bluuebunny/crossref_metadata_2025 huggingface dataset:
Mediating Role of External Shame and Self-compassion in the Relationship Between Peer Victimization and Depression in Adolescents
Authors:   Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran., Yaghoubi Soheila , Birashk Behrooz ,   Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran., Aghebati Asma ,   Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran., Ashouri Ahmad ,   Department of Clinical Psychology, School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran.
Published: July 2021

Objectives: The present study aims to examine the mediating role of external shame and self-compassion in the relationship between peer victimization and depression in adolescents. Methods: This is a descriptive-correlational study. Participants were 300 middle-school students of Shahin Shahr city in Isfahan, Iran (150 girls and 150 boys), who were selected using a multi-stage cluster sampling method. The data collection tools were Multidimensional Peer-Victimization Scale, the Other As Shamer Scale, Self-Compassionate Scale-Short Form, and Mood & Feeling Questionnaire. The collected data were analyzed in SPSS v. 19 and AMOS v. 20 applications. Results: There were significant relationship among peer victimization, external shame, self-compassion, and depression (P<0.01). The measurement model had a good fitness (Root mean square error of approximation=0.037, normed fit index=0.997, comparative fit index=0.999). Path Analysis results reported that peer victimization had indirect effect on depression through mediation by external shame and self-compassion. Conclusion: External shame and self-compassion can mediate the relationship between peer victimization and depression in adolescents. Considering them in designing effective preventive and therapeutic interventions can be helpful for adolescents to cope with peer victimization and depression.
An 8-year-old Boy With Three Failed Suicide Attempts by Hanging: A Case Report
Authors:   Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran., Mozafari Ali‌ Ashraf , Adibi Amir ,   Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran., Shafiei Elham ,   Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran., Sahebi Ali ,   Non-Communicable Diseases Research Center, Ilam University of Medical Sciences, Ilam, Iran.
Published: July 2021

Objectives: Suicidal behavior in children under 10 years of age is a warning and a matter of concern. It can be an important indicator for evaluating the mental health of individuals in the community. Case Report: This study reported an 8-year-old boy who had three failed suicide attempts by hanging. The psychiatric assessment revealed that he had major depressive disorder which had not been diagnosed. Conclusion: Evaluation of his behavior by using the Child Behavior Checklist completed by his parents showed that he had the highest scores in aggressive behavior, attention problems, rule-breaking behavior, and anxious/depressed subscales. Lack of parental attention to meeting the needs and creating a supportive environment may have led to behavioral-emotional disorders and risky behaviors such as suicide in the boy.
Depression, Anxiety, Psychosomatic Symptoms, and Perceived Social Support in Type D and Non-type D Individuals
Authors:   Department of Psychology, Shaheed Benazir Bhutto Women University, Peshawar, Pakistan., Kalsoom Ume , Hanifa Bibi ,   Department of Psychology, Shaheed Benazir Bhutto Women University, Peshawar, Pakistan.
Published: July 2021

Objectives: This study examines depression, anxiety, psychosomatic symptoms, and perceived social support among type D and non-type D individuals. Methods: A total of 300 individuals aged 18 to 40 years were recruited in the investigation. We used the distress personality scale (DS 14), Pakistan anxiety and despondency scale, psychosomatic symptoms, and perceived social support scales to obtain the study data. The study participants were divided into Type D (n=166) and non-Type D individuals (n=134) based on their DS 14 cut-off scores. In this descriptive study, a random cluster sampling technique was utilized to choose the samples. The study was conducted from September to December 2017. Data analysis was performed utilizing independent samples t-test and regression analysis. Results: The recurrence of the Type D personality was 55%. Results indicated a considerable difference between Type D and non-Type D personality on depression, anxiety, and psychosomatic side effects (P < 0.001 for all side effects). The findings also suggest that Type D individuals perceived less social support from family, friends, and significant others. Conclusion: People with type D character qualities show more depression, anxiety, psychosomatic symptoms, and less perceived social support when compared with non-Type D people.
O Estado De Bem-Estar Social E As Políticas Públicas De Saúde Direcionadas Ao Câncer Ginecológico
Authors: Fernandes Ingridy Tayane Gonçalves Pires , Ferreira Márcia Zotti Justo , Magalhães Plinio Regino , Flores Péricles Cristiano Batista , Conceição Keila Martins da , Caetano Solange Aparecida , Leoni Elaine Aparecida , Vieira Valdemir , Frinhani Jamille , Francesco Daniela Simões Silva Di
Published: July 2021

Este estudo propõe-se uma reflexão sobre o estado de bem-estar social e relevância das políticas públicas direcionadas ao câncer ginecológico, aprimorando a assistência ao bem-estar da mulher, que engloba a atenção primária, secundária e terciária no decorrer das fases nos ciclos feminino. Para isso, buscou-se uma interpretação histórica básica sobre o Welfare State apresentando suas principais características, com o objetivo de conceituar as teorias, os períodos e suas fases ao longo dos anos, tanto no exterior como no Brasil, esboçando assim o seu desenvolvimento em questões voltadas às políticas de proteção social, com intuito de maximizar as políticas voltadas a saúde da mulher em oncologia, promovendo dessa forma a qualidade de vida na sua sobrevida. Esta discussão bibliográfica descritiva, teve uma abordagem qualitativa, fundamentando-se em estudos sobre o estado do bem-estar social em conjunto com as ações das instâncias governamentais e organizações sociais, descrevendo sua trajetória histórica desde a década de 30. Buscou-se nesta revisão também evidenciar as dimensões que contribuem para a dignidade da mulher e sua melhoria em qualidade de vida, demonstrando que essas políticas possibilitam sua reabilitação e reinserção em sua vida social.
Analysis of the environmental impact generated by backyard swine production in Tepetlán, Veracruz, Mexico
Authors: Solís-Tejeda Miguel Á. , Lango-Reynoso Fabiola , Castañeda-Chávez María del R. , Ruelas-Monjardin Laura C.
Published: July 2021

Objective: To identify and estimate waste production, water consumption and production practices of backyard swine farms at the municipality of Tepetlán; Veracruz, Mexico, to foresee the possible influences on the environment and generate information that promotes new public environmental policies adapted to small producers.Methodology: 36 backyard livestock production units were identified and studied in Vicente Guerrero and Alto Tío Diego by a census in which structured surveys were applied to obtain data; the results were analyzed by descriptive statistics. The maximum pollutant potential of the load with the installed infrastructure was estimated.Results: We registered 503 swine heads of diverse zootechnical functions, mainly from the Landrace breed, in 36 studied farms, 54.7% of idle infrastructure was identified. We found that about three tons of excreta are produced per day between the towns of Vicente Guerrero and Alto Tío Diego, from which 78% are dumped into the municipal drainage. The average water consumption per unit of livestock production was 132.2 Land for each unit of animal population 28.5 L, with a standard deviation of 32.2 L per animal population unit. This research also provides information on the feeding and production practices of the animals. It was possible to estimate the volume of swine excreta generated in the assessed localities. However, it is necessary to quantify organic matter, nitrogenous products, phosphorus, and total and fecal coliforms.Conclusions: It is important to quantify and regulate the generated waste by this livestock activity, to take corrective and regulatory decisions, to establish solutions that protect natural resources without harming the economy of the small producer.
Defecation rates of white-tailed deer (Odocoileus virginianus) based on fiber content in feces
Authors: Vega-Hernández Dania M. , Clemente-Sánchez Fernando , Crosby-Galván María M. , Bárcena-Gama Ricardo , Olmos-Oropeza Genaro
Published: July 2021

Objective: To develop three models in order to estimate the defecation rate ofwhite-tailed deer (Odocoileus virginianus) according to the season of the year,content of neutral detergent fiber (NDF), and acid detergent fiber (ADF) in feces.Design / methodology / approach: Nine captive adult deer were assigned tothree levels of dietary fiber. Fecal groups (defecation rate) were counted, forageconsumption was estimated, and feces were analyzed for NDF and ADF content. Arandomized block design was used, where the effect of the treatments was blockedby season, and a multiple regression analysis was used to define the predictionmodels of the defecation rates.Results: The rates were different for dietary fiber levels (p<0.0001), and for theyear season (p = 0.0007). For spring, the defecation rate model (DR) was DR = -4.84696 - [0.02159 (NDF)] + [0.58397 (ADF)]; for summer DR = -51.0272 +[0.26868 (NDF)] + [1.61121 (ADF)]; and for winter DR = 7.82939- [0.02667 (NDF)]+ [0.17309 (ADF)].Limitations / implications: Defecation rate or fecal group counting is a useful toolto estimate deer populations. Nevertheless, the definition of an adequatedefecation rate represents a hard task, since it depends on various factors such asthe environmental conditions, and the components of the diet the deer consumes.Findings / conclusions: The defecation rate varies depending on the year seasonand the fiber content in the diet.
Managerial Resourcefulness and Quality Service Delivery: The Place of Information Sharing in Public Sector Organizations
Authors: Ochonogor D. I. , Amah E.
Published: July 2021

Service delivery is a key factor to be taken seriously for organizations that wants to survive and thrive. This study examines the influence of managerial resourcefulness on quality services delivery while assessing the relevance of information sharing in the process. The theory of learned resourcefulness was adopted to serve as an undergirded model in this review. It was concluded that; organizations can make excellence in customer service their hall work of success if they take advantage of the opportunity to have resourceful managers who will not feel discouraged and withdrawn in the face of a challenge, but who are posit to think critically and demonstrate readiness and enthusiasm to turn such situations around in favor of the organization. Therefore, organizational leadership should: Pay active attention to changes, events, and trends in the business environment and take practical steps to adapt to these changes to increase customer traffic to the organization in a seamless manner. Adopt a flexible disposition that allows the organization to modify these changes, events, and trends in the business environment and better understand what can drive the organization to succeed. Allow customers to prioritize change to help management get a better understanding of their expectations and respond sufficiently to improve the user experiences of these customers. Provide a lasting purpose to make informed decisions that will generate greater productivity and boosts organizational growth through effective collaborations. Give room for information sharing to dispense knowledge and competencies that will help in resource utilization, and cost-effective operation to improve service delivery.
Tax Write-Off and Remission on Revenue Mobilization in Wiawso Municipal Assembly of Ghana
Authors: Nkuah Joseph Kofi , Daboug Christopher Bright , Isaac Ampong
Published: July 2021

The maiden budget of the Akufo-Addo administration, presented by the Finance Minister on Thursday, March 2, 2021, saw the downward revision of certain taxes while others were completely abolished. According to Public Finance General Directorate, the purpose of taxation as enshrined in the French laws is “for the maintenance of public force and administrative expenses”. The need therefore to increase internally generated funds have been at the center stage of most developing countries, as Donor Partners insist on ensuring efficiency in tax administration before loans can be granted. Against the backdrop of tax cuts announced in the 2021 budget, this study seeks to evaluate the effect of tax cuts on revenue mobilization in the Wiawso Municipal Assembly of Ghana. The study employed the purposive sampling technique, making use of a population of 50. The result of the study showed that there is a strong negative relationship between tax cuts and revenue mobilization. Hence tax cuts can be assumed to reduce revenue mobilization. It also came to light that non-compliance was the main challenge facing the revenue collectors in the Wiawso Municipality. In the light of the above, the following recommendations were made. Government should support GRA by providing the necessary resources needed by the staff to carry out their daily activities effectively. For instance, the introduction of the taxpayer identification system. Technical training should also be organized regularly for GRA staff in other to help them acquire the necessary technical skills needed to carry out their activities effectively.
The Effect of Brand Value on Consumers' Purchasing Decisions: An Application in Turkey
Authors: Keskin Şerife , Durmaz Yakup
Published: July 2021

The purpose of this research is to determine the relationship between the purchasing decisions of consumers and their brand values depending on the factors that affect their wishes, desires, and needs while purchasing a product. Another purpose of the study is to determine whether the demographics of the participants change the opinions of the participants on purchasing decisions and brand values. In order to collect data 5-Point Likert type Consumer Decision-Making, Brand Loyalty, Perceived Quality, Brand Awareness and Brand Connotations Scales consisting of 22 questions, and 9 dimensions in addition to the Brand Value Scale including 19 items and 4 sub-dimensions were conducted on 400 consumers living in the Diyarbakır province of Turkey. The research is important both for consumers and businesses in terms of explaining how consumers are affected by brand value and make their consumption decisions.
Estimating the Market Power of Traders in the Arabica Coffee Value Chain in Lam Dong, Vietnam
Authors: Tuoi Nguyen Thi , Son Nguyen Phu , Thong Pham Le
Published: July 2021

Although some studies have assessed the market power of advanced degrees in Vietnam’s agricultural sector, this research only focuses on analyzing the level of market concentration through CR4 or HHI indexes. The stochastic cost frontier can estimate market power using the Lerner ratio when input price data are not available and with or without constant returns to scale. Thus, the stochastic cost frontier with a maximum likelihood approach of Kumbhakar et al. (2012) is used to assess the market power of traders in the coffee value chain in Lam Dong province, Vietnam. The estimated market power and Lerner rate results are 0.0001. This index shows that the local coffee market is a market with perfect competition. So the traders do not have market power. Thus, there is no collusion between coffee traders to lower the purchase price for farmers or increase the price for processors and exporters. An RTS ratio of 0.96 (less than one) shows that the return to scale for traders is decreasing. This number proves that the degree of competition in the local coffee market among traders is very high.
The Relation Between Trading Volume Concentration and Stock Returns
Authors: Lo Chen-Chang , Lin Yaling , Kuo Jiann-Lin , Wen Yi Ting
Published: July 2021

The Taiwan Stock Exchange discloses data on daily trading volume across brokerage firms for each listed stock. Market practitioners suggest that the concentration of trading volume contains information on the trading behaviors of big players. We use the Gini Coefficient to measure the degree of concentration, upon which a trading strategy is proposed. We conduct an event study to examine whether such a strategy will yield abnormal returns. Our sample contains 375 listed companies with events identified during the sample period from February 2020 to August 2020. The empirical results show that the trading signal based on the Gini coefficient is informative and that most of the average abnormal returns after the event date are significantly positive with the cumulative average abnormal returns increasing almost monotonically up to the end day of the event window. Consistent with prior studies in which different measures of concentration are utilized, our findings provide additional evidence that the Gini Coefficient could help investors to develop profitable stock selection and market timing strategies.
Does Brexit Have a Bullish or Bearish Effect on the Taiwan Stock Market?
Authors: Yu Jing Long , Lin Tse Mao , Wu Xin Hui
Published: July 2021

Using the event study method to analyze one year of daily trading data of formal and Over-The-Counter (OTC) stocks in Taiwan, this study investigates whether the Brexit referendum led to abnormal returns, as well as the financial characteristics of the stocks, and the influential financial variables. The Taiwan stock market had negative abnormal returns on the day of the Brexit referendum. The high-abnormal return group was more significantly affected than the low-abnormal return group. The book-to-market ratio, price-to-earnings ratio, yield rate, average foreign shareholding ratio, and stocks overbought and oversold had a more significant impact on the low-abnormal return group. Abnormal returns were generated mostly in the OTC (Over-The-Counter) market. This event affected financial stocks more significantly than electronics and information technology stocks. The effects on formal stocks, OTC (Over-The-Counter) stocks, and the overall market were the most significant for the turnover rate and stocks overbought and oversold, yield rate, and turnover rate and book-to-market ratio, respectively. The results confirm that the model of the impact of a special event on the behavioral response in the Taiwan stock market can be used to predict changes in stock market prices when a special event occurs in the future.
A Review on the Methods of Industrial Waste Water Treatment
Authors: M. Nahiun Khandakar , Sarker Bijoyee , N. Keya Kamrun , I. Mahir Fatin , Shahida Shahirin , A. Khan Ruhul
Published: July 2021

Nowadays environmental pollution is a great threat to us. Water resources are mostly polluted by industrial wastes. Among all other pollutions, water pollution is one of the most vital pollution caused by different sources like industrial, domestic, sewage, hazardous waste, municipal waste, medical waste, manufacturing waste, etc. Public concern over the impact of wastewater has increased. There are several methods for the treatment of wastewater. Among them, techniques like coagulation, adsorption, activated sludge are prominent. The use of aerobic wastewater treatment as a reductive medium is receiving attention for its low cost of operation and low cost of maintenance. The uses of low-cost adsorbents are also effective in wastewater treatment. The aerobic wastewater is effective in degrading the contaminants. There are different electrolytic techniques as well for wastewater treatment. This paper reviews the possible techniques available for the treatment of wastewater to remove contaminants such as halogenated hydrocarbon compounds, heavy metals, dyes, pigments etc. from the wastewater.
Surface and Ground Water Pollution: Causes and Effects of Urbanization and Industrialization in South Asia
Authors: Sarker Bijoyee , N. Keya Kamrun , I. Mahir Fatin , M. Nahiun Khandakar , Shahida Shahirin , A. Khan Ruhul
Published: July 2021

Water pollution in South Asia is an alarming issue that has immersed recently. Developing countries, particularly those in South Asia, are fast adopting industrial pollution control standards similar to those in developed countries. So both surface and groundwater are already scarce however, individuals and industries continue to pollute the already limited supply of water. On the other hand, the pollution of rivers is more severe and critical near urban stretches due to huge amounts of pollution load discharged by urban activities. Unplanned urbanization and industrialization occurring in these countries like Bangladesh, India, Nepal and Sri Lanka, etc. may be largely responsible for this grave situation. Therefore these human activities including industrialization and urbanization contributed immensely in no small measure to the degradation and pollution of the environment which adversely has an effect on the water resources such as surface and groundwater that is a necessity for life. This paper tries to discuss basically the causes and effects of urbanization and industrialization in surface and groundwater pollution and equally to address the controlling issues and challenges in South Asia.
Prospects and Challenges of Chrome Tanning: Approach a Greener Technology in Leather Industry
Authors: Ahmed MD. Dipu , Maraz Kazi Madina , Amin Khan Ruhul
Published: July 2021

The leather industry is one of the heavy-polluting and hazardous industries that is creating toxic and harmful effects on the environment and human health by producing waste chemicals, tannery effluents, and various pollutants. Moreover, Tanning is the required stage to convert raw skin to durable and sustainable skin but most of the chemicals, salts, organic and inorganic toxic pollutants are produced. In commercial practices, Chrome tanning is the highly employed approach that uses a large number of basic chromium salts that becomes the major source of chromium pollutant in the environment. Chromium salt is not only harmful to the environment and ecology but also harms the human body such as causing respiratory problems, infertility and birth defects, skin and lung cancer of the workers. This article has presented two alternatives eco-friendly greener approaches of chrome tanning and waste management technique to reduce the toxic effect on the environment and human health. Firstly, to get rid of these harmful effects, the possible remedy of environmental and human health problems may be considered the vegetable tanning process. Vegetable tanning uses tannins (a class of polyphenol astringent chemicals), which occur naturally in the bark and leaves of many plants. Secondly, chrome tanning associate with ultrasound having a frequency range of 20–100 kHz is commonly employed for enhancing the physical processes and for performing chemical reactions. The basic principle associated with the process is an ultrasonic cavitation in dissolved media. Ultrasound decreases the consumption of conventional water and chemicals because it can also function as a physical activator resulting reduction in environmental pollution which is a prime concern nowadays to approach greener leather technology and eco-friendly leather processing. Furthermore, the possible waste management technique of chrome tanning helps to prevent pollution and ensure eco-friendly green technology of leather processing. Therefore, vegetable tanning and chrome tanning associated with ultrasound having proper waste management will be the viable and sustainable options for the tanners in the forthcoming future.
Contextualizing a Maya Collection from Alta Verapaz, Guatemala, at the University of Ghent, Belgium
Authors: Montoya Julia
Published: July 2021

The aim of the present study is to contextualize a collection of Maya artifacts that have been kept for 125 years at the University of Ghent, in Belgium. The objects came from one of the first archaeological excavations carried out in Guatemala, between 1880 and 1900. The collection includes 130 pottery pieces, 64 jadeite pieces, 24 stone objects (serpentine, silex, and other stones), and 52 obsidian pieces. The study started in 2016, with the identification and location of the provenance site, which was visited in 2017. The phases of documentation and photographic registration of the objects were completed in 2019. It is the intention to digitize the collection and make it available to scholars for further research. This report presents a brief description of the site, Chich’en, and analyzes aspects of its geographical environment, as well as the historical and religious context that determined its relevance from the Classic period to the Late Postclassic and the early colonial period. A selection of the objects is presented, and outstanding iconographic elements are analyzed. The analysis is based on a bibliography review in the fields of archaeology, history, and ethnology in the Maya region and in Mesoamerica in general.

It is extraordinary to find an extensive collection of Maya archaeological artifacts in the reserves of a university museum, and a privilege to study them. These artifacts hold a wealth of information about the archaeological site Chich’en, where they were excavated 126 years ago. They enlighten the role of this site in the history of Verapaz (ancient Tezulutlán), strategically situated between the Northern Highlands and the Lowlands of Guatemala. Little is known about the history of this region. We are fortunate to lean on the research carried out by countless scholars in various disciplines to guide us in our search for answers to the many questions. Making this collection accessible for collaborative study should ensure that this cultural heritage will not remain silent nor stay forgotten.
Options of the placental dysfunction correction in women with preeclampsia
Authors: Karimov A.Kh. , Davlietova D.M.
Published: July 2021

Background. Placental dysfunction (PD) is one of the most common complications of pregnancy, which has not only medical but also social significance. The links of the PD pathogenesis include endothelial dysfunction, hemodynamic disorders of the placental vessels, disorders of arterial and venous blood flow in the placenta.

Objective. To study diagnostic methods and possibilities of PD correction in women with preeclampsia (PE).

Materials and methods. The study involved 68 women with PE in the II and III trimesters of pregnancy, treated at the multidisciplinary clinic of the Tashkent Medical Academy during 2017-2019. Patients underwent standard clinical, laboratory and instrumental examination with color Doppler mapping of vessels of the uterine-placental-fetal system and ultrasound evaluation of the fetoplacental system.

Results and discussion. Premature aging of the placenta was found in 77.3 % of cases, turbid amniotic fluid – in 59.09 %, oligohydramnion – in 27.3 %. Disorders of uteroplacental blood flow were detected in 28.3 % of cases, placentofetal blood flow – in 26.7 %. Impaired blood flow at both levels without critical values occurred in 10 % of pregnant women. In case of insufficiency of a blood circulation of 2nd grade the syndrome of fetal growth restriction was observed in 16,7 % of cases. Compensated forms of PD were subject to the comprehensive treatment with the addition of infusions of L-arginine (Tivortin, “Yuria-Pharm”) in the inpatient phase and oral administration of Tivortin aspartate in the outpatient phase. The length of the fetal thigh in the group of L-arginine at the beginning of treatment was 47.33 mm, which was by 9.04 % less than this parameter in physiological pregnancy. After treatment with Tivortin, in the full-term period, no significant difference was found. In pregnant women who received L-arginine at 25-29 weeks of pregnancy, after 2 weeks, the resistance indices (RI) of the umbilical artery and uterine artery decreased from 0.68±0.09 to 0.58±0.05 and from 0,58±0.16 to 0.43±0.08, respectively. The RI of the middle cerebral artery increased from 1.05±0.23 to 1.27±0.19. Parameters of RI dynamics indicate that the early treatment with Tivortin is more effective than late.

Conclusions. 1. Regardless of the presence of fetal growth restriction syndrome in women with disorders of uterine-placental-fetal circulation, it is advisable to include L-arginine in the treatment to prevent this condition. 2. Ultrasound examination is a reliable method for evaluating the effectiveness of PD treatment.
2020 challenge: the potential options of COVID-19 therapy
Authors: Kovalenko S.V.
Published: July 2021

Background. Coronavirus disease (COVID-19) is a new disease, and there is no vaccine, specific drugs and treatment protocols. In 15-20 % of patients the course is severe course, and 4 % of cases are fatal. 15 % of adults infected with the SARS-CoV-2 coronavirus develop pneumonia. In 5 % pneumonia progresses to a critically severe condition with the development of respiratory failure and acute respiratory distress syndrome.

Objective. To describe the potential options of COVID-19 therapy.

Materials and methods. Analysis of literature sources on this topic and the own clinical study, which involved 60 patients with COVID-19 (main and control groups, standardized by age and sex). In the control group, standard treatment was prescribed, and in the main group – basic therapy and Ksavron tid, Tivorel once a day and Reosorbilact once a day (all medications – by “Yuria-Pharm”).

Results and discussion. Antiviral drugs (nelfinavir, remdesivir, favipiravir), recombinant human monoclonal antibodies to interleukin-6 receptors tocilizumab, and chloroquine-related drugs (sometimes in combination with azithromycin) are used for COVID-19 pharmacotherapy. Usage of edaravone (Ksavron) to inhibit the cytokine storm and of Reosorbilact to reduce the incidence of pulmonary complications, the duration of mechanical ventilation, and the volume of infusions has a great potential. The use of the latter is especially appropriate under the conditions of restrictive infusion regimen. In addition, L-arginine and L-carnitine (Tivorel) can be used. L-arginine reduces spasm of smooth bronchial muscles and improves the vasomotor function of the pulmonary endothelium. L-carnitine has anti-inflammatory and immunomodulatory effects. The own study found out that the level of C-reactive protein in the main group (standard therapy + Ksavron, Tivorel and Reosorbilact) has decreased from 39.45 to 7.5 mg/L, and in the control group – from 46.26 to 12.50 mg/L, indicating a more pronounced reduction of inflammation in the main group. In addition, the content of D-dimer and ferritin decreased more markedly in the main group (by 24.1 % and 27.1 % respectively). The additional pathogenetic treatment listed above helped to improve blood oxygen saturation, reduce the number of leukocytes and decrease the length of hospital stay.

Conclusions. 1. Antiviral drugs, tocilizumab, chloroquine-related drugs, and azithromycin are used to treat COVID-19. 2. Potential treatment options include the usage of Ksavron, Reosorbilact and Tivorel. 3. According to own research, the inclusion of these drugs into the combined therapy reduces the activity of the inflammatory process in the lungs and counteracts the tendency to thrombosis.
Experience in the open multicenter randomized controlled trial of Rheo-STAT on the efficacy and safety of Reosorbilact in patients with sepsis
Authors: Cojocaru V.I.
Published: July 2021

Background. Elimination of intoxication syndrome is one of the main components of sepsis treatment. The Rheo-STAT study is an interventional open multicenter randomized controlled trial of the efficacy of Reosorbilact (“Yuria-Pharm”) in the treatment of intoxication syndrome. The study was conducted in 7 countries, patients of the sepsis subgroup were recruited in 5 of them (Ukraine, Moldova, Georgia, Kazakhstan, Uzbekistan).

Objective. To determine the efficacy and safety of Reosorbilact in patients with sepsis.

Materials and methods. The study involved 628 adult patients with sepsis, peritonitis, pneumonia and burns. The subgroup of sepsis consisted of 180 people (72 % males, mean age – 41.3 years), the most common comorbidities were cardiovascular diseases (24 %), diabetes mellitus (15 %), and infectious diseases (8 %). The inclusion criteria were the following: age 18-60 years, diagnosis of sepsis, established by the ACCP/SCCM criteria ≤24 hours before the initial visit, obtaining of the informed consent, baseline SOFA scale value ≥2. The primary endpoint was the total score on the SOFA scale on the 3rd day of treatment compared to the baseline value. The secondary endpoints included the change in the overall score according to the APACHE II, SAPS II, MODS, PSI/PORT, CURB-65 scales; changes in biochemical, immunological and integral markers of endogenous intoxication.

Results and discussion. Low-volume infusion therapy with Reosorbilact (200-400 ml per day) resulted in an increase in circulating blood volume and a decrease in the total volume of infusions required without the risk of volume overload, which is especially important for critically ill patients. Exogenous lactate in Reosorbilact did not increase the content of endogenous lactate (1st day – 2.27 mmol/L, 3rd day – 1.63 mmol/L), which indicates the high safety of the solution. In the complex of intensive care administration of Reosorbilact helped to reduce hyperthermia (1st day – 38.2 °C, 3rd day – 36.8 °C, p<0.001), heart rate (1st day – 95.43 beats/min, 3rd day – 81.13 beats/min, p<0.001) and the number of leukocytes (1st day – 14.5×109/L, 3rd day – 8.8×109/L) as a marker of endogenous intoxication. During 3 days of therapy Reosorbilact also normalized the acid-base composition of the blood.

Conclusions. 1. Elimination of intoxication syndrome is one of the main components of sepsis treatment. 2. Reosorbilact infusion therapy increases the volume of circulating blood without the risk of volume overload. 3. The inclusion of Reosorbilact in the complex treatment of sepsis after 3 days provides a decrease in body temperature, heart rate, white blood cell count and normalization of the acid-base composition of the blood.
Diabetic foot: diabetic ulcer care
Authors: Bolgarska S.V.
Published: July 2021

Background. Diabetic foot syndrome (DFS) is the presence of an infection and/or ulcer defect of the foot associated with neuropathy and circulatory disorders of the lower extremities of varying severity. Insensitivity of the foot, its deformation and constant load lead to the formation of necrosis under hyperkeratosis with the potential infectious process development.

Objective. To describe the features of the course and treatment of DFS.

Materials and methods. Analysis of literature data on this issue.

Results and discussion. Classification of diabetic ulcers is carried out according to the PEDIS system, where P means perfusion, E – extent, D – depth, I – infection, S – sensation. To assess the circulatory status of the lower extremities, the ankle-brachial index (ABI) and transcutaneous oxygen tension are determined. Critical ischemia is determined by the following criteria: tibial systolic blood pressure <50 mm Hg, big toe blood pressure <30 mm Hg, or transcutaneous oxygen tension <30 mm Hg, or ABI <0.5. DFS treatment involves unloading the foot with the help of special shoes or orthoses, ultrasonic or vacuum cavitation of wounds, surgery, antibiotic therapy. If necessary, anti-pseudomonad antibiotics should be used (ceftazidime, cefoperazone, cefepime, imipenem, meropenem, ciprofloxacin, amikacin). 95 % of the microorganisms present in the world are able to coexist in the form of biofilms – communities of microorganisms in a matrix of polymers (mucopolysaccharides), which are released by the same bacteria. Taking this into account, one should choose antibiotics that can penetrate biofilms. Diabetic ulcers should be covered with dressings such as Hydroclean plus, which contain an antiseptic that protects the wound from secondary infection, prevents excessive evaporation of moisture and has an atraumatic contact layer that prevents traumatization of the young granulation tissue. This dressing continuously releases Ringer’s solution into the wound and absorbs the wound exudate, creating a continuous washing effect. Lacerta (“Yuria-Pharm”) can be used to stimulate the regeneration of long-term defects of connective tissues. Lacerta activates the migration and proliferation of fibroblasts, accelerates their metabolic activity, and enhances angiogenesis. Other methods of accelerating of the wound healing include the use of cryopreserved amniotic membranes and the injection of stem cells.

Conclusions. 1. DFS is the presence of an infection and/or ulcerative defect of the foot associated with neuropathy and circulatory disorders of the lower extremities. 2. Classification of diabetic ulcers is carried out according to the PEDIS system. 3. Treatment of DFS involves unloading the foot with special shoes or orthoses, ultrasonic or vacuum cavitation of wounds, antibiotic therapy, surgery. 4. It is advisable to cover diabetic ulcers with hydrogel bandages. 5. Lacerta can be used to stimulate the regeneration of persistent skin defects.
Perioperative anesthesia
Authors: Lisnyi І.І.
Published: July 2021

Background. Ensuring adequate analgesia is a prerequisite for rapid recovery after surgery. Improving the management of acute pain is important to ensure the safe and effective analgesia needed for early mobilization and for avoidance of organ dysfunction due to inadequate analgesia. For this purpose, multimodal analgesia (MMA) is used. It includes opioid analgesics, nonsteroidal anti-inflammatory drugs (NSAID), paracetamol or metamizole, local anesthetics and ancillary drugs.

Objective. To describe modern views on perioperative analgesia.

Materials and methods. Analysis of literature data on this issue.

Results and discussion. MMA involves an opioid-preserving approach (reducing the dose of opioids without reducing the quality of analgesia), procedure and patient specificity. The postoperative recovery improvement program includes several items, three of which have been associated with a reduction in treatment duration, namely, multimodal prevention of postoperative nausea and vomiting, perioperative NSAID use, and post-operative opioid protocol. The combined use of NSAID and paracetamol provides a better result than the use of each of these drugs alone. At the correct dose, paracetamol (Infulgan, “Yuria-Pharm”) is an effective non-opioid analgesic for the treatment of acute pain with minimal side effects for a long time. Pre- and intraoperative administration of paracetamol is recommended in a number of guidelines. Intravenous administration of local anesthetics is an another important component of MMA. The 2016 Cochrane review showed that long-term intravenous perioperative infusion of lidocaine significantly reduced the postoperative need for opioids. However, the meta-analysis of 10 randomized controlled trials found that perioperative intravenous lidocaine did not differ from placebo in post-operative pain assessed with the help of a visual analog scale and in opioid requirements (Rollins K.E., 2020). Similar results have been obtained in other studies in recent years. Inclusion of nefopam in MMA can reduce the dose of opioids. The use of nefopam, paracetamol and deksketoprofen makes it possible to dramatically reduce the use of morphine. Neither pain nor postoperative recovery can be adequately controlled with a single treatment due to the multifactorial nature of the problem. It is recommended to use MMA, but there are no recommendations for optimal combinations of analgesics for specific procedures. Administration of paracetamol and NSAID in combination with the use of regional techniques is a golden standard of MMA.

Conclusions. 1. After the surgery, the patient should be adequately anesthetized. 2. To achieve optimal, preferably non-opioid, analgesia, it is recommended to use MMA. 3. NSAID, paracetamol, nefopam and regional techniques are the important components of MMA.
Neuroinvasion and neurological complications in COVID-19
Authors: Loskutov O.A.
Published: July 2021

Background. Coronavirus disease (COVID-19) affects not only the alveoli but also the central nervous system. The pathogenesis of neurological complications of COVID-19 is based on the receptor damage, cytokine-mediated injury, damage of the nervous system due to hypoxia, and neuronal damage due to the retrograde transport of the virus through nerve fibers.

Objective. To determine the mechanisms of coronavirus neuroinvasion and treatment of neurological complications COVID-19.

Materials and methods. Analysis of literature sources and own research on this topic.

Results and discussion. In 3 days after infection viral antigens are detected in the olfactory sensory neurons of the nasal cavity epithelium, which confirms the transnasal invasion of coronaviruses. According to various authors, 36.4-84 % of patients with COVID-19 have neurological manifestations. In general, neurological symptoms of COVID-19 can be divided into three categories: symptoms of the central nervous system disorders (headache, dizziness, consciousness disorders, nausea and vomiting, ataxia, acute cerebrovascular disease, and epilepsy), symptoms of the peripheral nervous system disorders (hypogeusia, hyposmia, hypopsia, and neuralgia) and musculoskeletal symptoms. As viral infections cause cytokine storm, inflammation and hyperactive oxidation, it is advisable to use antioxidants in their treatment. According to the Japanese clinical guidelines for the treatment of acute respiratory distress syndrome, edaravone may be used as a free radical scavenger in such patients. In the experiment, edaravone reduced the area of infarction and promoted functional recovery in cerebral thrombosis. Other properties of edaravone include the prevention of excessive permeability of the pulmonary vessels’ endothelium. Own research has shown that edaravone (Ksavron, “Yuria-Pharm”) reduces the severity of inflammation and mortality in patients with COVID-19. In the control group, the level of the proinflammatory mediator interleukin-6 exceeded the upper limit of normal values by 1652.40 %, and in the Ksavron group – only by 269.97 %. Mortality in the control group was 14.3 %, and in the Ksavron group – 0 %.

Conclusions. 1. Coronaviruses affect not only the lungs but also the nervous system. 2. Neurological symptoms of COVID-19 include headache, dizziness, consciousness disorders, nausea and vomiting, ataxia, acute cerebrovascular disease, hypogeusia, hyposmia, hypopsia, neuralgia, and musculoskeletal symptoms. 3. Edaravone (Ksavron) reduces the severity of inflammation and has an antioxidant effect, which justifies its use in COVID-19.
Presentation of European Society of Oncology Pharmacy: the need in standartization of modern oncology / oncology pharmacy (QUAPOS)
Authors: Meier K.
Published: July 2021

Background. Ljubljana declaration (2006) states that the close cooperation between oncologists and oncopharmacologists is vitally important to provide an optimal medical care. Multiprofessional approach allows to increase the cost-effectiveness of treatment and to make it safer.

Objective. To prove the importance of the multiprofessional approach and cooperation of various specialists in the oncology field.

Materials and methods. Analysis of the literature data on this topic.

Results and discussion. According to the questionnaires’ results, 59 % of the respondents want to receive information about drugs and their side effects from the pharmacist. It explains the importance of creation of European Society of Oncology Pharmacology (ESOP), which at the moment includes 63 countries. Key principles of ESOP are the compliance to the standards of treatment quality, continuous professional growth and multiprofessional collaboration. Tasks of ESOP include the increase of the compliance to the oral drugs for cancer treatment, the struggle with the lack of drugs in all the world and the providing safety for patients and healthcare workers, which works with cytotoxic drugs (CTD). According to the data of different authors, low adherence can be predicted by the depression and cognitive disorders, side effects of drugs, asymptomatic disease course, difficult and expensive treatment, unsatisfactory control of treatment, etc. Talking about lack of drugs, since 2000s their frequency has increased. Even the drugs, which are included in the List of the Essential Medicines, are not available in every country, that’s why doctors have to change treatment regimens, interchange drugs, decrease the doses and postpone treatment. Struggle to fight the environmental pollution by CTD is one more task of ESOP. Studies have revealed that the most polluted surfaces in hospitals include working surfaces, floors, counters, drug fridge doors. In general, such characteristics as patient-centricity, multidisciplinary and multiprofessional approach, general coordination of treatment process, defined responsibilities, strict treatment protocols, continuous education of medical stuff, and advanced information systems are the most important for high-quality medical care. ESOP also focuses on the increase of pharmacist’s influence, that’s why this organization provides specialized webinars, trainings and workshops in oncology pharmacy field.

Conclusions. 1. High-quality of medical care in cancer needs a pharmacist involvement. 2. Key principles of the ESOP include the compliance to the standards of treatment quality, continuous professional growth and multiprofessional collaboration. 3. Tasks of ESOP include the increase of the compliance to the oral drugs for cancer treatment, the struggle with the lack of drugs in all the world and the providing safety for patients and healthcare workers.