Metabolic Bone Profile of Healthy Adult North Indian Population from Chandigarh Urban Bone Epidemiological Study (CUBES)

We aimed to estimate metabolic bone profile in a large cohort of healthy, adult Indian population to generate reference standards of serum calcium, phosphate and alkaline phosphatase (ALP), 25 (OH) Vitamin D and iPTH, and also to find out the prevalence of Vitamin D deficiency in healthy population. Apparently healthy people in the age group of 20–80 years, residing in the union territory of Chandigarh were chosen. Fasting samples for serum calcium, phosphate, albumin, alkaline phosphatase (ALP), 25 (OH) D and iPTH were collected and were processed on the same day. We recruited 930 healthy subjects from different subsectors of Chandigarh. Final analysis was done for 915 subjects. Out of this, 530 (58%) were women and 385 (42%) were men. The study participants were divided into two groups, less than and more than 50 years for the men and pre and post-menopausal for the women. The serum calcium, phosphate, ALP and iPTH were significantly higher in the post-menopausal women compared to the pre-menopausal women. The median plasma 25 (OH) D in men and women was 12.5 ng/mL and 14.3 ng/mL, respectively. 25 (OH) D deficiency was seen in 65.4% of individuals. 25 (OH) D levels co-related negatively with iPTH levels (r = − 0.4, p < 0.0001), and showed an increasing trend with age. We have thus presented metabolic bone profile of healthy, adult north Indian population. These reference values can be used for diagnosis and monitoring of various MBDs. Vitamin D deficiency is still rampant in our population in spite of increasing awareness.     

Providing knowledge recommendations: an approach for informal electronic mentoring

The use of Web 2.0 technologies for knowledge management is invading the corporate sphere. The Web 2.0 is the most adopted knowledge transfer tool within knowledge intensive firms and is starting to be used for mentoring. This paper presents IM-TAG, a Web 2.0 tool, based on semantic technologies, for informal mentoring. The tool offers recommendations of mentoring contents built upon personal competencies of the mentee, combined with content and opinion tagging. To validate the tool, a case study comparing recommendations from the IM-TAG and a group of experts was conducted. Results show that the accuracy of IM-TAG's recommendations is notable and satisfactory. The main conclusions of this research may be valuable to organizations immersed in mentoring programs.     

Effect of corticosteroids on atrial fibrillation after catheter ablation: a meta-analysis

Objective

The purpose of this meta-analysis was to explore the effect of corticosteroids on atrial fibrillation (AF) following catheter ablation.

Methods

We searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for published articles describing the effect of corticosteroids in preventing AF recurrence after catheter ablation. Data on study and patient were extracted. Risk ratios (RRs) and 95% confidence intervals (CIs) were calculated by use of a random-effect model, and P values of <0.05 were considered significant.

Results

Two randomized controlled trials (RCTs) and three cohort studies involving 846 patients were included in this meta-analysis. Within one month of catheter ablation, corticosteroid use was associated with a declined risk of recurrence of AF in RCT (RR 0.57, 95% CI 0.39 to 0.85, P=0.005), but without significant effect in cohort studies (RR 1.01, 95% CI 0.79 to 1.30, P=0.94). After three months of catheter ablation, corticosteroids did not have a significant effect in the prevention of late recurrence of AF in either RCT (RR 0.78, 95% CI 0.38 to 1.59, P=0.49) or cohort studies (RR 0.96, 95% CI 0.70 to 1.31, P=0.78).

Conclusions

Our meta-analysis suggested that periprocedural administration of corticosteroids of catheter ablation was associated with reduction of early but not late recurrence of AF.

     

Envisioning Our Practice: Examining and Interpreting Pedagogical Visions of Four Early Career Teacher Educators

ABSTRACT

The purpose of this article is to explore how pedagogical visions inform our work as former classroom teachers and current teacher educators in rural and urban regions of the United States. Specifically, we explore the instructional decisions we make as we work to meet these visions in higher education. Teacher educators are charged with the task of fostering visionary teachers in today’s highly challenging educational landscape. We pose the question: How can teacher educators foster visionary beginning teachers without an examination of their visions for their practice? Using a self-study design, we examine the intersections of our pedagogical visions for teaching and the instructional actions we take to work toward our visions in higher education. Findings highlight specific instructional practices and strategies used to enact visions while providing a critical discussion of the lens of visioning within self-study research.     

An effective quadrilateral mesh adaptation

INTRODUCTION Adaptive grids are desired for solving partial differential equations (PDEs) (Khattri, 2006a; 2007). There are various techniques for generating adaptive quadrilateral meshes. For example, solution of cou- pled elliptic system (Khattri, 2006d; Thompson et al., 1998), minimization of a functional or variational approach (Cao et al., 1999; 2003; Huang, 2001), etc. In this article, we present a simple and effective technique for generating adaptive quadrilateral meshes. Sever…     

Role of pump prime in the etiology of cardio-pulmonary bypass associated acidosis

The development of metabolic acidosis during cardio-pulmonary bypass (CPB) is a well recognized but poorly explained phenomenon. It has been hypothesized that it is purely a development after the delivery of pump prime. A retrospective study was conducted at our hospital on 68 patients who underwent elective coronary artery bypass grafting (CABG). Sampling of arterial blood was performed at three time intervals: (T₁) Baseline, prior to induction; (T₂) 5 minutes after initiation of CPB and prior to administration of cardioplegia solution; (T3) during rewarming prior to weaning the patient off CPB. Measurements of Na⁺, K⁺, Cl⁻, pH, pCO₂, HCO₃ ⁻, Base excess, Anion gap, Strong ion difference at each collection point were performed. Results were analyzed in a quantitative manner. On delivery of pump prime, all patients' developed metabolic acidosis. However, it is very important to distinguish the metabolic acidosis as their management varies. Anion gap has been found to be useful in managing peri-operative metabolic acidosis.     

Fostering innovation through collaborative action research on the creation of shared instructional products by university science instructors

ABSTRACT

The purpose of this study is to profile four university science instructors who utilized action research as a means of learning how to develop and integrate a novel curriculum innovation – engineering design – in their science courses. Data included curriculum maps, lesson plans, notes from group meetings, and instructor reflections. Data analysis included document review and content analysis. Findings from this study suggest that action research effectively enabled the instructors to 1) establish shared ownership of the project goal – to improve preservice teachers’ learning of science through engineering design; 2) continuously test, revise, and recalibrate their shared instructional products; and 3) leverage multiple sources of innovation. Knowledge generated and used by the instructors represented different kinds of knowledge and distributed expertise resulting in products that were more useful and of higher quality than products created by individuals working alone. Consequently, this resulted in increased use of the products and increased instructor commitment to improve them over time. By simultaneously engaging in research and consequently taking specific action to inform their practice, science instructors in this study successfully created shared instructional products that both guided and enhanced their classroom teaching.     

Arterial blood gas management during cardiopulmonary bypass

This study sought to investigate the effects of α-stat and pH stat regimens on cardiac outcome during moderate hypothermic cardiopulmonary bypass. 100 patients undergoing elective coronary artery bypass grafting (CABG) were randomly assigned with respect to the target value for PaCO₂ during cardiopulmonary bypass (CPB) into 2 groups. In 50 patients the target PaCO₂ was 40 mmHg, measured at a standard electrode temperature of 37°C while in the other 50 patients the target PaCO₂ was 40 mmHg, corrected to the patients nasopharyngeal temperature (lowest value reached: 32±0.5°C). There were no significant differences between groups with regards to cardiac outcome such as appearance of new ‘Q’ waves on the electrocardiogram, postoperative creatinine kinase-MB fraction, systemic vascular resistance (SVR), cardiac index (Cl), need for inotropic or intra-aortic balloon pump support and the length of postoperative ventilation or intensive care unit stay. These findings support the hypothesis that CO₂ management during CPB at moderate hypothermia has no clinically significant effect on cardiac outcome.