of mental health problems between day 1 and day 7. Binary logistic regression was used to identify potential predictors of mental health problems.

Results

A total of 186 participants (68.3% female; mean age = 37.21 years (SD 13.66) were recruited. The depression, anxiety, and stress rate on day 1 of admission was 26.9%, 32.3% and 25.8%, respectively. Having mild COVID-19 symptoms was a significantly associated factor with anxiety (OR=2.69, 95%CI: 1.05-6.89) and stress (OR=4.53, 95%CI: 1.32-15.55).

Conclusions

There was a high rate of mental health problems in COVID-19 patients. Detecting and managing mental health problems should be considered standard care for COVID-19 patients.
Traumatic brain injury epidemiology and rehabilitation in Ireland: a protocol paper
Authors: O'Donnell Kate , Healy Andrea , Burke Teresa , Staines Anthony , McGettrick Grainne , Kwasky Andrea , O'Halloran Philip , Corrigan Catherine
Published: September 2022

Background: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In Ireland, a dearth of research means that we neither know the number of people affected by TBI, nor have the required data to improve neuro-rehabilitation services. This is a study protocol to examine the epidemiology and pathways through rehabilitation for a cohort of TBI survivors in the Republic of Ireland.

Aims: 

To document the epidemiological data of TBIs in Ireland.

To explore the pathway of TBI survivors through rehabilitation/health services.

To document the experiences of those providing care for TBI survivors in Ireland 

Methods: This is a quantitative cohort study. Existing routine datasets will be used to report epidemiological data. Participants with moderate or severe TBI will be recruited through two brain injury service providers, two acute hospitals that provide neurosurgical services, and the National Rehabilitation Hospital. Participants with TBI will be surveyed on two separate occasions, to explore their use of health and rehabilitation services. Those providing care or support to TBI survivors will be surveyed, on one occasion. Additionally, data from the medical records of TBI survivors will be extracted to capture key information about their TBI, such as mechanism of injury, severity, hospitalisation and follow-up. TBI survivors’ use of health care will be followed prospectively for six months. 

Expected outcomes: The epidemiological data of TBI in Ireland will be documented. Data on survivors’ experiences of how rehabilitation services are accessed, and any barriers encountered with rehabilitation/health services will be reported. The experiences of those providing care or support for TBI survivors will be captured. It is expected that the outcomes of the study will support advocacy efforts toward the redevelopment of neuro-rehabilitation services in the Republic of Ireland.
Development of an online pan-European Integrated Pest Management Resource Toolbox
Authors: Ramsden Mark , Furiosi Margherita , Debenedettis Paolo , Stojacic Isidora , Mendes Marta , Munier-Jolain Nicolas , Caffi Tito
Published: September 2022

The IPM WORKS IPM Resource Toolbox (Toolbox) has been developed as an interactive, online repository of integrated pest management (IPM) resources. Populated with high priority resources for farmers and their advisors during the project, its structure enables additional resources added over time. The repository is a public interactive website, available to anyone looking to access, understand, and implement IPM. Built on an open-source content management system, the toolbox is designed to require minimal post-production site maintenance and support, while being easily expanded to integrate resources from future initiatives.

To ensure an efficient but comprehensive website design, population, maintenance, a survey of target user needs was conducted. Different type of IPM stakeholders, both internal and external to the IPMworks project, ranked the key requirements for the Toolbox, such as practical information about diseases and pests’ management and economic thresholds: 343 feedbacks and answers from a survey of 10 questions, carried out across Europe in four languages, provided the key elements and foundation for the IPM Resource Toolbox website development and specification. The Toolbox resources are explained in different languages, with images, divided by topics, with the possibility to find additional details and accessible by smartphone.
The Fragility-Constrained Vehicle Routing Problem with Time Windows
Authors: Altman Clément , Desaulniers Guy , Errico Fausto
Published: September 2022

We study a new variant of the well-studied vehicle routing problem with time windows (VRPTW), called the fragility-constrained VRPTW, which assumes that (1) the capacity of a vehicle is organized in multiple identical stacks; (2) all items picked up at a customer are either “fragile” or not; (3) no nonfragile items can be put on top of a fragile item (the fragility constraint); and (4) no en route load rearrangement is possible. We first characterize the feasibility of a route with respect to this fragility constraint. Then, to solve this new problem, we develop an exact branch-price-and-cut (BPC) algorithm that includes a labeling algorithm exploiting this feasibility characterization to efficiently generate feasible routes. This algorithm is benchmarked against another BPC algorithm that deals with the fragility constraint in the column generation master problem through infeasible path cuts. Our computational results show that the former BPC algorithm clearly outperforms the latter in terms of computational time and that the fragility constraint has a greater impact on the optimal solution cost (compared with that of the VRPTW) when vehicle capacity decreases, stack height increases, and for a more balanced mix of customers with fragile and nonfragile items.

Funding: This work was supported by the Natural Sciences and Engineering Research Council of Canada [Grants RGPIN 2015-06289 and RGPIN 2022-03916].

Supplemental Material: The online appendices are available at https://doi.org/10.1287/trsc.2022.1168 .
Sirolimus-Induced Rash in a Kidney Transplant Patient
Authors: Bruss Zachary , Farook Shanza , Shah Sana , Baker Sheikh Abu
Published: September 2022

Sirolimus is an inhibitor of the mammalian target of rapamycin, which is used in kidney transplant immunosuppression. The clinical spectrum of cutaneous adverse events associated with sirolimus use varies, with maculopapular rash being an uncommon side effect very rarely reported in the literature. We present the case of a 78-year-old male renal transplant recipient who developed a diffuse maculopapular pruritic rash after starting sirolimus. This case report demonstrates that maculopapular rash is an uncommon sirolimus-related side effect that must be identified promptly so the medication can be discontinued and rash progression prevented.
LIVRO DIDÁTICO DE MATEMÁTICA: PRESCRIÇÕES TECNOLÓGICAS E ENTENDIMENTOS DE ALUNOS DO 6º ANO
Authors: Cruz Alixandre Marques , Vasconcelos Carlos Alberto
Published: September 2022

Neste trabalho são expostas partes de resultados identificados em pesquisa realizada em 2017 para um Trabalho de Conclusão de Curso (TCC) da Licenciatura em Matemática da Universidade Federal de Sergipe. Nessa perspectiva, o texto tem como objetivo apresentar entendimentos identificados sobre usos do livro didático de matemática por alunos do 6º ano do Ensino Fundamental de escolas da rede pública estadual de Aracaju (SE) para realizar leituras a partir de seu interesse, assim como também destacar prescrições tecnológicas presentes nas obras analisadas. A coleta de dados ocorreu em sete escolas, por meio da aplicação de 178 questionários, que foram respondidos por alunos, e através da análise de obras de matemática. A seleção das escolas pautou-se nas que possuíam uma das duas coleções aprovadas pelo Programa Nacional de Livro Didático PNLD (2017) mais adotadas desta cidade, sendo as obras “Vontade de Saber Matemática” e “Matemática: Compreensão e Prática”. Entre os autores considerados como referências para o trabalho, destacam-se Freitas (2009) e Jesus (2017), com informações acerca do livro didático, e Lévy (1999), Autor (2017), e Brasil (1998), por conta de apontamentos tecnológicos. A partir dos resultados, foi possível identificar que 51,68% dos alunos possuem interesse, sem que seja a pedido do professor, em realizar leituras sobre a história da matemática em seções do livro didático, assim como na abertura dos capítulos dos demais conteúdos. Quanto ao uso de tecnologias como recursos pedagógicos, identificaram-se prescrições acerca da calculadora, software Geogebra, planilha eletrônica e figuras tecnológicas nos problemas das atividades matemáticas.
PESQUISA NETNOGRÁFICA COM FAMÍLIAS E O SENTIDO DE NÚMERO NO INÍCIO DA ESCOLARIZAÇÃO
Authors: Santos Francieli Aparecida Prates dos , Ciríaco Klinger Teodoro
Published: September 2022

Compartilhamos encaminhamentos e resultados e de uma pesquisa de mestrado localizada no campo da Psicologia da Educação Matemática, especificamente nos estudos da Psicologia Cognitiva, cujo objetivo se encontra na discussão das possibilidades da abordagem netnográfica com famílias para a compreensão do sentido de número, em situações de cálculo, no início da escolarização a partir do auxílio em atividades remotas encaminhadas à casa, no período de isolamento social, de uma escola pública de São Carlos-SP. Para alcançar o objetivo proposto, tomamos como base os pressupostos da pesquisa qualitativa em Educação Matemática a partir da investigação netnográfica. Frente ao cenário da pandemia de COVID-19, os dados foram produzidos a distância a partir de interações virtuais, mais precisamente, conversas por grupos de WhatsApp e vídeos disponibilizados pelos responsáveis dos alunos do ciclo da alfabetização que exprimem que estratégias são mobilizadas nas tarefas matemáticas. Sobre os resultados, podemos inferir que o contato com os grupos familiares possibilitou adquirir informações que indicaram caminhos para um tipo de prática pedagógica da escola que precisa ir ao encontro da Matemática promovida nos lares, sendo esta um conhecimento fundamental ao desenvolvimento do sentido de número no início da escolarização e, portanto, ponto de partida para promoção de situações de cálculo flexíveis.
REFLEXÕES SOBRE A CULTURA DIGITAL NA EDUCAÇÃO MATEMÁTICA
Authors: Castellanos Aguirre Uriel José , Montoya González Yaimar Del Valle
Published: September 2022

O artigo tem como objetivo mapear, a partir de uma revisão sistemática da literatura, a estrutura discursiva da Cultura Digital na Educação Matemática em pesquisas acadêmicas, de mestrado e doutorado. Elaborou-se uma revisão sistemática a partir de 108 resumos das dissertações e teses da Biblioteca Digital Brasileira de Teses e Dissertações (BDTD) do Instituto Brasileiro de Informação em Ciência e Tecnologia (IBICT), no período de (2000-2021). Estes foram tratados através do software Atlas.ti®, obtendo as seguintes categorias teóricas: a formação de professores e o ensino da matemática. As pesquisas estabelecem que são importantes os processos formativos pautados desde e para a formação emancipatória dos sujeitos, onde o professor de matemática, deve estar em uma constante formação que permita utilizar diferentes metodologias e incluir as tecnologias digitais nas práticas pedagógicas, para possibilitar espaços inovadores, críticos, de criação de conhecimentos desde a colaboração e com uma perspectiva multidisciplinar.
INFLUÊNCIA DO TAMANHO DA MALHA EM SIMULAÇÕES NUMÉRICAS VIA ELEMENTOS FINITOS
Authors: Arroyo Felipe Nascimento , Lahr Francisco Antônio Rocco , Christoforo André Luis
Published: September 2022

Novos sistemas estruturais na construção civil estão sempre surgindo, e por isso é necessária uma caracterização. Como solução, ensaios em pequena ou grande escala são opções, utilizados para caracterizar um material ou o comportamento da estrutura. Contudo, sabe-se que alguns ensaios, seja em pequena ou grande escala, são realizados apenas em centros de pesquisas grandes, devido à complexidade e custo dos equipamentos. A vista disso, simulações via Elementos Finitos tornam uma solução interessante, visto que o custo é inferior e podem ser realizados em qualquer centro de pesquisa. Para melhor confiabilidade nos resultados obtidos na simulação, um teste de malha é necessário, verificando a influência desta nos resultados. Como existe dois tipos de malha principais (tetraédrica e hexaédrica) e vários tamanhos possíveis de discretização, este trabalho tem como objetivo avaliar a influência destes parâmetros em uma simulação numérica de um corpo de prova solicitado à flexão estática 3 pontos. Os dois tipos de malha e três tamanhos (1mm, 5mm e 10mm) foram adotados. Através dos resultados obtidos, pode-se concluir que a malha tetraédrica obteve melhores resultados. Foi possível concluir também que o tamanho da malha não alterou os resultados das tensões e deslocamentos no contorno da peça, apenas influenciando nos resultados das tensões no interior.
Uncovering data relationships to tackle fraud
Authors: Frame Alicia
Published: September 2022

Graph technology has reached a point of maturity where it can run off-the-shelf algorithms over massive networks to discover previously undetectable patterns. These algorithms also permit security professionals to take the necessary actions to render systems more robust and secure. As a result, financial and government institutions are making increasing use of graph database technology to tackle fraud.
SASE and the future of IoT security
Authors: Giess Martin
Published: September 2022

Secure Access Service Edge (SASE) is starting to become mainstream. And this approach promises unified policies that improve agility, fortify security and simplify the network stack – especially when it comes to the Internet of Things (IoT).
Using AI to combat fraud in the voice channel
Authors: Gupta Amit
Published: September 2022

Whether it's an attempt to defraud individuals by accessing their bank accounts, or a large-scale attack on an organisation targeting huge volumes of data, identity is at the heart of most sophisticated criminal activity today. And while most online channels have been continually strengthened to stay ahead of evolving criminal tactics, the voice channel – another critical customer connection point – has increasingly come to be seen as a vulnerable target.
Equine ambulatory nursing: maximising our teamwork potential and accelerating patient care
Authors: Woods Cassie
Published: September 2022

The equine ambulatory nursing role seeks to support and improve the multidiscplinary team skill set to improve patient welfare, client satisfaction, work–life balance and job retention. This exciting new opportunity gives equine nurses a chance to provide a more complete service to the client and patient. For this role to work, it is crucial that guidelines are adhered to and nurses stay within their limitations, and that correct training is given. Overall, it is a promising step forward in whole team patient care, vet–nurse referrals and quality of care.