bluuebunny/crossref_metadata_2025 huggingface dataset:
An analysis of certification processes for Good Clinical Practice and project management competencies
Authors:   Chair of Management Processes, Faculty of Management, Warsaw University of Technology, Warsaw, Poland, Zawada Marek , Gągała Dorota ,   Department of Scientific Research and International Cooperation, Division Clinical Trials, The Children’s Memorial Health Institute, Warsaw, Poland
Published: June 2021

Aim/purpose – The purpose of this paper is to clarify the certification process of the Good Clinical Practice (GCP) competencies based on a comparison with the project management (PM) certification process. This aim was accomplished by model development. Design/methodology/approach – The study was divided into three main phases: 1st phase – the identification of key characteristics of PM and GCP certification processes, 2nd phase – the development of certification models for PM and GCP, 3rd phase – the conclusions from in-depth interviews. Findings – As a result of the research, key characteristics of PM and GCP certification processes were identified, certification models for PM and GCP were developed. In addition, based on conclusions from in-depth interviews, solutions for organizing the way of confirming knowledge of GCP guidelines were proposed. Research implications/limitations – The proposed rules may be too complex and may exceed the needs and expectations of the clinical trial environment. The models focus on stakeholder relations, without the rules of certification granting procedures, to enable broader contextualization of the issues discussed in the paper. The analysis might be fragmented as it regards the sole certification process. The research refers to Poland only, hence it will be valuable to identify whether foreign authorities have the same attitude to the GCP competency certification model. It is recommended to increase the number of respondents’ interviews to obtain results of higher validity and reliability. Originality/value/contribution – The paper raises research topics at the crossroads of project management, clinical trials, and GCP, topics that have been underdeveloped so far. The results might be significant for all organizations involved in conducting clinical research projects. The findings contribute to the quality of clinical trials and provide public assurance that the rights, safety, and well-being of trial subjects are protected and the clinical trial data are credible. Keywords: project management, clinical trials, certification, Good Clinical Practice, GCP. JEL Classification: M10, O32, I11.
Hak atas Pekerjaan bagi Penyandang Disabilitas di Sektor Publik: Antara Model Disabilitas Sosial dan Medis
Authors: Dahlan Muhammad , Anggoro Syahriza Alkohir
Published: June 2021

The opportunity to fulfill the rights to work for persons with disabilities has been increasing since the ratification of Convention on the Rights of Persons with Disabilities (CRPD). Indonesia has adopted a “quota scheme” through the Law Number 8 of 2016 on Persons with Disabilities where government institution has set a minimum quantity of two percent as the number of workers for persons with disabilities as affirmative action targeted at promoting human rights. This article examines the progress of the legal framework for persons with disabilities by using a case study in civil cervants in the public sector. We argue that despite Indonesia’s disability legal regime has pushed the social model of disabilities that promotes human rights-based approach, its implementation is still based on the medical model of disability, in which it sees persons with disabilities on physical condition, and thus, they are assumed to be able to work in a certain field determined by the government. This article argues that affirmative policy does not provide equal opportunities to persons with disabilities as the special formation and medical requirements prevent them from applying for occupations that match their interests and educational background. The use of the medical model of disability in providing employment opportunities in the public sector prevents the level of participation and the formation of an inclusive workplace environment.

Abstrak

Peluang untuk memenuhi hak atas pekerjaan bagi para penyandang disabilitas terus meningkat sejak ratifikasi Convention on the Rights of Persons with Disabilities (CRPD). Indonesia mengadopsi “skema kuota” melalui UU Nomor 8 Tahun 2016 tentang Penyandang Disabilitas di mana institusi negara menetapkan minimal dua persen jumlah formasi pekerja bagi para penyandang disabilitas sebagai tindakan afirmatif yang ditargetkan untuk mempromosikan hak asasi manusia. Artikel ini memeriksa sejauh mana kerangka kerja hukum disabilitas di Indonesia memfasilitasi pemenuhan hak atas pekerjaan bagi penyandang disabilitas dengan menggunakan contoh kasus pada penyelenggaraan ketenagakerjaan di sektor publik. Kami berpendapat bahwa meskipun rezim hukum disabilitas di Indonesia menekankan model sosial disabilitas yang mempromosikan pendekatan berbasis hak asasi manusia, implementasinya masih didasarkan pada model medis disabilitas yang memandang penyandang disabilitas berdasarkan kondisi fisik dan karenanya diasumsikan hanya dapat masuk pada bidang pekerjaan yang telah ditentukan oleh negara. Artikel ini berpendapat bahwa kebijakan afirmatif tidak memberikan peluang yang setara bagi penyandang disabilitas karena formasi khusus dan persyaratan medis menghambat mereka untuk melamar pada bidang pekerjaan yang sesuai dengan minat dan latar belakang pendidikannya. Penggunaan model medis disabilitas dalam penyelenggaraan kesempatan kerja di sektor publik pada gilirannya menghambat tingkat partisipasi dan pembentukan lingkungan kerja yang inklusif.
Trikotomi Relasi dalam Penetapan Tersangka: Menguji Frasa “Pemeriksaan Calon Tersangka” Melalui Praperadilan
Authors: Marbun Rocky
Published: June 2021

The Constitutional Court Decision Number 21/PUU-XII/2014 has placed restrictions on the investigator’s discretional action in determining a person as a suspect in addition to being based on two valid evidence, it is also based on the completion of an examination of a potential suspect. However, in the realm of legal praxis, the meaning of the phrase “examination of potential suspects” has been reduced by means of grammatical-lexical knowledge produced by the authorities. As a result, it raises the meaning that the phrase “potential suspect” is not known only based on the Criminal Procedure Code. The problem that will be discussed in this research is “how does the Trichotomy of Relation work in reducing the meaning of” Suspect Candidate Examination “in the pretrial process?” This study uses a normative juridical research method based on secondary data through literature study. In this study, in order to complement the normative juridical method, also use a semiotic approach and a critical discourse analysis approach. The results of this study indicate a pattern of power that produces knowledge of the phrase “Examination of Potential Suspects” in order to defend the interests of formal and instrumental proof.

Abstrak

Putusan Mahkamah Konstitusi Nomor 21/PUU-XII/2014 telah memberikan pembatasan terhadap tindakan diskresional penyidik dalam menetapkan seseorang sebagai tersangka selain berbasis pada dua alat bukti yang sah, pun berbasis pada disertainya pemeriksaan terhadap calon tersangka. Namun demikian, dalam ranah praksis hukum, frasa “pemeriksaan calon tersangka” telah direduksi pemaknaannya melalui pengetahuan yang diproduksi oleh pemegang otoritas secara gramatikal-leksikal. Hal tersebut memunculkan pemaknaan bahwa frasa “calon tersangka” tidak dikenal hanya disandarkan pada KUHAP semata. Permasalahan yang dibahas dalam penelitian ini adalah bagaimana pola kerja trikotomi relasi dalam mereduksi makna ‘pemeriksaan calon tersangka’ dalam proses praperadilan. Penelitian ini menggunakan metode penelitian yuridis normatif yang berbasis pada data sekunder melalui studi kepustakaan. Pada penelitian ini, guna melengkapi metode yuridis normatif, digunakan pula pendekatan semiotik dan analisis wacana kritis. Hasil dari penelitian ini menunjukkan adanya suatu pola kekuasaan yang memproduksi pengetahuan terhadap frasa “pemeriksaan calon tersangka” guna mempertahankan kepentingan pembuktian yang formilistik dan instrumental melalui penggunaan konsep yang lazim digunakan dalam KUHAP (langue) dan menolak konsep yang belum dikenal dalam KUHAP (parole).
Reflexiones y experiencias educativas para la innovación
Authors: Campos-Céspedes Jensy
Published: June 2021

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Los hongos como elementos clave en la productividad del suelo, la agricultura y el bienestar social
Authors: Krystal Zúñiga-Castro  , Gerald Quirós-Cedeño
Published: June 2021

Resumen: El desconocimiento y manejo incorrecto de la tierra en ciertas prácticas agrícolas representa un problema para organismos que contribuyen a la salud del suelo, como los hongos. El objetivo de la investigación es demostrar la importancia del uso de los hongos como elementos clave en la productividad del suelo, la agricultura y el bienestar social e incentivar su uso, conservación y protección. El estudio se llevó a cabo en un sendero de 1,5km en Finca Boquete-Sibü, Pérez Zeledón, un Bosque Pluvial Montano Bajo, donde se observaron diferentes especies de cuerpos fructíferos por nueve meses durante la época seca y lluviosa, anotando su nombre, sustrato, altitud, y se investigaron por medio de revisión bibliográfica sus funciones para la agricultura, el suelo y el bien social.  Se observaron 25 individuos de 17 especies de hongos, los cuales tienen como función ser los principales descomponedores de la materia orgánica y recicladores de nutrientes, crear micorrizas, ser fijadores de nitrógeno y controladores de plagas, además de utilizarse para la biorremediación y como indicadores de la calidad del suelo. Adicionalmente, pueden ser utilizados como alimento, medicina, el arte o el turismo. El uso responsable de recursos naturales como los hongos permitirá la conservación del suelo y del ecosistema en general, además de aumentar la seguridad alimentaria y el bienestar social.
Educación ambiental desde el trabajo comunal universitario: experiencia de la Reserva Biológica Alberto Manuel Brenes, San Ramón, Costa Rica
Authors: Melvin Cartín Núñez
Published: June 2021

Resumen: La acción social es un pilar fundamental del quehacer de la Universidad de Costa Rica. El trabajo comunal universitario forma parte de los programas de extensión universitaria y se caracteriza por alentar a las comunidades a ser autónomas en la búsqueda de soluciones para sus problemas cotidianos. El proyecto de educación ambiental de la Reserva Biológica Alberto Manuel Brenes tiene como objetivo contribuir al conocimiento del área protegida y de sus recursos naturales con el fin de promover su conservación. El proyecto inició sus labores en el 2010 y desde entonces más de 200 estudiantes se han matriculado, lo cual representa al menos 64 000 horas de trabajo, en más de 50 centros educativos y similar número de comunidades. Gracias al proyecto, el número de personas que conocen la reserva biológica es indudablemente mayor que antes de su inicio.
COMPARİSON OF PREOPERATİVE PENİLE ELASTOGRAPHİC ULTRASOUND FİNDİNGS AND PATHOLOGİCAL TİSSUE RESULTS OF PATİENTS İMPLEMENTED WİTH PENİLE PROSTHESİS
Authors: BOZKURT Yunus Erol , Gumus Bilal , DÜZGÜN Fatih , NEŞE Nalan
Published: June 2021

Objective Histopathologically to determine the relationship between
penile elastography ultrasonography and erectile dysfunction. Material
and Method 12 patients who applied to our clinic for erectile
dysfunction in the last 1 year and accepted this study were included .
Preoperative two-dimensional shear wave elastography imaging was
performed in 12 patients and recorded in the Pascal (kPa) unit.
Approximately 0.5x0.5x0.5 cm tissue samples were taken from the right
and left spongy tissue during penile prosthesis implantation operation.
Tissue samples were sent to the pathology department. The percentage of
the area covered by muscle fibers and elastic fibers in the corpus
cavernosum was noted semi-quantitatively (ratio of muscle fibers and
cavernous body elastic fiber score). All data obtained were compared
with each other. Results Cavernous body elastic fiber score data(Grouped
Score 1, 2 and 3) and percentage of cavernous body muscle fibers data
(Grouped %10,%20,%30… %100) were compared with Shear wave
elastography data (kPa). The results were not statistically significant
according to the Kruskal Wallis Test and Spearman’s correlation test.
Cavernous body elastic fiber score and the percentage of cavernous body
muscle fibers were also compared, it was not statistically significant
according to the Kruskal Wallis test and Spearman’s correlation test.
The data we obtained as a result of our study showed that penile
elastographic imaging is not a reliable method in the diagnosis of
erectile dysfunction. Conclusions Penile shear wave elastography can be
used clinically to quantitatively assess the amount of smooth muscle
cells and elastic fibers in the penis, but it deserves to be studied
with a larger number of patients and a more specific interpretation of
the pathology preparation. Keywords: Penile elastography, erectile
dysfunction, penile prosthesis, shear wave
Hypercomplex Algebras and Calculi Derived from Generalized Kinematics
Authors: Brezov Danail
Published: June 2021

The paper provides a study of the commutative algebras generated by
iteration of the cross products in $\mathbb{C}^3$.
Focusing on particular real forms we also consider the analytical
properties of the corresponding rings of functions and relate them to
different physical problems. Familiar results from the theory of
holomorphic and bi-holomorphic functions appear naturally in this
context, but new types of hypercomplex calculi emerge as well. The
parallel transport along smooth curves in
$\mathbb{E}^3$ and the associated Maurer-Cartan
form are also studied with examples from kinematics and electrodynamics.
Finally, the dual extension is discussed in the context of screw
calculus and Galilean mechanics; a similar construction is studied also
in the multi-dimensional real and complex cases.
“COVID-19: The final nail in coffin for physical examination” Evaluation of the effects of COVID-19 pandemic on physical examination habits of residents in a university hospital: a cross-sectional survey
Authors: Erdevir Mehmet , Uyaroğlu Oğuz , Özdede Murat , Tanriover Mine Durusu
Published: June 2021

Aims: It is evident that COVID-19 pandemic have affected the medical
practice and training of residents. In this study, we evaluated the
Physical Examination (PE) habits of residents working in a university
hospital and how their PE practices did change during the pandemic.
Methods: This single-center, non-interventional, cross-sectional
descriptive study was conducted in a university hospital using an online
survey questionnaire from 5 to 20 October 2020. Results: 308 residents
participated in the study of whom 172 of them (55.8%) were female and
the median age was 27 (IQR:3). Among all, 263 participants (85.4%)
declared that they have worked in the areas where suspected/confirmed
COVID-19 patients were being served. A total of 262 (85%) residents
stated that PE habits have changed generally during the pandemic. There
was a significant difference between those residents who have worked in
the COVID-19 areas (n=230,87.5%) and those who have not (n=32, 71.1%)
(p=0.004). PE habits of Internal Medicine Residents were more changed
than others (p<0.001). The main reason for the change in PE
habits in general (77.9%) and during the examination of
suspected/confirmed COVID-19 patients (89.7%) were ‘’self-protection”.
Reliance on laboratory and radiologic investigations during practice and
not having a thought that less PE will disrupt the diagnosis and course
of COVID-19 were also independent risk factors for performing less PE in
suspected/confirmed COVID-19 patients. Discussion: This study clearly
demonstrated that the COVID-19 pandemic has had a serious impact on the
PE habits of the residents while examing patients in general and with
COVID-19.
Effects of general anesthesia and ultrasonography-guided interscalene block on pain and oxidative stress in shoulder arthroscopy: a randomized trial
Authors: ÖKSÜZ MURAT , Abitagaoglu Suheyla , Kaciroglu Ahmet , Koksal Ceren , Ozturk Burak Yagmur , Erel Özcan , Aydin Almila Senat , Ari Dilek Erdogan
Published: June 2021

Background/aim: The aim of this study was to evaluate the effects of
general anesthesia and ultrasonography-guided interscalene block on pain
and oxidative stress evaluated by thiol–disulphide balance and
C-reactive protein levels in patients undergoing shoulder arthroscopy.
Materials and methods: A total of 42 patients aged 18–75 years who were
scheduled to undergo shoulder arthroscopy were randomized into
interscalene block group (Group-IB, n = 20) and general anesthesia group
(Group-GA, n = 22). All patients received patient-controlled analgesia
during the postoperative period. Additional analgesics were administered
to patients with a visual analog scale score of > 4. Native
-thiol, total -thiol, disulphide and C-reactive protein levels were
measured. Patients’ visual analog scale scores, morphine and additional
analgesic consumption were recorded. A shift in thiol–disulphide
balance toward decreased thiol and increased disulphide levels was
regarded as an indicator of oxidative stress. Results: Pain level,
morphine and additional analgesic consumption were higher in Group-GA.
Native-thiol and total-thiol levels were higher in Group-IB
postoperatively and also disulphide levels were lower at postoperative
18 hours. C-reactive protein levels were similar in both the groups.
Conclusion: Interscalene block induced less oxidative stress during the
postoperative period, as evaluated by thiol–disulphide balance.
Characteristics of Macroreentries Using an Epicardial Bypass: Pseudo-Focal Atrial Tachycardia Case Series
Authors: Nakatani Yosuke , Nakashima Takashi , Duchateau Josselin , Vlachos Konstantinos , Krisai Philipp , Takagi Takamitsu , Kamakura Tsukasa , André Clémentine , Goujeau Cyril , Ramirez F. Daniel , Chauvel Remi , Tixier Romain , Takigawa Masateru , Kitamura Takeshi , Cheniti Ghassen , Denis Arnaud , Sacher Frederic , Hocini Mélèze , Haissaguerre Michel , Jais Pierre , Derval Nicolas , Pambrun Thomas
Published: June 2021

Introduction: Human atria comprise distinct epicardial layers, which can
bypass endocardial layers and lead to downstream centrifugal propagation
at the “epi-endo” connection. We sought to characterize anatomical
substrates, electrophysiological properties, and ablation outcomes of
“pseudo-focal” atrial tachycardias (ATs), defined as macroreentrant
ATs mimicking focal ATs. Methods and Results: We retrospectively
analyzed ATs showing centrifugal propagation with post-pacing intervals
(PPIs) after entrainment pacing suggestive of a macroreentry. A total of
26 patients had pseudo-focal ATs consisting of 15 perimitral, 7
roof-dependent, and 5 cavotricuspid isthmus (CTI)-dependent flutters. A
low-voltage area was consistently found at the collision site and
co-localized with epicardial layers like the: (1) coronary sinus-great
cardiac vein bundle (22%); (2) vein of Marshall bundle (15%); (3)
Bachmann bundle (22%); (4) septopulmonary bundle (15%); (5) fossa
ovalis (7%); and (6) low right atrium (19%). The mean missing
tachycardia cycle length (TCL) was 67 ± 29 ms (22%) on the endocardial
activation map. PPI was 9 [0-15] ms and 10 [0-20] ms longer than
TCL at the breakthrough site and the opposite site, respectively. While
feasible in 25 pseudo-focal ATs (93%), termination was better achieved
by blocking the anatomical isthmus than ablating the breakthrough site
[24/26 (92%) vs. 1/6 (17%); p < 0.001]. Conclusion:
Perimitral, roof-dependent, and CTI-dependent flutters with centrifugal
propagation are favored by a low-voltage area located at well-identified
epicardial bundles. Comprehensive entrainment pacing maneuvers are
crucial to distinguish pseudo-focal ATs from true focal ATs. Blocking
the anatomical isthmus is a better therapeutic option than ablating the
breakthrough site.
„Budući da je smrt csoveka istinita, csas pak smrti nepoznat…“
Authors: Lovaš Eldina
Published: June 2021

U radu se na temelju sačuvanih originala i prijepisa oporuka, koji se nalaze u fondu Poglavarstva slobodnog i kraljevskog grada Osijeka, analiziraju oporuke, oporučitelji i oporučna ostavština u neobjavljenim oporukama osječkog stanovništva. U analizu je uključeno 86 testamenata koji su napisani na hrvatskom jeziku između 1809. i 1850. godine. U središtu je rada prikazivanje oporuka kao izvora u fondu Poglavarstva slobodnog i kraljevskog grada Osijeka, zatim prikaz strukture osječkih oporuka, analiza brojčanog odnosa između oporučitelja i oporučiteljica, kao i obilježja testatora. U pogledu oporučne ostavštine, nabrojit će se ona najzastupljenija u oporukama osječkoga stanovništva, a to su novčani prilozi, nekretnine i materijalne stvari.
Ratne štete na kulturnim dobrima na području Osječko-baranjske županije
Authors: Nazor Ante , Holjevac Tuković Ana
Published: June 2021

Članak na temelju arhivskog gradiva, fonda Državna komisija za popis i procjenu ratne štete, daje pregled ratnih šteta na kulturnim dobrima na području Osječko-baranjske županije. Od početka velikosrpske agresije na Hrvatsku, područje Osječko-baranjske županije bilo je gotovo svakodnevno napadano, a sjeveroistočno područje županije, Baranja, bilo je okupirano od kolovoza 1991. do završetka procesa mirne reintegracije hrvatskog Podunavlja u siječnju 1998. godine. Područje Osječko-baranjske županije u vrijeme Domovinskoga rata pretrpjelo je silna razaranja graditeljske baštine, sakralnih spomenika, kao i pokretnih kulturnih dobara koja su otuđena i dijelom uništena.
Quantifying the Effects of Aircraft Engine Upgrades on Operating and Support Costs
Authors: Myers Bradford A. , White Edward D. , Ritschel Jonathan D. , Fass R. David
Published: June 2021

For fixed wing aircraft within the U.S. Air Force, Operating and Support (O&S) costs encompass a large portion of total life-cycle costs. O&S costs include fuel, maintenance, and engine upgrades. To the authors’ knowledge, no study to date has attempted to empirically quantify the realized effects of new aircraft engines on sustainment costs. Utilizing the Air Force Total Ownership Cost database, they focused on new engines appearing on the C-5s, C-130s, and C-135s. Although narrow in scope, results suggest newer engines have lower fuel costs. Maintenance costs for newer engines were not consistently higher or lower than the engines they replaced, although Contractor Logistics Support was not tracked by engine in this study. We found that savings from improved fuel efficiency tended to be greater than a potential increase in maintenance costs.
Design of automation control thermal system integrated with parabolic trough collector based solar plant
Authors: Nattappan Anbuchezhian , Ganesan Suganya Priyadharshini , Thiagarajan Velmurugan , Ranganathan Krishnamoorthy
Published: June 2021

This paper presents enhanced design for automation control of processes involved in a solar system which utilizes programmable logic controller to auto-mate tracking system for obtaining maximum solar radiation. Three areas are involved in this proposed multi area system where 1st and 2nd area considers solar power plant with thermal system based parabolic trough collector with fixed so-lar isolation and random isolation of solar energy whereas third area comprises of solar thermal system with dish Stirling realistic unit. Energy efficiency can be increased by using solar concentrator along with Stirling engine. Optimization of gain of the controller is by utilizing crow search novel algorithm. Crow search algorithm is an optimization technique, which provides better performance at complex time varying noisy condition and time in-varying noisy condition. The proposed controller is evaluated by obtaining the optimized parameters of the system whose comparison is done by operating proposed controller with and without renewable sources of energy thereby revealing better performance for both conditions. Testing is done in different areas with fixed solar isolation and random stisolation of solar energy involved in solar thermal power plant based on parabolic trough collector. Gain and parameters of the controller of the solar power plant are optimized by utilizing automation for operation of solar concentrator with parabolic trough collector. Data acquisition and monitoring is done by human machine interface in order to report safe operation. The simulation results of integrated solar thermal system involving dish Stirling with parabolic trough collector, shows that dynamic response of the proposed controller operating with renewable solar energy is better than that of non-renewable energy source.
Investigations on phase change materials for enhancement of thermal conductivity
Authors: Janumala Emeema , Govindarajan Murali , Bomma Reddi Venkateswara , Chinnasamy Sivakandhan
Published: June 2021

Experimental work has been undertaken to improve the thermal conductivity of the phase change material (PCM), paraffin wax (PW) by adding Al2O3 and Cu particles in increased mass fractions to elevate thermal energy storage efficiency. Composite PCM of PW-Al2O3 and PW-Cu with 5%, 10%, and 15% mass fractions were prepared by sonication. Morphology of microstructures of PW and composite PCM were examined using SEM. Thermophysical properties were measured using standard testing methods. Latent heat and specific heat were recorded with differential scanning calorimeter. Thermal conductivity was tested using two slab guarded hot plate apparatus. The results showed an improvement in thermal conductivity and latent heat of the composite PCM. The enhancement ratio of thermal conductivity was 10% and 80% for PW-Al2O3 and PW-Cu composite PCM respectively at 15 wt.%.
Three-dimensional assessment of the spheno-occipital synchondrosis and clivus after tooth-borne and bone-borne rapid maxillary expansion:
Authors: Leonardi Rosalia , Ronsivalle Vincenzo , Lagravere Manuel O. , Barbato Ersilia , Isola Gaetano , Lo Giudice Antonino
Published: June 2021

Objectives

To assess changes in spheno-occipital synchondrosis after rapid maxillary expansion (RME) performed with conventional tooth-borne (TB) and bone-borne (BB) appliances.

Materials and Methods

This study included 40 subjects with transverse maxillary deficiency who received TB RME or BB RME. Cone-beam computed tomography images (CBCT) were taken before treatment (T0), and after a 6-month retention period (T1). Three-dimensional surface models of the spheno-occipital synchondrosis and basilar part of the occipital bone were generated. The CBCTs taken at T0 and T1 were registered at the anterior cranial fossa via voxel-based superimposition. Quantitative evaluation of Basion displacement was performed with linear measurements and Euclidean distances. The volume of the synchndrosis was also calculated for each time point as well as the Nasion-Sella-Basion angle (N-S-Ba°). All data were statistically analyzed to perform inter-timing and intergroup comparisons.

Results

In both groups, there was a small increment of the volume of the synchondrosis and of N-S-Ba° (P < .05). Basion showed a posterosuperior pattern of displacement. However, no significant differences (P > .05) were found between the two groups.

Conclusions

Although TB and BB RME seemed to have some effects on the spheno-occipital synchondrosis, differences were very small and clinically negligible.
Baseline Predictors of Glycemic Worsening in Youth and Adults With Impaired Glucose Tolerance or Recently Diagnosed Type 2 Diabetes in the Restoring Insulin Secretion (RISE) Study
Authors: Sam Susan , Edelstein Sharon L. , Arslanian Silva A. , Barengolts Elena , Buchanan Thomas A. , Caprio Sonia , Ehrmann David A. , Hannon Tamara S. , Tjaden Ashley Hogan , Kahn Steven E. , Mather Kieren J. , Tripputi Mark , Utzschneider Kristina M. , Xiang Anny H. , Nadeau Kristen J. , Consortium The RISE
Published: June 2021

Objective: Identify predictors
of glycemic worsening among youth and adults with impaired glucose tolerance
(IGT) or recently-diagnosed type 2 diabetes in the RISE Study.

Research Design and Methods: Ninety-one
youth (10-19 years) were randomized 1:1 to 12 months of metformin (MET), or 3
months of glargine followed by 9 months of metformin (G-MET); 267 adults to
MET, G-MET, liraglutide plus MET (LIRA+MET) or placebo for 12 months. All
participants underwent baseline hyperglycemic clamp and 3-h oral glucose
tolerance test (OGTT) at baseline, month-6, month-12 and off treatment at month-15
and month-21. Cox models identified baseline predictors of glycemic worsening (HbA1c
increase ≥0.5% from baseline).

Results: Glycemic worsening
occurred in 17.8% of youth vs. 7.5% of adults at month-12 (p=0.008), and 36% of
youth vs. 20% of adults at month-21 (p=0.002). In youth, glycemic worsening did
not differ by treatment. In adults, month-12 glycemic worsening was less on LIRA+MET
vs. placebo (HR 0.21, CI 0.05-0.96, p=0.044). In both age groups, lower baseline
clamp-derived β-cell responses predicted month-12 and month-21 glycemic
worsening (p<0.01); lower baseline OGTT-derived β-cell responses predicted month-21
worsening (p<0.05). In youth, higher baseline HbA1c and 2-h glucose predicted
month-12 and month-21 glycemic worsening and higher fasting glucose predicted month-21
worsening (p<0.05). In adults, lower clamp and OGTT-derived insulin
sensitivity predicted month-12 and month-21 worsening (p<0.05).

Conclusions: Glycemic
worsening was more common among youth than adults with IGT or
recently-diagnosed type 2 diabetes, predicted by lower baseline β-cell responses
in both groups, hyperglycemia in youth and insulin resistance in adults.
Hyperglucagonemia Does Not Explain the β-Cell Hyperresponsiveness and Insulin Resistance in Dysglycemic Youth Compared With Adults: Lessons From the RISE Study
Authors: Kahn Steven E. , Mather Kieren J. , Arslanian Silva A. , Barengolts Elena , Buchanan Thomas A. , Caprio Sonia , Ehrmann David A. , Hannon Tamara S. , Marcovina Santica , Nadeau Kristen J. , Utzschneider Kristina M. , Xiang Anny H. , Edelstein Sharon L. , Consortium The RISE
Published: June 2021

Objective: To determine whether β-cell
hyperresponsiveness and insulin resistance in youth versus adults in the
Restoring Insulin Secretion (RISE) Study are related to increased glucagon
release.

Research Design and Methods: In 66 youth and 350 adults with
IGT or drug-naïve, recently diagnosed type 2 diabetes, we performed
hyperglycemic clamps and OGTTs. From clamps we quantified insulin sensitivity
(M/I), plasma fasting glucagon and C-peptide, steady-state glucagon and
C-peptide at glucose of 11.1 mmol/L and arginine-stimulated glucagon (AGR) and
C-peptide (ACPR) responses at glucose >25 mmol/L.

Results: Fasting (7.63±3.47 vs 8.55±4.47
pmol/L; mean±SD; p=0.063) and steady-state glucagon (2.24±1.46 vs 2.49±1.96
pmol/L, p=0.234) were not different in youth and adults, while AGR was lower in
youth (14.1±5.2 vs 16.8±8.8 pmol/L, p=0.001). Significant age group differences
in M/I, fasting C-peptide, steady-state C-peptide and ACPRmax were not related
to glucagon. Fasting glucose and glucagon were positively correlated in adults
(r=0.133, p=0.012), and negatively correlated in youth (r= -0.143, p=0.251). In
both age groups, higher fasting glucagon was associated with higher fasting
C-peptide (youth r=0.209, p=0.091; adults r=0.335, p<0.001) and lower M/I
(youth r= -0.228, p=0.066; adults r= -0.324, p<0.001). With comparable
fasting glucagon, youth had greater C-peptide and lower insulin sensitivity. OGTT
suppression of glucagon was greater in youth.

Conclusions: Youth with IGT or drug-naïve,
recently diagnosed type 2 diabetes have hyper-responsive β-cells and lower
insulin sensitivity, but their glucagon concentrations are not increased
compared to adults. Thus, α-cell dysfunction does not appear to explain the
difference in β-cell function and insulin sensitivity in youth versus adults.
Increased Hemoglobin A1c Time in Range Reduces Adverse Health Outcomes in Older Adults With Diabetes
Authors: Prentice Julia C. , Mohr David C. , Zhang Libin , Li Donglin , Legler Aaron , Nelson Richard E. , Conlin Paul R.
Published: June 2021

Objective: Short and long-term glycemic variability are risk factors for diabetes
complications. However, there are no validated A1c target ranges or measures of A1c
stability in older adults. We evaluated the association of a
patient-specific A1c variability measure, A1c time in range (A1c TIR), on major
adverse outcomes.

Research Design and
Methods:  We conducted a retrospective
observational study using administrative data from the Department of Veterans
Affairs and Medicare from 2004 - 2016. Patients were ≥65
years old with diabetes and at least four A1c tests during a three-year
baseline period. A1c TIR was the percentage of days during the baseline in
which A1c was in an individualized target range (from 6.0-7.0% up to 8.0-9.0%) based on clinical
characteristics and predicted life expectancy. Increasing A1c TIR was divided
into categories of 20% increments and linked to mortality and cardiovascular
disease (CVD) (i.e. myocardial infarction [MI] and stroke).

Results: The study
included 402,043 Veterans (mean [SD] age, 76.9 [5.7] years; 98.8% male). During
an average of 5.5 years of follow-up, A1c TIR had a graded relationship with mortality
and CVD. Cox proportional hazards models showed lower A1c TIR was associated
with increased mortality (A1c TIR 0-<20%; Hazard Ratio (HR) = 1.22; 95% CI, 1.20-1.25)
and CVD (A1c TIR 0-<20%; HR = 1.14; 95% CI, 1.11-1.19) when compared to A1c
TIR 80-100%. Competing risk models and shorter follow-up (e.g. 24 months)
showed similar results.

Conclusion: In older adults with diabetes,
maintaining A1c levels within individualized target ranges is associated with
lower risk of mortality and CVD.
The Anna Karenina Model of β Cell Maturation in Development and their Dedifferentiation in Type 1 and Type 2 Diabetes
Authors: Nimkulrat Sutichot D. , Bernstein Matthew N. , Ni Zijian , Brown Jared , Kendziorski Christina , Blum Barak
Published: June 2021

Loss of mature β cell function and identity,
or β cell dedifferentiation, is seen in both type 1 and type 2 diabetes. Two
competing models explain β cell dedifferentiation in diabetes. In the first
model, β cells dedifferentiate in the reverse order of their developmental
ontogeny. This model predicts that dedifferentiated β cells resemble β cell
progenitors. In the second model, β cell dedifferentiation depends on the type
of diabetogenic stress. This model, which we call the “Anna Karenina” model, predicts
that in each type of diabetes, β cells dedifferentiate in their own way,
depending on how their mature identity is disrupted by any particular
diabetogenic stress. We directly tested the two models using a β cell-specific lineage-tracing
system coupled with RNA-sequencing in mice. We constructed a multidimensional
map of β cell transcriptional trajectories during the normal course of β cell postnatal
development and during their dedifferentiation in models of both type 1
diabetes (NOD) and type 2 diabetes (BTBR-Lepob/ob). Using this unbiased approach, we show here that despite some
similarities between immature and dedifferentiated β cells, β cells dedifferentiation in the two mouse models is not a
reversal of developmental ontogeny and is different between different types
of diabetes.
LTB4-Driven Inflammation and Increased Expression of ALOX5/ACE2 During Severe COVID-19 in Individuals with Diabetes
Authors: Bonyek-Silva Icaro , Machado Antônio Fernando Araújo , Cerqueira-Silva Thiago , Nunes Sara , Cruz Márcio Rivison Silva , Silva Jéssica , Santos Reinan Lima , Barral Aldina , Oliveira Pablo Rafael Silveira , Khouri Ricardo , Serezani Henrique C. , Brodskyn Cláudia , Caldas Juliana Ribeiro , Barral-Netto Manoel , Boaventura Viviane , Tavares Natalia Machado
Published: June 2021

Diabetes is a known risk factor for severe
COVID-19, the disease caused by the new coronavirus SARS-CoV-2. However, there
is a lack of knowledge about the mechanisms involved in the evolution of
COVID-19 in individuals with diabetes. Therefore, we aimed to evaluate whether
the chronic low-grade inflammation of diabetes could play a role in the
development of severe COVID-19. We collected clinical data and blood samples of
hospitalized patients for COVID-19, with diabetes and without diabetes. Plasma
samples were used to measure inflammatory mediators and peripheral blood
mononuclear cells, for gene expression analysis of SARS-CoV-2 main receptor
system (ACE2/TMPRSS2) and main molecule of LTB4 pathway (ALOX5).
We found that diabetes activates LTB4 pathway, and during COVID-19,
it increases ACE2/TMPRSS2 as well as ALOX5 expression. Diabetes
was also associated with COVID-19-related disorders, such as reduced SpO2/FiO2
and PaO2/FiO2 levels, and increased
disease duration. In addition, the expression of ACE2 and ALOX5
are positively correlated, with increased expression in COVID-19 patients with
diabetes requiring intensive care assistance. We confirmed these molecular
results at the protein level, where plasma LTB4 is significantly
increased in individuals with diabetes.
Besides, IL-6 serum levels are increased only in individuals with diabetes requiring
intensive care assistance. Together, these results indicate that LTB4
and IL-6 systemic levels, as well as, ACE2/ALOX5 blood expression
could be early markers of severe COVID-19 in individuals with diabetes.
Samskabelse i grøn omstilling – nye roller og udfordringer for frontpersonalet
Authors: Horsbøl Anders , Andersen Pernille V.K. , Burri Hansen Sandra , Christiansen Ellen , Lindhardt Søren
Published: June 2021

’Samskabelse’ er i de senere år blevet en strategisk tilgang for kommuner, som ønsker grøn omstilling i løsningen af opgaver i forbindelse med forsyning, affaldshåndtering osv. Samskabelse ses som et værktøj til at skabe adfærdsændringer hos borgerne samt en forstærket involvering af borgerne i det lokale demokrati. Samskabelsesstrategien kan imidlertid forekomme modsætningsfyldt: Borgerne skal frivilligt samarbejde med offentlige myndigheder om at udforme initiativer til ændret adfærd på områder, hvor borgerne almindeligvis oplever, at de har autonomi. Dette modsætningsfyldte forhold gør opgaven til en udfordring for frontpersonalet, som står med borgerkontakten. Artiklen præsenterer analyser af kommunikationen i et skandinavisk EU-finansieret projekt om ’samskabende grøn omstilling’ (SGO), hvor kommunalt frontpersonale i fire tilfælde (to i Danmark og to i Sverige) har arbejdet med samskabelse i deres lokalområde for at udvikle en fælles samskabelsesmetode til grøn omstilling. Vi har som klimakommunikationsforskere fulgt projektet og undervejs samarbejdet med frontpersonalet om metodeudviklingen. Vores analyse af deltagernes kommunikation viser, at kompetence til at lytte til borgerne samt tid til kollegial erfaringsudveksling er afgørende for frontpersonalets udvikling af kompetence til samskabelse. Derfor konkluderer vi, at såvel det politiske som det ledelsesmæssige niveau i kommunerne bør tilgodese disse elementer, når man vælger en samskabelsesstrategi i forbindelse med påvirkning af borgernes adfærd i forhold til den grønne omstilling.
English abstract
Green transition via co-creation: new roles and challenges for the frontline staff
In recent years, notions of co-creation have come to play an important part in re-conceptualizing the relation between public authorities and citizens, not least as regards efforts towards green transition. This article focuses on the perspective of public frontline staff and the challenges related to co-creating a green transition with citizens. The empirical basis is a multilocal case study, where two Danish municipalities and two Swedish municipal associations have developed a method for employees who are in charge of ‘co-creational green transition’ in their local area. Based on transcripts from meetings of employees, in which they exchange their local experience, the article, using a qualitative content analysis, investigates how the employees understand their roles in the co-creation process. The analysis shows that due to several challenges experienced in the communication with citizens these roles evolved during the project period, and the article argues that this has implications for the political and managerial framing of co-creation as a pathway to green transition.
Krop og trivsel i udskolingen – fra et elevperspektiv
Authors: Olsen Steen Schytte , Madsen Katrine Dahl , Stolpe Malene Norup , Damgaard Thea Ilkjær , Nielsen Philip Nordstrand , Sederberg Mathilde
Published: June 2021

Ud fra forskellige argumenter om, at bevægelse og andre kropslige tilgange kan fremme både fysisk og mental sundhed, således at elevernes læring øges, har der i relation til skolereformen fra 2014 været en interesse for bevægelse som en del af skoledagen.
Implementeringen af elementerne fra skolereformen har imidlertid været kritiseret for at være præget af en top-down-tænkning, og derfor har vi i det tværprofessionelle projekt ’Krop og trivsel i udskolingen’ haft fokus på elevernes perspektiv på krop og trivsel. Inspireret af aktionsforskning har målet været at give opmærksomhed til elevernes ressourcer og deltagelse i det læringsmiljø, som de selv er med til at skabe.
Igennem otte måneder fulgte projektet to folkeskoleklasser (en 8.- og en 9.-klasse), og den aktionsforskningsbaserede tilgang bestod efter det forberedende arbejde af tre overordnede dele: 1) fremtidsværksted med eleverne for at identificere barrierer og muligheder, 2) projektarbejde i mindre grupper af elever faciliteret af forskerne, og 3) dialogmøde mellem forskere, lærere og skoleledelse.
Artiklen her formidler elevernes stemmer, som overordnet kategoriseres i tre temaer: 1) relationer og fællesskaber, 2) mange former for krop, og 3) deltagelse og modløshed. Artiklen diskuterer desuden mulige potentialer for at fremme elevernes deltagelse og trivsel i samarbejde med andre interessenter i skolen, fx andre klasser, elevråd, lærere og skoleledelse.
English abstract
Embodiment and well-being in Danish secondary school classes
Approaches involving bodily activity can promote physical and mental health, which in turn may increase learning outcomes. In the light of this, a recent reform of Danish state schools has focused on various forms of physical activity as a part of the school day.
However, the implementation process has been predominantly top-down. Therefore, the purpose of the present interprofessional study was – from the perspective of the pupils – to identify factors that enable or hinder well-being, activity and learning, as well as to facilitate actions leading to change.
Throughout a school year, the project followed two classes at secondary school level (year 8 and year 9), using an approach based on action research and consisting of three main parts: 1) A workshop with the students to identify barriers and opportunities; 2) Project work with small groups of students facilitated by the researchers; and 3) A dialogue meeting between researchers, teachers and school management.
This article presents the voices of the pupils, broadly categorised into three themes: 1) Relationships and fellowship; 2) Many ways of being ‘bodily aware’; and 3) Participation and discouragement. Finally, the article discusses possible ways of promoting student participation and well-being in collaboration with other interested parties in the school, such as other classes, student councils, teachers and school management.
Risk of Perforated Appendicitis in Patients with Hyperbilirubinemia
Authors: Ibrahim Mohammed , Alotaibi Mohammed , Alharthi Fawzi , Alzahrani Bader , Alotaibi Saad , Alfaqeh Eyad , Alsuwat Raad
Published: June 2021

Background: One of common causes of abdominal pain that needs an urgent medical intervention is Acute Appendicitis (AA), Perforated appendicitis that result of hyperbilirubinemia, and relation with age. Methods: This is a retrospective cross-sectional study that will be performed in King Abdulaziz Specialist Hospital, Taif city in Saudi Arabia on the period from January 2018 to January 2020. Sample size of 197 is determined by World Health Organization (WHO) sample size calculator. Oral consent is taken from those patients. We include patients based on their age and gender. That is, we include ages from 10 years old to 60 years old. We also select both genders, male and female. Those patients may be presented with typical or atypical features of appendicitis. Result: Out of 197 participants 49.7% (n=98) were male and 50.3% (n=99) were female. 21.8% (n=43) aged less than 20 years, 54.3% (n=107) aged from 20 to 40 years and 23.9% (n=47) aged more than 40 years. About 31% (n=61) had perforated appendix. a significant relationship between perforated appendix and age was found (p-value= 0.012), in addition to bilirubin level (p-value= 0.001) respectively. Conclusion: Our local community. The majority of perforated appendix cases we found to be association with increase hyperbilirubinemia
THE PROBLEM OF EVALUATION OF ECONOMIC EFFICIENCY OF SCIENCE AT THE MACRO LEVEL
Authors: Porev Sergiy , Smolynets Sofia
Published: June 2021

The article is devoted to solving the problem of evaluating the effectiveness of research and development systems of countries with the help of economic indicators that could be useful for solving the tasks of improving scientific policy and management, in particular in Ukraine.

It is noted that the main ones could be economic indicators of the effectiveness of research and development, which would represent the difference and the relationship between the sum of the prices of fragments of new knowledge and the cost of their creation. However, it is shown that the calculation of both of these components can hardly be accurate enough, due to the nature of knowledge formation and the peculiarities of their use.

It is shown that the publications number in Ukraine, especially in the case of social and economic sciences, is improved contrary to the decrease of funding and reducing the number of researchers. The growth of a publications number in Scopus can be explained mostly by the norms of the state power documents, as regard to scientific reports, and the award of scientific degrees and the assignment of academic titles. It is proved that at the macro level bibliometric indicators of publications have grounds not to reflect changes in human scientific potential and research funding, and in fact they are not equivalent to either cognitive achievements or economic results.

Indicators representing the direct ratio of industrial and business expenditures to total R&D expenditures, as well as a modification in which industrial and business expenditures are attributed to the sum of all other expenditures, are proposed. We think these indicators to some extent could represent the orientation of the research and development system of the country to meet the needs of the economy and technological development, its innovative orientation.

The originality of the approach is that we either limit ourselves to indicators that have economic meaning, or use their ratios, avoiding the comparison and combination of incommensurable entities. We believe that in evaluating the results of research and development, it is advisable to operate with the concepts of fragments of knowledge based on the ideas of classical epistemology and information as a means of mental and material cognitive communication. When creating new combinations of known economic indicators of research and development, we mean that their main result is the resulting fragments of new scientific knowledge, rather than secondary forms of publications, citations, financial expenditures, which may be non-equivalent to the main results.