National Research Research Articles

Major vascular complications are reduced by ultrasound guided venous puncture compared to conventional technique in cardiac catheter ablation: a meta-analysis

Abstract Background Puncture site vascular complications are relatively common during invasive electrophysiology. One of the most promising measures to minimize these adverse events is the use of vascular ultrasound during puncture. Objective We aimed to carry out a meta-analysis comparing conventional, anatomically guided femoral venous puncture to ultrasound-guided puncture during electrophysiology procedures, which, in contrast to, the previous meta-analyses, used a uniform endpoint and involved novel trials resulting in higher patients numbers. Methods We conducted a systematic search in relevant electronic databases for articles reporting the rate of vascular complications during EP procedures both with and without ultrasound guidance. We defined major vascular complications (MVCs, as defined in the 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus) as the primary endpoint. Secondary endpoints were arteriovenous fistula, pseudoanerurysm and major bleeding separately, and minor vascular complications and accidental arterial punctures. Statistical analysis was performed using a random effect model with the Mantel-Haenszel method. Results A total of 23605 patients were included in the 14 articles matching our selection criteria, and there were data on the primary outcome in 15160 of them (in 11 articles), with 236 (1.6%), who reached the primary endpoint of an MVC. Routine application of ultrasound guidance significantly reduced the incidence of major vascular complications (42/5645 vs. 194/9515, OR 0.36 [0.23–0.55], p<0.001). Furthermore, we found significantly lower incidence in several of our secondary endpoints: for total vascular complications the OR was 0.27 [0.13–0.53] (p<0.001), for major bleedings the OR was 0.42 [0.24–0.74] and for inadvertent artery puncture the OR was 0.24 [0.15–0.38] (p<0.001). Data was insufficiently reported in respect of arteriovenous fistulae and of pseudoanerurysms specifically. Conclusion With more than double of the number of patients compared to the previous meta-analyses, and with a more consistent MVC definition, we showed that ultrasound guidance for femoral venous puncture has significant benefits, most importantly reduces the incidence of major vascular complications and total vascular complications. Our results underscore the need for a randomized controlled trial in the question, with potentially important implications for daily clinical practice and patient safety. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Project no. NVKP_16-1–2016-0017 (“National Heart Program”) has been implemented with the support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund of Hungary, financed under the NVKP_16 funding scheme. -Project no. MEC_R-141548 has been implemented with the support provided by the Ministry of Innovation and Technology of Hungary from the National Research, Development and Innovation Fund, financed under the MEC_R_21 funding scheme.

CRT-D non-responders have worse cardiovascular outcome than patients after primary ICD implantation with similar baseline left ventricular ejection fraction

Abstract Background Cardiac resynchronisation therapy (CRT) fails to improve echocardiographic parameters and outcome in 20–40% of heart failure (HF) patients with reduced ejection fraction (EF) referred to as CRT non-responders (CRT-NR). The aim of this study was to compare the outcomes of CRT-NR patients who received a CRT defibrillator (CRT-D) device with patients after primary implantable cardioverter-defibrillator (ICD) implantation for impaired left ventricular (LV) function. Methods CRT-NR status was defined as no or less than 10% improvement in LV EF 12 months post implantation. CRT-NR patients and those after primary ICD implantation for LV EF<35% were identified in our database between 2010 and 2019. CRT-NR patients were further categorized as progressors (decrease in LV EF ≥5%) or non-progressors (LV EF change between +9 to −5%). Primary endpoint was all-cause mortality or the need for heart transplantation during follow-up. Statistical significance was assessed by Log-rank test of Kaplan-Meier survival analysis. Results 151 CRT-NR patients and 219 patients after primary ICD implantation were identified with a mean ± SEM follow-up of 43.7±2.5 and 47.3±2.2 months, respectively. Baseline (preoperative) LV EFs were higher (p<0.05) for the overall CRT-NR group (EF = 27.4±0.4%) than for the ICD group (EF = 25.2±0.3%) Further, both CRT-NR subgroups of progressors (n=49; EF = 28.6±0.7%) and non-progressors (n=102; EF = 26.9±0.5%) had also significantly higher baseline LV EF as compared to ICD patients (p<0.05). No statistical significance was found between the two CRT-NR subgroups. Event free median survival for the overall CRT-NR group (55.6 months) was significantly worse than for the ICD group (79.6; p<0.05). This difference was driven by progressor patients who had a significantly worse event free survival (37.8 months, p<0.05) than ICD patients, while vent free survival in non-progressors (60.8 months) was comparable to ICD patients (p=0.18). Conclusion Progressor subgroup of CRT-NR have worse outcome as compared to non-progressors and also to those after primary prevention ICD implantation. The poor prognosis of these patients should have implications for timely decision regarding all therapeutic measures currently available for the management of heart failure. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Project no. TKP2021-EGA-18 has been implemented with the support provided from the National Research, Developement and Innovation Fund of Hungary, financed under the TKP2021-EGA funding scheme

Pressure overload and volume overload-induced chronic heart failure are associated with characteristic left ventricular myocardial proteomic alterations

Abstract Introduction Hemodynamic overload induces pathological remodeling of the left ventricle (LV) and eventually heart failure (HF). The two types of chronic hemodynamic stress, namely pressure overload (PO) and volume overload (VO) evoke characteristically different functional and structural alterations in the myocardium. Nevertheless, whether PO- and VO-induced HF are also associated with distinct LV proteomic alterations has not been investigated yet. Aim Hence, we thought to perform a proteomic analysis on LV myocardial samples from rat models of PO- and VO-induced HF. Methods PO–induced HF was evoked by transverse aortic constriction (TAC). VO–induced HF was established by creating an aortocaval fistula (ACF). Age-matched sham-operated animals served as controls for TAC (ShamT) and ACF (ShamA), respectively. Pressure-volume (P-V) analysis, echocardiography, histology and quantitative real-time PCR were carried out to provide a detailed characterization of the two HF models. Peptides obtained via the digestion of myocardial proteins with trypsin and LysC were labeled with isobaric tags (TMT16) and measured with LC-MS/MS in a bottom-up explorative proteomic approach. Differential expression and gene ontology enrichment analysis (GO:BP) was carried out on summarized protein reporter ion intensities. Results In both the TAC and ACF groups, presence of typical signs and symptoms of HF (dyspnea at rest, fatigue, ascites) increased lung-to-tibial length ratio and elevated LV natriuretic peptide mRNA expression levels confirmed the development of advanced HF. Furthermore, the TAC model was associated with massive wall thickening, concentric LV hypertrophy (LVH), marked interstitial fibrosis and substantially impaired active relaxation and passive filling (slope of end-diastolic P-V relationship: 0.103±0.015 vs. 0.023±0.003mmHg/μl, TAC vs. ShamT, P<0.001). In contrast, the ACF model was predominantly characterized by LV dilatation, eccentric LVH, moderate fibrosis and severely reduced LV contractility (slope of end-systolic P-V relationship: 0.5±0.1 vs. 2.3±0.3mmHg/μl, ACF vs. ShamA, P<0.001). Proteomic analysis revealed that out of the 4691 identified and quantified proteins, 1404 and 913 have shown upregulation, while 1359 and 886 downregulation in the TAC and ACF groups respectively compared to their corresponding sham groups. GO:BP analysis has indicated that the downregulation of mitochondrion organization, ATP metabolic processes and oxidative phosphorylation and the upregulation of actin cytoskeleton organization were the most profound alterations in the TAC model. In contrast, the ACF model was associated with robust downregulation of fatty acid oxidation and upregulation of endocytosis, defense and immune response on the proteomic level. Conclusions PO and VO-induced advanced HF are not only associated with characteristically different functional and structural remodeling but also with distinct LV proteomic alterations. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Research, Development and Innovation Office (NKFIH) of Hungary

The effectiveness of ARNI medication in patients, non-responder to cardiac resynchronization therapy

Abstract Introduction Almost 30% of patients are non-responders to cardiac resynchronization therapy (CRT) with no improvement of heart failure (HF) symptoms and left ventricular ejection fraction (LVEF). Angiotensin Receptor Neprilysin Inhibitor (ARNI), a novel class of medication resulted in a significant improvement in HF with reduced ejection fraction (HFrEF) in recent trials. No data has been reported on the clinical effectiveness of ARNI in the specific HF patient cohort of CRT non-responders (CRT-NR). Objective Herein, we compared the efficacy of ARNI medication in a general HF patient population and in CRT-NR patients. Method CRT-NR patients on ARNI therapy initiated at least 6 months after CRT implantation in years 2019–2021 were enrolled. Criterium for CRT-NR was a no, or less than 10% improvement in LVEF measured with echocardiography 6 months post-implantation. HF patients on ARNI therapy from our HF Clinic were used as controls. Changes in LVEF, in NYHA functional class and in the level of NT-proBNP were compared before ARNI therapy initiation and 6 months thereafter in both groups. Results 70 patients (age: 66,03±9.06 years, 9 women) were enrolled in the CRT-NR and 135 patients (age 62,36±11.26 years; 31 women) in the control group. LVEF increased from 25,25±5.70% to 29,47±6.73% (p<0.001), NYHA class decreased from 2,74±0.55 to 2.03±0.68 (p<0.001) and NT-proBNP from 3884.21±2503.95 to 2676,16±1745.94 (p<0.001) in CRT-NR patients after a 6-month treatment with ARNI. Similar improvement was demonstrated in all parameters in the control group: LVEF increased from 26,64±6.47% to 29,91±6.64% (p<0,001), NYHA class decreased from 2,97±0.54 to 2,18±0.58% (p<0,001) and NT-proBNP from 5355,17±1731.71 to 2062,66±1919.07 (p<0,001). During a mean follow-up of 20,55±11,36 months mortality rates were 17,14% in the CRT-NR group, and 18,51% in the control group. Conclusion ARNI therapy resulted in significant improvement in functional class, LVEF and HF biomarker level in CRT-NR patients, similarly to what was observed in a general HF patient cohort with no CRT. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Project no. TKP2021-EGA-18 has been implemented with the support provided from the National Research, Development and Innovation Fund of Hungary, financed under the TKP2021-EGA funding scheme.

Pharmacological selectivity of SGLT2 inhibitors and cardiovascular outcomes in patients with type 2 diabetes: a meta-analysis

Abstract Background Sodium-glucose cotransporter 2 (SGLT2) inhibitors reduce major adverse cardiovascular events (MACE) in patients with type 2 diabetes mellitus. However, SGLT2 inhibitors show great variance in pharmacological selectivity to SGLT2 over SGLT1. Reduced functional capacity of SGLT1 is associated with lower risk of heart failure development and mortality in humans. Yet, the clinical relevance of additional pharmacological SGLT1 inhibition is unclear. Purpose To assess whether additional pharmacological SGLT1 blockade adds further benefits to SGLT2 inhibition. Methods In this preregistered meta-analysis, we included randomized placebo-controlled cardiovascular outcome trials (CVOTs) of SGLT2 inhibitors assessing MACE (composite of cardiovascular death, nonfatal myocardial infarction, and nonfatal stroke) in patients with type 2 diabetes. Hazard ratios (HRs) and 95% confidence intervals (CIs) of prespecified clinical endpoints were pooled using a random-effects model. Interactions were assessed according to low versus high pharmacological SGLT2 selectivity of the given medication. Mixed-effects meta-regression analysis was performed to quantify correlation between pharmacological SGLT2:SGLT1 selectivity ratio and clinical outcomes. Results A total of 6 independent CVOTs comprising 57553 type 2 diabetic patients (mean age 64.6±7.9 years; 36769 [63.9%] men) were included. Overall, SGLT2 inhibitors significantly reduced risk of adverse cardiovascular and renal outcomes, but had no significant impact on the risk of fatal and nonfatal stroke compared with placebo (HR, 0.92; 95% CI, 0.77–1.10; p=0.36; I2=63%). Agents with clinically relevant SGLT1 inhibitory effect (sotagliflozin, canagliflozin) significantly reduced the risk of stroke (HR, 0.78; 95% CI, 0.64–0.94) compared with placebo, whereas those with high SGLT2 selectivity did not (HR, 1.06; 95% CI, 0.92–1.22), yielding a significant interaction (p=0.018). The difference was also significant in patients with estimated glomerular filtration rate (eGFR) lower than 60 mL/min/1.73 m2 (p=0.047). Meta-regression indicated that lower SGLT2:SGLT1 pharmacological selectivity ratio was associated with lower risk of stroke (pseudo-R2=78%; p=0.011), which was evident even after adjusting for baseline eGFR values (p=0.047). Pharmacological selectivity of SGLT2 inhibitors had no significant impact on any other assessed clinical outcomes, including hospitalization for heart failure and all-cause death. Conclusion These hypothesis-generating results indicate that targeting SGLT1 in addition to SGLT2 inhibition might constitute a new avenue for stroke risk reduction in patients with type 2 diabetes. Further confirmatory studies are needed. Funding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): This project was supported by grants from the National Research, Development and Innovation Office (NKFIH) of Hungary (K134939 to T.R.), and by the New National Excellence Program of the Ministry of Human Capacities of Hungary (ÚNKP-21-3-II-SE-45 to A.A.S.).

A ROMANIAN NATIONWIDE INITIATIVE FOR MITIGATING THE AMR PHENOMENON THROUGH ONE HEALTH APPROACHES: THE RADAR PROJECT

In the RADAR project intitled Selection and dissemination of antibiotic resistance genes from wastewater treatment plants into the aquatic environment and clinical reservoirs (PN-III-P4-ID-PCCF 2016-0114 CONTRACT NO. 10/2018), five Romanian institutions with key scientific and public health assistance roles in the AMR research and surveillance: University of Bucharest as coordinator, National Research and Development Institute for Industrial Ecology, National Institute of Infectious Diseases “Prof. Dr. Matei Balș”, University Politehnica of Bucharest and National Military Medical Institute for Research Development “Cantacuzino“ have joined their complementary expertise in the first nationwide study of the AMR phenomenon using a One Health approach. The RADAR project aimed to evaluate the prevalence and dissemination of AMR from urban, clinical, and industrial wastewater into the aquatic environment via WWTPs and to correlate these results with the environmental and clinical resistome, thus identifying the possible mechanisms of AMR emergence and spread.

The Expression of Plasma Protein in Bali-polled Bulls Using 1D-SDS-PAGE

The fertility rate of bulls in a breeding program is not only described by the quantity and quality of semen. Factors, such as the interstice factor of the sperm and the plasma component of semen, affect the fertility rate of bulls. The fertility rate can also be determined by identifying the protein content of semen plasma. Therefore, the current study aimed to identify the relationship between seminal plasma protein molecular weight and semen quality of Bali-polled bulls. The study was conducted at the Laboratory of Semen Processing, Faculty of Animal Science, Hasanuddin University, Makassar, Indonesia, the Research Center for Applied Zoology, National Research and Innovation Agency, Cibinong, Indonesia and the Laboratory of Animal Biotechnology Center, IPB University, Bogor, Indonesia from November 2021 to January 2022. The samples came from 5 Bali-polled and 5 Bali-horned bulls. Semen collection was conducted twice a week using an artificial vagina. The concentration of seminal plasma protein was determined by the Bradford method of 1D-SDS-PAGE. The study results showed that fresh semen of Bali-polled and Bali-horned bulls was considered a normal category. Seminal plasma proteins of Bali-polled and Bali-horned bulls were classified using 8 bands to categorize molecular weight; 150 kD (IGF-1), 110 kD (A-kinase anchoring protein 3), 93 kD (A-kinase anchoring protein 4), 54-87 kD (Arylsulfatase-a), 44-62 kD (N-Acetyl-ß-Guicosaminidase), 44kD (Phosphoglycerate kinase), 15-30 kD (BSP A1/A2, BSP-A3 and BSP-30 [BSP1, BSP3, and BSP5]) and 12-14 kD (Acidic seminal fluid proteins). The findings indicated that both Bali-polled and Bali-horned bulls could have a high reproductive rate. In conclusion, protein analysis based on molecular weight using 1D-SDS-PAGE can be used as a biomarker for semen quality in Bali-polled bulls. Therefore, evaluating the semen quality with a molecular basis as an additional indicator of superior bull in the selection process is an alternative method.

TRADITIONAL METHODS OF CONFLICT MANAGEMENT AND RESOLUTIONS: THE CASE OF THE OLD OYO EMPIRE

<p>This study looked at traditional African conflict resolution methods, specifically in Yoruba-speaking communities in Nigeria's western region. The Old Oyo empire used traditional conflict resolution techniques such as mediation, adjudication, and reconciliation, as well as cross-examination, to offer a chance to interact with the parties involved, promote consensus building, reconstruct social bridges, and enforce order in the society, according to the paper that fully explains the resolution of disputes and justice dispensation. The study used an exploratory research approach, focusing on the history and Yoruba literature, academic journals on the internet, blogs, government publications and records, a variety of research reports, and individual research. The Western world regards these methods as superior for promoting peaceful coexistence. The traditional method of conflict management and resolution is thus recommended because it is less expensive and friendlier, and further national research into the causes of the 16-year-long inter-border war Ekiti-Parapo, popularly known as the Kiriji War, is also recommended for further finding.</p><p> </p><p><strong> Article visualizations:</strong></p><p><img src="/-counters-/edu_01/0595/a.php" alt="Hit counter" /></p>

Cohort profile: the Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) – a national research and quality registry with a biomaterial collection

PurposeThe Norwegian Registry of Persons Assessed for Cognitive Symptoms (NorCog) was established to harmonise and improve the quality of diagnostic practice across clinics assessing persons with cognitive symptoms in Norwegian...

Neck Imaging Reporting and Data System: More Than Just a Template.

The Neck Imaging Reporting and Data System (NI-RADS) is a guide developed and introduced in 2017 by head and neck radiologists who worked in an academic radiology department. Based on the Breast Imaging Reporting and Data System, the initial goals of NI-RADS were to make posttreatment head and neck cancer imaging dictations more succinct and efficient, guide treating physicians in the next appropriate steps when recurrence was suspected, and encourage institutional and national research. NI-RADS is more than a dictation template, and it is best instituted after a head and neck imaging practice is established. We support the use of NI-RADS once a radiologist understands the nuances of head and neck cancer, including the biology, common subsites involved, essentials of tumor staging, common posttreatment benign imaging appearances, and subtleties of recurrent disease.

AN OVERVIEW TO MANAGEMENT OF PROFESSIONAL DEVELOPMENT FOR PRIMARY SCHOOL TEACHERS BASED ON COMPETENCY APPROACH

The goals and requirements of the 2018 general education program have set out the contents, methods, forms, and conditions to ensure the management of professional development in general education and primary school teachers. Ultimately, the highest level of professional development for teachers aims to enhance teachers' professional and personal development, while benefiting students. The content of the article focuses on an overview international and national researches on managing professional development for primary school teachers to approach competencies with 03 researched issues: 1) Research on competency and competency approach; 2) Research on developing professionals for primary school teachers based on competency approach; and 3) Research on management of professional development for primary school teachers based on competency approach. On that basis, the article is generally evaluated in this review, as a basis for the identification and implementation of further studies.

Cover, Content, and Editorial Note from Borneo J Pharm Vol. 5 No. 3 August 2022

Assalamu’alaikum Wr. Wb.
 Alhamdulillahirabbil ‘alamin. The next edition of the Borneo Journal of Pharmacy (Borneo J Pharm), has been published at August 2022. This edition contains ten articles: Pharmacognosy-Phytochemistry, Pharmaceutical, Microbiology Pharmacy, Natural Product Development, Clinical-Community Pharmacy, and Management Pharmacy. This edition includes writings from four countries: Costa Rica, India, Indonesia, Netherlands, and Nigeria. The authors come from several institutions, including Universitas Ahmad Dahlan, K24 Indonesia, Institut Sains dan Teknologi Nasional, Universidad de Costa Rica, Kebbi State University of Science and Technology, Aliero, Federal University, Birnin Kebbi, Sekolah Tinggi Teknologi Industri dan Farmasi Bogor, IPB University, National Research and Innovation Agency Republic of Indonesia, Poltekkes Kemenkes Bandung, Sekolah Tinggi Ilmu Farmasi Riau, Universitas Islam Negeri Maulana Malik Ibrahim, Universitas Airlangga, Universitas Hang Tuah, Universitas Katolik Widya Mandira, University of Groningen, Universitas Gadjah Mada, Universitas Hasanuddin, Universitas Syiah Kuala, Poltekkes Kemenkes Maluku, and Universitas Islam Sultan Agung.
 Editorial boards are fully aware that there are still room for improvement in this edition, hence with all humility willing to accept constructive suggestions and feedback for improvements to the publication for the next editions. The editorial board would like to thank all editors and reviewers, and contributors of the scientific articles who have provided the repetoire in this issue. We hope that all parties, especially the contributors, could re-participate for the publication in the next edition on November 2022.
 Wassalamu’alaikum Wr. Wb.

Does a mentorship award in radiation oncology inspire medical students to pursue the specialty? A survey analysis of medical students, resident mentors, and research project supervisors

Background Radiation oncology (RO) residencies vary in popularity year-to-year. Many North American regions are experiencing increasing demand for radiation oncologists with a shortage in physician supply while numbers of radiotherapy cases are rising. This study aims to determine the impact of a national Medical Student Research and Mentorship Award on student exposure and interest in RO research and RO as a career, as well as its impact on mentorship and teaching in the perspective of RO residents and research supervisors. Methods Three separate surveys were created: one for medical student mentees, one for resident mentors, and one for staff physician research supervisors. These surveys were developed using best practice strategies for medical education surveys and circulated for peer-review amongst experts in oncology medical education. The surveys were sent to the 7 students, 7 residents, and 7 supervisors who participated in the award program. After anonymization, quantitative answers were analyzed using descriptive statistics and narrative responses were evaluated using a grounded theory approach. Results There was a 100% survey response rate. For the medical student mentees, the award maintained or increased interest in pursuing a career in RO for all respondents. It increased interest in 17% and maintained interest for 83%. According to these students, the most important aspects of the research award was conference registration costs and mentorship with an RO resident. Through the mentorship program, 50% of students felt they attained valuable information about a career in RO, 33% gained insight into RO residency, and 33% received helpful residency matching advice. From the perspective of the resident mentors, all respondents felt the program either maintained or increased motivation to mentor students in RO. Research project supervisors unanimously enjoyed their role in this program and would participate in this program again. Discussion This study characterized how a national research and mentorship award in RO impacted medical students, resident mentors, and research supervisors. Medical students greatly appreciated the opportunity to be mentored by RO residents and to present at a national conference with registration costs covered, motivating all to continue pursuing research and a potential career in RO. The program also enhanced mentorship skills in residents and staff physicians, which will encourage further mentorship in RO for the next generation of students. Further research can be done with future iterations of the award and with potential expansion of this type of award at other research conferences. Radiation oncology (RO) residencies vary in popularity year-to-year. Many North American regions are experiencing increasing demand for radiation oncologists with a shortage in physician supply while numbers of radiotherapy cases are rising. This study aims to determine the impact of a national Medical Student Research and Mentorship Award on student exposure and interest in RO research and RO as a career, as well as its impact on mentorship and teaching in the perspective of RO residents and research supervisors. Three separate surveys were created: one for medical student mentees, one for resident mentors, and one for staff physician research supervisors. These surveys were developed using best practice strategies for medical education surveys and circulated for peer-review amongst experts in oncology medical education. The surveys were sent to the 7 students, 7 residents, and 7 supervisors who participated in the award program. After anonymization, quantitative answers were analyzed using descriptive statistics and narrative responses were evaluated using a grounded theory approach. There was a 100% survey response rate. For the medical student mentees, the award maintained or increased interest in pursuing a career in RO for all respondents. It increased interest in 17% and maintained interest for 83%. According to these students, the most important aspects of the research award was conference registration costs and mentorship with an RO resident. Through the mentorship program, 50% of students felt they attained valuable information about a career in RO, 33% gained insight into RO residency, and 33% received helpful residency matching advice. From the perspective of the resident mentors, all respondents felt the program either maintained or increased motivation to mentor students in RO. Research project supervisors unanimously enjoyed their role in this program and would participate in this program again. This study characterized how a national research and mentorship award in RO impacted medical students, resident mentors, and research supervisors. Medical students greatly appreciated the opportunity to be mentored by RO residents and to present at a national conference with registration costs covered, motivating all to continue pursuing research and a potential career in RO. The program also enhanced mentorship skills in residents and staff physicians, which will encourage further mentorship in RO for the next generation of students. Further research can be done with future iterations of the award and with potential expansion of this type of award at other research conferences.

PUBLIC POLICIES, THE BNCC AND THE CURRICULUM IN THE BILINGUAL SCHOOL FOR THE DEAF

This article presents the Brazilian context in which Bilingual Education for the Deaf is inserted. We understand that such a context of linguistic minorities in deaf communities requires, in addition to the linguistic right in education, the construction of a bilingual curriculum, a reference for the insertion of the Brazilian Sign Language (Libras) as a curricular component. Such elements are fundamental in the integral process of schooling of deaf children, and they are in agreement with the evidence of international and national research according to which sign language in the curriculum should promote the consolidation of linguistic competence and the mastery of metalinguistic awareness of Libras, in order to constitute competent meanings in the languages ​​​​that circulate in the school. In this paper, we aim to promote reflections on the context of implementing the Bilingual Education for the Deaf curriculum in line with the standardizing and guiding document for all Brazilian schools, the National Common Curricular Base. The focus is on this document, as an important ally for the construction of the curricula of bilingual schools for the deaf, in a perspective of guaranteeing the learning rights of these students.

Home gardens of Central Asia: Reservoirs of diversity of fruit and nut tree species

Central Asia is an important center of origin for many globally valued fruit and nut tree species. Forest degradation and deforestation are cause for concern for the conservation of these valuable species, now confined to small remnant populations. Home gardens have the important function of sustaining household food consumption and income generation, and can potentially play a critical role in conserving diversity of fruit and nut trees. These systems have been very poorly documented in the scientific literature. This study contributes to filling this gap by describing the diversity of fruit and nut trees in home gardens of Kyrgyzstan, Uzbekistan, and Tajikistan, examining their dynamic flow of planting material and its sources, understanding their future prospects, and looking at significant differences between the three countries. Home gardens show a similar portfolio of the most abundant tree species (apple, apricot, walnut, pear, and plum). Although the diversity of tree species and varieties recorded is significant, small population sizes can limit future possibilities for this diversity to thrive, given the pressure on natural stands and on habitats where the preferred species are found. Furthermore, the selection of species and varieties to be planted in home gardens is increasingly influenced by market opportunities and availability of exotic material. Some of the most abundant tree species recorded are represented largely by exotic varieties (apple, pear), while others (e.g., apricot, walnut, plum) are still mainly characterized by traditional local varieties that are not formally registered. Home gardens continue to play a critical role in rural livelihoods and in national economies, and many rural inhabitants still aspire to maintain them. Thus, home gardens should be integrated in national research and extension systems and closely linked to national conservation efforts. Changes and possible declines in the diversity they host, their health status, and resilience should be carefully monitored.

U.S. Emergency Department Telepsychiatry Use in 2019.

Introduction: Although many emergency departments (EDs) receive telehealth services for psychiatry, or telepsychiatry, to manage acute psychiatric emergencies, national research on the usage of ED telepsychiatry is limited. To investigate ED telepsychiatry usage in the pre-COVID-19 era, we surveyed a sample of EDs receiving telepsychiatry in 2019, as a follow-up to a survey targeted to similar EDs in 2017. Methods: All U.S. EDs open in 2019 (n = 5,563) were surveyed to characterize emergency care. A more in-depth second survey on telepsychiatry use (2019 ED Telepsychiatry Survey) was then sent to 235 EDs. Of these EDs, 130 were randomly selected from those that reported telepsychiatry receipt in 2019, and 105 were selected based on their participation in a similar survey in 2017 (2017 ED Telepsychiatry Survey). Results: Of the 235 EDs receiving the 2019 Telepsychiatry Survey, 192 (82%) responded and 172 (90% of responding EDs) confirmed 2019 telepsychiatry receipt. Of these, five were excluded for missing data (analytic samplen = 167). Telepsychiatry was the only form of emergency psychiatric services for 92 (55%) EDs. The most common usage of telepsychiatry was for admission or discharge decisions (82%) and transfer coordination (70%). The most commonly reported telepsychiatry mental health consultants were psychiatrists or other physician-level mental health professionals (74%). Discussion: With telepsychiatry as the only form of psychiatric services for most telepsychiatry-receiving EDs, this innovation fills a critical gap in access to emergency psychiatric care. Further research is needed to investigate the impact of the COVID-19 pandemic on usage of ED telepsychiatry.

Traumatic brain injury vocational rehabilitation counselor competencies: Implications for training and practice

BACKGROUND: The Administration for Community Living (ACL) TBI State Partnership Program grants support states by providing funding to build capacity and infrastructure to support and maintain a system of services and supports to maximize the independence, well-being, and health of persons with traumatic brain injury (TBI). A Transition and Employment (T&E) workgroup identified competencies needed by Vocational Rehabilitation Counselors (VRC) to support people with TBI to obtain and maintain employment. OBJECTIVE: To: (1) identify self-perceived VRC TBI competence and (2) inform individual state VR training activities and competency goals. METHODS: A self-assessment online survey was employed. RESULTS: A total of 269 VR professionals across four states completed the VRC Self-Assessment between December 2020 and February 2021. The T&E workgroup identified TBI competencies across four domains (1) brain injury medical and rehabilitation, (2) employment, (3) state and local systems, resources, and service coordination, and (4) national systems, research and best practice. The results by TBI competency and the overall score for all participants show that state and local systems, resources, and service coordination is the highest area of competency, placing them close to the proficient level of knowledge. CONCLUSIONS: Future VR education and training opportunities may be informed by the results of this study.

Exploitation sexuelle des mineurs et traumatisme : revue narrative de littérature

ObjectiveThe sexual exploitation of minors is a multifaced phenomenon with deleterious consequences on the mental health of the children and adolescents who are victims. The traumatic dimension infiltrates this problem, both concerning the antecedents and the situations of sexual exploitation themselves and their psychological sequelae. This article aims to gather and discuss the current literature about the trauma in the sexual exploitation of minors. MethodA keyword and date (between 2010 and 2020) search was made on the search engine Summon 2.0 for articles on commercial sexual exploitation of children and trauma. ResultsTwenty-one articles were studied according to three lines of research, namely: (1) profiles of sexually exploited minors; (2) the traumatic consequences of sexual exploitation; (3) cares and treatments: from identification to therapy. DiscussionThese studies have some limitations. Validity, recruitment and representativeness biases, inherent in this specific population, are discussed. Recommendations for further research and practice were made. ConclusionThis narrative literature review highlights the difficulty of studying this population and insists on the need to carry out further national research with the aim to improve the understanding of commercial sexual exploitation of children in France and to experiment trauma-informed support and care devices, particularly those designed for the needs of these young people in great difficulty.

Research on Regional Economic High-quality Development Along the Belt and Road of China

Over the past 40 years of reform and opening up, China's economy has developed rapidly and made remarkable achievements. China has become the second largest economy in the world. But behind the high investment, high consumption and high growth, the quality problems of economic growth such as excessive consumption of energy, deterioration of environmental quality, imbalance of economic structure and widening income gap are gradually prominent. In 2018, General Secretary Xi Jinping called for high-quality belt and Road cooperation as a basic requirement for the next stage. "The Belt and Road" is an important regional development in China, and the study of its high-quality economic development level can provide an important basis and reference for the national high-quality economic development research. Therefore, it is of great significance to explore the high-quality economic development level of provinces and regions along the "Belt and Road" and clarify the current orientation of high-quality economic development for deepening opening-up, innovative development and sharing the fruits of development with the people. Global principal component analysis (pca), this paper calculates the inter-provincial economic development level of high quality composite scores, the clustering analysis, variation coefficient, thayer index method, such as in China during 2008-2017 "neighbourhood" all the way along the route 17 provinces and autonomous regions for evaluation and analysis, from the Angle of time sequence, regional perspective and dimension to analyze the differences, In order to analyze the high-quality economic development level of provinces and regions along the Belt and Road in a more comprehensive way, 17 provinces and regions are divided into different types.

The 5th Indonesian Society of Limnology (MLI) Congress and International Conference 2021

The 5th Indonesian Society of Limnology (MLI) Congress and International Conference 2021 is a biannual conference organized by the Indonesian Society of Limnology, with the theme is “Building synergies towards sustainable use of inland waters.” This year due to the COVID-19 pandemic, we hold the event virtually from 2nd to 3rd December. The objectives of this event are to (1) Connect, discuss, share and create a mutual network among communities from different backgrounds who are interested in inland waters ecosystem; (2) Disseminate science & technology and lessen the gap between scientific and common communities through fruitful discussion settings; (3) Underpin sustainable use and management of inland aquatic ecosystems.There were four keynotes speakers, four invited speakers, and 66 general presenters in the conference sessions. In total, 116 participants were registered and joined the conference. The first keynote speaker was Prof. Dr. Gadis Sri Haryani from the Research Center for Limnology and Water Resources, National Research and Innovation Agency of the Republic of Indonesia (BRIN), Indonesia, who presented research about Migratory freshwater fish in Indonesia: Threats and conservation efforts. The second presenter was Dr. Robert Walsh from the Australian Water Life, Australia, who presented research about Discover the world of Micro-invertebrates. The third keynote speaker was Dr. Khamla Inkhavilay from the National University of Laos, Lao PDR, who presented Persistent Organic Pollutants in Wetland of Mekong Basin. The fourth speaker was Dr. Kwanraree Joy Sirikanchana from the Chulabhorn Research Institute, Thailand, who presented Microbial Source Tracking and Quantitative Microbial Risk Assessment for Sustainable Water Pollution Management.In addition, the four invited speakers and 66 general presenters split into four rooms for parallel discussions which covered the latest research on inland water ecosystems, including; (1) Biotic resources, biodiversity, and conservation; (2) System Dynamic of inland waters; (3) Applied technology for the management and pollution control; (4) Modelling, system information, decision support tool, disaster risk reduction; (5) Management, policies, regulation, education, social, economy, and culture.We highly appreciate the generous support from Research Centre for Limnology-BRIN (Indonesia), Australian Water Life (Australia), Chulabhorn Research Institute (Thailand), National University of Laos (Lao PDR), Southeast Asian Limnological Network (SEALnet), Advisory Board, Steering and Organizing committee and all presenters and participants.List of Committees, Advisory Board, Steering Committee, Scientific Committee, Organizing Committee, Documentation, all photos are available in this pdf.