Extended Treatment With Recombinant Human Parathyroid Hormone (1-84) in Adult Patients With Chronic Hypoparathyroidism.

OBJECTIVE: Recombinant human parathyroid hormone (1-84) (rhPTH[1-84]) is efficacious in patients with hypoparathyroidism but additional data supporting its prolonged use are needed. We evaluated whether efficacy, safety, and tolerability are maintained during long-term rhPTH(1-84) treatment of patients with chronic hypoparathyroidism. METHODS: This was a phase 4, single-center, open-label, single-arm, 3-year extension (NCT02910466) of the phase 3 Hypo Extended (HEXT) study (NCT01199614). Patients self-administered rhPTH(1-84) once daily by subcutaneous injection, with doses individualized based on clinical parameters. Albumin-adjusted serum calcium levels (primary outcome measure), other disease biomarkers, health-related quality of life, and safety of rhPTH(1-84) were assessed using descriptive statistics. RESULTS: All patients (n = 39) had been exposed to rhPTH(1-84) (mean exposure [SD] 8.5 [3.5] years) before the start of the study, resulting in a mean exposure of 10.8 years including the present study. Mean patient age was 51.9 years, 79.5% were female, and 97.4% were White. Mean albumin-adjusted serum calcium concentrations were within the target range, and mean serum phosphate, serum calcium-phosphate product, and 24-hour urinary calcium excretion levels were within reference ranges at end of treatment. Mean doses of supplemental calcium and active vitamin D were maintained throughout the study. Bone turnover marker levels were maintained from baseline to end of treatment. No clinically relevant changes in bone mineral density were observed. Patient-reported health-related quality-of-life scores were generally maintained throughout the study. Four adverse events were considered treatment related and no new safety signals were identified. CONCLUSION: The effects of rhPTH(1-84) on biochemical, skeletal, and health-related quality-of-life parameters did not wane with extended use.

The relationship between students' psychological security level, academic engagement and performance variables in the digital educational environment.

In connection with the situation with COVID-19 almost all universities in the world were transferred to e-learning format, therefore new factors started to influence academic engagement and performance. Psychological security is one of these factors. Many researches have studied the importance of psychological security level among students, some of them proposed the methodology of assessing the indicator. Nevertheless, there are few studies that demonstrate the relationship between psychological security level of students and their academic engagement and performance. The aim of the current study is to close this scientific gap. For the assessment the Trustworthiness Factors survey, Academic Engagement Scale and academic performance results were used. A total of 351 students aged between 19 and 21 (M = 19.57, SD = 0.59), mainly female (57%), were integrated in the sample. Online surveys were conducted to reveal the level of students' psychological security, their academic engagement and performance in the process of e-learning and analyze the associations between these variables. The female students analyzed showed higher levels of psychological security, and especially in the communication of own ideas in webinar rooms. The same tendency was found in the levels of academic engagement and performance. The findings obtained by using the linear regression analysis technique indicated that psychological security predicted academic performance positively. In contrast to earlier studies, student safety is considered not only as an aspect of personal data security, but more as a psychological one. It was possible to conclude that the influence of psychological security on students' engagement and academic performance is particularly visible in the online educational environment.

The effect of online learning in modern history education.

Interactive digital technologies have become relevant in modern education. The use of these technologies in the classroom contributes to the development of professional competencies and skills. The purpose of the study is to analyze the effectiveness of interactive learning environments and online platforms in learning history. The features of modern online learning platforms and the possibilities of their use in the study of history have been analyzed. The research was carried out at the Department of National History of Moscow City University (Moscow, the Russian Federation). The experiment involved 623 history students of different years of study of the following training profiles: "History" (124 students of 1-4 years of study) and "Pedagogical education" ("History and a foreign language", "History and social studies" - 399 students of 1-5 years of study). Also, the survey was addressed to 29 faculty members from the university under consideration. The results of the first survey show that the majority of students (62%) noted the use of traditional methods and 38% of respondents indicated the use of the modern ones. The majority of students (52%) also answered that digital tools are rarely used in the study of history while 71% of respondents reported that digital technology affects their motivation to learn. Therefore, the majority of students rated their level of motivation as average (43%) or low (47%). The most frequent professional competencies and skills are "technical competence (modern technologies)" (62%), "creativity" (65%), "critical thinking" (60%), "strategic thinking" (55%), and "practical skills" (78%). Based on the results obtained in the first survey, a program was developed to increase the motivation of students to study history and archeology, as well as to familiarize themselves with modern educational technologies that can be used in the learning process. The second survey showed an increase in the indicators of students' motivation to learn, which indicates the effectiveness of the developed program for the study of history. The majority of students (85%) answered that digital tools affect their motivation to learn. Thus, they rated it as medium (50%), high (20%) and low (30%). Accordingly, the indicators of professional competencies and skills increased by 10%: "technical competence (modern technologies)" (72%), "creativity" (75%), "critical thinking" (71%), "strategic thinking" (65%), and "practical skills" (88%). No less significant were the shifts in students' creative thinking development indicators - they changed from 18% (before the experiment) to 58% (after the experiment). The practical significance and prospects for further research are explained by the possibility of using the developed program for the study of history in other universities located in different countries. Also, the methodological basis of the proposed program can be used to study not only history but also other subjects as digital technologies are relevant in the modern education system.

Distribution of (1->4)-beta-galactans, arabinogalactan proteins, xylans and (1->3)-beta-glucans in tracheid cell walls of softwoods.

Polysaccharides were located in the walls of normal and compression wood tracheids of Pinus radiata (radiata pine), Picea sitchensis (Sitka spruce) and Picea abies (Norway spruce) by transmission electron microscopy using immunogold labelling with monoclonal antibodies to (1-->4)-beta-galactan (LM5), (1-->3)-beta-glucan, arabinogalactan proteins (AGPs) (MAC207) and heteroxylans (LM10 and LM11). In fully differentiated compression wood tracheids, (1-->4)-beta-galactan was found in the S2((L)) layer and, to a smaller extent, at the interface between the compound middle lamella and the S1 layer. (1-->4)-beta-Galactan appeared to be displaced from, or modified in, the S1 layer during cell wall formation. (1-->3)-beta-Glucan (callose) was confined to the helical cavities in the inner S2 layer of severe compression wood. MAC207 AGP glycan epitope was found exclusively in the S1 and S3 layers of normal wood tracheids and in the S1 and inner S2 layers of compression wood tracheids. Binding of LM10, which specifically recognizes unsubstituted or low-substituted xylans, occurred at similar locations to the MAC207 epitope, whereas binding of LM11, which recognizes more highly substituted as well as unsubstituted xylans, occurred throughout the tracheid walls with the exception of the primary wall. Immunogold labelling showed that the different wall layers of softwood tracheids have different polysaccharide compositions which change abruptly during cell wall formation.

Individual doses for super cohort members exposed to atmospheric radioiodine from the Mayak releases with an emphasis on prenatal doses.

Time-dependent thyroid doses were reconstructed for 45,837 members of the Southern Urals Population Exposed to Radiation Cohort (SUPER-C) living in the region around the Mayak Production Association facilities in Russia from 131I released to the atmosphere from all relevant exposure pathways. The dose calculations are implemented in a Monte Carlo framework that produces best estimates and stochastic realizations of dose time-histories. The arithmetic mean thyroid dose from 131I for SUPER-C members was 195 mGy; the median was 61 mGy. Overall, 131I-thyroid doses for about 3.6% of SUPER-C members were larger than 1 Gy. For children born in 1940-1950, the dose was about 10% higher than in previous studies because doses during the prenatal period for 9,117 individuals are included in the current work. Half of the individuals born in the region in 1950-1960 who remained in the study domain through 1972 received 9.4% or more of their total dose during the prenatal period. SUPER-C members residing in areas contaminated by discharges of liquid radioactive releases into the Techa River or the Kyshtym Accident in 1957 received 80% of their thyroid dose from airborne 131I emissions.

Calculations of individual doses for Techa River Cohort members exposed to atmospheric radioiodine from Mayak releases.

Time-dependent thyroid doses were reconstructed for over 29,000 Techa River Cohort members living near the Mayak production facilities from 131I released to the atmosphere for all relevant exposure pathways. The calculational approach uses four general steps: 1) construct estimates of releases of 131I to the air from production facilities; 2) model the transport of 131I in the air and subsequent deposition on the ground and vegetation; 3) model the accumulation of 131I in environmental media; and 4) calculate individualized doses. The dose calculations are implemented in a Monte Carlo framework that produces best estimates and confidence intervals of dose time-histories. Other radionuclide contributors to thyroid dose were evaluated. The 131I contribution was 75-99% of the thyroid dose. The mean total thyroid dose for cohort members was 193 mGy and the median was 53 mGy. Thyroid doses for about 3% of cohort members were larger than 1 Gy. About 7% of children born in 1940-1950 had doses larger than 1 Gy. The uncertainty in the 131I dose estimates is low enough for this approach to be used in regional epidemiological studies.

Dolor y medicina complementaria y acupuntura / Pain and complementary medicine and acupuncture

El objetivo de este artículo es entregar información documentada sobre la situación actual de la Medicina Complementaria y la Acupuntura en Chile, su definición, reglamentación, mecanismos de acción y evidencia. Busca orientar sobre el uso de estas herramientas terapéuticas que son cada vez más solicitadas en el país.