bluuebunny/crossref_metadata_2025 huggingface dataset:
O przedmiocie i charakterze prawnym spraw rozstrzyganych przez Wojewódzkie Komisje do spraw Orzekania o Zdarzeniach Medycznych
Authors: Urszula Dorota Drozdowska
Published: April 2021

The article presents the current model of out-of-court compensation for medical damages. In particular, the aim of the publication is to analyze the legal nature of proceedings before the Provincial Committees for the Ruling of Medical Events, which are to determine the existence of a medical event. Originally, the entity responsible for medical events was to be primarily the insurer. As a result of the legislative changes which led to the abolition of the insurance obligation, the entity responsible in the procedure before the Commission became de facto hospital. The author describes the subject of the commission procedure and then confronts it with the subject of compensation proceedings before the civil court. She also considers the nature of the proceedings before the Commission in comparison with the mediation proceeding. Against this background, she formulates de lege ferenda postulates which, without pretending to propose final legal solutions, are intended to provoke a discussion on possible ways of repairing the described model.
O prawie medycznym i pojęciach o proweniencji medycznej w systemie prawa
Authors: Adam Górski
Published: April 2021

Prawo medyczne jest w doktrynie prawa przedmiotem wielu (prób) definicji. Powodem tego jest oczywiści stopień komplikacji materii, jak również jej względna nowość. Metody definiowania prawa medycznego wywodzą się z różnych przekonań teoretycznoprawnych. Artykuł zwraca uwagę na takie podstawowe problemy, jak określanie zakresu przedmiotowego prawa medycznego, stosunki społeczne nim regulowana oraz teoretycznoprawne podejścia do problemu wyjaśniania  systemu prawa
FEATURES OF KIDNEY DAMAGE IN HIV-INFECTED
Authors: Moskalyuk V.D. , Andrushchak M.O. , Sokolenko M.O. , Balanyuk I.V. , Boyko Y.I.
Published: April 2021

Relevance. In HIV-infected patients, renal disease, which is characterized by severe clinical manifestations, can significantly affect the prognosis of life. Given the growing number of HIV-infected people in the world and the increase in the life expectancy of such patients, an increase in the number of HIV-infected people in need of expensive renal replacement therapy, as well as kidney transplantation, should be expected. But the question of the nature of kidney damage in HIV infection in Ukraine is still insufficiently covered.

The objective of the work is to establish the clinical and laboratory features of kidney damage in HIV infection.

Materials and methods. 292 patients with HIV were examined. Screening for markers of kidney damage (albuminuria/proteinuria) was performed by test systems (using urine strips). The results obtained with the help of test strips were considered as indicative. In the presence of ≥1+ proteinuria in the screening test, which corresponded to a gradation of 30 mg/l, repeated urine analyzes were performed with quantitative determination of protein on a spectrophotometer, separated in time from 3 days to one week. The functional state of the kidneys was assessed by an integrated indicator that characterizes the degree of preservation/loss of mass of active nephrons. The criterion for renal impairment was a decrease in glomerular filtration rate (GFR) <60 ml/min by 1.73 m2. Chronic kidney disease was diagnosed when proteinuria or proteinuria was detected in combination with a decrease in GFR for 3 months or more.

Results. Based on the main markers of renal damage (persistent proteinuria (PU) and glomerular filtration rate <60 ml/min/1.73m2), 48 people were diagnosed with chronic kidney disease, which was often accompanied by dysfunction of these organs. Based on the analysis of complaints, anamnestic data, and clinical symptoms of kidney damage, patients were divided into 2 groups. The first group (n = 31, or 64.6%) - patients with tubulointerstitial, the second group (n = 17, or 35.4%) - patients with glomerular diseases. Increased PU levels are accompanied by significantly significant renal impairment and a more frequent combination with hypertension and hematuria in the absence of significant differences in the frequency of opportunistic diseases.

Conclusions. In HIV-infected kidney damage is most often characterized by their tubulointerstitial lesions. At the same time, glomerular kidney damage, which is much less common, is accompanied by significantly higher levels of HIV RNA.
Medication-related osteonecrosis of the jaw in patients with bone metastases from solid tumors: analysis of the Istituto Oncologico Veneto case series
Authors: Ahcene-Djaballah Selma , Zovato Stefania , Bacci Christian , Bettini Giordana , Maruzzo Marco , Di Sarra Francesca , Ferrara Alfonso Massimiliano , Brunello Antonella , Guarneri Valentina , Lamberti Evelina , Falci Cristina , Zagonel Vittorina
Published: April 2021

Treatment of BM bone metastases from solid tumors often includes the use of bone antiresorptive agents (BAA) beside tumor-directed specific treatment.  Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by BAA. This retrospective study evaluates the incidence of MRONJ in a real-world setting of patients with solid tumors treated with BAA for BM at Istituto Oncologico Veneto (IOV). Data for patients with solid tumors who received BAA for BM between January 2010 and December 2017 at Istituto Oncologico Veneto, Padua, Italy were retrieved from a prospectively maintained database, 1211 patients met the inclusion criteria and received BAA . In addition , we  defines the time to onset (TTO) and assess the role of dental prevention.
Difference in outcomes in surgical treatment of stage II-II MRONJ in oncological and non-oncological patients.
Authors: Garzino Demo Paolo , Ramieri Guglielmo , Malandrino Maria Chiara , Roccia Fabio , Bojino Alessandro
Published: April 2021

Medication-related osteonecrosis of the jaw (MRONJ) is a severe side effect caused by antiresorptive antiangiogenic medication for different pathologies. Although the main factors that seem to increase the risk of ONJ have been identified and the main scientific societies have recently disclosed rules of good behaviour regarding prevention, diagnosis and patient management, there are still no guidelines on therapeutic strategies to be adopted. In general, if conservative treatment fails, surgical treatment is considered, including local debridement, osteoplasty, and marginal or segmental osteotomy. To date, in literature, cohorts of heterogeneous patients with MRONJ have been analysed for a long time, with a lack of uniformity in information and difficulties in interpreting data. This retrospective study evaluates the results of surgical treatment of 62 patients with stage II-III of MRONJ according to the American Association of Oral and Maxillofacial Surgeons criteria, evaluated at the Department of Maxillofacial Surgery, in the University of Turin (Italy), by subdividing patients into different cohorts firstly according to the primary pathology, i,e. oncological and non-oncological, and secondly, according to the drug or combination of drugs taken.
Oral hygiene and ONJ: a proposal of protocol
Authors: Boffano Paolo , Agnone Anna Maria , Cavarra Francesco , Melle Andrea , Gerardo Tricarico , Rocchetti Vincenzo
Published: April 2021

Oral hygiene seems to be crucial to minimise their risk of ONJ. 

Oral hygiene was suggested as effective ONJ prevention in the literature. Attention regarding brushing, interdental cleaning and other oral hygiene techniques has been stressed. Furthermore, the prescription of high fluoride toothpaste for those patients with increased caries risk has been suggested.

Oral hygiene habits may also play an important role, thus creating a potential bias in oral health studies.

However, there does not seem to be plenty of studies in the literature explaining a precise protocol about a professional oral hygiene program that could be applied to cancer patients that are at risk for developing ONJ. 

Therefore, the aim of the present communication was to present and discuss our protocol for the management of oral hygiene in cancer patients that are going to start an antiresorptive therapy or that have already started it, in order to lower the risk for ONJ.
The use of platelet rich plasma in the management of medication-related osteonecrosis of the jaws: a cohort study
Authors: Ricotta Francesco , Del Principe Carlotta , Ferri Agnese , Bolognesi Federico , Arcangeli Giovanni Leandro , Parrulli Roberto , Felice Pietro , Marchetti Claudio
Published: April 2021

Medication-related osteonecrosis of the jaw (MRONJ) is an adverse drug reaction that occurs in a very different ways and affects patients with complex medical histories. 

The objective of this study is to evaluate the prognosis of surgically treated drug-related osteonecrotic lesions and to verify whether the platelet concentrates used during the surgical procedure can improve the prognosis.

The study was performed by analyzing a sample of 64 patients with medication-related osteonecrosis of the maxillary bones, in which 79 lesions were diagnosed and surgically treated at the S. Orsola-Malpighi Polyclinic in Bologna. 

The lesions treated with PRP showed a lower tendency to relapse compared to its non-use, the probability of recurrence. 

In conclusion, this study demonstrates that treatment with PRP may have positive effects in the therapy of Medication-Related Osteonecrosis of the Jaw (MRONJ).
CLINICAL AND RADIOLOGICAL FEATURES OF MEDICATION-RELATED OSTEONECROSIS OF THE JAWS: COMPARISON OF STAGING SYSTEMS
Authors: Antonelli Alessandro , Bennardo Francesco , Barone Selene , Caruso Davide , Cristofaro Maria Giulia , Giudice Amerigo
Published: April 2021

Medication-related osteonecrosis of the jaw (MRONJ) has been recognized as one of the most disabling comorbidities associated to the assumption of bisphosphonates (BPs) and antiresorptive drugs.

To date, several classifications identify the stages of this pathology to propose different protocols for a better management way.

This pilot retrospective study aims to compare two of the most used MRONJ classifications (AAOMS vs SIPMO-SICMF), analyzing CT scans and clinical features of patients with documented MRONJ.

For each patient, clinical features and radiological findings were analyzed before any therapeutic procedure. The diagnostic differences between the AAOMS and SIPMO-SICMF classification were recorded and analyzed according to the treatment outcomes. These findings highlight different approaches for the patient’s treatment related to the MRONJ stages.

Our results suggest a continuous update of the international guidelines to uniform the treatment for the improvement of the patients’ quality of life.
A PARTICULAR PHOTODYNAMIC THERAPY FOR THE TREATMENT OF REFRACTORY SPONTANEOUS MAXILLARY ONJ: A CASE REPORT
Authors: Casu Cinzia , Murgia Martina Salvatorina , Garau Valentino , Argiolas Lia Ester , Orrù Germano
Published: April 2021

Drug-related osteonecrosis of the jaw (MRONJ) is a drug complication characterized by the progressive destruction and necrosis of the bone, in the absence of previous radiation treatment. In the present report, a 58-year-old cancer patient treated with zolendronic acid developed a spontaneous palatal osteonecrosis. Following repeated courses of antibiotic therapy, there was no improvement of the osteonecrosis. Subsequently, after several attempts, an integrum healing occurred with the use of an 810 nm diode laser at 3.5 W and 10% povidone iodine as photosensitizer, with the addition of 0.330 g of acetylsalicylic acid. and 0.200 g of vitamin C as a final rinse. Therefore, the aim of our work is to illustrate the resolution of a spontaneous maxillary ONJ with this particular PDT.
A SINGLE REFERENCE CENTER, 2 YEARS RETROSPECTIVE STUDY ON THE RISK FACTORS ASSOCIATED WITH ANTI-RESORPTIVE MEDICATION-RELATED OSTEONECROSIS OF THE JAWS IN OSTEOPOROTIC AND ONCOLOGICAL PATIENTS
Authors: Pignatelli Pamela , Podda Gian Marco , Pergolini Daniele , Rocchetti Federica , Romeo Umberto , Tenore Gianluca , Gaglioti Domenico
Published: April 2021

Medication-related osteonecrosis of the jaws (MRONJ) has multiple exogenous and endogenous risk factors. The risk of MRONJ associated with anti-resorptive drugs (Bisphosphonates  and Denosumab) was reviewed in oncological and osteoporotic patients referred to the Department of Oral and Maxillo-Facial Sciences, Sapienza University of Rome (Italy), since January 2019 to January 2021. The incidence of MRONJ was analyzed according to local (dental extraction), systemic risk factors (diabetes, steroid, ecc), medication type, and drug treatment duration. The intake of Zolendronate was strongly associated with osteonecrosis of the jaws in oncological patients and the risk of MRONJ was higher in patients with metastases regardless of the type of anti-resorptive therapy. The use of Bisphosphonates  and Denosumab was very common in the treatment of osteoporosis, up to 42.4% of the patients, and the incidence of MRONJ was higher than previously reported. It was possible to prevent the occurrence of MRONJ after oral surgery due to medical prophylaxis, non-traumatic surgical procedures, and photobiomodulation therapy (PBMT).
Bilateral ONJ in a patient affected by metastatic prostate adenocarcinoma.
Authors: Boffano Paolo , Agnone Anna Maria , Cavarra Francesco , Melle Andrea , Rocchetti Vincenzo , Gerardo Tricarico
Published: April 2021

We present the diagnosis and management of a case of bilateral ONJ of the mandible in a patient that had been taking zoledronic acid treatment for 7 years following a diagnosis of metastatic prostate adenocarcinoma. 

The patient was referred to our Division by his dental practitioner, that had performed the extraction of the left lower first molar six months before. In the first months after the extraction the patient did not reported any symptom and he started to use a mandibular removable prosthesis. 

About 5 months following the extraction, the patient started to complain of pain in correspondence of the left body region. He had performed a panoramic radiograph and a CT scan showing a possible initial stage of mandibular ONJ bilaterally, with a predominance in the left mandibular body in the post-extraction socket.

Therefore, a curettage of the left mandibular body was decided. Postoperative course was uneventful.

Twelve months later, the patient complained of pain in the right mandibular region and in correspondence of the residual right lower third molar. A panoramic radiograph confirmed the extension of mandibular right ONJ. A curettage of the right mandibular body, together with the removal of the right lower third molar, was performed, with a following uneventful postoperative course. 

Two years later, the patient complained of pain in the left mandibular region in correspondence of the residual left lower second premolar. A panoramic radiograph confirmed the extension of mandibular left ONJ with involvement of the root of the aforementioned premolar. A curettage of the right mandibular body, together with the removal of the left lower second premolar, was performed, with a following uneventful postoperative course. Three years later, a complete healing was obtained.
OXIDIZED CELLULOSE WRAP IN SECONDARY INTENTION HEALING OF THE ORAL MUCOSA IN THE TREATMENT OF ONJ
Authors: Caruso Davide , Ferragina Francesco , Barca Ida , Giofrè Elio , Kallaverja Elvis , Sorrentino Alfonso , Antonelli Alessandro , Cristofaro Maria Giulia
Published: April 2021

Osteonecrosis of the jaws (ONJ) due to the use of bisphosphonate drugs is a particularly complex condition. The mechanisms through which this pathology develops are manifold. To date, the management of ONJ is controversial.

This study analyzed out-patients with documented ONJ treated in Oral and maxillofacial surgery Unit of University “Magna Graecia” of Catanzaro.

A total of 11 patients, 8 women and 3 men, were enrolled. The inclusion criteria were: (1) refusal to surgical treatment with flaps; (2) absence of antiplatelet therapy which would also make it impossible to prepare gel from platelet-rich plasma (PRP) or similar; (3) absence of antiblastic therapy in the healing phase. Each case was staged according to the classification of the Italian Societies of Oral Medicine and Maxillofacial Surgery (SICMF-SIPMO classification): a clinical-radiological bone involvement.

The following data were recorded: clinical data, comorbidities and concomitant drugs, antibiotic drugs used, type of treatment adopted, clinical mucosal healing time.

Each patient underwent antibiotic protocol prior to surgery. Endpoint with surgery was: complete removal of necrotic tissues, packaging of a “re-epithelialization trench” (RET) and apposition of a compress of oxidized cellulose inside this RET. 100% of the patients endured the post-surgery very well, 10 out of 11 (90,91%) patients had excellent healing by secondary intention of the surgical wound. Only one patient (9.09%) had prolonged bone exposure; he subsequently resumed antiblastic therapy and was therefore excluded from work.

The results indicate how the use of an oxidized cellulose pack associated with the correct packaging of a re-epithelialization site can guarantee satisfactory post-operative comfort and rapid wound healing. Radiological follow-up was performed at one year. It confirmed the correct healing of the site (clinical and radiological healing).
OSTEONECROSIS OF JAW (ONJ) IN PATIENTS WITH OSTEOPOROSIS AND OTHER NON-MALIGNANT DISEASES IN PIEDMONT AND AOSTA VALLEY 2004-2018
Authors: Gambino Alessio , Cabras Marco , Erovigni Francesco Maria , Dell'Acqua Alessandro , Della Ferrera Francesco , Appendino Paolo , Franchi Stefano , Caka Majlinda , Fasciolo Antonella , Migliario Mario , Ramieri Guglielmo , Garzino Demo Paolo , Pentenero Monica , Giordano Lia , Carossa Massimo , Arduino Paolo Giacomo , Fusco Vittorio
Published: April 2021

Osteonecrosis of the Jaws (ONJ) related to bisphosphonates (BPs) or denosumab is a concern for osteoporosis and Rheumatoid Arthritis (RA) patients. In a context of increasing prescription rate of BPs and denosumab amid those patients in the last decade, incidence and/or prevalence of ONJ in these categories of patients remain uncertain, with lack of solid epidemiologic data from observational studies. As an almost unique experience, the present work provides a multicenter, retrospective overview of ONJ in non malignant disease patients over a timespan of 15 years (Jan 1st 2004 - Dec 31st, 2018) from the oral care centers of Piedmont and Valle d’Aosta.  In detail, data from 165 patients (8 M, 157 F) were acquired. Mean age was of 74 (38-91) years, with more than half (64.2%) of patients diagnosed with ONJ between 70 and 89 years. Underlying diseases were osteoporosis (80%), RA (5.4%), osteoporosis and RA (3.6%), other bone disorders (11%). Treatment administered were alendronate (51.8%), ibandronate (12.3%), zoledronic acid (6.8%), others (29.1%). Concerning the latter, since 2014, 7 cases were related to denosumab (60 mg every 6 months), of which 5 to denosumab alone, 2 in patients switched from BPs to denosumab. Sites of ONJ were mandible (67%), maxilla (25%), mandible and maxilla (7%). Finally, an overall rise of ONJ occurrence was observed, with a median of 7 (2-13) yearly ONJ cases in the 2004-2010 period, gone up to 11.5 (6-24) yearly ONJ events in the 2011-2018 period. Such worrisome trend underlines the importance of eventual prevention measures and recurring assessment of oral health to reduce ONJ risk in non-malignant disease patients.
MULTIDISCIPLINARY APPROACH TO MEDICATION-RELATED OSTEONECROSIS OF THE JAW: REPORT OF A CASE
Authors: Poropat Augusto , Ottaviani Giulia , Rupel Katia , Lupato Valentina , Biasotto Matteo
Published: April 2021

Nowadays the multidisciplinary team (MDT) plays a critical role in the treatment of patients with osteonecrosis of the oral cavity, in particular for the reconstructive-rehabilitation phase of complex cases. Among the objectives of the MDT we find the improvement of the quality of life of patients, the restoration of the anatomical defect following surgery, as well as the planning of an aesthetic-functional rehabilitation.

The experience of the MDT composed of professionals belonging to the Medicine and Oral Pathology Outpatient Clinic of the Maggiore Hospital of Trieste and to the Department of Otolaryngology of the S. Maria degli Angeli Hospital in Pordenone is presented in relation to surgical-prosthetic rehabilitation in a patient with drug-induced osteonecrosis.

The patient, suffering from right maxillary osteonecrosis induced by therapy with Zoledronic Acid, underwent a demolitive surgical intervention of right maxillectomy. At the same time, reconstruction was carried out using a microvascularized fibula flap and insertion of 5 implants. Subsequently, the patient was rehabilitated with a fixed prosthesis on implants.

The rehabilitation of the treated patient allowed the resumption of functional activities such as chewing and phonation, guaranteeing the patient a good quality of life. Last but not least, it has allowed us to obtain a good result also from an aesthetic point of view.

There are numerous studies in literature which confirm the success of planning by the MDT in treating MRONJ hat demonstrate how an effective and dynamic MDT positively influences the patient's therapeutic and rehabilitative path. The MDT must therefore be able to formulate a personalized therapeutic and rehabilitation plan for the individual patient.
Lise Öğrencilerinin Okul Dışı Zaman Kullanımları: Değişken ve Birey Merkezli Bir Yaklaşım
Authors: Özdoğru Asil Ali
Published: April 2021

In addition to school and family, out-of-school time context can provide important opportunities in the development of children and adolescents. In order to examine the students' use of out-of-school time better, activity diversity, intensity, and profiles should be studied. The aim of this study is to identify different time use profiles among high school students through person-centered cluster analysis as well as variable-centered descriptive statistics. A total of 180 students, 93 female and 87 male, from the tenth and eleventh grades of a public high school in İstanbul participated in the study. A personal information form and a time use questionnaire prepared by the researcher were administered to the students. According to average time use, the first three activities with the highest values in weekly total time were (1) using internet or social media, (2) studying, and (3) watching television. The time that students devote to the activities was related to the day of the week, gender, grade level, academic achievement, and family income. Three different profiles emerged as a result of time use of the students and these profiles differed in terms of gender, grade level, and academic achievement. The results indicate the need for a closer and in-depth examination and evaluation of the out-of-school time context, which plays an important role in the development of students.
The Role of Digital Media in Image Formation: A Study on the Projection of Corporate Image on the Consumer
Authors: Savaş Sezgin , Karadoğan Doruk Sevimece
Published: April 2021

Bu makalede kurumsal kimliğin kurumlar tarafından dijital medya yoluyla nasıl yansıtıldığı, kimlik sunumu sonucu kurumsal imajın istenilen yönde oluşma düzeyi ve imaj oluşumu ile dijital medyanın bağımlılık düzeyi ortaya koyulmaktadır. Araştırma kapsamında, ilk olarak, içerik analizi ile kurumların dijital medya aktiviteleri incelenmiş ve belirli konularda kurumların oluşturmaya çalıştıkları imajlar tespit edilmiştir. Daha sonra ise kurumların tüketicilerine anket uygulanarak aynı konularda tüketicilerin kurumu nasıl algıladığı tespit edilmiştir. Araştırma sonucunda, seçilmiş olan kurumların istedikleri imajları tüketicilerine büyük ölçüde yansıtabildikleri ortaya çıkmıştır. Araştırma kapsamında gerçekleştirilmiş olan Ki-Kare analizi sonuçlarına göre, kurum imajının tüketiciler tarafından algılanmasının dijital medyaya bağımlı olmadığı bulunmuştur. Bu doğrultuda, imaj oluşturma ve sürdürme aşamasında dijital medya aktivitelerinden çok diğer aktivitelerin (sponsorluk, reklam vb.) önemli olduğu ortaya konulmuştur.
“Yeni” Teknolojiler ve Kurumsal İletişimin Yeni Araçları
Authors: Baygül Özpınar Şaha Burcu
Published: April 2021

In corporate communication, it is essential to use all communication tools that will contribute to the corporate identity and reputation in a continuous, systematic and balanced manner. In an age where technological developments are reshaping all forms of business and communication, the faster the new technologies are applied by corporate companies, the more competitive advantage they provide. Moving from this point, it is very important for institutions to follow and undertand these developments and realize how to take advantage of new trends. In this study, the development of corporate communication was briefly mentioned, and the reflections of the developments in the communication technologies sector since the 1980s in the field of corporate communication were examined by using a descriptive method. The study draws a conceptual framework on the technological applications adopted by institutions in communication management in an effort to contribute to future research.
Center for Plant Health Science and Technology Accomplishments, 2007
Authors:   United States. Animal and Plant Health Inspection Service. Center for Plant Health Science and Technology
Published: April 2021

This past year’s hard work and significant changes have enabled CPHST—a division of the U.S. Department of Agriculture (USDA), APHIS Plant Protection and Quarantine (PPQ) program—to be an organization more capable and better aligned to support and focus on PPQ’s scientific needs. In 2007, CPHST developed the first PPQ strategic plan for CPHST. The plan shows where CPHST is going over the next 5 years, how it is going to get there, and how it will know if it got there or not. Moreover, CPHST plan identifies critical elements of PPQ’s overall strategic plan that must be supported by the science and technology services CPHST provides. The strategic plan was followed by an operational plan, which guarantees that the strategic plan is a living and breathing document. The operational plan identifies the responsibilities and resources needed to accomplish priorities in this fiscal year and measures our progress. CPHST identifies the pathways by which invasive plant pests and weeds can be introduced into the United States. CPHST develops, adapts, and supports technology to detect, identify, and mitigate the impact of invasive organisms. CPHST helps to ensure that the methods, protocols, and equipment used by PPQ field personnel are effective and efficient. All the work of CPHST is identified under one of the five program areas: Agricultural Quarantine Inspection and Port Technology, Molecular Diagnostics and Biotechnology, Response and Recovery Systems Technology, Risk and Pathway Analysis, and Survey Detection and Identification. CPHST scientists are leaders in various fields, including risk assessment, survey and detection, geographic information systems (GIS), molecular diagnostics, biocontrol techniques, methods and treatment, and mass rearing of insects. The following list outlines some of CPHST’s efforts in 2007: Responding to Emergencies, Developing and Supporting Technology for Treatments, Increasing Diagnostic Capacity, and Supporting Trade.
Clashing Consciousness
Authors: Holder Bradley
Published: April 2021

In this paper, I consider practical strategies for resolving the epistemic injustice that ill persons face when seeking medical treatment. My arguments will expand upon those initially made by Havi Carel and Ian James Kidd in “Epistemic Injustice in Healthcare: A Philosophical Analysis.” My approach to this problem is twofold. First, I will demonstrate how the phenomenological toolkit, as it currently stands, emphasizes the patient’s experience and leaves the doctor’s experience unadjusted. After this, I will explain how the toolkit can be improved to include the doctor’s perspective.
Hegel's Projected Nihilism
Authors: Curnow Ryan
Published: April 2021

Georg Wilhelm Friedrich Hegel’s historical analysis of Buddhist philosophy not only fails as a sound interpretation of that tradition, it also well-exemplifies the Western practice of Orientalism as elucidated by Edward Said. I attempt to demonstrate this in three major parts: the nature of Orientalism as a concept and practice, the Orientalist analytical process that Hegel employs in judging Buddhism as well as religions in general, and how Hegel’s understanding does not work against a more charitably interpreted Buddhist defense. Moreover, I argue that the Orientalist erroneousness of Hegel’s reading deeply complicates his hierarchical philosophy of world history.
Assessing the Usefulness of Instant Feedback and the Hawthorne Effect: An Audit of Time Indexes of Ems Missions in Tehran
Authors: Saberian Peyman , Mousaeinezhad Negin , Hasani-Sharamin Parisa , Mohammadi Hasan , Jamshididana Mahnaz , Baratloo Alireza
Published: April 2021

Introduction

It has been well established that if a person is aware that they are being monitored their commitment and effort will be maximised (the Hawthorne effect), which then leads to efficiency increase and optimal workflow.

Objective

Our aim was to evaluate the efficacy of instant feedback and the Hawthorne effect of this intervention on pre-hospital time indexes during emergency medical service (EMS) missions.

Methods

This is a cross-sectional auditing study on the missions of the Tehran EMS Center (performed over a 12-month period) in three phases: pre-intervention, instant feedback, and monitoring without feedback. The measured time indexes were the different parts of mission times. To collect data, a pre-prepared checklist was set up. For the first phase, data were extracted from the database of the Tehran EMS Center. In the second and third phases, the data were entered into the relevant forms for each mission by the researcher and executive colleagues.

Results

The data of 229,847 missions were analysed. In the instant feedback phase, compared to the pre-intervention phase, the mean activation time, response time, scene time, transfer time and hospital delay time were decreased. When we compared the mean time indexes in the monitoring phase compared to the instant feedback phase, we saw that the average activation time, response time and transfer time were increased but they were still less than that in the pre-intervention phase. However, the scene time and hospital delay time were not changed compared to the instant feedback phase but were lower than that in the pre-intervention phase.

Conclusion

Auditing was effective in reducing the total time of missions and this effect was largely maintained in the monitoring phase under the Hawthorne effect.
New alkaloids from Ocotea duckei vattimo (Lauraceae)
Authors: Peixoto Laisla Rangel , Tavares Josean Fechine , Nascimento Yuri Mangueira do , Souto Augusto Lopes , Braz Filho Raimundo , Souza Fabio Santos de , Barbosa Filho José Maria
Published: April 2021

Ocotea duckei Vattimo, popularly known as “louro-de-cheiro”, “louro-pimenta”, and “louro-canela”  is a member of the Lauraceae family found in the Northeast region of Brazil. It is popularly used to treat neuralgia, dyspepsia, anorexia and pain. This current study aimed to promote the isolation and the identification / determination of new secondary metabolites of the species O. duckei Vattimo. In order to obtain the vegetable drug of O. duckei, its stem barks were harvested and submitted to a drying process followed by pulverization. The Crude Ethanolic Extract (BSE), obtained from the vegetable drug, was then subjected to an alkaloid extraction protocol in order to generate its Total Alkaloid Fraction (TAF). The isolation and identification of chemical compounds were carried out by chromatographic and spectroscopic methods respectively. The chemical investigation of O. duckei resulted in the isolation of three compounds: Ocoteaduccin A (OD-1, 0.020 g), Ocoteaduccin B (OD-2, 0.015 g), and N-methylcoclaurine (OD-3, 0.008 g). O. duckei proved to be a promising species, due to the variety of isolated chemical compounds. Further chemical, pharmacological and toxicological studies must be conducted in order to improve the phytochemical knowledge about this plant.
The contribution of Information and Communication Technologies to the improvement of the adaptive skills and the social inclusion of students with intellectual disability
Authors: Alexopoulou Arhondoula , Batsou Alexandra , Drigas Athanasios
Published: April 2021

The contribution of Information and Communication Technologies (ICTs) to the improvement of daily living skills of students with intellectual disability is a topic that has been of great concern to scientists in recent years. In the present systematic review, there has been an attempt to explore the potential of new technologies for the education, the improvement of the adaptive skills and the academic and social inclusion of students with intellectual disability, since they comprise a large part of the population with special educational needs. The review includes research of the last seventeen years on daily living skills, literacy, learning geometric concepts and shapes, focused attention, gross and fine motor skills, and visual-motor coordination. We consider that learning is facilitated with the use of ICTs, as students with intellectual disability are enabled to have equal access to innovative programs, curricula and classroom participation. Moreover, the training and education programs provided through ICTs seem to have a substantial and permanent impact on the quality of their lives, finally aiming at their social and vocational inclusion.
Plantas alimentícias não convencionais: existem potenciais consumidores e locais para comprar?
Authors: Barbosa Tadeu Patêlo , Lins Jadson Adyel Santos , Silva Geane Maria da , Valente Ellen Carine Neves , Lima André Suêldo Tavares de
Published: April 2021

A procura por alimentos mais saudáveis e de maior qualidade, coletados em ambientes naturais e sem o uso de agrotóxicos são o destaque das plantas alimentícias não convencionais ganhando assim reconhecimento pela capacidade de melhorar a qualidade na alimentação de muitas famílias rurais e urbanas. As hortaliças não convencionais são aquelas com distribuição limitada, restringidas a determinadas localidades, tendo grande peso na alimentação e na cultura de populações tradicionais. Além disso, são espécies que não estão organizadas enquanto cadeia produtiva, não despertando o interesse comercial por parte das empresas do setor. Diante do exposto o objetivo deste trabalho foi realizar pesquisa de campo com grupos de interesse potencial em PANC traçando seu perfil de consumo e identificar as PANC mais comumente encontradas em feiras de produtos orgânicos e agroecológicos no interior e capital Alagoana. Foram feitas visitas de campo as feiras de Maceió em que haviam relatos de comercialização das PANC e pesquisa com grupos de potencial interesse na temática de PANC: grupos de consumidores de produtos orgânicos e agroecológicos, grupos sobre o tema em redes sociais e alunos de agroecologia do campus Maragogi/IFAL. Todos os participantes assinaram termo de consentimento livre e esclarecido. A pesquisa com grupos de interesse indicou que há público alvo tanto para a comercialização das PANC como também para produtos educacionais voltados a essa temática. Há várias opções de PANC que poderiam ser comercializadas pelos moradores dos assentamentos, seja in natura ou em produtos processados (agregando valor), assim podendo contribuir com a renda familiar.
Análise da qualidade da carne moída comercializada em um município no interior da Paraíba
Authors: Lima Joyce Almeida , Felinto Ana Clara Bezerra , Marçal Eduarda Josefa Alves , Oliveira Igor Macêdo de , Sousa Juliana Barbosa de , Bú Steffany Albuquerque do , Melo Wagner Gomes de , Cavalcanti Mayra da Silva
Published: April 2021

A carne é um alimento muito importante para a população brasileira e seu setor econômico. O consumo de carne moída teve um grande aumento há três décadas, tanto em países desenvolvidos como nos em desenvolvimento, dado ao fato dela ser de baixo custo, além de uma forma melhor e mais conveniente de se aproveitar as carnes menos nobres. A presente pesquisa tencionou avaliar a qualidade higiênico-sanitária das carnes moídas comercializadas em uma cidade localizada no interior da Paraíba. Para tanto foram coletadas seis amostras deste tipo de carne em lugares distintos, ademais denotar os pontos de venda com contaminação. Para as análises físico-químicas foram testadas a atividade de água, a acidez, o pH e umidade do produto. Já para as análises microbiológicas foram seguidos os parâmetros recomendados pela legislação vigente. As amostras C, D, E e F atestaram presença para Salmonella spp. Para o grupo coliformes apenas as amostras C, E e F acusaram risco para a presença destes, enquanto para Staplhylococcus aureus, todas as análises apresentaram negatividade. Quanto a caracterização físico-química os valores mostraram susceptibilidade dessas carnes a proliferação de bactérias, uma vez que a umidade se mostrou alta e o teor de acidez voltado para o neutro. Esse estudo mostra a importância de uma análise de controle de qualidade e segurança no consumo para essas carnes e invoca a necessidade de trabalho recorrente de boas práticas de manipulação com os comerciantes na tentativa de minimizar a contaminação.
Utilização do questionário PSCHO na avaliação do clima de segurança do paciente: uma revisão integrativa
Authors: Silva Thaiane Almeida , Portella Patricia Cardoso , Figueiredo Karla Crozeta , Wolff Lillian Daisy Gonçalves , Lima Eliane de Fátima Almeida
Published: April 2021

Objetivo: Identificar na literatura estudos que utilizaram o questionário Patient Safety Climate in Healthcare Organizations (PSCHO) na avaliação do clima de segurança do paciente em serviços de saúde hospitalares. Método: Trata-se de uma revisão integrativa da literatura, definida como pesquisa concisa em área específica. A busca e seleção dos estudos foi realizada por duas revisoras, de forma independente nas bases de dados LILACS, MEDLINE, CINAHL e WoS. Os resultados foram apresentados por meio do fluxograma PRISMA. Resultados: Foram recuperados na busca seis artigos, dos quais quatro foram incluídos e analisados. Os estudos foram realizados na China e nos Estados Unidos e as dimensões “medo de culpabilização e punição” e “medo da vergonha” sobressaíram de forma negativa nos estudos chineses. O PSCHO apresentou similaridades quando comparado a outros estudos que avaliaram o clima de segurança do paciente utilizando outros questionários de clima.  Conclusão: Os resultados demonstraram que o PSCHO é útil para avaliar o clima de segurança do paciente. A ausência de estudos brasileiros utilizando o questionário indica uma potencialidade de sua aplicação em novas pesquisas, como estratégia para a melhoria da qualidade e promoção da segurança do paciente nas Organizações de Saúde.
Seasonal and interannual variation in lower Columbia River phytoplankton (2005-2018): environmental variability and a decline in large bloom-forming diatoms
Authors: Rose V , Rollwagen-Bollens G , Bollens SM , Zimmerman J
Published: April 2021

Understanding the influence of biotic and abiotic factors on riverine phytoplankton dynamics is challenging, particularly as anthropogenic stressors such as eutrophication, invasive species, and climate change alter these relationships. We examined a 14 yr (January 2005 to December 2018) dataset of phytoplankton and water quality variables, along with zooplankton and nutrient concentrations, from the Columbia River (the largest river in the US Pacific Northwest) to identify seasonal and interannual patterns of phytoplankton assemblage structure and their environmental associations. Non-metric multidimensional scaling, cluster, and indicator species analyses revealed: (1) a diatom/flagellate cluster in spring/summer, associated with chlorophylla, discharge, ciliates, and Sarcodina; (2) a cyanobacteria/chlorophyte cluster in late summer/early fall, associated with higher water temperatures, increased clarity, the invasive copepodPseudodiaptomus forbesi, and veligers of the invasive Asian clamCorbicula fluminea; and (3) a mixed-taxa winter cluster of minimal abundance and biomass. Nutrients were not strongly associated with the observed structural patterns. Phytoplankton bloom duration varied interannually, between years with short springtime blooms vs. years when blooms extended across multiple months. Springtime blooms of the diatomAsterionella formosadecreased in recent years, giving way to blooms of a mixed diatom assemblage. Further, high temperature, low discharge, and more invasive zooplankton were associated with cyanobacterial blooms, suggesting that increased temperature and reduced river flows predicted due to climate change in the Pacific Northwest may lead to further impacts on the late summer/early fall Columbia River plankton community.
Gut Microbiome and Osteoporosis: Pathogenetic Relationship and Perspectives of Therapeutic Interventions
Authors: Bulgakova S. , Romanchuk N.
Published: April 2021

Osteoporosis is a chronic metabolic disease of bone tissue, characterized by a decrease in bone density and microarchitectonic disorders under the influence of genetic and epigenetic factors, which makes the bone fragile and increases the risk of fractures. However, the exact mechanism for the development of osteoporosis is not fully understood. Hundreds of trillions of microorganisms live in the human gut, maintaining a close symbiotic relationship with the host's body and its health. With the development of modern sequencing platforms, there is growing evidence that the gut microbiome may play an important role in bone metabolism. This literature review is devoted to the analysis of the pathogenetic mechanisms of the involvement of the intestinal microbiota in the development of osteoporosis and possible therapeutic strategies involving probiotics, prebiotics, antibacterial drugs, and diet aimed at increasing bone density.
Penambahan Seal Air Pada Sensor Chuteplug Dan Discharge Coal Feeder Untuk Mencegah Mwh Losses Di Pltu Paiton 1 & 2
Authors: Indira Ila , Sulistiyanto Sulistiyanto
Published: April 2021

Data MWH losses yang didapat dari laporan pareto loss output menunjukkan bahwa jumlah frekuensi peralatan yang mengalami trip/gangguan paling banyak adalah coal feeder Dari berbagai penyebab trip coal feeder, frekuensi terbanyak disebabkan karena discharge plug. Terdapat 2 kondisi yang dapat membuat Trip coal feeder karena discharge plugged, yang pertama kondisi aktual batubara plugged pada discharge coal feeder sehingga sensor chute plug bekerja saat tertimbun batubara. Kondisi yang kedua kondisi tidak aktual (alarm palsu) yaitu sensor chute plug kotor terkena debu batubara dimana kondisi discharge coal feeder tidak ada batubara plugged. Penyebab terbesar terjadinya plugging di coal feeder dikarenakan kondisi batu bara yang basah dan lengket serta berdebu. Untuk mencegah hal tersebut solusi yang bisa dilaksanakan adalah dengan penambahan seal air pada discharge coal feeder dan sensor chute plug. Dengan menambahkan seal air maka dapat mengurangi frekuensi failure pada coal feeder sehingga meningkatkan keandalan dari pada coal feeder.
Smart Nurse Call Berbasis Mikrokontroler Arduino Untuk Komunikasi Antara Kamar Pasien Dengan Perawat Menggunakan Android
Authors: Erfan Fahmi , Widiantoro Anang
Published: April 2021

Rumah sakit adalah gedung tempat menyediakan dan memberikan pelayanan kesehatan yang meliputi berbagai masalah kesehatan. Rumah sakit juga memberikan fasilitas berupa kamar untuk menginap bagi pasien yang memerlukan perawatan lebih lanjut. Setiap kamar dari rumah sakit dilengkapi dengan fasilitas-fasilitas yang baik untuk memantau perkembangan kesehatan pasien. Dalam suatu rumah sakit, pasien yang menginap memerlukan bantuan dari para tenaga kesehatan baik perawat maupun dokter ahli. Pada saat pasien membutuhkan bantuan, seringkali orang yang sedang menjaga pasien tersebut meminta bantuan perawat secara manual dengan memanggil perawat yang sedang berada di ruang jaga perawat atau melalui telepon yang disediakan pada tiap-tiap kamar.System smart nurse call berbasis mikrokontroler arduino sebagai perantara komunikasi wireless antara kamar pasien dengan android di ruang jaga perawat adalah sebuah alat komunikasi antara ruang kamar pasien dengan ruang perawat  memanfaatkan sistem wireless yang terhubung dengan mikrokontroler sebagai otak dari alat kerja tersebut. Perancangan prototype system smart nurse call menggunakan beberapa komponen utama push button,  mikrokontroler arduino uno dan ethernet shield 911105A,TP-LINK,Hp android, modul df player, speaker, LED. Push button sebagai inputan arduino uno dan ethernet shield kemudian diproses, TP-LINK adalah sebagai penghubung wireless dengan mikrokontroler arduino uno dan ethrtnet shield, kemudian hp android sebagai alat untuk monitoring  bead head kamar pasien, Modul df player adalah modul MP3 dengan output yang telah disederhanakan langsung ke pengeras suara. Speaker sebagai output dari df player yang mengeluarkan suara panggilan kepda perawat, LED sebagai indikator pada kamar pasien bahwa pasien sedang membutuhkan bantuan.Dengan adanya prototyp smart nurse call kita dapat memonitoring pasien dengan menggunakan hp android dan suara panggilan melalui panggilan speaker dan terdapat indikator lampu LED pada kamar pasien.
Desain Ulang Proteksi Crusher Untuk Mencegah Kerusakan Crusher Dan Derating PLTU Paiton 1 & 2
Authors: Fatah Gilang Al , Bachrudin Moh
Published: April 2021

Crusher grinder mempunyai peranan yang sangat penting dalam proses pengelolaan material limbah bottom ash hasil pembakaran batubara di boiler, yakni sebagai penghancur material limbah dengan media crusher. Untuk meningkatkan kehandalan pembangkit, pada crusher grinder terdapat sistem proteksi berupa fluid coupling, yang mengamankan motor ketika crusher tidak mampu berputar karena terganjal oleh material yang sangat keras. Kegagalan operasi pada crusher grinder menyebabkan menyumbatan pada saluran pembuangan limbah (chute) sehingga material yang keluar dari chute dapat menyebabkan pencemaran lingkungan. Selain itu, faktor penting yang menentukan lifetimecrusher grinder adalah kehandalan sistem kontrolnya, karena sistem kontrol yang tidak sempurna dapat menyebabkan kerusakan serius pada crusher grinder yang mana berpotensi menyebabkan derating sehingga menurunkan kehandalan unit. Sistem proteksi eksistingcrusher grinder pada PLTU Paiton menggunakan fluid coupling, disamping memiliki akurasi yang kurang baik, juga tidak dapat dipastikan performancenya karena tidak dapat selalu dimonitor di Central Control Room (CCR) Fly Ash. Hasil implementasi desain ulang proteksi crusher dan perubahan logic control no motion pada crusher grinder ini memudahkan operator dalam melakukan pengoperasian emergency diverter gate hingga menghemat waktu untuk unit 1 sebanyak 8 menit dan untuk unit 2 sebanyak 6 menit dan dapat menghemat biaya jika terjadi terjadi derating sebesar 35 Milyar/Tahun untuk 2 unit.