bluuebunny/crossref_metadata_2025 huggingface dataset:
Caracterização epidemiológica das vítimas de acidentes motociclísticos atendidas no estado do Piauí
Authors: Monte Vanessa Oliveira do , Costa Maria Amélia de Oliveira , Lemos Matheus Henrique da Silva , Lemos Taciany Alves Batista , Morais Camilla Lemos , Rezende Thaysa Batista Vieira de , Lima Maysa Águida Silva , Júnior Antonio de Lima de Sousa , Veras Veridiana Mota , Chaves Liliana Negreiros Silva , Queiroz Bruna Furtado Sena de , Costa Isaias Silva , Vieira Jayris Lopes
Published: July 2019

Objetivo: Caracterizar o perfil epidemiológico das vítimas de acidentes motociclísticos atendidos na rede hospitalar no estado do Piauí. Métodos: Estudo descritivo, retrospectivo de abordagem quantitativa, com dados secundários do Sistema de Internação Hospitalar (SIH) do Departamento de Informática do Sistema Único de Saúde (DATASUS). A coleta de dados foi realizada no período de setembro a outubro de 2018 e foram analisadas as seguintes variáveis: faixa etária, sexo, cor/raça, número de óbitos, mês de ocorrência, mecanismo causador, estabelecimento de ocorrência e a média de permanência. A organização e análise dos dados ocorreu no mês de novembro de 2018 através do programa TABNET. Resultados: Foram registrados 5.680 acidentes com motociclistas no ano de 2017, sendo que a maioria está entre a faixa de 20 a 39 anos, de cor parda e do sexo masculino. Houve a predominância no mecanismo causador de acidente de trânsito não especificado e o estabelecimento que apresentou o maior número de vítimas foi o Hospital de Referência do município de Teresina, no mês de janeiro. Conclusão: O estudo demostrou os elevados índices de acidentes com motociclistas no estado do Piauí, evidenciando a necessidade da implantação de políticas públicas voltadas para a conscientização e educação no trânsito.
Avaliação da contribuição dos dados hemogasométricos pré extubação e na retirada da ventilação mecânica
Authors: Mota Jonas Davi Heiderick , Rodrigues Yuri de Souza , Souza Flávia dos Santos Lugão de
Published: July 2019

Objetivo: Analisar a importância dos dados gasométricos no processo de extubação e na retirada da ventilação mecânica de pacientes em uma unidade de tratamento intensivo de um hospital da Zona da Mata Mineira. Método: Pesquisa documental, retrospectiva dos meses de agosto a dezembro de 2018, de carácter descritivo. Resultados: Na amostragem inicial foram analisadas 75 amostras de controle de desmame, sendo excluídos 20 de pacientes que não passaram no teste de respiração espontânea. Assim a amostra foi realizada com 55 pacientes em tratamento intensivo, sendo 31 homens (56,4%) e 24 mulheres (43,6%) com idade mínima de 13 anos e máxima 88 anos. Conclusão: Foi constatado que os valores de PAO2 e PCO2 da gasometria arterial no processo de desmame não interferem no sucesso da retirada da VMI. Os dados hemogasométricos contribuem de forma positiva no processo de desmame e retirada da ventilação mecânica, fazendo parte da avaliação para a decisão da retirada ou cancelamento do Teste de respiração espontânea (TRE) e retorno para a ventilação artificial, além de predizer a necessidade de Ventilação Não Invasiva (VNI) pós extubação nos pacientes retentores de PCO2 no momento do TRE.
As relações de poder na atenção obstétrica e neonatal: perspectivas para o parto e o nascimento humanizados
Authors: Pieszak Greice Machado , Gomes Giovana Calcagno , Rodrigues Andressa Peripolli , Wilhelm Laís Antunes
Published: July 2019

Objetivo: refletir a respeito das relações de poder que permeiam a atenção obstétrica e neonatal, discutindo as perspectivas para o parto e o nascimento humanizados. Método: estudo teórico e reflexivo, ancorado em referenciais sobre o processo de parturição e sobre poder, especialmente, nos estudos de Foucault: A Microfísica do Poder e o sujeito e o poder. Resultados: destaca-se que as relações de poder que permeiam a assistência obstétrica se sustentam no modelo hegemônico e no predomínio de práticas intervencionistas, ancorada nas rotinas e padrões que necessitam de aporte científico e cuidado humanizado. Revela-se que o poder profissional em relação à parturição e o protagonismo feminino, define a genealogia dessa relação. Quanto às perspectivas de rompimento do paradigma dominante, tem-se a necessidade de reapropriação do corpo e do parto feminino, por meio de novas modalidades de assistência que potencializam o poder e o saber da mulher. Considerações finais: acredita-se que a assistência obstétrica baseada em evidências científicas e nas tecnologias educacionais oportunizem mudanças e rompimentos pragmáticos no processo de parto e nascimento.
The role of dupilumab in managing allergic contact dermatitis
Authors: Desrosiers Andrew , Huynh Thy , Helms Stephen , Brodell Robert
Published: July 2019

Recently, there has been vigorous debate about the value of using dupilumab, a biologic that targets TH2-mediated processes, in the management of recalcitrant allergic contact dermatitis.  A review of the current literature found the following:  1) The cytokine polarity of the immunologic response in ACD depends upon the inciting allergen, so the therapeutic approach to ACD must be individualized; 2) a single allergen can elicit different immunological responses in patients with and without underlying AD; 3) there is limited evidence in support of using dupilumab for ACD in patients without concomitant AD; 4) the cost of this drug further argues against its use in all patients with ACD; 5) dupilumab’s benign side effect profile, particularly its lack of immunosuppression, relative to other systemic therapies make it a reasonable option in AD patients with systemic ACD to certain allergens known to elicit a significant type 2 immune response who have failed other treatments.
Surgical Continuity of Care: A Multidisciplinary Approach to Managing the Mohs Micrographic Surgery Positive Deep Margin at the Parotid in Cutaneous Squamous Cell Carcinoma
Authors: Beal Brandon T , Varra Vamsi , Chu Melinda B , Armbrecht Eric S , Walker Ronald J , Varvares Mark A , Fosko Scott W
Published: July 2019

Background: While high-risk characteristics for cutaneous squamous cell carcinoma (cSCC) and the management of metastatic cSCC have received considerable attention in the literature, standard of care management for the positive MMS margin at the parotid fascia in cSCC has yet to be clarified. The aim of this study is to better define optimal management approaches for the positive deep Mohs Micrographic Surgery (MMS) margin at the parotid fascia. Methods: Inclusion criteria for this retrospective case series were patients presenting to the Saint Louis University with biopsy proven cSCC with a positive deep MMS margin at the parotid fascia who were referred to HNS and treated with curative intent. The following data were recorded: age; gender; NCCN high-risk factors; adjuvant surgical, medical, radiation (RT), or chemoradiation (CRT) therapies; outcomes; and follow-up data. Results: Eight patients undergoing MMS had a positive deep margin at the parotid fascia. HNS performed 7 parotidectomies and 1 wide local excision (WLE), obtaining negative margins in 75.0% (6/8) of patients (5/7 parotidectomies and 1/1 WLE). Obtaining negative surgical margins (6/8 patients) resulted in a disease free survival (DFS) and overall survival (OS) of 27.8 and 43.6 months, respectively; compared to a DFS of 20.6 months and OS of 39.1 months for positive margins (2/8 patients). Conclusion: This study demonstrates that resection with negative surgical margins results in excellent long-term local and regional disease control, and overall survival for cSCC patients with positive deep MMS margin at the parotid fascia.
Ditopic and Tetratopic 4,2':6',4''-Terpyridines as Structural Motifs in 2D- and 3D-Coordination Assemblies
Authors: Housecroft Catherine E. , Constable Edwin C.
Published: July 2019

We overview the coordination chemistry of ditopic and tetratopic ligands with 4,2':6',4''-terpyridine metal-binding domains and illustrate the adaptability of these divergent ligands as building blocks in 2D- and 3D-coordination networks. The ditopic ligands we discuss are limited to
roles as linkers in coordination assemblies, while the tetratopic ligands have the potential to be 4-connecting nodes. Both di- and tetratopic ligands are equipped with functionalities, typically alkyloxy chains, the nature of which has a profound effect upon the coordination assembly. Combinations
of 4-connecting ligand nodes with metal-linkers lead to both 2D- and 3D-networks, while combinations of 4-connecting metal and ligand nodes give 3D-architectures. We also demonstrate constraint of the coordination assembly to 2-dimensions by depositing ditopic 4,2':6',4"-terpyridine ligands
onto Au(111) or Cu(111) platforms with Cu adatoms in the former case; highly ordered ladder assemblies result which are independent of solvent molecules or anions.
Predicting Intermetallic Surface Energies with High-Throughput DFT and Convolutional Neural Networks
Authors: Palizhati Aini , Zhong Wen , Tran Kevin , Ulissi Zachary
Published: July 2019

Surface energy of inorganic crystals is crucial in understanding experimentally-relevant surface properties and thus important in designing materials for many applications including catalysis. Predictive methods and datasets exist for surface energies of monometallic crystals but predicting these properties for bimetallic or more complicated surfaces is an open challenge. Here we present a workflow for predicting surface energies \textit{ab initio} using high-throughput DFT and a machine learning framework. We calculate the surface energy of 3,285 intermetallic alloys with combinations of 36 elements and 47 space groups. We used this high-throughput workflow to seed a database of surface energies, which we used to train a crystal graph convolutional neural network (CGCNN). The CGCNN model was able to predict surface energies with a mean absolute test error of 0.0082 eV/angstrom^2 and can qualitatively reproduce nanoparticle surface distributions (Wulff constructions). Our workflow provides quantitative insights into which surfaces are more stable and therefore more realistic. It allows us to down-select interesting candidates that we can study with robust theoretical and experimental methods for applications such as catalysts screening and nanomaterials synthesis.
Metal-Free Aryl Cross-Coupling Directed by Traceless Linkers
Authors: Haensch Veit G. , Neuwirth Toni , Steinmetzer Johannes , Kloss Florian , Beckert Rainer , Gräfe Stefanie , Kupfer Stephan , Hertweck Christian
Published: July 2019

The metal-free, highly selective synthesis of biaryls poses a major challenge in organic synthesis. We report the scope and mechanism of a promising new approach to (hetero)biaryls by the photochemical fusion of aryl substituents tethered to a traceless linker (photosplicing). Interrogating photosplicing with varying reaction conditions and comparison of diverse synthetic probes (40 examples, including a suite of heterocycles) showed that the reaction has a surprisingly broad scope and involves neither metals nor radicals. Quantum chemical calculations revealed that the C–C bond is formed by an intramolecular photochemical process that involves an excited singlet state and the traverse of a five-membered transition state, thus warranting consistent ipso‑ipso‑coupling fidelity. These results demonstrate that photosplicing is a unique aryl cross-coupling method in the excited state that can be applied to synthesize a broad range of biaryls.
Vapour-Phase Deposition of Oriented Copper Dicarboxylate Metal-Organic Framework Thin Films
Authors: Stassin Timothée , Rodríguez-Hermida Sabina , Schrode Benedikt , Cruz Alexander John , Carraro Francesco , Kravchenko Dmitry , Creemers Vincent , Stassen Ivo , Hauffman Tom , De Vos Dirk , Falcaro Paolo , Resel Roland , Ameloot Rob
Published: July 2019

Copper dicarboxylate metal-organic framework films are deposited via chemical vapour deposition. Uniform films of CuBDC and CuCDC with an out-of-plane orientation and accessible porosity are obtained from the reaction of Cu and CuO with vaporised dicarboxylic acid linkers.
Imidazolyl-Phenyl (IMP) Anions: A Modular Structure for Tuning Solubility and Coordinating Ability
Authors: Wozniak Derek , Hicks Andrew , Sabbers William A. , Dobereiner Graham
Published: July 2019

The effect of counteranion upon a cation’s solution-phase reactivity depends on a subtle interplay of weak interactions. Although these effects are widely appreciated in synthesis and catalysis, probing and controlling anion-cation interactions remains a significant challenge. Here we report the synthesis, characterization and reactivity of the IMP anions, a family of anions with a coordinating ability that can be tuned for a given application. The anions are robust, compatible with both strongly basic and acidic media, suitable for isolation of unstable organometallic species, and effective as counteranions for homogeneous catalysis. IMP anions are prepared in two steps: deprotonation of substituted 2-phenylimidazoles with NaH, followed by addition of 2 equiv. B(C6F5)3. The anions prepared feature a range of functionality, including nitro, ester, amide, amine and alcohol groups. Based on the spectroscopic properties of [Pd(IPr)(C(O)C9H6N)] [IMP-R], the coordinating ability of [IMP-R]− ranges between BF4− and BArF4−, depending on the polarity of the R group. Gold complexes of type [L-Au-L’][IMP-R] have been isolated and characterized, resulting in the first X-ray structure of a (eta-2-diphenylacetylene)Au complex. [(tBuXPhos)Au(MeCN)][IMP-R] catalyzes [2+2] cyclization of alkenes and alkynes, as well as the hydroalkoxylation of alkynes. Unlike SbF6− and BArF4−, the [IMP-H]− and [IMP-CF3]− salts are sufficiently soluble to efficiently promote cyclizations in toluene with [(tBuXPhos)Au(MeCN)]+.
Plasma Etching for Fabricating Microfluidic Devices with Patterned Monolayers
Authors: Willems Stan B. J. , Zegers Jaccoline , Bunschoten Anton , Wagterveld R. Martijn , van Leeuwen Fijs W. B. , Velders Aldrik , Saggiomo Vittorio
Published: July 2019

By fabricating microfluidic devices via (covalent) plasma microcontact patterning (PµCP) and replica molding, we were able create β-CD patterns inside a microfluidic channel. Chemical reactivity and reusability of the devices were validated through host-guest interactions with diadamantane functionalized Cyanine 5 dye (Cy5-Ad2).
ChemBioServer 2.0: An Advanced Web Server for Filtering, Clustering and Networking of Chemical Compounds Facilitating Both Drug Discovery and Repurposing
Authors: Karatzas Evangelos , Eiros Zamora Juan , Athanasiadis Emmanouil , Dellis Dimitris , Cournia Zoe , Spyrou George
Published: July 2019

ChemBioServer 2.0 is the advanced sequel of a web-server for filtering, clustering and networking of chemical compound libraries facilitating both drug discovery and repurposing. It provides researchers the ability to (i) browse and visualize compounds along with their physicochemical and toxicity properties, (ii) perform property-based filtering of chemical compounds, (iii) explore compound libraries for lead optimization based on perfect match substructure search, (iv) re-rank virtual screening results to achieve selectivity for a protein of interest against different protein members of the same family, selecting only those compounds that score high for the protein of interest, (v) perform clustering among the compounds based on their physicochemical properties providing representative compounds for each cluster, (vi) construct and visualize a structural similarity network of compounds providing a set of network analysis metrics, (vii) combine a given set of compounds with a reference set of compounds into a single structural similarity network providing the opportunity to infer drug repurposing due to transitivity, (viii) remove compounds from a network based on their similarity with unwanted substances (e.g. failed drugs) and (ix) build custom compound mining pipelines. The updated web server is available in the URL: http://chembioserver.vi-seem.eu/
Non-Symmetrical Bis-Azine Biaryls from Chloroazines: A Strategy Using Phosphorus Ligand-Coupling
Authors: Boyle Benjamin T. , Hilton Michael C. , McNally Andrew
Published: July 2019

Distinct approaches to synthesize bis-azine biaryls are in demand as these compounds have multiple applications in the chemical sciences and are challenging targets for metal-catalyzed cross-coupling reactions. Most approaches focus on developing new reagents as the formal nucleophilic coupling partner that can function in metal-catalyzed processes. We present an alternative approach using pyridine and diazine phosphines as nucleophilic partners and chloroazines where the heterobiaryl bond is formed via a tandem SNAr-phosphorus ligand-coupling sequence. The heteroaryl phosphines are prepared from chloroazines and are bench stable solids. Using this strategy, a range of bis-azine biaryls can be formed from abundant chloroazines that would be challenging using traditional approaches and a one-pot cross-electrophile coupling of two chloroazines is feasible.
A Physics-Infused Deep Learning Model for the Prediction of Refractive Indices and Its Use for the Large-Scale Screening of Organic Compound Space
Authors: Haghighatlari Mojtaba , Vishwakarma Gaurav , Afzal Mohammad Atif Faiz , Hachmann Johannes
Published: July 2019

We present a multitask, physics-infused deep learning model to accurately and efficiently predict refractive indices (RIs) of organic molecules, and we apply it to a library of 1.5 million compounds. We show that it outperforms earlier machine learning models by a significant margin, and that incorporating known physics into data-derived models provides valuable guardrails. Using a transfer learning approach, we augment the model to reproduce results consistent with higher-level computational chemistry training data, but with a considerably reduced number of corresponding calculations. Prediction errors of machine learning models are typically smallest for commonly observed target property values, consistent with the distribution of the training data. However, since our goal is to identify candidates with unusually large RI values, we propose a strategy to boost the performance of our model in the remoter areas of the RI distribution: We bias the model with respect to the under-represented classes of molecules that have values in the high-RI regime. By adopting a metric popular in web search engines, we evaluate our effectiveness in ranking top candidates. We confirm that the models developed in this study can reliably predict the RIs of the top 1,000 compounds, and are thus able to capture their ranking. We believe that this is the first study to develop a data-derived model that ensures the reliability of RI predictions by model augmentation in the extrapolation region on such a large scale. These results underscore the tremendous potential of machine learning in facilitating molecular (hyper)screening approaches on a massive scale and in accelerating the discovery of new compounds and materials, such as organic molecules with high-RI for applications in opto-electronics.
Tailorable Aqueous-Media Synthesis of Heterogeneous Copper Nanoparticles Hybrids and Application in Selective Oxidation of Benzene
Authors: Losada-Garcia Noelia , Rodriguez-Otero Alba , Palomo Jose M
Published: July 2019

Novel heterogeneous nanocatalysts has been synthesized in aqueous media at multimilligram scale for highly selective direct oxidation of benzene to phenol in aqueous media. The synthesis of a novel biohybrids containing copper nanoparticles (CuNPs) by an efficient and green technology have been described. The methodology involves the combination of an enzyme and a copper salt in aqueous media at room temperature. It was possible to control the copper species and nanoparticle size depending on the experimental conditions, e.g. pH, reducing step, amount of enzyme, obtaining novel heterogeneous nanobiohybrids containing exclusively Cu (0)NPs, Cu2O (Cu(i)) NPs or very crystalline Cu3(PO4)2 (Cu (ii)) NPs. Very small dispersed copper nanoparticles were formed in all cases (from 3 to 15 nm). These novel CuNPs biohybrids were evaluated as catalyst in the selective oxidation of benzene to phenol in water at 30ºC using hydrogen peroxide as oxidant, obtaining excellent yields and selectivity of phenol (>80% yield, >95% selectivity).
Controlled Release of H2S and NO through Air-Stimulated Anion Exchange
Authors: Ishihara Shinsuke , Iyi Nobuo
Published: July 2019

H2S and NO are gas molecules with physiological activities; solid materials that release these gases under safe and ubiquitous stimuli offer broad medical applications. Herein, we report solid materials that autonomously release ppm-level H2S or NO under air. HS− or NO2− incorporated in the interlayer of layered double hydroxide (LDH), a clay mineral, is protonated by CO2 and H2O, yielding H2S or HNO2. HNO2 generates NO through disproportionation or reduction. Moreover, another NO-release method employs solid mixtures of NO2−-incorporated LDH and FeSO4, wherein wet air triggers NO2− reduction with Fe2+ through anion exchange between NO2− and SO42−. A potential application of the air-stimulated gas release system is demonstrated by creating a portable and battery-free NO inhaler for emergency treatment of respiratory distress.
Progress in trial registration in Latin America and the Caribbean, 2007–2013
Authors: Rodríguez-Feria Pablo , Cuervo Luis Gabriel
Published: July 2019

This descriptive study identifies trends in clinical trial registration in the World Health Organization International Clinical Trial Registry Platform (ICTRP) for Latin America and the Caribbean (LAC), from 2007–2013, and provides adjusted estimates for registration rates by population and publications (2007–2011). Trends and data are presented by subregion and language in interactive graphs, including annual registration rates by population (2007–2011) and publications (LILACS and MEDLINE) listed in SCIENTI Network (Science and Technology Indicators). Of the 11 945 clinical trials involving LAC countries, 8 282 were in South America, with Brazil leading at 4 070 (49%); 2 421 in North and Central America, with Mexico leading at 1 886 (78%); and 1 242 in the Caribbean, with Puerto Rico leading at 857 (69%). After adjusting by population and publication rates Chile, Panama, Argentina, and Peru led registration rates per 1 million inhabitants. Variations in the number of trials per year are quite substantial.

Clinical trial registration increased in a steady yet inconsistent way. The implementation of the Policy on Research for Health has been followed by an increase in countries that require registration and have established clinical trial registries. However, there is room for improvement in adherence throughout LAC. Trial registration is offered gratis by Brazilian, Cuban, Peruvian, and United States registries, among others.
Red CYTED-RITMOS: hacia la búsqueda de soluciones para fomentar la salud móvil en América Latina
Authors: Saigí-Rubió Francesc , Novillo-Ortiz David , Piette John D
Published: July 2019

El ámbito de las tecnologías móviles aplicadas a la salud (mSalud) es una tendencia en auge a nivel mundial que ha generado enormes expectativas para paliar los problemas de prestación de servicios médicos y de salud pública ocasionados por la escasez de recursos y el reducido número de especialistas. Las numerosas posibilidades que aportan las tecnologías móviles, junto con su facilidad de uso, han atraído el interés tanto de los gobiernos políticos como el de las universidades. Es el caso de la Red Iberoamericana de Tecnologías Móviles y Salud (Red CYTED-RITMOS). Como resultado del primer año de actividad de la Red, en octubre de 2015 tuvo lugar en Barcelona el Internacional Workshop RITMOS con el objeto de presentar las áreas prioritarias de América Latina donde podrían desarrollarse proyectos de investigación, desarrollo e innovación (I+D+i) en salud móvil y posibles soluciones. El objetivo de este trabajo es mostrar las potencialidades y la aplicabilidad de la mSalud en la región de las Américas.
Implementation strategy for advanced practice nursing in primary health care in Latin America and the Caribbean
Authors: Oldenburger David , Cassiani Silvia Helena De Bortoli , Bryant-Lukosius Denise , Valaitis Ruta Kristina , Baumann Andrea , Pulcini Joyce , Martin-Misener Ruth
Published: July 2019

Advanced practice nursing (APN) is a term used to describe a variety of possible nursing roles operating at an advanced level of practice. Historically, APN roles haves evolved informally, out of the need to improve access to health care services for at-risk and disadvantaged populations and for those living in underserved rural and remote communities. To address health needs, especially ones related to primary health care, nurses acquired additional skills through practice experience, and over time they developed an expanded scope of practice. More recently, APN roles have been developed more formally through the establishment of graduate education programs to meet agreed-upon competencies and standards for practice. The introduction of APN roles is expected to advance primary health care throughout Latin America and the Caribbean, where few such roles exist. The purpose of the paper is to outline an implementation strategy to guide and support the introduction of primary health care APN roles in Latin America and the Caribbean. The strategy includes the adaptation of an existing framework, utilization of recent research evidence, and application of knowledge from experts on APN and primary health care. The strategy consists of nine steps. Each step includes a national perspective that focuses on direct country involvement in health workforce planning and development and on implementation. In addition, each step incorporates an international perspective on encouraging countries that have established APN programs and positions to collaborate in health workforce development with nations without advanced practice nursing.
Evaluación de herramientas de implementación de la Guía de Práctica Clínica de infecciones de transmisión sexual
Authors: Rodríguez Moreno Jaime Hernán , Romero Vergara Antonio José , De Alba De Moya Danilo De Jesús , Jaramillo Rojas Hernán Javier , Díaz Rojas Claudia Milena , Ciapponi Agustín
Published: July 2019

Objetivo. Establecer la aceptabilidad, percepción de utilidad y la implantación de las herramientas de implementación y el acompañamiento técnico del Instituto de Evaluación Tecnológica en Salud (IETS) en los hospitales de dos regiones de Colombia.

Métodos. Se desarrolló acompañamiento para la implementación de la Guía de Práctica Clínica (GPC) en 24 hospitales (17 de Antioquía y 7 de Cundinamarca) en zonas de alta prevalencia de infecciones de transmisión sexual (ITS), así como la instalación de las herramientas de implementación. Se aplicaron encuestas a los profesionales y entrevistas a los referentes.

Resultados Del total de los encuestados, 86% conocen la GPC, 86% las recomendaciones trazadoras, 79% los flujogramas interactivos, 82% las hojas de evidencia y 41% nunca utilizó las herramientas de implementación. De los encuestados que han utilizado las herramientas, 55% lo hacen en el ordenador del sitio de trabajo, mientras que 24% utiliza su teléfono personal. Las herramientas de mayor utilidad son las hojas de evidencia y los flujogramas con 98% y las recomendaciones trazadoras con 92%. Las de más baja utilidad son las herramientas de impacto presupuestal (81%).

Conclusiones. Las herramientas de implementación y el acompañamiento técnico en los hospitales de dos regiones de Colombia se perciben como útiles y aceptables, aunque el grado de implantación es bajo. Los hallazgos de esta investigación contribuirán para que los diferentes actores, como el Ministerio de Salud y Protección Social, el IETS y el Departamento Administrativo de Ciencia, Tecnología e Innovación (Colciencias) entre otros, puedan mejorar los programas de implementación de guías de práctica clínica.
Los recursos humanos en salud según el nuevo modelo de atención en Ecuador
Authors: Espinosa Verónica , de la Torre Daniel , Acuña Cecilia , Cadena Cristina
Published: July 2019

Objetivo. Describir las estrategias implementadas por el Ministerio de Salud Pública del Ecuador (MSP) para fortalecer la rectoría de los recursos humanos en salud y responder al nuevo modelo de atención, como parte del proceso de reforma durante el periodo 2012–2015.

Métodos. Se realizó una revisión documental sobre el desarrollo del recurso humano en salud antes y después de la reforma recabando información en fuentes primarias y secundarias.

Resultados En el periodo de estudio, Ecuador generó un nuevo marco institucional y normativo para desarrollar recursos humanos en salud a fin de responder a los requisitos de un modelo de atención basado en la Atención Primaria en Salud (APS). El MSP consolidó su papel rector estableciendo alianzas estratégicas, aplicando métodos de planificación de los recursos humanos y realizando una inversión sin precedentes en la formación del personal sanitario, contrataciones e incrementos salariales. Estos elementos constituyen los ejes iniciales para la construcción de una política de recursos humanos en salud y una carrera sanitaria coherentes con los objetivos de la reforma.

Conclusiones. En el marco de la reforma realizada entre 2012 y 2015, el desarrollo del recurso humano en salud muestra logros importantes gracias al trabajo intersectorial realizado por el MSP. Entre dichos logros destacan el fortalecimiento de la rectoría, el desarrollo e implementación de normativa e instrumentos regulatorios, la creación de nuevos perfiles de profesionales, y el contrato de profesionales con el objetivo de implementar el Modelo de atención integral de salud (MAIS), lo cual contribuyó a resolver problemas arrastrados durante los años previos a la reforma.
Public health response and lessons learned from the 2014 chikungunya epidemic in Grenada
Authors: Forde Martin S , Martin Francis , Mitchell George , Bidaisee Satesh
Published: July 2019

In June 2014, the first cases of chikungunya virus (CHIKV) were diagnosed on the island of Carriacou, part of the tri-island state of Grenada. In the three months that followed, CHIKV spread rapidly, with conservative estimates of the population infected of at least 60%. Multiple challenges were encountered in the battle to manage the spread and impact of this high–attack rate virus, including 1) limited indigenous laboratory diagnostic capabilities; 2) an under-resourced health care system; 3) a skeptical general public, hesitant to accept facts about the origin and mode of transmission of the new virus; and 4) resistance to the vector control strategies used. Lessons learned from the outbreak included the need for 1) a robust and reliable epidemiological surveillance system; 2) effective strategies for communicating with the general population; 3) exploration of other methods of mosquito vector control; and 4) a careful review of all health care policies and protocols to ensure that effective, organized responses are triggered when an infectious outbreak occurs.
Seroprevalencia y tasa de ataque clínica por chikungunya en Nicaragua, 2014-2015
Authors: Ministerio del Poder Ciudadano para la Salud
Published: July 2019

Objetivo. Estimar la seroprevalencia, la tasa de ataque clínica y la proporción de infecciones subclínicas por chikungunya,

Métodos. Se realizó un estudio transversal en 39 sitios distribuidos en todo el territorio nacional de Nicaragua en octubre 2015. Se recopiló información demográfica y clínica a través de una encuesta personal. Se recolectaron muestras hemáticas para detectar la presencia de anticuerpos antivirus chikungunya utilizando el método de ELISA de inhibición desarrollado por el Centro Nacional de Diagnóstico y Referencia. Se utilizaron modelos lineales generalizados y modelos de multinivel de Poisson en el análisis de los Resultados

Resultados Se enrolaron 11 722 participantes mayores de dos años de edad y se procesaron 11 280 muestras. En el nivel nacional, la seroprevalencia fue de 32,8% (IC95% [intervalo de confianza de 95%]: 31,9-33,6), con una tasa de ataque clínica de 26,5% (IC95%: 25,7-27,3) y una proporción de infecciones subclínicas de 19,1% (IC95%: 17,8-20,4). Se observó variabilidad en la seroprevalencia de los 39 sitios, y los que presentaron mayor índice de infestación por el vector mostraron una mayor seroprevalencia. A nivel individual, esta fue más elevada en los participantes mayores de 11 años.

Conclusión. Este es el primer estudio sobre la seroprevalencia de chikungunya en América Latina continental desde su introducción, en el que se determinaron la prevalencia a nivel nacional, la tasa de ataque clínico y la proporción de infecciones subclínicas. El modelo utilizado, con una amplia participación comunitaria y el rol rector del Ministerio de Salud de Nicaragua, puede constituir un ejemplo para la realización de estudios similares en la región.
Evaluation of three commercially-available chikungunya virus immunoglobulin G immunoassays
Authors: De Salazar Pablo M , Marie Valadere Anne , Goodman Christin H , Johnson Barbara W
Published: July 2019

The emergence of chikungunya virus in the Americas means the affected population is at risk of developing severe, chronic, rheumatologic disease, even months after acute infection. Accurate diagnostic methods for past infections are essential for differential diagnosis and consequence management. This study evaluated three commercially-available chikungunya Immunoglobulin G immunoassays by comparing them to an in-house Enzyme-Linked ImmunoSorbent Assay conducted by the Centers for Disease Control and Prevention (Atlanta, Georgia, United States). Results showed sensitivity and specificity values ranging from 92.8% – 100% and 81.8% – 90.9%, respectively, with a significant number of false-positives ranging from 12.5% – 22%. These findings demonstrate the importance of evaluating commercial kits, especially regarding emerging infectious diseases whose medium and long-term impact on the population is unclear.
Specifics of Interrelations between the Russian and European Financial Markets
Authors: Zvonova E. A.
Published: July 2019

The subject of the researchis the state of interrelationship between the Russian and European financial markets in the context of the economic and financial sanctions imposed on Russia by the European Union.The relevanceof the research stems from the strategic goal set by the President of the Russian Federation — to ensure the “breakthrough” of the Russian economy in order to enter the top five world’s developed economies by 2024–2025.

The purpose of the paperwas to develop a roadmap for the implementation of the mobilization model of cross-border flows of the Russian capital in the context of modern transformations of the global monetary and financial system. Based on the revealed and analyzed mainstream trends in the interaction of the Russian and European financial markets, a mobilization model of cross-border flows of the Russian capital under the modern conditions has been developed. The asymmetry in mutual exchanges between the Russian and European financial markets is revealed and the risks of all identified forms of asymmetry are defined. The reference structure of foreign assets of the Russian financial market is determined, priority directions for the correction of the structure of external assets and liabilities have been established, and the institutional structure of the monetary and financial regulation of the Russian financial market are specified.

It is concludedthat based on the roadmap for the model of cross-border flows of the Russian capital under conditions of modern transformations of the global monetary and financial system developed for the period 2019–2025, the Russian financial market is expected to be fairly stable over the next three years, which should be taken into account by the Bank of Russia in making decisions on the monetary policy and accumulation of international currency reserves.
The Role of the Standardized Approach to Measuring the Counterparty Credit Risk Exposures (Basel III) in Order to Create Conditions for Russia’s Economic Growth
Authors: Shaker I. E.
Published: July 2019

The subject of the researchis the Standardized Approach to measuring the Counterparty Credit Risk (SA-CCR) exposures according to the reform of the international standards of macroprudential regulation to ensure a breakthrough in the scientific, technological and socio-economic development of Russia. The purposeof the research was to assess the introduction and use of the post-crisis Basel III standard until 2021 to create financially sound credit and banking institutions as the main triggers of the system risk in order to maintain public confidence in the financial system and ensure sustainable economic growth. The paper examines the prospects for the implementation of the Basel III standard, taking into account the standardized approach to measuring the counterparty credit risk to meet the challenges of Russia’s entry into the top five world economies.

Given the global financial market conditions, the economic growth is ensured by the economies of scale as well as by harmonization of structural macroprudential rules in different countries, which requires an international standardized approach to system risk management when macro-prudential policies are aimed at alleviating credit risks thereby having a positive impact on the economic growth.

The effectiveness of the macro-prudential policy for banks is reduced when less regulated financial intermediaries increase the market share and openness allowing organizations and households to receive money from foreign financial sources.

The paper concludesthat in shaping the country’s macro-prudential policies, it is necessary to assess the relative importance of each channel of manifestation and transformation of the system risk and its impact on the economic growth in the national economy.
The Draft Guidelines for the Development of the Russian Financial Market in 2019–2021 prepared by the Bank of Russia: Expert Opinion of Financial University
Authors: Abramova M. A. , Lavrushin O. I. , Pishchik V. Ya. , Rubtsov B. B. , Solyannikova S. P.
Published: July 2019

The relevance of the analysis of the draft guidelines for the development of the Russian financial market in 2019–2021 set forth in the draft program document issued by the Bank of Russia comes from the fact that in the current situation of the macroeconomic and financial instability Russia’s entry into the top five leading world economies is impossible unless business entities have access to internal sources of financing, primarily to debt and equity financing instruments, as well as to risk insurance tools.

The subject of the research is the plans of the Bank of Russia for the development of the Russian financial market in 2019–2021 set out in the draft program document of the Bank of Russia to be approved in the summer of 2019.

 The purpose of the paper was to assess the above guidelines in terms of whether they can achieve the goal of boosting the growth and efficiency of the economy. Proposals are made to harmonize issues related to the development of the financial market with monetary and fiscal policy issues.

The paper concludes that it is necessary to seek a balance between financial stability and stimulation of business activities of banks in the cooperation between the Bank of Russia and business corporations. It is noted that the program of the financial market development does not include issues related to the development of certain segments of the financial market (foreign exchange and precious metals markets).
Some Imperatives of the Russian Economic Leadership: The Development of Science
Authors: Sukharev O. S.
Published: July 2019

The paper outlines system capabilities of Russia to join the scientific and technological leaders through changes in the staff policy in the science field, which was the purpose of the research.

The subject of the research is institutional changes occurring in science and, particularly, staff training. The status of the Russian science is assessed in terms of changes in the basic rules and their adjustment with an emphasis on material and non-material incentives, staff rotation and training of young scientists. The paper proves that the frequency and content of institutional changes affect the quality of the scientific development and the training of scientific staff; moreover, copying the rules already in use reduces the competitive potential of science. From the scientific and practical standpoint, the research is novel in that it formulates proposals for establishing a labor compensation system and introduction of basic institutions (rules) to ensure the functioning of the scientific sphere and the efficiency of functions immanent to the latter. The paper proposes a “scientific product” doctrine that can be used for assessment of a scientist’s labor, according to which the scientist creates a product that is assessed not by the citation frequency or the number of published articles and books but by the importance of discoveries in theory and practice, the significance of new formulas and methods developed. It is suggested that the scientist’s labor compensation system be presented by two levels: the current salary and the estimated value of the total scientific product created. The problem of scientific work incentives can be solved by introducing a special tariffqualification grid tied to the system of the scientist’s promotion.
Reducing the Risks of the Financial Sector to Ensure Sustainable Growth of the Russian Еconomy
Authors: Minina T. I. , Skalkin V. V.
Published: July 2019

Russia’s entry into the top five economies of the world depends, among other things, on the development of the financial sector, being a necessary condition for the economic growth of a developed macroeconomic and macro-financial system. The financial sector represents a system of relationships for the effective collection and distribution of economic resources, their deployment according to public demand, reducing the risk of overproduction and overheating of the economy.

Therefore,the subject of the researchis the financial sector of the Russian economy.

The purpose of the researchwas to formulate an approach to alleviating the risks of increasing financial costs in the real sector of the economy by reducing the impact of endogenous risks expressed as financial asset “bubbles” using the experience of developed countries in the monetary policy.

The paper analyzes a macroeconomic model applied to the financial sector. It is established that the economic growth is determined by the growth and, more important, the qualitative development of the financial sector, which leads to two phenomena: overproduction in the real sector and an increase in asset prices in the financial sector, with a debt load in both the real and financial sectors. This results in decreasing the interest rate of the mega-regulator to near-zero values. In this case, since the mechanisms of the conventional monetary policy do not work, the unconventional monetary policy is used when the mega-regulator buys out derivative financial instruments from systemically important institutions. As a conclusion, given deflationally low rates, it is proposed that the megaregulator should issue its own derivative financial instruments and place them in the financial market.
Mapeamento da Distribuição Espacial da População Utilizando o Método Dasimétrico: Exemplo de Caso no Sudeste do Brasil (Mapping the Spatial Distribution of Population by Using Dasymetric Method: a Case Study in Southeastern Brazil)
Authors: Silva Ana Paula da , Morato Rubia Gomes , Kawakubo Fernando Shinji
Published: July 2019

O conhecimento da distribuição espacial da população urbana possui importância em várias áreas das ciências sociais. No Brasil, os mapas de densidade demográfica são normalmente construídos utilizando somente os dados do censo demográfico. O problema desta abordagem é que muitas vezes, os limites dos polígonos censitários não se restringem as áreas habitadas, incluindo também praças, cemitérios e indústrias. Para melhorar o mapeamento, dados auxiliares podem ser incorporados para refinar o cálculo da densidade (chamado de dasimetria). Neste trabalho, o método dasimétrico foi adotado para o município de Vespasiano, Minas Gerais, Brasil. A densidade foi calculada utilizando como dado auxiliar o mapa de uso da terra gerado a partir das imagens do Google Earth. As áreas residenciais foram combinadas com os dados do censo utilizando o Sistema de Informação Geográfica ILWIS. Os resultados revelaram que o método dasimétrico é uma alternativa viável para melhorar a visualização da distribuição espacial da população. AbstractUnderstanding the spatial distribution of urban population is crucial for a wide range of applications in social sciences. In Brazil, demographic density maps are usually set using only information acquired from the census datasets. Theproblem of adopting this approach lies on the fact that the unit the census boundaries often do not comprehend habited areas only, including also square, commercial, and industrial areas. Improvements in cartographic representation is possible using the dasymetric method, an approach that consists of refining the spatial structures of the census polygonsby using ancillary data. The dasymetric method was employed to refine the demographic density map of Vespasiano County, Minas Gerais. It was used the ILWIS Geographic Information System (GIS) for integrating the census datasets and the land use map. The result acquired in this research showed that the procedure adopted is a feasible alternative that may be used for improving the spatial distribution of population.
GREEN TEA MITIGATES STREPTOZOTOCIN-INDUCED DIABETIC MICE THROUGH ANTI-FIBROTIC ACTIVITY AND MODULATION OF PROINFLAMMATORY CYTOKINES
Authors: Salah Hend , Moussa Eman , Atta Mustafa , El. Bakr Samaa , Farrag Foad , Hafez Ahmed
Published: July 2019

This research was planned to assess the protective effect of green tea extract (GTE) in STZ-induced diabetes in mice. Seventy-five female albino mice were used. Mice randomly allocated into five groups of 15 mice in each as follows: group 1 (control), group 2 (STZ, diabetic), group 3 (green tea + STZ), group 4 (protective group with green tea), and group 5 (green tea only). Oral administration of the green tea extract for three weeks to diabetic mice resulted in significant regaining in body weight, decreased blood glucose, cholesterol, triglyceride, free fatty acid and low-density lipoprotein cholesterol (LDL-C) levels and lowered malondialdehyde (MDA) contents and increased total protein and high-density lipoprotein cholesterol (HDL-C) as compared to untreated diabetic group. Histopathological changes were compatible with these biochemical findings. Diabetic mice pre- or co-treated with green tea also exhibited a significant downregulation in TGFβ1 and TNFα genes expression. Green tea extracts had protective and antidiabetic effect in controlling blood glucose level in addition to improving lipid metabolism and body weight in diabetic mice.Key words: diabetes; green tea; liver; TNFα; TGF-Β1; mice