bluuebunny/crossref_metadata_2025 huggingface dataset:
Avaliação da dieta livre de glúten consumida por celíacos no município de Sobral, Ceará, Brasil
Authors: Oliveira Sampaio Maria Camila , Cavalcante Jorge Luis Pereira
Published: April 2022

A doença celíaca (DC) é uma condição autoimune que afeta o intestino delgado, desenvolvida em indivíduos geneticamente susceptíveis como consequência da ingestão de glúten. O tratamento da DC consiste unicamente ou preferencialmente no consumo de uma dieta livre de glúten rigorosa por toda a vida, visto que seu seguimento leva à recuperação intestinal e melhoria clínica. O objetivo desta pesquisa foi investigar a adequação nutricional da dieta livre de glúten (DLG) consumida por celíacos adultos no município de Sobral, CE. Trata-se de uma pesquisa de campo, quantitativa, descritiva e transversal, com celíacos adultos, através da aplicação de um registro alimentar. A DLG apresentou elevado consumo médio de lipídios e proteínas, porém baixo de glicídios. Houve insuficiente ingestão de fibras, ácido fólico, cálcio e magnésio, mas elevado consumo de niacina, piridoxina e zinco. O estado nutricional dos celíacos deve ser monitorado constantemente, para manter a sua qualidade de vida.
Conceitos da indústria 4.0 e seus principais desafios de implantação nas empresas contemporâneas
Authors: Pompeu Adriano Marinheiro , de Castro Oliveira Arthur Nunes
Published: April 2022

Com o crescente desenvolvimento da computação, o mundo presencia o surgimento de novas tecnologias capazes de impactar diretamente o cotidiano das pessoas, além das mais diversas áreas do mercado, como: economia, indústria e serviços. Diante deste contexto de avanços tecnológicos, surge o conceito de Indústria 4.0, em que o uso generalizado de sensores e a troca autônoma de dados entre dispositivos possibilitam a criação de Sistemas Físicos Cibernéticos ou Cyber-Physical Systems (CPS), cuja principal característica é a virtualização do ambiente fabril, possibilitando maior controle e monitoramentos dos processos. Porém essa nova Revolução Industrial traz consigo novos desafios. Desta forma, foi realizada uma Revisão Bibliográfica Sistêmica, a fim de analisar os principais conceitos referentes às Indústria 4.0, como também identificar as principais dificuldades de implantação dessas novas tecnologias na indústria. Para realização da pesquisa, foram utilizados os mecanismos de busca: Science Direct, Web of Science, IEEE Xplore e Scopus, utilizando palavras-chave relacionadas à Quarta Revolução Industrial e tecnologias afins. Foi realizada uma análise crítica do material bibliográfico, para identificar os principais desafios relacionados à implantação da Indústria 4.0 nas empresas. Os resultados preliminares evidenciaram que os principais problemas enfrentados consistem na falta de segurança das informações, falta de integração entre os processos de desenvolvimento e implantação dos algoritmos, complexidade de compilação de dados e elevado custo de implantação.
“TÜRKİYE’DE İLK VE TEK, ‘VİRÜS-FREE KAMPÜS’: DOĞUŞ ÜNİVERSİTESİ ATAŞEHİR DUDULLU YERLEŞKESİ”
Authors: BAYKARA Tarık
Published: April 2022

Halen daha yoğun bir biçimde ve yeni varyantlarıyla COVID 19 salgını sürmektedir. Ne zaman sonuçlanacağına dair kesin bir zamanlama da verilememektedir. Sürekli tekrarlanan korunma ve tedbirler kapsamındaki yöntemlerin (maske, mesafe ve temizlik) yanı sıra UVC ışınlarının virüslere karşın etkin bir dezenfektan olduğu bilinmektedir. UVC sistemlerinden oluşmuş ışıma donanımlarının COVİD 19 virüsüne karşı etkin bir önlem olabileceği değerlendirilmiş ve Doğuş Üniversitesi yeni taşındığı Ataşehir-Dudullu Kampüsünün (HVAC) havalandırma sistemi içerisine ve yeni kampüsün farklı mekanlarına UVC donanımları monte edilmiştir. Böylelikle, Doğuş Üniversitesi ülkemizin ilk ve tek “VİRÜS-FREE KAMPÜSÜ” olma özelliğini kazanmıştır. UVC ışıma işlevi ile bakteri, virus, mantar, spor ve benzeri mikroorganizmaların etkisiz hale getirilme mekanizması incelenmiş ve bu yöntemin COVID 19 için de etkin bir biçimde kullanılabileceği değerlendirilmiştir. Ardından, yeni kampüsün havalandırma sistemleri incelenmiş, uygun kısımları etüd edilmiş ve buralara etkin dezenfektan ve sterilizasyon işlevselliği olan HVAC TİPİ UVC donanımları monte edilerek tüm öğrenciler ve çalışanlarımız için önemli düzeyde ve güvenlikte bir koruma sağlanmıştır. Uygulamanın ilk 3 aylık verileri ele alınmış ve bu süreçte monte edilen donanımların etkinliği gösterilmiştir.
CARACTERIZAÇÃO FÍSICA E MECÂNICA DE BLOCOS DE CONCRETO PARA PAVIMENTAÇÃO COM AGREGADOS RECICLADOS
Authors: Rocha Oliveira Sandra Regina , Soto Izquierdo Indara , Soto Izquierdo Orieta
Published: April 2022

O Laboratório de Materiais de Construção da Universidade Federal do Tocantins, campus Palmas, produz resíduos de concreto em forma de corpos de prova, em função das pesquisas acadêmicas desenvolvidas pelos alunos de Engenharia Civil. Esses resíduos são descartados próximos ao laboratório e não possuem destinação adequada, e por isso tem se tornado um problema. A presente pesquisa buscou utilizar esses resíduos britados como agregados graúdos na produção de blocos de pavimentação pré-moldados e comparou com um traço de referência. As substituições foram nas proporções de 25%, 50% e 75%. A avaliação da viabilidade da substituição foi realizada por meio dos ensaios de análise dimensional, resistência à compressão e absorção de água dos blocos produzidos. A absorção de água de todos os blocos cumpriram satisfatoriamente com o especificado na norma. Os traços com uso de agregados reciclados alcançaram maiores resistências à compressão com relação ao traço de referência, sendo a mistura com teor de 75% que apresentou melhor comportamento mecânico. Dessa forma, foi possível mostrar por meio da pesquisa uma nova destinação aos resíduos de concreto dos laboratórios, minimizando os impactos ambientais e visuais no âmbito da universitário e possibilitando uma destinação adequada.
DEGRADABILIDADE IN SITU DA MATÉRIA SECA E DA FIBRA EM DETERGENTE NEUTRO DO CAPIM MOMBAÇA SOB DOSES DE NITROGÊNIO
Authors: Rocha Chaves Miotto Fabricia , Lopes Coelho Bárbara Percya , de Oliveira da Silva Rafael
Published: April 2022

A técnica in situ é considerada padrão para avaliação da degradação do alimento em dietas de animais ruminantes, permitindo contato direto do alimento com o ambiente ruminal. Objetivou-se avaliar a degradabilidade in situ da matéria seca (MS) e da fibra em detergente neutro (FDN) da lâmina foliar do capim Mombaça submetido a doses crescentes de adubação nitrogenada, 0; 150 e 300 kg de N/ha. As amostras das folhas do capim mombaça foram moídas a 2 mm e, posteriormente, incubadas no rúmen de dois bovinos machos adultos por 0; 4; 8; 12; 24; 48; 72 e 96 horas. Mensurou-se a degradabilidade potencial e degradabilidade efetiva a taxa de passagem a 2%; 4%; 6% sobre a degradabilidade MS e da FDN. A degradabilidade potencial da MS e da FDN foi maior nos tratamentos que receberam adubação nitrogenada (300 e 150 kg de N), assim como a degradabilidade efetiva às 96 horas de incubação. As curvas de degradação da MS e FDN foram paralelas entre si independetemente do tratamento. A adubação nitrogenada aumenta a degradabilidade da MS e da FDN da lâmina foliar do capim mombaça e adubações com 150 ou 300 kg de N ha-1 permitem níveis de degradação semelhantes da MS e FDN.
Improving tactile ground surface indicators based on fuzzy-ahp method: The case of Gulou district, Nanjing, China
Authors: Hong Xiaochun , Ji Xiang , Gong Yaxi
Published: April 2022

There are many problems in the practical use of tactile ground surface indicators (TGSIs), and the large amount of TGSI construction currently being carried out does not always have a beneficial impact on the travel of visually impaired groups. Taking the roadside pedestrian space in the Gulou District of Nanjing City as an example, this paper established a TGSI quality evaluation system including six first-level indicators and 24 second-level indicators. The analytic hierarchy process (AHP) was used to determine the weight of the indicators at all levels, and evaluate six urban main roads, six urban secondary main roads and six sidewalks beside access roads, which were selected randomly. Visually impaired people were then asked to evaluate the TGSIs in the pedestrian spaces along these roads. Statistical analysis and evaluation showed that the indicators used in the evaluation system were satisfactory. The evaluation results revealed problems with the standardization, safety, accessibility, continuity, comfort and aesthetics of TGSIs in the urban roadside pedestrian space of Gulou. Analysis of the combined data showed that travel conditions for the visually impaired are currently worse in the old city area than in the new city area and that they are worse in low-grade pedestrian space than along high-grade roads. In order to solve these problems, strategies are put forward for improving the quality of TGSIs in the pedestrian space of Nanjing’s Gulou District in four aspects: improving TGSI structure, optimizing TGSI location, improving the TGSI system, and adapting TGSI implementation according to local conditions.
Analysis of contributing factors to dissolved oxygen depletion in the anoxic zone and their respective contributions based on stratified hypolimnetic oxygen depletion
Authors: Liu Chang , Wang Shiyan , Liu Xiaobo , Zhou Huaidong , Li Budong , Du Yanliang , Wang Liang
Published: April 2022

Hypolimnetic anoxia is often observed in large reservoirs during thermal stratification. In the hypolimnion layer, dissolved oxygen (DO) is continuously consumed by biological and chemical reactions, resulting in a stable anoxic zone at the bottom of the reservoir. The areal hypolimnetic oxygen depletion (AHOD) has been a widely used indicator for hypolimnetic DO depletion, but this indicator could not reflect the DO depletion process at the bottom of deep reservoirs with deposits of pollutant sediments. With Daheiting Reservoir as the study case, the concept of stratified areal hypolimnetic oxygen depletion (S-AHOD) was proposed, and an S-AHOD calculation model was built, which could accurately describe the DO depletion process in the anoxic zone at the bottom of Daheiting Reservoir, identify the DO depletion rate at different water depths in the anoxic zone and quantify the contribution of sediment oxygen demand to the overall oxygen depletion. It was found that sediment oxygen demand contributed considerably (41.4%) to the overall hypolimnetic DO depletion in the reservoir, DO depletion rate varied considerably at different water depths, which increased from the surface to the bottom of the reservoir and reached the maximum at the bottom layer. Finally, based on results of existing works, an AHOD calculation equation applicable to lakes and reservoirs with considerable deposits of heavily pollutant sediments was put forward.
Empirical therapy as first-line treatment for vulvovaginal infections
Authors:   I.P.Pavlov Ryazan State Medical University, Ryazan, Russian Federation, Tazina T.V. , Bebneva T.N. ,   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation, Aleshkina O.S. ,   City Clinical Hospital No 8, Ryazan, Russian Federation, Soyunov M.A. ,   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation
Published: April 2022

Women with signs of urogenital system infections require diagnostic testing for timely and adequate verification of the pathogen and prescription of therapy considering pathogen eradication. However, the identification of specific pathogens in practice takes some time. Therefore, empirical therapy based on a subjective evaluation of the symptoms of vulvovaginal infections and assessment of drug susceptibility of pathogens is common in practical gynecology. At the same time, it is acceptable to use broad-spectrum agents that act on bacteria, fungi, and protozoa and do not contribute to the development of antibiotic resistance. These are topical antimicrobial agents – antiseptics. Objective. To study the efficacy of dequalinium chloride as first-line treatment of patients with signs of vulvovaginal noninflammatory and inflammatory diseases initiated by opportunistic pathogens and aerobic bacteria. Patients and methods. The study included 74 women aged 18 to 45 years (31.4 ± 0.5 years) who were diagnosed with other inflammation of vagina and vulva (N76) or other non-inflammatory disorders of vagina (N89) based on their complaints and examination during an initial visit to a gynecologist. Prior to treatment, laboratory testing of the vaginal microflora by real-time polymerase chain reaction using the test Femoflor was performed, and empirical therapy with dequalinium chloride was applied. Subsequently, the results of laboratory tests before and after treatment were analyzed, as well as the dynamics of clinical manifestations of vulvovaginal infections against the background of therapy with topical antiseptic. Results. The prescription of dequalinium chloride as empirical therapy is effective for both elimination of the clinical manifestations of vulvovaginal infections and for normalization of the qualitative and quantitative composition of the vaginal microbiota at the outpatient appointment. Conclusion. Dequalinium chloride (Fluomisin®) may be recommended to women for correcting disorders of the vaginal microbiocenosis at their initial visit before the results of laboratory tests are obtained. Key words: vulvovaginal infection, normal microbiota, empirical therapy, dequalinium chloride
Principles of surgical treatment of mixed urinary incontinence in women
Authors:   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation, Suleymanov S.I. ,   City Clinical Hospital No 13, Moscow, Russian Federation, Pavlov D.A. ,   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation, Arakelov S.E. ,   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation,   City Clinical Hospital No 13, Moscow, Russian Federation, Ramishvili V.Sh. ,   Peoples' Friendship University of Russia (RUDN), Moscow, Russian Federation, Suleymanova A.S. ,   A.I.Yevdokimov Moscow State University of Medicine and Dentistry, Moscow, Russian Federation
Published: April 2022

The analysis of current data on the prevalence of various forms of urinary incontinence in women is presented, and the relevant aspects of surgical treatment of patients with mixed forms of urinary incontinence combined with pelvic organ prolapse are considered. The methods of surgical correction of urinary incontinence used in urogynecology practice are described. The comparative study of the results of surgical interventions, including video endoscopy and robot-assisted surgery, as well as alternative non-surgical methods of urinary incontinence treatment in women is performed. The social significance of the problem of urinary incontinence in women is updated, making it a priority direction in modern urogynecology. Key words: urinary incontinence in women, incontinence, sacrocolpopexy, urogynecology
Polyetiological pathogenesis of pelvic organ prolapse in women. Current understanding of the problem
Authors:   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, A.I.Ishchenko A.I.Ishchenko , A.G.Yashchuk A.G.Yashchuk ,   Bashkir State Medical University, Ufa, Russian Federation, L.S.Aleksandrov L.S.Aleksandrov ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Yu.V.Chushkov Yu.V.Chushkov ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, R.A.Naftulovich R.A.Naftulovich ,   Bashkir State Medical University, Ufa, Russian Federation, E.M.Popova E.M.Popova ,   Bashkir State Medical University, Ufa, Russian Federation, A.A.Ishchenko A.A.Ishchenko ,   National Medical Research Center “Treatment and Rehabilitation Center”, Moscow, Russian Federation, V.V.Ivanova V.V.Ivanova ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, M.N.Pirogova M.N.Pirogova ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: April 2022

This review presents the analysis of literature which reveals the role of various factors contributing to the development of pelvic organ prolapse in women. The role and significance of factors leading to elevated intra-abdominal pressure, including obesity, are discussed. The effect of natural childbirth on the structure and function of pelvic floor is assessed. A current perspective on the influence of estrogen levels on the structure and properties of pelvic connective tissue in women is presented. The issue of metabolic and structural disorders of collagen in the development of pelvic organ prolapse as well as the role and significance of hereditary connective tissue disorders in the genesis of this disease are considered separately. The connection between pelvic surgeries such as hysterectomy and the subsequent development of pelvic organ prolapse is traced and analyzed. Particular attention is paid to the analysis of the effectiveness of surgical treatment for pelvic organ prolapse, also data on the use of mesh materials is provided, and the possibility of increasing the efficacy of surgical treatment by improving surgical techniques and using promising synthetic materials with stem cells is discussed. Key words: pelvic organ prolapse, hereditary connective tissue disorders, recurrence, pelvic floor, birth-related perineal trauma, risk factors for pelvic organ prolapse, surgical correction
Characteristics of COVID-19 in peri- and postmenopausal women. Role of hormone replacement therapy
Authors:   National Medical Research Center of Rehabilitation and Balneology, Moscow, Russian Federation, Marchenkova L.A. , Makarova E.V. ,   N.A.Semashko National Research Institute of Public Health, Moscow, Russian Federation
Published: April 2022

A literature review on the effect of peri- and postmenopausal period on the course of novel coronavirus infection and post-COVID-19 syndrome was performed. The aspects of hormone replacement therapy against the background of therapy for COVID-19 and post-COVID-19 syndrome were studied. The postmenopausal period in women was found to be a risk factor for a more severe course of COVID-19. Estradiol may act as a protective factor for women with COVID-19 by regulating cellular and humoral immunity factors such as interleukin-2, -6, -8, tumor necrosis factor-α and C3. Prolonged course of COVID-19, persistence of its symptoms and development of severe post-COVID-19 syndrome are associated with female sex, with women in peri- and postmenopausal period being most vulnerable. Symptoms of estrogen deficiency and menopause may be similar to the manifestations of post-COVID-19 syndrome, and these conditions can coexist and aggravate each other. According to international experts, the use of hormone replacement therapy will help to improve the well-being of women, their quality of life, and relieve the symptoms typical of menopause and post-COVID-19 syndrome. Key words: coronavirus infection, COVID-19, menopause, post-COVID-19 syndrome, hormone replacement therapy, estrogen
Endoscopic retrograde cholangiopancreatography in the treatment of obstructive jaundice in choledocholithiasis in pregnant women
Authors:   S.S.Yudin City Clinical Hospital, Moscow, Russian Federation, Papysheva O.V. , Voynovsky A.E. ,   S.S.Yudin City Clinical Hospital, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Davydov A.I. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Tokarev M.V. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Barbado Mamedova P.A. ,   S.S.Yudin City Clinical Hospital, Moscow, Russian Federation, Semenenko I.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Grashchenko S.A. ,   S.S.Yudin City Clinical Hospital, Moscow, Russian Federation
Published: April 2022

The results of the use of direct choledochoscopy with the SpyGlass system in a pregnant woman at 30 weeks’ gestation are presented. This method has been found optimal during pregnancy since it provides direct visualization of bile ducts, and there are no adverse health effects to a mother or fetus from ionizing radiation exposure. Key words: gallstone disease, choledocholithiasis, endoscopic retrograde cholangiopancreatography, choledochoscopy, SpyGlass
Pathogenesis of vulvar lichen sclerosus: potential genetic and immune markers of development
Authors:   Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology, Moscow, Russian Federation, Zharikova P.S. , Plakhova K.I. ,   Moscow Scientific and Practical Center for Dermatovenereology and Cosmetology, Moscow, Russian Federation
Published: April 2022

Lichen sclerosus is a hard-to-diagnose chronic inflammatory skin disease that is difficult to treat; it significantly reduces patient’s quality of life and is associated with a high risk of genital tract disorders and genital cancer development. Mechanisms of autoimmunity, endocrine disorders, infectious agents, and genetic predisposition are considered as prognostic factors for lichen sclerosus. The search for pathogenetic markers of lichen sclerosus development in recent years has been in the area of investigating immunological factors and the genes encoding them, which include p53, p16IINK4, p27Kip1, EMC1, FOXO3, CDKN1B, galectin-7, interleukins-6 and -10, microRNA, tumor necrosis factor-α, and collagen types I, III, V. These markers are potential therapeutic targets requiring further study and analysis and may form the basis for understanding the true etiology and pathogenesis of lichen sclerosus. Key words: extracellular matrix protein, galectin-7, vulvar lichen sclerosus, interleukins, microRNA, oxidative stress, lichen sclerosus, tumor necrosis factor-α
Health status of young children depending on their iodine level. Opportunities for correction
Authors:   Kemerovo State Medical University, Kemerovo, Russian Federation, Drakina S.A. , Perevoshchikova N.K. ,   Kemerovo State Medical University, Kemerovo, Russian Federation, Burmistrova E.Yu. ,   Kemerovo City Children's Clinical Hospital No 1, Kemerovo, Russian Federation, Zinchuk S.F. ,   Kemerovo State Medical University, Kemerovo, Russian Federation
Published: April 2022

Insufficient iodine intake is most dangerous during the prenatal stage and in early childhood. Objective. To evaluate the efficacy of iodine deficiency correction in toddlers attending kindergarten. Patients and methods. Efficacy of iodine prophylaxis was analyzed in three stages: 1) in infancy depending on iodine level in breast milk; 2) after one year of age when children started to receive regular food (according to age-specific reference ranges); 3) correction of iodine deficiency in children receiving adapted stage 3 baby formula. Results. We found that smoking, physical inactivity, anemia, and exposure to harmful chemicals had a negative impact on iodine level in the breast milk. Children whose mothers received potassium iodide demonstrated normal coefficient of neuropsychiatric development by their third month of life significantly more often than those whose mothers did not receive potassium iodide (in this group every second infant had some developmental delay). None of the children over 1 year of age who started to receive regular food had severe iodine deficiency. Nutritional correction with adapted stage 3 baby formula in 50 children aged 1 to 3 years ensured positive changes in their health status with a 2-fold decrease in vegetative complaints. Receiving of an adapted stage 3 baby formula increased median urinary iodine excretion from 78 μg/L [34–112] to 113 μg /L [55–174]. Key words: adapted baby formula, toddlers, iodine deficiency, correction, median urinary iodine excretion
Functional gastrointestinal disorders in infants: is it possible to treat them with infant formulas?
Authors:   Russian Medical Academy of Continuous Postgraduate Education, Moscow, Russian Federation, I.N.Kholodova I.N.Kholodova , E.S.Kiseleva E.S.Kiseleva ,   SweetMilk LLC, Moscow, Russian Federation
Published: April 2022

The etiology, pathogenesis, and characteristics of neonatal colic are being actively explored by clinicians and researchers. The impact of nutrition on colic in newborns is still not fully understood and requires further investigations. This article discusses the role of functional nutrients of infant formulas (including prebiotics and probiotics) in the prevention and correction of colic in newborns and their impact on the formation of the intestinal microbiota. It also focuses on the effect of prebiotics in the diet on the intestinal microbiome composition, severity of colic in newborns, and association between the presence of probiotic cultures in the diet and development of colic. We emphasize the importance of studying microbiome composition and metabolites produced by intestinal commensals, including short-chain fatty acids. We also describe possible prebiotic and probiotic effects of infant formula containing goat milk. Key words: infantile colic, infant formula, prebiotics, prebiotics, oligosaccharides 2'-FL, GOS, Bifidobacterium lactis, gut microbiota, goat milk
Gluten-related disorders: current concept. Part 2
Authors:   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation, Bakulin I.G. , Avalueva E.B. ,   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation, Khavkin A.I. ,   Research Clinical Institute of Childhood of the Moscow Region, Moscow, Russian Federation,   Belgorod State Research University, Belgorod, Russian Federation, Sitkin S.I. ,   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation, M.Yu.Serkova M.Yu. ,   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation, L.S.Оrеshkо L.S. ,   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation, I.V.Lapinsky I.V. ,   I.I.Mechnikov North-Western State Medical University, Saint-Petersburg, Russian Federation
Published: April 2022

The second part of this review focuses on the current concepts of pathogenesis of gluten-related disorders, in particular, IgEmediated and non-IgE-mediated gluten allergy, as well as different aspects of diet therapy. Key words: gluten-related disorders, IgE-mediated and non-IgE-mediated gluten allergy, gluten-free diet, wheat allergy
Nutrition for children with cystic fibrosis and carbohydrate metabolism disorders
Authors:   National Medical Research Center of Children's Health, Moscow, Russian Federation, Simonova O.I. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Lyabina N.V. ,   National Medical Research Center of Children's Health, Moscow, Russian Federation, Sokolov I. ,   Moscow Multidisciplinary Clinical Centre “Kommunarka”, Moscow, Russian Federation, Borovik T.E. ,   National Medical Research Center of Children's Health, Moscow, Russian Federation, Roslavtseva E.A. ,   National Medical Research Center of Children's Health, Moscow, Russian Federation, Bushueva T.V. ,   National Medical Research Center of Children's Health, Moscow, Russian Federation, Shirokova I.V. ,   National Medical Research Center of Children's Health, Moscow, Russian Federation, Kerimova V.A. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation
Published: April 2022

In children with chronic respiratory diseases, especially in cystic fibrosis (CF), poor nutritional status against the background of the underlying disease significantly affects their quality of life and disease prognosis. A special group of children with CF consists of patients who were diagnosed with carbohydrate metabolism disorders or with so-called cystic fibrosis-related diabetes. Early diagnosis of carbohydrate metabolism disorders in prediabetes and then treatment of this comorbid condition in CF is relevant and complex and requires a scientific and practical solution. Diet therapy contributes significantly to successful treatment of children with CF. Patients with CF and carbohydrate metabolism disorders especially need additional specialized therapeutic diet with high-calorie and low-glycemic food products. In our study, we obtained positive values of anthropometric measurements and body composition (based on bioelectrical impedance analysis), as well as positive dynamics of capillary blood glucose levels on the background of short-term intake of a specialized food product “Resource Diabet Plus”. Key words: cystic fibrosis, children, carbohydrate metabolism disorders, cystic fibrosis-related diabetes, diabetes mellitus, nutritional status, enteral feeding, Resource Diabet Plus
Accuracy of endoscopic indices in assessing the activity of ulcerative colitis in children
Authors:   National Medical Research Center for Children's Health, Moscow, Russian Federation, Tsvetkova V.S. , Budkina T.N. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation, Prokhorenkova M.O. ,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Vinokurova A.V. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation, Lokhmatov M.M. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Potapov A.S. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Semikina E.L. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation,   I.M.Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russian Federation, Surkov A.N. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation, Fisenko A.P. ,   National Medical Research Center for Children's Health, Moscow, Russian Federation
Published: April 2022

Objective. To evaluate the accuracy and informativeness of two endoscopic indices for ulcerative colitis (UC) activity recommended for pediatric practice (Ulcerative Colitis Endoscopic Index of Severity (UCEIS) and Mayo ES) and analyze their correlation with clinical and laboratory indicators of disease activity. Patients and methods. This study included 80 patients (42 boys, 38 girls) aged 5 to 18 years diagnosed with UC. The activity of UC was evaluated using the Pediatric Ulcerative Colitis Activity Index (PUCAI). Laboratory examination included measurement of hemoglobin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fecal calprotectin. All children underwent ileocolonoscopy with the assessment of endoscopic severity using the UCEIS and Mayo ES. Results. We identified a significant correlation between UCEIS and Mayo ES (Spearman ρ 0.771, p < 0.001). Both endoscopic indices also correlated with PUCAI (Spearman ρ 0.660, p < 0.001 and Spearman ρ 0.625, p < 0.001, respectively). The level of fecal calprotectin demonstrated the highest correlation with UCEIS and Mayo ES (Spearman ρ 0.594 and 0.595, p < 0.001, respectively). Conclusion. The UCEIS and Mayo ES are highly accurate and informative for the assessment of UC inflammatory activity in children. The UCEIS scale is more detailed, while Mayo ES scale is easier to use in clinical practice. Key words: ulcerative colitis, colonoscopy, endoscopic activity indices, UCEIS, Mayo ES.
Physical and neuropsychological development of children aged 7–8 years residing in the Central and Northern parts of Khabarovsk region
Authors:   The Far Eastern State Medical University, Khabarovsk, Russian Federation, Chernobrovkina М.А. , Senkevich О.А. ,   The Far Eastern State Medical University, Khabarovsk, Russian Federation
Published: April 2022

Objective. To evaluate physical and neuropsychological development of children aged 7–8 years residing in different climatic and geographic zones of Khabarovsk region. Patients and methods. This cohort study aimed to analyze physical development of children aged 7–8 years from the Central (n = 266) and Northern (n = 70) parts of Khabarovsk region by calculating their Z-scores of weight, height, and BMI. Two groups of healthy children (30 in each group) who resided in these regions since birth were formed to assess cognitive skills (including memory, logical thinking, and motor skills) and the level of minerals using inductively coupled plasma mass spectrometry (ICP-MS) Results. The assessment of physical development of children living in Khabarovsk region (regardless of their exact place of residence) demonstrated that 5% of them had malnutrition, 18% were overweight, 9% were obese, and 4% had stunted growth. Children from the Northern part of the region were twice as likely to be overweight and 8.6 times more likely to have stunted growth than children from the Central part of the region. We identified specific characteristics of children belonging to indigenous ethnic groups of the North: stunted growth was three times more common in them compared to Russian children. These children also demonstrated lower cognitive skills, which can be attributed to deficiency of magnesium, calcium, copper and selenium (minerals critical for the development of the central nervous system) along with excessive levels of manganese. Conclusion. Children living in cold climates cannot fulfil their potential for linear growth. Both physical and intellectual development are presumably associated with adaptation of children to suboptimal environmental conditions and the deficiency and/or excess of minerals originating from the specificity of biogeochemical provinces. Key words: physical development, neuropsychological development, primary school children, Far North, minerals
Neurosonography findings in healthy infants and outcomes of their neurological development at the age of two years
Authors:   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Shumilov P.V. , Mazmanyan P.A. ,   Mkh.Heratsi Yerevan State Medical University, Yerevan, Republic of Armenia, Sargsyan H.A. ,   N.I.Pirogov Russian National Research Medical University, Moscow, Russian Federation, Nikoghosyan K.V. ,   Mkh.Heratsi Yerevan State Medical University, Yerevan, Republic of Armenia
Published: April 2022

The morbidity and mortality of premature newborns, as well as their subsequent physical and psychomotor development were analyzed in many studies. Significantly fewer studies focused on neurosonographic examination of healthy full-term babies and their neurological characteristics later in life. Objective. To assess the effectiveness of screening neurosonography performed immediately after birth in healthy, full-term newborns by subsequent evaluation of their neurological and psychomotor development at the age of two years. Patients and methods. This study included 121 healthy full-term newborns (body weight at birth ≥ 2500 g; gestational age 39–41 weeks) born in 2018 in Yerevan, Republic of Armenia. All study participants underwent neurosonography; their neurological development at the age of 2 years was evaluated by a pediatrician using the Bayley scale. Results. No cases of serious brain lesions and hemorrhages were registered in out cohort of healthy full-term newborns. The majority of them (79%) had normal neurosonography results. The most common findings included lenticulostriate vasculopathy (7.4%), hyperechogenicity in the trigone region (6.6%), subependymal pseudocysts (1.6%), vascular plexus cysts (3.0%), and asymmetry of the lateral ventricles (3.3%). Conclusion. By the age of 2 years, problems with motor development were detected in 2% of participants, intellectual disability in 2% of participants, and speech disorders in 11% participants. None of the children had severe disability. Key words: preterm newborns, brain lesions, neurosonography, neurological development
Attempts to Purchase Misoprostol Online in Indonesia: A Mystery Client Study Design
Authors: Moore Ann M. , Philbin Jesse , Ariawan Iwan , Budiharsana Meiwita , Jorgy Geby Hasanah , Arifa Zahra Izza , Bankole Akinrinola
Published: April 2022

Background: Abortion is highly restricted in Indonesia; self-administered misoprostol can safely induce an abortion. Brick and mortar pharmacies, a common place to purchase misoprostol off-label in other parts of the world, are monitored closely by the government authority in Indonesia which controls drugs so that they cannot function outside the law without risking arrest and prosecution. An online marketplace has sprung up in response that sells misoprostol through in-country distributors. Such procurement offers a level of safety and anonymity to the buyer and seller. So as to understand online access to misoprostol, we created a protocol to identify the most visible universe of sellers. Methods: We carried out a mystery client methodology to replicate the experiences of women procuring misoprostol online. Our study consisted of five sections: (1) identify the universe of online sellers using the most common search terms, drawn from multiple platforms to capture diversity in interactions as well as products sold (2) remove duplicates across sites as determined by their telephone numbers (3) draw a roughly probability proportional to size sample (4) contact sellers as mystery clients through text/chat, depending on the platform and engage with them and (5) attempt purchase drugs offered by the seller. Descriptive statistics are presented.Results: The listing generated 727 sites: 441 websites, 153 marketplace sellers, and 133 Instagram profiles. After removing duplicate listings, we identified 281 unique sellers. We selected all sellers with greater than 12 listings, 60% of sellers with 4-12 listings, 50% of sellers with 2-3 listings, and 40% of sellers with only one listing. Mystery clients were able to send initial messages to 110 sellers, of which 16 never responded. The interaction progressed to purchasing misoprostol with 76 sellers, 64 of whom sent drugs.Conclusions: As women seek to terminate unwanted pregnancies in legally restrictive settings, online sales of misoprostol must be considered. With the Covid pandemic constraining movement, the importance of this way of procuring misoprostol will likely become more appealing. Understanding this unregulated landscape is important if we are to try to improve women’s ability to safely conduct an abortion in highly restrictive settings.
Children’s Adherence to Antiretroviral Therapy and Associated Factors: Multicenter Cross-Sectional Study
Authors: Gemechu Getahun B. , Habtamu J , Zarihun K
Published: April 2022

Background- Suboptimal adherence to antiretroviral therapy will lead to drug resistance, treatment failure, clinical deterioration, death and failure to thrive in children. Studies conducted among children below 15 years old were limited in Ethiopia in general and in the study area. Therefore, this study aimed to assess the status of children’s adherence to ART and associated factors in the study area. Methods- We conducted a facility-based cross-sectional study by including 282 children <15 years who received anti-retroviral therapy for at least one month. All children/caregivers who were attending the ART clinic during the data collection period were consecutively recruited for the study. Both bivariate and multivariate logistic regression were performed. Result- Out of 282 caregivers included with their children, 226 (80.2%) were females (mean age= 38.6 and SD = 12.35). In similar, among total number of children included in the study, half (50%) were female and 246 (87.2%) were between the ages 5–14 years (mean age= 8.5 and SD = 2.64). Two hundred and forty six (87.2%) children had an adherence status of ≥95% in the month prior to the interview.Children whose caregivers were residing in urban areas were 3.3 (95% CI: 1.17, 9.63) times more adherent to ART when compared to caregivers in rural areas. Children whose caregivers were biological parents, were 2.37(95% CI: 1.59, 3.3) times more adherent when compared with caregivers with non-biological parents. Additionally, children of caregivers who were knowledgeable about ART treatment, were 4.5(95% CI: 1.79, 9.8) times more adherent to ART than their counterparts.Conclusion and recommendation- The adherence status of children in our study area was comparable. Biological caregivers, residing in urban areas and knowledgeable about ART treatment facilitate adherence to ART. Ongoing education about treatment and further study with multiple adherence assessment methods were recommended.
Self-employment and health inequality of migrant workers
Authors: Zhou Deshui , Wen Xin
Published: April 2022

Objective
This research aims to discuss the impact of self-employment on health inequality of migrant workers, and explore the mechanism and group differences of the influence of self-employment on health inequality in Chinese migrant workers.
Background
Self-employment is one of the main types of employment for migrant workers in China, it is important to promote self-employment of migrant workers for Chinese employment-first policy. However, self-employment will affect the life and behavior of migrant workers, as well as health inequality of them.
Method
This research uses the data from the 2018 China Migrant Workers Dynamic Monitoring Survey, and examines the impact of self-employment on health inequality of migrant workers by using RIF-I-OLS decomposition method.
Results
We find that self-employment will reduce the health inequality of Chinese migrant workers significantly, especially among migrant workers with low education, low income groups and low social integration. Further analysis shows that self-employment can directly promote the self-rated health of migrant workers. Moreover, it indirectly alleviates the health inequality of migrant workers by mediating effect of improving public welfare accessibility such as health records and health education.
Conclusion
It is necessary to allow and support migrant workers to engage in self-employment activities, the government should provide public services such as health education, health records and health rights for migrant workers, focus on the employment of migrant workers in city, especially those with low income and low education. Therefore, we believe that measures should be taken to enhance the sense of belonging of migrant workers in city, and promote migrant workers to truly achieve “urbanization of people”. In this manner, reducing the health inequality of migrant workers.
The randomized controlled study of low-level laser therapy, kinesio-taping and manual lymphatic drainage in patients with stage II breast cancer related lymphedema
Authors: YILMAZ SEDEF SELCUK , Ayhan Fikriye Figen
Published: April 2022

Objective: We aimed to compare the effects of low level laser therapy, kinesio-taping and manual lymphatic drainage on the affected arm volume, quality of life, arm function, neuropathic pain and shoulder mobility in patients with stage II breast cancer related lymphedema.Materials and Methods: Forty-five breast cancer patients with stage II lymphedema were included in the study. The randomized patients in three groups were treated with manual lymphatic drainage, kinesio-taping and low-level laser therapy. After these different therapeutic modalities, all patients have received the application of multilayer compression bandage, lymphedema remedial exercises, skin care, and patient education program by the same lymphedema therapist. All treatments were applied 5 days a week for three weeks. The lymphedema compression garments has been prescribed to all patients and follow-up visits have been planned at the end of the treatment, 4thand 12th weeks. The efficacy of the treatments was evaluated by volumetric calculations of circumferential measurements using truncated cone formula, in addition to goniometric assessments for shoulder joint range of motion, and questionnaires of quick-DASH for arm disability, pain-detect for neuropathic pain, and quality of life for arm lymphedema (LYMQOL-Arm).Results: The baseline patient and disease characteristics, and outcome measures were similar between groups. All treatment modalities were found to be effective on decreased arm volume, quality of life, upper extremity disability and neuropathic pain. The percentage of decreased arm volume or treatment success was better in kinesio-taping group than MLD group at the end of the treatment, 4th and 12th weeks after treatment (p=0.009, p=0.039, and p=0.042, respectively). Conclusions: We found that kinesio-taping led to better results than manual lymphatic drainage and similarly effective with low-level laser in stage II breast cancer related lymphedema at 12th weeks follow-up. Kinesio-taping and low-level laser should be considered as alternative treatments in early-moderate stage of lymphedema. Following these modalities, multi-layer compression and compression bandaging are cornerstone of lymphedema treatment.
Sexual wellbeing and supportive care needs after cancer in a multiethnic Asian setting: a qualitative study
Authors: Kuan Wai-Chee , Kong Yek-Ching , Bustamam Ros Suzanna , Wong Li-Ping , Woo Yin-Ling , Taib Nur Aishah , Ho Gwo-Fuang , Zaharah Hafizah , Yip Cheng-Har , Bhoo-Pathy Nirmala
Published: April 2022

Purpose: The physical and emotional impact of cancer and its treatment may be detrimental to the sexual well-being of patients. We aimed to gain an in-depth insight on the impact of cancer on the sexual wellbeing of cancer patients living in a middle-income setting with limited supportive care services. Methods: Twenty focus group discussions, stratified by gender, were conducted among 102 patients with breast, cervical, colorectal, or prostate cancer. Participants were recruited from five hospitals in Klang Valley, Malaysia. Discussions were audio recorded and transcribed verbatim. Thematic analysis was performed using NVivo. Results: Three major themes emerged: loss, adjustments, and unmet supportive care needs. Under the main theme of loss, changes in physical appearances and childbearing abilities negatively impacted participants’ self-confidence and body image, particularly in the females. Changes in quality of sexual activity were commonly raised, which often brought about conflicts and marital strains. Various methods to cope with the changes were described, including reprioritization of sex, using sexual aids, employing other forms of intimacy, and reframing sex as an obligation. Participants further voiced the unmet need for professional counselling services to enable honest communication between patients and their partners, and also sexual healthcare services, which were all deemed as paramount to address their sexual issues.Conclusion: In the low- and middle-income countries, provision of sexual healthcare services including counselling and clinical management of sexual dysfunction should not be overlooked as an important component of supportive cancer care.