bluuebunny/crossref_metadata_2025 huggingface dataset:
Governança e coordenação intersetorial de políticas públicas: a Câmara Intersetorial de Segurança Alimentar e Nutricional
Authors: Moraes Verena Duarte , Machado Cristiani Vieira , Magalhães Rosana
Published: October 2021

RESUMO A trajetória da política de Segurança Alimentar e Nutricional (SAN) no Brasil expressa a construção de estratégias de governança para viabilizar a participação social e a articulação entre setores. Nesse processo, destacam-se as Conferências Nacionais, o Conselho Nacional de Segurança Alimentar e Nutricional (Consea) e a Câmara Intersetorial de Segurança Alimentar e Nutricional (Caisan), composta por ministérios e secretarias governamentais. O objetivo deste artigo é analisar a atuação da Caisan, de 2012 a 2016, na coordenação intersetorial da política no governo federal. A pesquisa se baseou na literatura sobre governança, considerando dois eixos de análise: estrutura e dinâmica de atuação da Câmara; a agenda da Caisan e sua relação com o Consea. As estratégias metodológicas foram: revisão bibliográfica, análise documental e entrevistas semiestruturadas. Observou-se que a atuação da Caisan favoreceu a coordenação intersetorial da política, influenciando medidas governamentais em resposta a demandas das Conferências e do Consea. Contudo, constataram-se fragilidades, como baixa participação de representantes governamentais com poder decisório e limitado enfrentamento de desafios em áreas que expressam conflitos entre interesses econômicos e sanitários. Conclui-se que o seu fortalecimento é essencial, sobretudo após a extinção do Consea, que favorecia a participação social e a intersetorialidade na política de SAN.
A voz da comunidade no enfrentamento da Covid-19: proposições para redução das iniquidades em saúde
Authors: Santos Hebert Luan Pereira Campos dos , Maciel Fernanda Beatriz Melo , Martins Poliana Cardoso , Santos Adriano Maia dos , Prado Nília Maria de Brito Lima
Published: October 2021

RESUMO Este artigo se propõe a discutir o papel do engajamento comunitário, a ação dos movimentos sociais e da sociedade civil para o enfrentamento de emergências em saúde. As questões norteadoras que balizaram a construção deste artigo foram: qual é o papel do engajamento comunitário no enfrentamento da Covid-19? O que o engajamento comunitário pode oferecer frente aos eventos de emergências globais em saúde? Quais ações têm sido desenvolvidas pela sociedade civil? Trata-se de um ensaio teórico, construído a partir da articulação de ideias da literatura científica e de documentos técnico-operacionais sobre engajamento e governança comunitária e a crise sanitária decorrente da Covid-19. Constata-se que, nos contextos internacional e nacional, a governança comunitária subsidiada pelo fortalecimento de canais de comunicação fomentados por instituições e/ou influenciadores sociais pode contribuir para ampliação do engajamento de coletivos organizados como retórica e prática ético-política comprometida com a cidadania. No cenário brasileiro, observa-se que o mecanismo necropolítico que tem operado as políticas de enfrentamento da Covid-19, no âmbito do governo federal, contrapõe as ações e a capacidade de resposta das populações. Ainda assim, as ações dos movimentos sociais têm mobilizado esforços para mitigar iniquidades e proteger os mais vulneráveis, mesmo na ausência de uma liderança sanitária nacional.
Dispositivos de uso único: políticas de regulação de reuso e implicações para a saúde coletiva
Authors: Costa Eliana Auxiliadora , Costa Ediná
Published: October 2021

RESUMO O reuso de dispositivos médicos de uso único implica segurança em saúde. Este estudo analisa sistemas regulatórios de reuso de produtos médicos de uso único em âmbito internacional. Trata-se de revisão integrativa, com descritores específicos, sem restrição de ano da publicação. A busca dos dados, entre outubro e dezembro de 2017, incluiu 23 estudos. As políticas de reuso desses produtos variam entre países, com normas legitimando essas práticas, como a norte-americana e a alemã, normas restritivas e regulações inexistentes em nível nacional, como no Canadá, no Japão e na Europa. Essas políticas centram-se na regulação pré-comercialização, estruturam-se na classificação dos produtos, com questões relacionadas ao rótulo dos produtos, se multiuso ou de uso único, ponto-chave do dilema desse reuso. Este estudo aponta a necessidade de reestruturação das políticas de reuso de produtos de uso único quanto à classificação desses dispositivos, bem como à adoção de mecanismos para clarificação do rótulo desses produtos. Ressalta os condicionantes internos e externos que envolvem o desenvolvimento das políticas de saúde e o papel do Estado na preservação dos direitos da saúde de seus cidadãos, em detrimento dos grupos de interesses privados e dotados de fortes recursos de poder, como a indústria de produtos médicos.
Diretivas antecipadas de vontade em pacientes com doença de Alzheimer
Authors: Dadalto Luciana , Arantes Alexandra Mendes Barreto , Baruffi Priscila Demari
Published: October 2021

Resumo Em todo o mundo a população idosa tem crescido e, juntamente com o envelhecimento populacional, nota-se o aumento da incidência de demências. Sob a ótica da importância dos instrumentos de manifestação de vontade, e mais especificamente das diretivas para demências, este artigo analisa fatores que contribuem com a perda de autonomia dos idosos acometidos pela doença de Alzheimer em sua fase mais avançada. Para que possa esclarecer seus desejos, é necessário que o idoso estabeleça diretivas preferencialmente na fase inicial da doença, ou seja, enquanto tem capacidade de decidir por si, manifestando suas opiniões e preferências. Conclui-se, no entanto, que ainda é preciso mais debates para que esse instrumento seja usado da melhor forma possível, garantindo a autodeterminação dos pacientes.
Autonomia do enfermeiro no cuidado à pessoa com lesão crônica
Authors: Silva Filho Benedito Fernandes da , Duque Caroline Borges , Yarid Sérgio Donha , Souza Júnior Edison Vitório de , Sena Edite Lago da Silva , Boery Rita Narriman Silva de Oliveira
Published: October 2021

Resumo O presente estudo reflete sobre a autonomia do enfermeiro no cuidado à pessoa com lesão crônica. O trabalho em enfermagem é influenciado por dimensões tecnológicas e definido pela responsabilidade profissional e o compartilhamento de atividades com outras categorias, fatores que impactam diretamente a autonomia do enfermeiro no tratamento de lesões crônicas. Por isso, é importante reconhecer as competências e limitações do trabalho desse profissional, de modo a reorientar condicionamentos. A autonomia do enfermeiro não deve se sobrepor à autonomia do paciente. Mediante ações educativas, deve-se considerar a heterogeneidade de papéis para assegurar a integridade do paciente e garantir a adesão terapêutica, enfatizando a importância da corresponsabilidade no processo de cura.
Médicos e hiperutilizadores de baixo risco em emergências: implicações éticas
Authors: Silva Gabriela Rodrigues da , Feliciano Deize Graziele Conceição Ferreira , Chioro Arthur
Published: October 2021

Resumo É crescente a demanda de usuários com problemas de baixa complexidade clínica que procuram serviços hospitalares de urgência e emergência frequentemente. Essa hiperutilização dos serviços impõe dilemas éticos aos médicos e demais profissionais. O presente estudo analisa as implicações éticas do encontro entre médicos e usuários hiperutilizadores em uma unidade universitária. Trata-se de pesquisa qualitativa desenvolvida por meio de entrevistas semiestruturadas com médicos e pacientes hiperutilizadores de baixo risco clínico e observação de campo etnográfica. Observou-se que os profissionais tendem a estigmatizar a demanda desses usuários. Já os usuários demonstram satisfação com os médicos, mas descontentamento com a atenção básica e especializada ambulatorial. Conclui-se que a hiperutilização gera conflitos ético-profissionais decorrentes sobretudo da estigmatização dos pacientes pelos médicos. Apesar disso, os hiperutilizadores se sentem satisfeitos com o atendimento, o que os motiva a continuar frequentando os serviços com frequência.
A verdade do mercado e os juros na Constituição de 1988
Authors: Laurindo Marcel Mangili , Heinen Luana Renostro
Published: October 2021

Resumo Este artigo busca compreender, sob uma perspectiva sociopolítica, os fundamentos das decisões tomadas por José Sarney, então presidente da República, e pelo Supremo Tribunal Federal (STF) a respeito da eficácia da norma que, na Constituição de 1988 (CF/88), determinava a limitação dos juros reais em 12% ao ano. Parte-se, aqui, com base em teses desenvolvidas por Karl Polanyi, Pierre Rosanvallon e Michel Foucault, da hipótese de que a interpretação dada ao § 3º do art. 192 da CF/88 não contrariou a verdade do mercado, que, ofuscando a política e o direito, via na limitação das taxas de juros uma afronta às suas próprias leis e, com isso, a deflagração do caos econômico. O artigo analisará o percurso que se inicia na aprovação da norma na Assembleia Constituinte até a decisão de José Sarney, amparada em parecer do consultor-geral da República, e ao julgamento da Ação Direta de Inconstitucionalidade levada à Corte Suprema pelo Partido Democrático Trabalhista. O estudo permitirá concluir que, no caso, José Sarney e o STF atuaram como guardiões de uma ordem econômica natural que, recusando a política, prescindiria de qualquer soberano.
Analysis of the Effect of the COVID-19 Pandemic on the Prices of Basic Food Sold in Traditional Markets: The Case of Jakarta Province, Indonesia
Authors: ZAHRATURRAHMI Zahraturrahmi , DEMIRCAN Vecdi , MORARU Radu Adrian , BODESCU Dan
Published: October 2021

The purpose of this study was to analyze the development and fluctuation of basic food prices in traditional markets in Jakarta before and during the coronavirus disease (COVID-19) pandemic. The study used performance reports from the Indonesian Central Statistical Institute (BPS), National Center for Food Price Information (PHPI), various government agencies, the latest news from reliable online media, and similar studies. The scope of the research focused on the development of basic food prices in traditional markets from January 2019 to May 2021 in Jakarta, Indonesia. The basic food prices discussed in this study were shallots, rice, red chili, and garlic. Results showed that, the impact of the COVID-19 pandemic on the price fluctuations of shallots in the traditional markets of Jakarta was not significant. During the COVID-19 pandemic, rice prices remained stable due to the government's welfare program. The price of red chili in traditional markets tended to decrease due to the COVID-19 outbreak. The COVID-19 pandemic caused fluctuations in garlic prices in traditional markets in Jakarta, and this was because garlic imports from China faced logistical difficulties.
Palliative Care in Primary and Metastatic Brain Tumors
Authors: SARIÇAM Gülhan , KAHVECİ Kadriye
Published: October 2021

Introduction: Early palliative care interventions and structured advance care planning can improve symptom control and quality of life in patients with a brain tumor. In this study, we aimed to investigate symptoms, hospital discharge conditions, and the length of stay of patients with primary and metastatic brain tumors in our palliative care center (PCC).
Material and Method: Ninety-one patients; who had been followed-up in the PCC with the diagnosis of a primary or metastatic brain tumor were included in this retrospective study. Demographic characteristics, Glasgow Coma Scale (GCS) scores, Karnofsky Performance Scale (KPS) scores, hospital discharge status, and symptoms of the patients included in the study were compared.
Results: The mean age of the patients was 60.67 years; 59.3% were male, and the mean length of hospital stay was 29.26 days. The rates of PEG, tracheostomy, seizures, and paresis symptoms were significantly higher in patients with a primary brain tumor (p<0.05). The rates of death in the hospital were significantly higher in patients with metastatic tumors and low GCS scores (p=0.032 and p=0.00, respectively).
Conclusion: We observed differences in clinical findings and prognoses between primary and metastatic brain tumor patients during the follow-up in PCC. Further to advances in treatment methods, we believe that identifying the need for palliative care and appropriate symptom management will improve the quality of life in brain tumor patients with poor prognosis.
Identification and Characterization of a Novel Plasmid-Encoded Laccase-Like Multicopper Oxidase from Ochrobactrum sp. BF15 Isolated from an On-Farm Bio-Purification System
Authors: Martini María Carla , Berini Francesca , Ausec Luka , Casciello Carmine , Vacca Carolina , Pistorio Mariano , Lagares Antonio , Mandic-Mulec Ines , Marinelli Flavia , Del Papa María Florencia
Published: October 2021

Research background. In recent decades, laccases (p-diphenol-dioxygen oxidoreductases; EC 1.10.3.2) have attracted the attention of researchers due to their wide range of biotechnological and industrial applications. Laccases can oxidize a variety of organic and inorganic compounds, making them suitable as biocatalysts in biotechnological processes. Even though the most traditionally used laccases in the industry are of fungal origin, bacterial laccases have shown an enormous potential given their ability to act on several substrates and in multiple conditions. The present study aims to characterize a plasmid-encoded laccase-like multicopper oxidase (LMCO) from Ochrobactrum sp. BF15, a bacterial strain previously isolated from polluted soil.
Experimental approach. We used in silico profile hidden Markov models to identify novel laccase-like genes in Ochrobactrum sp. BF15. For laccase characterization, we performed heterologous expression in Escherichia coli, purification and activity measurement on typical laccase substrates.
Results and conclusions. Profile hidden Markov models allowed us to identify a novel LMCO, named Lac80. In silico analysis of Lac80 revealed the presence of three conserved copper oxidase domains characteristic of three-domain laccases. We successfully expressed Lac80 heterologously in E. coli, allowing us to purify the protein for further activity evaluation. Of thirteen typical laccase substrates tested, Lac80 showed lower activity on 2,2’-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), pyrocatechol, pyrogallol and vanillic acid, and higher activity on 2,6-dimethoxyphenol.
Novelty and scientific contribution. Our results show Lac80 as a promising laccase for use in industrial applications. The present work shows the relevance of bacterial laccases and highlights the importance of environmental plasmids as valuable sources of new genes encoding enzymes with potential use in biotechnological processes.
To determine the effectiveness of physical therapy management among the toe walking children’s in Karachi Pakistan: An observational study
Authors: Vikash Chughani , Sonum Sachdev , Shobha Lekhraj , Aadil Ameer Ali
Published: October 2021

Objective: To evaluate the effectiveness of Physical Therapy Management among the toe walking children’s in Karachi Pakistan. Methodology: A cross sectional survey was conducted from June to October 2018 in Department of physiotherapy, Liaquat National medical college and hospital, Karachi, Pakistan. A self-fabricated questionnaire was used in 36 Toe walking children’s. The questionnaire consists of demographics (age and gender), evaluation of pain through visual analogue scale, range of motion through goniometer and cadence was measured .The statistical package for social sciences (SPSS) version 23 was used to interpret the data. Result: The majority (n=24, 66.6%) were belongs to age group of 8 to 12 years and (n=25, 69.4%) were male. Mostly (n=25, 69.4%) were clinically diagnosed cases of cerebral palsy. After checking the involvement it was found that (n=21, 58.3%) were suffering from bilateral toe walking and (n=22, 61.1%) were affected from the day of their birth. Conclusion: The study finalized that the Physical Therapy is effective in decreasing the pain, increasing the range of motion and improving the number of steps among the toe walking children’s.
Identification of Condition-Specific Biomarker Systems in Uterine Cancer v1
Authors: Hickman Allison
Published: October 2021

Protocol supporting publication in G3.
What Freirean Critical Pedagogy Says and Overlooks from a Durkheimian Perspective
Authors: Chiang Tien‐Hui
Published: October 2021

“Critical pedagogy” has become a prevalent grammar furthering the necessity of a change in pedagogy from a banking‐style to problem‐posing approach, which it argues will facilitate students’ development of independent values and equip them to lead the liberation of society from authoritarianism into democracy. To achieve this, classrooms need to serve as cultural forums, through which either engaged pedagogy or negotiated authority empowers teachers and students to engage in free dialogues that problematize school textbooks as “cultural politics.” This empowerment demands that teachers perform as transformative intellectuals, dedicating themselves to the amelioration of inequity in educational results by reconstructing new texts, making them more accessible to working‐class students. While these theoretical lexicons envision a new perspective for the “educational function,” alleviation of the phenomenon of cultural reproduction can only occur if critical pedagogists pay more attention to academic curricula. Student achievements in such curricula, which respond to the demands of the social division of labor, have a profound influence on their potential social mobility.
Demystifying Subjective Well‐Being of Academically At‐Risk Students: Case Study of a Chinese High School
Authors: Cheng Tianjun , Jin Jin , Chen Junjun
Published: October 2021

Student subjective well‐being (SWB) is increasingly incorporated into today’s education policies and positive education movements. There is a growing interest in how well schools promote student well‐being, especially for disadvantaged students, e.g., the academically at‐risk, and which factors affect this process. This study investigates how teachers and academically at‐risk students perceive SWB and its influential precursors in a high school in China. The influential precursors in the present research were allocated into four dimensions, namely contextual factors, school factors, family factors, and individual factors. Via semi‐structured individual interviews with 12 teachers and 18 students for about one hour and content analysis of the interview data, the responses revealed that while students tended to have a superficial understanding of well‐being, traditional concepts about studying, blind filial piety, peer relations, and self‐efficacy were important factors shaping and influencing their SWB. These findings can inform the development of inclusive education policies concerning student SWB and the intervention and prevention systems of schools in both local and international contexts. Recommendations for organising lectures for parents and implementing programs providing instruction on SWB‐related skills for students are proposed to support academically at‐risk students, aiming to achieve the educational goal of success for all.
Inclusive Leadership: Good Managerial Practices to Address Cultural Diversity in Schools
Authors: Gómez-Hurtado Inmaculada , Valdés René , González-Falcón Inmaculada , Jiménez Vargas Felipe
Published: October 2021

Educational inclusion of foreign pupils has become a priority objective in recent years in many countries worldwide. Attending to the cultural diversity of pupils and providing an inclusive educational response is now a main goal of education systems. In this context, educational leadership is a key factor for school improvement. Management teams face the difficult mission of responding to the diversity of people that make up the educational community in a scenario marked by the expansive increase in migrant families and the scarcity of inclusive and intercultural government programmes. This article explores good management practices for cultural diversity management in six early childhood and primary education centres in Spain and Chile from an inclusive leadership approach. Factors that influence the development of inclusive leadership and the process deployed to carry out diversity management are examined. Through a qualitative methodology, six case studies were carried out using the interview, participant observation, and document analysis as instruments. The main outcomes show the importance of leaders in promoting an inclusive collaborative culture, in classroom practices focused on the knowledge and cultural capital of foreign pupils, the development of organisational and didactic strategies based on the recognition and participation of the educational community, its commitment to social justice, a management of diversity based on collaboration, and a shared concept of educational inclusion. The conclusions show four common dimensions in the good practices of each country: professional development of the community, school participation, inclusive school culture, and positive management of diversity.
MATHEMATICAL SIMULATION OF THE HEATING SYSTEM RADIATOR OF AS A CONTROL OBJECT
Authors: MASLYANITSYN Alexander P. , MASLYANITSYNA Elena V. , KRASNOVA Marina S.
Published: October 2021

The problem of mathematical modeling of a heating system radiator as a control object is considered. The purpose of its development is to create a generalized mathematical model of thermal processes in a room heated by means of water radiators. A calculation scheme of heat transfer processes between the heat carrier of the radiator and the air of the room has been developed, on the basis of which the heat balance equations are writt en. This takes into account both steady and unsteady heat transfer processes between the coolant, radiator and room air. A block diagram of the mathematical model of a heating radiator has been developed. After the introduction of assumptions and transformation of the structural diagram of the nonlinear model, the structural diagram of the linear mathematical model of the heating radiator was obtained. On its basis, the transfer function of the heating radiator is derived, the output coordinate of which is the thermal power. The resulting transfer function can be used in a generalized mathematical model of a heated room. The analysis of the transfer function of the heating radiator is carried out and it is shown that its dynamics is determined not only by geometric parameters, but also by the fl ow rate of the heat carrier.
ECONOMIC DAMAGE ASSESSMENT METHODOLOGY IN CASE OF TRANSFORMER LOAD RATIO DEVIATION
Authors: LUKOVENKO Anton S.
Published: October 2021

The aim of the study is to develop a methodology for assessing economic damage when the transformer load factor deviates. In the process of research, a method was used to determine the optimal load of a power transformer. A method for assessing economic damage in case of a deviation of its load factor has been developed. The optimal load factor of a power transformer has been determined according to the criterion of the minimum cost of money for the transformation of electrical energy. The load level of power transformers can be assessed by two criteria: by the maximum integral value of the effi ciency and by the minimum loss of money during the transformation of electricity. According to the proposed methodology, the assessment of damage is carried out when the load factor of the transformer deviates from the optimal values, for which the relative losses of electrical energy are calculated. The results obtained when evaluating energy and fi nancial and economic effi ciency show that when the load factor is overestimated relative to the optimal values, it is much more preferable to overestimate than underestimate. The reliability of the results is confi rmed by the satisfactory agreement of the calculated results with the experimental data obtained at the operating power plant.
E-TİCARETİN ULUSLARARASI TİCARETE ETKİLERİNİN ANALİZİ: G20 ÜLKELERİ ÜZERİNE BİR ARAŞTIRMA
Authors: ARTAN Seyfettin , ACARAVCI Ali , KALAYCI Cemalettin , DEMİREL Selim Koray
Published: October 2021

Küreselleşmenin etkisiyle birlikte 2000’li yıllardan sonra bilgi ve iletişim teknolojilerindeki gelişmelere bağlı olarak ülkelerin ticaret yapılarında önemli değişiklikler meydana gelmiştir. Özellikle internet kullanımının küresel düzeyde yaygınlaşması uluslararası ticaretin elektronik ortamda gerçekleşmesine imkan sağlamıştır. Bu çalışmada, e-ticaretin uluslararası ticaret üzerindeki etkileri panel çekim modeli kullanılarak 2014-2019 döneminde G20 ülkeleri için test edilmiştir. Elde edilen sonuçlar, e-ticaret, ithalatçı ülkelerin pazar büyüklü-ğü, bilgi ve iletişim teknolojilerindeki gelişmeler ve mobil telefon kullanımındaki artışın ülkeler arasındaki ikili ticareti pozitif olarak etkilediğini göstermektedir. Ticaretin sürdürülebilir ekonomik büyümenin temel belir-leyicilerinden biri olduğu dikkate alındığında politika uygulayıcılarının, internet kullanımını yaygınlaştırarak, e-ticareti arttıracak, bilgi ve iletişim teknolojilerindeki gelişmeleri destekleyen alt yapı yatırımlarına ağırlık vermeleri önem arz etmektedir.
Neomalthusianismo, guerra fría y redes evangélicas transnacionales en la guerra contra el hambre, Chile (1960-1970)
Authors: Castro Arcos Javier
Published: October 2021

Este artículo explica episodios desconocidos de la historia de la guerra fría latinoamericana. En específico, las operaciones de la diplomacia religiosa estadunidense entre los tejidos sociales y las redes transnacionales evangélicas chilenas, bajo el contexto de la guerra contra el hambre. La premisa de potenciar el salto al desarrollo en países subdesarrollados y de prevenir caldos de cultivo para revoluciones socialistas en una década significativa para la guerra fría latinoamericana, hizo del neomalthusianismo y de los movimientos de planificación familiar un motivo de movilización social, religiosa y política para misioneros evangélicos en Chile y América Latina. El trabajo se basa principalmente en fuentes primarias de la Countway Library of Medicine de la Universidad de Harvard, y en archivos y audiencias del Comité de Crisis de Población del Senado de Estados Unidos, además de complementarse con fuentes de prensa y bibliografía secundaria.
Does the Market React to the Reputation of Capital Expenditure?
Authors: Juniarti  , Toly Agus Arianto
Published: October 2021

A phenomenon found in several case studies shows that investors are more interested in the projection of firm value than in periodic financial performance. Therefore, this study aims to determine whether the reputation of capital expenditure is an indication of a promising future for a company, so that it responds positively to the market. The research samples used were companies that had the highest increase in shares in their sectors during the Q1 2017 to Q2 2019 period. We used Tobin's Q (TQ) and cumulative abnormal return (CAR) as proxies for market response. The findings of this study are, first, that the market responded positively to the reputation of corporate capital expenditure, as seen from asset growth. Second, in the sample group with positive asset growth trends in the last five years, the reputation of capital expenditure, proxied by total assets and total fixed assets, consistently received positive responses from investors. Third, the market responded negatively, or had no response, to capital expenditure made by companies that had a negative growth trend. The results of this study invalidate the findings of previous studies that good financial performance responds positively. This study proves that the capital expenditure of a company is more of a concern to investors than its current performance.
Effect of preoperative glycemic status on postoperative complications of coronary artery bypass graft surgery in patients with diabetes
Authors: Andishmand Abbas , Froozannia Seyed Khalil , Namayandeh Seyedeh-Mahdieh , Mirhosseini Seyed Jalil , Salami Maryamalsadat , Mohamedi Farnaz
Published: October 2021

Objectives: Diabetes mellitus is one of the major risk factors for cardiovascular disease, and increases the risk of postoperative mortality. HbA1c is a measure of glycemic control. This study aimed to determine the effect of glycemic status on the complications of coronary artery bypass graf (CABG) surgery in diabetic patients.
Methods: This cross-sectional study was performed on 300 diabetic patients including 186 (62%) men and 114 (38%) women who underwent CABG from March 2010 to August 2011 and selected via census method. Preoperative blood glucose control status was determined using HbA1c levels, and the patients were evaluated for postoperative in-hospital complications.
Results: The mean age of the patients was 62.3±  6.9 years. In-hospital mortality was 1.0% (3/300). New-onset atrial fibrillation was the most common complication (35%). HbA1c level above 7.5% was a predictor of in-hospital mortality after CABG (unadjusted odds ratio 1.9, 95٪ CI: 1.1-3.2, p = 0.006). After stratifying analysis with Chi-sqaure test we found that gender history of myocardial infarction had no significant relationship with HbA1c level in two groups with or without complication.
Conclusions: Long-term uncontrolled blood glucose before CABG is associated with increased postoperative complications. Preoperative HbA1c measurement can be a predictor of high-risk patients.
Possible factors affecting the mortality rate in patients undergoing surgery for aortic type A dissection
Authors: Khalili Ahmadali , Parizad Razieh , Abbasnezhad Mohsen , Khezerlouy Aghdam Naser , Taban Sadeghi Mohammadreza
Published: October 2021

Objectives: Aortic dissections of type A are clinical emergencies that can prove fatal if not managed promptly in specialized care facilities. Poor clinical management is the cause of approximately 1% of deaths in patients; however, with advances in clinical practice, diagnostic imaging and clinician awareness, the mortality rate has been dramatically reduced to below 30% in most international centers. We examined the potential factors involved in mortality after surgery for type A dissections.
Methods: In this descriptive-analytical study, patients who underwent acute aortic dissection surgery in the Shahid Madani Hospital of Tabriz, Iran, between March 2009 and March 2020 were evaluated. Exclusion criteria included those who died before the surgery, patients with descending aortic dissection, and high-risk patients for surgery who were candidates for medical treatment. Among 185 operated patients, 137 were included. Males comprised 62.8% of the patients. Their mean (±SD) age was 53.9 (±15.3) years.
Results: Age (p-value < 0.0001), the presence of hypertension (p-value = 0.015), the amount of packed red blood cell transfusion (p-value = 0.024) and the amount of platelet transfusion (p-value = 0.018) were associated with increased mortality. Duration of intubation, use of fresh frozen plasma, postoperative drainage, duration of intensive care unit recovery, high serum creatinine, duration of aortic clamping, brain protection method, and smoking were not associated with increased mortality.
Conclusions: These findings suggest that participants' mortality is dependent on several variables. Mortality of the patients with type A dissection can be reduced by interventions and reducing those factors.
The antioxidant activity of Lactic acid bacteria and probiotics: a review
Authors: Faraki Azita , Rahmani Fatemeh
Published: October 2021

Probiotics and Lactic Acid Bacteria play important roles such as the production of antimicrobial compounds and other metabolites. So they have positive effects on human health. When reactive oxygen species generated in excess or cellular defenses are deficient, biomolecules can be damaged by the oxidative stress process. Various studies have shown that the best way to protect the human body from the effects of oxidation reactions is to avoid them, which can be accomplished by using antioxidants. Due to the damages of synthetic antioxidants, their usage has been discussed. Nowadays natural antioxidants derived from bio-resources have recently gained a lot of attention as a potential replacement for synthetic antioxidants. Probiotic bacteria are thought to defend against oxidative stress by restoring the gut microbiota, according to hypothesis of some scientists. This type of microorganisms indicated their antioxidant activity by producing and increasing antioxidant enzymes, production of secondary metabolites, small hydrolyzed peptides in food, resistance to the presence of hydrogen peroxide, and production of intracellular and extracellular compounds such as Exopolysaccharides. Also, they have shown their positive effect on in vivo models. In conclusion, according to the results of studies, lactic acid bacteria and probiotics are significant sources of natural antioxidants. Therefore, they have important research value and market development potential. Also, it should be noted that the mechanism of antioxidant activity of this group of microorganisms has not been fully investigated, this requires further research.
Isolation and identification of probiotic bacteria from Iranian traditional cheese produced by lamb or kid abomasum microorganisms
Authors: Hasani Iraj , Akhavan Sepahi Abbas , Shoeibi Shahram , Asadi Aghdash Gholamhassan
Published: October 2021

Different strains of lactic acid bacteria are the most common micro-organisms known as probiotics. Two major kinds of probiotic bacteria are members of the genera Lactobacillus and Bifidobacterium, that are generally associated with the genus Lactobacillus which play a vital role in the body health, as well as the ability to produce antimicrobials and vitamins in the gastrointestinal tract. The purpose of the study was the isolation of probiotics in traditional cheeses that are produced from the natural flora of the newborn mammalian digestive tract. Bacteria from lamb and kid abomasum are added to milk. The curd is slaughtered from the abomasum of a lamb or kid that is suckling and has now no longer began out to devour forage, after which its belly is dried, that is referred to as curd. In this study, sixteen samples of cheeses local to Markazi province of Iran have been prepared. The isolated bacteria have been examined for morphological, biochemical, probiotic properties, and molecular identity. Out of sixteen traditional cheese samples, five kinds of Lactobacillus have been diagnosed through PCR. L. casei strain J026 strain was identified in the traditional cheese samples as the most genera. Using probiotic starters from local sources is a beneficial strategy for producing traditional cheese, which the native strains are more compatible with the humans’ intestinal flora and therefore may also higher play their probiotic’s characteristic.
Solunum Yolları Hastalıklarının Toplumsal Görüngüleri Üzerine Nitel Bir Araştırma
Authors: ALKAN Ahmet , ERDEM Ramazan , KUH Zeynep
Published: October 2021

Kronik hastalıkların sayısı dünya genelinde gün geçtikçe artış göstermektedir. Bu durum aynı zamanda hem uzun süreli sağlık bakım hizmetlerinin hem de ölüm nedenlerinin önemli bir etkenini oluşturmaktadır. Araştırmanın amacı, solunum yolu hastalığı olan bireylerin bu hastalık sürecinden nasıl etkilendiklerinin (aile ilişkileri, gelecek beklentileri, eğitim hayatı, sosyal yaşam vs.) ele alınması ve hastalık sürecinin evrelendirilerek değerlendirilmesidir. Bu çalışma için Süleyman Demirel Üniversitesi Sağlık Bilimleri Etik Kurulunun 24.03.2021 tarih ve 50/1 sayılı kararı ile çalışmanın etik kurallara uygun olduğuna dair gerekli izin alınmıştır. Çalışmada veri toplama aracı olarak yarı yapılandırılmış görüşme formu kullanılmıştır. Görüşmeler hasta anlatısı yöntemine uygun olarak psikolojik ve sosyal (etkileşimsel), geçmiş, şimdi ve gelecek (süreç) ve hastalık hikâyesinin temellendiği yerler ve şartlar (durumsallık) boyutlarına uygun olarak yapılmıştır. Araştırma çerçevesinde sekiz kişi ile görüşülmüştür. Sonuç olarak diğer hastalıklarda olduğu gibi solunum yolları hastalıkları da hastalığın her aşamasında (teşhis öncesi, teşhis, tedavi ve rehabilitasyon) hasta ve hasta yakınlarını sosyal, psikolojik, ruhsal, bedensel ve ekonomik yönden etkilemektedir.
Türkiye’de Finansal Gelişme ve Enerji Tüketimi İlişkisi: Fourier Yaklaşımı
Authors: KIZILKAYA Fatma , CANPOLAT GÖKÇE Esra
Published: October 2021

Son zamanlarda küreselleşmenin bir sonucu olarak büyük hacimlere ulaşan finansal piyasalar ile birlikte gerçekleşen finansal gelişme ekonomik büyümenin önemli bir bileşeni haline gelmiştir. Bu durum finansal gelişme ile enerji kullanımı arasındaki ilişkiyi araştıran çalışmaların artmasına neden olmuştur. Bu çalışmada Türkiye için finansal gelişmişliğin enerji tüketimi üzerindeki etkisinin incelenmesi amaçlanmıştır. Yapılan analizlerde yapısal değişimler Fourier fonksiyonlarını temel alan modeller kullanılarak göz önünde bulundurulmuştur. Fourier yaklaşımı, ele alınan modelin deterministik bileşeninde bilinmeyen yapısal kırılmaları veya göz ardı edilen doğrusal olmama durumunu yakalamak için kullanılabilmektedir. Çalışmada kullanılan serilerin durağanlık özelliği Fourier ADF birim kök testi kullanılarak araştırılmıştır. Birim kök testi sonuçlarına göre değişkenlerin hepsi birinci seviyeden durağan bulunmuştur ve Fourier ADL eşbütünleşme analizi yapılmıştır. Değişkenler arasında uzun dönemli pozitif anlamlı ilişkiye rastlanmıştır. Ayrıca değişkenler arasında Fourier nedensellik analizi yapılarak finansal gelişmeden enerji tüketimine ve enerji tüketiminden enflasyon oranına doğru tek yönlü nedensellik ilişkisi olduğu sonucuna ulaşılmıştır. Yapısal değişimler dikkate alınarak yapılan bu çalışmanın bulguları literatürdeki çalışmalarla benzer sonuçlar içermektedir.
Comparison of Universities in Turkey in Terms of Entrepreneurship and Innovation
Authors: ORHAN Mehmet , YALÇIN İbrahim
Published: October 2021

This study aims to analyze the entrepreneurship and innovation effectiveness of universities in Turkey, determine the universities (reference set) that inefficient universities can refer to, and rank the universities according to their relative efficiency. In the study, firstly, the criteria to be considered in the ranking / used in the analysis were determined by reviewing the literature. Data Envelopment Analysis (DEA)method was used in this study to evaluate the entrepreneurship and innovation effectiveness of universities. According to the findings; Abdullah Gül University, Ankara University, Bezm-İ Âlem Vakıf University, Çankaya University, Hasan Kalyoncu University, Sabancı University, and TOBB Economy and Technology University, among the 49 universities evaluated in terms of entrepreneurship and innovation, are efficient; others are inefficient. Istanbul Okan University, Özyeğin University, and Yaşar University with efficiency scores between 0.9-1 are the closest universities to being efficient. The 10 universities with the lowest efficiency scores in terms of Entrepreneurship and Innovation are Çukurova University, Süleyman Demirel University, Gazi University, Ege University, Akdeniz University, Dokuz Eylül University, Istanbul University, Atatürk University, Marmara University and Hacettepe University. In addition, at the end of the study, universities that inactive universities can take as an example were also determined.
Recreation and Tourism: A Bibliometric Analysis Based on a Scopus Database
Authors: TEKELİ Mehmet , BOZKURT İrem
Published: October 2021

The aim of the research is to reveal academic publications related to recreation and tourism in terms of bibliometric indicators. In this context, 553 publications published between 2021-1964 were reached as a result of the scan performed in the Scopus database on May 4, 2021. According to the findings, it has been determined that the studies on recreation and tourism generally tend to increase over the years and the most studies were published in 2019. Most of the publications are in the type of article and the most preferred language is English. The words "tourism" and "recreation" are the most used keywords. Although “Tourism Recreation Research” has the most publications, “Journal of Travel Research” is the most cited journal. Beside, Pickering C.M. (2007) is the most cited document. In addition, America is the country with the highest number of publications, cooperation, and citations and has played an important role in the development of this field.
Cardiac troponins in hypertension: mechanisms of increase and diagnostic value
Authors: Chaulin A. M. , Duplyakov D. V.
Published: October 2021

The understanding of the diagnostic and prognostic value of many biomarkers of cardiovascular diseases (CVD), including cardiac troponins (cTnT and cTnI), is changing significantly with the development of methods for their determination. New highly sensitive immunoassays can detect minimal concentrations of cardiac troponin protein molecules in biological fluids (several ng/L or less), allowing the detection of cTnT and cTnI in all healthy individuals. Along with this, there are opportunities to use cTnT and cTnI both to assess the risk of developing CVD in healthy people, and to identify and monitor many early pathological conditions that pose a risk to the cardiovascular system and the life of patients. These pathological conditions include hypertension (HTN), which is the direct cause leading to coronary heart disease, acute myocardial infarction, stroke, and other CVD. A number of recent studies reported the possibility of using highly sensitive cTnT and cTnI in the management of HTN patients. In this article, we consider in detail the diagnostic and prognostic value of cardiac troponins in HTN, we also discuss the main possible mechanisms underlying the increase in cTnT and cTnI in human body fluids.
Orthostatic hypotension and atrial fibrillation: is there a relationship?
Authors: Antropova O. N. , Osipova I. V. , Efremushkin G. G.
Published: October 2021

Orthostatic hypotension (OH), a possible marker of autonomic dysfunction, reflects the inability of reflex cardiovascular mechanisms to compensate for the fall in venous return in the upright position. This is a manifestation of structural and functional abnormalities of the cardiovascular system. Significance of the orthostatic hypotension is underestimated, while it is associated with all-cause mortality and cardiovascular disease. The article reviews the relationship between atrial fibrillation (AF) and OH. The pathogenetic mechanisms of OH are considered, including various subgroups, e. g. elderly patients. The article also discusses the relationship between OH, AF and cerebrovascular complications. Available evidence suggests that impaired orthostatic hemodynamic response should be considered as a new risk factor for AF. Further research is needed for better understanding of the association between AF and OH, as well as their management.
Parameters of arterial stiffness in hypertensive patients with and without subclinical carotid atherosclerosis
Authors: Gumerova V. E. , Sayganov S. A. , Gomonova V. V.
Published: October 2021

Objective. To assess the relationship between arterial stiffness parameters in hypertensive patients with and without atherosclerotic lesions.

Design and methods. We included 127 subjects who were divided into 3 groups: patients with hypertension (HTN) without atherosclerosis (n = 42); patients with HTN and subclinical atherosclerosis (SА) (n = 52) and control group which consisted of individuals without HTN, SA, or coronary artery disease (n = 33). All groups matched by age and gender. All subjects underwent following examinations: ultrasonography of extracranial segments of carotid arteries, 24-hour blood pressure monitoring with the assessment of arterial stiffness parameters.

Results. In subjects with HTN compared to controls, pulse wave velocity in aorta (PWVao) was significantly higher (11,3 ± 1,5; 12,3 ± 1,8 vs 10,4 ± 1,3 m/s; p < 0,05), as well as pulse pressure (PP) (46,4 ± 9,8; 45,6 ± 10,6 vs 39,9 ± 6,5 mmHg; p < 0,05), central pulse pressure (PPао) (35,5 ± 8,5; 34,9 ± 8,5 vs 30,9 ± 5,4 mmHg; p < 0,05), and arterial stiffness index (ASI) (141 (127, 159); 139 (128,5, 160,5) vs 126 (118, 138) mmHg; p < 0,05). In subjects with HTN and SA, PWVao was significantly higher compared to other groups (p < 0,05). No significant difference in augmentation index was found (–32,5 (–45, –12); –22 (–36, –12); –37 (–50, –17); p = 0,25). Аmbulatory arterial stiffness index was higher in controls (0,5 ± 0,2) compared to HTN group (0,4 ± 0,2; p = 0,05), while HTN and SA group did not differ significantly (0,5 ± 0,2; p = 0,3). PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection.

Conclusions. In HTN patients, arterial stiffness is changed compared to healthy individuals. PWVao above 11,15 m/s is associated with 4,3 (2,3–8,2) times higher rate of atherosclerosis plaque detection. In patients with HTN and SA arterial stiffness is higher, which might have additional predictive value in risk stratification.
Gender and cardiovascular risk in rotational shift workers in the Arctic
Authors: Shurkevich N. P. , Vetoshkin A. S. , Gapon L. I. , Simonyan A. A. , Dyachkov S. M.
Published: October 2021

Objective. To study gender differences in potential risk factors (RF) for cardiovascular diseases in rotational shift workers in the Arctic.

Design and methods.Out of 213 examined patients, 183 individuals were enrolled in groups within 6 days of September 2019, in the polar settlement of Yamburg (68 N), on the basis of Health Service LLC “Gazprom Dobycha Yamburg” medical unit. They were comparable by age: 99 were males (M) aged 48 years (41,5; 58,5) and 81 were females (F) aged 49 years (43,6; 58,1) (p = 0,441); by number of years of rotational shift work: 16,5 (9,0; 26,4) years in M and 16,3 (8,5; 26,9) years in F (p = 0,635); by number of individuals with hypertension: 49,5% were M, 43,9% were F (p = 0,344) and normotensive individuals (p = 0,544). Office blood pressure was 149,4 (119,1; 180,2) mmHg in M group, 149,6 (128,5; 178,5) mmHg in F group (p = 0,250). All patients underwent ultrasound examination of carotid arteries (CA) for the detection of atherosclerotic plaque (ASP), and assessment of local stiffness parameters of CA and femoral arteries (FA); cardio-ankle vascular index, and pulse wave velocity. In addition, ambulatory blood pressure monitoring, echocardiography with calculation of HFpEF probability using H2FPEF score (Heavy; Hypertensive; Atrial Fibrillation; Pulmonary Hypertension; Elder; Filling Pressure); blood tests (lipid spectrum, levels of high-sensitivity C-reactive protein (hs-CRP), homocysteine, C-peptide, insulin, brain natriuretic propeptide (NT-pro-BNP)) were performed. The following RF were assessed: smoking, physical activity, and perceived stress level.

Results. Overweight (p = 0,039), smoking (p = 0,014) were more common in M than in F. Low self-esteem level of psychosocial stress was more frequently registered in F: 93% vs 54 % (p < 0,0001), while mean level was more often found in M: 46% vs 7 % (p < 0,0001). In M group, there was a significant increase in homocysteine (p < 0,001), which was associated with higher stiffness index β in CA (p = 0,004) and FA (p = 0,004), Peterson’s elastic modulus Ep CA (p = 0,009), higher detection rate of ASP in CA (p = 0,021). F group showed significant increase in hs-CRP (p = 0,03), and NT-pro-BNP, (p < 0,001). Odds ratio of gender-related indicators showed association of male sex with arterial stiffness, formation of ASP in CA, while female sex was associated with markers of systemic inflammation and neurohumoral activation. There were no significant differences between M and F regarding HFpEF probability, assessed by H2FPEF score (p = 0,303).

Conclusions. Our data will allow for identifying the most significant factors with high gender-specific cardiovascular risk in rotating shift-workers in the Arctic which can play role in cardiovascular prevention and early diagnosis with the focus on economic efficiency.