bluuebunny/crossref_metadata_2025 huggingface dataset:
Covid 19 pandemic and its impact on children
Authors: Chennadi Amith
Published: April 2021

Introduction:
Covid-19, like on every other age group, showed a
detrimental impact on children. We predicted more adversities
among vulnerable lower socio economic groups but outcome
is contrasting due to varied reasons. Despite minimal morbidity
and mortality, There is a substantial impact on lifestyle,
development , mental health and learning behaviour patterns
in Paediatric population.
Some of the positive impact1
:
• Awareness regarding pandemic in detail is explained
,reassurances and practical measures to be taken to keep
themselves and others safe.
• Spending quality time with children during the lockdown
enabled closer relationship and bonding.
• Children had an opportunity to understand the value of
nature and eco systems.
• Introduction of E learning helped the children to develop
more creative skills and activities that would benefit them
in later life keeping in pace with education.
Some of negative impact:
• Closing schools and library facilities which is only mode of
education for some children who cannot access to internet
impacted most in their learning. This is more seen in rural
areas and lower socio economic background2
.
• Anxiousness and frustration regarding reaching higher
heights in their career and success is seen in children.
• Lack of outdoor physical activity which resulted in
overeating and obesity.
• Nutritional deficiency is seen in children from rural and
lower socio economic groups due to school closure who
are dependent on government food programmes provided
at school3
.
• Isolation, physical distance , loneliness, fear of deprived of
company and misunderstanding with their own peer
groups are some challenging situations which brought
drastic behavior changes in children4,5.
• There is a spike in child marriages mostly in lower socio
economic groups .Child right crisis like child labour, child
abuse, more so seen in lower socio economic classes.
Editorial
1
• Addiction to social media and internet leading to cyber
bullying and sexual exploitation.
Conclusion:
Long term impact on children are yet to be seen.
Although some of these may be positive, but negative
impacts may be devastating and could affect child
development .There is a definite need for Government to
work together with child welfare organizations and
international health care organizations working for children
to minimize the negative impact on children
An analytical study of prevalence of ear disorders and their
risk factors among children in a resettlement colony of Delhi
Authors: Kalika Gupta , Goyal Gourav Kumar , Berad Akshay
Published: April 2021

Background: The world has more than 360 million population
(almost 5% of world’s population) with disabling hearing loss
and among them, 32 million are children. It is estimated that
over 166 million people in the developing world face a severe
lack of intervention services for hearing loss. There is a need
to estimate the magnitude of various ear morbidities in school
age children as well as to identify the various risk factors that
play a role in the emergence of these morbidities.
Aim: To find prevalence of various ear disorders and their risk
factors among children 5-11 years old.
Methodology: It was a cross-sectional, community based study
conducted at a resettlement colony named Gokulpuri, in East
Delhi. Study was conducted for a period of one year, Jan 2017
– Dec 2017. Children in the age group 5 yrs. to 11 yrs. were
included in the study. Results: Total prevalence of ear
morbidities in children was found to be 15.8%. Wax impaction
in the ears was found to be most prevalent morbidity 10.6%.
Educational status of mother and head of the family,
immunization status of child, history of slapping trauma and
coryza were among the associated risk factors. Exclusive breast
feeding was statistically insignificantly associated
Single stage Large LR recession with or without MR resection
and its motor outcomes in Concomitant Exotropia
Authors: B. Nalini Jayanthi , Y Raman , N. Sunitha
Published: April 2021

Exotropia is a manifest outward deviation of the visual axes,
which is either constantly or intermittently present. Untreated,
poorly controlled intermittent exotropia later progresses to
constant exotropia.
Sensory exotropia is unilateral divergent misalignment of the
eyes, resulting from loss of vision or long-standing poor vision
in an eye.
In sensory exotropia the angles are characteristically large,
ranging from 30 to 100 prism dioptres (PD) and increases
gradually over time as long as the cause of visual deficit remains
active. Treatment is directed to re-establish the normal ocular
alignment and binocular vision[1]. The preferred treatment
for manifest exotropia is surgery[2]. Large angle constant
exotropia negatively impacts the way the patients see
themselves and are perceived by others. The benefits of surgical
treatment of exotropia in adults is well proven, both
psychologically and visually. The surgical treatment for largeangle exotropia has been a subject of sufficient debate. A
variety of surgical plans have been described including two,
three or four horizontal rectus muscles recession and
resections with or without adjustable suture technique.[3] In
more recent studies, the management of large-angle exotropia
falls into two surgical approaches.
Large bilateral lateral rectus recession is done when the acuity
is good in each eye and indicated for true divergent excess
type. For basic exodeviation R-R procedure is done popularly.
Before embarking on surgical plan we do post occlusion test
and identify the clinical type.
If one eye is amblyopic, a maximal or supramaximal unilateral
recess- resect procedure is performed.
Records of previous studies have shown that monocular
surgery had shown good results for exotropia of < 60 PD. But
for exotropia of > 60 PD, monocular surgery was not so effective
(4).
In previous studies mild to moderate LR recessions were
described but our study involves maximum recession on LR.
In previous studies large LR recessions were reported to have
complications like Lid changes and palpebral aperture
widening.
This study was done to evaluate the outcome of single stage,
unilateral large LR recession with or without MR resection for
constant exotropia
Single centre experience of double valve replacement using
mechanical valves
Authors: KS Saurabh , K. Popli , SVPL , Chandrakumar , SA Guroo , A. Gupta
Published: April 2021

Introduction: Cardiac valvular disease in India is most
commonly caused by Rheumatic aetiology, many of which end
up getting operated for the same. There is still existing
controversy about the selection of ideal valves that can be used
for replacement.
Objective: Objective of this study was to retrospectively
analyse the variable which can be easily assessed in the patients
undergoing DVR (Double Valve replacement) using mechanical
valves for its outcomes.
Methods: All the patients who underwent DVR + Tricuspid
valve repair/annuloplasty between October 2017 to January
2019, were identified and retrospectively their data was
analysed.
Results: 72 patients who underwent the procedure. Most
common aetiology was Rheumatic. 69.4% were in NYHA (New
York Heart Association) class II, 33.33% had chronic atrial
fibrillation. 45.6% had associated tricuspid valve disease, and
no chordae was preserved in 27.7%. Overall mortality was 5.5%
Conclusion: The study revealed a favourable survival outcome
after DVR surgery. The operative mortality in patients
undergoing DVR depends on intra operative factors like total
surgical time, bypass time and aortic cross clamped time and
has improved remarkably over time, with the improvisation of
extracorporeal circulation methods, myocardial protection
techniques and postoperative management.
Functional assessment in left ventricular non-compaction cardiomyopathy in multimodality imaging era might improve the definition
Authors: Visoiu Ionela Simona , Rimbas Roxana Cristina , Gheorghiu Loredana , Antunes Guerra Ruxandra Dragoi Galrinho , Nicula Alina Ioana , Vinereanu Dragos
Published: April 2021

Left ventricular non-compaction (LVNC) is an increasingly recognized phenotype. The current definition of the LVNC does not mention LV dysfunction as an absolute criterion in addition to morphological criteria. LV dilatation and decreased LV ejection fraction (LVEF) are often late manifestations of the disease and correlate with the occurrence of cardiovascular complications. However, to define LVNC as a cardiomyopathy, functional criteria must be fulfilled, in addition to the morphological ones. Multimodality imaging, such as myocardial deformation and myocardial work analysis derived from speckle tracking echocardiography (STE), in combination with cardiac magnetic resonance (CMR) might improve diagnosis and characterization of non-compaction, exposing earlier signs of LV systolic dysfunction. We present two comparative cases of LVNC in order to highlight the idea of subclinical dysfunction even in apparently benign forms with preserved LVEF, and also the importance of multimodality imaging approach.
Fully penetrant genetic mutation results in wide familial variability: a cardiac magnetic resonance focused report
Authors: Iovanescu Maria Livia , Marcu Andreea Sorina , Militaru Cristian , Istratoaie Octavian , Gheonea Ioana , Militaru Sebastian
Published: April 2021

Dilated cardiomyopathy (DCM) is a myocardial disorder characterized by ventricular dilation (LV or biventricular) and systolic dysfunction, with a broad etiological spectrum, comprising numerous genetic and non-genetic causes. Cardiac magnetic resonance (CMR) has become an important tool in guiding the etiological diagnosis in DCM. We present the case of a 37-years old man admitted to our department in order to investigate the diagnosis of DCM using CMR. Cine imaging showed mild left ventricular (LV) dilatation and moderate systolic (LV ejection fraction = 42%) dysfunction, but also apical hypertrabeculation meeting the criteria for non-compaction and late gadolinium enhancement (LGE) images revealed mid-wall fibrosis in the basal and midventricular segments of the inferior interventricular septum (IVS) – typical of non-ischemic DCM. Complete family history revealed the diagnosis of DCM in the mother of the patient and in the maternal grandfather, who had died at 87. After genetic testing of the index patient showed a pathogenic mutation in the TTN (titin) gene (c.79273A>T), cascade genetic testing followed, for his mother, sister, uncle and two cousins who all came back positive for the same mutation. CMR examination of the mother done 6 years prior demonstrated severe LV dilatation and systolic dysfunction (LV ejection fraction = 23%), LV non-compaction and mid-wall IVS fibrosis. CMR examination was performed for the other members of the family and discovered pathological findings in the uncle (normal LV volume and function, but focal mid-wall fibrosis in the inferior IVS) and the male cousin (LV non-compaction), while the female cousin had a normal exam. Using CMR and genetic testing, this case report proves the phenotypic heterogenicity of a completely penetrant titin mutation in the same family. Moreover, CMR is shown to be essential in DCM evaluation, having the ability to guide etiologic diagnosis and to detect alterations such as fibrosis and non-compaction in the absence of LV dilation or dysfunction.
Multimodality diagnosis of cardiac involvement in COVID-19 patients
Authors: Balinisteanu Anca , Memis Hayat , Postulache-Cosmulescu Gratiela , Mihalcea Diana , Mihaila Sorina , Vinereanu Dragos
Published: April 2021

The Coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV2), exhibits a wide spectrum of manifestations, from asymptomatic presentations to acute respiratory failure, myocardial injury, arterial or venous thrombosis, multiorgan failure, and death. Although COVID-19 mainly disrupts the respiratory syndrome, it has been shown to have detrimental impact on cardiac morphology and function, resulting in a broad range of cardiovascular complications and poor outcome, increasing morbidity and mortality of these patients. This review will summarize the knowledge on characterization of myocardial injury in COVID 19, by using cardiac biomarkers, electrocardiographic, and cardiac multi-modality imaging findings for an early and accurate diagnosis, proper management, correct treatment, and follow-up of COVID-19 patients.
Aortic coarctation in adults: the role of multimodality cardiac imaging. Series of case reports and review of literature
Authors: Beladan Carmen , Gurzun Maria Magdalena , Bica Mihai Teodor , Deleanu Dan , Platon Pavel , Botezatu Sebastian , Ginghina Carmen , Popescu Bogdan A.
Published: April 2021

Coarctation of the aorta (CoA) is a relatively frequent congenital defect. Its natural evolution is marked by serious complications including aortic dissection, heart failure, coronary artery disease, infective endocarditis, or cerebral haemorrhages. Correction of CoA before complications arise is associated with a favourable long-term outcome. Timely diagnosis of CoA is therefore of utmost importance in the prognosis of these patients. Non-invasive imaging techniques, ranging from chest radiography to echocardiography, Cardiac Computed Tomography (CCT), and Cardiac Magnetic Resonance (CMR) have evolved to the extent where they can not only suggest but also precisely characterize the lesion and guide further management. We present a series of 3 case reports, highlighting the diagnostic approach and treatment for this pathology.
Large inferior vena cava tumor with cardiac extension revealed by venous thrombembolism in a patient with complete situs inversus: what are the odds?
Authors: Roscaneanu Diana-Andreea , Mitu Ovidiu , Crisu Daniela , Miftode Radu-Stefan , Haba Mihai Stefan Cristian , Petris Antoniu Octavian
Published: April 2021

Venous thromboembolism (VTE) can be the first symptom of an occult malignancy in apparently healthy individual. Inferior vena cava (IVC) tumors are rare conditions but with negative prognosis. We present the case of a 57 year-old male patient, with complete situs inversus, diagnosed with hepatic cirrhotic disease and frequent decompensations, that was hospitalized for deep venous thrombosis (DVT) and ascites. Further imagistic investigations revealed a 22 cm tumor inside the IVC with consequent Budd-Chiari syndrome that was actually causing the liver and kidney disease, extending from the infrarenal level to the right atrium. After compensation, the patient was referred to a multidisciplinary surgical team. However, the management of such patients is very difficult, and the prognosis is altered. Possible IVC leiomyosarcoma are very rare and such vascular extension has been rarely reported.
Indicadores para medir la erosión de los suelos por acción de la lluvia: Una revisión con énfasis en la estabilización masiva y control de las tasas de erosión.
Authors: Álvarez -Benaute Luisa Madolyn
Published: April 2021

La erosión del suelo conlleva a una serie de impactos, dentro y fuera del ecosistema que a su vez se encuentran relacionados con la capacidad productiva del suelo y el agotamiento de los nutrientes. Este documento nos brinda una visión del estado de la pérdida del suelo por la erosión hídrica, enmarcado en un conjunto de indicador es de servicios ecosistémicos seleccionados (ES) que comprenden indicadores de ofer ta y demanda que representan los tres principales categorías proveed oras, regulador as y socioculturales. La elección de los indicadores adecuados y su cálculo se presenta utilizando el ejemplo de la clase ES "estabilización masiva y control de las tasas de erosión" y el "control del agua de erosión del suelo". Los ecosistemas casi naturales a menudo resisten la erosión en mayor medida que las áreas en uso, cuyas tasas de erosión dependen de parámetros naturales y factores relacionados con el uso. El indicador principal, captura el efecto protector de los ecosistemas contr a pérdida de suelo, calculada a partir de la diferencia de las pérdidas anuales y la tasa de ero sión hipotética sin vegetación. El objetivo es mostrar el desarrollo de indicadores con un enfoque de participación de los interesados y adoptar procesos regulatorios que ayuden a contrarrestar los efectos de la erosión en los suelos.
Microorganismos eficaces (em) en el rendimiento del cultivo de habas (Vicia faba) variedad señorita en condiciones edafoclimaticos de Panao, Pachitea
Authors: Aquino-Duran Elizabeth
Published: April 2021

El objetivo del presente trabajo fue evaluar la efectividad de los Microorganismos Eficaces (EM) el rendimiento del cultivo de habas (Vicia faba) variedad señorita. En un DBCA con 4 bloque y 4 tratamientos, con una población total de 1440 plantas, 90 plantas por cada parcela experimental, 15 plantas por muestra. Se utilizó el ANDEVA y la prueba de DUNCAN al 5 % de nivel de significación. Los resultados T2 (1 ½ L EM /20 L. Agua), por área neta experimental fue de 8,150 kg/parcela de vaina verde cuyo valor estimado es de 13 583 kg/ha; es decir 13,58 t/ha. Con respecto al rendimiento de grano en verde con la dosis T2 (1 ½ L EM /20 L. Agua), por área neta experimental fue de 3,812 kg/parcela cuyo valor estimado es de 6 350 kg/ha, es decir 6,35 t/ha; superando estadísticamente a los demás tratamientos y al testigo. En el número y peso de vainas/planta el T2 registra promedios de 42,90 vainas y 627,17 g respectivamente; de igual forma para el número y peso de granos/ planta el T2 ocupa el primer lugar con 67,04 granos y 257,94 g; en tanto los tratamientos T3 y T1 con 238,83 g y 236 g.
Infusiones a base de plantas medicinales durante el embarazo: una actualización en la temática
Authors:   Universidad de Buenos Aires, Facultad de Medicina, Escuela de Nutrición, Centro de Promoción e Investigación en Nutrición Materna, Ciudad Autónoma de Buenos Aires, Argentina, García Karina Elizabeth , Barretto Luciana , Poy Mabel , Wiedemann Adriana , Agudelo Ignacio J , Anconatani Leonardo M , Ricco Rafael A , Wagner Marcelo L , López Laura Beatriz ,   Universidad de Buenos Aires, Facultad de Farmacia y Bioquímica, Cátedra de Farmacobotánica y Museo de Farmacobotánica "Juan A. Domínguez", Ciudad Autónoma de Buenos Aires, Arg
Published: April 2021

Introduction: in the last decades, the use of medicinal plants throughout the life cycle is increasing due, on the one hand, to a tendency to revalue knowledges that are part of the regional cultures of some communities and, on the other hand, to the use increasingly frequent in developed countries of complementary alternative medicines. Objectives: the purpose of this work is to carry out an update in relation to the consumption of medicinal herbal teas during pregnancy with emphasis on the positions on the subject issued by reference organisms. Development: the medicinal plants presented in this document are the ones that have the greatest scientific endorsement regarding the safety of their consumption in the form of infusions during pregnancy and include ginger, chamomile, peppermint, and linden. The characteristics of each plant, the production area in Argentina, the bioactive compounds present, the potential risks and the position of national and international organizations regarding their safety during pregnancy are presented. Conclusions: In all cases during pregnancy, safe consumption is in the form of an infusion, not more than two to three cups per day of each plant, and ideally it is recommended to alternate its consumption or combine it. In addition, it is highlighted that the community must recognize the need to consult a medical professional before using a medicinal plant. Key words: medicinal plants; pregnancy.
COMMUNICATIVE COMPETENCE`S DEVELOPMENT OF TEACHERS-PSYCHOLOGISTS` STUDENTS: PROBLEM STATEMENT
Authors: Zaru Kasymovna Kulsharipova  , Zebinsa  Bakhodirkyzy Solieva  , Zhanat Beisembayevich Issabekov
Published: April 2021

"Professional activity of a teacher-psychologist is connected with the need for constant communication with a wide range of people. These are children who have different psychological characteristics; their parents, who have different educational and age status; colleagues and the administration of the educational institution, who may have professional deformities. The communicative responsibility of teachers-psychologists acts in professional activity as the qualities and skills that make up the part of the professional competence and skill of the specialist, which can be called his communicative competence. Communication processes play a crucial role in any professional activity. Therefore, a person should strive to master effective ways of communication, i.e. to learn the ability to understand others and be understood. "
Upgrading ATM Security Using Finger Vein Authentication and Anti Theft Module
Authors: Nivedha R. Sri , Devi P. V. Sorna Saratha , Akilandeswary Mrs. G
Published: April 2021

Since crimes pertaining to ATMs have been increasing in recent times, there is a crying need to look into the issue. There have been various systems to prevent the misuse of ATM cards or breaking open the ATM machine but there is a lack of a single system to secure the whole ATM from both physical and logical attacks. This paper proposes a two-module system that contains an RFID and finger-vein authentication module as an alternative to the conventional ATM cards and a Raspberry Pi module for continuous monitoring and automated control when the security of the ATM is at risk. This two-factor authentication and a real-time monitoring system provide better security than the previous techniques which make use of biometric authentication such as fingerprint and face recognition or CCTV cameras.
Notes on Bipolar Interval Valued Intuitionistic Fuzzy Topological Space
Authors: Suganya M. , Manonmani A.
Published: April 2021

In this paper we have introduced Bipolar Interval Valued Intuitionistic Fuzzy Point, Bipolar Interval Valued Intuitionistic Fuzzy Neighbourhood,Bipolar Interval Valued Intuitionistic Fuzzy Interior and Bipolar Interval Valued Intuitionistic Fuzzy Closurein Bipolar Interval Valued Intuitionistic Fuzzy topological space and have verifiedsome of its properties.
Pilot Test of the Maximizing Adolescent Post-Secondary Success (MAPSS) Intervention: Supporting Parents of Autistic Youth
Authors: Kirby Anne V. , Feldman Kristina J. Cottle , Himle Michael B. , Diener Marissa L. , Wright Cheryl A. , Hoffman Jenna M.
Published: April 2021

Importance: Parents play an essential role in the transition to adulthood for autistic youth, yet often feel they do not have adequate training and resources.

Objective: To evaluate data on the preliminary efficacy of and collect participant feedback about the Maximizing Adolescent Post-Secondary Success (MAPSS) intervention.

Design: Single-group, pretest–posttest pilot study.

Setting: Clinic.

Participants: Twenty-two families of autistic youth (ages 13–19 yr, 72.7% male).

Intervention: MAPSS is a group intervention for parent–youth dyads that is designed to guide parents in facilitating the development of independent skills for adulthood.

Outcomes and Measures: Measures included the Transition Preparation Activities Measure (T-PAM), Family Empowerment Scale (FES), 10-item Perceived Stress Scale (PSS–10), Adulthood Expectations Questionnaire (AEQ), Adaptive Behavior Assessment System–Third Edition (ABAS–3), and a study-specific participant feedback survey.

Results: Frequency of transition preparation activities (T-PAM) significantly increased from before to after the intervention, and although the frequency of preparation activities decreased by 1-mo follow-up, it remained significantly higher than at baseline. Parent self-efficacy (FES), parent expectations (AEQ), and parent sense of control over outcomes (AEQ) also significantly increased from preintervention to follow-up; however, parent coping (PSS–10) was unchanged. Youth self-care skills (ABAS–3) demonstrated improvements 6 mo after the completion of the intervention, although other areas of adaptive behavior did not significantly change. Feedback from parents suggested they had positive experiences and felt the intervention was beneficial.

Conclusions and Relevance: Our data suggest that the MAPSS intervention is an appropriate candidate for larger, controlled clinical trials.

What This Article Adds: With additional evidence, this intervention can offer guidelines for occupational therapists to work with autistic youth and their parents to prepare for adulthood.
Investigating Alignment in a Quantitative Literacy Course for Social Sciences Students
Authors: Frith Vera , Lloyd Pam
Published: April 2021

The Numeracy Centre at the University of Cape Town has taught a one-semester quantitative literacy course for social sciences students since 1999. This study aims to provide an example for how the design of such a course can be assessed for alignment with quantitative reasoning goals. We propose a framework of learning outcomes for the course and use that framework to analyse the assessments and student performance on them. We find that just under half of the overall mark for the course was devoted to the interpretation and communication of quantitative information (our “main” outcomes), and about a quarter was devoted to the performing of calculations. The analysis revealed that statistics outcomes were under-represented in the make-up of the overall course mark, and assessment of these outcomes was restricted almost entirely to the two final examinations. The results of the analysis of the alignment between outcomes and assessment are useful to inform discussions about changes to the course curriculum. The analysis of student performance on the different outcomes provides insights which are useful for informing improvements to our teaching approach. The analysis demonstrates a relatively straightforward procedure that can be used or adapted by researchers in other institutions for ongoing monitoring of alignment between course outcomes, teaching, and assessment.
Improving harm reduction with a naloxone intervention in primary care to prescribe and educate a support person
Authors: Kirk, PharmD, CDE, BCPS Julienne K. , Tran, PharmD Matthew Q. , Pelc, PharmD Samantha , Moore, PharmD, BCPS, BCACP Katherine G.
Published: April 2021

Objective: To determine whether a pharmacist-led intervention would increase the number of naloxone prescriptions and naloxone administration education in a primary care family medicine setting.Design: Prospective quality improvement intervention in an academic family medicine clinic.Methods: We surveyed providers about naloxone knowledge, prescribing habits, and prescribing barriers. We identified patients on chronic opioid therapy, through electronic health records for the year 2019. Overdose risk categories based upon morphine milligram equivalent doses and concomitant benzodiazepine use were used to determine patients who met criteria for naloxone. Pharmacists phoned qualified patients to discuss overdose risk and naloxone benefits. Patients who accepted naloxone prescriptions used their local pharmacy through a department-approved standing order set.Results: From the survey results, there were 47 of 54 provider responses, and the majority noted that they do not routinely prescribe naloxone in high-risk patients. The predominant barriers were lack of time during visit and naloxone administration education. The population of patients from chart review included 93 high-risk patients with a mean age of 58 years. During the time of intervention, 71 patients remained eligible for naloxone coprescribing. Of the patients contacted, 29 (40 percent) accepted the intervention prescription, and subsequently, 22 picked up their prescription from the pharmacy. Sixteen received counseling with a support person. Twelve patients had naloxone already at home, and two received counseling with a support person.Conclusion: The naloxone prescribing intervention is achievable. The results of this intervention support identifying patients at increased risk of opioid overdose and offer education of a support person for naloxone in a large academic family medicine clinic.
Why we still prescribe so many opioids: A qualitative study on barriers and facilitators to prescribing guideline implementation
Authors: Zavaleta, MHSA Kathryn W. , Philpot, PhD, MPH Lindsey M. , Cunningham, PharmD, RPh Julie L. , Gazelka, MD Halena M. , Geyer, MD Holly L. , Rismeyer, MSN, RN, NPD-BC Denise L. , Stitz, DNP, APRN, ACNS-BC Amber M. , Clements, MD, PhD Casey M.
Published: April 2021

Introduction: Opioid prescribing occurs within almost every healthcare setting. Implementation of safe, effective opioid stewardship programs represents a critical but daunting challenge for medical leaders. This study sought to understand the barriers and aids to the routine use of clinical guidelines for opioid prescribing among healthcare professionals and to identify areas in need of additional education for prescribing providers, pharmacists, and nurses.Methods: Data collection and analysis in 2018-2019 employed a team of two trained facilitators who conducted 20 focus groups using a structured facilitation guide to explore operational, interpersonal, and patient care-related barriers to best practice adherence. Each professional group was interviewed separately, with similar care settings assigned together. Invitation to participate was based on a sampling methodology representing emergency, medical specialty, primary care, and surgical practice settings.Results: Key concerns among all groups reflected the inadequacy of available tools for staff to appropriately assess and treat patients’ pain. Tools and technology to support safe opioid prescribing were also cited as a barrier by all three professional groups. All groups noted that prescribers tend to rely upon default settings within the electronic medical record when issuing prescriptions. Both pharmacists and prescribers cited time and scheduling as a barrier to adherence.Conclusions: In spite of significant regulatory and public policy efforts to address the opioid crisis, healthcare organizations face significant challenges to improve adherence to best practice prescribing guidelines. These findings highlight several facilitators for change which could boost opioid stewardship initiatives to focus on critical systems’ factors for improvement.
The polymorphism of rs2227513 can affect the expression of IL-22 and the proliferation of FLS, which leads to the progress of rheumatoid arthritis
Authors: Yi Jinping , Quan Lijuan , Yi Chufeng , Huang Zikun , Chen Xiaowen
Published: April 2021

Introduction

MiR-101 rs7536540 may influence the expression of miR-101 and another polymorphism, rs2227513, which in turn affects the expression of IL-22, . However, studies on the combined effect of these polymorphisms are still scarce.

Material and methods

Quantitative real-time PCR was performed to analyze the expression of miR-101 and IL-22 mRNA. ELISA and Western blot were carried out to examine the expression of IL-22 protein. MTT assay and flow cytometry were used to assess the cellular proliferation and apoptosis . Immunofluorescence was performed to measure the expression of p-STAT3. Luciferase assay was carried out to explore the inhibitory role of miR-101 in the expression of IL-22.

Results

The severity of RA was progressively increased in patients with rs7536540 GG + rs2227513 AA, rs7536540 GG + rs2227513 AG, rs7536540 CC/CG + rs2227513 AA and rs7536540 CC/CG + rs2227513 AG genotypes. The CC/CG alleles at rs7536540 were correlated with up-regulated miR-101 expression in the serum and SF of RA patients, whereas both CC/CG alleles at rs7536540 and AG alleles at rs2227513 were correlated with elevated expression of IL-22. Incubation of FLS with SF isolated from RA patients carrying the CC/CG alleles at rs7536540 and AG alleles at rs2227513 remarkably increased the cell proliferation and inhibited the apoptosis of FLS. Luciferase assay demonstrated that the expression of IL-22 was notably suppressed by miR-101 in THP-1 cells.

Conclusions

Our study revealed the combined effect of polymorphisms rs7536540 and rs2227513 on the expression of IL-22 and the proliferation of FLS as well as their association with the severity of RA
Estudio de la normativa en la asignatura de Tecnología de educación secundaria obligatoria: el caso de Asturias
Authors: Tamargo Pedregal Luis Ángel , Agudo Prado Susana , Fombona Cadavieco Javier
Published: April 2021

Este artículo describe, en el contexto específico de la Comunidad Autónoma del Principado de Asturias (España), el periplo legislativo de los diferentes currículos de la asignatura de Tecnología en educación secundaria obligatoria (ESO), desde su implantación a principios de los años noventa del siglo XX hasta hoy, tras la aprobación de la Ley orgánica 8/2013, para la mejora de la calidad educativa (LOMCE), y la evolución de su carga lectiva hasta este momento. Además, se analizan, mediante la elaboración de tablas comparativas, los diversos currículos publicados a los largo de los 25 años de vida de la asignatura en la región, atendiendo especialmente a sus contenidos temáticos y a los criterios de evaluación descritos en cada uno, con vistas a conocer los mayores cambios en la materia.
La universidad española ante sus nuevos retos
Authors: Oliver Añó Ramón
Published: April 2021

La calidad del sistema universitario español es una de las cuestiones que más debate suscita entre la comunidad educativa. La buena reputación de la que, en general, gozan muchas de nuestras universidades choca con algunos indicadores como el escaso número de estudiantes extranjeros que eligen España para realizar sus estudios de grado o el discreto papel de las mismas en los rankings internacionales. Recientemente, uno de ellos, el «U21 Ranking of National Higher Education Systems», elaborado por la organización de ámbito global Universitas 21 y que analiza los sistemas de educación universitaria a nivel mundial, situaba a España en una mejorable posición número 23. Por otra parte, la actual inestabilidad política y la aparente incapacidad de los responsables políticos para alcanzar ese gran Pacto de Estado por la Educación, largamente reclamado por la sociedad, no contribuyen a mejorar la situación.
An Examination of the Role Female Traders Play in the Liberian Economy
Authors: Boye Dolo* Alvin
Published: April 2021

This study access the Investigation into the Involvement of Liberia Women in cross Border Trade at
the Guinea Border with Liberia; 2014-2016.” The significance of the include: The research findings are of value to
the various industries in the region that will have available information on the functions of the cross border trade.
Government and policy makers. The study was carried out through a descriptive survey design. The target group for
the purposes of this study was importers and exporters at border point. The study focused on female traders on the
Liberia side of the border. The total population of the study is 500 registered female traders with a sample size of 70
respondents. The study used both primary and secondary data was used in this research. The study shows that 25
respondents representing 42% and all comprising of females in the study were between 30 – 39 years and another 16
respondents representing 26% and all comprising of female in the study were between 20– 29 years. The study
shows that 30 respondents representing 50% in the study agreed that Liberia Females are involved in Traders at the
border between Guinea and Liberia, 20 respondents representing 33% and all comprising of females in the study
agreed that the involvement of Liberia Female Traders at the Liberian and Guinean has an impact on the
development of trade at the Liberian and Guinean border. Base on the findings the researcher concludes that: The
regional Governments have made considerable efforts in reducing the incentives to trade informally, by diminishing
the costs of formal importing/ exporting; enhancing compliance levels with existing regulations; and improving
trading opportunities and services for traders in the formal sector. The study recommends that: 1) Formulation of the
Customs Management Act, the Customs Management Regulations outlining standard forms and fees payable across
the region. 2) Simplifying and reducing documentation.
Abuso cibernético en el noviazgo y relación intrafamiliar en adolescentes estudiantes mexicanos
Authors: Javier-Juárez Sandra Paola , Hidalgo-Rasmussen Carlos Alejandro , Díaz-Reséndez Felipe de Jesús , Vizcarra-Larrañaga María Beatriz
Published: April 2021

El alcance de la tecnología ha permitido que comportamientos abusivos en las relaciones de noviazgo sean vividos a través de medios electrónicos e internet. El objetivo del estudio fue determinar la existencia de asociación entre el abuso cibernético en el noviazgo (ACN) y la relación intrafamiliar (RI) en adolescentes estudiantes mexicanos ajustada por sexo, consumo de alcohol y violencia cara a cara en el noviazgo. Participaron 394 adolescentes con edades de entre 15 y 18 años (62,4% mujeres). Se encontró que el 62,2% de los participantes fueron víctimas de control/vigilancia y el 35% de agresión directa. Todas las dimensiones de RI obtuvieron puntuaciones intermedias. El modelo de ecuaciones estructurales mostró una asociación negativa entre el ACN y la RI con una fuerza de asociación pequeña (β= -0,18; p< 0,01). Sería recomendable en programas de prevención del ACN fortalecer en la familia la comunicación, la unión, el apoyo y la solución asertiva de conflictos. Futuros estudios podrían añadir al modelo otras variables que expliquen al ACN.
Application of parent-child interaction therapy (PCIT) to two girls with behavioral problems
Authors: Castro Prados Ariadna , Valero Aguayo Luis
Published: April 2021

Parent-child interaction therapy (PCIT) is a form of behavioral therapy to deal with various behavioral problems in children. It works directly with parents and their home interactions with their children. In this paper the application of PCIT to a seven-year-old girl with oppositional defiant disorder (ODD) and her three-year-old sister with behavioral problems is described. A single-case A-B design with concurrent baseline was used. The positive behaviors and problems were assessed for both young girls using self-monitoring and parent video recordings during playtime and home interactions. The treatment was developed in 12 sessions for 3 months. A progressive evolution was observed in both girls’ baseline and in pre- and post-treatment measures of the problem behaviors. Finally, there was a reduction of stress and an increase in the self-efficacy of the parents’ abilities.
Validación del “Índice de calidad de vida, versión en español” (QLI-SP) en una muestra mexicana
Authors: Meda-Lara Rosa M. , Juárez-Rodríguez Pedro , de Santos-Ávila Fabiola , Solís-Cámara Pedro , Palomera-Chávez Andrés , Hernández-Rivas María Isabel , Yeo-Ayala Carmen , Herrero Marta
Published: April 2021

El objetivo de este estudio fue la validación del “Índice de calidad de vida, versión en español” (QLI-Sp), con una muestra no aleatoria de 3384 estudiantes del nivel técnico y universitario que informaron estar sanos, además, se recogieron datos de 386 estudiantes que informaron tener hipertensión. Se utilizó una batería de pruebas psicológicas que median calidad de vida, bienestar psicológico, satisfacción con la vida y estrés académico. Los análisis factoriales exploratorio y confirmatorio ratificaron la naturaleza unifactorial del QLI-Sp apoyando su uso para medir percepción de calidad de vida en estudiantes universitarios. La fiabilidad fue adecuada (α=0.93). Para explorar más la validez del QLI-Sp, se examinaron los datos de 396 estudiantes que informaron hipertensión. El grupo relativamente sano tuvo puntuaciones más altas en todos los ítems del QLI-Sp en comparación con el grupo hipertenso. El modelo final indicó que la calidad de vida se relaciona de manera positiva con el bienestar psicológico (autopercepción, autonomía, dominio del entorno, propósito en la vida) y la satisfacción con la vida, y de manera negativa con el estrés académico.
Yttrium-90 Microspheres for Intermediate- or Advanced-Stage Hepatocellular Carcinoma
Authors: Young Calvin , Subramonian Anusree , Argáez Charlene
Published: April 2021

Transarterial radioembolization using yttrium-90 (90Y) microspheres is a therapeutic option for patients with intermediate- or advanced-stage hepatocellular carcinoma, including those with recurrent or inoperable hepatocellular carcinoma.

Overall, the evidence suggests that patients treated with 90Y-based transarterial radioembolization may experience no difference in overall survival, progression-free survival, and tumour response when compared to patients who received transarterial chemoembolization therapies or systemic treatment with sorafenib or lenvatinib.

Patients treated with transarterial radioembolization generally experienced similar rates of adverse events compared to those treated with transarterial chemoembolization, although there were some instances where treatment with transarterial radioembolization led to increased or decreased risks of specific adverse events. The comparative safety of transarterial radioembolization versus systemic treatment with sorafenib was unclear as the included studies did not statistically compare the risks of experiencing adverse events.

Evidence regarding the cost-effectiveness of 90Y microspheres for treating hepatocellular carcinoma is conflicting. Three economic evaluations suggest treatment with transarterial radioembolization is likely to be cost-effective or dominant — less costly and more effective — compared to transarterial chemoembolization or systemic therapies, while a single economic study suggested treatment with sorafenib or lenvatinib is most likely to be cost-effective or dominant compared to transarterial radioembolization.
Pharmacological Interventions for Vaping Cessation
Authors: Khangura Sara D. , McGill Sarah C.
Published: April 2021

The use of electronic nicotine delivery systems and other vaping products is on the rise, and the health effects from these products remain uncertain.

No evidence-based guidelines regarding the use of pharmacological vaping cessation interventions were identified.

Some guidelines suggest that it may be reasonable to apply smoking cessation interventions and/or protocols for vaping cessation, but no guidance specific to the use of pharmacotherapy was identified.
Rehabilitation of a Severely Worn Dentition with Partial Lithium-disilicate Glass Ceramic Restorations: A Case Report
Authors: Oğuz Ece İrem , Berksun Semih
Published: April 2021

Rehabilitation of worn dentition is a challenging task because several predisposing factors may be included in the pathogenesis. The treatment options and process should be carefully considered based on the clinical condition and patients’ requirements. This case report represents the esthetic rehabilitation of a 68-year-old patient who exhibited severely worn teeth caused by attrition and erosion. After clinical evaluation, 3 mm increase in occlusal vertical dimension was planned with partial lithium-disilicate ceramic restorations as laminate veneers for anterior teeth and vonlays (onlays with veneer extentions) for posterior teeth in maxilla. The adaptation of the patient to the increased occlusal vertical dimension was tested for 1 month by provisional direct composite restorations. As the patient did not show any discomfort, definitive restorations were completed. The patient was satisfied with the esthetics and functionality of her new dentition.
Իսլամական արմատականությունը Վրաստանում. նոր միտումներ և մարտահրավերներ
Authors: Harutyunyan Lilit , Manukyan Tatevik
Published: April 2021

The purpose of the paper is to study the main features and tendencies of Salafi Islam and Islamic radicalism in Georgia, to identify the threats and challenges facing Georgia as well as the region.
The objectives of the article are to discuss the internal and external motives and impulses, preconditions and consequences of the spread of Sunni radical Islam in the Muslim communities of Georgia, the issues of their integration into the Georgian society, the causes and consequences of the propaganda of Salafism and Sunni Islamic radicalismamong the ethnic Shi’i Azerbaijanis of Georgia.
The paper was written on the basis of monitoring of the international press and materials on this topic, an extensive study of professional literature on various sides of Radical Islam in Georgia.
In the course of the study, the authors concluded that the spreed of Salafism and radical Islam in Georgia poses a serious threat not only to Georgia, but also to the security environment of the region. The Georgian authorities are losing real control over Adjara, gradually "handing it over" to Turkey. Therefore, a "platform of radicalism" can be formed here with the possibility of direct penetration into the surrounding areas. Adjara, which is actively used by various Turkish Islamic organizations, may also become a "hotbed of terrorism" against Armenia in the event of certain developments.
The spread of radical Sunni Islamic ideology in the Azerbaijani-populated regions of Georgia is leading to the retreat of traditional Shi’i Islam. This phenomenon, of course, affects not only the religious map of the region, but also changes the existing geopolitical balance of power. Turkey, using its Islamic tools, is consistently pushing Iran out of Georgia's ethnic Azerbaijani-populated regions, squeezing the circle of Islamic radicalism around Armenia.
Անցյալ կատարյալ ժամանակաձևի ուսուցումը ՀՀ հանրակրթական դպրոցում
Authors: Sargsyan Hripsime
Published: April 2021

The past perfect is one of the most difficult tenses of the verb. The issues of teaching this scientifically developed, thoroughly studied Tense, have been relatively little discussed among us. The aim of the article is to present the issue from a new perspective, to study the peculiarities of the past perfect tense and to present a relatively new version of teaching. In order to achieve the mentioned goal, we set a task to find out the manifestations of the temporal meaning of the past perfect and to examine the peculiarities of the composition.
During the research, both cognitive (analysis, synthesis) and scientific-pedagogical research methods were used: comparison, abstraction, coordination.
In the course of our study, we came to the conclusion that teaching Past Perfect Tense would be more effective if the middle school textbooks briefly presented the semantic divisions of action times, the semantic descriptions of times, its applications, comparisons with other past tenses, and the goal in high school was not only to remember all that, but also deepen the teaching: it is necessary to give an additional idea about the bases of the verbs, to present composition of the tense in more detail, noting its practical peculiarities.
Հանքարդյունաբերության ոլորտի կայուն զարգացման հեռանկարները Հայաստանում: SWOT վերլուծություն
Authors: Afyan Nadezhda , Gasparyan Garri
Published: April 2021

The purpose of the article is to present problems of sustainable development of Armenia's mining sector. The importance of the mining industry in the development of the economy of the Republic of Armenia is also assessed. Then models of the mining industry in Canada and Sweden are presented. Tasks arising in achieving the goal: to comparatively differentiate and identify economic and environmental priorities and disadvantages of the mining industry. A survey of Canadian and Swedish mining experiences is undertaken to find solutions to existing problems.
The article uses the SWOT data analysis method. As a result, it is concluded that it is possible to develop the mining industry in accordance with international environmental standards and requirements, while at the same time providing economic benefits in this area. And among metal mining companies, only large companies or coalitions consisting of a few medium-sized mining companies should be formed, which will enable the development of the mining sector in accordance with the principles of sustainable development.