bluuebunny/crossref_metadata_2025 huggingface dataset:
Tétanos, una enfermedad que se creyó superada: revisión de caso
Authors: Mendienta Iván A. , Florián Rodríguez Diana C. , Donato Marco , Alvarado Manuel , Vargas Sonia , Ríos Blanca , Toala Publio , Mendoza Ovidio , Miguelena Dayra , Coronado Luis
Published: October 2020

Resumen

El tétanos generalizado es una enfermedad infecciosa altamente mortal sin intervenciones médicas y en nuestro tiempo, prevenible mediante inmunización activa. Se presenta el caso de un preescolar de 4 años quien sufre herida cortante en la palma de la mano izquierda y quien se presenta 4 días más tarde con datos clínicos de tétanos generalizado. Fue intubado y admitido a la terapia intensiva del Hospital del Niño Dr. José Renán Esquivel. Su hospitalización se vio caracterizada por neumonía nosocomial, una lesión anfractuosa lingual e inestabilidad autonómica. Además de la antibioticoterapia con metronidazol y la aplicación de inmunoglobulina antitetánica, precisó apoyo hemodinámico con dobutamina y norepinefrina. Para lograr un completo control de las crisis de hipertonía, se ofreció manejo con infusión de midazolam, levetiracetam, clobazam, baclofeno y toxina botulínica.

Palabras clave: tétanos generalizado, inmunización, inestabilidad autonómica, opistótonos, trismos.
Peritonitis por Streptococcus pluranimalium, un patogéno poco habitual
Authors: Elgoibar Álvarez Borja , Miranda G. Katherina , McCarthy W. Florencio , Raúl Esquivel
Published: October 2020

Streptococcus pluranimalium es una bacteria descrita como causante de infección en animalesy su aislamiento es poco habitual en humanos. No se han descrito casos de peritonitispor esta bacteria, tampoco se han descrito infecciones por la misma en Panamá.Presentamos el caso de un masculino de 8 años con enfermedad renal crónica, en tratamientocon diálisis peritoneal, que ingresó por una descompensación de su balance hídrico.En liquido peritoneal presentó hallazgos compatibles con peritonitis y crecimiento deS.pluranimalium en los cultivos del mismo. El cuadro clínico se resolvió con 2 semanas detratamiento con cefotaxima+ cefalotina inicialmente intravenosa y después peritoneal.El avance de las técnicas de identificación de bacterias permite describir nuevas especiescomo causantes de infección. Al haber pocos casos reportados es difícil establecer guíassobre la sensibilidad antibiótica. El S.pluranimalium es habitualmente sensible a aminoglucosidos,vancomicina y cefalosporinas.
Evaluación de competencias del proceso formativo de los residentes utilizando el portafolio: una revisión de la literatura
Authors: Díaz A. Virginia E.
Published: October 2020

En el proceso dinámico de los cambios y mejoras curriculares en las diferentes especialidadesse han tomado en cuenta los conocimientos, habilidades, actitudes y valores; poreso tienen que integrarse nuevas formas de estudio, supervisión y evaluación de los médicosen formación. Experiencias recientes en nuestro país tratan de introducir los portafoliosprofesionales como herramientas de evaluación-aprendizaje en la formación especializadade posgrado. El portafolio es un instrumento de evaluación del proceso formativode los residentes que permite no sólo evaluar las competencias, sino fundamentalmenteidentificar en qué debemos mejorar permitiendo dar seguimiento a los medios en formaciónsegún vayan avanzando en la adquisición y desarrollo de competencias de maneraque se convierta en una herramienta enfocada a ayudarnos a aprender y aporta, al mismotiempo, elementos para valorar la participación de los tutores y la influencia de los mismosen los educandos.En el proceso de planeación, diseño y revisión de los portafolios los centrosformadores encuentran una excelente oportunidad de hacer una autoevaluación dela congruencia de su estructura curricular, de la claridad de las competencias que buscaformar y de las evidencias que puede exigir en la formación de sus residentes.
Modern Technologies of Medical Rehabilitation of Upper Limb Injury in Children
Authors: Khan M.A. , Vakhova E.L. , Vybornov D.Yu. , Tarasov N.I. , Pochkin Е.О. , Kirillova I.S.
Published: October 2020

The relevance of the problem of children with upper limb trauma medical rehabilitation is determined by the high frequency elbow joint fractures; the risk of complications development, disabilityc of the patient. A comprehensive medical rehabilitation program assumes a personalized approach and a differentiated prescription of physical factors, depending on the time period of rehabilitation. Early physical rehabilitation is a key link in the complete recovery of the function of a patient’s limb with damage to the elbow joint.
The purpose of this work is to analyze literature and summarize the results of our own research to determine the optimal approaches and methods for medical rehabilitation of children with upper limb injury.
The medical rehabilitation program includes various methods of kinesiotherapy, robotic mechanotherapy, massage, a wide range of apparatus physiotherapy to improve the trophism of the periarticular tissues, to maintain mobility in joints free from immobilization; gain of the full range of motion in the damaged joint; normalizing tone and strengthening the muscles of the upper limb.
Medical rehabilitation of children with elbow joint injury is carried out from the earliest stage, in stationary conditions, during the period of immobilization. The rehabilitation measures continue in outpatient and polyclinic conditions, during the entire period of immobilization (2–4 weeks) and then in the post-immobilization period until the limb function is fully restored.
It is necessary to monitor the main indicators of the function of the upper limb during the entire period of rehabilitation to assess the effectiveness of rehabilitation measures, objectify the course of the rehabilitation process and the continuity of rehabilitation programs.
Definition of the tasks of medical rehabilitation, differentiated for each stage; the choice of modern, pathogenetically grounded rehabilitation technologies with an assessment of their effectiveness contribute to a significant increase in the effectiveness of comprehensive rehabilitation programs for children with upper limb trauma.
Methods of Physiotherapy in the Medical Rehabilitation of Children with Primary Arterial Hypertension
Authors: Kuyantseva L.V. , Turova E.A. , Trunina I.I. , Petrova M.S. , Lomaga I.A.
Published: October 2020

Introduction. Arterial hypertension (AH) is a widely occurring disease of the cardiovascular system in the children’s population, which often debuts in childhood, persists into adulthood, which dictates the need for early treatment and prevention of arterial hypertension.
The formation of AH is associated with maladaptation of physiological mechanisms of self-regulation, with a complex interaction of psychosocial and genetic factors.
The use of non-medicinal agents to reduce blood pressure is a starting approach in the treatment of children and adolescents with hypertension and complements medication therapy.
Purpose. analysis of literature sources on the effectiveness of hardware physiotherapy methods in the treatment of hypertension in children.
Discussion. In the treatment of children with hypertension, the leading role belongs to hardware physiotherapy technologies. Widely used sedative, hypotensive and vegetative-corrective methods are pathogenetically justified and can be used at all stages of arterial hypertension development.
Transcranial pulsed electrotherapy (transcranial electrostimulation, electroson, infitotherapy), darsonvalization, aromafitotherapy and medicinal electrophoresis of sedatives belong sedative methods aimed at enhancing inhibitory processes in the Central nervous system.
Amplipulster therapy, intermittent normobaric hypoxytherapy, low-intensity magnetic therapy, medicinal electrophoresis of spasmolytic drugs, EHF therapy, laser therapy, which lead to a decrease in arterial hypertension and improve microcirculation, are hypotensive methods.
Bio-controlled aerionotherapy, aimed at correcting vegetative dysfunction, is a vegetative corrective method.
Conclusion. Currently, there is a wide range of scientifically-based methods of hardware physiotherapy used in the medical rehabilitation of children with arterial hypertension, allowing to improve cerebral hemodynamics, normalize neurophysiological and hemodynamic processes in the Central nervous system, provide sedative and hypotensive effects, stimulate peripheral vasodepressor mechanisms, normalize neuroendocrine processes.
The use of hardware physiotherapy methods in the complex treatment of hypertension can improve the quality of life of patients, achieve stable normalization of blood pressure, and reduce the risk of early cardiovascular diseases.
The Use of Dry Carbon Dioxide Baths in the Medical Rehabilitation of Children with Various Diseases
Authors: Nikityuk Y.V. , Khan M.A. , Mikitchenko N.A. , Ivanova I.I. , Dedurina A.V.
Published: October 2020

The purpose of this article is systematization and analysis of the results of studies on the effectiveness of using dry carbon dioxide baths in the medical rehabilitation of children with various diseases.
Dry carbon dioxide baths allow to dose carbon dioxide during the procedure. The method eliminates the hydrostatic component and excludes the penetration of carbon dioxide into the respiratory tract during the procedure. The article presents the main aspects of the formation of the mechanism of the therapeutic action of dry carbon dioxide baths in bronchial asthma, atopic dermatitis, vegetative dystonia syndrome, health improvement of children who often suffer from acute respiratory diseases.
The use of dry carbon dioxide bath in medical rehabilitation of children with bronchial asthma helps to reduce the intensity of allergic inflammation, bronchial obstruction, the frequency of exacerbations of the disease.
The use of SUV in atopic dermatitis in children allows you to stop or reduce the manifestations of the main clinical symptoms of the disease, improves the psycho-emotional state of the child.
The effectiveness of dry carbonic bath in the vegetative dystonia is shown (mainly in the sympathicotonic type). The improvement of autonomic regulation and the reduction of tension in the work of the sympathetic department of the autonomic nervous system have been established.
The application of dry carbon dioxide bath in sickly children helps to reduce clinical symptoms of acute respiratory infections, improves mucosal immunity, and reduces the frequency of recurrent infections throughout the year.
Psychological Assistance to Health Care Workers in the Conditions of Re-Profiling the Federal Hospital to Treat Patients with COVID-19
Authors: Shurupova M.A. , Abdurahmanov R.A. , Esejkina L.I. , Kutejnikova T.V. , Popova D.A. , Pchelinceva E.S. , Rusetskaya S.V. , Hlyupina E.A. , Mikadze Y.V. , Gordeev M.N. , Ivanova G.E.
Published: October 2020

In addition to physical mortality, the COVID-19 pandemic has a broad psychosocial and emotional impact on all population groups. Medical workers in the hospitals are experiencing unprecedented physical and psychological difficulties. Guided by the principles of providing professional psychological assistance to health care workers and based on the analysis of international experience, the “FCBN” of the FMBA of Russia organized several forms of psychological support. The purpose of this study was to investigate the methods and results of psychological support to health care workers during the period of re-profiling hospital for patients with COVID-19.
The study sample includes 578 employees of the “FCBN” of the FMBA of Russia, covered during a weekly call; 25 of them participated in "social questionnaire"; 33 people completed the MBI and GAD-7 questionnaires; more than 30 people received personal or distant consultations.
The results of questionnaires show that employees reacted to the new conditions adequately. The average values of indicators on the scales "emotional exhaustion" and "depersonalization" for the group fell within the normal range for medical workers in Russia.
Investigation of effectiveness of different psychological methods shows that for supporting health care workers in the new condition, the most effective were personal consultations, and to identify the actual problems of work organization and building vertical communication between staff and management – weekly calls and ≪social questionnaire≫.
In conclusion, our experience has shown the importance of maintaining the functioning of psychological service to help health care workers in an emergency situation for the health system.
Blockchain and Directions of its Using in Logistics in the Conditions of Digital Transformation
Authors: Kostukova H. N.
Published: October 2020

The purpose of the article is to show the possibilities of using blockchain in logistics. In the modern world, digital technologies are used in various fields including logistics. An important achievement of modernity is blockchain. Initially, its using was related to the field of cryptocurrencies, in particular, bitcoin. Based on analysis the article reflected the essence of the blockchain, features of its functioning, marked advantages and disadvantages. The directions of using blockchain in logistics are highlighted.
THE PROBLEM OF DEVELOPING PRACTICAL THINKING THE SUBJECT OF LABOR IN THE RESEARCH OF D. N. ZAVALISHINA
Authors: Обознов А.А.
Published: October 2020

Проанализирован вклад Д.Н. Завалишиной в изучение развития практического мышления субъекта труда. Отмечена социальная значимость психологических исследований развития и самореализации творческого потенциала субъекта труда в современном техногенном мире. Рассмотрены исследования Д.Н. Завалишиной, посвященные творческим аспектам практического мышления и их проявления в профессиональной деятельности. Показано, что автор рассматривает специалиста с позиций онтологического субъекта, что предполагает его соотнесение с основными отношениями к миру; с выбранными им способами существования в этих основных отношениях к миру; с событиями прошлого и будущего в его жизни.

The contribution of D. N. Zavalishina to the study of the development of practical thinking of the subject of labor is analyzed. The social significance of psychological research on the development and self-realization of the creative potential of the subject of labor in the modern technogenic world is noted. D. N. Zavalishina's research on creative aspects of practical thinking and their manifestation in professional activity is considered. It is shown that the author considers the specialist from the position of an ontological subject, which implies its correlation with the main relations to the world; with the ways of existence chosen by him in these main relations to the world; with the events of the past and future in his life.
RUSSIAN VALIDATION OF THE CONSIDERATION OF FUTURE CONSEQUENCES SCALE (CFC-14)
Authors: Нестик Т.А.
Published: October 2020

В статье представлен анализ ориентации на учет будущих последствий как одного из компонентов долгосрочной ориентации личности. Представлены результаты апробации шкалы учета будущих последствий (CFC-14; Strathman et al., 1994; Joireman et al., 2012). В ходе конфирматорного факторного анализа число утверждений было сокращено до 13 (CFC-13), была подтверждена двухфакторная структура методики, в которой один из факторов отражает ориентацию на краткосрочные последствия поведения, а второй - ориентацию на учет последствий в долгосрочном будущем. Разработана краткая версия методики (CFC-6), которая может быть использована в массовых опросах и онлайн-исследованиях. Выявлена связь учета ближайших и будущих последствий с характеристиками временной перспективы. Проведенная проверка шкал полной и краткой версий на ретестовую надежность, конвергентную, дискриминантную и критериальную валидность показала, что обе версии методики могут быть использованы в русскоязычных исследованиях для измерения долгосрочной ориентации личности. Намечены перспективные направления дальнейших исследований.

The article presents the results of adaptation of the Consideration of Future Consequences Scale (CFC-14; Strathman et al., 1994; Joireman et al., 2012) into Russian. Using a web-based survey, data were collected from 1443 participants (53,6% women) aged 17-85 years (M=33.2). CFA showed a two-factor model as the best solution for the 13-items version (GFI=0,986; CFI=0,985, RMSEA=0.033; SRMR 0.025; Pclose=1). Standardized regression weights (p<0.001) ranged from 0.419 to 0.642 for CFC-F and between 0.471 and 0.785 for CFC-I. Cronbach’s alpha was also adequate: CFC-F achieved 0.781 and CFC-I 0.811. There were no differences across gender and age. The CFC-F and ZTPI-Future subscales correlation was positive and significant. A short version of the scale (CFC-6) has been developed, which can be used in large sample surveys and online research. Our verification of the CFC-13 and CFC-6 scales for retest reliability, convergent, discriminant and criterion validity showed that both versions have adequate psychometric properties in a Russian population. Promising directions for further research are outlined.
A terrorizmus, mint katasztrófa
Authors: Faggyas Attila
Published: October 2020

There is a strong parallelism between global security challenges and disasters in many cases, those are occasionally overlapping each other. Managing disasters, especially in the first shock phase, belongs to Disaster Management Services. Like the whole management cycle the first response means complex activity and depending on the threat it requires special skills. The acute emergency medical care is one of those special skills. In case of a terrorist attack counter-terrorism units (CTU) are designated for the first response. Providing medical care for citizens who have been injured in a terrorist event is a new expectation of our community. Those CTUs who have taken this responsibility have to re-interpret their military based field care systems. That led to a new approach of tactical medicine (TM). The Hungarian Counter Terrorism Centre played an important role in reconsidering the system of tactical medicine and has built up a unique TM system. In the name of European counterterrorism cooperation TEK leads the ATLAS Medic Forum. In association with ATLAS network TEK has launched the Tactical Medicine Education/Training Program. On these courses 258 operators graduated from 29 CTUs of 28 European countries.
Magyarország és a Nyugat-Szaharai válság
Authors: Szabó László András
Published: October 2020

The author of the book is János Besenyő, leader of the Africa Research Centre at the Doctoral School on Safety and Security Sciences of the Óbuda University and acknowledged expert of the Western Sahara conflict. The author examines in his new book from several aspects the historical and political connections between Western Sahara, the official name is Sahrawi Arab Democratic Republic, and Hungary.
Shear-driven Transition to Isotropically Turbulent Solar Wind Outside the Alfvén Critical Zone
Authors: Ruffolo D. , Matthaeus W. H. , Chhiber R. , Usmanov A. V. , Yang 杨 Y. 艳 , Bandyopadhyay R. , Parashar T. N. , Goldstein M. L. , DeForest C. E. , Wan 万敏 M. 平 , Chasapis A. , Maruca B. A. , Velli M. , Kasper J. C.
Published: October 2020

Motivated by prior remote observations of a transition from striated solar coronal structures to more isotropic “flocculated” fluctuations, we propose that the dynamics of the inner solar wind just outside the Alfvén critical zone, and in the vicinity of the first

surface, is powered by the relative velocities of adjacent coronal magnetic flux tubes. We suggest that large-amplitude flow contrasts are magnetically constrained at lower altitude but shear-driven dynamics are triggered as such constraints are released above the Alfvén critical zone, as suggested by global magnetohydrodynamic (MHD) simulations that include self-consistent turbulence transport. We argue that this dynamical evolution accounts for features observed by Parker Solar Probe (PSP) near initial perihelia, including magnetic “switchbacks,” and large transverse velocities that are partially corotational and saturate near the local Alfvén speed. Large-scale magnetic increments are more longitudinal than latitudinal, a state unlikely to originate in or below the lower corona. We attribute this to preferentially longitudinal velocity shear from varying degrees of corotation. Supporting evidence includes comparison with a high Mach number three-dimensional compressible MHD simulation of nonlinear shear-driven turbulence, reproducing several observed diagnostics, including characteristic distributions of fluctuations that are qualitatively similar to PSP observations near the first perihelion. The concurrence of evidence from remote sensing observations, in situ measurements, and both global and local simulations supports the idea that the dynamics just above the Alfvén critical zone boost low-frequency plasma turbulence to the level routinely observed throughout the explored solar system.
Multi-gigayear White Dwarf Cooling Delays from Clustering-enhanced Gravitational Sedimentation
Authors: Bauer Evan B. , Schwab Josiah , Bildsten Lars , Sihao Cheng 程 思浩
Published: October 2020

Cooling white dwarfs (WDs) can yield accurate ages when theoretical cooling models fully account for the physics of the dense plasma of WD interiors. We use MESA to investigate cooling models for a set of massive and ultramassive WDs (0.9–1.3

) for which previous models have failed to match kinematic age indicators based on Gaia DR2. We find that the WDs in this population can be explained as C/O cores experiencing unexpectedly rapid 22Ne sedimentation in the strongly liquid interior just prior to crystallization. We propose that this rapid sedimentation is due to the formation of solid clusters of 22Ne in the liquid C/O background plasma. We show that these heavier solid clusters sink faster than individual 22Ne ions and enhance the sedimentation heating rate enough to dramatically slow WD cooling. MESA models including our prescription for cluster formation and sedimentation experience cooling delays of ≈4 Gyr on the WD Q branch, alleviating tension between cooling ages and kinematic ages. This same model then predicts cooling delays coinciding with crystallization of 6 Gyr or more in lower-mass WDs (0.6–0.8

). Such delays are compatible with, and perhaps required by, observations of WD populations in the local 100 pc WD sample and the open cluster NGC 6791. These results motivate new investigations of the physics of strongly coupled C/O/Ne plasma mixtures in the strongly liquid state near crystallization and tests through comparisons with observed WD cooling.
Preliminary Target Selection for the DESI Emission Line Galaxy (ELG) Sample
Authors: Raichoor Anand , Eisenstein Daniel J. , Karim Tanveer , Newman Jeffrey A. , Moustakas John , Brooks David D. , Dawson Kyle S. , Dey Arjun , Duan Yutong , Eftekharzadeh Sarah , Gaztañaga Enrique , Kehoe Robert , Landriau Martin , Lang Dustin , Lee Jae H. , Levi Michael E. , Meisner Aaron M. , Myers Adam D. , Palanque-Delabrouille Nathalie , Poppett Claire , Prada Francisco , Ross Ashley J. , Schlegel David J. , Schubnell Michael , Staten Ryan , Tarlé Gregory , Tojeiro Rita , Yèche Christophe , Zhou Rongpu
Published: October 2020

DESI will precisely constrain cosmic expansion and the growth of structure by collecting ∼35 million redshifts across ∼80% of cosmic history and one third of the sky to study Baryon Acoustic Oscillations (BAO) and Redshift Space Distortions (RSD). We present a preliminary target selection for an Emission Line Galaxy (ELG) sample, which will comprise about half of all DESI tracers. The selection consists of a g-band magnitude cut and a (g − r) versus (r − z) color box, which we validate using HSC/PDR2 photometric redshifts and DEEP2 spectroscopy. The ELG target density should be ∼2400 deg−2, with ∼65% of ELG redshifts reliably within a redshift range of 0.6 < z < 1.6. ELG targeting for DESI will be finalized during a “Survey Validation” phase.
A Sky Brightness Model for the Starlink “Visorsat” Spacecraft
Authors: Cole Richard E
Published: October 2020

A model of the brightness of the “visorsat” Starlink spacecraft is presented based on published information on the engineering design and 80 observations of individual visorsats. Comments are offered on the implications of this model on the visibility of visorsat spacecraft across the sky.
The application of selected invasion frameworks to urban ecosystems
Authors: Potgieter Luke J. , Cadotte Marc W.
Published: October 2020

Urbanization is a major driver of global change. Profound human-mediated changes to urban environments have provided increased opportunities for species to invade. The desire to understand and manage biological invasions has led to an upsurge in frameworks describing the mechanisms underpinning the invasion process and the ecological and socio-economic impacts of invading taxa. This paper assesses the applicability of three commonly used invasion frameworks to urban ecosystems. The first framework describes the mechanisms leading to invasion; the second and third frameworks assess individual species, and their associated environmental and socio-economic impacts, respectively.

In urban areas, the relative effectiveness of the barriers to invasion is diminished (to varying degrees) allowing a greater proportion of species to move through each subsequent invasion stage, i.e. “the urban effect” on invasion. Impact classification schemes inadequately circumscribe the full suite of impacts (negative and positive) associated with invasions in urban areas. We suggest ways of modifying these frameworks to improve their applicability to understanding and managing urban invasions.
Comparing the IUCN’s EICAT and Red List to improve assessments of the impact of biological invasions
Authors: Van der Colff Dewidine , Kumschick Sabrina , Foden Wendy , Wilson John R. U.
Published: October 2020

The IUCN recommends the use of two distinct schemes to assess the impacts of biological invasions on biodiversity at the species level. The IUCN Red List of Threatened Species (Red List) categorises native species based on their risk of extinction. Such assessments evaluate the extent to which different pressures, including alien species, threaten native species. The much newer IUCN Environmental Impact Classification for Alien Taxa (EICAT) categorises alien species on the degree to which they have impacted native species. Conceptually, the schemes are related. One would expect that: 1) if a native species is assessed as threatened under the Red List due to the impacts of alien species, then at least one alien species involved should be classified as harmful under EICAT; and 2) if an alien species is assessed as harmful under EICAT, then at least one native species impacted should be assessed as threatened by alien species under the Red List. Here we test this by comparing the impacts of alien gastropods, assessed using EICAT, to the impact on native species as assessed based on the Red List. We found a weak positive correlation, but it is clear there is not a simple one-to-one relationship. We hypothesise that the relationship between EICAT and the Red List statuses will follow one of three forms: i) the EICAT status of an alien species is closely correlated to the Red List status of the impacted native species; ii) the alien species is classed as ‘harmful’ under EICAT, but it does not threaten the native species with extinction as per the Red List (for example, the impacted native species is still widespread or abundant despite significant negative impacts from the alien species); or iii) the native species is classified as threatened under the Red List regardless of the impacts of the alien species (threatened species are impacted by other pressures with alien species potentially a passenger and not a driver of change). We conclude that the two schemes are complementary rather than equivalent, and provide some recommendations for how categorisations and data can be used in concert.
A priority-setting scheme for the management of invasive non-native species in protected areas
Authors: Ziller Sílvia R. , Dechoum Michele de Sá , Silveira Raphaela Aparecida Duarte , da Rosa Hugo Marques , Motta Marcelo Souza , da Silva Leonardo Filipe , Oliveira Beatriz Cunha Mello , Zenni Rafael D.
Published: October 2020

Invasion by non-native species is one of the major threats to the conservation of biodiversity and to the provision of ecosystem services by protected areas. Invasive species often co-occur in protected areas, represented by sparse, isolated individuals or populations in different stages in the process of invasion. Species invasiveness, habitat invasibility and impact also differ between ecosystems, so the risk of invasion varies. Besides, prioritization is required due to constraints on time, financial and other resources. Priority-setting is therefore key to help protected area managers invest efforts on biological invasions that offer the best chances of producing large-scale positive results at the lowest cost possible. A priority-setting scheme for the control of invasive non-native species in natural areas is presented in this paper. The scheme, based on field observations of species occurrences, was applied to the Itatiaia National Park (Brazil). Priorities are calculated from a combination of three criteria attributed to each occurrence: species risk of invasion considering local ecosystems, invasion stage, and species frequency. Data collected in the field in the Itatiaia National Park were used to calculate priorities for 50 non-native species (six animals and 44 plants) in four locations in the Park. The highest priorities were attributed to species of high risk in an early stage of invasion occurring in one site, whereas a few widespread species of low risk were given lower priority. The scheme has proven functional for setting priorities for the control of non-native species in the Itatiaia National Park and in many other protected areas in Brazil.
Harmonising the fields of invasion science and forest pathology
Authors: Paap Trudy , Wingfield Michael J. , Burgess Treena I. , Hulbert Joseph M. , Santini Alberto
Published: October 2020

Invasive alien species are widely recognised as significant drivers of global environmental change, with far reaching ecological and socio-economic impacts. The trend of continuous increases in first records, with no apparent sign of saturation, is consistent across all taxonomic groups. However, taxonomic biases exist in the extent to which invasion processes have been studied. Invasive forest pathogens have caused, and they continue to result in dramatic damage to natural forests and woody ecosystems, yet their impacts are substantially underrepresented in the invasion science literature. Conversely, most studies of forest pathogens have been undertaken in the absence of a connection to the frameworks developed and used to study biological invasions. We believe this is, in part, a consequence of the mechanistic approach of the discipline of forest pathology; one that has been inherited from the broader discipline of plant pathology. Rather than investigating the origins of, and the processes driving the arrival of invasive microorganisms, the focus of pathologists is generally to investigate specific interactions between hosts and pathogens, with an emphasis on controlling the resulting disease problems. In contrast, central to the field of invasion science, which finds its roots in ecology, is the development and testing of general concepts and frameworks. The lack of knowledge of microbial biodiversity and ecology, speciation and geographic origin present challenges in understanding invasive forest pathogens under existing frameworks, and there is a need to address this shortfall. Advances in molecular technologies such as gene and genome sequencing and metagenomics studies have increased the “visibility” of microorganisms. We consider whether these technologies are being adequately applied to address the gaps between forest pathology and invasion science. We also interrogate the extent to which the two fields stand to gain by becoming more closely linked.
Benefits of Methotrexate Use on Cardiovascular Disease Risk Among Rheumatoid Arthritis Patients Initiating Biologic Disease-modifying Antirheumatic Drugs
Authors: Xie Fenglong , Chen Lang , Yun Huifeng , Levitan Emily B. , Curtis Jeffrey R.
Published: October 2020

Objective.

Methotrexate (MTX) has been associated with reduced risk for cardiovascular disease (CVD) events among patients with rheumatoid arthritis (RA) not exposed to biologic disease-modifying antirheumatic drugs (bDMARDs). The effect of concomitant MTX on CVD risk among RA patients initiating bDMARDs remains unknown.

Methods.

A retrospective cohort study was conducted to assess the effect of MTX on CVD risk using 2006–2015 Medicare claims data for patients with RA initiating bDMARD. The main exposure was current use of MTX, updated in a time-varying fashion. The primary outcome was a composite of incident myocardial infarction (MI), stroke, and fatal CVD. Secondary outcomes were each event that comprised the primary outcome. Incidence rates (IR) and 95% CI were calculated using Poisson regression. Associations between MTX and risk of CVD were assessed using Cox regression.

Results.

A total of 88,255 bDMARD initiations and 1861 CVD events were included in this study. Mean age was 64.6 (12.3) years, 84.0% were female, and 68.2% were non-Hispanic White. The crude IRs (95% CI) for CVD were 17.9 (16.9–18.8) and 12.1 (11.1–13.2) per 1000 patient-years among MTX unexposed and exposed, respectively. The multivariable adjusted HR (95% CI) for CVD events associated with MTX was 0.76 (0.68–0.85). Multivariable adjusted HRs were 0.78 (0.66–0.91), 0.74 (0.62–0.88), 0.77 (0.68–0.86), and 0.82 (0.73–0.93) for MI, stroke, MI or stroke, and a composite CVD outcome, respectively. Results were robust in sensitivity and subgroup analyses.

Conclusion.

Among patients with RA receiving biologics, concomitant MTX use was associated with a 24% lower risk for CVD events.
The Prevalence of Rheumatoid Arthritis: A Systematic Review of Population-based Studies
Authors: Almutairi Khalid B. , Nossent Johannes C. , Preen David B. , Keen Helen I. , Inderjeeth Charles A.
Published: October 2020

Objective

To estimate the prevalence of rheumatoid arthritis (RA) from international population-based studies and investigate the influence of prevalence definition, data sources, classification criteria, and geographical area on RA prevalence.

Methods

A search of ProQuest, MEDLINE, Web of Science, and EMBASE was undertaken to identify population-based studies investigating RA prevalence between 1980 and 2019. Studies were reviewed using the Joanna Briggs Institute approach for the systematic review and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Results

Sixty studies met the inclusion criteria. There was a wide range of point prevalence reported (0.00–2.70%) with a mean of 0.56% (SD 0.51) between 1986 and 2014, and a mean period prevalence of 0.51% (SD 0.35) between 1955 and 2015. RA point and period prevalence was higher in urban settings (0.69% vs 0.48%) than in rural settings (0.54% vs 0.25%). An RA diagnosis validated by rheumatologists yielded the highest period prevalence of RA and was observed in linked databases (0.80%, SD 0.1).

Conclusion

The literature reports a wide range of point and period prevalence based on population and method of data collection, but average point and period prevalence of RA were 51 in 10,000 and 56 in 10,000, respectively. Higher urban vs rural prevalence may be biased due to poor case findings in areas with less healthcare or differences in risk environment. The population database studies were more consistent than sampling studies, and linked databases in different continents appeared to provide a consistent estimate of RA period prevalence, confirming the high value of rheumatologist diagnosis as classification criteria.
A Narrative Review on Measurement Properties of Fixed-distance Walk Tests Up to 40 Meters for Adults With Knee Osteoarthritis
Authors: Master Hiral , Coleman Grace , Dobson Fiona , Bennell Kim , Hinman Rana S. , Jakiela Jason T. , White Daniel K.
Published: October 2020

Knee osteoarthritis (OA) is a serious disease and has no cure to date. Knee OA is a leading cause of functional limitation (e.g., difficulty walking). Walking speed is 1 method of quantifying difficulty with walking and should be assessed in clinical practice for adults with knee OA because it has prognostic value and is modifiable. Specifically, slow walking speed is associated with increased risk of adverse health outcomes, including all-cause mortality in adults with knee OA and can be modified by engaging in physical activity or exercise. However, at present, there is little consensus on the distance and instructions used to conduct the walk test. Distance is often selected based on space availability, and instruction varies, from asking the participants to walk at a comfortable pace versus as fast as possible. Therefore, the purpose of this narrative review is to summarize the measurement properties, strengths, and limitations of a fixed-distance walk test ≤ 40 meters in adults with knee OA. Good measurement properties in terms of reliability and validity were observed across the different testing protocols for fixed-distance walk test (i.e., any distance ≤ 40 m and fast- or self-paced). Therefore, clinicians and researchers can select a testing protocol that can safely and consistently be performed over time, as well as provide a practice trial to acclimatize the patients to the fixed-distance walk test.
National Priorities for High-quality Rheumatology Transition Care for Youth in Canada
Authors: Barnabe Cheryl , Chomistek Kelsey , Luca Nadia , Hazlewood Glen , Barber Claire E.H. , Steiman Amanda , Stringer Elizabeth
Published: October 2020

Objective.

To conduct a needs assessment and environmental scan to support optimal transition from pediatric to adult rheumatology care in Canada.

Methods.

This initiative involved 3 phases: (1) a survey-based needs assessment of adult and pediatric rheumatologist members of the Canadian Rheumatology Association to identify perceived infrastructure, educational needs, and national resources to support transition care; (2) an environmental scan, through semistructured interviews, of existing rheumatology transition service care models and challenges in care delivery; and (3) a focus group to prioritize national activities.

Results.

The needs assessment survey was completed by 65 members, with 66% agreeing that a national approach to transition care was needed. Semistructured interviews reflecting activities at 9 transition care sites were conducted, and they identified candidate models of care, including direct transfer, progressive transfer, and shared care models. Challenges and needs experienced in these care models reflected resource and infrastructure needs, poor availability of mechanisms to support parents and youth through the transition process, and the need for evaluation to support quality improvement. The focus group and prioritization activity was attended by 26 participants, with each having the ability to cast 3 votes. “Supporting patient education for transition to adult rheumatology health care system” (n = 17 votes) and “advocacy activities to access allied health support, including funding” (n = 10 votes) emerged as the top priorities for national initiatives.

Conclusion.

We have identified priorities in education and advocacy for advancing transition care in Canada that require participation of pediatric and adult rheumatology providers, patients, and arthritis stakeholders in the interest of advancing transition care outcomes.
Erectile Dysfunction in Men With Psoriatic Arthritis: A Population-based Cohort Study
Authors: Wilton Katelynn M. , Achenbach Sara J. , Karmacharya Paras , Ernste Floranne C. , Matteson Eric L. , Crowson Cynthia S.
Published: October 2020

Objective

To define the incidence of erectile dysfunction (ED) in a population-based cohort of men with psoriatic arthritis (PsA).

Methods

Data pertaining to demographics, ED, and potential confounding diagnosis were extracted from a comprehensive medical record system for a population-based cohort of men with PsA and an age-matched male comparator cohort. Cumulative incidence of ED adjusted for competing risk of death was compared between the 2 cohorts.

Results

There were 128 age-matched pairs of men with PsA and without PsA in the described cohorts. At baseline, there was a 7% prevalence of ED in men with PsA prior to diagnosis compared to a 3% prevalence of ED in the comparator cohort (P = 0.16). After PsA diagnosis/index date, diagnosis with PsA was associated with an increased risk of ED (age-adjusted HR 1.45, 95% CI 0.79–2.68), but this association did not reach statistical significance. This was based on 24 cases of ED in the men with PsA and 18 cases within the comparator cohort. No confounding factors or ED treatment strategies differed significantly between men with PsA and ED and comparators with ED.

Conclusion

Men with PsA may have an increased risk of ED, which was detected but likely underpowered in this study. Whether this difference is secondary to higher prevalence of traditional risk factors of ED in men with PsA compared to the general population will require further study.
Mobile Application Design for Heritage Tourism Uses Gamification Approach in Indonesia
Authors: Widarti Erni , Suyoto Suyoto , Emanuel Andi Wahju Rahardjo
Published: October 2020

Heritage tourism is a trip traveling in certain areas that have historical value and ancestral heritage, such as temples, museums, palaces, etc. Indonesia is a country that has diverse historical heritages that have the potential to be developed be-cause there are historical sites and are considered as tourism potential. Technolo-gy plays a vital role in the development of heritage tourism to facilitate the deliv-ery of information to tourists, one of which is a mobile application. The proposed application design is a mobile application design with a gamification approach to facilitate tourists to obtain information and travel experiences to explore exciting tourist attractions. The gamification approach is used as a unique attraction where tourists are wrongly venturing for the concept of the game in conveying infor-mation using element games. This research was conducted in 3 temples, namely Gedongsongo temple, Prambanan temple, and Borobudur temple. The prototype design test was conducted on 100 tourists who visited 3 of the temple's tourist at-tractions. The results showed 86% of users agreed with the proposed prototype design. Based on the 95% confidence scale, shows that this research was suc-cessful in designing a prototype of a heritage tourism mobile application to ex-plore temple tourism. This application design is suitable for users based on four variables: Usefulness, Ease of Use, Ease of Learning, and Satisfaction.
The Position of STEM Higher Education Courses in the Labor Market
Authors: Kersanszki Tamas Laszlo , Nadai Laszlo
Published: October 2020

Using the Hungarian Higher Education Enrollment and Student Statistics, we address the major higher educational challenges facing STEM education, not only in Hungary but also in the European Union. We include the lack of methodologies for a transition to upper secondary education, the low enrollment rate for STEM programs and the high drop-out rates in these programs for various countries, including the presence of 'fall objects'. Based on enrollment numbers, we capture the characteristics of STEM undergraduate and graduate courses and training institutions, highlighting the regional differences and the resulting individual interventions.

Examining the statistical evidence behind STEM training, we conclude that Hungarian applicants for higher education do not have sufficient information concerning possible STEM career paths. The Labor market needs are not sufficiently reflected in curriculums and the development of basic competencies are not provided. The education is, therefore, typically, far from real-world workplace situations and problem-solving needs.

This study points to a need to reinterpret STEM training, to ensure future supply, through training and career guidance, highlighting a more active involvement of women and disadvantaged groups in STEM courses.
EMERGING CORONAVIRUSES IN NEOTROPICAL PRIMATES: A NEW THREAT?
Authors: Yunes Guimarães Victor , Augusto Justo André , Luís Martins Leandro , Catão-Dias José Luiz , Sacristán Carlos
Published: October 2020

Anthropogenic activities are the main reason for the current alarming conservation status of non-human primates (NHP) worldwide, and also lead to habitat-sharing, facilitating human-NHP (interspecific) viral transmission. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the ongoing COVID-19 pandemic, is well-known for its large genome plasticity and spike proteins (S proteins) highly adaptable to human receptor angiotensin-converting enzyme-2 (ACE2). NHP have been used as models for clinical, diagnostic, and therapeutic studies on SARS-CoV-2 and their correlates. However, the lack of systematic sanitary surveillance in NHP in the Neotropics, as well as the limited capacity to detect infections in their populations, challenge the implementation of consistent epidemiological connections regarding the potential interspecific transmission in the natural environment. Although the natural cross-transmission of SARS-CoV-2 between humans and NHP has not been demonstrated, the global spread of the virus represents a potential threat. Thus, establishing preventive, surveillance, and control measures for viruses of the family Coronaviridae in Neotropical NHP populations is crucial for their conservation.
THE VETERINARIAN IN PANDEMY SARS-CoV-2 (COVID-19): BACKGROUND AND ATTRIBUTIONS
Authors: Maria de Medeiros Gomes Simplício Kalina , Vargas-Hernández Giovanni , Henrique Bueno de Camargo Mauro , Fernandes de Macedo Michelly
Published: October 2020

In December 2019, the world watched in disbelief as a viral epidemic, originating in Wuhan, Hubei Province, China, took on frightening proportions. On January 30, 2020, the World Health Organization (WHO) declared the outbreak of the disease caused by the new coronavirus (SARS-CoV-2) to be a public health emergency of international importance, the highest level of alert of the Organization, as provided in the International Health Regulations (IHR, 2016). On March 11, 2020, the epidemic was declared a pandemic by the WHO. Despite the rapid distribution of the new virus, many countries were reluctant or slow to comply strictly with the prophylactic methods suggested by those who had already experienced the whole situation of threat to the health of their populations.
A Training Module to Empower Marginalised Northern Borneo Islanders for Tuberculosis Control
Authors: Jeffree Mohammad Saffree , Ahmedy Fatimah , Ibrahim Mohd Yusof , Awang Lukman Khamisah , Ahmed Kamruddin , Giloi Nelbon , Naing Daw Khin Saw , Yusuff Aza Sherin
Published: October 2020

Empowering marginalised urban islanders with limited health accessibility through knowledge transfer program for controlling pulmonary tuberculosis (PTB) requires a specific training module. The study was aimed to develop this training module by adapting and modifying the IMCI (Integrated Management of Childhood Illness) framework. Structuring the content for the knowledge and skills for PTB control in the module was based on the National Strategic Plan for Tuberculosis Control 2016-2020. A total of five knowledge and skills were structured: i) PTB disease and diagnosis, ii) PTB treatment, iii) preventive PTB measures, iv) prevention of malnutrition, and v) psychosocial discrimination. The IMCI framework was modified through 3 ways: i) identifying signs and symptoms of PTB, ii) emphasising the IMCI's 5 steps of integrated management: assess, diagnose, treat, counsel and detect, and iii) counseling on BCG immunisation, malnutrition, environmental modifications and stigma on PTB.