bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectivas de la reputación digital y de la estrategia de comunicación digital del sector hotelero en México
Authors: Madrigal Moreno Salvador , Villa-Hernández Yuselim Angélica , Ávila Carreón Fernando
Published: June 2021

El impacto del uso de las Tecnologías de la Información y la Comunicación (TIC) en el sector turístico y la utilización de la red social Facebook, por parte de los turistas, es cada vez mayor, lo que ha llevado a que la reputación digital sea hoy en día un activo intangible de gran valía para el sector hotelero. La digitalización ha transformado el proceso de toma de decisiones de los turistas, la forma en que buscan información, consideran y evalúan servicios de hospedaje, y realizan reservaciones o compras en línea. En esta investigación se presenta cómo se configura el sector hotelero de México de acuerdo al Sistema de Clasificación Hotelera (SCH) que permite a la Secretaría de Turismo (SECTUR) en México asignar a los hoteles una categoría representada por estrellas. También se muestra la calificación que hacen los usuarios de Facebook en las páginas de los hoteles registrados en el SCH para establecer la correlación entre estos mecanismos de evaluación que representan reputación. Además, a partir de la propuesta de Floreddu y Cabiddu (2016), se realiza un análisis netnográfico de la estrategia de comunicación digital del sector hotelero en México. La investigación permite confirmar la importancia de la reputación digital en el sector hotelero y la falta de una estrategia comunicativa en el manejo de la red social Facebook al ser utilizada por la mayoría de los hoteles como un canal más de comunicación sin priorizar lo social del medio.
POSSIBILITIES OF ACCELERATED SOWING OF AUTUMN CEREALS
Authors: Gergely Tóth
Published: June 2021

We examined the possibilities of accelerating sowing and its effect on accuracy with the help of 5 farmers in Hungary. Because there are a lot of work in the autumn period the speeding up of sowing is an important issue for optimal performance. Our objectives were in this experiment to show if there are any negative effects of speeding up the sowing of autumn cereals. In summary, it can be said that in the case of narrow row seed drills of different constructions and technologies, adequate quality can be achieved at increased speeds also in terms of sowing uniformity and sowing depth. Therefore, where it is necessary and the area and soil condition are suitable for it, it is worth speeding up the work in order to achieve the optimal sowing time.
Wokół dramaturgicznego debiutu Felicjana Faleńskiego
Authors: Dybizbański Marek
Published: June 2021

Nigdy niewydany pierwszy ukończony dramat Felicjana Faleńskiego – Smutne dzieje powstania w Dalekarlii z 1867 roku – odpowiada programowym założeniom Victora Hugo, wedle których dzieło sztuki dramatycznej powinno być „przeszłością ożywioną na rzecz teraźniejszości”. Pisany pod wpływem świeżego wspomnienia powstania styczniowego traktuje o zrywie Szwedów przeciwko dominacji Danii w związku państw skandynawskich ustanowionym przez unię kalmarską u schyłku XIV wieku, przedstawia nadużycia Duńczyków i króla Eryka Pomorskiego, bunt szwedzkich możnowładców i mas ludowych pod dowództwem prostego górnika, obalenie króla, zdradę jednego z feudałów, zamach stanu, skrytobójstwo. Akcja została skomponowana według mechanizmów dziejowych znanych z szekspirowskich kronik z przydaniem w losie monarchy calderonowskiego pierwiastka rządów Bożej opatrzności nad światem ziemskiej historii.
Performatyczne kłusowanie po operowych marginesach
Authors: Bogucki Marcin
Published: June 2021

Artykuł jest recenzją książki Sabiny Macioszek Opera, ciała, technologie: Strategie współdziałania w XXI wieku. Autor docenia oryginalne podejście badaczki będące próbą wykorzystania narzędzi performatycznych w studiach operologicznych, dyskutuje jednak z ogólnymi definicjami przyjętymi przez Macioszek, za sprawą których kwestia współdziałania ciał i technologii na scenie operowej zostaje odcięta od kontekstu społecznego i politycznego. W tekście została także podjęta polemika z wybiórczą interpretacją teorii Bojany Kunst, przede wszystkim zastosowaniem terminu „projekt”. Autor zwraca również uwagę na problematyczność usytuowania wobec siebie teorii i praktyki, które funkcjonują na zasadzie przyległości, co oznacza, że omawiane opery traktowane są jedynie jako egzemplifikacje omawianych pojęć teoretycznych, a nie pełnoprawne dzieła artystyczne.
Вплив вім-технологій на розробку технологічних карт будівельних процесів
Authors: Мудрий І.Б.
Published: June 2021

Запропоновано основні вимоги до формування організаційно-технологічної документації з врахуванням технології інформаційного моделювання, з розробкою нормативної бази та відповідним підвищення кваліфікації інженерно-технічних працівників, з можливістю їх навчання. Визначено причини низького рівня застосування інформаційних технологій для розробки технологічних карт будівельних процесів та їх зальний вплив на створення інформаційних моделей.
Research of the bridge structure by impact-echo method
Authors: Орешкович Матіа , Цвіткович Іван , Брлек Предраг , Клименко Євгеній , Кучіна Луція , Крантовська Олена
Published: June 2021

This article reflects the results of studies of the operated bridge on the river Mozdernyak in the municipality of Kneginek (Croatia), which was subject to expert analysis of the needs of reconstruction.
In the process of field research of the structures of the considered bridge, the Impact-Echo method was used and at the same time the peculiarities of the method of this method were investigated. In particular, on the basis of the Impact-Echo method, the construction of the old part of the studied bridge was checked, as well as the connection of this old part with the new part of the bridge was checked.
Also, studies on the example of the construction of this bridge found that the acoustic properties of the wall components (brick, block and mortar) are quite similar, that in most cases masonry building elements respond to Echo-Impact as a solid block and this should be taken into account. This method allows you to detect cavities in several walls and assess their scale and impact on the strength of structures.
The use of research equipment provided by the Impact-Echo method allowed to investigate the deposition of concrete in the lower and upper reinforcing zones of the bridge, as well as to determine the existing boundary between the layer of concrete and asphalt.
Thus, the results of the research presented in the article allow to improve the methodology of research of bridge structures by the Impact-Echo method. In addition, expert opinions were made on the condition and prospects of operation of the bridge considered in this article - the bridge structure is in a satisfactory condition, which allows its operation. However, after some time it is recommended to repeat the research of the bridge using the method of the Beat-Echo method, with the continuation of the research areas to a new section of the bridge.
Аналіз адгезійних добавок карбозалін
Authors: Пиріг Я.І. , Галкін А.В.
Published: June 2021

Розглянуто вплив на стандартні показники якості нафтового дорожнього в’язкого бітуму різних видів поверхнево-активної добавки Карбозалін. В досліджені особливу увагу приділено термостійкості адгезійних добавок, що визначалась згідно нормованих методик, наведених в ДСТУ Б EN 12607-1 та ДСТУ EN 12607-2.
Graphite Particle in Cornea- An Incidental Finding
Authors: Kalita Iva Rani
Published: June 2021

An eleven years old female came to Ophthalmology OPD for normal checkup. Her vision was 6/6 in BE's. On Slit Lamp Examination of Anterior Segment, LE Cornea showed crystalline greyish deposits scattered in infero-temporal quadrant mostly suggestive of Pencil Graphite. The rest details were absolutely normal. No entry wound could be made out. The patient and her parents gave no History of any pencil trauma in the past even after. As the particles were inert and patient had no symptom, no active intervention was done (Figures 1 and 2).
Indications of Scleral Contact Lenses in Ocular Surface Diseases
Authors: Dhanotia Sudhanshu
Published: June 2021

The use of scleral lenses is increased over the last decade. Not only it helps in the patient’s visual rehabilitation but also provides wearing comfort to the patient. Previously scleral lenses were mostly prescribed in cases where traditional therapies don’t work well. But nowadays due to advanced designing and customized fitting this lens are widely prescribed in various ocular surface diseases where these lenses not only improve patient comfort but act as an important tool in promoting healing of the corneal epithelium. Therapeutic Scleral lens indications include DED syndrome, exposure keratitis, graft-versus-host disease, Stevens-Johnson syndrome, ocular cicatri¬cial pemphigoid, persistent epithelial defects, neurotrophic keratitis, chemical burns, limbal stem cell deficiency etc.
Is the Generic Approach of Fitting Contact Lens Leading to Drop-outs? Role of Gender and Age in Ocular Surface Equilibrium
Authors: Tonmoy Chottopadhyay
Published: June 2021

Objective: To identify and synthesize evidence about ocular surface changes during the different phases of the menstrual cycle in women and to analyze the need for a gender-specific contact lens.

Methods: Studies, included in the review were targeted interventions towards the women population conducted in developing and developed countries related to the current research objective. 4 databases were searched for articles published in English and other languages between January 1990 and December 2016.

Results: Seventeen studies out of 166 total studies that met the inclusion criteria had positive results. Literature shows a high dependency on the ocular surface on gonadocorticoids. It stated that the frequent hormonal changes in women during the menstrual cycle also altered the overall ocular surface, especially the tear film physiology.

Conclusion: This review provides evidence that during the different phases of the menstrual cycle a cyclic and random changes take place in the ocular surface resulting in more incidence of dry in women which may lead to change in contact lens comfort and tolerance level. Hence questioning the use of a single contact lens throughout the phase and justify the need for a gender-specific contact lens.
Evaluation of efficiency and safety of apicold mint nose spray for allergic rhinitis
Authors: Kosakovsky Anatoly L.
Published: June 2021

Introduction: Allergic rhinitis affects 10 to 40% of the population, and among children the incidence is 2-25%.
Aim: Evaluation of the effectiveness and safety of "Apicold Mint" nasal spray in children and adults with allergic rhinitis.
Material and methods: The effect of "Apicold Mint" Nasal Spray (manufactured by APIPHARMA doo) was studied in 45 patients with allergic rhinitis. The clinical study involved 21 (47%) children aged 4 to 18 years and 24 (53%) adults.
Results and discussion: The use of the drug "Apicold Mint" nasal spray helps to reduce the symptoms of allergic rhinitis and eliminates the feeling of dryness, which often occurs with the use of topical corticosteroids and decongestants. In addition, the use of the drug "Apicold Mint" nasal spray significantly reduced the need for vasoconstrictor drops, which is also positive in the treatment of patients with allergic rhinitis.
Conclusion: Appointment of the drug "Apicold Mint" nasal spray in the complex therapy of allergic rhinitis contributes to a faster reduction of symptoms and increases the effectiveness of local drugs.
Olfactory dysfunction in coronavirus disease
Authors: Tsepkolenko Aleksandra V. , Pukhlik Sergey M.
Published: June 2021

Olfactory dysfunction may be the only early clinical manifestation in COVID-19 patients with no other significant signs. It is typical of the disease and can be significant for testing.
The purpose of the review is to provide guidance to the otorhinolaryngologist in the problem of olfactory dysfunction in SARS-CoV-2 infection.
Materials and Methods: The authors analyzed the available clinical data on the problem of olfactory dysfunction in SARS-CoV-2 infection. The data of statistics, clinical symptoms and pathogenesis were studied. Toexplain anosmia in COVID-19 patients, 4 possible mechanisms are considered: nasal congestion / nasal congestion and rhinorrhea; death of olfactory receptor neurons; infiltration of the brain and damage to the olfactorycenters; damage to the supporting cells of the olfactory epithelium.
The analysis of clinical cases of patients with prolonged ansomia against the background of COVID-19
was carried out.
Conclusions: Smell after COVID-19 in most cases is restored without specific treatment. There are no reports of studies in patients with long-term anosmia.
Identification Of Physiotherapy Student Fitness At Poltekkes Kemenkes Surakarta
Authors: Handari Herdianty Kusuma , Kusumaningtyas Mei
Published: June 2021

Background: The convenience provided by technology makes a person tend to reduce physical activity. In a long time it will certainly have an impact on one's fitness. This will also affect adolescents to young adults, where the average circle is students in college. Fitness is very important to support daily activities, without fitness someone will easily experience fatigue. Currently, students tend to do less physical activity because they lie too much or are sedentary as a result of technological advances. As a physiotherapy student who will treat patients later, fitness needs to be maintained since in the college. So far, fitness identification has never been done for students in health institutions, especially in physiotherapy students in the Poltekkes Kemenkes Surakarta, so this study aims to determine the fitness condition of physiotherapy students. 

Methods: this research is a descriptive study by measuring 8 fitness components namely flexibility, balance, strength, explosive power, speed, agility, coordination and endurance in 226 physiotherapy students and the data analized descriptively using Ms. Excel.

Results: Based on the measurement results, it was found that flexibility, balance and strength were included in the good category, explosive power, agility and coordination were in the very poor category, speed and endurance were in the excellent category. The physiotherapy student fitness index shows an average value of 3.125, which means that student fitness is included in the fair category.

Conclusion: there is efforts should be made to maintain and improve the fitness of physiotherapy students in the Poltekkes Kemenkes Surakarta.
The Effect Of Breathing Relaxation And Lavender Aromatherapy On Insomnia In The Elderly
Authors: Mahyuvi Tata , Perbawani Dhian Restika , Suwardianto Heru
Published: June 2021

Background: The elderly experience insomnia in the form of problems with symptoms of sleep disorders in the form of repeated difficulties in sleeping or maintaining sleep even though there is an opportunity to sleep. The objective of research was to analyze the effect of Breathing Relaxation Aromatherapy Combination Lavandula Angustifolia on Insomnia in the Elderly.

 Methods: The design was a pre-experiment with approach the one group pretest-posttest design. The research population was elderly insomnia in elderly Posyandu and the sample was 21 peoples. The sampling research was total sampling. Variabel independent was Breathing Relaxation combination with lavender aromatherapy is relaxation using breathing techniques slowly and deeply, variabel dependen was insomnia level. Statistic test use Wilcoxon Signed Ranks Test

 Results: The results showed that The Wilcoxon Signed Ranks Test ρ value = 0,000, H1 is accepted, meaning that there is an effect of the Breathing Relaxation and lavender aromatherapy on insomnia in the elderly. The combination of Breathing Relaxation and lavender aromatherapy increases the relaxation response in the elderly.

 Conclusion: Effect of Breathing Relaxation combination of lavender aromatherapy (Lavandula angustifolia) is more effective in reducing insomnia levels in the elderly and is highly recommended and safe for the elderly)
Factors Related To Schizoprenia Patients’ Ability In Performing Self-Treatment
Authors: Dwi Jayanti Desak Made Ari , Arwidiana Dewa Putu
Published: June 2021

Background: Schizophrenia is one of mental disorder occurring and raising number of problems. One of which is the ability in performing self-treatment. This phenomenon suggests that there be declination of motivation in performing self-treatment.  

Methods: The research purposed to know the factors related to schizophrenia patient’s ability in performing self-treatment. This research used descriptive correlation with cross-sectional approach. The samples taking were done by random sampling with 155 persons with schizophrenia as samples. The bivariate examination used Spearmen test.  

Results: The result of the research suggested that p value = 0,771; 0,959; 0,473; 0,500; 0,818; 0,837; 0,956 for each variable; sex, age, hallucination, delusion, violence behavior risk, the length of treatment, and the length of getting mental disorder with ability in performing self-treatment. It indicates that there is not any relationship between one variable with another. Meanwhile, variable in social isolation disturbance in body image and frequency related to how many times getting treatment with the ability in performing self-treatment. Each variable was found that p value were at 0,001; 0,001; 0,002 (p value <0, 0005).  

Conclusion: Those values indicate that there is relation between one variable to another. Further nursing intervention is needed to improve the ability of schizophrenia patients to perform self-care
A Közbeszerzési Hatóság legfrissebb állásfoglalásai : 2021. májusi összegfoglaló
Authors: Vén Gergely
Published: June 2021

A Közbeszerzési Hatóság állásfoglalások formájában ad felvilágosítást a közbeszerzési eljárásokban résztvevő jogalkalmazók számára a közbeszerzési törvény és kapcsolódó végrehajtási rendeleteinek alkalmazásával összefüggő általános jellegű megkeresésekre. Alábbiakban a Kbt. alkalmazásával összefüggő kérdésekre adott válaszainkat rendeztük sorrendbe, bízva abban, hogy iránymutatásaink nem csak a kérdésfeltevőknek, hanem valamennyi Olvasónknak hasznos információkkal szolgálnak. Felhívjuk Tisztelt Olvasóink figyelmét, hogy a közbeszerzésekre irányadó jogszabályok alkalmazásával kapcsolatos döntések meghozatala mindenkor a közbeszerzési eljárások résztvevőinek joga és felelőssége. Hangsúlyozzuk továbbá, hogy az állásfoglalásokban megfogalmazott véleményeknek jogi ereje, kötelező tartalma nincsen.
Dynamic Programming in Topological Spaces
Authors: Cakir Merve Nur , Saleemi Mehwish , Zimmermann Karl-Heinz
Published: June 2021

Dynamic programming is a mathematical optimization method and a computer programming method as well. In this paper, the notion of sheaf programming in topological spaces is introduced and it is demonstrated that it relates very well to the concept of dynamic programming.
НАУКОВЕ ЗАБЕЗПЕЧЕННЯ ПРОЄКТУ «ПРЕЗИДЕНТСЬКИЙ УНІВЕРСИТЕТ»
Authors: Луговий Володимир Іларіонович , Саух Петро Юрійович , Таланова Жаннета Василівна
Published: June 2021

Представлено візію, місію, ключові особливості Президентського університету, діяльність якого спрямовуватиметься на впровадження ефективних освітніх стратегій для реалізації інтелектуального і творчого потенціалу громадян України, що забезпечить підготовку лідерів для стратегічних галузей розвитку держави, готових до викликів сучасного мінливого світу. Наведено стратегічні цілі для реалізації діяльності університету як сучасного інноваційного освітнього і наукового центру. Висвітлено порівняльні концептуальні характеристики Каліфорнійського інституту технології (California Institute of Technology, Caltech) та майбутнього Президентського університету. Наведено ризики, зумовлені відсутністю законодавчого забезпечення, особливим статусом університету, складністю конкурентних умов з топовими українськими університетами.
Development of designing and implementation method of magnetic execution unit of downhole valve for the bottomhole assembly
Authors:   State Oil Company of Azerbaijan Republic, Shirali I.Y. , Tsivilitsin V.Yu. ,   Institute for Problems of Material Sciences named after I.M. Frantsevich of NAA, Ukraine, Bondar İ.B. ,   Institute for Problems of Material Sciences named after I.M. Frantsevich of NAA, Ukraine, Hasanov R.A. ,   Azerbaijan State University of Oil and Industry, Ramazanov F.A. ,   State Oil Company of Azerbaijan Republic
Published: June 2021

The structure of two types of magnetic valve is offered and the calculation methods of their pull-in force developed as well. The formulas of calculation of pull-in force in the main area of valves’ power characteristics are obtained. Experimental data are in alignment with theoretical calculations. Power characteristics of offered structures of magnetic valves may be changed in terms of the offered structural execution of magnetic valves. Experimental test of obtained formulas has been carried out. The ways of changing the power characteristics of magnetic valves in accordance with the requirements of certain applications are presented. The structures of magnetic reversing valves for drilling tools used in well drilling in various oil-gas bearing areas of SOCAR have been developed.
Geopolitical Risks of Hydrocarbon Development in the Russian Arctic
Authors:   Northern (Arctic) Federal University named after M.V. Lomonosov, Arkhangelsk, Russia, TRUBITSINA Olga P. , BASHKIN Vladimir N. ,   ISSP Institute of Physicochemical and Biological Problems of Soil Science RAS, Moscow Oblast, Pushchino, Russia
Published: June 2021

The article is devoted to the issues of geopolitical risks (GPR) in the hydrocarbon development of the Russian Arctic. The authors pay special attention to the analysis of modern geopolitical and geostrategic challenges of the Arctic region development. The article identifies the key geopolitical factors that affect the sustainable development of the Arctic and analyzes the similarities and differences in the geostrategic positions of the Arctic Five. One of the most important factors of the XXI century that determines the alignment and interaction of various geopolitical forces is the struggle for resources. In this regard, an increase in GPR in the Arctic, related to its resource potential, is inevitable. For oil and gas industry facilities, GPR can be transformed into opposite environmental factors in the form of additional opportunities or threats, which the authors identify in detail for each type of risk. The authors focus on such positions of the GPR, which are related to ensuring access and obtaining control rights over the Arctic's hydrocarbon resources from different countries, the uncertainty of the legal status of the Arctic region, and the use of geoecological risks (GER) as manipulative priorities of attention to Russia's actions in the Arctic.
Anti-Mutant Efficacy of Combination Therapy with Doripenem and Levofloxacin: In Vitro Model Studies with Pseudomonas Aeruginosa
Authors: Golikova M. V. , Strukova E. N. , Alieva K. N. , Filimonova A. V. , Portnoy Yu. A. , Firsov A. A.
Published: June 2021

Relevance. The tendency to a decrease in sensitivity of bacterial agents to old antibiotics, as well as the slowdown in creation of new medications, dictate the need to develop effective approaches to combat bacterial resistance.

Aim. Evaluation of the applicability of a pharmacokinetically-based approach to predicting anti-mutant effectiveness of combined therapy with doripenem and levofloxacin against gram-negative bacteria Pseudomonas aeruginosa.

Material and methods. A collection strain of Pseudomonas aeruginosa was used in the study. The values of MPC (mutant prevention concentration) of the combination of doripenem and levofloxacin were evaluated at a ratio of their concentrations equal to therapeutic ratios of the area under the pharmacokinetic curve in the in vitro dynamic model. 5-day treatments with clinical doses of doripenem and levofloxacin individually and in combination were simulated. Bacteria-containing medium was sampled during the experiments and plated on agar media containing 2MIC of each antibiotic.

Results. The MPCs of doripenem and levofloxacin decreased 4 times when used in combination compared to MPC values when used separately. P.aeruginosa population was enriched with resistant mutants during monotherapy with each medication; the number of the bacteria did not decrease or even increased by the end of observation period. The use of doripenem/levofloxacin combination completely prevented development of resistance to both drugs in P.aeruginosa. The observed anti-mutant effect of antibiotic combination was consistent with higher (compared to monotherapy) values of the time during which the concentration of the antibiotic exceeded MPC (T>MPC).

Conclusion. The anti-mutant effectiveness of combined therapy with doripenem and levofloxacin increased with the decrease in the values of MPC of antibiotics when used simultaneously, which consequently led to the increase in the values of T>MPC. Obtained results confirm the applicability of a pharmacokinetically-based approach to the estimation of MPC of combined antibiotics for predicting anti-mutant effectiveness of combination therapy in the treatment of infections caused by gram-negative bacteria.
Eradication, Strain Preservation, Strain Change — Outcomes of Helicobacter pylori Therapy
Authors: Golubkina E. V. , Sorokin V. M. , Levitan B. N. , Umerova A. R. , Kamneva N. V.
Published: June 2021

Relevance. If we reduce the treatment exclusively to the eradication of Helicobacter pylori (Hp), the question of monitoring the results of anti-Hp therapy is controversial, given the widely known data on the detection of Hp, including virulent strains of Hp, in most healthy individuals.

The aim of the study: to track the dynamics of stomach colonization with various Hp strains in patients with gastric ulcer and duodenal ulcer (PUD) immediately after the use of standard three-component anti-Hp therapy (AHT) and 1.5–2 months after AHT.

Methods. Genotyping of Hp strains was carried out by the VNTR method together with the determination of the cagA gene.

Results. Assessment of the results of AHT in the form of «eradication of Hp — re-detection of Hp» (i. e., without taking the determination of Hp strains into account) showed less reliability in the differences than the «eradication — preservation of the strain or change of the strain» score in patients with PUD; in addition, the differences between the initial bacteriological picture and that observed immediately after AHT were on the verge of reliability, while the differences between the initial bacteriological picture and that observed after 1.5–2 months had a high degree of reliability. The number of eradications increased (eradication achieved immediately after AHT was not preserved, except for one) and the number of cagA-containing strains decreased (due to new eradication detected at late follow-up periods and due to a change in strains) in long-term follow-up in patients with PUD.

Conclusion. Since all patients with PUD achieved clinical remission, which lasted for the next 1.5–2 months, the success of AHT should not be unambiguously associated with the eradication of Hp; the restoration of the organism's colonization resistance to Hp after a course of therapy is more likely.
Study of Cases of Bacteremia with Gram-Negative Pathogens with Multiple and Extreme Antibiotic Resistance in Real Clinical Practice
Authors: Zhuravleva M. V. , Rodionov B. A. , Lysenko M. A. , Yakovlev S. V. , Andreev S. S. , Ilyukhina N. N. , Prokofiev A. B.
Published: June 2021

Aim:To study cases of bacteremia caused by multidrug-resistant (MDR) and extremely-resistant (XDR) gram-negative bacteria in the departments of a multidisciplinary hospital.

Material and Methods.Since 2017, a retrospective epidemiological study has been conducted to investigate cases of infections with bacteremia caused using gram-negative bacteria with multiple or extreme antibiotic resistance. The pathogens were identified using the MALDI-TOF MS method, the sensitivity to antibacterial drugs was determined using the automatic Phoenix system, the beta-lactamase genes were detected using real-time PCR on a GeneXpert analyzer.

Results.In 2017, bacteremia caused by MDR and XDR pathogens was detected in 42 and 76 patients, in 2018 — in 57 and 81 patients, in 2019 — in 65 and 111 patients, respectively. During three years of observation, the most frequent XDR microorganisms were, in descending order,Klebsiella pneumoniae,Acinetobacter baumannii,Pseudomonas aeruginosa. In 2019, among 11K.pneumoniaestrains, class D carbapenemase (OXA-48) was detected in 5 cases (45.5%), 3 strains produced NDM metallo-carbapenemase, and 3 strains had a combination of NDM and OXA-48 enzymes. Infections caused by MDR and XDR pathogens were characterized by high mortality. Thus, the relative risk of death in patients with XDR infection was 1.33 times higher than in patients from the MDR group (95% CI 1.04-1.69, P<0.05) in 2019. The duration of hospital stay also increased: in the XDR group — up to 29.5 days, in the MDR group – up to 16.4 days, with an average length of hospitalization of 6.0 bed-days in 2019.

Conclusions.K.pneumoniaeandA.baumanniiwith extreme antibiotic resistance are the main causative agents of severe late nosocomial infections in immunosuppressed patients. Nosocomial infections with bacteremia caused by gram-negative bacteria with the XDR phenotype and resistant to carbapenems are characterized by a high mortality rate (from 72 to 80%), and increase the duration of hospitalization by more than 4 times.
Analysis of Antibiotic Resistance of Vibrio Сholerae Isolated From Environmental Objects in Russia in 2019
Authors: Selyanskaya N. A. , Egiazaryan L. A. , Ezhova M. I. , Pasyukova N. I. , Vodopyanov S. O.
Published: June 2021

The aim of the study was to analyze the resistance to antibacterial drugs of Vibrio cholerae strains isolated from environmental water bodies on the territory of Russia in 2019.V.cholerae O1 El Tor (14) and V.cholerae nonO1/nonO139 strains were used in this work. Sensitivity/resistance to 11 antibacterial drugs was determined using the method of serial dilutions in a solid nutrient medium. The presence of drug resistance genes was determined using real-time PCR. Fluctuations in sensitivity/resistance of V.cholerae were found in various years. The phenotypic resistance of the strains to tetracycline and trimethoprim/sulfamethoxazole correlated with the presence of the tetR and dfrA1 genes in them. The presence of ICE was not detected in V.cholerae strains containing the tetR and qnrVC1 genes. The variability and wide spectrum of V.cholerae resistance require close attention to the problem of antibiotic resistance of cholera. The detection of ICE in the studied V.cholerae strains, as well as antibiotic resistance genes not associated with ICE elements, emphasize the need for molecular genetic monitoring of V.cholerae antibiotic resistance.
Possibilities of Hyperinflammation Correction in COVID-19
Authors: Simutis I. S. , Boyarinov G. A. , Yuriev M. Yu. , Petrovsky D. S. , Kovalenko A. L. , Parfenov S. A.
Published: June 2021

Objective. To evaluate the effect of sodium meglumine succinate on the severity of the systemic inflammatory response syndrome when used in complex therapy in patients with severe COVID-19.

Material and Methods. The clinical and laboratory data of 12 patients with the diagnosis «Novel coronavirus infection COVID-19 complicated by community-acquired bilateral polysegmental interstitial pneumonia» were analyzed. All patients underwent intensive therapy with a limited volume of water load in the intensive care unit in accordance with the recommendations of the Ministry of Health of the Russian Federation. Seven patients (observation group) received a polyelectrolyte solution containing meglumine sodium succinate (Reamberin) as part of the therapy at a daily dose of 5 ml/kg during the entire period of stay in the ICU (3–10 days). The control group included 5 patients who received a similar volume of a conventional polyelectrolyte solution containing no metabolically active substrates. The study was pilot in nature due to the small number of patients. The laboratory parameters of arterial and venous blood were measured at the following stages: 1) upon admission to the ICU; 2) 2–4 hours after the completion of Reamberin infusion; 3) 8–12 hours after drug administration; 4) 24 hours after the start of intensive care. Mortality rate and the incidence of thrombotic complications in the groups were assessed on the 28th day of observation. The presence of the therapeutic intervention effect was established using multivariate analysis of variance (MANOVA).

Results. A positive effect of the study drug on the severity of systemic inflammatory response syndrome (SIRS) against the background of ongoing etiotropic therapy was noted. Efficiency criteria were the correction of hyperfibrinogenemia, normalization of the platelet count, decrease in the level of C-reactive protein, ferritin, and leukocytosis. A significant decrease in the frequency of thromboembolic events was observed within 28 days of treatment, as well as a reduction in the length of time the patients spent in the ICU.

Conclusion. Based on the results of the pilot study, it can be assumed that the antihypoxic and antiradical effects of the drug contribute to the reduction of pulmonary and systemic endotheliitis, which is characteristic of severe forms of the disease and, as a result, inhibits the development of the systemic inflammatory response syndrome. The data obtained can serve as a basis for further in-depth studies.
An Older Adults Perspective on the Impact of Spirituality Towards Pandemic COVID-19
Authors: Sipollo Berliany Venny , Nugroho Kristianto Dwi
Published: June 2021

Purpose: This research aims to understand the perceptions of impact of spirituality towards pandemicCOVID-19 from the perspective of the older adults, explores the themes of such perception older adultsregarding spirituality in the pandemic COVID-19. Methods: This research is based on qualitative research ina phenomenological methodology. The research participants included older adults aged 60-90 living at homein Malang, Jawa Timur Provinces, Indonesia. Data collection methodologies included in-depth interviewsand observation of participants. The data were analyzed in the phenomenological methodology by Colaizzi.Results: As a result of the research, it was found that all significant statements about the Indonesian olderadults perception of spirituality in the pandemic COVID-19 fell within 10 categories with 2 major themesand 3 minor themes. The 2 major themes were: The COVID-19 pandemic is coming to an end and Spiritualimprovement of the older adults. Conclusion: This study provides factor –factor to use on foundation toachieve spiritual need of older adults in the pandemic COVID-19.
Nurses’ Competence in Safety Blood Transfusion: The Impact of a Training Module
Authors: Soliman Hanan Mohamed , Elhapashy Heba Mahmoud
Published: June 2021

The Aim: The aim of this study was to evaluate the effectiveness of a training module about safety bloodtransfusion on nurses’ competence. Methods: Pre experimental one group pre and post-test design wasadopted. The study was conducted at the hematology department in Oncology Center Mansoura UniversityHospital. A convenient sample of 60 staff nurses were included. Data were collected by a structured interviewquestionnaire to assess nurses’ knowledge level and observation checklist to assess nurses’ practices pre,and post-blood transfusion training. Data were analyzed by using both descriptive and inferential statistics.Results: Revealed a highly statistically significant difference in the mean score of the nurses’ knowledgelevel and practice about safe blood transfusion pre and post the training intervention (p=0.001). There wasa strong positive relation between nurses’ knowledge and practices scores post-training (r=0.745, P<0.000).Otherwise, it was observed that there was no correlation in the nurse’s knowledge or practice with age and yearsof experience. Data were presented using tables and charts. Conclusion: Training module on safety bloodtransfusion can positively improve nurses’ level of knowledge and practice. Recommendation: Ongoingin-service training to nurses at hematology units are essential to improve their knowledge and practice level.Evidence-based practices for blood transfusion should be integrated into the nursing curriculum.
A Study to Assess the Effectiveness of Facilitated Tucking Position on Pain Perception among Neonates During Vaccination in Selected Hospital of Panipat, Haryana
Authors: Nandini  , Sharma Nidhi
Published: June 2021

Background and Objective: A study was done to assess the effectiveness of facilitated tucking position onpain perception among neonates during vaccination in selected hospital of Panipat. Material & Methods:The methodology of the present study was true experimental research design. Sample size of the study was60 neonates during vaccination selected with random sampling technique. 30 neonates in each group washeld in the facilitated tucking position & in routine care during Hepatitis B vaccination. NIPS was used fordata collection. Data collection method was interview & observation method; data analysis was done withthe help of descriptive and inferential statistics. Result: The mean pain scores of neonates vaccinated in thefacilitated tucking position (2.53±1.042) were significantly statistically lower than the scores of neonatesvaccinated in the routine position (5.80±0.925) (p<0.05). Conclusion: The pain perceptions of neonatesheld in the facilitated tucking position during Hepatitis B vaccination were lower. The facilitated tuckingposition is a non-pharmacological method & recommended as an effective and useful method for reducingpain during the procedure.
Quality of Life of Greek Patients with Type 2 Diabetes and the Role of Rehabilitation
Authors: Adamantios Theodorakopoulos , Nikolaos Bakalis , Eleni Michalopoulos , Anastasios Tzenalis , Makri Roza  , Georgia Kotsela , Nikolaos Filiotis
Published: June 2021

Introduction: Diabetes mellitus is a chronic disorder that is increasing rapidly worldwide. Appropriatemanagement of this chronic disease can improve patient’s quality of life, increase life expectancy and relievesociety of the huge financial burden.Purpose: The aim of this study was to measure the quality of life of patients with type 2 diabetes and toinvestigate the role of rehabilitation.Methodology: Data were collected with the use of a questionnaire that consisted of three (3) sections:The Short Form 36 Health Survey Questionnaire, (17) questions adapted from the Diabetes SatisfactionQuestionnaire (DTSQs) and the Problem Areas In Diabetes (PAID) scale and questions regarding medicaldata and demographic information. The sample included a total of n = 122 individuals suffering from type2 diabetes. The research was carried out in outpatient clinics of two general hospitals and private practiceswithin the region of Western Greece. The results of the study were analyzed using the statistical programSPSS v.25.0.Results: Age and the existence of another health problem besides diabetes have a negative impact on thequality of life of these patients on their physical and emotional health. As patients age, their quality of lifedecreases affecting all eight scales of the SF-36 Questionnaire. In contrast, patients who had several hoursof professional work managed to have a positive outcome on all eight scales. Regarding these patient’srehabilitation, the results showed that the more satisfied the patients were regarding their treatment plan,doctor and nursing staff, their family’s support, and their diabetic diet, the grater their functionality on allscales.Conclusions: The results showed that it is important for patients with type 2 diabetes to have an activeprofessional life and follow an appropriate rehabilitation program, in order to improve their quality of life.
Effectiveness of Core Stability Exercise and Proprioception Exercise on Balance in Subjects with Diabetic Neuropathy- A Randomized Controlled Trial
Authors: Pavana  , Premrajan Nair Anjali
Published: June 2021

Background and Objectives: Long standing Diabetes Mellitus leads to Diabetic Peripheral Neuropathyin the subjects which alter their daily activities performed. As physical activities are the key elements toprevent the further progress of Diabetes Mellitus. The neuropathy also affects the postural stability leadingto impaired balance and risk of falls in the subjects. The integrated activity of the motor and the sensorysystems play an important role in maintain the postural stability which depends upon the strength of thecore muscles and proper integrated activity of the proprioceptors of the lower limb. The prevalence of theDiabetic Peripheral neuropathy in India is around 10.5% to 32.2%. The Toronto Clinical scoring System isused as a marker to assess the level of neuropathy which has a relation on the stability. Thus, the aim of thestudy is to find the effectiveness of proprioception exercise or core stability exercise on balance in DiabeticPeripheral Neuropathy subjects.Objectives: To assess the effectiveness of core stability exercise on balance in Diabetic Neuropathysubjects.To assess the effectiveness of proprioception exercise on balance in Diabetic Neuropathy subjects.To compare the effectiveness of core stability exercise and proprioceptive exercise on balance in DiabeticNeuropathy subjects.Design: Comparative Randomized Parallel Open Label Study

Methods: Eighty subjects between the age 40-60 years were recruited for the study. Written informed consentand institutional ethical clearance was obtained. Demographic data were obtained and subjects were assignedto one of two groups: Group A: experimental group given Proprioception exercise (n=40) and Group B:control group given Core Stability exercise (n=40). The therapy was given for six weeks with three days in aweek and was measured with Berg Balance Scale as an outcome measure at the end of the 6 week protocol.Results: Both the groups showed improvement in the balance according to the Berg Balance Scale. Themean ± SD of pre and post Berg Balance Scale of GROUP A was 37.18 ± 4.81 and 39.41 ± 4.95 respectivelyand that of GROUP B was 36.95 ± 4.27 and 38.55 ± 4.29 respectively. Conclusion: The results showed asignificant improvement within Group A and Group B (P<0.001) but there is no significant improvement between both the groups (P>0.05). Thus thestudy concluded that proprioception exercise and core stability exercise are worthwhile in improving the balance in subjects with diabeticperipheral neuropathy.
Retrospective Analysis of Scapula Posture Assessment in Patients with sub-acromial Impingement Syndrome in a Tertiary Care Hospital
Authors: Rajam Reema , Mhatre Bhavana , Wagh Vibhawari , Iyer Saraswati
Published: June 2021

Background: Sub-acromial impingement syndrome is one of the commonest musculoskeletal disorders.Abnormal posture and scapula dyskinesis are considered major risk factors for developing shoulder pain.Methods: A retrospective cross-sectional study was carried out involving 68 participants. Scapula postureassessed using acromion to plinth distance, distance from T4 to medial border, distance from T7 to inferiorangle and observation was analyzed.Results: The affected side demonstrated a significantly greater acromion to plinth distance (affected side:6.71±1.27 cm, non-affected side: 6.0±1.3 cm, p<0.0001), lesser distance from T4 to medial border (affectedside: 6.33±1.33 cm, non-affected side: 6.60±1.28 cm, p=0.0034) and lesser distance from T7 to inferiorangle (affected side: 6.8±1.98 cm, non-affected side: 7.37±2.03 cm, p<0.0001) as compared to the nonaffectedside. On observation, the superior angle on the affected side was elevated in 62.8% subjects andmedial border and inferior angle were closer to midline in 34.2% and 37.1% subjects, respectively.Conclusion: Scapula posture is altered in the patients with SIS, not only on the symptomatic but alsoasymptomatic side. Thus, assessing and correcting scapular alignment should be considered as an importantaspect in the rehabilitation of patients with sub-acromial impingement syndrome.
Effectivenessof Isometric And Stretching Exercises with and Without Ergonomics in Mechanical Neck Pain among Dental Students
Authors: Pavana  , Chaitanya.M.V
Published: June 2021

Background & Purpose: In the practice of dentistry, stress, tension and postural practices can contributeto neck and lower backache problems. This is due to the limited work area with a limited scope ofmovement and narrow visual field associated with the oral cavity. The prevalence and severity of variousmusculoskeletal disorders decreased by performing regular specific exercises among large group of thedentists. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, caninduce musculoskeletal disorders. The symptoms begin to appear early in their dental carrier. Objectives:This study is to compare the effectiveness of isometric and stretching exercises with and without ergonomicadvice in mechanical neck pain among dental students.Methods: The investigator personally visited two different dental colleges in Bengaluru, obtained permissionfrom the concerned authorities and screened final year students and interns using standardized NordicQuestionnaire forms. Students with mechanical neck pain were then selected according to the inclusion andexclusion criteria. The selected students from two dental colleges were grouped as Group A and Group B.The students were asked to fill NDI and NPRS forms prior the intervention. Group A were given isometricand stretching exercise along with ergonomic advice, whereas group B were given isometric and stretchingexercises only. The students were asked to follow the protocol for 4 weeks. NDI and NPRS were the outcomemeasures used.Result: The incidence of mechanical neck pain among 152 dental students screened was 52.63%. 14 outof 60 students who participated in the study were male. Paired t-test and unpaired t test were used forstatistical analysis within the group and between the group respectively. Both the groups improved in painand disability associated with mechanical neck pain. But improvement in neck related complications ingroup A was more significant than group B in this study. The difference in P value for both NDI and NPRSbetween both the groups was highly significant.Conclusion: Isometric and stretching exercises with ergonomic advice were more effectiveness thanisometric and stretching exercise without ergonomic advice in mechanical neck pain among dental students.