bluuebunny/crossref_metadata_2025 huggingface dataset:
RECURSOS DA TERAPIA NARRATIVA DE SESSÃO ÚNICA EM TEMPOS DE PANDEMIA E ISOLAMENTO SOCIAL
Authors: Vilela e Souza Laura , Martins Lion Camila , Trombini Vidotto Letícia , Moscheta Murilo
Published: January 2021

A terapia de sessão única tem sido estudada em seus potenciais terapêuticos e suas possibilidades interventivas em cenários de emergência. No contexto da pandemia do Covid-19, um conjunto complexo de fatores emergem e podem produzir diferentes demandas para intervenções especializadas em saúde mental. Nesse texto, apresentamos as contribuições da modalidade de intervenção em sessão única fundamentada nos pressupostos da terapia narrativa. Iniciamos nosso texto com um esboço da complexidade que marca diferentes experiências da pandemia e isolamento social. Em seguida, apresentamos de forma breve os principais cuidados a serem realizados no atendimento psicológico voluntário brevíssimo, online e em situação de emergências. Na sequência, abordamos a metáfora narrativa e a estrutura, finalidade e passo a passo da terapia narrativa de sessão única. Destacamos a importância da construção um uma agenda de trabalho para delimitação do foco da intervenção, da descrição rica e externalizada do problema, seus efeitos e sua influência na vida do cliente, da busca, reconhecimento e valorização de narrativas alternativas e finalmente da construção de possibilidades de futuras a partir dos recursos identificados na sessão. Acreditamos que os recursos apresentados possam inspirar aplicações em variadas situações, sobretudo ao tomar em consideração a possibilidade de ampliar o acesso ao atendimento psicológico.
Global Think Tanks. Policy Networks and Governance
Authors: Morales Juan Jesús
Published: January 2021

Reseña del libro Global Think Tanks. Policy Networks and Governance, de James G. McGann y Laura C. Wheelan
Tele Education in Diabetic Patients during Coronavirus Outbreak
Authors: Dehghan Kamran , Zareipour Morad Ali , Zamaniahari Sahar , Azari Mina Tasouji
Published: January 2021

The number of cases of infection to coronavirus disease (COVID)-19, human casualties and economic losses are increasing, and one of the high-risk groups in which the risk of infection and death is high is diabetics. People with diabetes experience severe symptoms and complications if they are infected by COVID-19. One way to control and prevent the spread of the coronavirus is to stay home, avoid daily physical interactions, and quarantine at home. Due to the high prevalence of diabetes and the importance of long-term follow-up, Tele education in diabetic patients is one of the methods that provide care using communication means. As the quality of information received by diabetic patients improves, their awareness of treatment goals and, consequently, their acceptance of treatment methods will increase, which in turn will lead to greater effectiveness and better treatment outcomes. Finally, Tele education reduces contact between diabetics and physicians, therapists, and health care providers, thereby reducing the risk of disease.
Complications of Coronavirus Disease-19 in a Hospitalized Patient: A Case Report
Authors: Meshkova Iskra , Mijakoski Dragan , Simeonova Magdalena , Markovska Zorica , Markoska Vesna
Published: January 2021

BACKGROUND: Coronavirus (CoV) disease (COVID)-19 infection is a major public health issue worldwide with no specific therapy or vaccine.
CASE REPORT: COVID-19-positive patient was hospitalized due to a dry irritating cough that has persisted for 3 days. The polymerase chain reaction test to severe acute respiratory syndrome-CoV-2 was positive. Computed tomography (CT) scan of the lungs showed massive bilateral consolidation. The patient was set to oxygen support (6 L/min). Two hours after referring the patient’s condition worsened with shortness of breath, suffocation, wheezing, and decreased saturation (77%). The patient was given mechanical support with continuous positive airway pressure mask. Therapy included azithromycin 500 mg and ceftriaxone 2 g. On the 3rd day of hospitalization, there was a sharp deterioration of the condition and a decrease in saturation (40%). The patient was intubated and immediately placed on intermittent positive pressure ventilation. Azithromycin was now combined with meropenem 3 × 1 g. The next morning patient’s condition further worsened with decrease in saturation and heart rate. The resuscitation was unsuccessful.
CONCLUSION: COVID-19 is primary a respiratory infection, but the virus also affects other organs with poor outcome.
Coronavirus Disease-19 and Dentistry: A Review
Authors: Ali Fareedi Mukram , Patil Kishor , Albashir Elnur Ibrahim , Alamir Abdulhamid Aidarous
Published: January 2021

Novel coronavirus (nCoV) is a novel form of virus with a new strain identified recently in humans. Common clinical signs and symptoms primarily consist of fever, cough, and breathing difficulties. In severe cases, it can results in pneumonia, severe acute respiratory syndrome, kidney failure, and even death. It is important to follow all infection control measures in prevention of the nCoV from spreading and controlling the epidemic situation. The risk of cross infection can be high between dental practitioners and patients due to the features of dental clinical settings. Here, we are summarizing the nCoV related information and infection control measures to be followed in dental practice.
Antifascisme, démocratie, révolution : l’antifascisme italien durant l’entre-deux-guerres, une lutte pour l’éternité ?
Authors: Prezioso Stéfanie
Published: January 2021

L’hégémonie conquise par les droites italiennes à partir des années 1990 a imposé une relecture falsificatrice des antifascismes de l’entre-deux-guerres, d’autant plus virulente que, à l’instar des « valeurs de la Résistance » en France, « l’antifascisme » avait servi de référent unificateur commode à l’ensemble du champ politique depuis la Seconde guerre mondiale. L’une des opérations majeures consiste à dépolitiser l’antifascisme en le détachant de tout horizon anticapitaliste et à le circonscrire à une « parenthèse » historique définitivement close. Or, ce que montre en particulier l’analyse du mouvement laïque et non communiste Giustizia e Libertà, c’est que l’antifascisme le plus actif est d’emblée conçu pas seulement de manière défensive mais comme une lutte perpétuelle pour l’émancipation de toutes les oppressions.
Comment on les a eus la dernière fois
Authors: Renton David , Roueff Olivier
Published: January 2021

Comment on les a eus la dernière fois… et pourquoi ce sera différent cette fois. Quelle a été et quelle doit être la place de l’activisme culturel dans la lutte contre le fascisme ? David Renton revient sur l’histoire de Rock Against Racism, de la Anti Nazi League, à partir de son livre Never Again : Rock Against Racism and the Anti-Nazi League 1976-1982 (Londres, Routledge, 2018).
Unir les travailleur.euses et les jeunes contre le racisme et le fascisme
Authors: Constantinou Petros , Roueff Olivier
Published: January 2021

Le 2 septembre 2019, Iannis Delatolas, membre de Marx21, a retrouvé Petros Constantinou pour parler du travail que mène KEERFA (Mouvement uni contre le racisme et la menace fasciste) pour construire un front uni face au racisme anti-immigré et au fascisme en Grèce. En 2012, l’entrée d’Aube dorée au Parlement grec a provoqué une onde de choc dans le monde entier. Cette organisation néo-nazie violente a tenté de tirer profit de la crise économique et politique en Grèce. La crise humanitaire provoquée par les mesures d’austérité sauvages et la réduction des dépenses sociales, et les licenciements (alias Mémorandum d’accord) imposés par l’UE, le FMI et la BCE ont créé des souffrances, un climat de peur et d’incertitude qu’Aube Dorée a tenté d’utiliser. Sa présence au Parlement a servi d’écran à ses commandos de rue, et ses bureaux parlementaires ont permis aux troupes de souffler entre deux attaques violentes. Les victimes étaient des migrant·es, des réfugié·es, des personnes LGBTQ, des anarchistes et des gauchistes. Le mouvement antifasciste a alors émergé, après le meurtre de l’artiste hip hop Pavlos Fyssas – pour lequel 7 cadres d’Aube Dorée viennent (octobre 2020) d’être condamnés, pour « avoir dirigé et appartenu à une organisation criminelle ». L’interview revient sur le rôle que le KEERFA a joué dans l’organisation d’un front uni contre le racisme et le fascisme, et qui a conduit à la crise actuelle d’Aube Dorée.
Hériter de Ras l’front
Authors: Monzat René , Palheta Ugo , Simon Patrick
Published: January 2021

Auteur de nombreux ouvrages très fouillés sur les extrêmes droites, René Monzat fait aussi partie des fondateur·trices et animateur·trices de Ras l’front. De 1990 à la fin des années 2000, ce réseau à la fois très dense et peu centralisé a été l’un des fers de lance de la lutte antifasciste en France. D’abord militant d’extrême gauche investi dans de nombreuses mobilisations (des luttes lycéennes à la solidarité avec les luttes démocratiques dans les pays du bloc de l’Est, en passant par le syndicalisme étudiant et évidemment le combat antifasciste), René Monzat revient dans cet entretien sur la trajectoire de Ras l’front, ce qu’a été sa stratégie dans la lutte contre l’ascension du Front national, les apports mais aussi les limites de ce mouvement. Il s’interroge pour finir sur ce que pourrait être l’antifascisme aujourd’hui, plaidant pour une connexion plus étroite avec l’antiracisme politique et la nécessité d’un projet de société alternatif au néolibéralisme comme aux extrêmes droites identitaires.
Aux sources de la gouvernance dans le Rwanda post-génocide
Authors: Reyntjens Filip
Published: January 2021

Cet article étudie les sources d’inspiration de la gouvernance dans le Rwanda contemporain. Au-delà des continuités avec l’ancien Rwanda, d’autres expériences du FPR, du moins de ses élites, doivent être prises en compte pour comprendre les grandes caractéristiques du système politique mis en place en 1994. Nous présentons un large éventail de thèmes fondateurs de cette gouvernance et nous montrons que leurs sources d’inspiration sont très diverses. Nous nous interrogeons en conclusion sur la viabilité de narratifs et de fondements cognitifs qui ne sont pas partagés par de nombreux Rwandais.
Clenbuterol plasma concentrations after therapeutic administration in fit Standardbred horses: threshold recommendations
Authors: McKeever K.H. , Filho H.C. Manso , Rankins E.M. , Duchamp C.S. , Salah Y. , Fenger C.K. , Duer W.C. , Malinowski K. , Maylin G.A.
Published: January 2021

Clenbuterol, (RS)-1-(4-amino-3,5-dichlorophenyl)-2-(tert-butylamino)ethan-1-ol, as Ventipulmin is an FDA approved β2 agonist medication for the management of airway obstruction in horses. Administration above the FDA approved doses for clenbuterol produces repartitioning effects, which have led to restrictions on its use in human athletics and Quarter Horse and Thoroughbred racing. Clenbuterol, however has long been used therapeutically at FDA approved doses in Harness racing. The goal of this study was to identify a withdrawal time guideline for its use at FDA approvsed dose levels in Harness racing, where horses may start at seven-day intervals. Eight healthy, moderately fit Standardbred horses (4 mares, 4 geldings, weight 491±40 kg, age 13±2 years) were administered 0.8 μg/kg of clenbuterol as Ventipulmin syrup twice daily (BID) for three days. Blood samples were collected prior to dosing and at 1, 24, 48 and 96 h post administration. Clenbuterol was quantified in all samples using the New York Drug Testing and Research Laboratory ISO-17025 Racing and Medication Testing Consortium (RMTC) accredited quantitative procedure. The lower limit of quantitation of the method was 1.0 pg/ml, and three data points at 96 h post administration were censored. One horse developed diarrhoea and data from this horse was excluded from the overall analysis. Plasma regulatory thresholds were calculated using the 95/95 tolerance method and Gauss Camp Meidell at P=0.05 and P=0.001. Horses were also evaluated for effects of clenbuterol on body composition using body mass and ultrasound measurements of rump fat thickness. There were no effects (P>0.05) of clenbuterol on any of the measures including fat mass and fat free mass and thus no repartitioning effect was observed. The pharmacokinetic data and the 96 h data set support the therapeutic use of clenbuterol in Harness horses at the FDA approved 0.8 μg/kg BID dose for three days and suggest a 41 pg/ml regulatory threshold for a 96 h withdrawal time with a P=0.001 probability of randomly exceeding this regulatory threshold.
The Effects of Nano-Casein Encapsulation and Productions of a Controlled-Release on Eugenol Containing Bio-Pesticide Toxicity
Authors: Sahlan Muhamad , Tejamaya Mila , Arbianti Rita , Baruji Teguh , Adawiyah Robiatul , Hermansyah Heri
Published: January 2021

The concern against long-term health and environmental adverse effects of synthetic pesticides has encouraged the development of biopesticides. Eugenol, a major constituent of clove oil, has been proven as potential bio-pesticides. However, the evaporation and photosensitive properties of Eugenol need to be controlled. Nano-encapsulation is a promising method that can preserve eugenol from evaporating and photodegradation. This study aims to investigate the production of a controlled-release of eugenol in casein micelle as well as the effects of nano-encapsulation on Eugenol Containing Biopesticide (ECB) toxicity against Artemia salina sp. Brine Shrimp Lethality Test (BSLT) was implemented to investigate effect of nano-encapsulation on ECB and the Response Surface Methodology was used to optimize the formula to investigate the production of a controlled-release of eugenol. The optimum condition revealed loading capacity and encapsulation efficiency response for 64.67% and 79.64%, respectively. The average diameter of the obtained nanocapsule-eugenol (NCE) was 179.83 nm. Release study was performed at 40 °C that represent as pesticide applied in farm, revealed that casein micelle capsule could delayed the release of eugenol. A cytotoxicity assay showed that the NCE has 21 times more effective compared with eugenol only. It was found that nano encapsulated ECB was statistically more toxic than ECB-suspension (without nanoencapsulation) with a confidence level of 95%. Lethal Concentration 50 (LC50) of nano-ECB was 0.264 µg/L while LC50 of ECB-suspension was 4.445 µg/L. The increase of toxic properties after nano-encapsulation by casein could be explained by the increase of eugenol stability. Thus nano-encapsulation can be proposed as a method for improving the bio-pesticide ability of eugenol.
Molecular Docking Studies of Indolyl-Benzodioxyl-Chalcone, Pyrrolyl-Benzodioxyl- Chalcone, and Thiophenyl-Benzodioxyl-Chalcone as an Antimalarial Agent
Authors: Mustikasari Kamilia , Harap Joshua Eka , Susilo Tanto Budi , Komari Noer
Published: January 2021

The drug resistance condition of P. falciparum pose a major challenge in the fight against malaria. This prompts a comprehensive research in an effort to discover new drug candidates. Therefore, chalcone was modified into 24 new compounds, including indolyl-benzodioxyl-chalcone, pyrrolyl-benzodioxyl-chalcone, and thiophenyl-benzodioxyl-chalcone in the course of this study. Moreover, these compounds are commercial malaria mediciations screened for their inhibitory activity using molecular docking simulations. Subsequent results of combined indolyl-benzodioxyl-chalcone and PfDHFR-TS showed the intrinsic indolyl components produced stronger interactions referenced to pyrrolyl-benzodioxyl-chalcone, thiophenyl-benzodioxyl-chalcone, and chloroguanide. Under these circumstances, intense PfDHFR-TS-indolyl-benzodioxyl-chalcone complex was produced with lower binding affinity values (-7.32 to -8.43 kcal/mole) referenced to PfDHFR-TS-pyrrolyl-benzodioxyl-chalcone (-6.38 to -6.68 kcal/mole), PfDHFR-TS-Thiophenyl-benzodioxyl-chalcone (-6.47 to -6.52 kcal/mole), and PfDHFR-TS-chloroguanide (-6.75 kcal/mole). Furthermore, the hydrogen bond interactions developed by indolyl-benzodioxyl-chalcone (7-10) are observably similar to standard chloroguanide compounds and WR99210. These compounds also possess a binding affinity similar to WR99210 (native ligand) and are expected to be potentially anti-malarial candidates.
Isolation and Characterization of Poly-(R)-3-hydroxybutyrate Produced by Bacillus thuringiensis TH-01
Authors: Rizki Wa Ode Sri , Sabiqoh Zuhdina , Ratnaningsih Enny , Hertadi Rukman
Published: January 2021

Poly-(R)-3-hydroxybutyrate (PHB) is a biopolymer that can be synthesized by several microorganisms such as bacteria, yeast, and fungi as secondary metabolites. PHB is produced by bacteria in a medium containing a limited amount of key nutrients such as nitrogen, phosphorus, and magnesium but rich in carbon sources. PHB is a biodegradable plastic that has many applications in the medical and industrial fields. This study aimed to isolate and characterize a biopolymer produced by a bacterium strain isolated from a termite nest in India that was identified by 16S rRNA method as Bacillus thuringiensis TH-01. The biopolymer was produced by growing the bacteria in a high medium overnight at 37 °C in a shaking incubator at 150 rpm, and the resulting biopolymer was extracted with a mixture of chloroform–NaOCl (1:1). The efficiency of biopolymer production was about 10.545% ± 26.125%. Fourier transform infrared analysis gave prominent absorption peaks at 3400 cm−1 (stretching of O–H), 2900 cm−1 (stretching of C–H), 1700 cm−1 (stretching of C=O), 1280 cm−1 (symmetric deformation of C–H), and 1050 cm−1 (stretching of C−O), confirming that the biopolymer is PHB. The thermal stability of PHB granules as was determined by thermogravimetry analysis (TGA) and differential scanning calorimetry (DSC) showed that the decomposition temperature and of the polymer were 271.6–310.0 °C and 7.48 J/g respectively, and its crystallinity was about 5.12%.
Recombinant Expression and Biochemical Characterization of Levansucrase from Halophilic Bacteria Bacillus licheniformis BK1 and BK2
Authors: Permatasari Nur Umriani , Ratnaningsih Enny , Hertadi Rukman
Published: January 2021

Levansucrase was an extracellular polysacharride (EPS) which has a role in synthesizing levans by transferring fructose moiety from sucrose to acceptor molecules. In the previous study, we have successfully cloned the levansucarese gene from two Bacillus licheniformis strains of BK1 and BK2 labeled as lsbl-bk1 and lsbl-bk2. The present study aims to optimize the expression level of both genes in E. coli expression system and also to obtain the optimum conditions for the recombinant enzymes activity by applying the response surface methodology (RSM). The optimization result found that the highest Lsbl-bk1 production in E. coli expression system was occurred when the recombinant cells grown in the medium containing 0.6% (w/v) NaCl at 42°C, and induced by 0.6 mM IPTG. Different optimum conditions were found for Lsbl-bk2 production. It was achieved when 1.1% (w/v) NaCl added to the production medium and induced by 0.7 mM IPTG at 40°C. RSM optimization result for biochemical characterization of Lsbl-bk1 levansucrase showed the highest specific activity achieved at 56°C and pH 7.5, whereas for the Lsbl-bk2 levansucrase reached the highest specific activity at 50°C and pH 7.5. The addition of Co2+, Ti2+, Mg2+, Ba2+, Zn2+, Fe3+, Ca2+ metal ion to both levansucrases solution did not significantly altered their specific activity, indicating that both levansucrases are not metalo enzymes. Furthermore, the specific activity of levansucrase was also not affected by the addition of 1-25% (w/v) NaCl, suggesting that the variation of ionic strength did not alter the native state of both enzymes. The plot results of levansucrase specific activities toward sucrose concentration showed that both levansucrases follow Michaelis-Menten profile with kcat/KM values ​​about 3.8 and 3.6 s-1/mM respectively. These data indicated that the recombinant levansucrases from halophilic bacteria B. licheniformis BK1 and BK2 are a non metaloenzyme with high affinity and binding rate to sucrose substrate, in which the catalytic efficiency on hydrolysis reactions is relatively low.
Mobilization of γδ T Cells and IL-10 Production at the Acute Phase of Hepatitis E Virus Infection in Cytomegalovirus Carriers
Authors: Barragué Hugo , Fontaine Jessica , Abravanel Florence , Mauré Emilie , Péron Jean-Marie , Alric Laurent , Dubois Martine , Izopet Jacques , Champagne Eric
Published: January 2021

Alterations in the γδ T cell compartment have been reported in immunocompromised individuals infected with hepatitis E virus (HEV)–g3. We now report the analysis of blood γδ T cells from acutely HEV-infected individuals in the absence of immunosuppression. In these patients, non-Vδ2 (ND2) γδ T cells outnumbered otherwise predominant Vδ2 cells selectively in human CMV (HCMV)-seropositive patients and were higher than in HCMVpos controls, mimicking HCMV reactivation, whereas their serum was PCR-negative for HCMV. Stimulation of their lymphocytes with HEV-infected hepatocarcinoma cells led to an HEV-specific response in γδ subsets of HCMVpos individuals. HEV infection was associated with a lowered expression of TIGIT, LAG-3, and CD160 immune checkpoint markers on ND2 effector memory cells in HCMVneg but not in HCMVpos HEV patients. γδ cell lines, predominantly ND2, were generated from patients after coculture with hepatocarcinoma cells permissive to HEV and IL-2/12/18. Upon restimulation with HEV-infected or uninfected cells and selected cytokines, these cell lines produced IFN-γ and IL-10, the latter being induced by IL-12 in IFN-γ–producing cells and upregulated by HEV and IL-18. They were also capable of suppressing the proliferation of CD3/CD28–activated CD4 cells in transwell experiments. Importantly, IL-10 was detected in the plasma of 10 of 10 HCMVpos HEV patients but rarely in controls or HCMVneg HEV patients, implying that γδ cells are probably involved in IL-10 production at the acute phase of infection. Our data indicate that HEV mobilizes a pool of ND2 memory cells in HCMV carriers, promoting the development of an immunoregulatory environment.
Knowledge of hepatitis B virus infection and vaccination status among college of medicine students in Enugu State, south-east, Nigeria
Authors: Orji Chinonyelu , Chime Onyinye , Nwoke Ijeoma Ngozi , Madu Anselem , Aneke Tonna
Published: January 2021

Background: College of Medicine students are at high risk of contracting hepatitis B since they come in contact with infected patients during their training program and are expected to have proper knowledge of the hepatitis B virus infection and know their vaccination status.

The aim of the work: To determine the level of knowledge of hepatitis B virus and the vaccination status among college of medicine students in Enugu State, South-East Nigeria. Methods: A school-based descriptive cross-sectional study was carried among college of medicine students at ESUT College of Medicine, Enugu State. A pretested self-administered questionnaire was used to collect information from 437 students. Data analysis was carried out using the Statistical Package for Social Sciences version (SPSS) 22 and a p-value of 0.05 was used to determine statistical significance.

Results: The mean age of the respondents was 22.3 ± 3.7 years and the majority were single (91.1%) and female (54.7%). A high proportion (68.2%) of the students had a good knowledge of HBV while a minority (20.0%) were aware of their vaccination status. Lack of vaccination programs for students (36.6%) and poor awareness of HBV vaccine for adults (32.5%) were the commoner reasons for non-vaccination. While final year students, (95% CI=1.73-28.92), respondents who consume herbal concussions (95% CI= 0.98-2.96) and those who were at least 30 years old (95% CI=0.32-5.16) were 7.1, 1.7 and 1.3 times respectively more likely to have good knowledge of HBV disease, females (95% CI=0.30-0.83) and respondents who consumed alcohol (95% CI= 0.32-0.89) were about twice less likely to have poor knowledge of HBV than males and non-alcohol consumers.

Conclusion: Although most of the students had a good knowledge of HBV infection their vaccination status was low indicating the need for government to make a policy that would mandate that all college of medicine students should get vaccinated as part of the admission process.
La dimensione etica nella formazione infermieristica: un problema di stile di vita, di contenuti specifici e di integrazione culturale
Authors: Binetti Paola
Published: January 2021

La recente entrata in vigore della nuova Tabella XVIII ter, che contiene l’ordinamento didattico di tutti i diplomi universitari afferenti alla Facoltà di medicina offre, rispetto alla precedente, maggiori spazi per lo studio della Bioetica, sia come disciplina a sè stante sia come disciplina trasversale, punto di riferimento essenziale anche per gli altri corsi.

La Bioetica, collocata al termine del corso di studi nel cuore del corso di Diritto sanitario, deontologia e Bioetica applicata, può trovare i suoi fondamenti culturali nello studio della Antropologia, - parte integrante delle Scienze umane previste nel II anno di Corso, e della Storia e Filosofia della Medicina, corso previsto nel III anno. La proposta formativa del LIU è quella di anticipare una serie di crediti del corso di Filosofia della Medicina al I anno, in modo da aumentare l’esposizione dello studente alle problematiche di tipo etico, inserendole fn dal primo momento nel suo progetto educativo.

Obiettivo di fondo è quello di fare della Bioetica e delle sue implicazioni culturali la rete concettuale di riferimento, vera struttura portante, di tutto l’edificio formativo dello studente del DUI, dal momento che una vera innovazione oggi è possibile solo nel quadro di valori etici con cui l’infermiere si relaziona con il malato e la sua famiglia, elabora risposte coerenti per le nuove esigenze emergenti sul territorio e si dispone ad affrontare una linea di ricerca di alto profilo scientifico.
Responsabilità etico-deontologiche del medico del lavoro di fronte all’infezione da HIV
Authors: Spagnolo Spagnolo , Magnavita N. , Morgani A.R. , Tortoreto F. , Sgreccia E.
Published: January 2021

Fra i problemi etico-sociali che l’infezione da HIV ha sollevato, quello delle ripercussioni in ambito lavorativo è certamente rilevante, sia per l’aumento della sieropositività fra la popolazione lavorativa sia per il possibile verificarsi di condotte discriminanti come l’ingiustificato rifiuto di un posto di lavoro o l’allontanamento da esso.

Fra le molte responsabilità coinvolte e correlate fra loro, la riflessione e lo studio degli autori si incentrano su quella del medico del lavoro che, infatti, è chiamato a valutare situazioni delicate come la reale entità del rischio di infezione connesso con lo specifico lavorativo e con la presenza di lavoratori infetti, l’influenza negativa dell’ambiente lavorativo su tali lavoratori, la loro idoneità ai compiti lavorativi specifici. La funzione valutativa del medico del lavoro, dunque, esige competenza scientifico-professionale ma implica anche una dimensione di responsabilità etico-deontologica, strettamente connessa a particolari aspetti della infezione da HIV come quello della riservatezza, della discriminazione, della imposizione di procedure non scientificamente fondate, dell’attività di prevenzione e di formazione.

Dopo un’analisi della normativa italiana ed auropea a riguardo, gli autori descrivono un’indagine conoscitiva svolta fra i medici del lavoro della regione Lazio, invitati a fornire le proprie opinioni circa alcuni aspetti cruciali dell’infezione da HIV, tramite un questionario di quindici domande.

Dalla calutazione e dalla discussione dei dati emersi da tale indagine scaturiscono necessarie considerazioni che in conclusione portano gli autori a delineare gli obiettivi prioritari da perseguire in materia di infezione da HIVnell’ambiente di lavoro: 1) tutela dei diritti dei soggetti colpiti dall’infezione; 2) informazione e formazione dei lavoratori; 3) salubrità dell’ambiente di lavoro.
Ingegneria tessutale: bioetica e prodotti bioartificiali
Authors: Donati Luigi , Tallacchini Mariachiara
Published: January 2021

Con ingegneria tessutale (IT) si fa riferimento a un campo disciplinare che applica i principi dell’ingegneria e delle scienze della vita per la realizzazione di sostituti biologici che ripristinino, mantengano o migliorino le funzioni di tessuti o organi. Questo nuovo settore di ricerca e applicazione clinica, che attualmente consente di realizzare principalmente cute, cartilagine e osso semiartificiali, può in prospettiva sostituire le tecnologie dei trapianti di organi naturali. Ma l’ingegneria dei tessuti pone dei quesiti bioetici: alcuni di tipo generale, implicati anche da altre questioni di interesse bioetico, altri ad essa peculiari. Quesiti generali sono, per esempio, i limiti della donazione di tessuti e i rapporti tra il mercato e la scienza. Un problema che l’ingegneria dei tessuti pone invece con sfumature inedite verte sullo statuto da riconoscere ai prodotti bioartificiali: entità che utilizzano (in alcuni casi) tessuti umani, ma che si collocano al confine tra naturale e artificiale. Interessante è, inoltre, nella ridefinizione della coppia naturale/artificiale, il ruolo assunto dal diritto, che in particolare con le norme sulla brevettabilità del biologico - integra ormai la scienza nella definizione delle stesse realtà scientifiche, e che diventa, quindi, al pari della scienza, un elemento fatturale da sottoporre al vaglio etico.

Data la novità della materia, l’articolo ha un intento essenzialmente descrittivo: l’esposizione dei più importanti conseguimenti dell’ingegneria dei tessuti e dei temi di interesse bioetico che esigono un dibattito.
Comparison of ringer's lactate and plasmalyte-a as cardiopulmonary bypass prime for bypass associated acidosis in valve replacement surgeries
Authors: Surabhi Sandill , Kumar Meenakshi
Published: January 2021

Introduction:

A wide range of acid base fluctuations are seen during Cardiopulmonary bypass (CPB) and the development of metabolic acidosis is well recognized. We conducted a study tocompare the metabolic effects of Ringer lactate and Plasmalyte-A as CPB prime in causing bypass associated acidosis in valve replacement surgeries.

Methods:

We performed a prospective, randomized controlled study on a total of 80 adult patients undergoing CPB for valvular heart surgeries. The patients were randomized into two groups: Group I (Ringer Lactate) and Group II (Plasmalyte-A). Arterial blood samples were taken before initiating CPB, 30 minutes after starting CPB, then every half hourly till termination of CPB and after half an hour stay in the ICU post operatively to analyze primarily H+ ions, bicarbonates, lactate and strong ion difference.

Results and Discussion:

The results were analyzed in a quantitative manner. In Ringer Lactate group, during CPB, there was reduction in pH from 7.428 ± 0.029 at T1 to 7.335 ± 0.06 (P < 0.01) and 7.358 ± 0.06 (P < 0.01) at T2 and T3 respectively. Mean bicarbonates decreased in Ringer Lactate group during CPB from 24.28 ± 1.65 mEq/L at T1 to 20.98 ± 2.97 mEq/L at T2 (P < 0.01). In Plasmalyte-A group, mean pH, bicarbonate, strong ion difference (SID) were comparable at all time intervals (P > 0.05). In Ringer Lactate group, maximum surge in mean blood lactate levels was seen from 0.85 ± 0.35 mmol/l at T1 to 4.29 ± 1.78 mmol/L (P < 0.01) and 4.17 ± 1.28 mmol/L (P < 0.01) at T2 and T3, respectively. Such surge was not seen in Plasmalyte-A group. The mean SID decreased during the CPB in Ringer Lactate group from 41.102 mEq/L at T1 to 35.66 mEq/L (P = 0.033) at T2 implying metabolic acidosis. Numbered patients having hypotension and arrhythmias were also higher in Ringer Lactate group again indicating higher acidosis.

Conclusion:

The different composition of Plasmalyte-A and Ringer Lactate have different metabolic implications for patients undergoing cardiac surgery. Patients who received Plasmalyte-A as cardiopulmonary bypass prime developed less metabolic acidosis. Hence we conclude that Plasmalyte-A is the preferred cardiopulmonary bypass prime in adult patients undergoing valve replacement surgeries.
PRO
Authors: Szabo Christian , Betances-Fernandez Maria , Navas-Blanco Jose R , Modak Raj K
Published: January 2021

Ever since its clinical introduction, the utilization of the pulmonary artery catheter (PAC) has been surrounded by multiple controversies, mostly related to imprecise clinical indications and the complications derived from its placement. Currently, one of the most important criticisms of the PAC is the ambiguity in the interpretation of its hemodynamic measurements and therefore, in the translation of this data into specific therapeutic interventions. The popularity of the PAC stems from the fact that it provides hemodynamic data that cannot be obtained from clinical examination. The assumption is that this information would allow better understanding of the individual's hemodynamic profile which would trigger therapeutic interventions that improve patient outcomes. Nevertheless, even with the current diversity of hemodynamic devices available, the PAC remains a valuable tool in a wide variety of clinical settings. The authors present a review exposing the benefits of the PAC, current clinical recommendations for its use, mortality and survival profile, its role in goal-directed therapy, and other applications of the PAC beyond cardiac surgery and the intensive care unit.
Comparison of thromboelastography with routine laboratory coagulation parameters to assess the hemostatic profile and prognosticate postoperative critically ill patients
Authors: Bhattacharyya Amrita , Tewari Prabhat , Gupta Devendra
Published: January 2021

Background:

Patients undergoing surgery often demonstrate coagulopathy. Usually, this derangement in coagulation is assessed by the laboratory based evaluation of blood samples. However, collection of samples, their transportation to the lab, and the analyses can result in several errors and as such these tests may not be representative of the complete coagulation process. In our study, we compared the lab coagulation parameters with the point of care TEG indices and attempted to compare the outcome prediction of our patients based on the TEG indices and the various practiced ICU scores.

Methods:

A prospective, observational study was conducted between May 2014 and May 2015. Fifty adult patients who had undergone noncardiac surgery and had developed new onset 2 or more than 2 system involvement in the postoperative period were enrolled in the study. They were sampled simultaneously for lab coagulation parameters (PT, APTT, INR, fibrinogen, and platelet count) and TEG on days 1, 3, and 5 post admission.

Results:

There were significant differences between TEG and lab coagulation parameters on day 1 of the study 1 (P = 0.004) but not on days 3 and 5. On days 1 and 3 of our study, the ICU scores (SOFA and APACHE II) were significantly higher in the group with deranged TEG parameters (P = 0.003, 0.02). The patient subpopulation with deranged TEG parameters had significantly higher mortality at median survival time (P = 0.014). Such a difference was not found in patients with higher ICU scores or deranged lab coagulation times. We constructed a ROC curve and arrived at a cutoff value of the reaction time to predict the median survival day mortality.

Conclusions:

The agreement between TEG and conventional lab parameters remains poor but the TEG parameters seem to be more deranged in sicker patients. As the relationship between the overall severity of illness and derangement in the hemostatic system has been well explored in medical literature, TEG may be a more appropriate modality in such patients.
Successful medical management of fungal infective endocarditis post VSD closure
Authors: Gourav Kalla Krishna Prasad , Mandal Banashree , Mishra Anand Kumar , Nayanar V Krishna Narayanan
Published: January 2021

Fungal infective endocarditis (IE) is uncommon in postoperative cardiac surgical patients. The fungal IE accounts for 1.3%–6.8% of all IE cases and is considered the most severe form with a mortality rate as high as 45%–50%. There are various predisposing factors for fungal IE which include congenital heart defects, cardiac interventions like pacemaker insertion, degenerative valvular heart diseases, long-term use of broad-spectrum antimicrobial therapy, and long-term use of central venous. Mortality can reach up to 100% without specific treatment. Definitive therapy necessitates surgical debridement of vegetations/mass/abscess followed by long-term treatment with antifungal agents in patients who have symptoms of heart failure despite optimum medical management. We, hereby, report a case of fungal IE which occurred after the closure of a ventricular septal defect and was treated successfully with liposomal amphotericin B.
Preexisting right ventricular systolic dysfunction in high-risk patients undergoing non-emergent open abdominal surgery
Authors: Chou Jody , Ma Michael , Gylys Maryte , Salvatierra Nicolas , Kim Robert , Ailin Barseghian , Rinehart Joseph
Published: January 2021

Background:

The prognostic value of right ventricular systolic dysfunction in high-risk patients undergoing non-emergent open abdominal surgery is unknown. Here, we aim to evaluate whether presence of preexisting right ventricular systolic dysfunction in this surgical cohort is independently associated with higher incidence of postoperative major adverse cardiac events and all-cause in-hospital mortality.

Methods:

This is a single-centered retrospective study. Patients identified as American Society Anesthesiology Classification III and IV who had a preoperative echocardiogram within 1 year of undergoing non-emergent open abdominal surgery between January 2010 and May 2017 were included in the study. Incidence of postoperative major cardiac adverse events and all-cause in-hospital mortality were collected. Multivariable logistic regression was performed in a step-wise manner to identify independent association between preexisting right ventricular systolic dysfunction with outcomes of interest.

Results:

Preexisting right ventricular systolic dysfunction was not associated with postoperative major adverse cardiac events (P = 0.26). However, there was a strong association between preexisting right ventricular systolic dysfunction and all-cause in-hospital mortality (P = 0.00094). After multivariate analysis, preexisting right ventricular systolic dysfunction continued to be an independent risk factor for all-cause in-hospital mortality with an odds ratio of 18.9 (95% CI: 1.8-201.7; P = 0.015).

Conclusion:

In this retrospective study of high-risk patients undergoing non-emergent open abdominal surgery, preexisting right ventricular systolic dysfunction was found to have a strong association with all-cause in-hospital mortality.
Right ventricular injury and pulmonary embolism
Authors: Purkayastha Biswarup , Kapoor Lalit , Toshniwal Vikash , Kumar Devraj
Published: January 2021

An inadvertent vent in the right ventricle (RV) resulted during dissection of a deep intramyocardial left anterior descending coronary artery (LAD), during off-pump coronary artery bypass grafting (OPCAB), led to pulmonary artery air embolism and hemodynamic instability, requiring conversion to cardiopulmonary bypass (CPB) prior to repair. This required a special maneuver in positioning the patient to identify the RV injury and prevent the pulmonary air embolism.
Smoking behavior after coronary artery bypass surgery
Authors: Ampatzidou Fotini , Ioannidis Rafail , Drosos Odysseas , Mavromanolis Charisios , Vlahou Athanasia , Drossos George
Published: January 2021

Objective:

Tobacco smoking represents a major risk factor for coronary artery disease. Our study aimed to investigate whether Coronary Artery Bypass Graft (CABG) surgery could act as a motivating factor to enforce smoking cessation. Specifically, we observed the success rate in individuals who quitted smoking, along with the number and reasons of relapse(s) at least one year after the operation.

Methods:

The pre-operative characteristics, pre-operative tobacco exposure, socioeconomic factors and perioperative complications in patients who underwent isolated Coronary Artery Bypass Graft surgery in our Department from June 2012 to September 2016 were reviewed. Our survey was conducted via phone interview and using a standardized questionnaire. Only patients who were current smokers at the time of surgery were interviewed.

Results:

Our study group consisted of a total of 120 patients, 91 (75.8%) reported initially quitting tobacco smoking. Because of relapse(s), one year after the procedure the number of patients who were still non-smokers dropped to 69 (57.5%). Smoking cessation attempts were not supported by professional assistance.

Conclusions:

Our findings demonstrate that there is a desire from CABG patients to quit smoking, as indicated by the high percentage of initial attempts in early postoperative period. However, a year after the procedure, only 57.5% of CABG patients were able to achieve or maintain smoking cessation. Patients who were retired or who were unemployed at the time of the surgery, found it easier to stop smoking than patients who were active employees. Patients who lived alone at the time of surgery also found it harder to stop smoking. Finally, patients with COPD also found quitting smoking harder in the post-operative period.
Modulation of Telocytes in Women with Preeclampsia
Authors: Abu-Dief Eman Elsayed , Elsayed Hoda M. , Atia Esraa W. , Abdel-Rahman Mohamed , Fawzy Mohamed
Published: January 2021

Background:

Telocytes (TCs) are networking cells with enigmatic functions. Placenta is a noninnervated organ with the TCs could have function of signal transmission to placental myofibroblasts, being likely a regulator for maternal blood flow. Preeclampsia (PE) is a disease complicating the second half of pregnancy associated with hypoxia probably due to failure of vascular remodeling of spiral arteries resulting in poor placental perfusion. We hypothesized that disturbance in the morphology of TCs may have a role in the pathogenesis of PE.

Materials and Methods:

Women with normal or physiological pregnancy (Group I; 15 women) and with PE (Group II; 15 women) participated in this study. Specimens were obtained from the central cotyledons and the superficial myometrium beneath the implantation sites processed for light microscopy and stained with Hematoxylin and Eosin, toluidine blue, masson trichrome, and CD117.

Results:

The villi of group II has thick-walled blood vessels with increased peri-villous fibrinoid deposition, reduced areas of vasculosyncytial membrane and apparent increase in connective tissue density. Morphometric study and statistical analysis revealed a significant increase in the mean number of syncytial knots and significant decrease in placental (villous and decidual) and myometrial TCs and extravillous trophoblasts (EVTs) beneath the placental implantation site in Group II (P < 0.011) in comparison with group I.

Conclusions:

PE is associated with significantly low number of placental TCs interestingly with low number of EVTs. Further studies are needed to support our findings.
О стандартной гипотезе для проективных компактификаций моделей Нерона $3$-мерных абелевых многообразий
Authors: Tankeev Sergey Gennadievich
Published: January 2021

Доказано, что стандартная гипотеза Гротендика типа Лефшеца верна для гладкого комплексного проективного $4$-мерного многообразия $X$, расслоенного на абелевы многообразия (возможно, с вырождениями) над гладкой проективной кривой, если кольцо $\operatorname{End}_{\overline{\kappa(\eta)}} (X_\eta\otimes_{\kappa(\eta)}\overline{\kappa(\eta)})$ эндоморфизмов общего геометрического слоя не является порядком мнимого квадратичного поля. Это условие автоматически выполнено в случаях, когда редукция общего схемного слоя $X_\eta$ в некоторой точке кривой является полустабильной в смысле Гротендика и имеет нечетный торический ранг или общий геометрический слой не является простым абелевым многообразием.
Библиография: 43 наименования.
Study of Performance and Emission Characteristics of C.I Engine fuelled with Hybrid Biodiesel
Authors: Telgane Veerbhadrappa a, b, , Godiganur Sharanappa , Keerthi kumar N. , Chandrashekar T.K.
Published: January 2021

In the present experimental investigation, the performance and emission characteristics of four stroke single cylinder water-cooled DI diesel engine using dual hybrid biodiesel is evaluated. Dual hybrid biodiesel produced from Simarouba Oil Methyl Ester (SuOME) and Jatropha Oil Methyl Ester (JOME) is used as a fuel to run the engine. Both the methyl esters are mixed in equal % and blended with diesel (B20 to B100). The fuel properties such as kinematic viscosity, calorific value, flash point, carbon residue and specific gravity were found for the prepared biodiesel. The results showed that B20 has almost closer brake thermal efficiency compared to that of the conventional diesel fuel. Except NOx, B100 has recorded very less emission of CO, CO2 and HC compared to that of diesel fuel.
Numerical Study of Scramjet Combustor with Tandem Dual Cavity for Nonreactive Jets
Authors: Branesh Ajin , Kaur Jeevanjot , Singh Akashdeep
Published: January 2021

In the past decades flame out is a major phenomenon that paves way for high fuel consumption in scramjet combustion. For enhancing mixing and flame holding characteristics, different types of cavities are introduced in a scramjet combustion chamber which can hold air for a bit and acts like an atomizer. For increasing combustion efficiency and burnout ratios recirculation is maintained by using cavity and ramp angle techniques. In this paper numerical analysis has been carried out for two dimensional non-reacting flows in the combustor of scramjet engine with tandem dual cavity that creates high turbulent kinetic energy for ensuring combustion instability. This work is an enlightened approach for predicting the flow phenomenon that induces re-circulations after implementing various tandem dual cavities with varying length to diameter ratio and ramp angle. These in turn overcome low mixing rates due to compressibility effects at high convective Mach number.
Elliptical Tabs as a Mixing Enrichment Tool for Jet Nozzles
Authors: Pal Sourav , Singh Prabhat , Mishra Aadya , Chand Dharmahinder Singh
Published: January 2021

Mixing efficiency helps to thrust gain and jet noise reduction. Aerospace and aviation research communities around the world are constantly demanding cleaner, quieter and more efficient commercial aircrafts. Though there are many sources of noise during flight, one such is deficient mixing of air at the rear of the nozzle, uneven expansion of nozzle and corresponding engine noise is quite dominant. The mixing proficiency is achieved by mixing of cold air at the surroundings with the hot air that exits through the nozzle. To reduce the engine noise, elliptical tabs are employed at the exit of convergent nozzle. These are passive noise controllers which create vortices to the existing flow and entrains cold mass from the surroundings in order to reduce noise level. This paper is concerned with the various shapes and sizes of tabs to test the mixing efficiency at different Mach numbers. Further, it is evaluated by both qualitative and quantitative analysis of shadowgraph system and the pressure identifying method using some of the propitious pressure scanner.
Material Removal Rate and Tool Wear Ratio for Powder Mixed Dielectric Based Electric Discharge Machining
Authors: Malhi Gurmail Singh , Sokhal Gurpreet Singh , Dhindsa Gurprinder Singh , Sokhal Kamaljit Singh
Published: January 2021

Electrical discharge machining (EDM) is used in die making and aerospace industries. This paper presents the performance study of the conventional EDM when used with powder mixed dielectric. Copper, graphite and mix (copper and graphite) were used. Pulse on, pulse off and current are the parameters which were varied at three levels. Copper, graphite and tungsten-copper were used as the electrode. The material removal rate and tool wear rate are assessed using design of experiments.