Catalina Research Institute

La baja motivación y participación estudiantil en matemáticas constituye una problemática persistente en la educación básica contemporánea. Esta investigación analizó la efectividad del modelo de clase invertida como estrategia pedagógica para potenciar la motivación y participación estudiantil en el aprendizaje de matemáticas durante la educación básica mediante una revisión sistemática de la literatura científica. Se implementó un diseño cualitativo fundamentado en análisis bibliográfico sistemático, empleando el protocolo PRISMA para la identificación, selección y análisis de fuentes. La búsqueda se realizó en múltiples bases de datos académicas utilizando términos descriptivos en español e inglés, aplicando criterios de inclusión y exclusión específicos que resultaron en fuentes primarias para análisis en profundidad. Los resultados evidenciaron mejoras significativas en motivación y participación estudiantil, siendo la participación digital y la motivación intrínseca de las dimensiones con incrementos más sustanciales. Las competencias digitales docentes y el acceso tecnológico emergieron como factores críticos de éxito, mientras que la sobrecarga laboral docente constituyó la principal limitación identificada. El modelo de clase invertida demuestra efectividad consistente para transformar las dinámicas tradicionales del aula hacia construcción activa del aprendizaje matemático, requiriendo implementaciones sistémicas que consideren factores contextuales específicos para garantizar resultados equitativos y sostenibles.

The ‘kambô’ ritual involves application of Phyllomedusa Bicolor poison to superficial burns made on the user’s skin. Existing kambô literature describes case reports of severe harms. The objective of the current study was to better characterize typical observed responses to kambô administration. We performed a retrospective review of a kambô practitioner’s practice. Statistical analysis was descriptive, and characterized the number of kambô points or location of points administered as well as physical responses such as facial swelling, diaphoresis, immediate bowel movement, syncope, and occurrence of emesis. There were 147 unique participants that underwent 241 kambô rituals included. The mean number of points administered was 4.2 ± 2.2, while the median was 3 (range 1–11). Common physical responses included facial swelling (70.5%), diaphoresis (53.3%), bowel movement (45.2%), and syncope (10.4%). Higher number of points administered and receiving kambô at multiple locations appeared to increase facial swelling and diaphoresis. Responses to kambô are likely to be dose-dependent. No severe adverse effects were recorded in the sample, although some responses or components of the kambô ritual may promote risks of harm due to hyponatremia, asphyxiation from emesis, and injury due to syncope.

NAFLD is characterized by insulin resistance and dysregulated lipid and glucose metabolism. Saroglitazar, a dual peroxisome proliferator activated receptor-α/γ agonist, improves insulin sensitivity, and lipid and glycemic parameters. Saroglitazar improved NASH histology in animal studies. In this randomized controlled clinical trial, we evaluated the efficacy and safety of saroglitazar in patients with NAFLD/NASH. A total of 106 patients with NAFLD/NASH with alanine aminotransferase (ALT)≥50U/L at baseline and body mass index ≥25kg/m2 were randomized in a 1:1:1:1 ratio to receive placebo or saroglitazar 1mg, 2mg, or 4mg for 16weeks. The primary efficacy endpoint was percentage change from baseline in ALT levels at week 16. Liver fat content (LFC) was assessed by MRI proton density fat fraction. The least-squares mean percent change from baseline in ALT at week 16 was -25.5% (5.8), -27.7% (5.9), and -45.8% (5.7), with saroglitazar 1mg, 2mg, and 4mg, respectively, versus 3.4% (5.6) in placebo (P<0.001 for all). Compared with placebo, saroglitazar 4mg improved LFC (4.1% [5.9] vs. -19.7% [5.6]), adiponectin (-0.3μg/mL [0.3] vs. 1.3μg/mL [0.3]), homeostatic model assessment-insulin resistance (-1.3 [1.8] vs. -6.3 [1.7]), and triglycerides (-5.3mg/dL [10.7] vs. -68.7mg/dL [10.3]) (P<0.05 for all). Saroglitazar 4mg also improved lipoprotein particle composition and size and reduced lipotoxic lipid species. Saroglitazar was well-tolerated. A mean weight gain of 1.5kg was observed with saroglitazar 4mg versus 0.3kg with placebo (P=0.27). Saroglitazar 4mg significantly improved ALT, LFC, insulin resistance, and atherogenic dyslipidemia in participants with NAFLD/NASH. (ClinicalTrials.gov identifier: NCT03061721.).

This research investigated the parents and learners’ perceptions on modular distance learning that they are experiencing during this time of pandemic as part contemporary new normal education setup. The main purpose of this study was to understand parents’ and learners’ perceptions on modular distance learning as contemporary teaching strategy and how they coped with the experiences and challenges of the new normal education settings. The participants of this study where five (5) senior high school learners and five (5) parents/guardians of senior high school learners of Sta. Catalina Integrated National High School. The research was conducted in Majayjay District from School Year 2020-2021. This study used Qualitative Research through Descriptive research where in-depth interviewing and storytelling was done to gather the narratives or accounts of the research participants. Using an interview protocol and with a strong collaboration with the participants, the researcher will manage all the fieldwork and ensured the depth and breadth of the study. Through the analysis of the data from the interview, the Perception of Parents and Learners on Modular Distance learning as contemporary teaching strategy shows effectiveness even facing different challenges and disadvantage

IN BRIEF Glucose variability is a potential independent risk factor of poor clinical outcome among people with diabetes, with adequate measurement technically difficult and cumbersome. For this study, a novel 14-day continuous sensor was used to assess glucose variability among people with type 2 diabetes (T2D). The aim was to characterize glucose profiles for up to 2 weeks in T2D and to survey device utilization in a standard clinical setting and its potential to collect clinically meaningful data.

Mrs. B was a 68-year-old, Asian-American woman with a 15-year history of type 2 diabetes. Her coexisting medical conditions included unilateral intraductal carcinoma of the breast, which was treated with a modified radical mastectomy 6 years ago and showed no evidence of recurrence. Although there was no history of alcohol use, her liver function studies had been elevated to two times the upper limit of normal for several years. A liver biopsy revealed the presence of nonalcoholic steatohepatitis (NASH). She was admitted to the hospital on one occasion within the past year for bleeding esophageal varices. Mrs. B had no history of macrovascular disease, chronic kidney disease, retinopathy, or neuropathy. For the past 10 years, she had taken 10 mg glyburide daily. Her primary care provider (PCP) was concerned that her A1C had increased from 7.4 to 7.9% in the past 6 months. Her family members stated that they rarely spoke about diabetes, self-monitoring of blood glucose (SMBG), or diabetes-related complications. In fact, the patient's 72-year-old husband also has type 2 diabetes and is undergoing dialysis. In the past year, Mr. B has had at least two episodes of severe hypoglycemia that required hospitalization. He blames his end-stage renal disease on medication he is taking to control his blood glucose levels. Because of concerns about Mrs. B's increasing A1C, her PCP asked her to consult with a local endocrinologist who added basal insulin to her diabetes treatment regimen. She was not provided with any specific instructions about how to inject the basal insulin or when to perform SMBG. Her son noted that she tended to get “confused,” but he did not attribute this to her blood glucose level because he never saw her checking her glucose. Her handwritten glucose log showed several readings in the low 50 to 60 mg/dl …

Diabetes management is firmly based within the primary care community. Landmark randomized, controlled trials have demonstrated that even modest reductions in glycated hemoglobin (HbA1c) can yield improvements in economic and medical end-points. Diabetes is a chronic, progressive disease associated with loss of pancreatic β-cell function. Therefore, most patients will eventually require insulin therapies in order to achieve their individualized targeted HbA1c as their β-cell function and mass wanes. Although clinicians understand the importance of early insulin initiation, there is little agreement as to when to introduce insulin as a therapeutic option. Once initiated, questions remain as to whether to allow the patients to self-titrate their dose or whether the dosing should be tightly regulated by the clinician. Physicians have many evidence-based basal insulin protocols from which to choose, all of which have been shown to drive HbA1c levels to the American Diabetes Association target of ≤7%. This article will discuss ways by which insulin therapies can be effectively introduced to patients within busy primary care practices. Published evidence-based basal insulin protocols will be evaluated for safety and efficacy.

To assess safety and clinical outcomes in patients with inflammatory arthritis after intraarticular (IA) injection of rAAV2-TNFR:Fc, a recombinant adeno-associated viral vector containing the human tumor necrosis factor (TNF) receptor-immunoglobulin (IgG1) Fc fusion (TNFR:Fc) gene. In this phase 1/2 randomized study, adults with persistent moderate or severe inflammation in a target joint, being treated with or without systemic anti-TNF therapy, received a single IA injection of either rAAV2-TNFR:Fc (1 x 10(11), 1 x 10(12), or 1 x 10(13) DNase-resistant particles/ml joint volume) or placebo, followed by open-label rAAV2-TNFR:Fc 12-30 weeks later, depending on when the target joint met predetermined criteria for reinjection. 127 subjects received the first injection of blinded study drug; 95 subjects received open-label rAAV2-TNFR:Fc. Administration site reactions, consisting of transient mild to moderate increases in tenderness and swelling of the injected joint, occurred after 23/191 (12%) rAAV2-TNFR:Fc injections and were dose-dependent. Rates of other adverse events were not dose-dependent. Notable serious adverse events (SAE) included culture-negative septic arthritis in a subject receiving leflunomide and fatal disseminated histoplasmosis considered unrelated to rAAV2-TNFR:Fc in a subject receiving adalimumab. In the phase 2 portion of the study, a 30% decrease in target joint global visual analog scale was observed in 21/50 (42%) rAAV2-TNFR:Fc subjects and 3/16 (19%) placebo subjects 12 weeks after first injection (p = 0.14). IA rAAV2-TNFR:Fc resulted in administration site reactions after 12% of injections. A fatal SAE, disseminated histoplasmosis, was considered not related to study agent. Patient-reported outcome measures of clinical response showed greater improvement in treated patients than placebo patients.