bluuebunny/crossref_metadata_2025 huggingface dataset:
THE CONSUMER OR THE TRADER – WHO DECIDES ON HOW A PRODUCT IS USED? An analysis of the application of excise duty exemptions under Directive 92/83/EEC to alcohol
Authors: Mickutė Karolina
Published: April 2023

Twenty-two years after adopting Directive 92/83/EEC, the European Commission initiated a review of the Directive because it did not correspond with the developments and the challenges, they pose for the alcohol sector. After six years of deliberation, amendments to Article 27.1. of the Directive entered into force this year, which, according to the study, will not address the critical problems with the Directive’s application. The research analyses the concept of ‘not for human use or consumption’, the interpretation of which had been identified by experts and the EC as problematic and detrimental not only to the interests of Member States but also to their residents and legal entities. In particular, the study found that official sources and national systems use definitions that are linguistically and substantively different, which does not ensure homogeneity in the application of the Directive, which is one of the EC’s priority objectives (harmonisation of the excise duty regime).The second part of the study asks whether the Court of Justice of the European Union (CJEU) can resolve the problems of the article’s interpretation. The case law on classifying products for taxation purposes is inconsistent and fragmented, selectively applied, and the judgments are often diagonally opposed. In one case, the CJEU relied on the consumer behaviour argument. In contrast, in another case, the Court held that the trader alone decides on the use of the product and that consumer behaviour is entirely irrelevant. This case is unique because the court legalised fraudulent schemes in selling surrogate alcohol, which is contrary to the EU’s goals to prevent health risks.Given that neither the CJEU nor legislative review and amendment can effectively ensure that the issue of excise duty is harmonised, the study invites us to explore the possibilities of changing the methodology on how court decisions are made. In particular, whether the issue of excise duty exemptions could be addressed by applying economic science. The study explores the concept of ‘not for human use or consumption’ by using the methodologies of mainstream post-Keynesian economic theory and mainline Austrian economic theory. The study finds that an analysis of consumer behaviour would ensure an effective interpretation of Article 27.1. of the Directive.
Control of singlet and triplet states in organic intramolecular charge transfer compounds
Authors:   , Jovaišaitė Justina
Published: April 2023

Singletinių ir tripletinių būsenų valdymas vidumolekulinės krūvio pernašos molekulėse
How to Improve Clinical Outcomes and Reduce Cardiovascular Risk in Older People with Cardiovascular Disease: Bridging Evidence Gaps
Authors: Wajngarten Mauricio
Published: April 2023

The geriatric population is greatly impacted by cardiovascular disease. Thus, it becomes essential to ‘geriatricise’ the cardiologist through the dissemination of geriatric cardiology. In the early days of geriatric cardiology, it was discussed whether it was simply cardiology ‘well done’. Today, 40 years later, it seems clear that this is indeed the case. Patients with cardiovascular disease usually have several chronic conditions. Clinical practice guidelines often address a single condition and do not provide sufficient guidance for patients with multimorbidity. There are several evidence gaps regarding these patients. Physicians and members of the care team need a multidimensional understanding of the patient to better promote the optimisation of care. It is important to understand that ageing is inevitable, heterogeneous and increases vulnerability. Caregivers must know how to assess elderly patients in a multidomain practical way and how to recognise the factors that may have implications on treatment.
Aplicabilidade dos princípios da gestão democrática nos processos de compras e contratações do IFG/Campus Formosa
Authors: Fernandes de Brito Emilia , Faustino Teles Ricardo
Published: April 2023

O objetivo deste estudo foi apresentar contribuições para que os processos de compras e contratações do IFG/Campus Formosa sejam realizados democraticamente, de forma a  envolver efetivamente a comunidade acadêmica em sua execução. A abordagem adotada foi a de Bardin (2011), mediante análise de conteúdo para investigação dos dados que foram coletados. Como desdobramento da pesquisa foi desenvolvido e aplicado o produto educacional, o qual consistiu em uma oficina formativa. A atividade de formação foi realizada durante o evento institucional e contemplou tópicos sobre licitações e contratos, além de uma breve conversa sobre a Educação Profissional e Tecnológica e a gestão participativa. Diante dos resultados obtidos, infere-se que os procedimentos de compras e contratações no âmbito do IFG/Campus Formosa podem ser conduzidos coletivamente, sendo aplicáveis a eles os princípios da gestão democrática. Todavia, respeitando sempre a atribuição de cada indivíduo na execução das suas funções.
The transformation of the vowel system in Gallic Latin as evidenced in inscriptions and the problem of dialectal positioning of Roman Gaul
Authors: Adamik Béla
Published: April 2023

The present study analyzes the transformation of the vowel system and especially the process of vowel mergers based on the Latin inscriptions of the Gallic and Germanic provinces. With the help of the Computerized Historical Linguistic Database of the Latin Inscriptions of the Imperial Age (http://lldb.elte.hu/), it tries to draw and then compare the phonological profiles of the selected provinces and to describe the dialectal position of Gaul and the Germanic provinces regarding vocalism in three periods (AD 1–300, 301–500 and 501–700). The analysis, which also covers comparisons with certain provinces of Italy, Spain and Dalmatia, is carried out considering four aspects: the ratio of vocalic versus consonantal changes, the ratio of vowel mergers compared to vocalic changes, the ratio of e-i and o-u mergers compared to each other, and the ratio of vowel mergers by stressed and unstressed syllable. As a result of the present study, it was revealed that Gallic provinces cannot be treated as a unit or as clearly separate from the other areas studied according to either aspect of the study, especially not in the early, pre-Christian period. Gallic provinces appear to behave in the same or a levelled manner at most in the later and/or latest periods. The Germanic provinces, especially Germania Superior, have, albeit with some delay, adapted to the Gallic provinces in their late development. The present study, which continued József Herman's research, managed to explore the hitherto little-known linguistic and dialectological features of Latin in the Gallic and Germanic provinces.
The Norming Sets of Multilinear Forms on the Plane with a Certain Norm
Authors: Kim Sung Guen
Published: April 2023

Let n ∈ ℕ. An element (x1, … , xn) ∈ En is called a norming point of if and , where denotes the space of all continuous symmetric n-linear forms on E. For , we define

Norm(T) is called the norming set of T.

Let be the plane with a certain norm such that the set of the extreme points of its unit ball ext for some .

In this paper, we classify Norm(T) for every . We also present relations between the norming sets of and .
Conversations, Chaplaincy Boundaries, Moral Injury, Suicide and Using Electronic Patient Record Systems to Enhance Spiritual Care
Authors: Carey Lindsay B , Grossoehme Daniel H , Kissack Fran , Newitt Mark , Nuzum Daniel , Paal Piret , Ross Linda , Snowden Austyn , Swift Chris
Published: April 2023

A diverse range of topics are covered in this issue of Health and Social Care Chaplaincy, namely: (i) end of life care, (ii) chaplaincy boundaries, (iii) moral injury, (iv) suicide, and (v) the increasingly important issue of electronic patient records. This issue also includes, once again, a number of book reviews. Finally, we welcome two new Co-Editors to the HSCC team, and note an upcoming European conference planned for 2024 focusing on spiritual care interventions.
The use of questions as a form of interaction in the Italian EMI setting
Authors: Costa Francesca , Mariotti Cristina
Published: April 2023

Questions play a fundamental role in the interaction between students and teachers. In English-medium instruction (EMI) classes, the strategic use of questions can strongly influence not only the learning process regarding content, but also the active participation of students, and consequently the development of their interaction skills, thereby allowing them to deploy higher-order thinking skills, which are particularly important in higher education. Online teaching, which has come to the forefront during the past two years due to the COVID-19 pandemic, has made lecturer–student interaction even more challenging. The present paper seeks to frame questions as a potential source of interaction in EMI and to qualitatively compare questions produced by lecturers in face-to-face and online lectures. First, it will categorize questions as referential, display, or procedural, looking into their implications and potential in terms of both language and content processing and learning. It will then illustrate examples of the use of questions in four EMI lectures, two face-to-face lectures and two online, from four different disciplines, which were transcribed, analysed and compared. Results reveal differences in the distribution of questions across the two learning methods and shed light on the interactional style used in traditional and online EMI lectures.
Efecto de arcilla Montmorillonita K10 como refuerzo mecánico en almidón termoplástico de yuca
Authors: Noguera-Guayacan Carlos Julian , Fernández-Solarte Alejandra María , Villalba-Vidales Jorge Armando
Published: April 2023

En el presente trabajo se obtuvieron películas termoplásticas de almidón yuca por medio del proceso de gelatinización del almidón. La formulación base (BPG), es decir la matriz se realizó con 30% en peso de glicerina, la cual posteriormente fue reforzada con tres porcentajes de arcilla Montmorillonia K10 diferentes (MMT): 3%, 5% y 10%, denominadas BPGK-3%, BPGK-5% y BPGK-10%, respectivamente.  Se midieron las propiedades mecánicas y se visualizó por microscopia óptica todas las películas de las cuatros formulaciones, en donde la formulación que obtuvo las mejores propiedades mecánicas fue la formulación  BPGK-5%, debido a la distribución de las partículas de la arcilla en la matriz termoplástica.
Educación Inclusiva. Estado del arte, tendencias investigativas y desafíos desde la Revisión Sistemática de la literatura
Authors: Lizcano-Gomez Karime Griselda , Soto-Céspedes Juan Carlos , Montes Gallego César Augusto , Celis-Méndez Javier Rodolfo
Published: April 2023

El objetivo del presente artículo de revisión, fue establecer el estado del arte y las tendencias en el estudio de la educación inclusiva, además de los retos de esta educación en el contexto mundial. Fue un análisis cualitativo, bajo el modelo de revisión sistemática de la literatura, utilizando 20 documentos científicos digitales en el contexto mundial en el período 2017-2023. El proceso de análisis se subdivide en dos dimensiones: el estado del arte y las tendencias contentivas de una orientación epistémica y metódica de futuras investigaciones. El proceso de análisis se fundamenta en la hermenéutica a través del análisis crítico de los documentos tomados como referencia. Se concluye que el concepto de educación inclusiva no se ha transformado a lo largo del tiempo, más si se han integrado enfoques de análisis del objeto de estudio con los sistemas de salud, los sistemas educativos, las políticas públicas mundiales y sectoriales, y las investigaciones académicas, evolucionando hacia comprender la discapacidad desde las necesidades educativas especiales, que ameritan tratamiento educativo inclusivo.
Procedimiento de ingeniería para la certificación de procesos y servicios bajo requerimientos normativos, para empresas fabricantes y comercializadoras de productos eléctricos en Colombia
Authors: Pacheco-Llanes Sandra Milena
Published: April 2023

Se planteó una investigación con el objetivo de caracterizar a fin de estandarizar el procedimiento y los requerimientos de certificación de procesos y servicios bajo los principios del ICONTEC, para empresas en el ramo de la fabricación y comercialización de productos eléctricos. Fue un estudio bajo el paradigma cualitativo, con diseño de campo y documental, realizado en una empresa de Norte de Santander dedicada a comercializar bienes de transmisión y distribución de redes de energía. Las técnicas de recolección fueron la entrevista a personal de la empresa, y la revisión documental de los elementos normativos y legales de certificación nacionales de Colombia. Se concluye en el diseño de un procedimiento adaptado a la empresa con base en la normativa requerida por el ente certificador, además de la detección de importantes factores clave de éxito empresarial que marcan una experiencia positiva en el ramo de la certificación.
EXAMINING BLACK MALE STUDENT PARTICIPATION CHALLENGES IN A HIGH SCHOOL ACADEMY OF ENGINEERING
Authors: Fletcher Edward C. , Hines Erik M. , Asunda Paul , Ford Donna Y. , Moore III James L.
Published: April 2023

In this study we followed a qualitative case study design to examine the perspectives of 20 school stakeholders (e.g., district and school administrators, school board members, teachers, school counselors, parents, staff, and advisory board members) regarding (in)equitable ways they promote and broaden the participation of Black male students in a high school academy of engineering. Using the concept of cultural matching and the formation of STEM identities, we understood that Black students at Madison River Academy did not participate in rigorous academic programs (e.g., the academy of engineering), partially due to a lack of the school stakeholders' abilities to provide culturally congruent, compatible, responsive, or synchronized learning environments that connected them with their home cultures and lived experiences. Findings from our case study demonstrate how the change in the historical mission of career academies has limited access to rigorous STEM opportunities and engagement of ethnically and racially diverse (particularly Black) students. In this academy, the lack of Black male student and teacher representation as well as mathematics were two barriers limiting the engagement of Black male students. Thus, we contend that it is critical that STEM academy school stakeholders, particularly school leaders, prioritize equity as a strategic goal for their STEM programs and recruit Black teachers who are willing to create culturally responsive curricular experiences to elicit interest in STEM for Black students.
A review of the enhanced degradation of pesticides in tropical agricultural soils
Authors: Getenga Zachary M , Mogusu Emmanuel O , Ngige A N , Kimosop S Jemutai , Mutua G K , Kengara Fredrick , Reiner S , Ulrike D
Published: April 2023

Pesticides newly introduced into the soil are normally poorly degraded by native soil microbes. However, studies have demonstrated that repeated exposure of pesticides to soil microbes potentially enhances their biodegradation through selective enrichment of pesticide-metabolising microorganisms, particularly when the compound is used as a carbon (C) or nitrogen (N) and energy source. Enhanced degradation of recalcitrant compounds in soil has a significant environmental impact, as the chemicals are less likely to contaminate environmental ecosystems. The authors have undertaken several studies to isolate these adapted microbes that rapidly degrade chemicals hitherto known to be recalcitrant in soil. These microbes could potentially be used for bioremediation (bioaugmentation). In addition, other studies have shown their potential to remove pesticide contamination from the environment by the use of organic materials locally generated as organic amendments (biostimulation). In this review, the various methods used in the course of the authors’ studies in determining the utilisation of selected chemicals (pesticides) by adapted microbes as a source of carbon and nitrogen for growth and energy are discussed. This review also presents some of the compounds that the authors have worked with and the successes registered in isolating key degraders of the respective pesticides and the extent to which the locally generated organic materials are able to enhance the degradation of the respective chemicals in soil.
Slow beauty: Refocusing Oliver Hermanus’s Skoonheid through a slow cinema lens
Authors: Wanyonyi Emmanuel
Published: April 2023

Oliver Hermanus’s Skoonheid is often read as a representation of South African queer realities and political progressiveness both during and since the dissolution of apartheid. Consequently, Hermanus’s contribution to the aesthetic of slowness in Skoonheid has gone largely unnoticed in the broader context of slow cinema. In this article, I examine how Hermanus, through the slow cinema conventions, urges the viewer to contemplate issues of crucial importance to human behaviour, thereby putting Skoonheid’s meditative qualities on display. Drawing on Ira Jaffe’s concept of expressive minimalism, Emre Çağlayan’s poetics of slow cinema, and Thomas Elsaesser’s observations on the virtues and demands of slow cinema, I analyse the narrative and aesthetic strategies deployed in Skoonheid within the purview of slow cinema and beyond a representation of queer sexuality. This analysis reveals that Skoonheid represents a mode of narrative-formal expressiveness distinct from, yet in dialogue with, slow cinema in its emphasis on contemplation. Principally, Hermanus finds a way to testify to some of the most urgent concerns in contemporary society through the film’s contemplative approach, which draws the viewer’s attention to the mystery and ambiguity of human experience. Skoonheid’s contemplative approach is informed by the film’s processes and experiences of alienation, incommunicability, and existentialism.
Анатомия архитектуры
Authors: Кавтарадзе Сергей
Published: April 2023

Цель книги искусствоведа Сергея Кавтарадзе — максимально простым и понятным языком объяснить читателю, что такое архитектура как вид искусства. Автор показывает, как работают механизмы восприятия архитектурного сооружения, почему зритель получает от него эстетическое удовольствие. Книга учит самостоятельно видеть и анализировать пластические достоинства формы и бесконечные слои смыслового наполнения архитектурных памятников, популярно излагая историю европейских стилей и логику их развития. Книга адресована широкому кругу читателей, интересующихся архитектурой и историей искусства. На обложке — фрагмент фасада собора Санта-Мария дель Фьоре во Флоренции (фото автора). Книга - лауреат премии Дмитрия Зимина "Просветитель" 2016 г. за лучшую научно-популярную книгу на русском языке в номинации "Гуманитарные науки".
Fikir Geliştirme Laboratuvarı: Şeffaf, Güvenilir ve Disiplinlerarası Bir Model
Authors: TAKAN Savaş , ERGÜN TAKAN Duygu
Published: April 2023

Disiplinlerarası çalışmalarda öğrenme ve uygulama döngüsü oldukça önemlidir. Teknoloji transfer ofisleri ve teknokentler, tam da bu öğrenme ve uygulama döngüsünü sağlamak için hayata geçirilmiş organizasyonel yapılardır. Ancak teknoloji transfer ofisleri ve teknokentler, fikir üretiminden ziyade, üretilmiş fikirlerin uygulama alanları olarak hayata geçirilmiştir. Dolayısıyla teknoloji transfer ofisleri ve teknokentlerin bir ön basamağı olarak düşünülebilecek, fikir üretimine ve geliştirilmesine odaklanan bir mekanizmaya ihtiyaç bulunmaktadır. Toplumsal ihtiyaçlar ve sorunların çözümüne yönelik yenilikçi fikirlerin üretilmesinde akademisyenler, öğrenciler, sektörel aktörler ve toplum birbirlerinden kopuk olduğundan, sistematik bir zeminde bir araya gelememektedir. Bu durum, yenilikçi fikirlerin rassal, bireysel ve yetersiz bir şekilde geliştirilmesine, fikirlerin korunamamasına ve dolayısıyla zaman ve maaliyet kayıplarına neden olmaktadır. Çalışmamızda, söz konusu problemlerin çözümüne yönelik, yenilikçi fikirlerin üretilmesi, takibi ve korunmasına odaklanarak akademisyenleri, öğrencileri ve çeşitli sektörel, toplumsal aktörleri bir araya getiren, fikrin üretildiği andan projeye dönüştürülmesi sürecinde tüm bu unsurların disiplinlerarası şekilde çalışabileceği yeni bir fikir laboratuvarı modeli önerilmiştir. Önerdiğimiz model, fikirlerin korunumu, tartışılması ve takibine yönelik şeffaflığın sağlanabilmesi amacıyla, blok zincirinin veri yapısından esinlenilerek geliştirdiğimiz ve Etiket adını verdiğimiz yeni bir veri yapısı üzerine inşa edilmiştir. Geliştirdiğimiz veri yapısı sayesinde, fikirlerin korunması, geliştirilmesi ve takibinin yanı sıra mantıksal ilişkilerin yaratılabildiği güvenilir bir tartışma ortamı elde edilmiştir.
Clinical approbation today: analysis of current problems and solutions
Authors: Omelyanovskiy V. V. , Lukyantseva D. V. , Alekseeva T. I. , Voropaeva Yu. V. , Tomilina T. A. , Teryan R. A. , Gadzhieva A. O.
Published: April 2023

Objective: description of the current problems concerning the development and conducting of a protocol of clinical approbation (CA) of methods of prevention, diagnosis, treatment and rehabilitation to optimize the implementation of innovative medical technologies in practical health care through CA.Material and methods. The review of the legislative framework governing CA and analysis of the proceedings of CA issues strategic session were carried out, management decisions to improve the effectiveness of CA were proposed. Analysis of legal acts stipulating the notion and status of CA was performed. The study included orders of the Ministry of Health of the Russian Federation, which established regulations on the organization of CA, the CA protocol templates, etc. Methodological materials, review articles on the organization of health care in the Russian Federation selected from various open sources were studied. The basis for making management decisions on improving the quality of CA procedure was formed by the participants of the CA issues strategic session which had been initiated by the Center for Healthcare Quality Assessment and Control.Results. Based on the results of the strategic session and the analysis of legal acts, current issues related to CA regulation, such as lack of СА coordination and research publications, poor methodological quality of clinical and economic evaluations within CA, promotion of innovation through CA were identified. The developed managerial decisions on improvement of CA and promotion of innovations in practical health care were presented.Conclusion. Current legal acts regulating CA activities should be updated with a view to establishing a transparent system of clinical and economic evaluations of new and innovative methods for making an informed decision to include them in clinical guidelines and routine clinical practice. It is proposed to legally assign the functions of CA coordinator to the federal medical development organizations. Regarding the promotion of innovative technologies in practical health care, it is advisable to create a system for the introduction of innovations, including taking into account conducting CA.
Non-invasive respiratory support in patients with severe community-acquired pneumonia
Authors: Korotchenko S. V. , Korabelnikov D. I.
Published: April 2023

Acute respiratory failure (ARF) is the leading cause of death in hospitalized patients with severe forms of COVID-19. At the beginning of COVID-19 pandemic the starting respiratory protocol suggested early use of intubation and artificial lung ventilation (ALV) in patients with severe pneumonia complicated by ARF. However, after the analysis of the published studies it was noted that the pathophysiology of the development of ARF in COVID-19 had features that determine the atypical clinical pattern – “silent hypoxemia”. This leads to the late onset of respiratory support (RS) and, as a result, to the lower effectiveness of non-invasive RS methods. This article discusses the creation of an algorithm for the early use of various non-invasive RS methods in patients with COVID-19 complicated by ARF, that will decrease the frequency of hospitalization to the Intensive care units, tracheal intubation and ALV, reduce the duration of treatment and improve prognosis.
Dioses y demonios en Las horas muertas (1959) de José Manuel Caballero Bonald
Authors: Rodríguez Lazaro Nuria
Published: April 2023

Caballero Bonald alude directa e indirectamente a Dios y a la moral católica en los años 50-60. Nuestro poeta se centrará en el concepto de pecado y de sentimiento de culpa que el catolicismo asoció durante años a la noción de placer carnal. Ese es uno de los demonios que junto con el paso inexorable del tiempo atormenta al yo poético en Las horas muertas. El texto orienta hacia la búsqueda de una actitud eficaz para enfrentar esos temores, impulsando una dinámica vital.
Reseñas
Authors: Montenegro Florencia , Calabrese Giuliana , Núñez Díaz Pablo , Fernández Martínez Sergio , Arias Cachero Patricia , Díez de Revenga Francisco Javier , Martínez Cantón Clara I. , Balcells Doménech José María , Gallardo Calvo Lara , Lanz Juan José , Domingo Mariano
Published: April 2023

Sin resumen
Presentación
Authors: Abril Juan Carlos
Published: April 2023

Sin resumen
Progressive Calcification of Supraspinatus Tendon in Patients With Calcific Tendinitis: Two Case Reports
Authors: Ryazantsev Mikhail S. , Olchev Aleksandr A. , Logvinov Alexey N. , Frolov Aleksandr V. , Andreev Pavel S. , Korolev Andrey V.
Published: April 2023

Background. Calcific tendinitis (CT) is a common disease characterized by the presence of calcific deposits in the tendons of the rotator cuff. CT has a wave-like course, and the formed calcification tends to be resorbed. The lysis of the calcium deposits is characterized by a strong pain syndrome, and the site of the calcification is replaced by collagen.
The aim to demonstrate clinical observations in which the deposited calcification in the rotator cuff did not resorb but increased over time.
Cases presentation. We report on two rare clinical cases of an increase in calcification of the rotator cuff in patients aged 51 and 50 years old. Calcific tendinitis occurred with periods of remission and exacerbation. During exacerbations, conservative treatment was carried out, including courses of massage, physiotherapy, and pain relief therapy. In one case, a single injection of a hormonal drug was performed. Control X-rays and MRI during one of the exacerbations showed an increase in the size of the calcifications. Due to the lack of effect from conservative treatment and the detected increase in calcifications, a decision was made to perform surgical treatment. Arthroscopic removal of calcifications with re-fixation of the supraspinatus tendon and elimination of internal damage was performed on both patients. Good results were noted on the follow-up examination according to the ASES orthopedic score, as well as clinical examination data.
Conclusion. The presented case reports illustrate the possible increase in calcification, unlike the standard course of the disease, in which the calcification is resorbed. Further study of this pathology is necessary to establish the causes and mechanisms of calcification increase over time and its dependence on the phase of the disease.
Caracterización de los eventos adversos a hidroxicloroquina, ivermectina, azitromicina y tocilizumab en pacientes hospitalizados por la COVID-19 en un hospital del Seguro Social de Salud del Perú
Authors: Rodríguez-Tanta L. Yesenia , Cachay Rojas Enrique , Fiestas Saldarriaga Fabián , Alva Lozada Guisela , Fernández-Rojas Paola , Delgado-Escalante Raquel
Published: April 2023

Objetivos. Caracterizar los eventos adversos (EA) asociados a hidroxicloroquina (HQ), azitromicina (AZI), tocilizumab(TOB) e ivermectina (IVM) prescritos como «fuera de etiqueta» en el tratamiento de pacientes hospitalizados porla COVID-19. Materiales y métodos. Se realizó un análisis secundario transversal de la base de datos del sistema defarmacovigilancia del Seguro Social de Salud del Perú (EsSalud) de las notificaciones de EA a HQ, AZI, TOB e IVMprovenientes del Hospital Nacional Edgardo Rebagliati Martins de abril a octubre del 2020. Se revisaron las historiasclínicas digitales, se estimaron las tasas de reporte de EA y se evaluaron sus características por tipo de fármaco, tiempo de aparición, tipo por órgano-sistema afectado, gravedad y causalidad. Resultados. Se identificaron 154 notificaciones que describen un total de 183 EA posiblemente relacionados con HQ, AZI, TOB e IVM, siendo 8% la tasa de reporte de EA.La mediana de tiempo de aparición de EA fue de 3 días (RIC: 2–5). La mayoría fueron cardiovasculares, destacándosela prolongación del intervalo QT. Se observaron EA hepatobiliares principalmente asociados a TOB. La mayoría de los casos fueron moderados, no obstante, el 10,4% fue grave. Conclusiones. Se identificaron EA potencialmente asociados al uso de HQ, AZI, TOB e IVM contra la COVID-19, siendo los más frecuentes los de tipo cardiovasculares. A pesar de que la AZI, HQ e IVM poseen perfiles conocidos de seguridad, su empleo en la COVID-19 podría incrementar la aparición de EA por los factores de riesgo propios de esta infección. Se sugiere reforzar la vigilancia, especialmente, de TOB.
Detección molecular de infección natural por parásitos tripanosomátidos en Didelphis marsupialis de una zona rural del norte de Colombia
Authors: Ardila Marlon M. , Villadiego Yoselin , Herrera Leidi , Zabala-Monterroza Wendy , Pérez-Doria Alveiro
Published: April 2023

Se evaluó la prevalencia de infección por parásitos tripanosomátidos en Didelphis marsupialis y su relación con los aspectos morfológicos/etarios en una zona rural de El Carmen de Bolívar, Colombia. En cinco visitas (2018-2019)se instalaron trampas Tomahawk® en los ecótopos peridoméstico y silvestre en la Vereda El Alférez, durante tres noches consecutivas/visita. A los animales recolectados, se les determinaron medidas corporales, sexo y edad; y se les extrajo sangre por cardiopuntura, previa sedación, para extracción del ácido desoxirribonucleico (ADN) total y amplificación de la región conservada del ADN de minicírculos de kinetoplasto (ADNk) de parásitos tripanosomátidos. La asociación entre parámetros morfológicos de los didélfidos y su frecuencia de infección por parásitos tripanosomátidos fue determinada mediante una regresión binomial. Se recolectaron 30 individuos de D. marsupialis (60,0% hembras y 40,0% machos/66,7% adultos y 33,3% juveniles). El diagnóstico molecular reveló una frecuencia de infección por parásitos tripanosomátidos del 46,7%. El estadio (p=0,024) fue determinante para la infección. Se discute el papel de D. marsupialis como potencial reservorio de parásitos tripanosomátidos en la zona evaluada.
Oxigenoterapia hiperbárica como tratamiento complementario en mucormicosis asociada a COVID-19: a propósito de dos casos
Authors: Valencia-Caballero Víctor , Cachay-Diaz José , Huamán-Muñante José , Romaní-Montoro Lourdes , Vásquez-Zevallos Norka , Carozzi-Calvo César , Chian-García Cesar , Hernández-Chávez Hugo , Agustín-Paredes Cristhian , Vergara-de la Rosa Esteban
Published: April 2023

Reportamos los dos primeros casos, en Perú, sobre el uso del tratamiento con oxigeno hiperbárico coadyuvante (TOHC) en pacientes con mucormicosis asociado a COVID-19 (MAC). El primer caso es una mujer de 41 años, con dolor en hemicara y región palatina izquierdas con rinorrea purulenta de un mes de evolución. Al examen físico, solo evidencia fístula oroantral. El segundo caso se trata de un varón de 35 años, con disminución de agudeza visual izquierda y dolor palatino con fístula que drena secreción purulenta de cuatro meses de evolución. Ambos pacientes tienen el antecedente de diabetes, tuvieron COVID-19 moderado cuatro meses antes del ingreso, y recibieron corticoterapia por este diagnóstico. Ambos pacientes tuvieron una evaluación tomográfica que mostró compromiso del seno maxilar y tejido óseo circundante, con endoscopia nasal diagnóstica y terapéutica para desbridamiento. Se obtuvieron muestras compatibles con mucormicosis en estudio histológico. Los pacientes fueron tratados con limpieza quirúrgica y anfotericina B desoxicolato, sin embargo, presentaron evoluciones tórpidas. Por lo tanto, se adicionó la TOHC y mostraron una mejoría evidente tras cuatro semanas de tratamiento con controles subsiguientes sin presencia de mucormicosis. Resaltamos la evolución de estos pacientes con TOHC, en una enfermedad con importante morbimortalidad, que ha sido emergente durante la pandemia.
Asociación entre sobrepeso/obesidad y tuberculosis multidrogoresistente
Authors: Peinado Jesus , Lecca Leonid , Jiménez Judith , Calderón Roger , Yataco Rosa , Becerrra Mercedes , Murray Megan
Published: April 2023

Objetivo. Evaluar la asociación entre el sobrepeso/obesidad y la multidrogoresistencia en pacientes con y sin antecedentes de tratamiento para tuberculosis. Materiales y métodos. Estudio transversal realizado a través de un análisis secundario de la base de datos de una cohorte de tuberculosis, que incluyó datos de pruebas antropométricas y pruebas de sensibilidad a drogas en la visita basal de pacientes con y sin tratamiento previo para tuberculosis. Resultados. Se evaluaron 3,734 casos nuevos y 766 con antecedente de haber recibido tratamiento para tuberculosis. El sobrepeso/obesidad no se asoció a la multidrogoresistencia en pacientes con antecedente de tratamiento para tuberculosis, mostrando una razónde prevalencia de 0,97 con un intervalo de confianza al 95% de 0,68-1,38. Conclusiones. El sobrepeso/obesidad no está asociado a la multidrogoresistencia en tuberculosis; siendo el sobrepeso/obesidad un proceso dinámico que puede influir en las relaciones entre el sistema inmune y el sistema metabólico.
Papilomatosis laríngea recurrente con compromiso pulmonar: reporte de caso
Authors: Zumaeta-Saavedra Enrique , Chiara-Chilet Christian , Maquera-Afaray Julio , Luna-Vilchez Medalit
Published: April 2023

La papilomatosis respiratoria recurrente es una enfermedad neoplásica causada por el virus del papilomahumano y caracterizada por el crecimiento de lesiones proliferativas exofíticas que afectan la mucosa de las vías respiratorias. En su epidemiología se presenta una  distribución bimodal, con una forma juvenil en menores de 20 años, más agresiva, con múltiples lesiones apilomatosas y alta frecuencia de recurrencia, en comparación con la forma adulta. El compromiso pulmonar es poco frecuente y su manejo es un desafío. Se presenta el caso de un varón  de 13 años con antecedente de papilomatosis laríngea  desde los dos años. El paciente mostró dificultad respiratoria y múltiples nódulos estenosantes en laringe y tráquea, y varios quistes pulmonares visualizados en la tomografía de tórax. Se le realizó exéresis de las lesionespapilomatosas y traqueostomía. Recibió dosis única de bevacizumab 400 mg intravenoso y terapias respiratoriascon evolución favorable, sin recurrencias en el seguimiento.
La indefensión de la constitución neutral
Authors: Biglino Campos Paloma
Published: April 2023

Por expreso deseo de los constituyentes y según la jurisprudencia del Tribunal Constitucional, la Constitución carece de cláusulas de intangibilidad expresas. Este carácter abierto favoreció, en su momento, la apertura y el carácter integrador de nuestra norma fundamental. Ahora bien, en la actualidad, esta neutralidad constitucional suscita problemas. Algunos son de carácter teórico, ya que la ausencia de límites al poder de reforma no es coherente con el carácter racional normativo de nuestra norma fundamental. Otros pueden llegar a tener consecuencias prácticas, ya que se deja a la Constitución sin defensa ante sus enemigos. La experiencia europea, así como la historia constitucional, demuestra que las cláusulas de intangibilidad aparecen y se extienden para salvaguardar los elementos esenciales del propio derecho constitucional. En nuestro ordenamiento, no cabe excluir que el Tribunal Constitucional revise su propia jurisprudencia, dado que esta no tiene un carácter sustantivo. Mientras tanto, reconocer que la reforma constitucional ha de tener límites, al menos implícitos, puede servir para distinguir las modificaciones legítimas de la Constitución de otras que, aunque respeten los procedimientos, no son más que máscaras de legalidad.
Educación bajo la modalidad virtual y desempeño del docente en contexto de la Covid- 19
Authors: Escuza Mesías César Daniel , Chávez Alván Luis Martín , Alarcón Díaz Mitchell Alberto
Published: April 2023

La presente investigación tuvo como propósito determinar la relación entre la educación bajo la modalidad y el desempeño de los docentes de una universidad pública de Lima, Perú. El estudio se llevó a cabo a través de un enfoque cuantitativo, de tipo básico, con método hipotético deductivo y diseño descriptivo correlacional. Se consideró una muestra de 127 estudiantes de educación superior, quienes cursan los ciclos intermedios; los instrumentos empleados consideraron las dimensiones: recursos, asesoría virtual, dinámica virtual, competencias a desarrollar (para la medición de la educación virtual), planifica y organiza, gestión del proceso de enseñanza y compromiso docente (para recolectar los datos de la variable desempeño docente). Los resultados descriptivos muestran un nivel regular en ambas variables y la conclusión general revela la existencia de una correlación significativa entre las variables consideradas (Rho. ,987 y Sig. ,020).
Study of functional outcome of tibial plateau fractures treated with anatomical contoured locking compression plate
Authors: Mukherjee Subhankar , Vadadoriya Kevin , Chatterjee Rajiv , Sarkar Tapendranath , Sengupta Arunabha , Hashib Golam , Sardar Indrajit
Published: April 2023

Tibial plateau fractures tend to occur in patients with polytrauma and in elderly patients with history of significant fall. This study was undertaken to evaluate and explore new generation implant fixation in tibial plateau fractures which is expected to provide a stable fixation with minimum exposure, early mobilization, less complications and a better quality of life.

About 43 cases who had sustained tibial plateau fractures (Schatzker type I-VI) and operated with anatomical contoured locking compression plate were included. Follow-up of these patients was done at 6 weeks, 3 months, and 6 months after surgery. We analyzed all our subjects using IKDC score for functional outcome and plateau depression measurement for radiological outcome at 3 months and 6 months.

All the 43 fractures analysed in this study were graded in accordance to the Schatzker classification. It was observed that most of these fractures, i.e., 16 out of 43 (37.2%) were type VI and 13 out of 43 (30.2%) type V. The average knee flexion at 3 months was 105.7±8.49 degrees and at 6 months 120.6±8.61 degrees. After evaluation, it was observed that at 6 months, 3 patients had extension lag (7%) out total 43 patients. Most of the patients had average IKDC score of 80.2±7.91% at 3 months which increased to average 86.92±8.05% at 6 months.

Achieving and maintaining anatomical reduction becomes easy with advanced design of these plates, which helps in early mobilization and hence obtaining good functional and radiological outcomes of tibial plateau fractures.
Functional outcome in the total hip arthroplasty
Authors: Chiranjeevi K P  , Vinjamuri A Raj Sharma , Sivanandan M Hari , Sangolgi Nagesh , Athipathi S
Published: April 2023

Total hip arthroplasty is a surgical treatment that has been thoroughly documented. The capacity of Total Hip Replacement arthroplasty to treat pain associated with hip joint pathology while retaining mobility and stability of the hip joint is the key to its effectiveness.

The goal of this study was to use the Modified Harris hip score and radiological examination to assess the clinical and functional outcomes of total hip arthroplasty.

The study was carried out on 33 hips of 30 patients of Total Hip Replacement operated in the Department of Orthopedics, Vinayaka missions medical College and Hospital and Vinayaka missions Hitec Hospital, Salem, from August 2012 to September 2014. This was a retrospective as well as prospective study. Patient follow up was for a minimum of 6 weeks to a maximum of 12 months (1yr).

9 patients underwent uncemented total hip replacement in which for 5 patients the acetabular cup was fixed with 2 acetabular screws each. During the procedure 1 patient had Type A2 Vancouver fracture of the proximal femur which was fixed with SS wire cerclage which united as documented by the follow up X-rays. Postoperatively, for two patients we came across dislocation due to adductor contracture, was reduced following adductor tenotomy. Patients were found to be doing normal daily activities by the follow-up. The mean overall pre-operative score was 33.3, which improved to a mean score of 94.2 after surgery.

Dislocation was seen in 2 individual patients.

After THR, which was conducted on a population of active individuals, 96.9% of patients experienced excellent or good pain reduction and function. When pain sufferers were included, the overall average score was 90 points, but after a minimum of five years of follow-up of 91 hips treated with the PCA prosthesis, the average score was 93 points.
Comparison of clinical outcomes of Endoscopic vs Microscopic lumbar discectomy: A prospective randomized controlled study
Authors: Krishnan Nandu , Vellara Jim F , Krishnan Jai , Augustine John , Mohan Vipin
Published: April 2023

To compare clinical and functional outcomes of Endoscopic and Microscopic lumbar discectomy in patients with L3-L4, L4-L5, L5-S1 intervertebral disc prolapse.

50 patients planned for surgical discectomy, were randomized by selecting every alternate case for either ED or MD, and their outcomes were compared on basis of Pain relief by VAS at pre op and at 6 months POD, difference in surgical time, complications, number of days of stay at the hospital, patient satisfaction assessment and time to return to work.

On comparing the VAS scores of both the groups at preop and at 6-month post op period, the average VAS is reduced by 74% in the Endoscopic groups (Mean VAS (preop)= 8.76 +/- 1.12 to Mean VAS (at 6months) = 1.36 +/- 1.15) while it reduced by 72.4% (Mean VAS (preop)= 8.56+/- 1.12 to Mean VAS (at 6months) = 1.36 +/- 1.142) in the microscopic group. The mean time for ED is 81.4 minutes (SD=15.38) and for MD is 85.20 minutes (SD= 19.36). 80% patients iMD patients got discharged by POD3 compared to 64% in ED. Satisfaction rates by McNab criteria in ED is 72% and in MD 64%. 60% patients with ED went back to work within POD30 compared to 40% in MD group.

Both the techniques are effective and safe for lumbar discectomy, but when it comes to patient satisfaction and return to work, endoscopic method has a slight advantage whereas in levels above L4/L5 and far lateral discs, microscopic technique is the technically better choice.
Modeling mental peculiarities of a decision maker by a Fourier-holography technique
Authors:   ITMO University, Pavlov A.V. , Gaugel A.O. ,   ITMO University
Published: April 2023

A task of modeling individual mental features of a decision-maker using a Fourier holography setup is considered. The problem is considered for a situation when current conditions of decision-making contradict to the previously learned rule of decision-making logic modeled by the non-cooperative game "Prisoner's Dilemma". The approach to the problem is based on a hypothesis of the correlation between mental features and the properties of the neural network as a material carrier of intelligence. The 6f Fourier holography scheme of the resonant architecture is considered as a three-layer neural network implementing a neuro-physiologically motivated concept of the "excitation ring" proposed by A.M. Ivanitsky. We analytically assess the dependence of the validity limits of the classical total probability formula for a disjunction of incompatible events on the characteristics of low-frequency filters in holograms and the correlation radii of the training image of the basic decision rule. Analytical results are confirmed by results of the numerical simulation.
On classification of Sentinel-2 satellite images by a neural network ResNet-50
Authors:   ISDCT SB RAS – Matrosov Institute for System Dynamics and Control Theory of the Siberian Branch of the RAS, Bychkov I.V. , Ruzhnikov G.M. ,   ISDCT SB RAS – Matrosov Institute for System Dynamics and Control Theory of the Siberian Branch of the RAS, Fedorov R.K. ,   ISDCT SB RAS – Matrosov Institute for System Dynamics and Control Theory of the Siberian Branch of the RAS, Popova A.K. ,   ISDCT SB RAS – Matrosov Institute for System Dynamics and Control Theory of the Siberian Branch of the RAS, Avramenko Y.V. ,   ISDCT SB RAS – Matrosov Institute for System Dynamics and Control Theory of the Siberian Branch of the RAS
Published: April 2023

Various combinations of neural network parameters and sets of input data for satellite image classification are considered in the article. The training set is completed with a NDVI (normalized difference vegetation index) and local binary patterns. Testing of classifiers created on a different number of epochs and samples is carried out. Values of the neural network hyperparameters are determined that allow a classification accuracy of 0.70 and an F-measure of 0.65 to be achieved. Separation into classes with similar spectral characteristics is shown to offer low classification quality at different parameters and input data sets. Additional information is required. For example, for forests to be divided into more detailed classes, one needs to employ classifiers that use images from different seasons and vegetation periods. In addition, the training set needs to be extended to take into account various natural zones, soils, etc.
Masculino y femenino : dualidad y poder en el Tahuantinsuyo
Authors: Hernández Astete Francisco
Published: April 2023

En esta ponencia buscamos acercarnos al papel "político" de la mujer en el Tahuantinsuyo desde el discutido y clásico criterio de la dualidad, dado que éste cobra en las oposiciones masculino-femenino su más clara representación, pues definitivamente el hombre y la mujer constituyen la más clara combinación de oposición y complementariedad y, por supuesto, una sociedad organizada en términos duales no podía dejar de tener este tipo de representación. Esta dualidad por géneros involucraría no sólo la vida doméstica y la distribución de tareas a ese nivel, sino que además imprimía de caracteres duales según el género a todos los ámbitos de la vida en el Tahuantinsuyo, desde el comportamiento de las divinidades hasta el propio ejercicio del poder.
Conflictos políticos e identidad étnica : el Altiplano peruano entre 1866 y 1868
Authors: Jacobsen Nils
Published: April 2023

Los días 4 y 5 de noviembre de 1866 cientos de campesinos de las comunidades aledañas a Huancané invadieron esta capital provincial, situada cerca al Lago Titicaca, a unos 1,000 kilómetros al sureste de Lima, cercana a la frontera con Bolivia. Don Mariano Días, el subprefecto, salvó a duras penas la vida al refugiarse en la iglesia del pueblo, mientras que la muchedumbre saqueaba su casa. El 11 de noviembre la multitud de campesinos fue apaciguada por una delegación enviada desde la capital departamental, Puno, y encabezada por uno de los jueces de la Corte Superior y el obispo. Sin embargo, y contra las recomendaciones del obispo, 200 efectivos de la Guardia Nacional bajo el comando de un poderoso gamonal de la vecina provincia de Azángaro ocuparon el pueblo y procedieron a perseguir a los campesinos que aún se hallaban acampados en los cerros vecinos, matando varias docenas de ellos y adueñándose de sus ganados. Empezaba así a extenderse un ciclo de movilización rural en el Altiplano que duraría hasta inicios de 1868.