bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of treatment of moderate ulcerative colitis with prolonged mesalazine in real clinical practice
Authors: Knyazev O. V. , Kagramanova A. V. , Lishchinskaya A. A.
Published: October 2021

Introduction.Ulcerative colitis (UC) is one of the severe therapeutic diseases. High doses of oral granular mesalazine are required to maintain clinical and endoscopic remission of UC, which may be sufficient and supposedly more acceptable for patients, as some studies showed that adherence to topical therapy is significantly lower than to oral 5-ASA drugs.

Objective of the study. To evaluate the efficacy of therapy of patients with moderate left-sided ulcerative colitis (UC) and pancolitis receiving prolonged-release ethylcellulose-coated mesalazine.

Materials and methods. The evaluation of the outcomes of treatment of UC patients who received prolonged-release mesalazine was carried out. We examined 87 patients with UC who received granular ethylcellulose-coated mesalazine, of those 38 (43.7%) men and 49 (56.3%) women. The average age of the enrolled patients was 38.3 ± 12.6 years.

Results and discussion. After 2 weeks from the beginning of therapy with prolonged-release mesalazine, the majority of patients – 71 (81.6%) responded to the therapy. After 12 weeks, 71 (81.6%) of 87 UC patients, who responded to therapy with prolongedrelease mesalazine, remained in clinical remission. On average, the Mayo score in the group decreased from 7.6 ± 0.99 to 2.6 ± 0.25 points. There was a significant decrease in CRP, ESR, leukocytosis, and fecal calprotectin. After 26 weeks, Mayo score in the group of patients remained on average at the level of 2.2–2.3 points. The number of UC patients with colon mucosal healing was 32 (36.8%) patients. A year after the start of therapy with prolonged-release mesalazine, 69 (79.3%) UC patients who responded to therapy had a clinical remission, of those 32 (36.8%) patients had a clinical and endoscopic remission. During the year of observation, no case of surgical intervention or re-hospitalization due to exacerbation of the disease was recorded in patients with UC who achieved remission.

Conclusions.Treatment of moderate active UC should begin with oral mesalazine ≥ 3 g per day in combination with topical mesalazine. The prolonged-release mesalazines are the most preferred
Clinical-pharmacological aspects of the choice of phytocomponents for the regulation of the gastrointestinal function
Authors: Shikh E. V. , Rykova S. M. , Shikh N. V.
Published: October 2021

The presentations of dyspepsia include a range of clinical symptoms, each of which has different mechanisms of development, and, therefore, requires different approaches to the correction. In this context, the combination preparations containing components of natural origin with polymodal action on the gastrointestinal tract deserve special attention. Combination of synergistic components: highly bioavailable curcumin and prebiotic fibers; artichoke leaf extract and chamomile flower extract provide simultaneous effects on three key digestive organs: stomach, pancreas and liver. Curcumin has an anti-inflammatory effect, helps to normalize acidity and restore microflora; epithelialization of ulcers; normalization of the gallbladder function; elimination of toxins. It inhibits the processes of primary tumour formation and prevents the development of metastatic processes in gastrointestinal cancer. Pharmaceutical technologies using cyclodextrin as an excipient increase curcumin’s water solubility, dispersibility and absorption, which has been confirmed in several comparative bioavailability studies in healthy volunteers. Chamomile flower extract has anti-inflammatory, antimicrobial, antispasmodic, antiulcer, wound healing and astringent effects. Chamomile is rich in slimy substances that envelop and protect the inflamed mucous membrane, including the stomach, from irritation with hydrochloric acid, bile components, food, and drugs. Mucous substances also have an anti-inflammatory effect and improve digestion. The artichoke facilitates the outflow of bile, affects the secretion of gastric glands, pancreas, increases the enzymatic activity of gastric juice, enhances intestinal motility during its atony, and has a hepatoprotective effect. As can be seen from the above, a combination of these synergistic components can be used in patients with chronic diseases, functional disorders as part of combination therapy, as well as for the prevention of gastrointestinal diseases in healthy people.
Gastritis and dyspepsia: 2 names of one problem? Relations between predominant symptom and syndromal characteristics of upper GI disorders: results of a survey of physicians
Authors: Bakulina N. V. , Oganesova I. A. , Topalova Yu. G. , Bakulin I. G.
Published: October 2021

Introduction. Chronic gastritis is one of the most common problems in gastroenterology and general medical practice. In this study, we tried to analyze the actions of therapists in relation to patients with symptoms of dyspepsia, to assess how different symptom complex affects the choice of therapy and the diagnostics.

Aim. Identifying the process of a preliminary diagnosis by symptoms, determining the ability of physicians to differentiate clinical syndromes, and determining the approaches to empirical therapy at first visit and following the “test and treat” strategy aimed at identifying the H. pylori infection.

Materials and methods. The study was conducted using the CAWI (Computer-assisted Web Interview) method. Each physician who agreed to participate in the study received a link to take the survey and independently entered the answers to the questions formulated by the researcher. The descriptions of three profiles of adult patients with suspected gastritis diagnosis who applied for the first time were suggested: 1) a patient with a pain syndrome and dyspepsia symptoms; 2) a patient with dyspepsia symptoms; 3) a patient with a pain syndrome.

Results. The study involved 205 physicians from 33 cities of Russia. The most commonly assumed diagnosis was gastritis: 50% of responders suggested it for patient 1, 51% – for patient 2, and 40% – for patient 3. Despite the unambiguous description of the delayed motility symptoms in patients 1 and 2, the most commonly assumed diagnoses did not reflect the presence of a problem. At the same time, physicians did not conduct diagnostic tests for H. pylori infection in case of patients 1 and 3 with obvious symptoms of gastritis. In case of infection, physicians suggest prescribing eradication drugs to each patient, and the most popular pharmacological group suggested were PPIs (91%). However, every tenth physician suggested eradication without PPIs.

Conclusion. The results of the survey indicate a lack of awareness among therapists about the symptoms of delayed motility. This leads to the symptomatic pharmacotherapy, which does not provide the rupture of pathogenetic mechanisms
Modern approaches to pharmacotherapy of chronic gastritis
Authors: Skvortsov V. V. , Zaklyakova L. V. , Levitan B. N. , Bolgova M. Yu. , Zaklyakov I. K. , Golieva E. A.
Published: October 2021

The definition of gastritis is based on the histological features of the gastric mucosa. This is not the erythema observed during gastroscopy, and there are no specific clinical manifestations or symptoms that determine it. The modern classification of gastritis is based on time (acute and chronic), histological features, anatomical distribution and the main pathological mechanisms. Acute gastritis will develop into chronic if left untreated. Helicobacter pylori (H. pylori) is the most common cause of gastritis worldwide. However, from 60 to 70% H. pylori-negative subjects with functional dyspepsia or non-erosive gastroesophageal reflux were also found to have gastritis. H. pylori-negative gastritis is considered when a person meets all four of these criteria: negative triple staining of biopsies of the gastric mucosa, no history of treatment of H. pylori. In these patients, the cause of gastritis may be associated with tobacco smoking, alcohol consumption and / or the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or steroids. Other causes of gastritis include autoimmune gastritis associated with antibodies of serum anti-parietal and anti-internal factor; organisms other than H. pylori, such as Mycobacterium avium intracellulare, Herpes simplex and Cytomegalovirus; gastritis caused by acid reflux; Rare causes of gastritis include collagen gastritis, sarcoidosis, eosinophilic gastritis and lymphocytic gastritis. The clinical picture, laboratory studies, gastroscopy, as well as histological and microbiological examination of tissue biopsies are important for the diagnosis of gastritis and its causes. Treatment of gastritis caused by H. pylori leads to the rapid disappearance of polymorphic-nuclear infiltration and a decrease in chronic inflammatory infiltrate with gradual normalization of the mucous membrane. Other types of gastritis should be treated based on their etiology.
Study on bioretention for stormwater management in cold climate, part II: water quality
Authors: Kratky Hannah , Li Zhan , Yu Tong , Li Xiangfei , Jia Haifeng
Published: October 2021

Typical continental, cold climate conditions were applied to four large, laboratory columns to simulate temperatures ranging from −20 to +20 °C over summer, winter, and spring runoff. The goal of this research was to assess the seasonal effectiveness of bioretention application in cold climate regions that are currently experiencing the impacts of climate change. 1.6 years’ worth of equivalent Edmonton precipitation volume was applied over a 10-month period to evaluate the water quality improvement through two soil types (i.e., loam and sandy loam) with and without amendments intended to enhance nutrient removal. During summer, excellent removal of total suspended solids (TSS), phosphate, and ammonium (i.e., ≥90% average concentration reduction) was observed in both the loam and sandy loam columns without the nutrient removal amendments. The columns containing the amendments also reduced TSS, ammonium, and phosphate, but not as effective as the non-amended columns for TSS and ammonium. During winter and spring runoff, if infiltration occurs, physical removal of TSS, phosphate, and ammonium was still achieved, only days after the complete freezing (and subsequent thawing) of bioretention media at −20 °C. After an initial maturation and leaching period, nitrate was well removed (≥65.2% average concentration reduction) via denitrification in the columns with the nutrient removal amendments and submerged zone.
Exploring uncertainty in thermodynamic modeling of the lead carbonate aqueous system
Authors: Kushnir C. , Robinson C. E.
Published: October 2021

Thermodynamic models of the lead carbonate aqueous system have been used in prior studies to evaluate the effect of water chemistry on lead solubility and corrosion scale composition in water distribution systems. A common challenge in these studies is uncertainty arising from the thermodynamic equilibrium constants (logK values) used to parameterize the models. The objective of this study is to evaluate the way in which uncertainty in logK values propagates through thermodynamic models of the lead carbonate system and provide guidance for future modeling efforts. This was done by conducting a full factorial statistical analysis implemented using a custom Python (v3) code coupled with a PHREEQC (v1.4.2) geochemical model, along with batch lead solubility experiments. Two lead carbonate solid phases (cerussite and hydrocerussite) and nine aqueous lead complexes are considered in the geochemical model with conditions simulated ranging from pH 4 to 11 and dissolved inorganic carbon (DIC) ranging from 0 to 250 mg C/L. Main effect analysis indicates that model uncertainty is predominately associated with logK values for five species (in order of decreasing effect): hydrocerussite, , cerussite, PbOH+, and PbCO3o, with model uncertainty varying depending on the specific pH and DIC conditions simulated. Interaction effects show that logK values cannot be selected independently, as their influence on lead solubility is connected. Finally, by considering uncertainty in logK values it was possible for the thermodynamic model to match batch hydrocerussite solubility experimental data over a range of pH and DIC conditions. Six combinations of logK values that provided a good match between the simulated and experimental data were determined with the average difference between the simulated and experimental lead concentrations calculated to be 0.031 mg/L when the recommended logK value combination was used.
Reflexiones teóricas sobre la Investigación Acción Participativa (IAP)
Authors: Padrón Carla , Barboza Jorge Luis , de González Geimy
Published: October 2021

El documento nos brinda algunas posiciones teóricas sobre la investigación acción participativa (IAP), vista desde su naturaleza epistemológica. Esta investigación es de corte documental y cualitativo, su propósito es presentar algunas reflexiones sobre este tipo de investigación, considerando diferentes referentes teóricos a modo de reconocer y caracterizar cómo se estructura, y la forma en la que se establecen relaciones para valorar y alcanzar la transformación social. La revisión teórica devela que la IAP busca la reflexión sobre las problemáticas que afectan a una localidad a partir de variables históricas y sociológicas, permitiendo a los participantes proponer y ejecutar soluciones con autonomía científica y cultural; en su planteamiento epistemológico cambia la relación sujeto-objeto, y en lo ontológico aflora la dimensión espiritual de las comunidades que rebasa el ámbito personal para darle paso al interés colectivo.
Caracterización sociodemográfica, académica y laboral de los egresados del Programa de Administración de Empresas de CECAR
Authors: Cardona Arce Yolanda , Contreras Contreras Martha , Mendoza Cerpa Jesús
Published: October 2021

La investigación tiene como objetivo caracterizar las condiciones sociodemográficas, académicas y laborales de los egresados del Programa de Administración de Empresas de la Corporación Universitaria del Caribe –CECAR, ubicada en el departamento de Sucre-Colombia. La investigación es de tipo descriptiva, con un diseño transeccional, contemporáneo, multivariable, no experimental y de campo. El estudio se sustenta en una ontología realista, una epistemología positivista y un enfoque cuantitativo. La población está constituida por 325 profesionales cuya muestra representativa para este estudio fue de 87 graduados, que comprende a los graduados de los años desde 2010 hasta 2017, y se implementó una encuesta estructurada para medir las variables del estudio. La investigación es de corte transversal, en cuanto se evalúa en un momento de tiempo.
Reach Outcomes and Costs of Different Physician Referral Strategies for a Weight Management Program Among Rural Primary Care Patients: Type 3 Hybrid Effectiveness-Implementation Trial (Preprint)
Authors: Porter Gwenndolyn , Michaud Tzeyu L , Schwab Robert J , Hill Jennie L , Estabrooks Paul A
Published: October 2021

BACKGROUND

Rural residents are at high risk for obesity; however, little resources exist to address this disproportional burden of disease. Primary care may provide an opportunity to connect primary care patients with overweight and obesity to effective weight management programming.

OBJECTIVE

The purpose of this study is to examine the utility of different physician referral and engagement processes for improving the reach of an evidence-based and technology-delivered weight management program with counseling support for rural primary care patients.

METHODS

A total of 5 rural primary care physicians were randomly assigned a sequence of four referral strategies: point-of-care (POC) referral with active telephone follow-up (ATF); POC referral, no ATF; a population health registry–derived letter referral with ATF; and letter referral, no ATF. For registry-derived referrals, physicians screened a list of patients with BMI ≥25 and approved patients for participation to receive a personalized referral letter via mail.

RESULTS

Out of a potential 991 referrals, 573 (57.8%) referrals were made over 16 weeks, and 98 (9.9%) patients were enrolled in the program (58/98, 59.2% female). Differences based on letter (485/991, 48.9%) versus POC (506/991, 51.1%) referrals were identified for completion (100% vs 7%; P<.001) and for proportion screened (36% vs 12%; P<.001) but not for proportion enrolled (12% vs 8%; P=.10). Patients receiving ATF were more likely to be screened (47% vs 7%; P<.001) and enrolled (15% vs 7%; P<.001) than those not receiving ATF. On the basis of the number of referrals made in each condition, we found variations in the proportion and number of enrollees (POC with ATF: 27/190, 50%; POC no ATF: 14/316, 41%; letter ATF: 30/199; 15.1%; letter no ATF: 27/286, 9.4%). Across all conditions, participants were representative of the racial and ethnic characteristics of the region (60% female, P=.15; 94% White individuals, P=.60; 94% non-Hispanic, P=.19). Recruitment costs totaled US $6192, and the overall recruitment cost per enrolled participant was US $63. Cost per enrolled participant ranged from POC with ATF (US $47), registry-derived letter without ATF (US $52), and POC without ATF (US $56) to registry-derived letter with ATF (US $91).

CONCLUSIONS

Letter referral with ATF appears to be the best option for enrolling a large number of patients in a digitally delivered weight management program; however, POC with ATF and letters without ATF yielded similar numbers at a lower cost. The best referral option is likely dependent on the best fit with clinical resources.

CLINICALTRIAL

ClinicalTrials.gov NCT03690557; http://clinicaltrials.gov/ct2/show/NCT03690557
Development and validation of a machine learning predictive model for acute kidney injury nonrecovery at hospital discharge (Preprint)
Authors: Liu Chien-Liang , Tain You-Lin , Lin Yun-Chun , Hsu Chien-Ning
Published: October 2021

BACKGROUND

Some kidney functions may not be recovered at hospital discharge after acute kidney injury (AKI) exposure resulting in subsequent kidney replacement therapy and mortality. However, there is a lack of evidence about prognosticators of AKI nonrecovery to identify high-risk patients requiring post-discharge AKI care to improve long-term outcomes.

OBJECTIVE

To develop and validate a machine learning model for predicting AKI nonrecovery at hospital discharge from AKI hospitalization using electronic health record data.

METHODS

Data for hospitalized patients in the Acute Kidney Injury Recovery Evaluation Study were derived from a large healthcare delivery system in Taiwan between January 2011 and December 2017. Patients alive with AKI nonrecovery were used to derive and validate multiple feature predictive model. AKI nonrecovery was defined by a serum creatinine (SCr) level at hospital discharge of ≥1.5 times of pre-hospitalization baseline level. Sixty-four candidate features, including demographic characteristics, comorbidity, healthcare services utilization, laboratory values, and nephrotoxic medication use, were measured within 1 year before the index admission and during hospitalization for AKI.

RESULTS

The risk predictive model was derived from 8600 patients with AKI in 2010–2015 and validated with data from 2866 patients with AKI in 2016–2017. The proportion of AKI nonrecovery was 45% in both the derivation and validated cohorts. Among the top 20 important features in the predictive model, eight features had a positive effect on AKI nonrecovery prediction: AKI during hospitalization, SCr level at admission, receipt of dialysis during hospitalization, baseline comorbidity of cancer, AKI at admission, and baseline proportions of lymphocyte count, potassium, and low-density lipoprotein cholesterol. The predicted AKI nonrecovery risk model using the XGBoost algorithm achieved an area under the receiver operating characteristic curve statistic of 0.81 and discrimination with a sensitivity of 0.73 and a specificity of 0.72 in the temporal validation cohort.

CONCLUSIONS

The machine learning model approach can accurately predict AKI nonrecovery using routinely collected health data in practice. These results suggest multifactorial risk factors involved in AKI nonrecovery, requiring patient-centered risk assessment and promotion of post-discharge AKI care to prevent AKI complications.

CLINICALTRIAL

Not applied
Clinical decision support systems for antibiotic prescribing: an inventory of current French-language tools (Preprint)
Authors: Durand Claire , Alfandari Serge , Béraud Guillaume , Tsopra Rosy , Lescure François-Xavier , Peiffer-Smadja Nathan
Published: October 2021

BACKGROUND

Clinical decision support systems (CDSSs) are increasingly being used by clinicians to support antibiotic decision making in infection management. However, coexisting CDSSs often target different types of physicians, infectious situations and patient profiles.

OBJECTIVE

The objective of this study was to perform an up-to-date inventory of French-language clinical decision support systems (CDSSs) currently used in community and hospital settings for antimicrobial prescribing and to describe their main characteristics.

METHODS

A literature search, a search among mobile application stores and an open discussion with antimicrobial stewardship (AMS) experts were conducted in order to identify all French-language CDSSs available. Any clinical decision support tool that provides a personalized recommendation based on a clinical situation and/or a patient was included. A data collection form was developed and reviewed by infectious disease and AMS specialists. Collected data included the CDSS characteristics regarding administration, access, targeted users and patients, search criteria and type of information provided.

RESULTS

Eleven CDSSs were identified through the search strategy. Most CDSSs were designed on a regional scale by multidisciplinary teams and were intended for both inpatient and outpatient care. The majority of CDSSs were available free of charge (n=8/11, 73%). Only 2 CDSSs were designed exclusively for ambulatory care. Most CDSSs were accessible via smartphone applications (n=9/11, 82%) and online websites (n=8/11, 73%). Recommendations for antibiotic prescribing in urinary tract infections, upper and lower respiratory tract infections and digestive tract infections were provided by over 90% of the CDSSs. Recommendations for the treatment of cardiovascular infections, bloodstream infections and central venous catheter-related infections were advised by less than half of the CDSSs. More than 90% of the CDSSs displayed recommendations for antibiotic selection, prioritization, dosage, duration, route of administration and alternatives in case of allergy. Information about antibiotic side effects, prescribing recommendations for specific patient profiles and adaptation to local epidemiology were often missing or incomplete.

CONCLUSIONS

There is a significant but heterogeneous offer for antibiotic prescribing decision support. Standardized evaluation of these systems is needed to assess their impact on antimicrobial prescribing and antimicrobial resistance.
A Study on Prevalence and Determinants of Ototoxicity During Treatment of Childhood Cancer (SOUND): Protocol for a Prospective Study (Preprint)
Authors: Diepstraten Franciscus A , Meijer Annelot JM , van Grotel Martine , Plasschaert Sabine LA , Hoetink Alexander E , Fiocco Marta , Janssens Geert O , Stokroos Robert J , van den Heuvel-Eibrink Marry M
Published: October 2021

BACKGROUND

Some children with central nervous system (CNS) and solid tumors are at risk to develop ototoxicity during treatment. Up to now, several risk factors have been identified that may contribute to ototoxicity, such as platinum derivates, cranial irradiation, and brain surgery. Comedication, like antibiotics and diuretics, is known to enhance ototoxicity, but their independent influence has not been investigated in childhood cancer patients. Recommendations for hearing loss screening are missing or vary highly across treatment protocols. Additionally, adherence to existing screening guidelines is not always optimal. Currently, knowledge is lacking on the prevalence of ototoxicity.

OBJECTIVE

The aim of the Study on Prevalence and Determinants of Ototoxicity During Treatment of Childhood Cancer (SOUND) is to determine the feasibility of audiological testing and to determine the prevalence and determinants of ototoxicity during treatment for childhood cancer in a national cohort of patients with solid and CNS tumors.

METHODS

The SOUND study is a prospective cohort study in the national childhood cancer center in the Netherlands. The study aims to include all children aged 0 to 19 years with a newly diagnosed CNS or solid tumor. Part of these patients will get audiological examination as part of their standard of care (stratum 1). Patients in which audiological examination is not the standard of care will be invited for inclusion in stratum 2. Age-dependent audiological assessments will be pursued before the start of treatment and within 3 months after the end of treatment. Apart from hearing loss, we will investigate the feasibility to screen patients for tinnitus and vertigo prevalence after cancer treatment. This study will also determine the independent contribution of antibiotics and diuretics on ototoxicity.

RESULTS

This study was approved by the Medical Research Ethics Committee Utrecht (Identifier 20-417/M). Currently, we are in the process of recruitment for this study.

CONCLUSIONS

The SOUND study will raise awareness about the presence of ototoxicity during the treatment of children with CNS or solid tumors. It will give insight into the prevalence and independent clinical and cotreatment-related determinants of ototoxicity. This is important for the identification of future high-risk patients. Thereby, the study will provide a basis for the selection of patients who will benefit from innovative otoprotective intervention trials during childhood cancer treatment that are currently being prepared.

CLINICALTRIAL

Netherlands Trial Register NL8881; https://www.trialregister.nl/trial/8881

INTERNATIONAL REGISTERED REPORT

DERR1-10.2196/34297
Can Novel Potassium Binders Liberate People with Chronic Kidney Disease from the Low-Potassium Diet?
Authors: St-Jules David E. , Clegg Deborah J. , Palmer Biff F. , Carrero Juan-Jesus
Published: October 2021

The advent of new potassium binders provides an important breakthrough in the chronic management of hyperkalemia for people with CKD. In addition to the direct benefits of managing hyperkalemia, many researchers and clinicians view these new medications as a possible means to safely transition patients away from the low-potassium diet to a more healthful eating pattern. In this review, we examine the mechanisms of potassium binders in the context of hyperkalemia risk related to dietary potassium intake in people with CKD. We note that whereas these medications target hyperkalemia caused by potassium bioaccumulation, the primary evidence for restricting dietary potassium is risk of postprandial hyperkalemia. The majority of ingested potassium is absorbed alongside endogenously secreted potassium in the small intestines, but the action of these novel medications is predominantly constrained to the large intestine. As a result and despite their effectiveness in lowering basal potassium levels, it remains unclear whether potassium binders would provide protection against hyperkalemia caused by excessive dietary potassium intake in people with CKD. Until this knowledge gap is bridged, clinicians should consider postprandial hyperkalemia risk when removing restrictions on dietary potassium intake in people with CKD on potassium binders.
Drug-resistant Tuberculosis: First Line Drug Resistance Pattern among Mycobacterium Tuberculosis Strains Isolated from a Reference Laboratory in Kerala State, India
Authors: Murthy Neetha S , Nair Sanjeev , Ramya PK , George Renu Susan , Ravikrishnan B , Kumar M Sunil , Philip Sairu , Rakesh PS , Balakrishnan Shibu
Published: October 2021

Resistance to antimycobacterial agents consistently remains a major obstacle to end TB in India. Geographical prevalence data regarding drug-resistant evolutionary genetics of M. tuberculosis (MTB) remains sparse in India. Our objective was to determine the genotypic drug resistance mutation pattern for Rifampicin and Isoniazid of MTB isolates to gain an understanding of the prevailing molecular epidemiology of drug-resistant tuberculosis. In this study 2528 M. tuberculosis DNA isolates from presumptive DRTB suspects received at the nodal TB reference laboratory in Kerala were tested for Rifampicin and Isoniazid resistance by sequence-based diagnostic Line Probe assay (LPA). Geographical prevalence and associations of rpoB, katG, inhA resistance codons was analyzed from January 2019 to March 2020. Among the 2528 DNA samples subjected for Rifampicin and Isoniazid resistance determination by LPA, 146 (5.8%) isolates were resistant to both drugs. Isoniazid mono-resistance was found in 164 (6.5%) and Rifampicin mono-resistance in 38 (1.5%) isolates. The most frequent rpoB mutation was S531L (60.32%) followed by S531W/L533P mutations seen in 8.15% of the isolates. S315T1 KatG mutation was seen in 97.33% of Isoniazid resistant isolates. 84.68% isolates with rpoB S531L mutation were found to be multidrug-resistant. 82.9% of isolates with rpoB S531L mutation showed katG S315T1 mutation. Mono isoniazid-resistant isolates were significantly higher compared to mono rifampicin-resistant isolates among the DNA isolates studied in our region. The molecular epidemiological pattern most frequently associated with multidrug resistance was rpoB S531L which was significantly associated with the co-presence of S315T1 mutation.
Normalization Effect of Both ST36 and CV11, 12, 13 Meridian Points on the Abnormal Gastric Myoelectrical Activity in Two Cases of Functional Dyspeptic Patients
Authors: Yoon Sang-Hyub
Published: October 2021

Objectives: The aim of this study was to introduce the normalization effects of stimulation of both ST36 and CV11, 12, 13 meridian points on the abnormal gastric myoelectrical activity in two cases of functional dyspeptic patients with gastric dysmotility.Methods: Gastric myoelectrical activity was recorded by electrogastrography every two weeks until their gastric myoelectrical activity finally reached the normality. Dominant frequency of gastric slow waves in the fasting and postprandial periods and a dominant power ratio were obtained on each occasion. Patients were treated three times each day: 9 am, 1 pm, and 7 pm. The first treatment consisted of manual and immersion stimulation on all used meridian points for 20 min. In the second and third treatments, electrical stimulation of both ST36 was added. It was conducted for 20 min at a strength intensity of 1.2 times the pain threshold at a frequency of 3 Hz.Results: Stimulation of the above meridian points normalized abnormal gastric myoelectrical activity. The time taken to return from abnormal gastric myoelectrical activity to normal was 16-19 weeks.Conclusion: Stimulation of both ST36 and CV11, 12, 13 meridian points normalized the abnormal gastric myoelectrical activity in the functional dyspepsia of gastric dysmotility.
Screening and optimization of indole-3-acetic acid production by bacterial strain isolated from rice rhizosphere and its effects on plant growth
Authors: Mukherjee Biyas , Roy Sanchali , Dhara Ankita , Dutta Sikha
Published: October 2021

The present study deals with the isolation of plant growth-promoting bacterial strains from rhizospheric soil collected from a rice field of Purba Bardhaman District, West Bengal, India. Among the isolated five strains, A5 was the best-performing strain as it had, plant growth promoting traits like, production of indole‑3‑acetic acid (IAA), siderophore, hydrogen cyanide and exopolysaccharides, ammonia, phosphate solubilization, nitrogen fixation etc. Strain A5, identified as Bacillus xiamensis by phenotypic characters and 16S rDNA sequence-based homology, was able to produce a copious amount of IAA, particularly in the case of 42‑h culture with 1.5% L‑tryptophan as a precursor. Media optimization with different carbon and nitrogen sources was conducted for maximum production of IAA. Strain A5 used fructose and casamino acid most efficiently as carbon and nitrogen sources, respectively. Growth parameters were increased in A5‑treated seedlings of mung bean compared to control seedlings. Considering the observed traits, strain A5 can definitely be considered as a novel plant growth-promoting bacterial strain that may serve very well as a biofertilizer in agricultural fields.
La experiencia de los cuidadores familiares de personas con cáncer. Estudio fenomenológico
Authors: Duque-Ortiz Camilo , Giraldo-Toro Yenny Andrea
Published: October 2021

Objetivo: Comprender la experiencia vivida de los cuidadores familiares de personas que padecen enfermedades oncológicas. Materiales y métodos: Estudio de enfoque cualitativo, basado en la fenomenología interpretativa. Se desarrolló en Medellín, Colombia entre julio de 2018 y junio de 2019. La recolección de información se realizó a través de entrevistas semiestructuradas a diez cuidadores familiares de personas con enfermedades oncológicas. El total de los participantes estuvo determinado por la saturación teórica de los temas emergentes. Resultados: La experiencia que vive el cuidador familiar de una persona que padece cáncer, se representa a través de tres temas emergentes: enfrentarse a un nuevo camino, en el que hay situaciones derivadas de la enfermedad que imponen unas cargas y demandan un sobre-esfuerzo al cuidador. Organizarse para cuidar, el cual se refiere a la manera como se organizan a través del establecimiento de roles, rutinas y redes de apoyo, para hacer frente al cuidado del ser querido. Transformaciones para la vida, que se refiera a la manera como la vida cambia a partir de la experiencia de cuidado.  Conclusiones: La experiencia que viven los cuidadores familiares de personas con cáncer se representa como una vida de entrega hacía su pariente enfermo, en la que el nuevo camino al que se enfrentan, la organización de su vida para cuidar y las transformaciones que experimentan se dan en torno a la enfermedad y al cuidado que demanda la persona con cáncer
Palabras clave: Cuidadores, emociones, adaptación psicológica, costo de enfermedad.
Quality of life and special issues in women with inflammatory bowel diseases
Authors: Constantinescu Gabriel , Gheorghe Gina , Rinja Ecaterina , Plotogea Oana , Sandru Vasile , Butuc Andreea , Diaconu Camelia , Oprescu Anca , Popa Bogdan , Ilie Madalina
Published: October 2021

Introduction. The impact of inflammatory bowel diseases (IBD) on the quality of life (QoL) of patients is significant and it has important social and professional consequences. Materials and methods. We aimed to describe the patients’ perspective regarding the impact of IBD on their overall QoL and to evaluate the differences between men and women. An observational cross-sectional study, that included 180 patients with IBD in clinical remission, was conducted. All the patients completed a number of 3 questionnaires in order to evaluate the general aspects of their QoL. A separate questionnaire was created regarding genderspecific issues in women with IBD encounter. Also, particular features such as the incidence of anemia and osteoporosis among IBD patients were documented. The data obtained were analyzed and compared between the two genderclassified groups. Results. According to the Short Inflammatory Bowel Disease Questionnaire (SIBDQ), patients had a general perception of a good QoL, but the impact was higher in women. Fatigue and tiredness were severely perceived almost to the same degree regardless of their gender, whereas anxiety and unemployment were more present in men. No significant differences in women with IBD during the active disease and during disease remission were found. Conclusions. The overall quality of life of IBD patients is affected in many aspects, leading to the deterioration of their social and professional lives, for both men and women, but some aspects remain gender-specific and require a personalized standard of care.
Neuroendocrine carcinoma of the breast: a case report
Authors: Gîvan Iulia , Ciulei George , Cozma Angela , Indre Mădălina , Țâru Vlad , Pop Anca , Tăut Adela , Țărmure Simina , Negrean Vasile , Orășan Olga
Published: October 2021

Neuroendocrine breast carcinomas represent a rare subtype of breast cancer. Their definition, prevalence and prognosis remain controversial in the literature. Regarding the presentation, there are no differences from other breast carcinomas and clinical syndromes related to hormone production are extremely rare. Refinement of the classification of neuroendocrine neoplasms of the breast is needed in order to improve the reproducibility of their diagnostic criteria and to define their clinical significance. This article presents the case of a 44-year-old female patient diagnosed with invasive breast carcinoma with neuroendocrine features, according to the 2012 World Health Organization (WHO) definition, with focus on presentation, clinical manifestations, diagnostic approach and differential diagnosis.
Collagen-based biomaterials with possible therapeutic effects
Authors: Nedelcuţă Ramona , Călin Gigi , Nedelcuţă Mihai , Baleanu Vlad , Davitoiu Dragos , Socea Bogdan , Stănoiu Bogdan-Petre
Published: October 2021

Epidermolysis bullosa (EB) is a rare, serious genetic disease, incurable through the current means. Apart from this initial definition, there was later some ease in the definition of the disease, including the manifestations of toxic epidermal necrolysis and Stevens Johnson syndrome in this entity. In medical practice, there are cases that do not overlap with the description in the literature, thus the treatment must be adapted and personalized to the particularities. We present the case of a female new-born, with "de novo" mutation for the early-onset antenatal epidermolysis and our personalized therapeutic management, based on collagen from bovine corneas by enzymatic process. The histological examination showed that the collagen membranes serve as a support for the epithelial cells that formed a surface monolayer after 48 hours. Therefore. this case report shows that collagen-based biomaterials could be used to accelerate the dermal-epidermal healing in various conditions of the child, such as Stevens Johnson syndrome, bullous epidermolysis and widespread burns.
Congenital Epulis: A Two-Case Report
Authors: Ivanov Monica , Stroe Bianca , Ardeleanu Valeriu , Hainarosie Razvan , Constantin Vlad , Dumitriu Anca , Paunica Stana , Kadar Anna
Published: October 2021

Congenital epulis is a rare benign tumor of the newborn that could be detected in the prenatal period. Females are more often affected than males and the premaxillary region is usually the predilection site for this oral mass. Excision is the treatment of choice and no recurrences have been reported so far. We present our experience with two cases of congenital epulis, detected in the second trimester of gestation and treated shortly after birth with no further complications. Histopathology should differentiate between congenital epulis and other congenital oral tumors even if its clinical appearance is usually enough to make a tentative diagnosis. A multidisciplinary assessment in the management of this tumor can avoid unwanted complications such as airway obstruction or bleeding.
Triple reverse order law of Drazin invertible operators
Authors: Chrifi Safae , Tajmouati Abdelaziz
Published: October 2021

In this paper we study the triple reverse-order law (ABC)D = CDBDAD for the
Drazin invertible operators A,B and C under the commutative relations [AB,
B] = 0, [BC, B] = 0 and [AB, BC] = 0.
New directions in LB-valued general fuzzy automata: A topological view
Authors: Abolpour Khadijeh , Zahedi Mohammad
Published: October 2021

In the current study, we define the different L-valued operators on LB-valued
general fuzzy automata or simply LB-valued GFA, where B is considered as a
complete infinitely distributive lattice of propositions about the GFA. In
particular, this study demonstrates that the L-valued successor and
predecessor operators induce L-valued co-topologies while the L-valued
residuated and approximation operators induce L-valued topologies on the
state set of given LB-valued GFA. Further, we show that the continuity and
separation properties of such LB-valued general fuzzy automaton can be
examined in terms of these topologies. Moreover, we study and explicate the
LB-valued GFA structure space and LB-valued GFA homotopy in more details.
Neighbourhood star selection properties in bitopological spaces
Authors: Lakehal Rachid , Kocinac Ljubisa , Seba Djamila
Published: October 2021

In this paper we introduce and study some new types of star-selection
principles ((i,j)-NSM, (i,j)-NSR and (i,j)-NSH) in bitopologivcal spaces.
Various properties of these selection properties are established and their
relations with known selection principles are discussed. Several examples
are given.
Caracterización psicoacadémica para la autorregulación del estudiante ingresante en Pedagogía en una universidad regional chilena
Authors: Ruay Garcés Rodrigo , Elzel Castro Luisa Magaly , Quintana Püschel Magaly Andrea , Maturana Martínez Héctor Hugo
Published: October 2021

El presente estudio se focaliza en la caracterización psicoacadémica de estudiantes ingresantes a carreras pedagógicas en la Universidad de Los Lagos, Osorno (Chile), con el fin de identificar factores de posibles alteraciones generadas entre los que ingresan a la educación superior, que pueden influir en su trayectoria formativa universitaria y así encontrar las causas de un posible fracaso de su inserción universitaria. En este contexto, se utiliza una investigación mixta con una muestra de participantes de la cohorte 2017 de cuatro carreras pedagógicas a quienes se le apli- caron tres cuestionarios: autoeficacia académica, autorregulación para el aprendizaje y enfoques de aprendizaje. A partir de los antecedentes recopilados, tanto de los sistemas de evaluación apli- cados como de los mecanismos de soporte implementados se generan las bases para un modelo de evaluación e intervención permanente como mecanismo de apoyo a la gestión académica. Esta investigación, de carácter exploratorio, permite tener una radiografía de la población estudiantil ingresante de carreras pedagógicas en una universidad pública regional y lleva a concluir que no hay diferencias sustantivas respecto a la autoeficacia académica para asumir tareas y roles propios de un estudiante universitario, independientemente de las vías de ingreso. Por otro lado, permite generar un sistema de gestión para el levantamiento permanente de información sobre los estudiantes, conducente a la implementación de acciones de mejora.
Describing agreement in the Main Condition coding field using Canadian ICD-11 inpatient data
Authors: Wiebe Natalie , Quan Hude , Southern Danielle A , Doktorchik Chelsea , Eastwood Catherine
Published: October 2021

IntroductionCountries use varying coding standards, which impact international coded data comparability. The `main condition' (MC) field is coded within the Discharge Abstract Database as "reason for admission" or "largest resource use".
ObjectiveWe offer a preliminary analysis on the frequency of and contributing factors to MC definition agreements within an inpatient Canadian dataset.
MethodsSix professional coders performed a chart review between August 2016 and June 2017 on 3,000 randomly selected inpatient charts from three acute care hospitals in Calgary, Alberta. Coders classified the MC as "reason for admission", "largest resource use" or "both". Patients were admitted between 1st January and 30th June 2015 and met the inclusion criteria if they were >18 years, had an Alberta personal health care number, and had an inpatient visit for any service outside of obstetrics. Agreement between the two MC definitions was stratified by length of stay (LOS), emergency department admission, hospital of origin, discharge location, age, sex, procedures, and comorbidities. Chi-square analysis and frequency of inconsistencies were reported.
ResultsOnly 34 (1.51%) of the 2,250 patient charts had disagreeing MC definitions. Age, emergency visit on admit, LOS, hospital, and discharge location were associated with MC agreement. Chronic conditions were seen more often in MC definition agreements, and acute conditions seen within those disagreeing.
ConclusionThere was a small proportion of cases in which the condition bringing the patient to hospital was not also the condition occupying the largest resources. Within disagreements, further research using a larger sample size is needed to explore the presence of MC in a secondary/tertiary condition, the association between patient complexity and disagreeing MC definitions, and the nature of the conditions seen in the inconsistent MC definitions.
influencia de la extra edad en el proceso de aprendizaje de las ciencias sociales en los estudiantes del grado 8° de las instituciones educativas San Judas Tadeo y Santa María de la Cruz
Authors: Jiménez Yurani , Restrepo Andrea , Moná Yepes Daniela , Ríos Marín Catherin
Published: October 2021

La investigación tiene como objetivo indagar sobre la influencia que tiene la extra edad en el proceso de aprendizaje de las Ciencias Sociales de los alumnos del grado 8° de dos instituciones educativas: El colegio Santa María de la Cruz, en Manrique, El Colegio Parroquial San Judas Tadeo, de Castilla, de la ciudad Medellín. La investigación tiene un enfoque cualitativo, un paradigma hermenéutico y el método biográfico. Para estos se escogieron varias técnicas e instrumentos, como la observación participante con el diario de campo, la encuesta con su cuestionario, y la entrevista semiestructurada con un cuestionario. Con esta investigación se espera develar un porcentaje de alumnos en extra edad en los grados 8° de las dos instituciones educativas, además de evidenciar un desequilibrio en el aprendizaje de éstos en el área de Ciencias Sociales.
Oppressions in Popular Culture’s SpongeBob SquarePants Episode of “Drive Thru”
Authors: Suwandi Kenny Christian , Dukut Ekawati Marhaenny , Riyandari Angelika
Published: October 2021

Abstract: This article is a development of the research done for an undergraduate study, which has the objectives to find the oppressions exercised by Mr. Krabs in USA’s “Drive Thru” episode of SpongeBob SquarePants cartoon TV series. Using Karl Marx’s theory in the study, it is revealed that the episode represents the oppressions by the Bourgeoisie capitalist towards the Proletariat. The data were discussed by using descriptive explanation and were analyzed and interpreted with the finding that the Bourgeoisie treated Proletariat rudely when it comes about money. As a development of the study, this article adds into the discussion on the explanation of Mr. Krabs actions based on the concept of Popular Culture’s strategies of making profit at the expense of the Proletariat.Key words: popular culture, cartoon, oppression, Marxism, profit makingAbstrak: Artikel ini merupakan pengembangan dari penelitian yang dilakukan sebagai bagian dari studi S1, yang bertujuan untuk  untuk menemukan penindasan yang dilakukan oleh Tuan. Krabs pada episode “Drive Thru” dari serial kartun televisi SpongeBob SquarePants. Menggunakan teori Karl Marx terungkap bahwa episode tersebut merepresentasikan penindasan kaum kapitalis Borjuis terhadap kaum Proletar. Data yang ada dibahas dengan menggunakan penjelasan deskriptif dan dianalisa serta ditafsirkan dengan temuan bahwa kaum borjuis memperlakukan kaum proletar secara kasar dalam hal uang. Sebagai kelanjutan dari studi tersebut, artikel ini menambahkan penjelasan tentang perbuatan yang dilakukan tuan Krabs berdasarkan konsep strategi budaya popular yang mencari keuntungan dengan mengorbankan kaum proletar.Kata kunci: karya sastra popular, kartun, penindasan, Marxism