Search

Background: The gold standard of treatment for ulnar collateral ligament (UCL) injuries has been reconstruction. Despite early repair studies yielding less than satisfactory results, there has been recent renewed interest in UCL repair due to improved outcomes and new technologies. Data regarding clinical use of these procedures are lacking. The purpose of this study was to define the epidemiological trends of UCL repair and reconstruction surgery from 2010 to 2019, compare demographic characteristics of patients undergoing either procedure, and determine incidence of concomitant procedures in each surgical group as well as comparing respective patient-level charges. Methods: A retrospective database analysis of UCL surgeries was performed through the Texas Healthcare Information Collection database, a comprehensive and publicly available statewide billing dataset. Inclusion criteria were defined using Current Procedural Terminology billing codes for elbow UCL repair and reconstruction between 2010 through 2019, excluding patients who had concomitant elbow fractures or lateral collateral ligament tears indicative of high-energy trauma. Procedural volume changes, patient demographics, and commonly performed concomitant procedures including elbow arthroscopy, ulnar nerve surgery, and platelet-rich plasma injection were compared. Total patient-level charges were compared across groups. Results: A total of 1664 patients were included, consisting of 484 UCL repairs and 1180 reconstructions. Total UCL surgeries increased eleven-fold when corrected for population growth from 2010 (N = 25) to 2019 (N = 315). In 2010, repair constituted 23% of all UCL tear surgeries and increased to 40% by the end of 2019. The annual frequency of UCL repair increased at a 5.4% faster rate than UCL reconstruction from 2010 to 2019 (P

In the new normal, educational institutions find ways for teaching-learning to continue. It is remarkable that distance education has been a great means of continuous learning. In this kind of learning condition, access to quality learning is paramount. The main goal of this research was to determine the effect of the factors of distance education on learning quality during the time of the COVID-19 pandemic. The research design was an exploratory descriptive approach that involved the teachers and students in the Senior High School (SHS) Department of four different campuses. Based on the results, the factors in distance education such as instructional design, support system, and implementation significantly predicted the learning quality of SHS students during the COVID-19 pandemic. When grouped according to campuses, the perceived level of learning quality in distance education noted a significant difference. This may indicate that learning quality can be intensified by the factors in distance education and be carried out on the four campuses. This intensification may be considered in the formulation of the Distance Education Program in the SHS on all campuses of the university.

This study assessed the factors of educational resource management that relate to the quality of work-life among public elementary school teachers. Descriptive-correlational research design was employed to gather data among 534 teaching personnel from 26 public elementary schools in Candelaria District during the academic year 2021-2022. The primary instrument of the study was a researcher-made survey questionnaire distributed using Google forms. The study revealed that physical resources in different schools is managed while time, financial, human, information and communication technology and community resources is well-managed. Moreover, the community and physical/material resources are factors that significantly relate to the respondents’ quality of work-life in terms of job satisfaction, workplace stress, financial reimbursement, working condition, work-life balance, and safety and health based on the regression of variables. However, there is no significant difference in the perceptions of two groups of respondents to educational resource management and level of their quality of work-life. School leaders may prioritize the management of community and physical resources since these are the two factors that can be linked to personnel’s quality of work-life. This is important for all organizational inputs because it leads employee’s satisfaction and influences organizational effectiveness.

This study focused on the preparedness and promotion of technology leadership towards self- efficacy and instructional performance of public elementary school teachers. This utilized 442 public elementary school teachers from Candelaria, Quezon through a descriptive correlational design conducted during academic year 2021- 2022. A researcher- made survey questionnaire was utilized via Google form. The study revealed that self- efficacy was significantly predicted by systematic development when it comes to preparedness of technology leadership while promotion of technology leadership, self- efficacy was significantly predicted by technology infrastructure and support and vision, planning and management. Meanwhile, instructional performance was significantly predicted by systematic development and visionary leadership when it comes to preparedness of technology leadership while promotion of technology leadership, it was significantly predicted by vision, planning and management, technology and infrastructure support, and evaluation and research. This implies that working with peers and doing reflection may also help in enhancing self-evaluation towards teaching performance so teachers can assess points they are good at and they need to develop further.

Abstract Background Direct cannulation of the innominate artery for selective antegrade cerebral perfusion has been shown to be safe in elective proximal aortic reconstructions. We sought to evaluate the safety of this technique in acute aortic dissection. Methods A multi-institutional retrospective review was undertaken of patients who underwent proximal aortic reconstruction for Stanford type A dissection between 2006 and 2016. Those patients who had direct innominate artery cannulation for selective antegrade cerebral perfusion were selected for analysis. Results Seventy-five patients underwent innominate artery cannulation for ACP for Stanford Type A Dissections. Isolated replacement of the ascending aorta was performed in 36 patients (48.0%), concomitant aortic root replacement was required in 35 patients (46.7%), of whom 7 had a valve-sparing aortic root replacement, ascending aorta and arch replacement was required in 4 patients (5%). Other procedures included frozen elephant trunk (n = 11 (14.7%)), coronary artery bypass grafting (n = 20 (26.7%)), and peripheral arterial bypass (n = 4 (5.3%)). Mean hypothermic circulatory arrest time was 19 ± 13 min. Thirty-day mortality was 14.7% (n = 11). Perioperative stroke occurred in 7 patients (9.3%). Conclusions This study is the first comprehensive review of direct innominate artery cannulation through median sternotomy for selective antegrade cerebral perfusion in aortic dissection. Our experience suggests that this strategy is a safe and effective technique compared to other reported methods of cannulation and cerebral protection for delivering selective antegrade cerebral perfusion in these cases.

Transcatheter aortic valve replacement (TAVR) has become a widely adopted treatment modality for severe aortic stenosis. Transfemoral access is the approach of choice; however, approximately 25% of patients undergoing TAVR also have concomitant peripheral arterial disease. The recent advent of intravascular lithotripsy has enabled preservation of transfemoral access in some patients; although, a proportion still require alternative, non-femoral access. Alternative access sites can be broadly categorized into transthoracic and peripheral, facilitated by surgical or percutaneous techniques. In this review, the technical details and clinical outcomes of various TAVR accesses are discussed. Initially, transthoracic approaches were most common, but recently, the trend has been toward alternative peripheral access due to superior outcomes. Although there are no randomized data to support all the alternative access sites, the experiences reported provide available options for a large portion of patients to be candidates for TAVR. The intervention site should be selected by a multidisciplinary heart team based on patient anatomical factors and institutional expertise.

Lagrangian isopycnal diffusivities quantify the along-isopycnal mixing of any tracer with mean gradients along isopycnal surfaces. They are studied in the Southern Ocean of the 1/10° Parallel Ocean Program (POP) model using more than 50 000 float trajectories. Concurrent Eulerian isopycnal diffusivities are estimated directly from the eddy fluxes and mean tracer gradients. Consistency, spatial variation, and relation to mean jets are evaluated. The diffusivities are calculated in bins large enough to reduce contributions from the rotational components that do not lead to net tracer mixing. Because the mean jets are nonzonal and nonparallel, meridional dispersion includes standing eddies and is significantly different from cross-stream dispersion. With the subtraction of the local Eulerianmean, the full Lagrangian diffusivity tensor can be estimated. Along-stream diffusivities are about 6 times larger than cross-stream diffusivities. Along-streamline averages of Eulerian and Lagrangian isopycnal diffusivities are similar in that they are larger north of the Antarctic Circumpolar Current (ACC) and smaller in the ACC in the upper 500 m. Eulerian diffusivities are often twice as large as the Lagrangian diffusivities below 500 m. There is large longitudinal variability in the diffusivities and in their relation to the mean flow. In bins with one prominent jet, diffusivities are reduced at the surface in the jet and increased to the north and south of the jet. There is a local maximum at depths of 500-1000m. In other bins where mean jets merge and diverge because of topography, there is no consistent relation of the diffusivities with the mean flow. Eulerian fluxes are upgradient in about 15% of the bins. © 2014 American Meteorological Society.

© The Author 2014.Background: The iPrEx study demonstrated that combination oral emtricitabine and tenofovir disoproxil fumarate (FTC/TDF) as preexposure prophylaxis (PrEP) protects against HIV acquisition in men who have sex with men and transgender women

This study is focused on the school head's professional identity, emotional intelligence, and perfectionism as three tier factors to advance pedagogical leadership. The study employed the quantitative descriptive methodology, combining descriptive and multiple linear regression analysis. The researchers-made online survey instrument, via a google form. Responses from 132 school heads were analyzed using descriptive statistics such as mean, and standard deviation. Multiple linear regression analysis was employed to determine the significant relationships of the variables. The results reveal that professional identity has a positive relationship with pedagogical leadership. Contradicting result is the emotional intelligence which has a negative relationship with pedagogical leadership. Lastly, perfectionism has a positive relationship with pedagogical leadership. It is concluded that a school head's professional identity, emotional intelligence and perfectionism significantly predict pedagogical leadership. Hence, the department (DepEd) may conduct series of training and workshops for teachers as a capacity building to equip them with knowledge and competencies to handle the numerous challenges in the delivery of quality, relevant, inclusive, and liberating education to the Filipino learners. Further, during Gender and Development programs one activity to consider is the training in emotional development among teachers and school heads. [ABSTRACT FROM AUTHOR]

Stakeholders were an important element in any institution, especially in the educational arena. It was composed of teachers, guardians, students, and local government units who play meaningful roles in achieving a quality education, affordable education, school performance as well as resources. This study aimed to assess the awareness level of internal and external stakeholders' participation in the implementation of sustainable school programs and projects, input to effective stakeholders' management. This paper used descriptive- correlational research designed. There were 1,198 respondents, were female, high school level, age 11-15 years old, and occupation belong to stay at home parent, unemployed, students, retired. Stakeholders perceived the level of awareness was "moderate" while they "agreed" with stakeholders' management plan and "much effective" on the implementation of sustainable school programs and projects. This study revealed that there is a significant relationship between the awareness level of both internal and external stakeholders' participation as well as the stakeholders' management plan to the sustainability of school programs and projects. There is a significant difference between the awareness level of internal and external stakeholders' participation and their perceived level of implementation to sustain the school programs and projects. The stakeholders' management plan also predict that it has a significant effect on the awareness of stakeholders' participation and the sustainability of school programs and projects. [ABSTRACT FROM AUTHOR]

Sarcomas are a heterogenous group of tumours that commonly carry poor prognosis with limited therapeutic options. Adolescents and young adults (AYAs) with sarcoma are a unique and understudied patient population that have only achieved modest survival gains compared to other groups. We present our institutional experience of AYAs with sarcoma who underwent comprehensive molecular profiling (CMP) via either large-panel targeted DNA sequencing or whole genome and transcriptome sequencing and evaluated the feasibility and clinical impact of this approach. Genomic variants detected were determined to be clinically relevant and actionable following evaluation by the Molecular Tumour Board. Clinicians provided feedback regarding the utility of testing three months after reporting. Twenty-five patients who were recruited for CMP are included in this analysis. The median time from consent to final molecular report was 45 days (interquartile range: 37–57). Potentially actionable variants were detected for 14 patients (56%), and new treatment recommendations were identified for 12 patients (48%). Pathogenic germline variants were identified in three patients (12%), and one patient had a change in diagnosis. The implementation of CMP for AYAs with sarcoma is clinically valuable, feasible, and should be increasingly integrated into routine clinical practice as technologies and turnaround times continue to improve. [ABSTRACT FROM AUTHOR]

Dry direct-seeded rice is widely practiced in drought-prone environments in tropical Asia where mechanized options for crop establishment are in great demand. The objective of this study is to identify the suitable design of a hand tractor-mounted multigrain seed drill under biophysical conditions in the Philippines. The prototype was newly designed and tested under field conditions in three provinces in 2015 and 2016. The results suggested that the prototype with tined furrow openers and an inclined circular seed plate in the hopper for seed metering driven by the ground wheel through the combination of chain and sprocket produced rice grain yield similar to the crop established from broadcasting. Field experiments also confirmed that the seed drill has a capacity of over 2 ha day−1 for rice and over 3 ha day−1 for mung bean, and thus, the prototype appears promising for rainfed lowlands in the Philippines. Abbreviations: BS: broadcast seeding; FS: furrow seeding; IRRI: International Rice Research Institute; MSD: Multigrain seed drill; PhilRice: Philippine Rice Research Institute

The drastic development of urban districts around the world has caused changes in the environment, specifically on metropolitan waterways such as the Pasig River in the Philippines. These significant changes resulted in diversity of microorganisms and their mechanisms employed such as antibiotic resistance and their communication system or quorum sensing (QS). In this study, four bacterial isolates from Pasig River, identified as Aeromonas salmonicida, Acinetobacter sp., Morganella morganii, and Citrobacter freundii, were observed to employ short-chain acyl homoserine lactone (AHL) as their signalling molecule based on in vitro assays using the biosensor strain Chromobacterium violaceum CV026. Furthermore, M. morganii isolate was shown to be resistant to chloramphenicol. This poses a significant threat not just to public health but also to the aquatic life present in the river. Thus, green tea (Camellia sinensis) extract was tested for its capability to inhibit in vitro biofilm formation in M. morganii, as well as the short-chain acyl homoserine lactone QS system using C. violaceum ATCC 12472. Results showed that the extract significantly (p < 0.05) inhibited biofilm formation in M. morganii at as low as 62.5 μg/mL (31.55%). Increasing the concentration (500 μg/mL) did not significantly (p > 0.05) enhance the activity (41.21%). Furthermore, the extract also inhibited pigmentation in C. violaceum ATCC 12472, suggesting QS inhibition. This study adds into record the production of short-chain AHLs by Aeromonas salmonicida, Acinetobacter sp., Morganella morganii, and Citrobacter freundii, as well as the potential of green tea extract as inhibitor of biofilm formation in antibiotic-resistant M. morganii possibly through QS inhibition.

The study's dependent variable is the teacher's compelling desire to know the Degree of job satisfaction in terms of fundamental requirements, self-actualization, supervision, and indicators. Job safety, predictable income, vessel maintenance and equipment, mental stress on the job, your earnings or Pay, cleanliness of the work, hours worked, peace of mind/security, time away from home, healthfulness of the workplace, and physical exhaustion on the job are all necessities. Accountability, productivity, recognition, job challenge, excitement, and undertaking something worthwhile are all components of self-actualization. The study on principals' effective leadership and supervisory abilities as predictors of work satisfaction among teachers in public primary schools seeks to determine whether the two qualities of the principal have anything to do with teachers' passion for their jobs. The study uses additional supporting material to demonstrate the relationship between leadership, supervisory skills, and job happiness. The respondents strongly agreed with the claims about their respective publicschool principals' leadership abilities, demonstrated effective supervisory skills in their respective schools, improved those institutions, and produced outstanding students. The findings suggest a strong relationship between teachers' job satisfaction and the principal's leadership abilities. Furthermore, teacher job satisfaction and the effectiveness of the principal's supervision are highly correlated. [ABSTRACT FROM AUTHOR]

Summary: CD19‐directed chimeric antigen receptor (CAR) T‐cell therapy is an important therapy for relapsed or refractory acute lymphoblastic leukaemia, but its use carries the risk of immune effector cell‐associated neurotoxicity syndrome (ICANS). In children, severe ICANS is almost universally reported in association with cytokine release syndrome and is reversible. We describe two cases of severe, intractable neurotoxicity following CAR T‐cell therapy in children with pre‐existing central nervous system (CNS) vulnerabilities. The cases were atypical in their delayed onset and independence from cytokine release syndrome and did not respond to standard therapies. [ABSTRACT FROM AUTHOR]

Abstract Objective: To determine seroprotection for the vaccine‐preventable diseases (VPDs) measles, mumps, rubella, varicella and hepatitis B among new employees seen at a Victorian tertiary hospital staff clinic. Methods: Employees who presented to the staff clinic for immunisation assessment between 1 January 2012 and 31 December 2013 were included. Demographic data, self‐reported disease history and previous vaccination status were reviewed retrospectively to determine impact on serological results. Results: A total of 1,901 new employees were included, 83% of whom were at risk of direct contact with blood or body substances. Overall, the proportion of workers seropositive to measles was 88%, mumps 90%, rubella 78%, varicella 93% and hepatitis B 80%. Staff born before 1966 were more likely to have positive measles or mumps serology but negative rubella or hepatitis B serology (p

The main problem of the study was to develop a standard school support program to enhance the implemented basic research program at San Jose National High School. Specifically, the determine the teachers' level of readiness in research, the extent do the School Factors affect the teachers' participation in research, the extent is the perceived supportive environment affect the level of research competency of teachers, Level of Competency of teachers in conducting research, the perceived level of Research Writing skills of the teachers. It identified the relationship between the teachers' level of competency in research and the perceived level of the teachers' readiness to conduct research and the effect of school factors, the relationship between the extent of school factors affecting participation in the conduct of research and challenges in conducting research, level of research productivity, and level of research skills and whether the perceived level of supportive environment significantly mediate the relationship between teacher's level of readiness and the level of research productivity and level of research skills. The study was descriptive with a researcher-made questionnaire as the instrument of the study. The questionnaire was administered to 661 teachers in the Division of San Pablo City for school year 2022-2023. The data collected were treated using mean scores, standard deviation, Pearson product moment correlation, simple regression, and multiple regression analysis. Results show following findings: the teachers are all well equipped with the desired readiness needed to conduct research studies; school-related factors are very important in influencing teachers' engagement in research investigations; teacher's ability to do research projects is greatly influenced by their cognitive ability, the school's support and assistance, the principal's leadership skills, and the research culture at their institution; the teachers were all well-versed in each of the parts of a research paper; the teachers' research skills is significantly related to the teachers' readiness to conduct research and the effect of school factors; the relationship between effect of school factors in research engagement and challenges in conducting research is significant as well as with research productivity and research skills; and the supportive environment significantly mediate the relationship between the teachers' level of research readiness and level of teachers' research skills but does not significantly mediate the teachers' level of research readiness and level of their research productivity. Strategic planning and support from the school through the developed standard school support program is encouraged. [ABSTRACT FROM AUTHOR]

Background: Antibiotics, while an essential component of supportive care in allogeneic hematopoietic cell transplantation (allo‐HCT), can have adverse effects and select for antibiotic resistance. Understanding of patterns of use will inform antimicrobial stewardship (AMS) interventions. Methods: Retrospective, single‐center cohort of children undergoing first allo‐HCT (n = 125). Antibiotic prescription and infection data were included from the date conditioning was commenced until 30 days post allo‐HCT. Antibiotic use was reported as length of therapy (LOT) (number of days a patient received an antibiotic) and days of therapy DOT (aggregating all antibiotics prescribed per day). Infections were classified as microbiologically documented infection (MDI) or clinically documented infections. Results: At least one course of antibiotics was administered to 124 (99%) patients. The LOT was 636 per 1000 patient days and DOT was 959 per 1000 patient days. The median duration of cumulative antibiotic exposure per patient was 24 days (interquartile range [IQR] 20–30 days). There were 131 days of fever per 1000 patient days with patients febrile for a median of 4 days (IQR 1–7 days). Piperacillin–tazobactam was used for 116 (94%) of patients with an LOT of 532 per 1000 patient days. A total of 119 MDI episodes occurred in 74 (59%) patients, including blood stream infection in 30 (24%) and a proven/probable invasive fungal infection in 4 (3%). Conclusion: Pediatric HCT patients receive prolonged courses of broad‐spectrum antibiotics relative to the frequency of fever and bacterial infections. This study has identified opportunities for AMS intervention to improve outcomes for our HCT patients. [ABSTRACT FROM AUTHOR]

This study examined the Mediating Effect of Philosophical Orientation to the Transformational Instruction Practices and the Implementation of Flexible Learning: Basis for Institutionalizing Students' University Experience. Thus, this design used in the study is mixed-method design utilizing three thousand 3rd and 4th year students of LSPU system. The results were analyzed using descriptive statistics which includes Cross tabulation, standard deviation, mean, and regression analysis for the quantitative part. The study revealed that the philosophical orientation among faculty in LSPU system as "Highly Observed". The transformational instruction practices of faculty in LSPU system as "Highly Practiced". Implementation of flexible learning at LSPU system as "Highly Effective". The students' university experience at LSPU system as "Often". The teacher's transformational instruction practices as to collaboration and inspirational motivation and intellectual stimulation of implementation of flexible learning affect only the level of students' university experience. While the remaining sub-variables does not affect the level of students' university experience. Still, the null hypothesis is rejected. The philosophical orientations of the teacher mediate the effect of transformational instruction practices and implementation of flexible learning to the student's university experience. Thus, the null hypothesis is rejected. In the light of the findings and conclusions, here are the recommendations: Continuous need for reskilling and upskilling and professional development for our faculty to be competitive and relevant in the new normal in education. A technology-enriched collaborative environment could be promoted since collaborative learning environments are where students thrive. In dealing with teachers' philosophical orientation, they may specify existentialism as philosophy that could be the focus of the study phenomenological method to really dive to the personal and in-depth experiences of the learners. [ABSTRACT FROM AUTHOR]