bluuebunny/crossref_metadata_2025 huggingface dataset:
PROFIL DRUG RELATED PROBLEMS (DRPs) PADA PASIEN SKIZOFRENIA DI INSTALASI RAWAT INAP RUMAH SAKIT JIWA MUTIARA SUKMA PROVINSI NTB TAHUN 2020
Authors:   Program Studi Sarjana Farmasi, Fakultas Kedokteran, Universitas Mataram, Mataram, Indonesia, Wanda Utami Virnia , Rahmatul Aini Siti ,   Program Studi Sarjana Farmasi, Fakultas Kedokteran, Universitas Mataram, Mataram, Indonesia, Eka Puspitasari Candra ,   Program Studi Sarjana Farmasi, Fakultas Kedokteran, Universitas Mataram, Mataram, Indonesia
Published: February 2023

Skizofrenia merupakan suatu gangguan mental parah dan kronis dimana ditandai dengan adanya distorsi dalam berpikir, perilaku, persepsi, emosi, bahasa, dan rasa diri. Tatalaksana terapi skizofrenia utamanya adalah antipsikotik. Pemberian kombinasi terapi baik antara antipsikotik ataupun antipsikotik dengan non-antipsikotik berpotensi menimbulkan Drug Related Problems (DRPs) yang berisiko keamanan pengobatan ataupun efektivitas terapi. Tujuan penelitian ini adalah melakukan identifikasi profil DRPs atau permasalah terkait dengan terapi obat di Instalasi Rawat Inap Rumah Sakit Jiwa Mutiara Sukma NTB. Penelitian ini merupakan penelitian deskriptif dengan desain Cross-sectional dengan teknik pengambilan sampel yaitu purposive sampling. Jumlah sampel yang digunakan adalah 105 pasien skizofrenia yang telah memenuhi kriteria inklusi (pasien skizofrenia dengan usia 18-60 tahun, ditanggung BPJS dan data rekam medis lengkap dan terbaca) dan eksklusi (pasien hamil, pasien COVID-19 dan pasien skizofrenia dengan penyakit penyerta diabetes melitus, gagal ginjal, CHF (Congestif Heart Failure), hipertensi, stroke, kanker, dan HIV/AIDS). Penelitian ini berbasis rekam medis pada periode Januari-Desember 2020. Data yang telah diperoleh dianalisis menggunakan pedoman PCNE V9.01 dan diolah dengan software Microsoft excel 2019 sehingga didapatkan hasil berupa persentase kejadian Drug Related Problems (DRPs). Hasil penelitian menunjukkan terdapat kejadian DRPs pada pasien skizofrenia di Instalasi Rawat Inap Rumah Sakit Jiwa Mutiara Sukma NTB tahun 2020. Berdasarkan 105 pasien skizofrenia, 89,5% mengalami DRPs dengan total 117 kejadian. Kategori DRPs masing-masing dari yang tertinggi adalah kategori efek buruk obat mungkin terjadi (76,9%) dengan risperidon dan lorazepam mendominasi (tingkat keparahan moderat), obat tanpa indikasi (10,3%), dosis obat terlalu rendah (8,5%), waktu pemberian dan/atau interval pemberian dosis tidak tepat (1,7%), obat tidak tepat menurut pedoman/formularium (0,9%), terlalu banyak obat yang diresepkan untuk indikasi (0,9%), dan lama pengobatan terlalu singkat (0,9%).
INFORMATION INTEGRITY LAB AND THE IMPORTANCE OF CONTINUING DIGITAL EDUCATION FOR INTELLIGENCE PROFESSIONALS
Authors: Jones Alan
Published: February 2023

On November 22, 2022, Alan Jones, Executive Advisor in the University of Ottawa Professional Development Institute (uOttawa PDI), presented Information Integrity Lab and the Importance of Continuing Digital Education for Intelligence Professionals. The presentation was followed by a question-and-answer period with questions from the audience and CASIS Vancouver executives. The focus of the presentation was the role of uOttawa PDI in regard to educating on national security.
WHERE IS TERRORISM GOING AND ARE CANADIAN AGENCIES PREPARED TO CONFRONT IT?
Authors: Gurski Phil
Published: February 2023

On November 22, 2022, Mr. Phil Gurski, President and Chief Executive Officer of Borealis Threat and Risk Consulting Ltd., presented on Disruption and National Security. The presentation was followed by a question-and-answer period with questions from the audience and CASIS Vancouver executives. The key points discussed were the difficulties of the current definition of Ideologically Motivated Violent Extremist groups (IMVE), as well as the need for Canada’s security agencies to shift focus from IMVE back to Islamist terrorist organizations. Mr. Gurski also discussed the importance of maintaining public trust through oversight and improved communication with the public, as well as improving technology and understanding context when assessing data sourced from social media platforms.
 
Received: 2022-12-05Revised: 2022-12-28
LESSONS LEARNED AS A NEW POLICE FORCE
Authors: Hyland Jennifer
Published: February 2023

On November 24, 2022, Deputy Chief Constable (DCC) Jennifer Hyland of the Surrey Police Service presented Lessons Learned as a New Police Force. The presentation was followed by a question-and-answer period with questions from the audience and CASIS Vancouver executives. The key points discussed were the development of the Surrey Police Service (SPS) over the past year and understanding their engagement with the community and other policing organisations.
 
Received: 2023-01-06Revised: 2023-01-21
THE ROLE OF AI IN SAFEGUARDING CHILDREN: A CESIUM CASE STUDY
Authors: Anning Stephen
Published: February 2023

On November 25, 2022, Stephen Anning, Product Manager for CESIUM at Trilateral Research, presented on The Role of AI in Safeguarding Children: A CESIUM Case Study. The presentation was followed by a question-and-answer period with questions from the audience and CASIS Vancouver executives. The key points discussed were the future of privacy, CESIUM’s ability to audit evidence and provide a user-friendly atmosphere, information management and dataset governance, and mitigating the impact of techno-colonialism.
 
Received: 2023-01-28Revised: 2023-01-29
Book review: Héroes y Villanos de la Patria
Authors: Stallaert Christiane
Published: February 2023

Ludger Mees ed., Héroes y Villanos de la Patria. Tecnos, Madrid, 2020. 416 pp. ISBN 9788430979332
State of Nationalism (SoN): Nationalism and Private Property
Authors: Magnus Fuglestad Eirik
Published: February 2023

This article reviews research on the relationship between property rights and nationalism. A property rights perspective to the study of nationalism is relevant to understanding the origins and development of nationalism and nation states. Yet, key theorists of nationalism have mostly ignored the relationship between property rights and nationalism, or looked at it only indirectly. There are a variety of ways in which ownership or possession more generally can be related to nationalism, for instance through colonialism, racism, and dispossession (Bannerji et al. 2001; Bhandar 2016; Bhandar & Toscano 2015). This review, however, in order to build a consistent perspective on the historical emergence of nation states and nationalism, will have its main focus on property rights, property regimes and state-building. The literature on state-building and democratization bears important insights about this relationship which can be applied to the study of nationalism. This review will therefore draw on such literature, in addition to works on nationalism where the topic of property has been mentioned, to show how an integrated property rights perspective to the study of nationalism may yield important insights to our understanding of nations and nationalism. The article is structured as follows. First, it offers a brief discussion of what property rights are and why they are key to understanding the long-term historical development of nations and nationalism. After this, it outlines the links between property regimes and the formation of nation states, followed by a discussion of the conceptual links between nationalism and private property. The final section offers some brief reflections on Marxism, property and nationalism.
The Dilemma of Dual Loyalty. Werner Hasselblatt and the Rise and Failure of Baltic German Minority Politics in the Inter-War Period
Authors: Hackmann Jörg
Published: February 2023

German minority politics in the Baltic states during the inter-war period has regained significant scholarly attention since the 1990s, when the Estonian concept of cultural autonomy from 1925 was rediscovered as a strategy for solving post 1989 minority conflicts as well as addressing issues of multiculturality. The case of the Baltic German politician Werner Hasselblatt, who is in the focus of this text, however, reveals a Janus-faced political approach: On the one hand, he had a significant share in the implementation of the law on cultural autonomy in Estonia, and he was also a major actor within the Congress of European Nationalities. On the other hand, from 1933 onwards Hasselblatt turned into an expert of Nazi resettlement and population politics, contrary to his earlier positions. Here, a critical analysis of his approach towards loyalty is undertaken, in order to discuss the tilting point in his political activities. My argument is that his attitude towards loyalty was based on the assumption of an irreconcilable conflict of dual loyalty to the ‘host’ state and the ‘kin’ nation. Whereas Hasselblatt regarded loyalty to German Volkstum not as a matter of individual choice for Baltic Germans and thus as not negotiable, he saw loyalty towards the Estonian state as connected to the fulfilment of the German minority’s political claims. Such an instrumental approach towards loyalty together with Hasselblatt’s primordial understanding of nationality in contrast to citizenship may be identified as crucial issues that led his concept of constructive minority politics tilt towards the destructive notion of ‘dissimilation’.
Historicising the Normative Boundaries of Diversity: The Minority Treaties of 1919 in a Longue Durée Perspective
Authors: Cârstocea Raul
Published: February 2023

The article accounts for the specific form a certain legal and, indeed, normative understanding of diversity informed the so-called Minority Treaties of 1919 by historicising the evolution of certain interlocking discourses over the remit of ‘rights’, as well as the identity of their holders. It seeks to account for why certain groups (national minorities) rather than others were singled out for protection and why the rights they were given took the form they did (cultural and linguistic) by positioning them in the context of broader debates within which they were embedded. I thus argue against reading the Minority Treaties from a ‘presentist’ perspective that not only retrojects a certain teleological narrative that tends to read them along the familiar lines of ‘progress’, but bears the danger of naturalising certain categories – such as ‘the nation’, ‘the nation-state’, or ‘nationalism’ – in light of their subsequent prominence, which consequently acquires a certain air of inevitability. To do so, the article first discusses normative conceptions of ‘diversity’ in a longue durée perspective, arguing for the emergence and contestation of hybrid and combined models of managing ‘difference’ during the long 19th century, prompted by the opposing tractions of efforts at homogenisation and hierarchisation. Second, it places the Minority Treaties in their immediate 1919 context, arguing that the form they took was significantly influenced also by contingent and extraneous contemporary factors, such as the expansion of the franchise after World War I or the sustained attempts to contain socialist revolutionary activity. The paper illustrates these developments by making specific reference to the situation of the Jewish minorities in Central and Eastern Europe as a case study.
Mobilization in crisis – demobilization in peace: protagonists of competing national movements in border regions
Authors: Klatt Martin
Published: February 2023

Border zones are characteristic for being the site of competing national movements’ struggle on a territory and its population: a population did not only have to awaken to a nationality, but also to the ‘correct’ nationality.
Studying national protagonists of competing national movements in border regions therefore promises solid evidence of the reasons underpinning national movements’ success and/or failure to attract the masses.
Transnationalism. A review of the literature
Authors: Munro Gayle
Published: February 2023

This installment of the State of Nationalism is dedicated to a review and annotated bibliography about 'transnationalism'. This highly discussed term has its origins in migration studies, but has in recent years become increaslingly influential in nationalism studies.
Writing national history for small nations
Authors: Hroch Miroslav
Published: February 2023

Almost all theories of nationalism show one common deficit: they ignore the basic difference in the process of modern nation formation between those cases where it took off within an old, established state nation and the other where it started within a non-dominant ethnic group (or ethnic community). This difference concerns also the writing of national histories. In this article, the author tries to qualify this difference by asking how far writing the history of a small nation differs from the same for state nations.
Boletín Agroclimático Regional: mesa técnica agroclimática de Magdalena, Cesar, La Guajira y Atlántico noviembre 2022
Authors:   Corporación Colombiana de Investigación Agropecuaria - AGROSAVIA,   Ministerio de Agricultura y Desarrollo Rural, Bogotá (Colombia),   Instituto de Hidrología, Meteorología y Estudios Ambientales, Bogotá (Colombia),   Organización de las Naciones Unidas para la Alimentación y la Agricultura, Bogotá (Colombia)
Published: February 2023

La Mesa Técnica Agroclimática (MTA) de Magdalena, Cesar, La Guajira y Atlántico, es un espacio de diálogo y análisis entre actores locales, regionales y nacionales, que busca comprender el posible comportamiento del clima. Se realizó reunión de carácter mixto (presencial/Virtual) donde se presentó la perspectiva climática para el trimestre noviembre-diciembre de 2022 y enero de 2023 para los departamentos de Magdalena, Cesar, La Guajira y Atlántico. Con base en esta información, se debatieron los posibles impactos y recomendaciones para el sector agropecuario de la región. La información generada se ha recopilado en el presente Boletín Agroclimático para la edición correspondiente del mes de noviembre de 2022 a cargo de FEDEARROZ y se presenta por cultivo o sector productivo. Agradecemos a los asistentes de la reunión, representantes de gremios, centros de investigación, entidades públicas y privadas interesadas en la construcción de este boletín agroclimático. Especialmente en el apoyo logístico a Cenipalma, Agrosavia, FAO e IDEAM.
Componente animal: bienestar animal y comportamiento ingestivo
Authors: Perdomo Ayola Sandra Carolina , Cubides Cárdenas Jaime Andrés , Aguayo Ulloa Lorena Angelica
Published: February 2023

¿Qué es el bienestar animal? Designa “el estado físico y mental de un animal en relación con las condiciones en las que vive y muere” (OIE, 2018).
BCG therapy and clinical management of bladder cancer in a rural cohort: A small-scale Australian study (Preprint)
Authors: Rai Sunil , Smith Alexandra , Vermeulen Elke
Published: February 2023

BACKGROUND

Bladder cancer is the third most common urological malignancy, and one of the 15 most common cancers, diagnosed in Australia. This reflects a global landscape in which it is the most common urological malignancy and responsible for over 400,000 diagnoses and around 165,000 deaths per year.1-3 Despite changing treatment paradigms, survival outcomes have ostensibly remained consistent over the last 30 years. In particular, there is little recent research focused on regionally and rurally based bladder cancer patient cohort, access to standard-of-care and other treatment, and outcomes.

OBJECTIVE

This small-scale retrospective review study aimed to examine the sociodemographic, treatment, and survival outcome characteristics of a rurally-located cohort of patients with a diagnosis at outset of non-muscle invasive bladder cancer. As a secondary objective, the study aimed to identify future research foci and options for enhancement of clinical pathways for bladder cancer patients.

METHODS

A facility-based cross-sectional review of medical record data was undertaken, for all patients aged 18 years and over, with a diagnosis of bladder cancer and referred for BCG treatment at a regional cancer care facility, between 2010-2022. In total, 23 patients were identified. Sociodemographic and treatment-related factors were summarized as frequencies with percentages, or mean with SD. Distribution of treatment- and survival-related outcomes (recurrence-free survival, progression-free survival, overall survival) were analyzed using regression analysis and one-way ANOVA.

RESULTS

Reflecting broader trends in bladder cancer treatment and survival outcomes, a majority of the study population were male (n=18, 78%) and over the age of 60 (n=18, 78%). A weakly positive but not significant relationship was identified between: age and recurrence-free survival; and total BCG doses administered and both recurrence-free and overall survival. No correlation was observed between age and overall survival, nor sex and overall survival.

CONCLUSIONS

While the study showed some general congruence with national and global trends in bladder cancer populations, the small sample size posed significant limitations in drawing further statistical conclusions. However, this study does therefore point to the value of further research incorporating larger study population samples in rural/regional areas, with potential for attention to be paid to cross-center comparative studies. As well, it indicates the imperative to better utilize BCG as a treatment option, and to ensure that patient referral pathways facilitate early use of BCG as a known means of reducing the risk of cystectomy, and improving the chances of preservation of both the bladder and health-related quality of life. Further work to embed bladder cancer and BCG clinical pathways, as well as improved data documentation and collection for research purposes, is thus highlighted by this study.

CLINICALTRIAL

n/a
Arithmetic Fact Fluency Supported by Artificial Intelligence
Authors: Samuelsson Joakim
Published: February 2023

The main purpose of this study was to investigate to what extent students aged eight years developed their arithmetic fact fluency by using artificial intelligence to practice number combinations. The study compares the effects of three different ways of practicing number combinations: Artificial Intelligence (AI), Memorization (Mem), and Guided Learning (GL). The design was a split-plot factorial design with group as a between-subject factor and time (i.e., before and after a six-week intervention) as a within-subject factor. Pre- and post-test were performed to assess students’ fluency with respect to basic number combinations, i.e., addition, such as 3 + 4, 2 + 1, 6 + 3, etc. The results show that students developed their fluency significantly with respect to basic number combinations when practicing this skill with support of artificial intelligence. It seems that the technique is effective at analyzing and recommending content based on students’ learning patterns and what has worked best for similar students. The results therefore strengthen the findings of previous studies that artificial intelligence presents great opportunities to offer individual support to maximize learning. The results also show that practicing number combinations with artificial intelligence is more effective compared to practicing with a focus on memorization and guided learning.
Sobre la personalidad múltiple de un corpúsculo
Authors: Lopez Carrillo Alejandra , Chamizo Guerrero José Antonio
Published: February 2023

Diversos historiadores de la ciencia, así como investigadores de la educación en ciencias (Izquierdo, 2010; Schütt, 2008; Kohler, 1971) han hablado de la existencia de un átomo químico y uno físico, para recuperar los procesos explicativos en los que se ha visto involucrada dicha entidad en los problemas propios de cada disciplina. Este análisis ha evidenciado no solo los diferentes intereses, aspiraciones y metodologías que persiguen la práctica de la química y de la física, sino también el estatus ontológico que adquieren las entidades como resultado del desarrollo de sus herramientas teóricas.            Este artículo muestra un panorama del proceso de construcción de la primer partícula subatómica identificada —el electrón— y del papel que desempeñó en las prácticas teóricas y experimentales que se estructuraron entorno a ella. Analizando la apropiación del electrón en la práctica de la física y de la química, pretendemos argumentar que también podemos hacer alusión a un electrón químico y uno físico. El propósito es que este análisis histórico confiera un reconocimiento más profundo del significado químico de esta entidad, con su consecuente repercusión en nuestros procesos de enseñanza-aprendizaje.
Las sustancias no bullen a la temperatura de ebullición
Authors: Donati Edgardo Rubén , Andrade-Gamboa Julio José
Published: February 2023

En el argot científico existen muchos términos que por tradición histórica subsisten a pesar de no guardar estricta rigurosidad semántica con una dada fenomenología. De esta manera en una denominación pueden convivir significados científicos diferentes. Esta «polisemia» provoca confusiones en la interpretación y en el uso que los estudiantes de cursos iniciales de ciencias hacen de ellos (términos y conceptos). En este trabajo, presentamos ejemplos dentro del tema de cambios de estado, focalizando en la temperatura de ebullición. Su definición genera la incongruencia de que las sustancias no bullen a la temperatura de ebullición. Además de la discusión sobre el posible origen y las implicancias de esta paradoja, presentamos una propuesta de modificación de ciertas definiciones que, más allá de las dificultades que podría aparejar su imposición, intenta generar un espacio de reflexión sobre el tema entre los docentes que podría extenderse al aula enriqueciendo el aprendizaje de los estudiantes.
Química Clic el sistema premiado con el Premio Nobel de Química 2022. ¿Cómo funciona la Química Clic?
Authors: Catalá Rodes Rosa María , Palacios-Arreolab Margarita Isabel , Huerta-Lavoriec Raúl
Published: February 2023

Se presenta una hoja didáctica basada en la comprensión lectora del artículo de referencia sobre el premio de química 2022 sobre la química clic. La estrategia se presenta para apoyar a los profesores en la difusión del conocimiento de la tecnología que aplicada a contextos biológicos es la base de lo conoce como química bioortogonal, de gran relevancia en síntesis bioquímica y farmacológica más eficiente y específica. La actividad consiste en un cuestionario (idealmente aplicado vía Google Forms, para contar con datos estadísticos de las respuestas de manera inmediata) dirigido a estudiantes nivel medio, medio superior o universitario. Esto se realiza en un contexto que permite, dependiendo de la unidad o tema de estudio del curso, introducir y revisar ejemplos de conceptos, modelos y metodologías de vanguardia en campos que van desde la química orgánica hasta la biología molecular. Asimismo, la historia del descubrimiento del sistema, el desarrollo de la tecnología para sus aplicaciones y el Premio Nobel al que fueron acreedores los tres investigadores involucrados constituyen un contexto perfecto para fomentar la reflexión acerca del carácter colaborativo de la ciencia y la frontera entre la llamada ciencia básica y la ciencia aplicada.
Stock Market Prediction Techniques: A Literature Review
Authors: Nath Om , Shakhari Swapan
Published: February 2023

Abstract: This literature review summarizes the existing research on the use of machine learning for stock market prediction. The review covers studies from various sources such as journals, conference proceedings, and theses. The methods used for stock market prediction using machine learning include decision trees, support vector machines, artificial neural networks, and time-series analysis. The review also highlights the advantages and limitations of these methods, as well as their applications in the stock market. The findings of the review indicate that machine learning has the potential to provide valuable insights into the stock market, but there is still room for improvement in terms of accuracy and robustness. The review concludes by suggesting future directions for research in this field
THE EFFECT OF USING BISPECTRAL INDEX MONITORING ON THE AMOUNT OF PROPOFOL USED DURING TRANSVAGINAL OOCYTE RETRIEVAL PROCEDURE: A PROSPECTIVE, RANDOMIZED, CONTROLLED, CLINICAL TRIAL
Authors: Bilgen Sevgi , Erdogan Dilek , Ökten Sabri Berkem
Published: February 2023

Objective: To investigate whether the use of bispectral index
(BIS) monitoring would decrease total propofol consumption during the
transvaginal oocyte retrieval procedure Design: Prospective,
randomized, controlled, parallel-group clinical trial Setting:
Operating room, postoperative recovery room Population: One
hundred and thirty, American Society of Anesthesiologists (ASA) I-II
patients, over age 18, undergoing transvaginal oocyte retrieval
Methods: All patients were administered 2μg/kg fentanyl, and
2mg/kg propofol for the induction of anesthesia. The patients were
divided into two groups. Patients in the group bolus were given 0.5
mg/kg of propofol when necessary, according to the observer’s range of
motion. Patients in the group BIS were given 10 mg/kg/hour propofol
infusion adjusted to keep the BIS value between 40-60. Main
Outcome Measures: The primary outcome was the total dose of propofol
administered per patient. The secondary outcomes were the time to reach
the value of 5 on the Modified Observer’s Assessment of Alertness
Sedation Scale (MOASs), the time to reach Post Anesthetic Discharge
Scoring System (PADSS) ≥9 of the patients, satisfaction of the patient,
and the gynecologist. Results: The amount of total propofol was
higher in the group BIS than in the group bolus administered according
to the patient’s clinic. There was no difference in the time to reach
the value of 5 on the MOASs between the groups. The time to reach PADSS
≥9 was longer in the group BIS than in the group bolus. There was no
difference between the two groups in terms of the satisfaction of the
patient and the gynecologist. Conclusion: Administration of
propofol as an infusion with BIS monitoring did not reduce the amount of
propofol administered to patients during transvaginal oocyte retrieval.
Funding: This research did not receive any specific grants from
funding agencies in the public, commercial, or not-for-profit sectors.
Research and application of high-power pruning robot based on RTK positioning and heavy load mountings
Authors: Xiaohui Zhu , Yongming Mao , Yongling Ying , Yao Wenjie , Zhaoxi Hong
Published: February 2023

Aiming at the problem that short circuit tripping may be caused by the
insufficient safe distance between trees and lower phase conductors in
high voltage transmission line corridors, a high-power pruning robot
with RTK positioning and heavy-load mounting is studied and designed,
which includes five modules: mathematical model and control principle of
multi-rotor UAV, multi-rotor auxiliary obstacle avoidance control
system, RTK aircraft positioning, UAV digital video transmission, and
remote control cutting. First of all, according to the analysis of
working space, the configuration principle of a high-power pruning robot
based on RTK positioning and heavy-load mounting is put forward, and the
three-dimensional model is set up. The finite element stress-strain
analysis and modal analysis of the combined insulation clamping arm are
carried out by using ABAQUS software, and the minimum mass solution that
meets the mechanical performance requirements is given, which is 15.3%
lower than that of similar robots, and the load capacity of trimming
tools is increased by 20.2%. Secondly, the mathematical model of a
multi-rotor UAV is established, and the multi-rotor auxiliary obstacle
avoidance control system is designed. The control accuracy is 10.1%
higher than that of the traditional control system, and the positioning
of RTK aircraft is realized. In addition, based on RTK positioning,
three design schemes of pruning robots are given: pruning tool and
camera handling, UAV tree obstacle pruning control, and UAV tree
obstacle removal. Finally, the prototype has carried out several
heavy-load pruning tests on 220KV live lines, and the test results show
that the prototype meets the tree pruning requirements of 220KV live
lines, and the pruning accuracy is 89.42% higher than that of similar
robots, and the live working time is extended by 26.8%, which verifies
the rationality and practicability of the design.
Understudied Proteins and Understudied Functions in the Model Bacterium Bacillus subtilis -- a Major Challenge in Current Research
Authors: Stülke Jörg , Wicke Dennis , Meißner Janek , Warneke Robert , Elfmann Christoph
Published: February 2023

Model organisms such as the Gram-positive bacterium Bacillus
subtilis have been studied intensively for decades. However, even for
such model organisms no function has been identified for about one
fourth of all proteins. It has recently been realized that such
understudied proteins as well as poorly studied functions set a
limitation to our understanding of the requirements for cellular life,
and the Understudied Proteins Initiative has been launched. Obviously,
poorly studied proteins that are strongly expressed, are likely to be
most important to the cell and should therefore have priority in further
studies. Since the functional analysis of unknown proteins can be
extremely laborious, a minimal knowledge is required prior to targeted
functional studies. In this review, we discuss strategies to obtain such
a minimal annotation, e.g. from global interaction, expression or
localization studies. We present a set of 41 highly expressed and poorly
studied proteins of B. subtilis. Several of these proteins are
thought or known to bind RNA and/or the ribosome, some may may control
the metabolism of B. subtilis, and another subset of particularly
small proteins may act as regulatory elements to control the expression
of downstream genes. Moreover, we discuss the challenges of poorly
studied functions with a focus on RNA-binding proteins, amino acid
transport and the control of metabolic homeostasis. The identification
of the functions of the selected proteins will strongly advance our
knowledge on B. subtilis, but also on other organisms since many
of the proteins are conserved in many groups of bacteria.
Evaluation of biologic therapies for the treatment of moderate-to-severe plaque psoriasis in the brazilian private healthcare system: a Cost Per Responder (CPR) and Treatment Cost Analysis
Authors: Corona Prandi Bruno , P Rosim Mariana , Ogata Pedro Gabriel , Papadimitropoulos Manny
Published: February 2023

Introduction: Psoriasis is a chronic, immune-mediated inflammatory skin disease presenting with localized or generalized erythematous, sharply demarcated plaques covered with whitish or silvery scales in a symmetrical distribution. Moderate-to-severe plaque psoriasis in Brazil are usually treated with synthetic systemic drugs, and only patients who do not respond to these therapies or are intolerant to them may be eligible for treatment with biologic agents. These agents are significantly more costly than most synthetic alternatives and, therefore rational resource allocation is necessary to guarantee coverage across the country. Comparative efficacy assessments are usually obtained from network meta-analyses (NMA) and are useful in clinical decision-making. These NMA allow the calculation of the number needed to treat (NNT) which is an easier-to-understand concept for clinicians and decision makers and is the number of patients needed to be treated with a specific therapy to achieve one particular outcome. Objectives: The objective of this study is to determine the efficacy of different biological therapies available in Brazil for the treatment of moderate-to-severe plaque psoriasis in terms of cost per responder (CPR) for the different levels of Psoriasis Area Severity Index (PASI) response. The treatment cost for 1 and 2 years of therapy were also calculated. Methods: A NMA by Núnez et al (2018) presented the data that was used to estimate the CPR of adalimumab, etanercept, infliximab, ixekizumab, secukinumab and ustekinumab. NNT was calculated relative to the placebo response for the outcomes of PASI score reduction of ≥75%, ≥90% or 100% (Table 1). In order to estimate treatment costs for year 1 and 2, the number of doses and unit prices were considered. Since the time horizon of this analysis was 1 year, only treatment costs in the first year (R$, Brazilian currency) were considered for CPR estimation (Table 2), using as reference the Brasíndice pharmaceutical guide (wholesale prices plus 18% taxes (Table 3)). The number of doses used in the analyses for each of the products was based on the current product labels in Brazil. Results: Ixekizumab had the lowest NNT (1.18 for PASI-75, 1.41 for PASI-90 and 2.46 for PASI100) and the lowest CPR for PASI-90 and PASI-100 (R$ 126.364 and R$ 220.464, respectively). Conclusion: For PASI-90 and PASI-100 responses, ixekizumab is the most cost-efficient therapy for moderate-to-severe plaque psoriasis in the first year in the Brazilian private healthcare system, presenting the lowest NNT and CPR.
Devolução de medicamentos e omissão na administração de doses em uma unidade de terapia intensiva
Authors: Lima de Almeida Leite Bartyra , Costa de Sousa Ivellise , Novais Rodrigues Silva Renata Kelly , Mistro Sóstenes
Published: February 2023

Introdução: Omissão na administração de doses de medicamentos prescritos a pacientes hospitalizados em unidade de terapia intensiva pode implicar em consequências negativas para o paciente, bem como para o sistema de saúde. A omissão indevida pode resultar em ausência de efeito terapêutico e, consequentemente, levará o prescritor a uma mudança na conduta terapêutica que implica maiores custos. Fatores relacionados às etapas de uso dos medicamentos interferem diretamente na ocorrência de erro e a revisão periódica dos processos promove redução de erros relacionados ao uso de medicamentos. Objetivos: Estimar a incidência de erros de medicação por omissão de doses e as justificativas para a não administração de medicamentos pela equipe de enfermagem de uma unidade de terapia intensiva (UTI) em um hospital universitário no nordeste brasileiro. Método: Estudo observacional prospectivo no qual todas as doses de medicamentos de uso sistemático dos pacientes hospitalizados na UTI foram monitoradas a cada horário de administração durante 10 dias não consecutivos. As equipes médica e de enfermagem estavam cegas em relação aos objetivos do estudo. Resultados: Foram monitoradas 831 doses de medicamentos dispensadas para os pacientes hospitalizados na UTI no período de estudo. Dessas, 108 (13%) deixaram de ser administradas aos pacientes, por diversas causas. A incidência de erro por omissão na administração de doses foi de 6,7% (n=56), o que correspondeu a 52% (56/108) das doses devolvidas ao Serviço de Farmácia. Outras causas mais comuns de devolução de medicamentos foram suspensão da dose pelo médico 3,9% (n=32) e a administração de subdose 1,2% (n=10). As doses omitidas envolveram medicamentos para o sistema nervoso (30,4%), seguidos pelos de ação em órgãos hematopoiéticos (21,4%), os que atuam no trato gastrointestinal (19,6%) e antimicrobianos (12,5%). Conclusão: A incidência de erros de medicação por omissão de doses na UTI foi elevada, sendo a principal causa de devolução de medicamentos não administrados ao Serviço de Farmácia.
Lesão hepática induzida por dolutegravir
Authors: Carmo Novais Júnior Fernando , Esquivel Reis Ricardo Gabriel
Published: February 2023

Introdução: A lesão hepática induzida por drogas pode desenvolver-se após o uso de muitas drogas, tanto prescritas quanto de venda livre, através de uma variedade de mecanismos. Um alto índice de suspeita é muitas vezes necessário para estabelecer rapidamente o diagnóstico. A DILI tem uma incidência anual estimada entre 10 e 15 por 10.000 a 100.000 pessoas expostas a medicamentos prescritos, o que representa cerca de 10 por cento de todos os casos de hepatite aguda, e é a causa mais comum de insuficiência hepática aguda nos Estados Unidos. O abuso de álcool e a desnutrição predispõem a DILI em alguns casos. Objetivos: Trata-se de um relato de caso de reação adversa a medicamento com hepatotoxicidade após uso de Dolutegravir para tratamento de AIDS em paciente feminina em um Hospital Universitário de Salvador-Bahia. Método: Estudo observacional descritivo intervencionista. Resultados e Discussão: Paciente 24 anos, refere histórico de dislipidemias, nega outras comorbidades, etilismo, alergias e uso prévio de medicamentos contínuos. Foi internada no hospital de sua cidade com quadro infeccioso e apresentou teste rápido positivo para HIV. Encaminhada para o serviço de infectologia do Hospital Universitário Prof. Edgard Santos. Admitida nesta instituição no dia 22/02/2017 para investigação e compensação do quadro de infecção (diarreia, febre intermitente com astenia, pancitopenia e lesões de cavidade oral) associado ao HIV. Fez uso de um concentrado de hemácias. Fez uso de ceftriaxona (2g/ dia, EV, entre 18 e 21/02/2017), metronidazol (1500mg/dia, VO, entre 17 e 28/02/17) e fluconazol (200mg/dia, VO, de 18 a 28/02/17) durante o internamento no hospital de sua cidade. Ao ser admitida no HUPES foi feito coleta para os testes confirmatórios de HIV e introduzido azitromicina (1500mg/semana, VO) no dia 22/02/2017. Exames laboratoriais para função hepática na admissão: TGO 173U/L; TGP 49U/L; FA 290U/L; GGT 182 U/L. Em 24/02/2017 foi introduzido sulfametoxazol+trimetoprim (800mg + 160mg/dia, VO). Após resultados de carga viral (1.590.438 cp) e CD4+ (45 cels), foi introduzido esquema antirretroviral com tenofovir (300mg/dia, VO), lamivudina (300mg/dia, VO) e dolutegravir (50mg/dia, VO) no dia 02/03/2017. Dose única de filgrastim (300mcg, SC) nesta data. No dia 09/03/17 a paciente apresentou cefaleia, náuseas e vômitos e exames mostraram enzimas canaliculares e transaminases elevadas: TGO 275; TGP 197; FA 487; GGT 227. Atingiu valores máximos no dia 14/03/17: TGO 445; TGP 496; GGT 441; FA 2.575. O dolutegravir foi suspenso neste dia. No dia 27/03/17 exames demonstraram melhora do perfil hepático, mantendo-se os demais medicamentos. Conclusão: De acordo com a avaliação de causalidade, através da aplicação dos algoritmos de Naranjo, RUCAM, OMS e da União Européia, tento com resultados provável, altamente provável, certa ou provada e categoria A, respectivamente, foi possível concluir que a lesão hepática do tipo colestática foi causada pelo uso do dolutegravir.
Avaliação da atividade da doença e qualidade de vida de pacientes com doença inflamatória intestinal em uso de infliximabe em um Hospital Universitário da Bahia
Authors: Da Silva Pereira Fernanda , Moreira Lauton Priscila , Nunes Wildemberg Brauer Alline Mikaelle , Souza Rocha Ana Flávia , De Moura Santos Pablo
Published: February 2023

Introdução: Doença de Crohn (DC) e Retocolite ulcerativa (RCU) são doenças inflamatórias intestinais (DII) caracterizadas por períodos de atividade e remissão, que acometem principalmente pessoas jovens em idade produtiva, podendo alterar de forma impactante a qualidade de vida. O infliximabe é um anticorpo monoclonal anti-TNF-α indicado no tratamento de pacientes com DII refratários ao tratamento convencional. Objetivos: O objetivo deste trabalho foi avaliar o grau de atividade da doença e a qualidade de vida em pacientes com DII em uso de infliximabe. Métodos: Trata-se de um estudo transversal descritivo realizado com pacientes com diagnóstico de DC ou RCU, em tratamento regular com infliximabe há pelo menos um ano, atendidos em um Centro de Infusão de um Hospital Universitário na Bahia. Para avaliação da atividade da doença, foi aplicado o Índice de Harvey-Bradshaw (IHB) em pacientes com DC e o score Mayo parcial em pacientes com RCU. Para avaliação da qualidade de vida, foi utilizado o questionário Inflammatory Bowel Disease Questionnaire (IBDQ), validado em português. O IBDQ é um questionário de múltipla escolha que avalia quatro domínios com as seguintes pontuações máximas: intestinal (70), sistêmico (35), social (35) e emocional (84). O escore total pode variar entre 32 (pior qualidade de vida) e 224 (melhor qualidade de vida). Resultados: Foram avaliados 62 pacientes. A média de idade foi de 38 anos, sendo 34 (54,8%) do sexo masculino. 55 (89%) pacientes possuíam diagnóstico de DC e os demais, RCU. Com relação à situação ocupacional, tem-se: 24 (39%) pacientes empregados, 17 (27%) desempregados, 12 (19%) aposentados por invalidez, oito estudantes (13%) e um aposentado por idade (2%). A renda familiar média foi de dois salários-mínimos. Com relação ao grau de atividade da doença, 53 (85%) pacientes estavam em remissão clínica, 5 (8%) em atividade leve e 4 (6%) em atividade moderada. Nenhum paciente apresentava alta atividade da doença. Quatro (6%) pacientes foram hospitalizados por descompensação clínica no último ano, com média de 19 dias de internação. Nenhum paciente necessitou de procedimento cirúrgico em decorrência da doença no último ano. O IBDQ total encontrado variou entre 93 e 209, com média de 187. Com relação ao score por domínio, a média do domínio intestinal foi de 61, domínio sistêmico 27, domínio social 31 e domínio emocional 66. Conclusão: Os índices de atividade da doença e os resultados obtidos por meio do IBDQ revelaram que os pacientes em uso de infliximabe avaliados apresentam um bom controle da doença, com alta prevalência de remissão, e níveis elevados de qualidade de vida.
Caracterização das intervenções farmacêuticas na farmacoterapia de pacientes em uma unidade de unidade de oncohematologia e transplante de medula óssea em Salvador-Bahia
Authors: Candeias da Silva Taiane , Da Silva Lima Milena , Sávia Luana
Published: February 2023

Introdução: A atuação do farmacêutico clínico no cuidado ao paciente contribui para prevenção e resolução de problemas relacionados a medicamentos (PRM). Esse cuidado correlaciona a situação clínica do paciente, otimizando o uso dos medicamentos, promovendo o uso racional, além de auxiliar na prevenção de erros de medicação. Os pacientes internados em unidade de oncologia têm necessidades constantes de modificação da terapia medicamentosa. Diante disso, a descrição das intervenções farmacêuticas no cuidado prestado ao paciente oncológico quanto ao uso dos medicamentos representa uma ferramenta importante para garantia da segurança na condução da farmacoterapia. Objetivo: Caracterizar as intervenções realizadas pelo farmacêutico clínico de uma unidade de oncohematologia e transplante de medula óssea em um hospital universitário em Salvador-BA no período de janeiro de 2018 a fevereiro de 2022. Método: Trata-se de um estudo retrospectivo, quantitativo e descritivo. A coleta de dados foi realizada a partir de dados secundários obtidos de planilha específica da Unidade de Farmácia Clínica no período de janeiro de 2018 a fevereiro de 2022. Foi aplicada estatística descritiva. Esse estudo está sob aprovação do CEP sob número 4.465.789. Resultados: Nesse período, foram acompanhados 1610 pacientes. Houve um total de 1595 intervenções farmacêuticas registradas, sendo 1479 (92,7%) aceitas, 5 (0,3%) parcialmente aceitas e 111 (7%) não aceitas pela equipe. Ao considerar a categoria profissional alvo da intervenção, identificou-se que 1511 (94,7 %) foram profissionais médicos, 66 (4%), enfermeiros, 13 (1%) familiares e pacientes e 5 (0,3%) outros profissionais. As intervenções mais frequentes foram suspensão de medicamentos 411 (25,7%), ajustes de dose 235 (14,7%), modificação do medicamento disponível no hospital 153 (9,6%) e ajuste posológico 152 (9,5%). Conclusão: As intervenções do farmacêutico clínico em uma unidade de oncolohematologia permitem discussões alinhadas de condutas relacionadas ao paciente e contribuem para garantia de um cuidado integral e seguro quanto à terapia medicamentosa.
Análise das intervenções farmacêuticas e problemas relacionados a medicamentos em pacientes pediátricos de um hospital universitário
Authors: Maldonado Baia Simone , Calil-Elias Sabrina , Miranda Salles Marcela , Samel Rocha Tostes Fernanda , Alves Farias Eron
Published: February 2023

Os problemas relacionados à medicamentos (PRM) são a principal causa dos eventos adversos, e podem estar presentes durante a análise de prescrições pediátricas. Nesse contexto, o cuidado farmacêutico torna-se essencial, pelo intuito de promover a segurança e efetividade da farmacoterapia, levando em consideração a epidemiologia da população, na qual apresenta peculiaridades na farmacocinética e farmacodinâmica destes pacientes. As intervenções farmacêuticas (IFs) trazem benefícios e auxiliam na promoção do uso racional dos medicamentos. Diante disso, este estudo objetiva descrever os PRM encontrados a partir dos registros farmacêuticos e realizar e analisar as IFs realizadas pela equipe de farmacêuticos clínicos, na enfermaria pediátrica no Hospital Universitário Antônio Pedro (HUAP), através de um estudo observacional e retrospectivo. Os dados sociodemográficos e clínicos empregados na construção do perfil amostral foram coletados a partir dos registros provenientes dos Formulários de Conciliação e Evolução da Unidade de Farmácia Clínica (UFCLI). Além disso, foram coletados os registros de PRM e respectivas IFs realizadas pela UFCLI e utilizados como indicadores de qualidade do serviço. Os PRM foram categorizados conforme metodologia PWDT (PHARMACISTS’ WORKUP OF DRUG THERAPY) desenvolvido por Cipolle et al 2004, já adotada pela UFCLI para a documentação e os medicamentos envolvidos foram categorizados conforme a Classificação Anatômica-Terapêutica-Química (ATC). Todos esses dados foram tabulados em planilhas específicas utilizando o software Microsoft Excel® e os resultados foram mensurados através de estatística descritiva. Como resultados preliminares dentre o período de março a outubro de 2022, com base nos registros da UFCLI na pediatria, foram acompanhados 50 pacientes, sendo 58% correspondentes ao sexo masculino. Quanto ao grau de escolaridade, os lactentes perfizeram 34% dos registros. Dentre os diagnósticos mais comuns estavam encefalopatia crônica não progressiva (n=8), seguido por pneumonia (n=6). Foram realizadas 164 intervenções farmacêuticas, sendo a maior parte delas aceitas pela equipe multiprofissional (n=136). Verificou-se que as principais categorias terapêuticas envolvidas nas IFs estavam relacionadas a medicamentos do trato alimentar e metabolismo (24%) e antimicrobianos de uso sistêmico (18%). A maior parte das IFs referiam ao PRM de adesão (29%), atribuídas à indisponibilidade de apresentações farmacêuticas mais adequadas ao público pediátrico, como por exemplo a sugestão de transformação farmacêutica de comprimidos ou cápsulas em xaropes e suspensões garantindo a continuidade do tratamento. Dessa forma, pretende-se trazer ao conhecimento dos gestores a importância dos farmacêuticos integrados à equipe de saúde ao contribuírem com a efetividade e segurança da farmacoterapia dos pacientes pediátricos.