bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic changes of hepatic vein Doppler velocities predict preload responsiveness in mechanically ventilated critically ill patients
Authors: Bruna Mario , Alfaro Sebastian , Muñoz Felipe , Cisternas Liliana , Gonzalez Cecilia , Conlledo Rodrigo , Ulloa-Morrison Rodrigo , Huilcaman Marcos , Retamal Jaime , Castro Ricardo , Rola Philippe , Wong Adrian , Argaiz Eduardo R. , Contreras Roberto , Hernandez Glenn , Kattan Eduardo
Published: May 2024

Background

Assessment of dynamic parameters to guide fluid administration is one of the mainstays of current resuscitation strategies. Each test has its own limitations, but passive leg raising (PLR) has emerged as one of the most versatile preload responsiveness tests. However, it requires real-time cardiac output (CO) measurement either through advanced monitoring devices, which are not routinely available, or echocardiography, which is not always feasible. Analysis of the hepatic vein Doppler waveform change, a simpler ultrasound-based assessment, during a dynamic test such as PLR could be useful in predicting preload responsiveness. The objective of this study was to assess the diagnostic accuracy of hepatic vein Doppler S and D-wave velocities during PLR as a predictor of preload responsiveness.

Methods

Prospective observational study conducted in two medical–surgical ICUs in Chile. Patients in circulatory failure and connected to controlled mechanical ventilation were included from August to December 2023. A baseline ultrasound assessment of cardiac function was performed. Then, simultaneously, ultrasound measurements of hepatic vein Doppler S and D waves and cardiac output by continuous pulse contour analysis device were performed during a PLR maneuver.

Results

Thirty-seven patients were analyzed. 63% of the patients were preload responsive defined by a 10% increase in CO after passive leg raising. A 20% increase in the maximum S wave velocity after PLR showed the best diagnostic accuracy with a sensitivity of 69.6% (49.1–84.4) and specificity of 92.8 (68.5–99.6) to detect preload responsiveness, with an area under curve of receiving operator characteristic (AUC–ROC) of 0.82 ± 0.07 (p = 0.001 vs. AUC–ROC of 0.5). D-wave velocities showed worse diagnostic accuracy.

Conclusions

Hepatic vein Doppler assessment emerges as a novel complementary technique with adequate predictive capacity to identify preload responsiveness in patients in mechanical ventilation and circulatory failure. This technique could become valuable in scenarios of basic hemodynamic monitoring and when echocardiography is not feasible. Future studies should confirm these results.
Rare recurrence pattern after complete response to chemotherapy in a patient with rectal cancer: a case report
Authors: Nomura Masatoshi , Tei Mitsuyoshi , Goto Takayoshi , Hirano Masataka , Nishida Kentaro , Mori Soichiro , Yoshikawa Yukihiro , Tamai Koki , Hamakawa Takuya , Takiuchi Daisuke , Tsujie Masanori , Akamaru Yusuke
Published: May 2024

Background

Colorectal cancer (CRC) often metastasizes to the liver, lungs, lymph nodes, and peritoneum but rarely to the bladder, small intestine, and skin. We here report the rare metastasis of anal cancer in the left bladder wall, followed by metastases to the small intestine and skin, after abdominoperineal resection and left lateral lymph node dissection with chemotherapy in a patient with clinician Stage IVa disease.

Case presentation

A 66-year-old man presented with 1-month history of bloody stool and anal pain and diagnosed with clinical Stage IVa anal cancer with lymph node and liver metastases (cT3, N3 [#263L], M1a [H1]). Systemic chemotherapy led to clinical complete response (CR) for the liver metastasis and clinical near-CR for the primary tumor. Robot-assisted laparoscopic perineal rectal resection and left-sided lymph node dissection were performed. Computed tomography during 18-month postoperative follow-up identified a mass in the left bladder wall, which was biopsied with transurethral resection, was confirmed as recurrent anal cancer by histopathologic evaluation. After two cycles of systemic chemotherapy, partial resection of the small intestine was performed due to bowel obstruction not responding to conservative therapy. The histopathologic evaluation revealed lymphogenous invasion of the muscularis mucosa and subserosa of all sections. Ten months after the first surgery for bowel obstruction and two months before another surgery for obstruction of the small intestine, skin nodules extending from the lower abdomen to the thighs were observed. The histopathologic evaluation of the skin biopsy specimen collected at the time of surgery for small bowel obstructions led to the diagnosis of skin metastasis of anal cancer. Although panitumumab was administered after surgery, the patient died seven months after the diagnosis of skin metastasis.

Conclusions

This case illustrates the rare presentation of clinical Stage IVa anal cancer metastasizing to the bladder wall, small intestine, and skin several years after CR to chemotherapy.
Atrioventricular nodal re-entrant tachycardia with a 2:1 atrioventricular block in a young man: What is the mechanism?
Authors: Pinos Javier , Piedra Diego Serrano
Published: May 2024

A 16-year-old man presented with short VA supraventricular tachycardia and 2:1 atrioventricular ratio. The correct maneuvers allowed us to guide not only the mechanism but also the probable location of the atrioventricular block.
Efficacy and Safety of the Melphalan/Hepatic Delivery System in Patients with Unresectable Metastatic Uveal Melanoma: Results from an Open-Label, Single-Arm, Multicenter Phase 3 Study
Authors: Zager Jonathan S. , Orloff Marlana , Ferrucci Pier Francesco , Choi Junsung , Eschelman David J. , Glazer Evan S. , Ejaz Aslam , Howard J. Harrison , Richtig Erika , Ochsenreither Sebastian , Reddy Sunil A. , Lowe Michael C. , Beasley Georgia M. , Gesierich Anja , Bender Armin , Gschnell Martin , Dummer Reinhard , Rivoire Michel , Arance Ana , Fenwick Stephen William , Sacco Joseph J. , Haferkamp Sebastian , Weishaupt Carsten , John Johnny , Wheater Matthew , Ottensmeier Christian H.
Published: May 2024

Background

Uveal melanoma (UM) has a poor prognosis once liver metastases occur. The melphalan/Hepatic Delivery System (melphalan/HDS) is a drug/device combination used for liver-directed treatment of metastatic UM (mUM) patients. The purpose of the FOCUS study was to assess the efficacy and safety of melphalan/HDS in patients with unresectable mUM.

Methods

Eligible patients with mUM received treatment with melphalan (3.0 mg/kg ideal body weight) once every 6 to 8 weeks for a maximum of six cycles. The primary end point was the objective response rate (ORR). The secondary end points included duration of response (DOR), overall survival (OS), and progression-free survival (PFS).

Results

The study enrolled 102 patients with mUM. Treatment was attempted in 95 patients, and 91 patients received treatment. In the treated population (n = 91), the ORR was 36.3 % (95 % confidence interval [CI], 26.44–47.01), including 7.7 % of patients with a complete response. Thus, the study met its primary end point because the lower bound of the 95 % CI for ORR exceeded the upper bound (8.3 %) from the benchmark meta-analysis. The median DOR was 14 months, and the median OS was 20.5 months, with an OS of 80 % at 1 year. The median PFS was 9 months, with a PFS of 65 % at 6 months. The most common serious treatment-emergent adverse events were thrombocytopenia (15.8 %) and neutropenia (10.5 %), treated mostly on an outpatient basis with observation. No treatment-related deaths were observed.

Conclusion

Treatment with melphalan/HDS provides a clinically meaningful response rate and demonstrates a favorable benefit-risk profile in patients with unresectable mUM (study funded by Delcath; ClinicalTrials.gov identifier: NCT02678572; EudraCT no. 2015-000417-44).
Static timing analysis, delay calculation and timing sign-off algorithms for small scale (sub-40nm) digital electronic circuits
Authors: Σίμογλου Σταύρος
Published: May 2024

Οι σύγχρονες ροές σχεδιασμού ASIC εξαρτώνται σε μεγάλο βαθμό από την Ποιότητα των Αποτελεσμάτων (Quality of Results - QoR) της Στατικής Χρονικής Ανάλυσης (Static Timing Analysis - STA), καθώς αποτελεί την πλέον εδραιωμένη μέθοδο επαλήθευσης και επικύρωσης χρονισμού για δεκαετίες. Τα έντονα παρασιτικά φαινόμενα, λόγω της ολοένα και περισσότερης συρρίκνωσης των γεωμετριών των νανοηλεκτρονικών συσκευών, σε συνδυασμό με την αυξανόμενη πολυπλοκότητα των κυκλωμάτων, τόσο σε αριθμό συσκευών όσο και διασυνδέσεων, έχουν αποτελέσει πρόκληση για την επίτευξη της μέγιστης δυνατής ακρίβειας και ταχύτητας των τυπικών αλγορίθμων STA. ΄Ενας από τους αλγορίθμους με την υψηλότερη επιρροή για την QoR της Στατικής Χρονικής Ανάλυσης είναι ο υπολογισμός καθυστερήσεων, ο οποίος επηρεάζει επίσης την απόδοση. Η παρούσα διατριβή παρουσιάζει μια μεθοδολογία υπολογισμού καθυστέρησης, η οποία είναι συμβατή με βιομηχανικά μοντέλα χρονισμού και επιτυγχάνει αποτελέσματα με μέγιστη ακρίβεια σε σύγκριση με την ηλεκτρική εξομοίωση SPICE, ενώ είναι τάξεις μεγέθους ταχύτερη και έτσι είναι κατάλληλη για τους σκοπούς της Στατικής Χρονικής Ανάλυσης. Επιπλέον, καθώς η αξιοπιστία των κυκλωμάτων έχει γίνει μια καίρια ανησυχία για τα σύγχρονα συστήματα mission-critical εφαρμογών, αυτή η διατριβή παρουσιάζει δύο νέες μεθοδολογίες ανάλυσης και εκτίμησης της ευαισθησίας των κυκλωμάτων όταν αυτά λειτουργούν σε περιβάλλοντα με ιοντίζουσα ακτινοβολία. Οι προτεινόμενες μεθοδολογίες βασίζονται σε αρχές STA. Η μία βασίζεται σε βιομηχανικά εργαλεία Αυτοματοποιημένης Ηλεκτρονικής Σχεδίασης (Electronic Design Automation - EDA) και αναλύει το φαινόμενο Propagation Induced Pulse Broadening (PIPB). Αντίθετα, η δεύτερη έχει υλοποιηθεί εντός του εργαλείου EDA του εργαστηρίου Κυκλωμάτων και Συστημάτων (CASlab) και χρησιμοποιεί αλγορίθμους STA και την προαναφερθείσα μέθοδο υπολογισμού καθυστερήσεων για να παρέχει μια ολοκληρωμένη εικόνα της ευαισθησίας του κυκλώματος. Αυτό μπορεί να θεωρηθεί το πρώτο βήμα προς τη δημιουργία μιας γενικευμένης ροής σχεδιασμού ASIC τα οποία είναι ανθεκτικά στην ακτινοβολία, καθώς η αποτελεσματικότητα και η απόδοσή της επιτρέπουν την εφαρμογή της σε κλειστές ροές βελτιστοποίησης. Τέλος, δύο από τις δημοσιεύσεις που προέκυψαν σχετικά με την ανάλυση ευαισθησίας τιμήθηκαν με το Βραβείο Καλύτερου ΄Αρθρου σε διεθνή συνέδρια του IEEE.
Distribution of sea urchin barrens in shallow algal communities along the eastern Adriatic coast
Authors: CVITKOVIĆ IVAN , DESPALATOVIĆ MARIJA , ŽULJEVIĆ ANTE , VUČIĆ IVAN , LUČIĆ PETRA , NEJAŠMIĆ JELENA
Published: May 2024

The sea urchins Paracentrotus lividus and Arbacia lixula are important herbivores in algal communities of the infralittoral rocky bottoms in the Mediterranean Sea. However, grazing by sea urchins that outweighs natural algal recruitment processes might result in the formation of barrens, which are areas dominated by urchins and coralline algae. We present the results of the first large-scale mapping of sea urchin barrens and analyses of sea urchins’ impact on the main algal communities across 1955.5 km of rocky coastline on the eastern side of the Adriatic Sea (Croatia). Since mapping was performed over a geographically wide area and covered a representative quantity of approximately 40% of the coastline of the central part of the Adriatic Sea, the results could be considered to reflect the general situation in that area of the eastern Adriatic coast. Mapping revealed that sea urchin barrens are present along over 35% of the coastline, while the complete absence of algal cover was recorded in 8% of the inspected area. Communities with canopy-forming algae, which are the most valuable shallow-water communities of the Mediterranean Sea, represent the largest proportion of the observed coastline and are affected by sea urchins in over 28% of their extent. Among other factors, the extensive harvesting of date mussels (Lithophaga lithophaga) in the 1970s, 1980s, and early 1990s is likely one of the main activities that resulted in exceptional sea urchin expansion via the removal of micropredators and establishment of shelters for subadult urchins.
Updating the national list of marine alien species in Morocco
Authors: MGHILI BILAL , LAMINE IMANE , RAMI LAAMRAOUI MOHAMED , AKSISSOU MUSTAPHA , GALANIDI MARIKA
Published: May 2024

This study provides an updated list of alien marine species that have been introduced to Morocco by analyzing both previous data and new findings. A total of 46 marine alien and 15 cryptogenic and crypto-expanding species were recorded in Moroccan waters. Alien species are more abundant in the Mediterranean (35 species) than in the Atlantic (16 species) waters. The number of records of introductions increased in recent years in Moroccan waters. Macrophyta ranked first in terms of the number of species (19 species), followed by Mollusca (8 species), Crustacea (7 species), Cnidaria (5 species), Pisces (3 species), and Tunicata (2 species), while Nematoda and Annelida each contain only one species. The finding of Phyllorhiza punctata, a new species recorded for the first time in the Moroccan Mediterranean waters, is described. The Moroccan Mediterranean harbors more established species (77%) than the Atlantic (69%), contrary to casual records (25% in the Atlantic and 20% in the Mediterranean). Within Moroccan waters, 12 species have been identified as either invasive or potentially invasive: Rugulopteryx okamurae, Sargassum muticum, Asparagopsis armata, Asparagopsis taxiformis, Caulerpa cylindracea, Codium fragile, Agarophyton vermiculophyllum, Artemia monica, Callinectes sapidus, Caprella scaura, Microcosmus squamiger, and Branchiomma luctuosum. The Transport- Stowaway pathway accounted for 23 and seven records in the Mediterranean and Atlantic, respectively. In the Mediterranean, the second most frequent pathway was Transport-Contaminant (6 species), while in the Atlantic was Escape (4 species). This list serves as a starting point for management measures and for selecting invasive alien species to assess their impact.
Οι Φοιτητές του Παιδαγωγικού Τμήματος Δημοτικής Εκπαίδευσης δημιουργούν ψηφιακά συμμετοχικά βίντεο για την αειφορία
Authors: Κλεισαρχάκης Μιχάλης
Published: May 2024

Η τεχνολογία έχει διεισδύσει σε όλες τις εκφάνσεις της ζωής μας, και μπορεί να σταθεί αρωγός μας και στην προσπάθειά μας για μάθηση. Ιδιαίτερα στην εκπαίδευση παίζει πρωταρχικό ρόλο, καθιστώντας τον καθένα από μας ικανό για συμμετοχική, μετασχηματιστική μάθηση, με κύριο μέσο το συμμετοχικό βίντεο. Στην έρευνα αυτή έγινε η προσπάθεια να χρησιμοποιηθεί το Συμμετοχικό Βίντεο (ΣΒ) στην προώθηση της γνώσης και τον μετασχηματισμό των απόψεων των ανθρώπων πάνω σε καθημερινά θέματα που τους αφορούν άμεσα με έμφαση στην αειφορία. Η εργασία αυτή εκπονήθηκε από τους φοιτητές του Παιδαγωγικού Τμήματος Δημοτικής Εκπαίδευσης του Πανεπιστημίου Κρήτης κατά τα ακαδημαϊκά έτη 2017 – 2018 & 2018 – 2019. Συνολικά συμμετείχαν 60 φοιτητές 3ου και 4ου έτους, οι οποίοι χωρίστηκαν σε ομάδες 3-4 ατόμων. Χρησιμοποιήθηκαν συμμετοχικές τεχνικές, όπως συζητήσεις ομάδων, μεμονωμένες συνεντεύξεις και σενάρια γραφής. Το ΣΒ δημιουργήθηκε με τη χρήση κινητών τηλεφώνων και εφαρμογών Web 2. Με το ΣΒ οι δημιουργοί κατάφεραν να μετασχηματίσουν τις απόψεις της τοπικής κοινωνίας σχετικά με τα προβλήματα που ταλανίζουν την καθημερινότητα τους.
Νέοι εκπαιδευτικοί, νέες συνθήκες και νέα εργαλεία για την εκπαίδευση παιδιών με μεταναστευτικό και προσφυγικό υπόβαθρο
Authors: Μακρογιάννη Τσαμπίκα , Κούρτη-Καζούλλη Βασιλεία
Published: May 2024

The main objective of the Language Curriculum is to make the educational system responsive to the new conditions that have emerged in schools. Considering the requirements of the Curricula, new learning tools were used in this research and were applied in the context of language teaching at primary schools at the Department of Primary Education, University of  the Aegean. These tools included a combination of theories, i.e. Cummins' (2005) theory for the development of Academic Language Proficiency, approaches about New Learning (Kalantzis & Cope, 2005) and Transformative Pedagogy (Cummins, 2005; Kalantzis & Cope, 2013). The aim of the research was for future teachers to learn how to support the multilingual students in schools in critically processing the diverse textual types in the language lessons, thereby achieving both  the development of linguistic and communicative competence and the interaction of the  school community with the wider society.
Η ποικιλομορφία και η πολυλειτουργικότητα του ρατσισμού σε άρθρα μεταναστευτικής εφημερίδας
Authors: Αρχάκης Αργύρης , Τσάκωνα Βίλλυ
Published: May 2024

Contemporary western nation-states are built on national and racist discourses and values which are not easily contested by majority members and may affect the discourse and behaviors of minority members as well, even though the latter suffer from the discriminatory consequences of such discourses and values. Research has shown that minority members do not always resist national/racist pressures but often succumb to them, thus accepting majority values and perceiving themselves as Others, namely as majority members usually perceive them. In this context, the present study attempts to explore ways of detecting minority members’ (in the present case, migrants’) internalized racism (Pyke, 2010). The critical analyses performed on two newspaper articles written by young female migrants living in Greece aim to show that, in their effort to adjust themselves to the Greek linguacultural context and to form ties with majority members, the authors reproduce racist views and values usually attested among members of the Greek majority. Given that these articles are published in a newspaper of left wing, antiracist, and pro-migrant orientation, the co-existence of racist and antiracist meanings and values in the same texts blurs the boundaries between racism and antiracism. This renders the texts examined here instances of liquid racism (Weaver, 2016), namely an ambiguous form of racism giving rise to opposing (i.e. racist and antiracist) interpretations and further entrenching the hegemony of racist discourse.
The interaction between brain-based learning strategies and patterns of infographics and its influence on the development of information concepts among Saudi undergraduate cybersecurity students
Authors: Mohammed Yasser Shabaan Abdelaziz , Daif-Allah Ayman Sabry
Published: May 2024

The study reported in this paper investigates the impact of the interaction between brain-based learning strategies (spaced repetition and distributed practice - mental models) and patterns of infographics (static/animated) in e-learning environments and its impact on the development of informational concepts among cybersecurity students. The quantitative data were collected by means of Information Concept Test to determine the levels of information concepts according to the Frayer model (1969). The research sample consists of 80 male and female undergraduate students in Qassim University, who were classified into four quasi-experimental groups according to their preferred patterns in the infographic. Quantitative analysis of findings from this study shows an effect for the interaction between the variables of brain-based learning strategies (spaced repetition and distributed practice - mental models) and patterns of infographics (static/animated) in e-learning environments in the test scores of information concepts in the post-administration, where the significance level (.011) is less than the significance level (0.05). Findings also revealed that the repetition of information at increasing intervals of time using the infographics is effective to learning concepts in an organized manner and to improving short memory. Furthermore, the mental model’s strategy also helped to retain information. The study recommends encouraging the use of brain-based learning strategies and patterns of infographics (static/animated) in e-learning environments to explore the relationships between different scientific concepts, to expand students’ knowledge, and to discover inter-relationships between different subject elements. The study provides a platform for further research to employ different brain-based learning strategies within e-learning environments to acquire higher-order thinking skills and improve students’ memory and mental capacity with the use of modern technological techniques that achieve learning quality.
Exploring the moderating effects of SIRT1 and gene polymorphisms rs7895833 on the relationship between hemoglobin levels and physical frailty in elderly adults with comorbid chronic diseases: A moderated mediation analysis
Authors: Ardinata Dedi , Sari Harahap Novita , Lubis Nenni Dwi Aprianti , Nasution Tetty Aman
Published: May 2024

Background Relationship age, hemoglobin, and physical frailty have all been investigated in older people with more than one chronic disease. There has been little analysis of the relationship between hemoglobin, age, physical frailty, plasma levels of Sirtuin1 (SIRT1), and the gene polymorphism (SNP) rs7895833 A>G. The goal of this study was to find out how SIRT1 level, SNP rs7895833, hemoglobin, age, and physical frailty (frail score) are related in older Indonesian adults with comorbid chronic diseases. Methods This was an observational study. Demographic and clinical data were retrieved from the electronic health records of Universitas Sumatera Utara Hospital, Medan, Indonesia. Physical frailty, SIRT1 level, and SNP rs7895833 were measured using an appropriate and valid method. Purposive sampling was used to determine the eligibility of 132 elderly adults from November 2022 to February 2023. Results The indirect effect of hemoglobin on the frail score (FS) through age was negative and significant, according to a conditional mediation analysis (β=-0.0731; p=0.023). Meanwhile, the direct effect of hemoglobin on the FS was negative and not significant (β=0.1632; p=0.052). According to the conditional moderated mediation analysis, the size of the direct effect of age on FS was increased by genotype AG-GG and SIRT1 level (βlow=0.2647; p=0.002, βmiddle=0.2956; p<0.001, and βhigh=0.319; p<0.001). The size of the conditional indirect effect of Hemoglobin on FS through age was negative and significantly increased by SNP genotype AG-GG and SIRT1 level (βlow=-0.0647; p=0.032, βmiddle=-0.0723; p=0.024, and βhigh=-0.078; p=0.02). Conclusions Higher plasma levels of SIRT1 and the SNP genotype AG-GG may both contribute to physical frailty in the elderly population. Hemoglobin levels in the blood fall with age, which can negatively impact older persons who already have chronic diseases. However, the interactions between these factors are intricate, requiring more study to completely understand the processes underlying development.
Dostępność cyfrowa jako standard e-usług polskiej administracji publicznej – zarys problemu
Authors: Firlus Jakub Grzegorz
Published: May 2024

An e-service provided by public administration must, like any other product, meet certain requirements. The study attempts to assess whether e-services of the Polish public administration are compliant with the digital accessibility standard. For the purposes of the study, the validity of the accessibility standard in the legal order was verified. An effort was made to systematize the conse quences of violating the pattern of digitally accessible behavior. The option of transplanting the administrative procedural norms as a tool for measuring the legality of competence behavior that is digitally inaccessible was also considered.
Publiczna usługa hybrydowa jako instrument przeciwdziałania wykluczeniu cyfrowemu i usprawniania ogólnego postępowania administracyjnego – wybrane zagadnienia
Authors: Kosicki Tomasz
Published: May 2024

The entry into force of the provisions of the Electronic Delivery Act of 18 November 2021 can be seen as a kind of revolution. This is due to the introduction of e-delivery services, which were previously unknown or little known to the Polish legislator. These are the public registered electronic delivery service, the public, hybrid service and the qualified registered electronic delivery service. The cited Act has also influenced the provisions of specific laws, such as the Act of 14 June 1960 – Code of Administrative Procedure, explicitly modifying the principle of the officialness of service contained therein. One of the aims of introducing the indicated services is to address digital exclusion. The drafters have assigned a challenging task to the Public Hybrid Service, which involves converting an electronic document received from a public entity into traditional letter mail. Therefore, the objective of this paper is twofold: to provide a characterization of the Public Hybrid Service and to address whether this service can effectively fulfil the legislator’s goals in addressing digital exclusion. The second objective was to highlight the changes made to the Code’s provisions on service, with particular reference to the conditions and consequences of using the title service in the context of general administrative proceedings.
Territorios inteligentes
Authors: Martínez Garcés Jairo Enrique , Ospina Becerra Victoria Eugenia , Ceballos Zuluaga Andrea
Published: May 2024

El concepto de ciudades inteligentes ha cambiado y se ha comenzado a discutir sobre territorios inteligentes que pueden comprender desde una organización hasta todo un país. En la actualidad, se destaca la importancia de centrar las decisiones gubernamentales y los planes de desarrollo en los ciudadanos y en cómo se mejorará la calidad de vida de estos. Dicha mejora se puede dar gracias a los avances tecnológicos en información y comunicaciones. Es por ello que en este capítulo se hace una conceptualización general sobre territorios inteligentes, sus objetivos y las tecnologías disponibles para implementar proyectos en la temática. Adicionalmente, se mostrarán las aplicaciones de estos conceptos, las ventajas y desventajas asociadas a los mismos para la Armada de la República de Colombia y el impacto que tendría su implementación en la institución.
Rechtsherrschaft und Tugendherrschaft
Authors: Zhiping Liang
Published: May 2024

Was zeichnet den sozialistischen Rechtsstaat chinesischer Prägung aus? Warum verbindet die Kommunistische Partei Rechtsherrschaft mit dem Konzept der Tugendherrschaft? Sind Anleihen an die Tradition des Konfuzianismus nur einem vordergründigen Bemühen der Partei um Legitimität geschuldet oder gehören sie zu den wesentlichen Inhalten der chinesischen Rechtsmodernisierung? Dieses Buch bewertet die chinesische Rechtsentwicklung nicht anhand von Maßstäben liberaler Rechtsstaatlichkeit, sondern untersucht die chinesische Realität eines der Parteiführung unterworfenen Rechtssystems aus der Innenperspektive. Liangs Ausgangspunkt sind dabei die innere Logik gesellschaftlicher Entwicklung sowie die Perspektiven der chinesischen Akteure. Diesem Ansatz folgend, der sowohl die chinesische Rechtskultur wie auch die Parteiideologie als Grundlagen des Rechts ernst nimmt, erläutert der Autor an konkreten Beispielen die Rolle des Rechts in der chinesischen Gesellschaft. https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode
How carers' needs can be met by staff within inpatient settings: a qualitative study
Authors: Berry Katherine , King Jenna , Vikram Anvita , Muller Claire
Published: May 2024

Background/Aims

Inpatient admissions can increase carer stress rather than provide respite. The aim of this study was to gain carers' perspectives about how their needs can be met during an inpatient admission.

Methods

Semi-structured interviews were conducted with 12 carers whose relatives had been admitted to inpatient care at least once. Interviews were analysed thematically.

Results

Carers described a fear of relinquishing responsibility for care, which was exacerbated by concerns about the quality of care provided by staff. Better experiences were possible when carers were given information, ranging from generic information about symptoms or how the mental health system works, information about patients' needs and carer support systems.

Conclusions

Communication is key and needs to be a two-way process, with carers and staff learning from each other to support patients.

Implications for practice

Inpatient staff need training in carer involvement, including ways of engaging carers when patients do not give consent to information sharing.
Craniofacial Morphology and Knowledge of the Stability in Class III Malocclusion Growing Subjects
Authors: Razza F.C. De , Balboni A. , Lugli L. , Bollero P.
Published: May 2024

Introduction: to investigate the palatal and craniofacial relationship in Class III growing patients between successful and failed treated groups.
Methods: Thirty-one patients treated with RME/FM/BB were enrolled (inclusion criteria: Caucasian ancestry, III Class malocclusion, maturation stage CS1-CS2, mixed dentition). Digital cast and cephalometric analysis were performed on pre-treatment and post-treatment records. Statistical analysis and a discriminant analysis was performed. GMM was used on digital dental casts with Procrustes analysis to assess the covariation between palatal and craniofacial morphology. Two groups (relapse, R, 19 and success S, 12) were identified.
Results: R group showed a greater maxillary-anterior transversal width at T0. At T1 R showed a shorter maxillary-anterior length than S. A larger maxillary-anterior and posterior-transversal widths was found in both groups. S had greater maxillary-anterior and posterior-sagittal length. A larger mandibular-anterior and posterior-transversal widths was shown in R, while S showed no differences in mandibula. Maxillary-anterior and maxillary-posterior length were two predictive variables found by discriminant analysis. The PC1 showed significant changes in the palatal morphology and revealed differences for the craniofacial vertical components. Palatal and craniofacial shapes showed a significant covariation, linking the palatal width to skeletal divergence.
Discussion: In Class III malocclusion increases in vertical divergence are correlated with a higher palatal vault and narrower width. A wider and shorter maxillary morphology could be a relapse factor for Class III orthopedic treatment, while the lack of mandibular modification could be predisposing for treatment success.
DO RUGBY BOOTS WITH A BLADED STUD INCREASE CONTACT PRESSURES THROUGH THE FIFTH METATARSAL COMPARED WITH A ROUNDED STUD? A BIOMECHANICAL STUDY
Authors: Winson D. , Lawrence O. , Cazzola D. , Winson I.
Published: May 2024

Fifth metatarsal fractures in sport are known to be associated with acceleration and cross cutting movements when running. It is also established that playing surface has an impact on the ground reaction forces through the foot, increasing the strain through the fifth metatarsal. But what impact does boot design have on these forces? Current thought is that boots that utilise a blade stud design resist sideways slipping of the planted foot more than boots with a rounded stud. This study aims to compare ground reaction forces through the fifth metatarsal in 2 two different designs of rugby boot to assess what impact stud design might have. The forces across the foot were measured using Tekscan in-shoe pressure plates in 24 rugby players. Each player was asked to complete an agility course to measure acceleration, cutting and cross-cutting in the two different designs of rugby boot, reproducing true playing conditions. The boots used were the Canterbury Phoenix Club 8 Stud boot and the Canterbury Speed Club Blade boot. The trial was conducted on an 4G artificial pitch at the Cardiff Arms Park rugby ground. Ethical approval was obtained from Bath University and a research grant was provided by British Orthopaedic Foot and Ankle Society. The blade boot had significantly higher contact pressures than the stud boot on the fifth metatarsal in the combined movements (17.909 ± 10.442 N/cm2 Blade Vs 16.888 ± 9.992 N/cm2 Boot; P < .0125; n= 864 steps in each boot group). The blade boot also produced higher pressure during cross-cutting (32.331 ± 13.568 N/cm2 Vs 27.651 ± 15.194 N/cm2 p < 0.007). Pressures were also higher in both acceleration and cutting, although not significantly so. These results will guide clinicians advising athletes in shoe design, especially those predisposed to or rehabilitating from a fifth metatarsal fracture.
PLATELET-RICH PLASMA FOR ACUTE ACHILLES TENDON RUPTURE: RESULTS OF THE PATH-2 STUDY, A DOUBLE-BLIND MULTICENTRE RANDOMIZED PLACEBO-CONTROLLED TRIAL
Authors: Keene D.J. , Alsousou J. , Harrison P. , Hulley P. , Wagland S. , Parsons S. , Thompson J. , O'Connor H. , Schlüssel M.M. , Dutton S. , Lamb S.E. , Willett K.
Published: May 2024

Background

Disability and slow return to sport and work after tendon rupture are major challenges. Platelet Rich Plasma (PRP) is an autologous supraphysiological concentration of platelets from whole blood that has demonstrated positive cellular and physiological effects on healing in laboratory conditions but evidence from adequately powered robust clinical trials is lacking. We aimed to determine the clinical efficacy of PRP for treatment of acute Achilles tendon rupture.

Methods

In a placebo-controlled, participant- and assessor-blinded, trial at 19 NHS hospitals we randomly assigned 230 adults starting acute Achilles rupture non-surgical management to PRP injection or dry-needle insertion (placebo) to the rupture gap under local anaesthetic. Patients with confounding or contraindicated concurrent medical conditions were excluded. The primary outcome was muscle-tendon function, assessed by the limb symmetry index (LSI, uninjured limb/injured limb × 100, higher scores better) of the work (Joules) performed during the heel-rise endurance test at 24 weeks. Secondary outcomes were: Achilles Tendon Rupture Score (ATRS, 0–100, higher scores better), quality of life (SF-12), pain, and goal attainment. Trial registration: ISRCTN54992179

Results

Participants were aged mean 46 years and 57 (25%) were female. 103/114 (90%) of the PRP group and all (n=116) in the placebo group received allocated treatment. At 24 weeks, mean LSI was 34.4 for the PRP group and 38.8 for placebo (adjusted mean difference −4.4 95% CI −11.2 to 2.5, n=201) and ATRS was mean 65.2 PRP vs 65.8 (adjusted mean difference −0.6, 95% CI −4.9 to 3.7, n=224). There were no differences between groups in the other secondary outcomes.

Conclusion

We found no evidence of PRP efficacy for improving muscle-tendon function or patient-reported recovery after acute Achilles tendon rupture. Our findings challenge the increasing global use of PRP for acute tendon injury and indicate that robust evaluations are required in other applications.
ANATOMY OF THE INSERTION OF THE POSTERIOR INFERIOR TIBIOFIBULAR LIGAMENT AND ITS RELEVANCE TO POSTERIOR MALLEOLAR ROTATIONAL PILON FRACTURES
Authors: Jayatilaka M.L. , Fisher A. , Fisher L. , Molloy A. , Mason L.
Published: May 2024

Introduction

The treatment of posterior malleolar fractures is developing. Mason and Molloy (Foot Ankle Int. 2017 Nov;38(11):1229-1235) identified only 49% of posterior malleolar rotational pilon type fractures had syndesmotic instabilities. This was against general thinking that fixation of such a fragment would stabilize the syndesmosis.

Methods

We examined 10 cadaveric lower limbs that had been preserved for dissection at the Human Anatomy and Resource Centre at Liverpool University in a solution of formaldehyde. The lower limbs were carefully dissected to identify the ligamentous structures on the posterior aspect of the ankle. To compare the size to the rotational pilon posterior malleolar fracture (Mason and Molloy 2A and B) we gathered information from our posterior malleolar fracture database. 3D CT imaging was analysed using our department PACS system.

Results

The PITFL insertion on the posterior aspect of the tibia is very large. The average size of insertion was 54.9×47.1mm across the posterior aspect of the tibia. Medially the PITFL blends into the sheath of tibialis posterior and laterally into the peroneal tendon sheath.

78 posterior lateral and 35 posterior medial fragments were measured. On average, the lateral to medial size of the posteromalleolar fragment was 24.5mm in the posterolateral fragment, and 43mm if there is a posteromedial fragment present also. The average distal to proximal size of the posterolateral fragment was 24.5mm and 18.5mm for the posteromedial fragment.

Conclusion

The PITFL insertion on the tibia is broad. In comparison to the average size of the posterior malleolar fragments, the PITFL insertion is significantly bigger. Therefore, for a posterior malleolar fracture to cause posterior syndesmotic instability, a ligamentous injury will also have to occur. This explains the finding by Mason and Molloy that only 49% of type 2 injuries had a syndesmotic injury on testing.
ARTHROSCOPIC ARTHRODESIS OF THE ISOLATED TALONAVICULAR JOINT
Authors: Parsons A. , Parsons S.
Published: May 2024

Background

Whereas arthroscopic arthrodesis of the ankle is commonplace and of the subtalar joint is established, reports of arthroscopic talo-navicular fusion are a rarity.

Aim

To review a case series to establish if arthroscopic talo-navicular arthrodesis is a feasible surgical option.

Methods

Arthroscopic decortication of the talo-navicular joint is performed via x1-2 sinus tarsi portals and x1-2 accessory talo-navicular portals using a standard arthroscope and a 4.5 barrel burr. Internal fixation is by a 5mm screw from the navicular tuberosity and x2 headless compression screws introduced under image intensification from the dorsal navicular to the talar head. Between 2004 and 2017 a consecutive series of 164 patients underwent arthroscopic hindfoot arthrodeses of which 72 involved the talo-navicular joint. Only 13 procedures were of that joint alone in unsullied feet. The medical records of these 13 patients were reviewed to assess radiological fusion, complications and improvement of pre-operative state.

Results

All Talo-navicular joints were successfully decorticated. All united radiologically by a mean 4.4 months (range 3–8). There were no major complications. All patients reported improvement to their pre-operative symptoms but one patient developed lateral column pain requiring fusion.

Conclusions

Arthroscopic Talo-navicular arthrodesis is technically feasible with good rates of union. Complications were rare, making the technique attractive when encountering a poor soft tissue envelope. The surgery cannot be used if bone grafting is required. Long term discomfort can arise from adjacent joints. Accurate alignment is critical.
Exploring the antibacterial activity of endophytic bacteria from Andaliman (Zanthoxylum acanthopodium DC.) against Bacillus subtilis
Authors: RIZQOH DEBIE , SIPRIYADI SIPRIYADI , SURYANI UTARI HARTATI , PUTRI CINTYA NABILA , AGUSTIN MEUTIA , TAURUSTYA HERNITA , LESTARI NOVRIANTIKA , SARIYANTI MARDHATILLAH
Published: May 2024

Abstract. Rizqoh D, Sipriyadi, Suryani UH, Putri CN, Agustin M, Taurustya H, Lestari N, Sariyanti M. 2024. Exploring the antibacterial activity of endophytic bacteria from Andaliman (Zanthoxylum acanthopodium DC.) against Bacillus subtilis. Biodiversitas 25: 700-707. Infectious diseases are still one of the global health problems. Increasing antibiotic resistance against several pathogenic microbes causes antibiotics to be less effective in treating infectious diseases. One pathogenic bacteria that causes infection is Bacillus subtilis, which causes bacteremia, septicemia, and endocarditis. Therefore, searching for new alternative antibiotics is urgently needed to overcome bacterial resistance. Andaliman (Zanthoxylum acanthopodium DC.) extract produces antimicrobial bioactive compounds. Thus, this study aims to explore endophytic bacteria from Z. acanthopodium and determine their antibacterial activity against Bacillus subtilis. This study used a qualitative experimental method, namely isolation of endophytic bacteria, characterization of endophytic bacteria colonies and cells, antagonistic test against B. subtilis, extraction of compounds from endophytic bacteria, and determine Minimum Inhibitory Concentration (MIC) of crude extract of endophytic bacteria against B. subtilis. This study showed that 16 endophytic isolates from Z. acanthopodium could inhibit the growth of B. subtilis, and potential isolates were EA7 and EA26, which have Minimum Inhibitory Concentration (MIC) at 40%, and EB6 at 80%.
The phenetic relationship of citrus plants based on the morphological and anatomical characteristics
Authors: NURZAMAN MOHAMAD , SETIAWATI TIA , HASAN RUSDI , QOTRUNNADA NAZLA KARUNIA , KUSMORO JOKO , PERMADI NANDANG , JULAEHA EUIS
Published: May 2024

Abstract. Nurzaman M, Setiawati T, Hasan R, Qotrunnada NK, Kusmoro J, Permadi N, Julaeha E. 2024. The phenetic relationship of citrus plants based on the morphological and anatomical characteristics. Biodiversitas 25: 1201-1213. Indonesia stands as a global biodiversity hub, boasting an exceptional richness that earns it the distinction of being a mega-biodiversity country. Among its diverse ecosystems, the Rutaceae family holds significance, encompassing numerous genera, notably the Citrus genus, which showcases a splendid array of citrus plants. This research aimed to determine phenetic relationships based on the morphological and anatomical characters of seven citrus plants (Citrus reticulata var. Chokun, C. reticulata var. Fremont, C. reticulata var. Santang, C. reticulata var. Dekopon, C. aurantium var. variegata, C. aurantium, and C. limon) in Parongpong District, West Bandung Regency, West Java. The method used in this research was explorative with purposive sampling. This study collected three samples for respective citrus plants for character observations of leaf morphology, anatomy, and fruit morphology. Morphology and anatomy observations were conducted in the Department of Biology, Padjadjaran University laboratory. The description of morphological and anatomical data obtained from each orange plant was then analyzed using NTSYS PC version 2.11a software to obtain similarity values using the dendrogram analysis method. Phenetic analysis of seven orange plants produced a dendrogram divided into 2 main branches, branch I and branch II, with a similarity coefficient of 0.3846. Branch I consists of Chokun orange (Citrus reticulata var. Chokun), Fremont orange (C. reticulata cv. Fremont), Santang orange (C. reticulata cv. Santang), and variegated orange (C. sinensis cv. variegata) and branch II consists of dekopon orange (C. reticulata var. Dekopon), Sunkist orange (C. aurantium), and lemon (C. limon).
Bio-psycho-social problems of a child with bronchial asthma with regard to the educational and caring role of the parent
Authors: Piaszczyk Diana , Gryz Paulina
Published: May 2024

Bronchial asthma is a chronic respiratory disease of heterogeneous nature, manifested by paroxysmal but reversible bronchoconstriction. The aim of this work is to identify nursing problems of a child with bronchial asthma and determine nursing interventions based on ICNP® guidelines. In the study the fallowing research methods were used: individual case study, interview, observation, measurement, documentation analysis, scales, and nursing process. The research subject is a patient 17 years and 7 months old admitted to the children’s hospital on an emergency basis with suspected pneumonia of unknown etiology and an exacerbation of asthma. History: runny nose, cough for 3 weeks, and periodic dyspnea for 2 weeks. On admission to the hospital: weakness, difficulty climbing stairs, expiratory dyspnea, headache, pallor, decreased appetite, nausea, and vomiting. On physical examination: weakened alveolar murmur over the lung fields, expiratory wheezes, furrows, moist rales, reddened throat. As a result of treatment, the patient’s condition improved. She was discharged home with the recommendation: systematic medication, avoidance (of noxious agents and human concentrations), overheating, hypothermia, oral rehydration, oral hygiene, an easy-to-digest diet, blood count control in 1-2 months and follow-up at the Pulmonology Clinic. During hospitalization, the child was diagnosed with biological, psychological, and social problems, which were solved by the diagnostic, care and therapeutic, educational activities of the nurse. Education about the disease (symptoms and treatment) was required by the patient’s mother. The prevalence of asthma imposes an obligation to implement educational activities in educational institutions, since comprehensive education of parents and teachers improves the emotional state of a child with asthma.
Teacher's readiness for inclusive education: examples from selected primary schools
Authors: Strumińska-Doktór Anna , Jagodzińska Małgorzata
Published: May 2024

The main aim of the research was to determine whether teachers working in chosen primary schools were ready for the inclusive education. The diagnostic poll method based on the survey technique was used in order to conduct the research. The nonprobability sampling of the research sample guaranteed obtaining the optimal information necessary for the purpose of the study. Teachers who took part in the research had various work experience, they represented various career advancement levels within the field of education.
The research problems mentioned in this work concerned: the level of schools’ preparation for working with students with special educational needs (SEN), actions that were undertaken by the school in order to support students with SEN, teachers’ qualifications in the field of inclusive education, and finally the benefits of inclusive education for students with SEN.
On the basis of the analysis of the research results, it can be concluded that inclusive education brings huge benefits to students with special educational needs. It undoubtedly influences children’s social and emotional development as well as contributes to the broadening of their knowledge. However, some teachers point out that not all children are prepared to benefit from the inclusive education.
Children of re-emigrants in a Polish school
Authors: Jędryszek-Geisler Aleksandra
Published: May 2024

The main objective of this study was to check the knowledge of teachers from Polish schools about the problems faced by children with migration experience, awareness of the possibilities of helping these students and teachers’ knowledge about the functioning of Polish schools in the world.The respondents were 312 primary school teachers from the Pomorskie, Warmińsko-Mazurskie, Mazowieckie, Wielkopolskie, Kujawsko-Pomorskie and Podlaskie. A self-designed questionnaire was used in the study. The analysis of the results showed that the teachers had partial knowledge about the problems of children with migration experience, possibilities of help and generally little knowledge about the functioning of Polish schools in the world.
Analysis of educational support for children with special educational needs
Authors: Grądzki Waldemar
Published: May 2024

The article discusses the educational support process for children with special educational needs (SEN), who may have various dysfunctions such as speech, hearing, vision impairments, motor problems, shyness, high abilities, or developmental issues, including children with the autism spectrum. Technological development, especially in the field of multimedia and artificial intelligence, is changing the traditional approach to educating these children. Information and communication technologies, virtual reality, augmented reality, and the Internet of Things are becoming increasingly common in the teaching process. Despite the wealth of educational tools available, educators often do not fully utilize them, partly due to a lack of adequate technical support, equipment, software, and teacher training. Older teachers may have more difficulty adapting to new technologies compared to younger ones.