bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term follow up after denosumab treatment for osteoporosis – rebound associated with hypercalcemia, parathyroid hyperplasia, severe bone mineral density loss, and multiple fractures: a case report
Authors: Maugars Yves , Guillot Pascale , Glémarec Joëlle , Berthelot Jean-Marie , Le Goff Benoit , Darrieutort-Laffite Christelle
Published: August 2020

Background

The rebound effect after stopping treatment with denosumab may be associated with rapid loss of the gains in bone mineral density achieved with treatment, high levels of bone remodeling markers, the occurrence of vertebral fractures, and even hypercalcemia.

Case presentation

A 64-year-old osteoporotic Caucasian woman suffered from a fracture of her second lumbar vertebra in 2004. From January 2005, she was treated with denosumab for 9 years, with good densitometry results for her hip and lumbar areas, and no fractures over the last 6 years of treatment. Ten months after the treatment with denosumab was stopped, a cascade of vertebral fractures, including some in unusual locations (third thoracic vertebra), and multiple rib fractures in a context of hypercalcemia, suggested possible malignancy. A complete evaluation, including systemic, biological, and biopsy analyses, ruled out this hypothesis. The hypercalcemia was associated with normal plasma phosphate and vitamin D concentrations, and a high parathyroid hormone level, with an abnormal fixation of the lower lobe of the thyroid on sesta-methoxy-isobutyl-isonitrile scintigraphy. Histological analysis of the excised parathyroid tissue revealed hyperplasia. The associated thyroidectomy (goiter) led to the discovery of a thyroid papillary microcarcinoma.

Conclusions

We consider the consequences of this rebound effect, not only in terms of the major loss of bone density (return to basal values within 3 years) and the multiple disabling fracture episodes, but also in terms of the hypercalcemia observed in association with apparently autonomous tertiary hyperparathyroidism. Several cases of spontaneous reversion have been reported in children, but the intervention in our patient precluded any assessment of the possible natural course. The discovery of an associated thyroid neoplasm appears to be fortuitous. Better understanding of the various presentations of the rebound effect after stopping treatment with denosumab would improve diagnostic management of misleading forms, as in this case. Bisphosphonates could partially prevent this rebound effect.
Subcutaneous hemangioma on nasal dorsum: a case report
Authors: Kadriyan Hamsu , Sulaksana Muhammad Alfian , Yudhanto Didit , Aryani I. Gusti Ayu Trisna , Yuliani Eka Arie , Ardianti Nurul Endah , Suprayogi Moh. , Djannah Fathul
Published: August 2020

Introduction

Hemangioma is a benign tumor made up of blood vessels and typically occurs as a slightly elevated purplish or reddish area of skin. Hemangioma is mostly found superficially; subcutaneous hemangioma in the nasal dorsum is rare.

Case presentation

In West Nusa Tenggara Regional Hospital, the authors found two cases of subcutaneous hemangioma in patients of very different ages. The first patient was a 2-year-old Sasak girl, and the other was a 40-year-old Sasak man. The pediatric patient was treated with an elliptical approach, whereas the adult patient was treated with lateral rhinotomy extended by an elliptical approach to remove the hemangioma and ligate the feeding arteries. After surgery, the adult patient was followed up for 5 months, whereas the pediatric patient was followed up for 3 months. The results for both patients were good, with minimal scar formation.

Conclusion

Despite the limitations of technology and human resources in a remote area of Indonesia, the surgical approach used in these cases produced good outcomes for both patients.
The mitochondrial K-ATP channel opener diazoxide upregulates STIM1 and Orai1 via ROS and the MAPK pathway in adult rat cardiomyocytes
Authors: Gavali Joice T. , Carrillo Elba D. , García María C. , Sánchez Jorge A.
Published: August 2020

Background

Openers of mitochondrial adenosine triphosphate-dependent potassium (mKATP) channels like diazoxide increase reactive oxygen species (ROS) production in cardiac cells and reduce Ca2+ elevations produced by ischemia–reperfusion, protecting the heart from damage. In this study we tested the hypothesis that opening mKATP channels regulates expression of the major components of store-operated Ca2+ entry (SOCE) STIM1 and Orai1.

Results

Quantitative reverse transcriptase polymerase chain reaction (qRT-PCR) and western blot experiments showed that diazoxide increased expression of STIM1 and Orai1 at the mRNA and protein levels, respectively, in adult rat cardiomyocytes. Immunofluorescence analyses revealed that diazoxide also disrupted the striated distribution pattern of STIM1. These effects were prevented by the ROS scavenger N-acetyl cysteine (NAC), the mKATP channel antagonist 5-hydroxydecanoate (5-HD), or the protein synthesis inhibitor cycloheximide (CHX). Confocal microscopy revealed that diazoxide also led to nuclear translocation of the transcription factors c-Fos and NFκB, which was also blocked by NAC or 5-HD. Finally, the MAPK pathway inhibitor UO126 attenuated diazoxide-induced upregulation of STIM1 and Orai1 expression.

Conclusions

Our results suggest that opening mitochondrial potassium ATP channels with diazoxide upregulates the expression of STIM1 and Orai1 by de novo synthesis by a mechanism that involves NFkB, c-Fos, and ROS via MAPK/ERK signaling.
Simulation of vocational activities: experimental evidence of (no) changes in vocational interests
Authors: Martončik Marcel , Babjáková Jaroslava , Čupková Lena , Köverová Natália , Kačmárová Monika
Published: August 2020

Many school-age pupils are undecided about their future vocation. This often stems from a lack of occupational information or lack of vocationally related experience. The goal of this study was to develop and evaluate an intervention focused on the possibility of changing vocational interests through the simulation of vocational activities. The sample consisted of 250 pupils who were finishing primary school. The intervention was constructed for practical and artistic interests and consisted of workbooks that aim to simulate these vocational activities. MANCOVA showed no effect in the change of vocational interests among the pupils. An alternative idea of intervention in the form of virtual reality simulations is also presented.
A review of analytical methods for assessing preservation in waterlogged archaeological wood and their application in practice
Authors: High Kirsty E. , Penkman Kirsty E. H.
Published: August 2020

Waterlogged archaeological wood can present management challenges due to its vulnerability to chemical and biological decay, both during burial and post-excavation. Decay processes also often leave it severely weakened and therefore susceptible to mechanical damage. Quantifying preservation and understanding active decay mechanisms is therefore critical in informing the management of this unique cultural resource. It is critical that assessments of preservation are robust, and sensitive enough to allow changes over time to be detected. A wide range of analytical methods can be applied to assess the state of preservation of waterlogged archaeological wood, and determining which of these is most appropriate to the circumstances can be challenging. This review summarises some of the most commonly reported methods suitable for the analysis of waterlogged archaeological wood, ranging from widely used ‘low-tech’ methods, to assessment using advanced analytical instrumentation. Methods are evaluated in terms of the information gained weighed up against their cost, logistical considerations, and time investments, with the aim of supporting the development of an analytical strategy. We conclude that although an analytical strategy must be informed by the aims of assessment as well as any external restrictions, the best available analytical techniques should be employed in order to supply an accurate baseline against which future change can be measured. Critically, a multi-analytical approach is vital in obtaining a clear picture of the present state of decay, as no single technique gives the best assessment.
Factors associated with empathy among community pharmacists in Lebanon
Authors: Hobeika Eva , Hallit Souheil , Sacre Hala , Obeid Sahar , Hajj Aline , Salameh Pascale
Published: August 2020

Introduction

Empathy is the cornerstone of the relationship between the healthcare provider and the patient. In Lebanon, no studies have investigated the factors associated with empathy among community pharmacists. Hence, the importance of this research to better understand empathy and help community pharmacists with this vital aspect of their practice.

Objective

This study aimed to evaluate empathy and possible factors associated with it among Lebanese community pharmacists.

Methods

This cross-sectional study was carried out between March and July 2018. It enrolled a proportionate random sample of 435 community pharmacists from all Lebanese districts. The Epi info software calculated the minimum sample size, based on a total number of 3762 community pharmacists, with an expected frequency of 50% of pharmacists with low empathy, and a 95% confidence interval. The minimal sample size required was 350 community pharmacists; our sample size was 435 to account for missing values.

Results

Our results revealed that 228 (53.4%) pharmacists had low empathy. Lower empathy was significantly associated with more physical (Beta = − 0.331) and mental (Beta = − 0.126) work fatigue, higher age (Beta = − 0.125) and a practice experience between 3 years and less than 6 years compared to less than 6 months (Beta = − 2.440).

Conclusion

This study shed the light on some factors associated with empathy among Lebanese community pharmacists. Low empathy levels were significantly associated with factors such as age, practice experience, and mental and physical work fatigue, all of which impact the practice, as the accepted model of pharmacy practice requires that pharmacists establish effective communication and use interpersonal skills. Therefore, developing empathetic communication skills is considered essential. Furthermore, increased mental and physical work fatigue should not hinder community pharmacists’ access to self-care, whether for their mental or physical health.
Reducing the arbitrary: fuzzy detection of microbial ecotones and ecosystems – focus on the pelagic environment
Authors: Bagnaro Antoine , Baltar Federico , Brownstein Gretchen , Lee William G. , Morales Sergio E. , Pritchard Daniel W. , Hepburn Christopher D.
Published: August 2020

Background

One of the central objectives of microbial ecology is to study the distribution of microbial communities and their association with their environments. Biogeographical studies have partitioned the oceans into provinces and regions, but the identification of their boundaries remains challenging, hindering our ability to study transition zones (i.e. ecotones) and microbial ecosystem heterogeneity. Fuzzy clustering is a promising method to do so, as it creates overlapping sets of clusters. The outputs of these analyses thus appear both structured (into clusters) and gradual (due to the overlaps), which aligns with the inherent continuity of the pelagic environment, and solves the issue of defining ecosystem boundaries.

Results

We show the suitability of applying fuzzy clustering to address the patchiness of microbial ecosystems, integrating environmental (Sea Surface Temperature, Salinity) and bacterioplankton data (Operational Taxonomic Units (OTUs) based on 16S rRNA gene) collected during six cruises over 1.5 years from the subtropical frontal zone off New Zealand. The technique was able to precisely identify ecological heterogeneity, distinguishing both the patches and the transitions between them. In particular we show that the subtropical front is a distinct, albeit transient, microbial ecosystem. Each water mass harboured a specific microbial community, and the characteristics of their ecotones matched the characteristics of the environmental transitions, highlighting that environmental mixing lead to community mixing. Further explorations into the OTU community compositions revealed that, although only a small proportion of the OTUs explained community variance, their associations with given water mass were consistent through time.

Conclusion

We demonstrate recurrent associations between microbial communities and dynamic oceanic features. Fuzzy clusters can be applied to any ecosystem (terrestrial, human, marine, etc) to solve uncertainties regarding the position of microbial ecological boundaries and to refine the relation between the distribution of microorganisms and their environment.
Psychometric validation of a Saudi Arabian version of the sf-36v2 health survey and norm data for Saudi Arabia
Authors: AboAbat Ahmad , Qannam Hazem , Bjorner Jakob Bue , Al-Tannir Mohamad
Published: August 2020

Background

Adaptation of a patient-reported outcomes survey into a new language requires careful translation procedures as well as qualitative and quantitative psychometric testing. This study aimed to evaluate the basic psychometric properties of the new Saudi Arabian SF-36v2 and establish norm data for Saudi Arabia.

Methods

Translation and adaptation of the SF-36v2 used standard methodology. Psychometric validation included two stages: 1) A qualitative study (n = 100) explored the components of health and health-related quality of life considered important in Saudi Arabia and evaluated the content validity of the SF-36v2 in Saudi Arabia, and 2) A quantitative study (n = 6166) evaluated the basic psychometric properties of the Saudi SF-36v2 and established norm data for Saudi Arabia. Comparison with US general population data (n = 4040) evaluated differential item function (DIF) and cross-national differences.

Results

The qualitative study supported the content validity of the Saudi SF-36v2. Cognitive debriefing identified only few and minor problems. Psychometric analyses supported item convergence within scales and differentiation across scales of the SF-36v2. Scale level exploratory factor analyses did not support the typical distinction between physical health and mental health components. Internal consistency reliability was satisfactory for all scales except the social function scale (alpha = 0.67). Cross-national DIF was identified for 9 items. In the Saudi general population, the average vitality score was lower for women (− 2.71 points) compared to men. For men, older age groups scored lower on the physical function scale (− 3.31) and the physical health component (− 3.06). For women, older age groups scored lower on the role physical (− 3.72), bodily pain (− 3.66), and vitality (− 2.32) scales as well as the physical health component (− 3.52). Compared to the 2009 United States general population, and after adjusting for age, gender, and differential item function, persons in Saudi Arabia had lower average scores for the physical function (− 3.10), role physical (− 4.75), social function (− 4.23), role emotional (− 5.67), and mental health (− 4.82) scales, as well as the mental health component (− 4.57).

Conclusion

This Saudi normative study of patient reported outcomes supported the validity and reliability of the new Saudi SF-36v2 and found cross-national differences with the USA.
Localized Wilms’ tumor in low-middle-income countries (LMIC): how can we get better?
Authors: Asfour Hosam Y. , Khalil Sahar A. , Zakaria Al-Shimaa , Ashraf El-Sayed , Zekri Wael
Published: August 2020

Background

Wilms’ tumor (WT) represents about 6% of all childhood cancers. The overall survival markedly improved to exceed 90% in developed countries, yet some studies from developing counties still have poorer outcomes. The aim of this study is to assess the clinical outcome and the different prognostic factors that influence the outcome of pediatric loco-regional WT cases treated at National Cancer Institute (NCI), Cairo University, Egypt. This is a retrospective study which included pediatric loco-regional WT patients presented between January 2008 and December 2017. Patients were followed up till June 2019.

Results

Ninety-two eligible patients were included. Median age was 3 years (range 1 month–9 years). Abdominal mass was the commonest presentation (72.8%). The 5-year EFS and OS of the whole group was 83.7% and 94.6% retrospectively. Despite having a similar EFS (84.8 vs. 82.6%), stage III patients had a significantly lower OS than those in stages I and II (89.1% vs. 100%,pvalue 0.024). Twelve patients had unfavorable histology and had a significantly lower EFS and OS than the patients with favorable histology (50 and 83.3% vs. 88.8 and 96.3%,pvalue < 0.001 and 0.043, respectively).

Conclusion

Loco-regional Wilms’ tumor cases treated in Egypt had OS nearly the same as in developed countries, but had a lower EFS than expected mainly stages I and II. The stage and histological type are the main factors influencing the survival, and further studies are needed to investigate nuclear unrest grades and proper management of such cases.
Response of past and present Mediterranean ecosystems to environmental change
Authors: Allen Harriet D.
Published: August 2020

Mediterranean ecosystems contain some of the highest levels of plant diversity of any region on Earth and are amongst those believed to be most at risk from the consequences of global warming. Yet such ecosystems are not static and have responded to environmental changes at a variety of scales and from a variety of causes, particularly climatic and anthropogenic. The purpose of this paper is to review recent research on environmental change and ecosystem response. Long-term records are available to analyse changes over glacial-interglacial cycles, while high resolution records show the sensitivity and coupling of Mediterranean, North Atlantic and Greenland records. For the Holocene, there is continued debate about the relative impact of anthropogenic activity, but there is also increasing recognition that mediterranean-type ecosystems should not be regarded as fragile, degraded landscapes, but are disturbance- adapted. Nevertheless, conservation measures face increasing challenges from contemporary climate change and human pressures. Some insights into the identification of refugial areas, either in glacial times or for present-day conservation purposes, come from molecular Biogeographical studies of past faunal and floral distribution.
Excess Mortality Among Hospitalized Patients With Hypopituitarism—A Population-Based, Matched-Cohort Study
Authors: Ebrahimi Fahim , Kutz Alexander , Wagner Ulrich , Illigens Ben , Siepmann Timo , Schuetz Philipp , Christ-Crain Mirjam , Mueller Beat , Christ Emanuel R
Published: August 2020

Context

Patients with hypopituitarism face excess mortality in the long-term outpatient setting. However, associations of pituitary dysfunction with outcomes in acutely hospitalized patients are lacking.

Objective

The objective of this work is to assess clinical outcomes of hospitalized patients with hypopituitarism with or without diabetes insipidus (DI).

Design, Setting, and Patients

In this population-based, matched-cohort study from 2012 to 2017, hospitalized adult patients with a history of hypopituitarism were 1:1 propensity score–matched with a general medical inpatient cohort.

Main Outcome Measures

The primary outcome was in-hospital mortality. Secondary outcomes included all-cause readmission rates within 30 days and 1 year, intensive care unit (ICU) admission rates, and length of hospital stay.

Results

After matching, 6764 cases were included in the study. In total, 3382 patients had hypopituitarism and of those 807 (24%) suffered from DI. All-cause in-hospital mortality occurred in 198 (5.9%) of patients with hypopituitarism and in 164 (4.9%) of matched controls (odds ratio [OR] 1.32, [95% CI, 1.06-1.65], P = .013). Increased mortality was primarily observed in patients with DI (OR 3.69 [95% CI, 2.44-5.58], P < .001). Patients with hypopituitarism had higher ICU admissions (OR 1.50 [95% CI, 1.30-1.74], P < .001), and faced a 2.4-day prolonged length of hospitalization (95% CI, 1.94–2.95, P < .001) compared to matched controls. Risk of 30-day (OR 1.31 [95% CI, 1.13-1.51], P < .001) and 1-year readmission (OR 1.29 [95% CI, 1.17-1.42], P < .001) was higher among patients with hypopituitarism as compared with medical controls.

Conclusions

Patients with hypopituitarism are highly vulnerable once hospitalized for acute medical conditions with increased risk of mortality and adverse clinical outcomes. This was most pronounced among those with DI.
Tubular Secretory Clearance Is Associated With Whole-Body Insulin Clearance
Authors: Huber Matthew P , Zelnick Leila R , Utzschneider Kristina M , Kahn Steven E , de Boer Ian H , Kestenbaum Bryan R
Published: August 2020

Context

The kidneys eliminate insulin via glomerular and peritubular mechanisms; consequently, the kidney contribution to insulin clearance may be underestimated by the glomerular filtration rate (GFR) alone.

Objective

To determine associations of tubular secretory clearance with whole-body insulin clearance and sensitivity in a dedicated study of glucose and insulin metabolism.

Design, Setting, and Participants

We performed an ancillary, cross-sectional study of tubular secretion in the Study of Glucose and Insulin in Renal Disease (SUGAR). Hyperinsulinemic-euglycemic clamps were performed in 57 nondiabetic persons with chronic kidney disease and 38 persons without kidney disease.

Intervention

We measured plasma and 24-hour urine concentrations of endogenous solutes primarily eliminated by tubular secretion. Kidney clearances of secretory solutes were calculated as the amount of blood fully cleared of that solute per minute.

Main Outcome Measures

Whole-body insulin clearance, insulin sensitivity.

Results

Mean whole-body insulin clearance was 924 ± 228 mL/min. After adjustment for age, sex, Black race, fat and fat-free mass, each 20% lower estimated GFR was associated with a 13 mL/min lower insulin clearance (95% confidence interval [CI], 2-24 mL/min lower). Each 20% lower clearance of isovalerylglycine and xanthosine were associated with a 16 mL/min lower (95% CI, 5-26 mL/min lower) and 19 mL/min lower (95% CI, 7-31 mL/min lower) insulin clearance, respectively. Neither estimated GFR nor secretory solute clearances were associated with insulin sensitivity after adjustment.

Conclusions

These results highlight the importance of tubular secretory pathways to insulin elimination but suggest that kidney functions in aggregate contribute only modestly to systemic insulin clearance.
Accuracy of three-dimensional photogrammetry and cone beam computed tomography based on linear measurements in patients with facial deformities
Authors: Zhao Zhenqi , Xie Lizhe , Cao Dan , Izadikhah Iman , Gao Pengcheng , Zhao Yang , Yan Bin
Published: August 2020

Objectives:

This study was aimed to investigate the accuracy of soft-tissue measurements obtained by two imaging modalities, three-dimensional (3D) photogrammetry and cone beam CT (CBCT) when confounded by influence factors (facial deformities and partitions).

Methods:

60 wax facial models from facially deformed patients were captured by 3D photogrammetry and CBCT. 19 linear distances on each image were measured and juxtaposed to reference values attained via a coordinate-measuring machine (CMM) as the gold-standard. Paired t-tests were used to compare linear accuracy of the test and reference systems. The influence of deformities and partitions (created by dividing the face with three vertical and five horizontal lines) on the measurement errors were analyzed by independent sample t-test and one-way ANOVA.

Results:

Statistically significant differences were found between linear accuracy of the test and reference systems. The test values obtained by 3D photogrammetry were closer to the reference values than CBCT’s. 3D photogrammetry’s measurement errors were significantly higher in deformed areas, unlike CBCT’s. Both systems reported significantly lower errors within partitions 8 and 13 compared to other partitions; for CBCT, aside from partitions 8 and 13, the differences in the errors for partitions 6 and 10 were significant compared to partitions 8, 12, 13, 14.

Conclusion:

3D photogrammetry showed a higher linear accuracy than CBCT in patients with facial deformities due to protuberances. Facial reconstruction by both test modalities was significantly influenced in different facial partitions, but facial deformities extensively affected the results from 3D photogrammetry.
HbA1c – A predictor of dyslipidemia in type 2 Diabetes Mellitus
Authors: Kidwai Saera Suhail , Nageen Ayesha , Bashir Farhat , Ara Jamal
Published: August 2020

Objective: This study was aimed to determine the predictive value of HbA1c in detecting dyslipidemia in patients with Type-2 Diabetes Mellitus.

Methods: A total of 142 consecutive patients of Type-2 diabetes mellitus were recruited in this study after informed consent. The study was conducted for 6 months from January 2019 – June 2019 in Creek General Hospital, Korangi, Creek, Karachi. Demographic data and detailed history was taken. A complete systemic examination was done for any complications or co-morbids present and related investigations were performed including Fasting lipid profile (CHO, TG’s, HDL, LDL, CHO/HDL), serum HbA1c, Creatinine and ECG. Data is analyzed on SPSS 16 for mean, frequencies and correlations. Pearsons Chi square test is used for analyses of Correlation

Results: In a total of 142 Type-2 diabetic patients 39(27.5%) were Males and 103(72.5%) were females with a male to female ratio of 1: 2.6. Mean age was 54.9yrs ± 10.7SD. Mean duration of diabetes was 7.37yrs ±5.64 SD years. Mean BMI is 26.8 ± 3.67kg/m2. 27(19.01%) patients had HbA1c ≤ 7% whereas 115(80.9%) had >7%. 81(57.04%) patients had dyslipidemia. HbA1c exhibited direct correlations with BMI, cholesterol, TG’s and LDL and inverse correlation with HDL with significant P value of <.05. TG’s were found significantly higher in females when compared with male patients. In addition, Metabolic syndrome also showed a strong correlation with increasing HbA1c levels especially in female gender (P0.001).

Conclusion: The results of our study indicates that HbA1c can be used not only as a useful biomarker of long-term glycaemic control but also a good predictor of lipid profile.

doi: https://doi.org/10.12669/pjms.36.6.2000

How to cite this:Kidwai SS, Nageen A, Bashir F, Ara J. HbA1c – A predictor of dyslipidemia in type 2 Diabetes Mellitus. Pak J Med Sci. 2020;36(6):1339-1343. doi: https://doi.org/10.12669/pjms.36.6.2000

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effects of stretching exercises on human gait: a systematic review and meta-analysis
Authors: Vialleron Thomas , Delafontaine Arnaud , Ditcharles Sebastien , Fourcade Paul , Yiou Eric
Published: August 2020

Background: Stretching is commonly used in physical therapy as a rehabilitation tool to improve range of motion and motor function. However, is stretching an efficient method to improve gait, and if so, for which patient category?

Methods: A systematic review of randomized and non-randomized controlled trials with meta-analysis was conducted using relevant databases. Every patient category and every type of stretching programs were included without multicomponent programs. Data were meta-analysed where possible. Estimates of effect sizes (reported as standard mean difference (SMD)) with their respective 95% confidence interval (95% CI) were reported for each outcome. The PEDro scale was used for the quality assessment.

Results: Twelve studies were included in the analysis. Stretching improved gait performance as assessed by walking speed and stride length only in a study with a frail elderly population, with small effect sizes (both SMD= 0.49; 95% CI: 0.03, 0.96; PEDro score: 3/10). The total distance and the continuous walking distance of the six-minute walking test were also improved only in a study in an elderly population who had symptomatic peripheral artery disease, with large effect sizes (SMD= 1.56; 95% CI: 0.66, 2.45 and SMD= 3.05; 95% CI: 1.86, 4.23, respectively; PEDro score: 5/10). The results were conflicting in healthy older adults or no benefit was found for most of the performance, spatiotemporal, kinetic and angular related variables. Only one study (PEDro score: 6/10) showed improvements in stance phase duration (SMD=-1.92; 95% CI: -3.04, -0.81), swing phase duration (SMD=1.92; 95 CI: 0.81, 3.04), double support phase duration (SMD= -1.69; 95% CI: -2.76, -0.62) and step length (SMD=1.37; 95% CI: 0.36, 2.38) with large effect sizes.

Conclusions: There is no strong evidence supporting the beneficial effect of using stretching to improve gait. Further randomized controlled trials are needed to understand the impact of stretching on human gait.
New technologies to improve healthcare in low- and middle-income countries: Global Grand Challenges satellite event, Oxford University Clinical Research Unit, Ho Chi Minh City, 17th-18th September 2019
Authors: Ngoc Dinh Minh , Nygate Joseph , Hoang Minh Tu Van , Thwaites C. Louise ,   Global Grand Challenges Event Vietnam Group
Published: August 2020

We report the outputs of a satellite event in Ho Chi Minh City, Vietnam, organized as part of the “2nd Global Grand Challenges of Engineering Summit”. The event considered challenges and potential solutions for improving low- and middle-income country (LMIC) healthcare systems, with particular reference to critical care.  Participants from key regional and local stakeholders in healthcare and engineering discussed how new advances in technology, especially in the field of Artificial Intelligence, could be of potential benefit. This article summarizes the perspectives and conclusions of a group of key stakeholders from LMICs across South and South East Asia.
Perfil de Competencia Tecnológica: Una propuesta para el sector productivo
Authors: Candolfi Arballo Norma , Hualde Alfaro Alfredo , Morales Gamboa Rafael , Espinosa Díaz Yessica
Published: August 2020

La presente investigación tiene por objetivo caracterizar el Perfil de Competencia Tecnológica, que representa los niveles de conocimiento tecnológico deseable de los líderes de una organización. La metodología para la construcción del Perfil de Competencia Tecnológica se estructura en tres etapas: el análisis conceptual del término de competencia tecnológica, la revisión teórica sobre la valoración de competencias tecnológicas y un estudio de contexto, que responde a una evaluación cualitativa a expertos en el sector evaluado. El caso de estudio analizado se enfoca en la industria, seleccionada por el impacto a nivel mundial y por ser considerado uno de los principales gremios en desarrollo en la zona fronteriza del estado de Baja California. Los resultados se exponen en cuatro ejes, los cuáles indican las competencias, habilidades y acciones que un líder de la industria deberá cumplir para demostrar un nivel adecuado respecto a sus competencias tecnológicas, que le permitan orientar el escalamiento industrial de la organización, el crecimiento del capital humano, la mejora de productos y/o servicios que se ofrecen, a partir de la incorporación de las tecnologías de la información, comunicación y colaboración en sus procesos, así como una vinculación y participación activa en la sociedad y la industria.
Una Aproximación desde la Escuela Austriaca a la RSE (responsabilidad social empresarial)
Authors: Chavarro M. Fernando
Published: August 2020

Por cambios ocurridos en el entorno de las organizaciones, como la globalización de los mercados, el aumento de la repercusión social, la contribución al desarrollo de las comunidades, en las que participan las empresas por medio de prácticas y acciones que permiten el enriquecimiento económico, el bienestar social, la protección y promoción del medioambiente, estas se han visto en la necesidad de incorporar nuevas prácticas de RSE; y desde luego para lograrlo, se deben Identificar las diferencias conceptuales sobre la RSE entre las teorías convencionales y el pensamiento de la escuela de pensamiento Austriaca; por lo que en este documento se considera tener presente algunas acepciones teóricas de la praxeología, la responsabilidad empresarial RSE y la acción humana, para llegar a determinar una aproximación a la interpretación de la RSE desde la praxeología.
Para descolonizar el hábitat rural. Un análisis de la matriz colonial de las políticas públicas habitacionales en Córdoba (Argentina)
Authors: Cejas Noelia
Published: August 2020

El artículo recupera las reflexiones de la perspectiva decolonial, especialmente conceptualizaciones que Rita Segato (2013) realiza en torno a la noción de “Colonialidad del Poder”, concepto originalmente acuñado por el sociólogo peruano Aníbal Quijano. Me propongo abordar las políticas habitacionales orientadas a las comunidades rurales campesinas del noroeste cordobés, valiéndome de los ejes argumentales que Segato define para organizar su crítica al orden colonial. El supuesto que guía el trabajo consiste en señalar - críticamente- la matriz colonial que subyace en las intervenciones territoriales en comunidades rurales campesinas, produciendo efectos de afirmación de la exclusión por medio de políticas asistencialistas y pretendidamente compensatorias.
Migración y vivienda en la Aglomeración Gran Buenos Aires: un estudio sobre condiciones habitacionales a partir de una tipología de áreas residenciales
Authors: Mera Gabriela
Published: August 2020

En el marco de un interés por las formas que asume la distribución espacial de los migrantes en las ciudades, el artículo busca incorporar la pregunta por las características que asumen las áreas receptoras de los grupos. Para ello propone una tipología de entornos residenciales que tiene en cuenta el carácter formal o informal de la urbanización y las condiciones habitacionales que prevalecen en las distintas áreas, considerando la incidencia de situaciones inadecuadas en relación con el tipo de vivienda, la materialidad y el acceso a servicios urbanos. El trabajo se centra en la Aglomeración Gran Buenos Aires, y se acota el universo a los migrantes nacidos en Bolivia, Paraguay y Perú. Se trabaja a partir de un diseño metodológico cuantitativo que toma como principal fuente de datos el Censo Nacional de Población, Hogares y Viviendas 2010.
Optimal Monitoring Schedule in Dynamic Contracts
Authors: Chen Mingliu , Sun Peng , Xiao Yongbo
Published: August 2020

Monitoring in Dynamic Contract Design
An exploration of the role of advanced clinical practitioners in the East of England
Authors: Hooks Claire , Walker Susan
Published: August 2020

Medical staff shortages in the UK have provided impetus for the introduction of advanced clinical practitioners (ACPs). This case study explored the views of 22 ACPs, managers and doctors in primary and acute settings in a region of England, to understand how the role is used, and barriers and facilitators to its success. ACP roles improved the quality of service provision, provided clinical career development and enhanced job satisfaction for staff and required autonomous clinical decision-making, with a high degree of self-awareness and individual accountability. Barriers included disparate pay-scales and funding, difficulty accessing continuing education and research, and lack of agreed role definition and title, due to a lack of standardised regulation and governance, and organisational barriers, including limited access to referral systems. Facilitators were supportive colleagues and opportunities for peer networking. Regulation of ACP roles is urgently needed, along with evaluation of the cost-effectiveness and patient experience of such roles.
Pessary offer documentation in women undergoing surgery for pelvic organ prolapse at a tertiary care hospital
Authors: Masood Zubaida , Imtiaz Rahila , Husain Samia , Husain Sonia , Izhar Rubina
Published: August 2020

Background:

Women report similar functional outcomes after pessary treatment or surgery for pelvic organ prolapse (POP).

Aims:

To assess the documentation of pessary counselling in women who underwent surgery for POP. Methods: This was a retrospective cohort study conducted on women who underwent hysterectomy for prolapse. The primary outcome measure was documentation regarding offer of pessary. ‘Pessary offer’ was defined as documentation that clearly stated that the care provider offered pessary to the patient.

Findings:

Over the study period, 81 hysterectomies took place for POP; pessary offer was documented for only 19 (23.5%) case records. Characteristics significantly associated with pessary offer were history of chronic cough (P=0.031), previous pelvic surgery (P<0.001), no secondary indication for surgery (P=0.012), concomitant surgery performed other than hysterectomy (P=0.046), age range (P<0.001) and BMI range (P<0.001).

Conclusion:

Pessary offer was documented in less than quarter of cases. This denotes a need to strengthen documentation of offer, counselling for pessary, or both of these.
Death anxiety and compassion fatigue in critical care nurses
Authors: Milligan Fiona , Almomani Emad
Published: August 2020

It may be argued that altruism, or the selfless concern for others, was fundamental to the discipline of nursing; however, with the evolution of nursing, there has been debate within the profession and among service users about whether this element has been lost. Nurses deal with increasingly complex and stressful situations, both patient and performance related. Additionally, demands on the service and capacity constraints continue to place a significant burden on nurses and other health professionals. There are concerns that the cost of caring has had an impact at a personal and performance level within the nursing profession, highlighted particularly by the negative experiences described by NHS service users in the Francis report. Debate continues about the definition of ‘compassionate care’ and how we measure its delivery. Resolving these concerns is a high priority for recruitment and retention strategies within both the NHS and private sector healthcare organisations.
How Nightingale's concept for a school of nursing changed global nurse education
Authors: Glasper Alan
Published: August 2020

In recognition of the International Year of the Nurse and Midwife Emeritus Professor Alan Glasper of the University of Southampton discusses how Nightingale led the way for schools of nursing across the world
The importance of leading with care
Authors: Foster Sam
Published: August 2020

Sam Foster, Chief Nurse, Oxford University Hospitals, considers how and why healthcare leaders should embed a culture of leading with care across their organisation
Y2O3: Eu3+/PMMA hybrid film as a converter for enhanced harvesting of broadband solar-blind UV light
Authors: Li Xue , Li Chen , Gao Linhui , Zhu Hongliang , Wang Longcheng , Chen Jing , Li Yongtao , Zheng Jinsheng
Published: August 2020

At present, the most common materials for solar-blind UV light detectors are wide band-gap semiconductors, which generally have high requirements and complex methods for preparation. Ordinary semiconductor materials such as silicon,

T
i

O

2

, and

C

u

2

O

were industrialized, but they were excluded for direct harvest of solar-blind UV light due to their inability to absorb solar-blind light photons. Here, inorganic-organic hybrid film of

Y

2

O

3

:

E

u

3
+

/

P
M
M
A

was used as a spectral converter to realize the detection of broadband solar-blind UV light by ordinary semiconductor, converting broadband solar-blind UV luminescence to visible luminescence based on down-conversion process, after which the visible luminescence was detected by the Si photo-resister. The results show that hybrid film based on rare earth luminescence materials is particularly valuable for broadband solar-blind UV detection.
Dynamic parallel phase-shifting electronic speckle pattern interferometer
Authors: Toto-Arellano Noel-Ivan , Gómez-Méndez Gustavo A. , Martínez-García Amalia , Otani Yukitoshi , Serrano-García David I. , Antonio Rayas Juan , Rodríguez-Zurita Gustavo , García-Lechuga Luis
Published: August 2020

Methods for measuring variations in diffuse surfaces using electronic speckle pattern interferometry (ESPI) are widely used and well known. In this research, we present an out-of-plane ESPI system coupled to a Michelson configuration to generate simultaneous parallel interferograms with different phase shifts. The system uses circular polarization states to generate parallel phase shifted interferograms. Due to the polarization states, the fringes do not experience a contrast reduction, thus avoiding measurement errors that affect spatial or temporal phase-shifting in interferometry. The basic operating principle of polarization modulation is described, and results that represent the temporal evolution of an aluminum plate are presented. The generation of two simultaneous patterns allows one to track the dynamic performance of the plate.
Application of UV-vis optical spectroscopy in electrochemical processes: case-study of graphite anion intercalation
Authors: Trabattoni Silvia , Tavazzi Silvia , Yivlialin Rossella , Duò Lamberto , Ciccacci Franco , Bussetti Gianlorenzo
Published: August 2020

The possibility of following electrochemical processes in situ and in real time using optical techniques is important in view of shining a light on the chemical processes at the surface. The interest grows if the optical apparatus is compact and can be employed in industrial quality-check protocols. Here, we show how graphite anion intercalation–an important chemical process to massively produce graphene flakes–can be monitored by a UV-vis spectrometer when the graphite works as an electrode immersed inside the electrochemical cell. Important information on the reversibility or quasi-reversibility of the reaction shows a clear visualization in optical color maps.
Three-parameter measurement optical fiber sensor based on a hybrid structure
Authors: Nan Tong , Liu Bo , Wu Yongfeng , Mao Yaya , Wang Junfeng , Zhao Lilong , Sun Tingting , Wang Jin , Han Yang
Published: August 2020

We have proposed a hybrid-structured optical fiber sensor that can measure curvature, temperature, and transverse load. The hybrid structure is made by fusing a section of hollow-core fiber (HCF) between an air bubble and an up-taper. The air bubble acts as a Fabry–Perot interferometer (FPI) and at the same time serves as excitation for a Mach–Zehnder interferometer (MZI). HCF is used as an anti-resonant reflected optical waveguide (ARROW), which periodically decreases in the resonant wavelength of the optical transmission spectrum. The transverse load can be measured by demodulating the reflection spectrum of the FPI. By demodulating the wavelength shift of the MZI for temperature sensing and the intensity change of ARROW inclination for curvature sensing, the curvature and temperature can be measured simultaneously. The experimental results show that the transverse load sensitivity of the FPI is 1.53 nm/N. The curvature and temperature sensitivities are

33.23

d
B

/

m

−
1

and 20.3 pm/°C, respectively, and the cross-sensitivity is

0.0003

m

−
1

/

∘

C

. Due to its ease of manufacture, low crosstalk, and high sensitivity, the hybrid-structured optical fiber sensor is suitable for multi-parameter measurement applications.
High-resolution in vivo optical-sectioning widefield microendoscopy
Authors: Zhang Qinrong , Pan Daisong , Ji Na
Published: August 2020

Microendoscopy incorporating a gradient index (GRIN) lens has emerged as a powerful tool for in vivo imaging. The lack of optical sectioning capability of widefield microendoscopy and the intrinsic optical aberrations of the GRIN lens itself, however, limit the achievable image contrast and resolution in three-dimensional (3D) tissues. In this study, we applied HiLo, a structured illumination method, to widefield microendoscopy in order to achieve optical sectioning. We also utilized adaptive optics (AO) to measure and correct GRIN lens aberrations. Together, HiLo and AO enabled subcellular-resolution microendoscopy imaging with optical sectioning and allowed us to image fine neuronal processes and synapses in the mouse brain in vivo.
Subwavelength generation of nondiffracting structured light beams
Authors: Hu Yanwen , Fu Shenhe , Yin Hao , Li Zhen , Li Zhaohui , Chen Zhenqiang
Published: August 2020

Nondiffracting light beams have been attracting considerable attention for their various applications in both classical and quantum optics. Whereas substantial investigations on generation of the nondiffracting beams were made, their lateral dimension is much larger than optical wavelength. Here we present both theoretically and experimentally a study of the generation of nondiffracting light beams at deep-subwavelength scale. The highly localized light field is a result of in-phase interference of high-spatial-frequency waves generated by optical sharp-edge diffraction with a circular thin film. It is shown that the generated beam can maintain its spot size below the optical diffraction limit for a distance of up to considerable Rayleigh range. Moreover, the topological structure of both the phase and polarization of a light beam is found to be preserved when it passes through the diffractive configuration, which enables generating nondiffracting vortex beams as well as transversely polarized vector beams at deep-subwavelength scale. This work opens a new avenue to manipulate higher-order vector vortex beams at subwavelength scale and may find intriguing applications in subwavelength optics, e.g., in superresolution imaging and nanoparticle manipulation.
Covid-19 Pandemic: Mental Dynamics of Quarantine and Social Isolation
Authors: Patel Jainish , Patel Prittesh
Published: August 2020

This paper explores the two major preventive concepts of the unpredictable life-threatening viral infection caused by Coronavirus that is ravaging the entire world from the beginning of the year 2020, as it pertains to mental health. Through scientific consultations, the expectation is that effective vaccine for the Coronavirus disease-2019 (COVID-19) may not come into the market this year. Two (among others) preventive measures, namely Social Distancing and Quarantine are suggested by the World Health Organization (WHO). Using the principle of explorative research, this study established the flipside of quarantine and social distancing from the metal health perspective. It was discovered that there is a relationship between a long period of self-isolation and a high probability of concerned persons having anxiety, stress, and depression, which gradually leads to mental and emotional health issues. Consequently, mental health affects the overall health and affects how we handle different situations during the Covid-19 pandemic. By considering this important matter, this article recommended different ways to improve mental health during the pandemic in the quest to keep oneself away from psychological issues arising due to the Covid-19 situation.