bluuebunny/crossref_metadata_2025_split huggingface dataset:
ОСОБЛИВОСТІ ОРГАНІЗАЦІЇ НАВЧАЛЬНОГО ПРОЦЕСУ В ТЕРНОПІЛЬСЬКОМУ НАЦІОНАЛЬНОМУ МЕДИЧНОМУ УНІВЕРСИТЕТІ ІМЕНІ І. Я. ГОРБАЧЕВСЬКОГО МОЗ УКРАЇНИ ЗА УМОВ ПАНДЕМІЇ ВІРУСУ SARS-COV-2 COVID-19
Authors: Яшан О. І. , Герасимюк М. І. 
Published: November 2021

Анотація. Внаслідок епідеміологічної ситуації навчальні заклади змушені були працювати за дистанційною формою навчання. При цьому підготовка спеціалістів галузі знань «Охорона здоров’я» отримала реальну проблему: як надати студенту можливість оволодіти практичними навичками. Вирішення знайшли у запровадженні компʼютерної платформи Microsoft Teams. Напередодні 6-годинного заняття викладач створює у застосунку зустріч-нараду, до якої за допомогою електронних скриньок запрошує студентів.
Зокрема, з курсу оториноларингології заняття розпочиналося із вступної частини, на якій викладач коротко ознайомлював студентів із темою заняття, наголошував на важливих моментах, давав відповіді на запитання.
Оскільки програма була одночасно завантажена та встановлена на смартфон, то викладач не був прив’язаний до персонального комп’ютера, а міг з телефону шляхом відеочату проводити огляд пацієнта, демонструвати методи обстеження, а також зміни зі сторони ЛОР-органів, пов’язуючи результати обстеження з діагнозом, пояснювати підходи до лікування. Після кожного обстеження проводилася коротка відеонарада з розбором незрозумілих моментів. Іншим варіантом проведення практичної частини заняття була онлайн-трансляція оперативних втручань, під час якої студенти мали можливість бачити всі етапи оперативного втручання, а також чути коментарі. Крім того, практична частина заняття заповнювалася демонстрацією навчальних відеофільмів.
Протягом другої частини заняття проходило традиційне семінарське обговорення, під час якого викладач мав можливість провести із студентами живе двобічне спілкування, розібрати цікаві випадки або питання.
Третя частина заняття – контроль у дистанційній формі. На платформу Moodle було завантажено базу тестових занять відповідно до тем практичних занять. Студент міг пройти тестовий контроль у визначений час напередодні заняття або за бажанням уже на занятті.
Таким чином, застосунок Microsoft Teams може використовуватися для проведення практичних занять та читання лекцій у дистанційному режимі.
Alternative Mitophagy Protects the Heart Against Obesity-Associated Cardiomyopathy
Authors: Tong Mingming , Saito Toshiro , Zhai Peiyong , Oka Shin-ichi , Mizushima Wataru , Nakamura Michinari , Ikeda Shohei , Shirakabe Akihiro , Sadoshima Junichi 
Published: November 2021

Rationale:
Obesity-associated cardiomyopathy characterized by hypertrophy and mitochondrial dysfunction. Mitochondrial quality control mechanisms, including mitophagy, are essential for the maintenance of cardiac function in obesity-associated cardiomyopathy. However, autophagic flux peaks at around 6 weeks of high-fat diet (HFD) consumption and declines thereafter.

Objective:
We investigated whether mitophagy is activated during the chronic phase of cardiomyopathy associated with obesity (obesity cardiomyopathy) after general autophagy is downregulated and, if so, what the underlying mechanism and the functional significance are.

Methods and Results:

Mice were fed either a normal diet or a HFD (60 kcal% fat). Mitophagy, evaluated using Mito-Keima, was increased after 3 weeks of HFD consumption and continued to increase after conventional mechanisms of autophagy were inactivated, at least until 24 weeks. HFD consumption time-dependently upregulated both Ser555-phosphorylated Ulk1 (unc-51 like kinase 1) and Rab9 (Ras-related protein Rab-9) in the mitochondrial fraction. Mitochondria were sequestrated by Rab9-positive ring-like structures in cardiomyocytes isolated from mice after 20 weeks of HFD consumption, consistent with the activation of alternative mitophagy. Increases in mitophagy induced by HFD consumption for 20 weeks were abolished in cardiac-specific
ulk1
knockout mouse hearts, in which both diastolic and systolic dysfunction were exacerbated. Rab9 S179A knock-in mice, in which alternative mitophagy is selectively suppressed, exhibited impaired mitophagy and more severe cardiac dysfunction than control mice following HFD consumption for 20 weeks. Overexpression of Rab9 in the heart increased mitophagy and protected against cardiac dysfunction during HFD consumption. HFD-induced activation of Rab9-dependent mitophagy was accompanied by upregulation of TFE3 (transcription factor binding to IGHM enhancer 3), which plays an essential role in transcriptional activation of mitophagy.

Conclusions:
Ulk1-Rab9-dependent alternative mitophagy is activated during the chronic phase of HFD consumption and serves as an essential mitochondrial quality control mechanism, thereby protecting the heart against obesity cardiomyopathy.
Retinol‐Binding Protein 4 Promotes Cardiac Injury After Myocardial Infarction Via Inducing Cardiomyocyte Pyroptosis Through an Interaction With NLRP3
Authors: Zhang Kang‐Zhen , Shen Xi‐Yu , Wang Man , Wang Li , Sun Hui‐Xian , Li Xiu‐Zhen , Huang Jing‐Jing , Li Xiao‐Qing , Wu Cheng , Zhao Can , Liu Jia‐Li , Lu Xiang , Gao Wei 
Published: November 2021

Background
Acute myocardial infarction (AMI) is one of the leading causes of cardiovascular morbidity and mortality worldwide. Pyroptosis is a form of inflammatory cell death that plays a major role in the development and progression of cardiac injury in AMI. However, the underlying mechanisms for the activation of pyroptosis during AMI are not fully elucidated.

Methods and Results
Here we show that RBP4 (retinol‐binding protein 4), a previous identified proinflammatory adipokine, was increased both in the myocardium of left anterior descending artery ligation‐induced AMI mouse model and in ischemia‐hypoxia‒induced cardiomyocyte injury model. The upregulated RBP4 may contribute to the activation of cardiomyocyte pyroptosis in AMI because overexpression of RBP4 activated NLRP3 (nucleotide‐binding oligomerization domain‐like receptor family pyrin domain‐containing 3) inflammasome, promoted the precursor cleavage of Caspase‐1, and subsequently induced GSDMD (gasdermin‐D)‐dependent pyroptosis. In contrast, knockdown of RBP4 alleviated ischemia‐hypoxia‒induced activation of NLRP3 inflammasome signaling and pyroptosis in cardiomyocytes. Mechanistically, coimmunoprecipitation assay showed that RBP4 interacted directly with NLRP3 in cardiomyocyte, while genetic knockdown or pharmacological inhibition of NLRP3 attenuated RBP4‐induced pyroptosis in cardiomyocytes. Finally, knockdown of RBP4 in heart decreased infarct size and protected against AMI‐induced pyroptosis and cardiac dysfunction in mice.

Conclusions
Taken together, these findings reveal RBP4 as a novel modulator promoting cardiomyocyte pyroptosis via interaction with NLRP3 in AMI. Therefore, targeting cardiac RBP4 might represent a viable strategy for the prevention of cardiac injury in patients with AMI.
Network-Based Phase Space Analysis of the El Farol Bar Problem
Authors: St. Luce Shane , Sayama Hiroki 
Published: November 2021

AbstractThe El Farol Bar problem highlights the issue of bounded rationality through a coordination problem where agents must decide individually whether or not to attend a bar without prior communication. Each agent is provided a set of attendance predictors (or decision-making strategies) and uses the previous bar attendances to guess bar attendance for a given week to determine if the bar is worth attending. We previously showed how the distribution of used strategies among the population settles into an attractor by using a spatial phase space. However, this approach was limited as it required N − 1 dimensions to fully visualize the phase space of the problem, where N is the number of strategies available.Here we propose a new approach to phase space visualization and analysis by converting the strategy dynamics into a state transition network centered on strategy distributions. The resulting weighted, directed network gives a clearer representation of the strategy dynamics once we define an attractor of the strategy phase space as a sink-strongly connected component. This enables us to study the resulting network to draw conclusions about the performance of the different strategies. We find that this approach not only is applicable to the El Farol Bar problem, but also addresses the dimensionality issue and is theoretically applicable to a wide variety of discretized complex systems.
Assessment of elements in the exoskeleton of the red swamp crayfish, Procambarus clarkii (Girard, 1852) (Decapoda, Cambaridae), indicating distinctly regulated and separate accumulations of nutrition and toxic elements
Authors: Xiong Lijing , Tan Yunfei , Peng Bo , Peng Guohui , Bai Xufeng 
Published: November 2021

Abstract
The red swamp crayfish, as a typical crustacean, grows by moulting periodically. Thus, the exoskeletons of this species, including inter-moult (IME), pre-moult (PME) and the discarded fully moulted exoskeletons (ME), respectively, could be collected from different sites in China in order to assess the nutritional condition and the level of toxic elements. The mean concentration of Na (3650 mg/kg) and K (2420 mg/kg) in IME were significantly higher than those in PME (). Furthermore, the concentrations of the five toxic elements analysed, Al (176 mg/kg), Ti (4.75 mg/kg), Cr (0.38 mg/kg), Ni (0.42 mg/kg) and As (0.80 mg/kg) in ME were significantly higher than those in IME (), whereas the opposite was true for the nutrition elements, Ca, Mg, Na, K, Fe, Cu, Zn and Se. Together, these results suggest that the eight nutritional elements monitored could metabolically be retained, but the five toxic elements could be excreted through the series of moulting events during the lifespan of an individual.
China’s New Foreign Investment Law and Its Contribution Towards the Country’s Development Goals
Authors: Zheng Yawen 
Published: November 2021

Abstract
This article analyses China’s new foreign investment legal regime and assesses its contribution to the country’s development goals. Fulfilment of the goals entails an increase in ‘good’ investment flows and more effective regulation and management thereof. This article finds that the reform makes some positive progress towards the development goals. First, administrative control over foreign investments is eased, since a less burdensome report mechanism is established, while foreign investments not included on negative lists are exempt from the approval procedure. Second, a new system is established to strengthen post-entry supervision of foreign investments. Third, equal treatment of foreign investments as well as investment promotion and protection are strengthened. Fourth, the rules have become clearer and more transparent. However, due to certain regulatory flaws, problematic implementation, and a lack of ambition, the progress may be slower than intended. Therefore, the recent reform is only an incremental step towards China’s development goals.
Evaluation and Uncertainty of Radioxenon Transport with a Mesoscale Model after the February 2013 Underground Test in North Korea
Authors: Kurzeja Robert J. , Werth David W. , Buckley Robert L. 
Published: November 2021

Abstract
The transport of radioxenon released from the February 2013 underground nuclear weapons test in North Korea was analyzed at two receptors—one at the Comprehensive Nuclear Test Ban Treaty site Rn58 in Russia (400 km downwind) and a second at Rn38 in Japan (1000 km downwind). Transport was modeled with two ensembles of mesoscale simulations, one generated with varying initial and lateral boundary conditions taken from the Global Forecasting System uncertainty ensemble, and a second created from different parameterizations and surface conditions. The wind variability was similar for the two ensembles and consistent with observations at 925 mb (1 mb = 1 hPa) but not at the surface. Biases in calculated surface winds and the radioxenon concentration in the ensembles were attributed mainly to poor simulation of the sea breeze at both locations and mountain lee affects at Rn38 in Japan. These wind regimes affected the timing of the surface radioxenon plume at Rn58 and its duration at Rn38. Surface wind variability induced by terrain and land–sea contrast (the sea breeze) also had a significant effect on the surface winds and plume dynamics, including blocking of flow approaching elevated terrain near Vladivostok and the west side of Japan. Increased plume uncertainty was seen at night because of surface wind variability. Measured surface chemical variability was larger than found in the first European Tracer Experiment in central Europe. The study found that horizontal model resolution contributes to uncertainty but not as much as vertical resolution, boundary layer parameterizations, and assimilation of surface meteorological data near the receptor.
Otoendoscopes to Enhance Telemedicine During the COVID-19 Pandemic
Authors: Ronner Evette A. , Stenerson Matthew E. , Goldschmidt Nicole H. , Chari Divya A. , Diercks Gillian R. , Lee Daniel J. , Keamy Donald G. , Mankarious Leila A. , Cohen Michael S. 
Published: November 2021

Objectives: As telemedicine has become increasingly utilized during the COVID-19 pandemic, portable otoendoscopy offers a method to perform an ear examination at home. The objective of this pilot study was to assess the quality of otoendoscopic images obtained by non-medical individuals and to determine the effect of a simple training protocol on image quality. Methods: Non-medical participants were recruited and asked to capture images of the tympanic membrane before and after completion of a training module, as well as complete a survey about their experience using the otoendoscope. Images were de-identified, randomized, and evaluated by 6 otolaryngologists who were blinded as to whether training had been performed prior to the image capture. Images were rated using a 5-point Likert scale. Results: Completion of a training module resulted in a significantly higher percentage of tympanic membrane visible on otoendoscopic images, as well as increased physician confidence in identifying middle ear effusion/infection, cholesteatoma, and deferring an in-person otoscopy ( P < .0001). However, even with improved image quality, in most cases, physicians reported that they would not feel comfortable using the images to for diagnosis or to defer an in-person examination. Most participants reported that the otoendoscope was simple to use and that they would feel comfortable paying for the device. Conclusions: At-home otoendoscopes can offer a sufficient view of the tympanic membrane in select cases. The use of a simple training tool can significantly improve image quality, though often not enough to replace an in-person otoscopic exam.
Linking Emergency Medical Services and Emergency Department Data to Improve Overdose Surveillance in North Carolina
Authors: Fix Jonathan , Ising Amy I. , Proescholdbell Scott K. , Falls Dennis M. , Wolff Catherine S. , Fernandez Antonio R. , Waller Anna E. 
Published: November 2021

Introduction Linking emergency medical services (EMS) data to emergency department (ED) data enables assessing the continuum of care and evaluating patient outcomes. We developed novel methods to enhance linkage performance and analysis of EMS and ED data for opioid overdose surveillance in North Carolina. Methods We identified data on all EMS encounters in North Carolina during January 1–November 30, 2017, with documented naloxone administration and transportation to the ED. We linked these data with ED visit data in the North Carolina Disease Event Tracking and Epidemiologic Collection Tool. We manually reviewed a subset of data from 12 counties to create a gold standard that informed developing iterative linkage methods using demographic, time, and destination variables. We calculated the proportion of suspected opioid overdose EMS cases that received International Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes for opioid overdose in the ED. Results We identified 12 088 EMS encounters of patients treated with naloxone and transported to the ED. The 12-county subset included 1781 linkage-eligible EMS encounters, with historical linkage of 65.4% (1165 of 1781) and 1.6% false linkages. Through iterative linkage methods, performance improved to 91.0% (1620 of 1781) with 0.1% false linkages. Among statewide EMS encounters with naloxone administration, the linkage improved from 47.1% to 91.1%. We found diagnosis codes for opioid overdose in the ED among 27.2% of statewide linked records. Practice Implications Through an iterative linkage approach, EMS–ED data linkage performance improved greatly while reducing the number of false linkages. Improved EMS–ED data linkage quality can enhance surveillance activities, inform emergency response practices, and improve quality of care through evaluating initial patient presentations, field interventions, and ultimate diagnoses.
Emergency Medical Services and Syndromic Surveillance: A Comparison With Traditional Surveillance and Effects on Timeliness
Authors: Rock Peter J. , Quesinberry Dana , Singleton Michael D. , Slavova Svetla 
Published: November 2021

Objective Traditional public health surveillance of nonfatal opioid overdose relies on emergency department (ED) billing data, which can be delayed substantially. We compared the timeliness of 2 new data sources for rapid drug overdose surveillance—emergency medical services (EMS) and syndromic surveillance—with ED billing data. Methods We used data on nonfatal opioid overdoses in Kentucky captured in EMS, syndromic surveillance, and ED billing systems during 2018-2019. We evaluated the time-series relationships between EMS and ED billing data and syndromic surveillance and ED billing data by calculating cross-correlation functions, controlling for influences of autocorrelations. A case example demonstrates the usefulness of EMS and syndromic surveillance data to monitor rapid changes in opioid overdose encounters in Kentucky during the COVID-19 epidemic. Results EMS and syndromic surveillance data showed moderate-to-strong correlation with ED billing data on a lag of 0 ( r = 0.694; 95% CI, 0.579-0.782; t = 9.73; df = 101; P < .001; and r = 0.656; 95% CI, 0.530-0.754; t = 8.73; df = 101; P < .001; respectively) at the week-aggregated level. After the COVID-19 emergency declaration, EMS and syndromic surveillance time series had steep increases in April and May 2020, followed by declines from June through September 2020. The ED billing data were available for analysis 3 months after the end of a calendar quarter but closely followed the trends identified by the EMS and syndromic surveillance data. Conclusion Data from EMS and syndromic surveillance systems can be reliably used to monitor nonfatal opioid overdose trends in Kentucky in near–real time to inform timely public health response.
Characterizing Opioid Overdoses Using Emergency Medical Services Data
Authors: Sivaraman Josie J. , Proescholdbell Scott K. , Ezzell David , Shanahan Meghan E. 
Published: November 2021

Objectives Tracking nonfatal overdoses in the escalating opioid overdose epidemic is important but challenging. The objective of this study was to create an innovative case definition of opioid overdose in North Carolina emergency medical services (EMS) data, with flexible methodology for application to other states’ data. Methods This study used de-identified North Carolina EMS encounter data from 2010-2015 for patients aged >12 years to develop a case definition of opioid overdose using an expert knowledge, rule-based algorithm reflecting whether key variables identified drug use/poisoning or overdose or whether the patient received naloxone. We text mined EMS narratives and applied a machine-learning classification tree model to the text to predict cases of opioid overdose. We trained models on the basis of whether the chief concern identified opioid overdose. Results Using a random sample from the data, we found the positive predictive value of this case definition to be 90.0%, as compared with 82.7% using a previously published case definition. Using our case definition, the number of unresponsive opioid overdoses increased from 3412 in 2010 to 7194 in 2015. The corresponding monthly rate increased by a factor of 1.7 from January 2010 (3.0 per 1000 encounters; n = 261 encounters) to December 2015 (5.1 per 1000 encounters; n = 622 encounters). Among EMS responses for unresponsive opioid overdose, the prevalence of naloxone use was 83%. Conclusions This study demonstrates the potential for using machine learning in combination with a more traditional substantive knowledge algorithm-based approach to create a case definition for opioid overdose in EMS data.
Improvements in Toxicology Testing to Identify Fentanyl Analogs and Other Novel Synthetic Opioids in Fatal Drug Overdoses, Connecticut, January 2016–June 2019
Authors: Clinton Heather A. , Thangada Shobha , Gill James R. , Mirizzi Amy , Logan Susan B. 
Published: November 2021

Objectives Drug overdose deaths in Connecticut increasingly involve a growing number of fentanyl analogs and other novel nonfentanyl synthetic opioids (ie, novel synthetics). Current postmortem toxicology testing methods often lack the sophistication needed to detect these compounds. We examined how improved toxicology testing of fatal drug overdoses can determine the prevalence and rapidly evolving trends of novel synthetics. Methods From 2016 to June 2019, the Connecticut Office of the Chief Medical Examiner increased its scope of toxicology testing of suspected drug overdose deaths in Connecticut from basic to enhanced toxicology testing to detect novel synthetics. The toxicology laboratory also expanded its testing panels during this time. We analyzed toxicology results to identify and quantify the involvement of novel synthetics over time. Results From 2016 to June 2019, 3204 drug overdose deaths received enhanced toxicology testing; novel synthetics were detected in 174 (5.4%) instances. Ten different novel synthetics were detected with 205 total occurrences. Of 174 overdose deaths with a novel synthetic detected, most had 1 (n = 146, 83.9%) or 2 (n = 26, 14.9%) novel synthetics detected, with a maximum of 4 novel synthetics detected. Para-fluorobutyrylfentanyl/FIBF, furanylfentanyl, and U-47700 were most identified overall, but specific novel synthetics came in and out of prominence during the study period, and the variety of novel synthetics detected changed from year to year. Conclusions Enhanced toxicology testing for drug overdose deaths is effective in detecting novel synthetics that are not identified through basic toxicology testing. Identifying emerging novel synthetics allows for a timely and focused response to potential drug outbreaks and illustrates the changing drug market.