Late Class Research Articles

Facework in teacher-student email interactions

Two trends have become prominent in higher education worldwide. On the one hand, globalization has favored the expansion and influence of the English language. On the other hand, email has become one of the main forms of communication in academic settings, especially in teacher-student out-of-class correspondence. While these facts have increasingly attracted scholarship attention, studies in education seem to focus more on the students’ display of face(work) alone, while neglecting the teacher’s counterpart. To redress this imbalance, the present study aims to examine face(work) as displayed in students’ email requests for consideration (e.g., on late assignments submission and class attendance) and teachers’ responses. A qualitative analysis of 20 sets of teacher-student interactions reveals different strategies opted for by the students and the teacher in face(work) management. Drawing on face-constituting theory, the findings show that whilst the students are concerned with their own face alone, the teacher is concerned with how to avoid classroom conflicts in the way that attends to one’s own face, the students’ face and the classroom harmony. In this way, the management of face(work) operates in a complex and dynamic way that allows the co-construction and reaffirmation of their respective identities. For example, whilst the students’ actions overlook the relevance of the interdependence relation between them, their peers and the teacher, which is critical for the harmony of the classroom, the teacher’s actions privilege connectedness over separateness. Furthermore, the findings suggest that cultural specificities governing the backgrounds of both the teacher and the students are not always influential in the management of face in email interactions.

<성진사전>의 문제의식과 사회적 갈등의 해소 양상

<Seong Jinsa-Jeon> was written by Lee, Ok, a writer in the late Joseon Dynasty. It deals with a fraud case that Jinsa Seong, Hui-ryong in Sangju went through. However, the social critical consciousness of <Seong Jinsa-Jeon> draws attention to the serious economic imbalance in late Joseon society and class conflicts between the yangban and the common people, the rich and the poor through the appearance of refugees caused by famine, not just in fraud cases. In particular, the essence of <Seong Jinsa-Jeon> lies in its approach to resolving societal conflicts. The purpose of this study is to the perspective on and proposed solutions to conflict within <Seong Jinsa-Jeon> with a particular focus on the relationship between its two protagonists, Seong, Hui-ryong and a beggar. The narrator argues that Seong, Hui-ryong's self-refinement[謹身] was instrumental in resolving the conflict, exploring the broader connotation of such self-refinement. Within <Seong Jinsa-Jeon> the ‘door’ represents both the starting point of the incident and is the boundary that separates the space between Seong, Hui-ryong and the beggar. The space in <Seong Jinsa-Jeon> is divided into a rich inner space inside the door where the rich reside along the boundary of the door, and an outer space outside the door of the refugees who become beggars and wander after losing their homes. Therefore, it is recognized that the ‘door’ should be closed and protected for the rich, and open for the beggars. Nonetheless, the door also serves as a conduit that connects and associates the two worlds inside and outside. By opening the door and recognizing the beggar as another subject, Seong, Hui-ryong facilitates conflict resolution through dialogue. Face-to-face communication fosters empathy centered on the other, paving the way for conflict resolution. In other words, ‘face-to-face’ is to recognize the other outside the door as another subject like me. ‘Self-refinement’ encompasses not only self-cultivation but also placing others at the core of one's concern. The possibility of resolving such conflicts offers insights into bridging the gap between the reality of laws and legal sentiments. In a space governed by legal standards, endless opposition between legality and illegality persists due to a binary perception that merely seeks a stronger law to satisfy one's legal sentiments. Recognizing the other as a mutual subject through communication allows for attentiveness to one's conscience, unveiling hidden truth, and enabling forgiveness through empathy. This is the way to resolve conflict suggested by <Seong Jinsa-Jeon>. Although it is a short work, what <Seong Jinsa-Jeon> has achieved is truly great.

Effect of Different Mini Implant Assisted Rapid Palatal Expansion (MARPE) Designs on Maxillary Protraction in Skeletal Class III malocclusion: An FEM Study.

Four different designs of mini-implant-assisted rapid palatal expansion (MARPE) and protraction in nasomaxillary complex and mid-palatal sutures in late adolescent skeletal Class III malocclusion were compared using a three-dimensional finite element analysis. A finite element model of skull and related sutures was constructed using the computed tomography scan of a 16-year-old female patient with skeletal Class III and ANB of -2°. Four appliance designs: Type I: MARPE with palatal force, Type II: MARPE with buccal force, Type III: Hybrid hyrax with palatal force, and Type IV: Hybrid hyrax with buccal force. Protraction vectors were and analyzed using Ansys software (ANSYS 2021 R2). The displacement pattern of the nasomaxillary structures and the stress distribution in the sutures were examined in all four appliance designs. All the appliance designs resulted in a forward movement of the maxilla, while Type I and III, which used palatal protraction force, caused the greatest forward displacement. In Type I, II, and III, along with forward movement, a clockwise rotation of maxilla was observed, while in Type IV, an anticlockwise rotation of maxilla was observed. Type I, II, and III resulted in higher stress distribution around the superior structures, while Type IV resulted in less stress distribution around the superior structures of maxilla. The forward displacement was enhanced when palatal plates were used to protract the maxilla. The effective appliance design for skeletal class III with open bite case was Type I, II, and III and Type IV for deep bite cases.

Accounting teachers’ teaching practices associated with learners’ performance in high schools

Grade 12 learners, in many instances, have early and late classes unlike the rest of the learners in the school. Sometimes their classes run over weekends and during school holidays. The aim of this study was to establish whether there was value in subjecting learners to extra classes over and above their normal class periods. We used the qualitative approach and purposive sampling to select the sample. The teaching of only 1 subject, accounting, was studied and the value of extra classes evaluated. Schools in the KwaZulu-Natal province, South Africa, that have consistently produced a 100% pass rate over a period of 3 years were selected to participate in the study. Data were collected using an interview schedule. The analysis of the data confirms that there is value in subjecting learners to more teaching because there is a direct relationship between teaching and learner performance. The worked example effect, as recommended through the cognitive load theory, was found to be dominant among the teaching strategies that accounting teachers used in extra classes.

Hand preference trajectories as predictors of language outcomes above and beyond SES: Infant patterns explain more variance than toddler patterns at 5 years of age.

Prior studies found hand preference trajectories predict preschool language outcomes. However, this approach has been limited to examining bimanual manipulation in toddlers. It is not known whether hand preference during infancy for acquiring objects (i.e., reach-to-grasp) similarly predicts childhood language ability. The current study explored this motor-language developmental cascade in 90 children. Hand preference for acquiring objects was assessed monthly from 6 to 14 months and language skill was assessed at 5 years. Latent class growth analysis identified three infant hand preference classes: left, early right, and late right. Infant hand preference classes predicted 5-year language skills. Children in the left and early right classes, who were categorized as having a consistent hand preference, had higher expressive and receptive language scores relative to children in the inconsistent late right class. Consistent classes did not differ from each other on language outcomes. Infant hand preference patterns explained more variance for expressive and receptive language relative to previously reported toddler hand preference patterns, above and beyond socioeconomic status (SES). Results suggest that hand preference, measured at different time points across development using a trajectory approach, is reliably linked to later language.

A Story of Serendipities: From Phlorizin to Gliflozins.

Diabetes has been acknowledged since ancient times. However, it was only during the late 1800s that we realized that the primary organ for blood glucose regulation was the pancreas. The 20th century witnessed insulin purification, which revolutionized the treatment of diabetes maigre; this was followed by the development of oral antidiabetic drugs. The sodium-glucose cotransporter 2 inhibitors or gliflozins are the latest class. Unique cardio- and renoprotective effects separate them from other oral antidiabetic drugs. Here, we present the history behind the development of these inhibitors, arguably the hottest and the most pleasant topic in nephrology. The first serendipity was Koninck and Stas (assistants to Prof. Van Mons, a renowned pomology expert); these researchers isolated a crystalline glycoside called phloridzin (phlorizin) from the bark of apple trees while working at their boss's nursery. Their discovery was published in German in 1835. The second serendipity, after a half century, was from Prof. von Mering, who decided to administer phlorizin to dogs. Oskar Minkowski initially observed polyuria than glucosuria. Insightfully, von Mering postulated that phlorizin affects kidneys. In 1887, they reported that phlorizin induced glucosuria in people with diabetes. The third serendipity was that phlorizin causes several gastrointestinal side effects and has poor oral bioavailability. The first phlorizin-based drug to enter trials was T-1095. The first clinically available gliflozin was dapagliflozin, receiving approval in Europe and the United States in 2012 and 2014, respectively. The 2015 EMPA-REG Outcome trial reported extremely satisfying results that no one expected. Subsequent trials and real-world data have resulted in changes in all impactful guidelines. The impact of these agents on heart failure and chronic kidney disease seems independent of their antidiabetic properties. More than 100 years after von Mering's original discovery, descendants of phlorizin are fast becoming the most inspiring medicine for the 21st century physician.

Evaluating the Student’s Misbehavior in the Class (In Case of Hidase Fire High School 10th Grade)

The purpose of this research is to evaluate the misbehavior of the student in the class using action methodology techniques. An Evaluate the student misbehavior in the class was used to draw data from focused on selected students in school. The findings reveal that leaving class in middle, late coming, and not doing homework is common among students in selected secondary schools of Hidase Fire. In this study, the teacher and student interventions are undertaken to evaluate the misbehavior of the student in the class. As the result obtained 60 % of the misbehavior student is leaving the class in the middle of class this misbehavior activity act 53.33 % during the morning time. The punishment for the student that acts misbehavior is 40 % sending to the director and assigning extra work respectively. The main causes of misbehavior in class 73.33 % are lack of interest of students and the teacher observed misbehavior in the class 33.33% is coming to late class and not doing homework respectively. Overall, the major causes of misbehavior in class are lack of the implementation of the rule and laws of the school. To solve those behavioral problems in school action strategies and interventions have been taken then the student behavior has improved. Keywords: Misbehavior, Teacher challenges, Student behaviors, Class activity, Environment DOI: 10.7176/PPAR/13-4-01 Publication date: May 31 st 2023

Natural mortality estimations for beaked redfish (Sebastes mentella) – A long-lived ovoviviparous species of the Northeast Arctic

Beaked redfish (Sebastes mentella) is one of the few commercially important fish species producing living offspring. Like many other deep-water fishes, it is slow growing, late maturing and long-lived, getting as old as 65 years or even 75 years in some populations. The stock in the Norwegian and Barents Seas is analytically assessed since 2012, assuming a natural mortality (M) of 0.05 yr−1 across all ages, based on Hoenig’s longevity related estimator. Since then, several reviews and new studies have been published, affording a re-evaluation of the natural mortality in the assessment model. We estimated natural mortality of beaked redfish using 48 different estimators in two categories, either estimating M across the population or dependent on age, length or weight. The obtained estimates were highly variable, ranging from 0.01 to 0.32 yr−1 for estimates across the population, and 0.05–0.62 yr−1 for age or size dependent median-M. These wide ranges demonstrate the sensitivity of SSB to the input parameters as well as the pitfalls of using estimators developed for distant taxa. Of the 48 estimates, 20 were considered as potential candidates for updating the stock assessment model, yet not all of these were realistic. The frequency distribution of the estimators showed a peak around a value of 0.07 yr−1, lowering the estimated spawning stock biomass in the last year by about 300 kt but keeping it above the precautionary reference point for the stock. Estimators across the life-history of beaked redfish indicate a potential underestimation of natural mortality for early and overestimation for late age classes. Age and size related estimators are promising for the older ages but tend to extreme estimates for the early ages, which deserves further investigation.

Roper and Race: the Nature and Effects of Death Penalty Exclusions for Juveniles and the “Late Adolescent Class”

In Roper v. Simmons (2005), the US Supreme Court raised the minimum age at which someone could be subjected to capital punishment, ruling that no one under the age of 18 at the time of their crime could be sentenced to death. The present article discusses the legal context and rationale by which the Court established the current age-based limit on death penalty eligibility as well as the scientific basis for a recent American Psychological Association Resolution that recommended extending that limit to include members of the “late adolescent class” (i.e., persons from 18 to 20 years old). In addition, we present new data that address the little-discussed but important racial/ethnic implications of these age-based limits to capital punishment, both for the already established Roper exclusion and the APA-proposed exclusion for the late adolescent class. In fact, a much higher percentage of persons in the late adolescent class who were sentenced to death in the post-Roper era were non-White, suggesting that their age-based exclusion would help to remedy this problematic pattern.

Developmental trajectories of internalizing distress among ethnic minoritized mothers following childbirth: Associations with early child psychological adjustment.

A substantial body of work has established that mothers' internalizing distress can negatively affect children's socioemotional development. Yet few studies have examined how distinct patterns of mothers' distress over time differentially impact child behaviors across early childhood. To address this gap, the current study explored developmental trajectories of mothers' internalizing distress and examined the associations of these patterns with child adjustment outcomes. Mexican immigrant, Dominican immigrant, and African American mothers (N = 272) were annually assessed for internalizing distress over the first 6 years following childbirth. Children's psychological adjustment (internalizing, externalizing, and hyperactivity behaviors) was measured at the last yearly assessment in first grade. A growth mixture model revealed two distinct classes of distress where mothers were classified as having low stable distress (82.4%) or moderate distress that began as stable then declined when their children were 64 months old (17.6%). Children of mothers in the moderate, late decline class showed greater internalizing, externalizing, and hyperactivity behaviors in the first grade compared to children of mothers in the low stable class. Findings highlight the necessity of supporting the mental health of ethnic minoritized mothers following childbirth and further expand our knowledge of family psychopathology to promote healthy psychological adjustment in children.

Peran Guru Sebagai Figur Panutan Dalam Penerapan Keterampilan Saling Berbagi Di Era Disrupsi

Individual dualism has become a symptom of a society in the 21st century, with all its excesses, including materialism and selfishness, which are present at all levels of society. 21st-century teachers have a different role from conventional teachers, where they act as facilitators, collaborators, mediators, and motivators in learning and teaching activities with effective and fun learning targets that require abilities that are influenced by knowledge, training, and experience. The era of disruption makes a form of play that leads to selfishness, including through gadgets, so there are limitations in interacting directly with peers. Therefore, the teacher strives to encourage sharing skills as a form of skill to students so that they can receive and give to others who are instilled in the early to late class so that it affects the ongoing interaction. This study used Slavin Theory, about efforts to increase social contact among students to achieve goals and the role of teachers in learning and teaching activities. This study used qualitative methods with a phenomenological approach.Keywords: Teacher’s role, sharing, era of disruption

Identification and Characterization of the Alternative σ28 Factor in Treponema denticola.

FliA (also known as σ28), a member of the bacterial σ70 family of transcription factors, directs RNA polymerase to flagellar late (class 3) promoters and initiates transcription. FliA has been studied in several bacteria, yet its role in spirochetes has not been established. In this report, we identify and functionally characterize a FliA homolog (TDE2683) in the oral spirochete Treponema denticola. Computational, genetic, and biochemical analyses demonstrated that TDE2683 has a structure similar to that of the σ28 of Escherichia coli, binds to σ28-dependent promoters, and can functionally replace the σ28 of E. coli. However, unlike its counterparts from other bacteria, TDE2683 cannot be deleted, suggesting its essential role in the survival of T. denticola. In vitro site-directed mutagenesis revealed that E221 and V231, two conserved residues in the σ4 region of σ28, are indispensable for the binding activity of TDE2683 to the σ28-dependent promoter. We then mutated these two residues in T. denticola and found that the mutations impair the expression of flagellin and chemotaxis genes and bacterial motility as well. Cryo-electron tomography analysis further revealed that the mutations disrupt the flagellar symmetry (i.e., number and placement) of T. denticola. Collectively, these results indicate that TDE2683 is a σ28 transcription factor that regulates the class 3 gene expression and controls the flagellar symmetry of T. denticola. To the best of our knowledge, this is the first report establishing the functionality of FliA in spirochetes. IMPORTANCE Spirochetes are a group of medically important but understudied bacteria. One of the unique aspects of spirochetes is that they have periplasmic flagella (PF, also known as endoflagella) which give rise to their unique spiral shape and distinct swimming behaviors and play a critical role in the pathophysiology of spirochetes. PF are structurally similar to external flagella, but the underpinning mechanism that regulates PF biosynthesis and assembly remains largely unknown. By using the oral spirochete Treponema denticola as a model, this report provides several lines of evidence that FliA, a σ28 transcriptional factor, regulates the late flagellin gene (class 3) expression, PF assembly, and flagellar symmetry as well, which provides insights into flagellar regulation and opens an avenue to investigate the role of σ28 in spirochetes.

Dolutegravir in Mexico for special populations: A cost analysis perspective.

Integrase strand-transfer inhibitors (INSTI) are the latest class of antiretrovirals registered in Mexico. They include raltegravir (RAL), elvitegravir/cobicistat (EVG/c), dolutegravir (DTG) and bictegravir (BIC). Along with international guidelines, Mexico adopted the use of INSTI about two years ago as initial antiretroviral therapy (ART). This is partially due to the increase in the pre-treatment resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI), mainly efavirenz (EFV). Furthermore, INSTI depict greater efficacy, safety and less drug-drug interactions than NNRTI and protease inhibitors (PI). DTG is a second generation INSTI with a high barrier to resistance. It is recommended in international and national guidelines in a wide variety of clinical scenarios for persons living with human immunodeficiency virus (HIV) (PLWHIV), including treatment-naïve, first-line NNRTI treatment failure, simplification switch in suppressed patients, pregnancy, women with childbearing potential, adolescents and children over 6 years of age. DTG is mostly metabolized by the liver UDP-glucuronosyltransferase, and exhibits low drug-drug interactions overall; on the other hand, it has an extremely low renal elimination, therefore may be used in PLWHIV with advanced kidney disease without dose modification. Tuberculosis is a common coinfection in Mexico that requires rifampin-based anti-tuberculosis therapy, which requires increasing DTG to double dosing (50 mg BID). In Mexico, DTG-based regimens are likely to be cost-effective in many scenarios, given its acquisition costs and the particularities of the HIV population and associated clinical conditions, including a relatively high proportion of the following: i) new HIV diagnoses presenting at acquired immunodeficiency syndrome (AIDS) stage; ii) high rate of tuberculosis coinfection; iii) frequent first-line NNRTI treatment failures; and iv) relatively high proportion of infected children and adolescents.

메이지 소설을 통해 본 ‘고등유민(高等遊民)’의 언어 활동 연구 - 어휘 표현 관점에서 소세키(漱石)의 『소레카라(それから)』를 중심으로 -

The purpose of this study is to confirm the actual state of language activities from a specific class called the 'intelligent non employed' (Daisuke). This class was newly created along with the modernization of Japan within various Japanese studies. The linguistic characteristic that distinguishes the knowledgeable class from that of the general employee is especially seen in vocabulary expressions. The frequency and proportion of Chinese words used by ‘the intelligent non employed’ (Daisuke) are of a higher proportion than that of the general employee (kadono), and among them, the frequency and proportion of Atype Chinese words made after the modern period are higher than usual. Among Atype's Chinese words, we see linguistic characteristics that frequently use terminology that belong to specialized fields, such as economics, philosophy, botany, law, and medicine. Therefore, the actual state of language activities of ‘intelligent non employed’, a class of the late Meiji intellectual class, could be confirmed through the work of Soseki's Sorekara.

Photometric study and absolute parameters of four short period W UMa binary stars of late spectral classes

We present the first CCD complete light curves for the W Ursae Majoris systems NSVS 870615, NSVS 0912043, NSVS 5049537 and LINEAR 3636597. The observations were performed at the IRIDA South dome of the NAO Rozhen–Bulgaria and they confirm and revise the short-period (0.22-0.25 days) for these objects. In particular two of them show periods near to the cut-off limit. The modeling of the light curves was done using the Wilson–Devinney code and the elements obtained from this analysis are used to compute the physical parameters of the system in order to study its evolutionary status. From a reasonable synthetic fit of the original data we can derive that all components of the systems are of K spectral types (T1< 5000K), one of the secondaries is of M spectral type. All targets are contact binary systems of W-subtype, which is a common feature of K spectral type contact binaries, and two of them, having 1/q> 0.72, belong to the class of the high mass ratio binaries (H/W type). One, with a total mass of about 0.73(M⊙) can be considered as Low Mass Contact Binary system (LMCB). The degrees of contact (fill-out factors) f are shallow for three of our targets, while for NSVS 0912043 the analyzes return an important high value of f = 80.7%. The O’Connell effect in the light curves is well explained by employing star spots on the binary surface, which confirms that the systems are active at present. The four systems are in good thermal contact with ΔT between 170K and 420K. The absolute elements of the systems are estimated and the positions of the components is shown in the logarithmic diagrams.

Intraoperative Technical Performance Score Predicts Outcomes After Congenital Cardiac Surgery

BackgroundThe utility of the intraoperative technical performance score (IO-TPS) in predicting outcomes after congenital cardiac surgery remains unknown. MethodsData from patients undergoing surgery for congenital heart disease from January 2011 to December 2019 at a single institution were retrospectively reviewed. Intraoperative echocardiograms were used to assign IO-TPS for each index operation (class 1, no residua; class 2, minor residua; class 3, major residua). The primary outcome was a composite of in-hospital mortality, transplant, unplanned reintervention in the anatomic area of repair, and new permanent pacemaker implantation. Secondary outcomes included postdischarge (late) mortality or transplant and unplanned reintervention. Associations between IO-TPS and outcomes were assessed using logistic (primary) and Cox or competing risk (secondary) models, adjusting for preoperative patient- and procedure-related covariates. ResultsThe primary outcome was observed in 784 (11.5%) of 6793 patients who met entry criteria. On multivariable analysis, IO-TPS was a significant predictor of the primary outcome (class 2: odds ratio, 1.7 [95% CI, 1.4-2.0; P < .001]; class 3: odds ratio, 6.0 [95% CI, 4.0-8.9; P < .001]). Among 6661 transplant-free survivors of hospital discharge observed for up to 10.5 years, there were 185 (2.8%) deaths or transplants and 1171 (17.6%) reinterventions. Class 3 patients had a greater adjusted risk of late mortality or transplant (hazard ratio, 2.2; 95% CI, 1.2-4.2; P = .012) and late reintervention (subdistribution hazard ratio, 2.5; 95% CI, 1.8-3.3; P < .001) vs class 1 patients. ConclusionsIO-TPS is significantly associated with adverse early and late outcomes after congenital heart surgery and may serve as an important adjunct for self-assessment and quality improvement.

Apostles of Change: Latino Radical Politics, Church Occupations, and the Fight to Save the Barrio

Apostles of Change: Latino Radical Politics, Church Occupations, and the Fight to Save the Barrio

Comparison of Intraoperative and Discharge Residual Lesion Severity in Congenital Heart Surgery

BackgroundWhile the predischarge technical performance score (DC-TPS) is significantly associated with outcomes after congenital cardiac surgery, the utility of the intraoperative TPS (IO-TPS) remains unknown. MethodsThis was a single-center retrospective review of consecutive patients who underwent congenital cardiac surgery from January 2011 to December 2019. Intraoperative and predischarge echocardiograms were used to assign IO-TPS and DC-TPS, respectively, for each index operation (class 1, no residua; class 2, minor residua; class 3, major residua). Anatomic modules identifying the principal residual lesion were assigned to all class 2/3 patients. Overall and module-specific TPS comparisons were made. Multivariable regression models with IO-TPS and DC-TPS as separate predictors of postoperative outcomes were compared. ResultsOf 6201 patients, overall agreement between IO-TPS and DC-TPS was observed in 4251 patients (68.6%); scores were likelier to be worse at discharge (P < .001). Paired comparative analyses revealed that among patients with at least class 2 atrioventricular and semilunar valve residua, IO-TPS was likelier to worsen than improve (both P < .001). Class 3 patients had a higher risk of in-hospital/early mortality (IO-TPS: odds ratio, 7.5; 95% CI, 2.4-23; DC-TPS: odds ratio, 6.6; 95% CI, 3.0-15), postdischarge/late mortality (IO-TPS: hazard ratio [HR], 3.1, 95% CI, 1.3-7.1; DC-TPS: HR, 2.3; 95% CI, 1.2-4.4), and late unplanned reintervention (IO-TPS: HR, 2.8; 95% CI, 1.9-4.0; DC-TPS: HR, 3.4; 95% CI, 2.8-4.2) vs class 1 (all P < .05). IO- and DC-TPS models were equivalent fits for predicting early and late mortality; the latter was a marginally better fit for late reintervention. ConclusionsIO-TPS and DC-TPS are both important adjuncts for quality improvement in congenital cardiac surgery.

Is Dapagliflozin future for CKD?

Dapagliflozin belongs to the latest class of anti-diabetic medication Sodium-glucose co-transporter two inhibitors (SGLT2i). The drug is mainly used in type 2 diabetes (T2D) by preventing the reabsorption of glucose in the proximal tubule of the kidney causing glycosuria and regulating blood glucose levels. It is a well-tolerated drug with rare side effects including hypoglycemia, diabetic ketoacidosis, genital and urinary tract infections. The drug gain popularity through its effect in lowering cardiovascular and renal events in patients with T2D through mechanisms independent of lowering blood glucose levels. (1) Adding to its benefits, Wheeler et al stated that Dapagliflozin decreases the risk of renal and cardiovascular events and reduces overall mortality in diabetic and non-diabetics with chronic kidney disease (CKD). Reduction in non-cardiovascular deaths was the critical factor to improve the mortality rates, most common among which were infections and malignancies. (3) Another 2021 publication of the European Heart Journal also showed that Dapagliflozin significantly reduces mortality in patients suffering from CKD with or without type 2 diabetes. Reduction in non-cardiovascular deaths was the key factor in improving the mortality rates, most common among which were infections and malignancies. (4) The prevalence of CKD in South Asian countries is relatively high. Pakistan tops the list with the highest prevalence of 21.2%. (4) Dapagliflozin has been approved for use in Pakistan in the year 2017.(5) Also, the more compelling pieces of evidence and greater recognition of CKD, and greater use of SGLT2 inhibitors in non-diabetics in clinical practice are imperative for the many people who stand to benefit from longer and healthier lives. The drug is opening new horizons for the treatment of CKD. Continue..

Skeletal, Dental, and Soft Tissue Changes after Applying Active Skeletonized Sutural Distractor (ASSD) for Class III Malocclusion Patients

Background: Nonsurgical treatment of Class III malocclusion may reduce the chances for orthognathic surgery in the future. This study aimed to determine the post-treatment skeletal, dental and soft tissue changes in the anteroposterior plane applying active skeletonized sutural distractor (ASSD) in late adolescent Class III malocclusion patients. Materials and Methods: After screening 13,500 students from 18 secondary schools, a sample of 26 subjects was recruited for this study, with a mean age of 15(±1.4) years after considering the inclusion and exclusion criteria. ASSD appliances were inserted into patients, and lateral cephalometric x-rays were taken for pre- and post-treatment analysis. Dental casts of the patients were also taken and scanned using a 3D laser scanner for comparisons. Results: The intraclass correlation coefficients (ICC) for inter-examiner were 0.87 to 0.99 and 0.96 to 0.99 for lateral cephalometric and dental cast measurements, respectively. The difference in pre- and post-treatment of cephalometric measurements of the mandible showed statistically significant changes for mandibular plane angle (p &lt; 0.001) and SNB angle (p = 0.029). The dental cast measurements showed statistically significant changes of inter-molars width (p &lt; 0.001) as well as palatal (p = 0.002). Conclusions: The results showed statistically significant improvement in skeletal, dental, and soft tissue changes after treatment applying ASSD for Class III malocclusion patients.