bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, attitude and practice of physicians and nurses at the cape coast teaching hospital in the Central Region of Ghana on spontaneous adverse drug reaction reporting
Authors: Powell Julianne Frimpomaa , Henneh Isaac Tabiri , Ekor Martins
Published: July 2023

Ghana’s rate of reporting adverse drug reaction (ADRs) over the past years has consistently been below the WHO standard despite utilizing the spontaneous or voluntary reporting system. While underreporting undermines the pharmacovigilance system and poses a huge threat to public health safety, there is limited information on the perspectives of healthcare workers directly involved in drug administration. The present study investigated the knowledge, attitude and practice of physicians and nurses at the Cape Coast Teaching Hospital (CCTH) towards spontaneous reporting of ADRs (SR-ADRs). A descriptive cross-sectional survey was employed in the study. Pre-tested (Cronbach’s alpha value of 0.72) and validated questionnaires comprising 37 open-ended and close-ended questions were administered to 44 doctors and 116 nurses at the CCTH who had been practicing for at least six months prior to study. Out of the 160 administered questionnaires, 86 was administered face-to-face and the remaining via e-mails. Descriptive analysis was performed and the results were presented in simple frequencies and percentages. Binary logistic regression model was used to test association of the independent variables with SR-ADRs. With a response rate of 86.4% for physicians and 59.5% for nurses, 38 (35.5%) physicians and 69 (64.5%) nurses completed the questionnaires and returned same. Majority (82.3%, 88) of the respondents knew that it is their responsibility to report ADRs although their knowledge levels was found to be inadequate (that is ≤80%) in majority (66.7%) of the text items that assessed knowledge levels. On the attitude of respondents, it was found that 57% (61) of them agreed that under-reporting was due to complacency whereas 80.4% (86) of them agreed that it was due the lack of adequate training. On the issues of practice, the prevalence of encountering, assisting in the management, and reporting of ADRs were 26.1% (28), 17.8% (19) and 7.5% (8) respectively. Also, nurses were 1.22 times more likely to encounter a patient with ADRs and twice more likely to fill and forward ADR form than doctors during management. Respondents with more than six months but less than one year of practice experience were more likely (AOR = 1.38, 95% CI: 2.72–7.3) to encounter a patient with ADRs as compared to those with just six months of practice experience. Furthermore, male respondents were more likely (AOR = 2.42, 95% CI: 1–5.85) to encounter patients with ADRs but less likely (AOR = 0.49, 95% CI: 0.91–2.6) to fill and forward ADR form compared to their female counterparts. In conclusion, doctors and nurses at the CCTH had inadequate knowledge about ADRs and its existing pharmacovigilance systems, thus accounting for the low spontaneous ADRs reporting in the facility.
Integration degree of China’s the new development pattern of dual circulation and industrial green development
Authors: He Jianlin
Published: July 2023

The long-standing development pattern dominated by international circulation makes China face the risk of "low-end lock-in" and "being decoupling". In addition, the current global climate change and environmental crisis are becoming increasingly severe, coupled with the COVID-19 impact. Chinese enterprises must actively build a green development system for domestic industries in a mutually reinforcing manner in the context of the domestic general circulation, in order to adapt to the new dual circulation environment as soon as possible. This paper analyzes the specific coupling and coordination relationship between the two systems based on the relevant data of China’s three major industries from 2008–2014 using Index DEA, entropy value method, gray correlation analysis and coupling coordination model. The results of the study show that: the two systems of dual circulation pattern and industrial green development have a strong correlation and basically present a coupling relationship, but within the industry, there is a problem of the collapse of the tertiary industry. In terms of the type of coupling, the domestic and international circulation in general gradually present the green development leading state, except for the primary industrial segment of the international circulation. On the whole, the coupling quality of the two systems needs to be further improved. Based on this, this paper puts forward the following suggestions: (1) coordinate the internal and external development of the industry; (2) take innovation as the driving force to promote the green transformation of industries; (3) take green sharing as the goal to strengthen the policy orientation of green development; (4) take the opportunity of mutual promotion of dual circulation to stabilize the steady state of green development coupling.
Pathogen and human NDPK-proteins promote AML cell survival via monocyte NLRP3-inflammasome activation
Authors: Trova Sandro , Lin Fei , Lomada Santosh , Fenton Matthew , Chauhan Bhavini , Adams Alexandra , Puri Avani , Di Maio Alessandro , Wieland Thomas , Sewell Daniel , Dick Kirstin , Wiseman Daniel , Wilks Deepti P. , Goodall Margaret , Drayson Mark T. , Khanim Farhat L. , Bunce Christopher M.
Published: July 2023

A history of infection has been linked with increased risk of acute myeloid leukaemia (AML) and related myelodysplastic syndromes (MDS). Furthermore, AML and MDS patients suffer frequent infections because of disease-related impaired immunity. However, the role of infections in the development and progression of AML and MDS remains poorly understood. We and others previously demonstrated that the human nucleoside diphosphate kinase (NDPK) NM23-H1 protein promotes AML blast cell survival by inducing secretion of IL-1β from accessory cells. NDPKs are an evolutionary highly conserved protein family and pathogenic bacteria secrete NDPKs that regulate virulence and host-pathogen interactions. Here, we demonstrate the presence of IgM antibodies against a broad range of pathogen NDPKs and more selective IgG antibody activity against pathogen NDPKs in the blood of AML patients and normal donors, demonstrating thatin vivoexposure to NDPKs likely occurs. We also show that pathogen derived NDPK-proteins faithfully mimic the catalytically independent pro-survival activity of NM23-H1 against primary AML cells. Flow cytometry identified that pathogen and human NDPKs selectively bind to monocytes in peripheral blood. We therefore used vitamin D3differentiated monocytes from wild type and genetically modified THP1 cells as a model to demonstrate that NDPK-mediated IL-1β secretion by monocytes is NLRP3-inflammasome and caspase 1 dependent, but independent of TLR4 signaling. Monocyte stimulation by NDPKs also resulted in activation of NF-κB and IRF pathways but did not include the formation of pyroptosomes or result in pyroptotic cell death which are pivotal features of canonical NLRP3 inflammasome activation. In the context of the growing importance of the NLRP3 inflammasome and IL-1β in AML and MDS, our findings now implicate pathogen NDPKs in the pathogenesis of these diseases.
Construction and application of an applicability evaluation system for garlic planters based on fuzzy comprehensive evaluation
Authors: Song Haichao , Dai Xiang
Published: July 2023

The widespread use of garlic planters has been hampered by the lack of comprehensive applicability evaluation criteria, as their functional and structural designs are sometimes subpar and their purchase and use are not always financially advantageous. In order to close this gap in the applicability evaluation system for garlic planters, a three-level index system based on Technical indicators, Economic indicators, and Working condition indicators was proposed in the current study. A fuzzy comprehensive evaluation method was then applied to achieve the evaluation with the help of an analytical hierarchy process and validity test. By providing basic descriptions, physical test results and specific calculation results to the consulted ten experts and collecting the scores for the 3rd level indicators, the first-generation garlic planter was analyzed for the practical application of the Pizhou-white garlic planting area based on the established applicability evaluation system. The evaluated score of 74.47 was towards the bottom of the "good" range. The findings also suggest that enhancing operational safety, implementing plant spacing and planting depth adjustments, enhancing ease of operation, and to some extent lowering capital cost will improve functional performance and economic performance. The upgraded machine was subsequently created using the optimization guidelines. Its applicability score was 77.52, representing a 4.1% gain over the original computer. It has reached the midpoint of the "good" range and has achieved the optimization goal. The proposed applicability evaluation system can generally draw unbiased conclusions and provide scientific evaluation methods for the promotion of garlic planters in specific areas, benefiting not only the design and improvement of garlic planters but also the purchasing and application of them. However, further indicator refinement and a more thorough evaluation method appear necessary before the evaluation system is made more widely available.
Health and wellness in the Australian coal mining industry: An analysis of pre-post findings from the RESHAPE workplace health promotion program
Authors: Bezzina B. Aaron , Ashton Lee , Watson Trent , James Carole L.
Published: July 2023

Objectives

Non-communicable diseases are the leading cause of death worldwide, accounting for 71% of deaths in 2021. The chronic and pervasive nature of these diseases spurs the need for novel treatment approaches, including using the workplace as a front for the promotion and dissemination of health messages and activities. Taking this into consideration, this study aimed to assess the efficacy of a workplace health promotion program that targeted nutrition, physical activity, and obesity outcomes in a New South Wales (NSW) coal mine site.

Design

A 12-week quasi-experimental pre-test–post-test study.

Setting

A coal mine site in rural NSW, Australia.

Participants

At baseline there were n = 389 participants, with similar numbers at follow-up (n = 420) as well as 61 participants from both timepoints (8.2% repeated measures), with 89% of participants being male.

Intervention

A multicomponent wellness intervention was implemented incorporating aspects of education, goal setting, and competition.

Outcomes

Physical activity, nutrition, and weight.

Results

The mean BMI at baseline was 30.01 kg/m2, and at follow-up 29.79 kg/m2(p = 0.39). At follow-up, participants reported 81% lower odds of engaging in the exercise category ‘no moderate physical exercise’ (OR = 0.09, p < 0.001), as well as 111% higher odds of meeting physical activity and exercise guidelines (OR = 2.11, p = 0.057). There were no changes to diet outcomes and no association between employment characteristics and participating in physical activity.

Conclusions

Workplace health promotion programs can be an efficacious strategy in improving physical activity outcomes and marginally improving weight outcomes in those in the mining industry. Further research is needed to determine the true effectiveness of these programs long-term, particularly in an environment as challenging and dynamic as the mining industry.
Does grit protect against the adverse effects of depression on academic achievement?
Authors: Kilgore Jenna , Collins Amanda C. , Miller Julie Anne M. , Winer E. Samuel
Published: July 2023

Depressive symptoms have been shown to be negatively related to academic achievement, as measured by grade point average (GPA). Grit, or the passion for and the ability to persevere toward a goal despite adversity, has been linked to GPA. Thus, grit may potentially buffer against the negative effects of depressive symptoms in relation to academic achievement. However, social desirability may might impact the validity of grit when assessed by self-report measures, so how these constructs are all related is unknown. The current study explored the relationship between depressive symptoms, grit, social desirability, and GPA among University students (N = 520) in the United States using a cross-sectional design. We conducted a moderated-moderation model to examine how social desirability moderated the relationship between depressive symptoms, grit, and GPA. Findings replicated prior work and indicated negative relationships between depressive symptoms and social desirability with GPA and a positive relationship, albeit non-significant, between grit and GPA. However, results suggest that grit did not moderate the relationship between depressive symptoms and GPA when including social desirability in the model. Future research should investigate this relationship in a longitudinal setting to further examine how grit and depressive symptoms influence one another in academic domains.
The influences of surface effect and elastic strain energy on structure and mechanical properties of dislocations in several diamond- and sphalerite-structured materials
Authors: Zhang Huili
Published: July 2023

The fundamental properties of dislocations in diamond-structured Si and sphalerite-structured GaAs, InP and CdTe are investigated based on lattice theory of dislocation, hoping to provide some theoretical references in improving the properties of related materials. The influences of the surface effect(SE) and elastic strain energy on the structure and mechanical property of dislocation are discussed systematically. After considering the SE, the core width of dislocation becomes wider due to the elastic interaction between atoms becomes stronger. Compared to glide partial dislocation, the correction of SE to shuffle dislocation is more obvious. Both the SE and the elastic strain energy affect the energy barrier and Peierls stress of dislocation. The influence of SE on energy barrier and Peierls stress mainly results from the misfit energy and elastic strain energy become lower when the core of dislocation becomes wider. While the influence of elastic strain energy on energy barrier and Peierls stress mainly results from the cancellation between misfit energy and elastic strain energy for they possess comparable amplitudes but opposite phases. In addition, it is deduced that for the studied crystals, the shuffle dislocations control the deformation at medium and low temperatures, while glide partial dislocations are responsible for high temperature plasticity.
Repurposing the Medicines for Malaria Venture’s COVID Box to discover potent inhibitors of Toxoplasma gondii, and in vivo efficacy evaluation of almitrine bismesylate (MMV1804175) in chronically infected mice
Authors: dos Santos Bruna Ramos , Ramos Amanda Bruno da Silva Bellini , de Menezes Renata Priscila Barros , Scotti Marcus Tullius , Colombo Fábio Antônio , Marques Marcos José , Reimão Juliana Quero
Published: July 2023

Toxoplasmosis, caused by the obligate intracellular parasite Toxoplasma gondii, affects about one-third of the world’s population and can cause severe congenital, neurological and ocular issues. Current treatment options are limited, and there are no human vaccines available to prevent transmission. Drug repurposing has been effective in identifying anti-T. gondii drugs. In this study, the screening of the COVID Box, a compilation of 160 compounds provided by the "Medicines for Malaria Venture" organization, was conducted to explore its potential for repurposing drugs to combat toxoplasmosis. The objective of the present work was to evaluate the compounds’ ability to inhibit T. gondii tachyzoite growth, assess their cytotoxicity against human cells, examine their absorption, distribution, metabolism, excretion, and toxicity (ADMET) properties, and investigate the potential of one candidate drug through an experimental chronic model of toxoplasmosis. Early screening identified 29 compounds that could inhibit T. gondii survival by over 80% while keeping human cell survival up to 50% at a concentration of 1 μM. The Half Effective Concentrations (EC50) of these compounds ranged from 0.04 to 0.92 μM, while the Half Cytotoxic Concentrations (CC50) ranged from 2.48 to over 50 μM. Almitrine was chosen for further evaluation due to its favorable characteristics, including anti-T. gondii activity at nanomolar concentrations, low cytotoxicity, and ADMET properties. Administering almitrine bismesylate (Vectarion®) orally at dose of 25 mg/kg/day for ten consecutive days resulted in a statistically significant (p < 0.001) reduction in parasite burden in the brains of mice chronically infected with T. gondii (ME49 strain). This was determined by quantifying the RNA of living parasites using real-time PCR. The presented results suggest that almitrine may be a promising drug candidate for additional experimental studies on toxoplasmosis and provide further evidence of the potential of the MMV collections as a valuable source of drugs to be repositioned for infectious diseases.
An acidic microenvironment in Tuberculosis increases extracellular matrix degradation by regulating macrophage inflammatory responses
Authors: Whittington Ashley M. , Turner Frances S. , Baark Friedrich , Templeman Sam , Kirwan Daniela E. , Roufosse Candice , Krishnan Nitya , Robertson Brian D. , Chong Deborah L. W. , Porter Joanna C. , Gilman Robert H. , Friedland Jon S.
Published: July 2023

Mycobacterium tuberculosis (M.tb) infection causes marked tissue inflammation leading to lung destruction and morbidity. The inflammatory extracellular microenvironment is acidic, however the effect of this acidosis on the immune response to M.tb is unknown. Using RNA-seq we show that acidosis produces system level transcriptional change in M.tb infected human macrophages regulating almost 4000 genes. Acidosis specifically upregulated extracellular matrix (ECM) degradation pathways with increased expression of Matrix metalloproteinases (MMPs) which mediate lung destruction in Tuberculosis. Macrophage MMP-1 and -3 secretion was increased by acidosis in a cellular model. Acidosis markedly suppresses several cytokines central to control of M.tb infection including TNF-α and IFN-γ. Murine studies demonstrated expression of known acidosis signaling G-protein coupled receptors OGR-1 and TDAG-8 in Tuberculosis which are shown to mediate the immune effects of decreased pH. Receptors were then demonstrated to be expressed in patients with TB lymphadenitis. Collectively, our findings show that an acidic microenvironment modulates immune function to reduce protective inflammatory responses and increase extracellular matrix degradation in Tuberculosis. Acidosis receptors are therefore potential targets for host directed therapy in patients.
Material-led creative processes in the context of design education
Authors: Laamanen Tarja-Kaarina , Mäkelä Maarit , Seitamaa-Hakkarainen Pirita
Published: July 2023

This article discusses research from the Design Experimentation and Exploration (DEE) course in the higher education context. The DEE course was designed to support MA design students’ understanding of their creativity in an explorative course. The data were drawn from the students’ weekly and final reflections, as well as from the notes by one of the researchers. We were interested in how material-led processes developed through repeated material explorations and experimentation during the DEE course. We found that, in this context, the material process was related to identity building, overcoming challenges in idea development, and conceptual inquiry. The results highlight how materials and making can intertwine with personal goals. They thus provide an example for educators in other contexts to support students in bravely following uncertain processes, letting go, and experimenting freely.
Los archivos municipales en Extremadura (España) a finales del s. XVIII a través del interrogatorio de la real audiencia
Authors: Solano Macías Carmen , Vivas Moreno Agustín
Published: July 2023

A principios de 1791, la Real Audiencia de Extremadura llevó a cabo un interrogatorio en todas las localidades de la provincia, que entonces estaban agrupadas en nueve circunscripciones territoriales llamadas “partidos”. Este cuestionario fue respondido por las autoridades de todas las poblaciones extremeñas, y complementado con los informes realizados por el visitador de la Audiencia responsable de cada partido. En el interrogatorio se aborda, entre otras temáticas, la situación y características de los archivos públicos. Tomando como base la información recogida en los pliegos de respuestas de las distintas localidades y en los informes de los visitadores, hemos elaborado un sistema de información que nos ha permitido analizar la situación de estos archivos dentro del entorno geográfico - temporal en el que se realizó el interrogatorio. Descubrimos, así, la ambigüedad que existía en el propio concepto de archivo, la existencia de éstos en las poblaciones de Extremadura, su ubicación física, quién los gestionaba, los tipos documentales que se conservaban en ellos o los problemas que presentaban. Todo ello muestra el panorama general de los archivos públicos en la Extremadura de finales de la Edad Moderna.
Feminismos de datos en los labs: brechas y tensiones en las agendas de innovación iberoamericanas
Authors: Brussa Virginia
Published: July 2023

El artículo recorre dos grandes agendas situadas en Iberoamérica. Una desarrollada desde los laboratorios de innovación pública –espacios de encuentro, experimentación, intercambio y colaboración en el ámbito de las políticas públicas– y la otra desde el feminismo en vinculación con la ciencia de datos. El objetivo es dar cuenta de la necesidad de profundizar la interrelación entre políticas de innovación pública, procesos de ciencia de datos y activismos de datos feministas para disminuir sesgos en los procesos de políticas públicas. Para ello, se analizan los mensajes de Twitter de ocho laboratorios de innovación pública entre diciembre de 2021 y mayo de 2022 y se investigan las agendas de innovación ampliada a partir de los aportes de siete entrevistas en profundidad realizadas a referentes iberoamericanas en laboratorios, ciencia de datos, feminismos y activismos. Este análisis muestra desacoples y desconexiones entre la «agenda de innovación» pública y la «agenda de innovación ampliada». Esta última provista de acciones y miradas del activismo y ciencia de datos feminista. Esa conformación actual de las agendas, permeadas por una coyuntura que fomenta la automatización, inteligencia artificial y uso de técnicas de ciencia de datos, pone de manifiesto la relevancia de ajustes desde el campo de la justicia de datos y los principios feministas. Por último, el artículo propone una hoja de ruta de conversaciones abiertas para potenciar las conexiones y acoples necesarios entre dichas agendas de interés público. Allí las connotaciones tecnológicas y técnicas, pero también territoriales, tienen un rol importante como punto de partida e inflexión para promover procesos de cocreación inclusivos en las agendas de los laboratorios de innovación pública.
La criatura en mí: género y salud mental en Why be happy when you could be normal? y Fármaco
Authors: León Prieto Luis
Published: July 2023

El objetivo de este texto es establecer un análisis comparativo entre dos obras contemporáneas: Why Be Happy When You Could Be Normal? (Jeanette Winterson, 2011) y Fármaco (Almudena Sánchez, 2021). Partiendo de diferentes contextos, ambas incluyen un relato autobiográfico atípico, no lineal y que comparte el trasfondo de la enfermedad mental, de forma especial en cuanto a la depresión y el suicidio. A partir de estos dos motivos temáticos, se expondrá el modo en el que ambas historias los reflejan, además de otros relacionados, como el empleo de medicamentos como estrategia de curación o las diferencias en las condiciones sociales y económicas de las autoras, que también influyen en cómo afrontan sus procesos. La lectura crítica de estas obras se apoyará en una serie de fuentes secundarias, siendo de especial relieve aquellas que estudian el estamento médico según una perspectiva de género, para llegar a la conclusión de que, si bien Winterson y Sánchez comparten una sensibilidad creativa común al narrar su propia experiencia, es esta última quien valora de forma más positiva la metodología farmacológica que ha mejorado su salud, pero no olvida otras cuestiones sociales necesarias también para su bienestar; en el caso de Winterson, su enfermedad se muestra como un episodio dentro de la búsqueda de la figura materna, pero asimismo como una parte interna de su personalidad con la que debe convivir. Este es un aspecto en común con Sánchez, aprender a compartir la existencia con su «monstruo» particular y, además, utilizar el poder curativo de la escritura como parte de su terapia.
Repensando el malestar de las mujeres y la atención psiquiátrica desde una mirada descolonial: aportes a una práctica antirracista
Authors: Solis-Gomez Susana Beatriz
Published: July 2023

La premisa de este artículo guarda relación con la idea de que los estudios feministas que han abordado el vínculo de las mujeres con la disciplina Psiquiátrica y han analizado la emergencia de malestares y/o sufrimiento psíquico en estas, lo han hecho desde un marco de análisis centrado en el contexto occidental-moderno. Ello ha hecho que se pase por alto el análisis del fenómeno en el caso de las mujeres cuyas vivencias no responden, o al menos no del todo, a la lógica eurocentrada, como es la situación de aquellas que pertenecen a Pueblos Afrodescendientes y Pueblos Originarios o Primeras Naciones. Ante esto, se sostiene que una perspectiva descolonial permite situarse críticamente ante la Psiquiatría en su entrecruzamiento con el racismo, haciendo visibles, por un lado, las ideas y prácticas psiquiátricas y la afectación específica de estas a las poblaciones no occidentales, y por otro, dando cuenta de la relación entre las condiciones estructurales, cruzadas por la colonialidad, y la emergencia de malestares. Aparte de ello, posibilita lograr un análisis en términos epistemológicos que da cuenta de los efectos particulares de la Psiquiatría como paradigma médico en los Pueblos que se distancian de las lógicas eurocentradas. El artículo presenta, primeramente, un recorrido por los principales aportes feministas a este ámbito, para luego describir, sintéticamente, el desarrollo de la práctica psiquiátrica, dando lugar, en una tercera parte, a la aplicación de un análisis descolonial de los elementos descritos. Se culmina con la presentación de aportes a una práctica antirracista en el ámbito de la salud mental.
Investigating the Role of Culture in Legal Practices in Spain
Authors: Bozorgi Majedeh
Published: July 2023

Law, as the science that organizes and regulates society, will inevitably change its method and approach with the change in social relations. Developments, especially in the field of public law, with the speed with which the laws adopted in the legislative process cannot be adapted and updated with them, have made other sources of law, such as judicial procedure, have different functions. The following article seeks to examine and analyze the question of whether culture has influenced the formation of judicial procedure in Spanish public law. And in case of a positive answer, in what form? The results of the positive response to the developments in the contemporary world and their impact on the science of law are the judicial procedure in three parts: a) creating and establishing new norms, b) supplementing the existing norms in the legal system, c) protect the rights and freedoms of individuals, which have been recognised as a consequence of the status of judicial proceedings among the sources of public law and its promotion.
EPHEDRACEAE: Main Substances and Pharmacological Applications
Authors: De Godoi Diego , Ginizeli Natalia Giovana , Moraes Valdete Catarina de Almeida , Francisco Bruno Santos
Published: July 2023

This study aims to analyze the relationships among various species of Ephedraceae, such as
Ephedra sinica Stapf
, Ephedra intermedia Schrenk & C.A.Mey. and
Ephedra gerardiana Wall. ex Klotzsch & Garcke, regarding their medicinal and pharmacological uses, revisiting their history in ancient Traditional Chinese Medicine, as well as their current applications in treating respiratory tract diseases and analyzing studies on their use in various applications. Platforms such as Google Scholar, Scielo, and PubMed were used for the search, using the following keywords: Ephedraceae; Ephedra and obesity; Ephedra and pharmacology; ephedrine and risks. Additionally, this study seeks to highlight and disseminate information about the dangers associated with the indiscriminate and non-prescribed use of products and substances with a high content of ephedrine alkaloids, by investigating bibliographies addressing such topics, thus highlighting the benefits and risks associated with the pharmacological use of these plants. Due to its medicinal compounds, Ephedraceae plants have been used in traditional Chinese medicine for thousands of years. Research is being conducted to identify these compounds and their application in medicine. Yet, ephedrine is indiscriminately used for weight loss and supplementation, with serious side effects. It is crucial that the dosage and use of these compounds be supervised by a medical professional.
Medication-Wide Study: Exploring Medication Use 10 Years Before a Diagnosis of Inflammatory Bowel Disease
Authors: Bonfils Linéa , Karachalia Sandri Anastasia , Poulsen Gry J. , Agrawal Manasi , Ward Daniel J. , Colombel Jean-Frederic , Jess Tine , Allin Kristine H.
Published: July 2023

INTRODUCTION:

There is growing interest in the prediagnostic phase of inflammatory bowel disease (IBD) and in the overlap of IBD with other diseases. We described and compared use of any prescription medication between individuals with and without IBD in a 10-year period preceding diagnosis.

METHODS:

Based on cross-linked nationwide registers, we identified 29,219 individuals diagnosed with IBD in Denmark between 2005 and 2018 and matched to 292,190 IBD-free individuals. The primary outcome was use of any prescription medication in years 1–10 before IBD diagnosis/matching date. Participants were considered as medication users if they redeemed ≥1 prescription for any medication in the World Health Organization Anatomical Therapeutic Chemical (ATC) main groups or subgroups before diagnosis/matching.

RESULTS:

The IBD population had a universally increased use of medications compared with the matched population before IBD diagnosis. At 10 years before diagnosis, the proportion of users was 1.1-fold to 1.8-fold higher in the IBD population in 12 of 14 ATC main groups of medication (P-value < 0.0001). This applied across age, sex, and IBD subtypes, although it was the most pronounced for Crohn's disease (CD). Two years before diagnosis, the IBD population had a steep increase in medication use for several organ systems. When analyzing therapeutic subgroups of medication, the CD population exhibited 2.7, 2.3, 1.9, and 1.9 times more users of immunosuppressants, antianemic preparations, analgesics, and psycholeptics, respectively, than the matched population 10 years before diagnosis (P-value < 0.0001).

DISCUSSION:

Our findings demonstrate universally increased medication use years before IBD, especially CD, diagnosis and indicates multiorgan involvement in IBD.
The Clinical Impact of Obesity in Patients With Disorders of Defecation: A Cross-Sectional Study of 1,155 Patients
Authors: Chaichanavichkij Pam , Vollebregt Paul F. , Keshishian Karekin , Knowles Charles H. , Scott S. Mark
Published: July 2023

INTRODUCTION:

Obesity is a global epidemic. Its clinical impact on symptoms of fecal incontinence (FI) and/or constipation and underlying anorectal pathophysiology remains uncertain.

METHODS:

This is a cross-sectional study of consecutive patients meeting Rome IV criteria for FI and/or functional constipation, with data on body mass index (BMI), attending a tertiary center for investigation between 2017 and 2021. Clinical history, symptoms, and anorectal physiologic test results were analyzed according to BMI categories.

RESULTS:

A total of 1,155 patients (84% female) were included in the analysis (33.5% normal BMI; 34.8% overweight; and 31.7% obese). Obese patients had higher odds of FI to liquid stools (69.9 vs 47.8%, odds ratio [OR] 1.96 [confidence interval: 1.43–2.70]), use of containment products (54.6% vs 32.6%, OR 1.81 [1.31–2.51]), fecal urgency (74.6% vs 60.7%, OR 1.54 [1.11–2.14]), urge FI (63.4% vs 47.3%, OR 1.68 [1.23–2.29]), and vaginal digitation (18.0% vs 9.7%, OR 2.18 [1.26–3.86]). A higher proportion of obese patients had Rome criteria-based FI or coexistent FI and functional constipation (37.3%, 50.3%) compared with overweight patients (33.8%, 44.8%) and patients with normal BMI (28.9%, 41.1%). There was a positive linear association between BMI and anal resting pressure (β 0.45, R2 0.25, P = 0.0003), although the odds of anal hypertension were not significantly higher after Benjamini-Hochberg correction. Obese patients more often had a large clinically significant rectocele (34.4% vs 20.6%, OR 2.62 [1.51–4.55]) compared with patients with normal BMI.

DISCUSSION:

Obesity affects specific defecatory (mainly FI) and prolapse symptoms and pathophysiologic findings (higher anal resting pressure and significant rectocele). Prospective studies are required to determine whether obesity is a modifiable risk factor of FI and constipation.
Metachronous Squamous Cell Carcinoma of the Esophagus After Resolution of Previous Adenocarcinoma
Authors: Taj Sobaan , Hussain Azhar , Sanekommu Harshavardhan , Miller Brett , Austin Christopher , Kilada Catherine , Dandu Sowmya , Ahsan Eram , Erler Brian S.
Published: July 2023

Esophageal cancer is the sixth leading cause of cancer-related death worldwide. Metachronous malignancies refer to multiple independent primary cancers diagnosed at least 6 months apart. The incidence of metachronous esophageal cancers with different histologic subtypes is extremely rare. This case presents an unprecedented occurrence of esophageal adenocarcinoma, followed by metachronous squamous cell carcinoma.
O processo de construção do texto escrito de um ponto de vista cognitivo-discursivo
Authors: Prado Anne Carolline Dias Rocha , Pereira Márcia Helena de Melo
Published: July 2023

Neste artigo, buscamos refletir sobre o texto enquanto um trabalho processual que demanda esforço e envolve diversas etapas. Ancoradas teoricamente no Círculo de Bakhtin (BAKHTIN, 2015 [1930-1936]; 2016 [1952-1953]; VOLÓCHINOV, 2018 [1929]; 2019 1930]), para quem a linguagem é viva e dialógica, apresentamos uma proposta de modelo de processamento da escrita, assumindo a ideia de que um texto escrito é sempre elaborado no fenômeno social da interação discursiva e, dessa forma, mais do que etapas distintas, abrange aspectos históricos, ideológicos, cognitivos, textuais e discursivos. Os dados que analisamos, relacionados ao processo de construção de uma resenha acadêmica elaborada por uma estudante universitária, mostram que não se pode falar em processamento textual sem levar em consideração o contexto situacional, os campos de atuação humana, os gêneros do discurso, as relações dialógicas, além da mobilização de conhecimentos e das próprias etapas de escritura. Além disso, o material de análise comprova que apenas com trabalho e esforço é possível produzir um texto escrito.
Associations between secure base script knowledge in early childhood and perceived quality of attachment in middle childhood
Authors: Fernandes Carla , Fernandes Marilia , Antunes Marta , Santos António J. , Vaughn Brian , Verissimo Manuela
Published: July 2023

Previous studies suggest that mental representations of attachment can show moderate stability across childhood but none of these considered the child’s use of the Secure Base Script (SBS). This study tested the longitudinal stability of attachment representations from early to middle childhood, providing data that will allow us to determine whether the SBS score behaves like other attachment measures for early childhood in this regard. A sample of 70 Portuguese preschool children (36 girls) was assessed regarding their access to and use of the SBS when producing narratives relevant to attachment themes (e.g., separation, fear of ambiguous threat) at age 5 years using the Attachment Story Completion Task. Follow-up assessments were obtained at 8 and 9 years of age using the Kerns Security Scale. Security scores for both parents were obtained from the child in both years. All cross-time correlations were positive and significant. Subsequent tests on correlation magnitudes for mothers vs. fathers were not significant. Finally, correlations for mother/father security scores were significant at both age levels. Our findings indicate that children’s access to and use of the SBS in early childhood does predict their perceived quality of attachment with parents in middle childhood. Overall, our results indicate that access to and use of SBS in young children’s attachment-relevant narratives is a valid and potentially productive measure.
Mismidad y unicidad de la persona (según la perspectiva cristiana)
Authors: González Fernández Enrique
Published: July 2023

La persona no está sola y aislada, sino en convivencia. Aunque yo sea una realidad cambiante, no idéntica, soy el mismo que antes y que después; hay, por tanto, una esencial mismidad, que no es «identidad» en el sentido de las cosas o, más aún, de los objetos ideales. Según esta nueva lógica y nueva metafísica, yo me veo a mí mismo como alguien inconfundible, una persona concreta y única, una realidad histórica, no «algo», «quién» unido a mi «qué», con nombre propio. Me siento libre y, por tanto, responsable, capaz de elección y decisión. Mi vida es mía, la de cada cual, única e irrepetible. Pero, desde los griegos, hay una larga serie de intentos de «cosificación» del hombre: las viejas lógica y metafísica (basadas en la identidad y en la inmovilidad) ven a la persona como sustancia.
«Homo cogitat». La teoría spinoziana de la mente consciente
Authors: Travaglia Marcos
Published: July 2023

Este trabajo se inserta en la discusión sobre la filosofía de la mente de Spinoza, específicamente en torno a si ofrece o no una teoría de la consciencia. Sostenemos que sí lo hace y que se explica a través de la articulación de varios conceptos según una particular lectura del llamado «paralelismo». Procedemos de la siguiente manera. Primero ofrecemos una caracterización preliminar de definición spinoziana de mente. Entonces damos una interpretación de la ontología. Por último, aplicamos esta lectura a la relación mente-cuerpo, deteniéndonos en la física, las ideas de ideas y el conatus.
Verkehrskonzepte für Stadt und Umland zwischen Krisenmanagement und Zukunftsgestaltung
Authors: Topp Hartmut H.
Published: July 2023

In Großstädten kommt etwa die Hälfte des Autoverkehrs aus dem Umland. Die “Pendlerschere” öffnet sich weiter. Es gibt keine in sich konsistente Verkehrs- und Umweltpolitik. Was die Städte machen, ist Krisenmanagement, und das versagt im Umland. Kooperatives Verkehrsmanagement, Park-and-Ride-Terminals, Güterverkehrszentren und City-Logistik, individuelle Leitsysteme und computergestütztes Autofahren werden kritisch behandelt. Fazit: Die technischen Ansätze bleiben Krisenmanagement, solange sie nicht durch neue Verkehrspolitik geänderte Ziele erhalten. Der Autor plädiert für einen Gesamtansatz, indem preispolitische Komponenten mehr Gewicht haben sollen.
Die ästhetischen Komponenten des Landschaftsverbrauchs
Authors: Wienken Ralf
Published: July 2023

Der Begriff Landschaftsverbrauch ist bislang meist entweder auf die Versiegelung von Freifläche reduziert oder diffus zur Beschreibung negativer Auswirkungen von infrastrukturellen Maßnahmen oder der industriellen Produktion gebraucht worden. Inhaltlich und sprachlich sinnvoll ist er jedoch nur, wenn er Veränderungen im anorganischen, organischen und anthropologischen Bereich der Landschaft umfaßt, die jeweils durch raumwirksame menschliche Aktivitäten hervorgerufen werden. Dementsprechend sollte von Landschaftsverbrauch nur gesprochen werden, wenn drei Komponenten vorliegen: Freiflächenverbrauch als Versiegelung vorher freier Fläche, Landschaftsbeeinträchtigung als Sinken der Diversität oder des Integrationsniveaus von Ökosystemen und Landschaftsentwertung als Verarmung der Landschaft hinsichtlich kultureller Standards. Nur auf diese Weise wird der Begriff dem vielschichtigen Phänomen des Verbrauchs der Landschaft gerecht. Bei Bedarf läßt sich seine (unvermeidliche) Komplexität ohne weiteres auflösen, indem er in seine Bestandteile differenziert wird.
Ressourcenverteilung und Ressourcentransfer im deutschen Bundesstaat
Authors: Kunz Volker
Published: July 2023

Im vereinigten Deutschland gewinnt die Diskussion um die zukünftige Ausgestaltung des Föderalismus zunehmend an Stellenwert. Vor allem die Frage, ob, und wenn ja, nach welchen Grundprinzipien die Finanzverfassung zu reformieren ist, erlangt in Anbetracht zurückgehender Verteilungsspielräume zentrale Bedeutung. Die Zeiten, in denen politische Entscheidungen durch den Stil der Konsenspolitik bestimmt waren, scheinen vorbei zu sein. Die Auseinandersetzungen in den 80er Jahren um die Ausgestaltung des Länderfinanzausgleichs bezeichnen einen entscheidenden Einschnitt in die föderalen Interaktionsbeziehungen. Vor diesem Hintergund wird die Forderung nach Regionalisierung der Finanzpolitik im Rahmen einer umfassenden Reform der institutionellen Arrangements durch Regionalisierung erhoben. Als Grundlage dient eine entscheidungstheoretisch und empirisch orientierte Analyse der bestehenden Mängel der Politik- und Finanzverflechtung.
Entwicklungspolitik für und in den neuen Bundesländern
Authors: Maier Jörg , Satzinger Thomas
Published: July 2023

In Ergänzung zu der Entwicklungspol-Konzeption des Bundes in den neuen Bundesländern erscheint es notwendig, auch die weniger beachteten ländlichen Räume zu fördern und zu entwickeln. Dies um so mehr, um in Zukunft nicht lang anhaltende regionale Disparitäten zu schaffen. Grundlage dafür kann auf kommunaler Ebene die Erarbeitung eines Kreisentwicklungsprogramms sein, das als gemeinsamer Orientierungsrahmen für die politischen Entscheidungsträger dient. Die Schritte dabei sind neben eingehenden Struktur-Analysen, der Feststellung der Stärken und Schwächen des Untersuchungsgebietes, der Entwurf von Visionen, die Ausarbeitung konkreter Strategien und Maßnahmen. Alle Untersuchungsschritte sind dabei von einem hohen Partizipationsgrad der Betroffenen gekennzeichnet, um die Akzeptanz des Programms zu erhöhen und somit seine Realisierung zu erleichtern.Als Instrument der Problem- und Zukunftsbewältigung in den neuen Bundesländern ist ein Kreisentwicklungsprogramm durchaus geeignet, diesen Anspruch zu erfüllen, besonders deshalb, weil derzeit die Regionalplanung sich erst im Aufbau befindet. Die Konzeption einer Entwicklungspolitik auf Kreisebene am Beispiel des Kreises Eilenburg nördlich von Leipzig soll den politisch Verantwortlichen Mut für einen eigenen Weg der regionalen Entwicklung machen.
Verkehrsvermeidung – welche Rolle kann die Raumplanung spielen?*
Authors: Schmitz Stefan
Published: July 2023

Die Siedlungsstruktur stellt eine der zentralen Rahmenbedingungen für das Verkehrsgeschehen dar. Die in den letzten Jahrzehnten abgelaufenen Prozesse, die man mit den Schlagworten „Ausdifferenzierung der räumlichen Nutzungsstrukturen“, „Suburbanisierung“ und „großräumige Arbeitsteilung“ zusammenfassend beschreiben kann, haben einerseits zu längeren Wegen im Verkehr geführt. Sie haben gleichzeitig aber auch schwächere und schwerer bündelbare Verkehrsströme produziert. Disperse räumliche Zielstrukturen bieten nur geringe Chancen für Fahrgemeinschaften, bieten kaum sinnvolle Möglichkeiten der Abstimmung von öffentlichem Verkehr und Individualverkehr und bieten nur geringe Attraktivität für die „Eigenfortbewegung“ mit dem Fahrrad und zu Fuß.Durch kompakte Siedlungsgebilde mit ausgewogener Nutzungsmischung ließe sich nicht nur Verkehr vermeiden, es ließe sich auch der verbleibende Restverkehr umweltschonender abwickeln. Es ist jedoch zumindest dafür zu sorgen, daß eine weitere Entflechtung z.B. von Wohnen und Arbeiten oder von Produktion und Konsum verhindert wird. Hierbei ist zweifellos die Raumplanung mit ihren Instrumenten zur Steuerung der Flächennutzung gefordert. Eine solche Forderung ist gerade vor dem Hintergrund der dramatischen Entwicklung der Siedlungsstruktur in den neuen Ländern mit ihren Folgen für das Verkehrswachstum berechtigt. Angesichts der Schwäche ihrer Steuerungsinstrumente werden aber Stadtplanung, Regionalplanung und Raumordnung allein das Problem nicht lösen können. Hier muß man sich vielmehr die tiefere Ursache des Auseinanderdriftens der räumlichen Nutzungstrukturen und der Verkehrsentwicklung vergegenwärtigen: die immer geringer werdenden Raumwiderstände aufgrund fallender Verkehrskosten und dauernd verbesserter Verkehrsinfrastruktur.Das Ziel der Verkehrsvermeidung verlangt eine integrierte Verkehrs‑, Raumordnungs- und Umweltpolitik, die einerseits auf nationaler und europäischer Ebene die notwendigen Rahmenvoraussetzungen schafft und andererseits auf lokaler und regionaler Ebene „konkret vor Ort“ dafür sorgt, daß diese Voraussetzungen in ein umweltbewußtes Verkehrsverhalten umgesetzt werden können. Denn Verkehrsvermeidung heißt nicht Verkehrsverbot, sondern die Bereitstellung der Möglichkeiten zur Verhinderung unnötiger Mobilität.
Dos nuevas especies de la subfamilia Asclepiadoideae (Apocynaceae) en la provincia de Salta, Argentina
Authors: Keller Héctor A.
Published: July 2023

Recent botanical explorations carried out in the northwest of Argentina allowed us to find two new species of Apocynaceae, one of them, which belongs to the genus Petalostelma, was found in the Garrapatas Private Reserve, General Güemes, in the Mountain Chaco region, the other, of the genus Philibertia, was found in the Quebrada de Escoipe, Chicoana, in inter-Andean valleys. In this contribution both taxa are described and illustrated.
El estudio patológico en tiempos de Building Information Modeling: de la teoría a la práctica
Authors: Chica-Segovia Angélica , León Carlos Alberto , Patiño-León Liilana Rocío
Published: July 2023

El Building Information Modeling (BIM) ha generado cambios importantes en la arquitectura y los estudios de patología no son ajenos a ello, pero su inmersión supone retos como armonizar los lenguajes digitales convencionales y contemporáneos aprovechando adecuadamente lo que ofrece el BIM. Este proyecto propuso una metodología partiendo de lo digital-convencional usada actualmente, con miras a vincularla con el BIM, integrando datos gráficos, cualitativos y cuantitativos en todas sus dimensiones para los diagnósticos y las intervenciones, sabiendo que la mirada experta debe formar parte de ello en todo caso. En una primera fase se estructuró la metodología convencional integral usando el concepto mecanismo de daño y la matriz de diagnóstico con los datos recolectados en campo, para ser parametrizados en un modelo BIM promoviendo su adecuado uso y su análisis, al ser posible integrar todas las disciplinas y las fases que intervienen en el proceso. Este artículo presenta la fase de formulación metodológica para la caracterización de edificaciones en su componente de patología, como instrumento de recolección de información en un lenguaje cualitativo y cuantitativo que se pueda gestionar desde el modelo BIM definiendo una estructura y una ruta para la elaboración del protocolo en sus tres fases: reconocimiento, diagnóstico e intervención, e integrando ordenadamente el análisis de la información mediante el método hipotético-inductivo que caracteriza la patología y que, por ahora, solo puede hacerse de la manera convencional.