Search

Abstract: The increase in COVID-19 cases and the limited availability of personal protective equipment cause residents to be prone to contracting COVID-19 and lose some of their rights as consumers of education programs. This study analyzes the legal protection of resident’s rights fulfilment during a pandemic in Indonesia. This normative study using the statute approach is prescriptive and applied in nature. The data sources used are primary, secondary, legal and non-legal materials collected using literature study and confirmation techniques. The legal materials were analyzed using a syllogistic method of deductive mindset. The findings conclude that the resident's right fulfilment is not optimal at present. To achieve legal protection ideals, Indonesian universities as educational service providers must provide all forms of PPE and the reserves during the education period. Setting resident’s status as workers in teaching hospitals can result in the implications of providing incentives and determining working hours. Keywords: Legal Protection, Resident’s Rights, Pandemic Abstrak: Penelitian ini bertujuan untuk menganalisis perlindungan hukum di Indonesia dalam pemenuhan hak residen selama masa pandemi. Residen harus melaksanakan tugas belajar mengajar dan peningkatan kasus positif COVID-19 tidak berbanding lurus dengan ketersediaan alat pelindung diri. Residen rawan terjangkit COVID-19 dan terlanggarnya beberapa hak sebagai konsumen dari program pendidikan. Metode penelitian yang digunakan adalah normatif, dengan pendekatan undang-undang. Sifat penelitian bersifat preskriptif dan terapan. Sumber penelitian berupa bahan hukum primer, sekunder, dan non-hukum, dengan teknik studi kepustakaan serta melakukan konfirmasi. Teknik analisis bahan hukum dengan metode silogisme melalui pola pikir deduktif. Dapat disimpulkan bahwa kondisi kekinian berkenaan pemenuhan hak residen adalah belum optimal. Dari segi idealitas perlindungan hukum, Indonesia yang saat ini menganut masih university-based, universitas sebagai penyedia jasa pendidikan harus menyediakan segala bentuk APD dan cadangannya dalam penggunaan harian selama masa pendidikan. Penetapan status residen sebagai pekerja di RS Pendidikan, dapat berimplikasi terhadap pemberian insentif dan penetapan jam kerja. Kata Kunci: Hak Mahasiswa Peserta Program Pendidikan Dokter Spesialis, Masa Pandemi, Perlindungan Hukum

MONOGRAFÍA 1: ENSEÑANZA DE LA GRAMÁTICA EN ELE: RESULTADOS DE INVESTIGACIÓN Y NUEVAS PROPUESTAS Tradicionalmente, la enseñanza del contraste modal en el aula de español como lengua extranjera (ELE) se ha apoyado en un enfoque formalista basado en las diferentes conexiones sintácticas y semánticas (y/o funcionales) entre la matriz o cláusula principal y la proposición o cláusula subordinada. Esto conlleva generalmente la presentación de una extensa clasificación de estructuras que activan el uso de cada modo (subjuntivo o indicativo) en la proposición junto a otra clasificación de excepciones que los aprendientes necesitan memorizar para poder completar actividades de práctica controlada. En este artículo se presenta una aplicación empírica a la enseñanza del contraste modal basada en un enfoque cognitivo-operativo, es decir, en los conceptos de declaración y no declaración formulados por Ruiz Campillo (2004). Los resultados muestran una mejora sustancial no solo en la comprensión / recepción del contraste modal entre los participantes de este estudio sino también en sus destrezas de producción. ABSTRACT Traditional (or formalist) methods for the teaching of mood contrast in Spanish are generally focused on the different syntactic and semantic (or/and functional) connections between the matrix and the embedded clause. This generally entails the provision of an extensive classification of subordinate clauses with the embedded verb in the subjunctive (or indicative) mood plus another classification with the exceptions that students need to memorise in order to use them under controlled conditions. In this paper, an empirical study is presented in which L2 learners were introduced to Spanish mood contrast by means of a cognitive-operative approach, which is based on the concepts of declaration and non-declaration by Ruiz Campillo (2004). The results show a significant improvement not only in the comprehension abilities of mood contrast among the students participating in this study but also in their production abilities.

Substandard and counterfeit medicines (SCMs) are a major public health threat in Africa. In Nigeria, the manufacture and distribution of substandard and counterfeit medicines in the drug market are booming, despite the efforts of law enforcement agencies to crack down on criminal syndicates over the years. The current situation has been exacerbated due to factors tied to unregulated open drug markets, lack of counterfeit detection technology, poor local pharmaceutical manufacturing capacity, and porous cross-border monitoring and surveillance systems. However, industrial pharmacists have a key role to play in combatting the production and circulation of SCMs in the Nigerian drug market. In this commentary, we examine the prevalence of SCMs in Nigeria and proffer feasible recommendations that industrial pharmacists can leverage to ensure its effective containment.

People can affect change in their eating patterns by substituting ingredients in recipes. Such substitutions may be motivated by specific goals, like modifying the intake of a specific nutrient or avoiding a particular category of ingredients. Determining how to modify a recipe can be difficult because people need to 1) identify which ingredients can act as valid replacements for the original and 2) figure out whether the substitution is “good” for their particular context, which may consider factors such as allergies, nutritional contents of individual ingredients, and other dietary restrictions. We propose an approach to leverage both explicit semantic information about ingredients, encapsulated in a knowledge graph of food, and implicit semantics, captured through word embeddings, to develop a substitutability heuristic to rank plausible substitute options automatically. Our proposed system also helps determine which ingredient substitution options are “healthy” using nutritional information and food classification constraints. We evaluate our substitutability heuristic, diet-improvement ingredient substitutability heuristic (DIISH), using a dataset of ground-truth substitutions scraped from ingredient substitution guides and user reviews of recipes, demonstrating that our approach can help reduce the human effort required to make recipes more suitable for specific dietary needs.

Abstract Background The WHO has recently published the FRAX® tool to determine the absolute risk of osteoporotic fracture at 10 years. This tool has not yet been validated in Spain. Methods/design A prospective observational study was undertaken in women in the FRIDEX cohort (Barcelona) not receiving bone active drugs at baseline. Baseline measurements: known risk factors including those of FRAX® and a DXA. Follow up data on self-reported incident major fractures (hip, spine, humerus and wrist) and verified against patient records. The calculation of absolute risk of major fracture and hip fracture was by FRAX® website. This work follows the guidelines of the STROBE initiative for cohort studies. The discriminative capacity of FRAX® was analyzed by the Area Under Curve (AUC), Receiver Operating Characteristics (ROC) and the Hosmer-Lemeshow goodness-of-fit test. The predictive capacity was determined using the ratio of observed fractures/expected fractures by FRAX® (ObsFx/ExpFx). Results The study subjects were 770 women from 40 to 90 years of age in the FRIDEX cohort. The mean age was 56.8 ± 8 years. The fractures were determined by structured telephone questionnaire and subsequent testing in medical records at 10 years. Sixty-five (8.4%) women presented major fractures (17 hip fractures). Women with fractures were older, had more previous fractures, more cases of rheumatoid arthritis and also more osteoporosis on the baseline DXA. The AUC ROC of FRAX® for major fracture without bone mineral density (BMD) was 0.693 (CI 95%; 0.622-0.763), with T-score of femoral neck (FN) 0.716 (CI 95%; 0.646-0.786), being 0.888 (CI 95%; 0.824-0.952) and 0.849 (CI 95%; 0.737-0.962), respectively for hip fracture. In the model with BMD alone was 0.661 (CI 95%; 0.583-0.739) and 0.779 (CI 95%; 0.631-0.929). In the model with age alone was 0.668 (CI 95%; 0.603-0.733) and 0.882 (CI 95%; 0.832-0.936). In both cases there are not significant differences against FRAX® model. The overall predictive value for major fracture by ObsFx/ExpFx ratio was 2.4 and 2.8 for hip fracture without BMD. With BMD was 2.2 and 2.3 respectively. Sensitivity of the four was always less than 50%. The Hosmer-Lemeshow test showed a good correlation only after calibration with ObsFx/ExpFx ratio. Conclusions The current version of FRAX® for Spanish women without BMD analzsed by the AUC ROC demonstrate a poor discriminative capacity to predict major fractures but a good discriminative capacity for hip fractures. Its predictive capacity does not adjust well because leading to underdiagnosis for both predictions major and hip fractures. Simple models based only on age or BMD alone similarly predicted that more complex FRAX® models.

Abstract Background Osteoporosis is a serious health problem that worsens the quality of life and the survival rate of individuals with this disease on account the osteoporotic fractures. Studies have long focused on women, and its presence in men has been underestimated. While many studies conducted in different countries mainly assess health-related quality of life and identify fracture risks factors in women, few data are available on a Spanish male population. Methods/Design Observational study. Study population Men ≥ 40 years of age with/without diagnosed osteoporosis and with/without osteoporotic fracture included by their family doctor. Measurements The relationship between customary clinical risk factors for osteoporotic fracture and health-related quality of life in a Spanish male population. A telephone questionnaire on health-related quality of life is made. Statistical analysis The association between qualitative variables will be assessed by the Chi-square test. The distribution of quantitative variables by Student's t-test. If the conditions for using this test are not met, the non-parametric Mann-Whitney's U test will be used. The validation of the results obtained by the FRAX™ tool will be performed by way of the Hosmer-Lemeshow test and by calculating the area under the Receiver Operating Characteristic (ROC) curve (AUC). All tests will be performed with a confidence intervals set at 95%. Discussion The applicability and usefulness of Health-related quality of life (HRQOL) studies are well documented in many countries. These studies allow implementing cost-effective measures in cases of a given disease and reducing the costly consequences derived therefrom. This study attempts to provide objective data on how quality of life is affected by the clinical aspects involved in osteoporosis in a Spanish male population and can be useful as well in cost utility analyses conducted by health authorities. The sample selected is not based on a high fracture risk group. Rather, it is composed of men in the general population, and accordingly comparisons should not lead to erroneous interpretations. A possible bias correction will be ensured by checking reported fractures against healthcare reports and X-rays, or by consulting health care centers as applicable.

Abstract Background Age-related bone loss is asymptomatic, and the morbidity of osteoporosis is secondary to the fractures that occur. Common sites of fracture include the spine, hip, forearm and proximal humerus. Fractures at the hip incur the greatest morbidity and mortality and give rise to the highest direct costs for health services. Their incidence increases exponentially with age. Independently changes in population demography, the age - and sex- specific incidence of osteoporotic fractures appears to be increasing in developing and developed countries. This could mean more than double the expected burden of osteoporotic fractures in the next 50 years. Methods/Design To assess the predictive power of the WHO FRAX™ tool to identify the subjects with the highest absolute risk of fragility fracture at 10 years in a Spanish population, a predictive validation study of the tool will be carried out. For this purpose, the participants recruited by 1999 will be assessed. These were referred to scan-DXA Department from primary healthcare centres, non hospital and hospital consultations. Study population: Patients attended in the national health services integrated into a FRIDEX cohort with at least one Dual-energy X-ray absorptiometry (DXA) measurement and one extensive questionnaire related to fracture risk factors. Measurements: At baseline bone mineral density measurement using DXA, clinical fracture risk factors questionnaire, dietary calcium intake assessment, history of previous fractures, and related drugs. Follow up by telephone interview to know fragility fractures in the 10 years with verification in electronic medical records and also to know the number of falls in the last year. The absolute risk of fracture will be estimated using the FRAX™ tool from the official web site. Discussion Since more than 10 years ago numerous publications have recognised the importance of other risk factors for new osteoporotic fractures in addition to low BMD. The extension of a method for calculating the risk (probability) of fractures using the FRAX™ tool is foreseeable in Spain and this would justify a study such as this to allow the necessary adjustments in calibration of the parameters included in the logarithmic formula constituted by FRAX™.

Abstract Background MicroRNAs (miRs or miRNAs) regulate several biological processes in the cell. However, evidence for miRNAs that control the differentiation program of specific neural cell types has been elusive. Recently, we have shown that apoptosis-associated factors, such as p53 and caspases participate in the differentiation process of mouse neural stem (NS) cells. To identify apoptosis-associated miRNAs that might play a role in neuronal development, we performed global miRNA expression profiling experiments in NS cells. Next, we characterized the expression of proapoptotic miRNAs, including miR-16, let-7a and miR-34a in distinct models of neural differentiation, including mouse embryonic stem cells, PC12 and NT2N cells. In addition, the expression of antiapoptotic miR-19a and 20a was also evaluated. Results The expression of miR-16, let-7a and miR-34a was consistently upregulated in neural differentiation models. In contrast, expression of miR-19a and miR-20a was downregulated in mouse NS cell differentiation. Importantly, differential expression of specific apoptosis-related miRNAs was not associated with increased cell death. Overexpression of miR-34a increased the proportion of postmitotic neurons of mouse NS cells. Conclusions In conclusion, the identification of miR-16, let-7a and miR-34a, whose expression patterns are conserved in mouse, rat and human neural differentiation, implicates these specific miRNAs in mammalian neuronal development. The results provide new insights into the regulation of neuronal differentiation by apoptosis-associated miRNAs.