bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of COVID-19 on platelet count and its indices
Authors: Güçlü Ertuğrul , Kocayiğit Havva , Okan Hüseyin Doğuş , Erkorkmaz Unal , Yürümez Yusuf , Yaylacı Selcuk , Koroglu Mehmet , Uzun Cem , Karabay Oğuz
Published: September 2020

SUMMARY BACKGROUND Easily accessible, inexpensive, and widely used laboratory tests that demonstrate the severity of COVID-19 are important. Therefore, in this study, we aimed to investigate the relationship between mortality in COVID-19 and platelet count, Mean Platelet Volume (MPV), and platelet distribution width. METHODS In total, 215 COVID-19 patients were included in this study. The patients were divided into two groups. Patients with room air oxygen saturation < 90% were considered as severe COVID-19, and patients with ≥90% were considered moderate COVID-19. Patient medical records and the electronic patient data monitoring system were examined retrospectively. Analyses were performed using the SPSS statistical software. A p-value <0.05 was considered significant. RESULTS The patients’ mean age was 64,32 ± 16,07 years. According to oxygen saturation, 81 patients had moderate and 134 had severe COVID-19. Our findings revealed that oxygen saturation at admission and the MPV difference between the first and third days of hospitalization were significant parameters in COVID-19 patients for predicting mortality. While mortality was 8.4 times higher in patients who had oxygen saturation under 90 % at hospital admission, 1 unit increase in MPV increased mortality 1.76 times. CONCLUSION In addition to the lung capacity of patients, the mean platelet volume may be used as an auxiliary test in predicting the mortality in COVID-19 patients.
Laboratory findings in SARS-CoV-2 infections: State of the art
Authors: Pereira Miguel Augusto Martins , Barros Isabella Carolina de Almeida , Jacob Ana Luiza Veríssimo , Assis Mayara Lopes de , Kanaan Salim , Kang Hye Chung
Published: September 2020

SUMMARY OBJECTIVE The scientific community is constantly assessing the clinical and laboratory manifestations of COVID-19 in the organism. In view of the fragmentation of the large amount of information, knowledge gaps in relation to laboratory markers, and scarcity of papers in Portuguese, we propose a Literature review on laboratory changes observed in patients infected with SARS-CoV-2. METHODS Analysis of articles published between December 2019 and May 2020 on the PubMed and SciELO databases. The articles were identified, filtered, and evaluated based on the approach to the subject, language, and impact. Then, the articles were subjected to a thorough reading, in full, by 4 (four) independent researchers. RESULTS Leukopenia and lymphopenia were included in most studies, even in case definitions. Platelet count and platelet-lymphocyte ratio, at peak platelet, were associated with advanced age and longer hospital stay. Eosinopenia showed a sensitivity of 74.7% and specificity of 68.7% and, together with increased CRP, these are one of the future prospects for screening for disease. A high level of procalcitonin may indicate bacterial co-infection, leading to a worse prognosis. COVID-19 manifests itself with increased levels of many inflammatory markers such as IL-1, IL-2, IL-6, IL-7, IL-12, IP10, IFN-γ, MIP1A, MCP1, GSCF, TNF-α, and MCP1/CCL2, as well as LDH, ESR, D-dimer, CK, ALT, and AST. CONCLUSION There is a need for further studies on the new SARS-CoV-2. So far, there is no consensus regarding laboratory findings and their usefulness, whether as a prognostic marker, mortality, or disease severity.
A pragmatic approach and treatment of coronavirus disease 2019 (COVID-19) in intensive care unit
Authors: Loss Sergio Henrique , Nunes Diego Leite , Franzosi Oellen Stuani , Teixeira Cassiano
Published: September 2020

SUMMARY There is a new global pandemic that emerged in China in 2019 that is threatening different populations with severe acute respiratory failure. The disease has enormous potential for transmissibility and requires drastic governmental measures, guided by social distancing and the use of protective devices (gloves, masks, and facial shields). Once the need for admission to the ICU is characterized, a set of essentially supportive therapies are adopted in order to offer multi-organic support and allow time for healing. Typically, patients who require ventilatory support have bilateral infiltrates in the chest X-ray and chest computed tomography showing ground-glass pulmonary opacities and subsegmental consolidations. Invasive ventilatory support should not be postponed in a scenario of intense ventilatory distress. The treatment is, in essence, supportive.
Disputa eleitoral e representação política na Região Metropolitana de São Paulo
Authors: Padilha Frederica Valle de Queiroz
Published: September 2020

Resumo Este artigo analisa como a dinâmica política de representação pode se traduzir em obstáculos para a mobilização de atores políticos do Legislativo em torno de uma agenda metropolitana. Seu objetivo é verificar a representatividade dos deputados de base metropolitana na Assembleia Legislativa de São Paulo e caracterizar a disputa eleitoral nos municípios paulistas a partir de dois indicadores: um de concentração (número efetivo de candidatos) e um de competitividade (índice T). Os resultados apontam que os deputados metropolitanos paulistas não são sub-representados na Assembleia e a disputa eleitoral nos municípios metropolitanos tende a ser menos concentrada, com um “efeito metrópole” sobre a concentração da disputa, mas não necessariamente mais competitiva.
Opinión pública y nuevas estrategias comunicativas en la industria audiovisual: el caso de Netflix y la serie Sense8
Authors: del Olmo Francisco Javier Ruiz , Díaz Javier Bustos
Published: September 2020

Los nuevos operadores audiovisuales muestran una creciente y mayoritaria influencia que los constituyen en una seria competencia a los canales televisivos tradicionales. Junto a ello, las redes sociales y la interactividad que los contenidos audiovisuales proporcionan con las audiencias representan un cambio de paradigma en la actividad de los públicos televisivos. En este contexto, el presente artículo analiza, mediante un estudio de caso, la situación de opinión pública y crisis comunicativa que se produjo a partir de la cancelación de contenidos (la serie Sense8, 2017, producida por Netflix) y la repercusión en redes sociales (Twitter). Entre sus conclusiones se apunta a una novedosa estrategia por parte de esta nueva compañía audiovisual para responder e integrar en su discurso y prácticas productivas las demandas de sus audiencias.
De Médico de Família a Preceptor de Estudantes no Sistema Único de Saúde: Relato de Experiência
Authors: Oliveira Daniel Almeida de , Souza Eder Viana de
Published: September 2020

Abstract: Introduction: This article reports the experience of a physician, specialist in Family and Community Medicine, who works in a Basic Health Unit in the southern region of the city of São Paulo, in the Primary Health Care of the Unified Health System, when he became a Preceptor of Medical students at Universidade São Caetano do Sul. Method: The students learned about the typical structure of a Basic Health Unit. They learned how to acquire the medical history during anamnesis, under supervision, and the physical examination, as they acquired the necessary skills. They also learned how to request complementary examinations. With this training, they learned how to apply the clinical method during practice. The students also learned the competence to apply the clinical method in uncontrolled environments through the home visit, which also made it possible to know the reality of the patient in loco. The follow-up of families and the index cases for a few years gave the students the opportunity to experience the different care cycles of the Family Health Strategy, including the question of death, which started in the socio-family context. They also participated and carried out assistance and knowledge transmission groups for the community, in which students were able to train communication and adaptation at the population level. They met and participated in the team meetings, which allowed showing the weekly planning of activities, the interdisciplinary discussion of more complex cases and the created strategies. Results: The promising results of the Active Methodologies based on student autonomy, in relation to the learning process, are applied to the teaching of Medicine in clinical practice environments, since the contact with reality improves learning, challenges the students to research and reflect with autonomy to think about what they must do with the established learning goals and teaches them to use previous experiences to interrelate new knowledge with previous information through Evidence-Based Medicine and reflect on medical practice. Conclusion: Comments are also made on the National Curricular Guidelines, which request the inclusion of the medical student within the scope of the Unified Health System, aimed mainly at Primary Health Care learning.
Desafios do Feedback na Avaliação Formativa, no Programa Interinstitucional de Interação Ensino-Serviço-Comunidade: Perspectiva de Alunos
Authors: Miranda Guilherme Roberto Naves , Pessoa Tályta Freitas , Marco Lilian Bianca Miller Martelo de , Borges Arthur Carlos Bernardes , Neves Breno Lima Silva , Miotto Igor Alves , Ribeiro Matheus Alves Pedroso , Lorenzon Luiza Engel , Marques Maira Vilagra
Published: September 2020

Abstract: Introduction: This present study assesses the use of the feedback mechanism in the formative assessment during medical training, considering this instrument is of great importance for this training stimulation, which is based on active teaching methodologies. The study aims to characterize the application of this tool and to identify possible failures in its application in the daily routine of the PINESC module in the Anhanguera University (Uniderp) medical course. Method: This is a quantitative, sectional research, including students from the first to the eighth semesters of the medical course, attending the PINESC longitudinal module. In the data collection, a questionnaire was used with questions related to the formative assessment performed by the preceptors, which is reported to the students according to the sample calculation. The feedback is the core activity of the formative assessment and allows the development of reflective and self-evaluation capacities and the development of skills. However, the use of feedback still faces barriers, mainly due to the difficulty of the evaluators in listing negative points and capabilities of the evaluated individuals. Result: In this study, some shortcomings and positive points were reported regarding the application process of this tool, listing and suggesting improvements for a better use of feedback and thus a more favorable academic achievement. Conclusion: In conclusion, as the basis of formative evaluation, the feedback still shows many weaknesses regarding its form and application.
Zulliger R-Optimized in the Evaluation of Depressive Characteristics
Authors: Gonçalves André Pereira , Villemor-Amaral Anna Elisa de
Published: September 2020

Abstract Depression is one of the most prevalent mental disorders in the world with more than 300 million diagnoses. Studies on the contributions that instruments offer in understanding the functioning of depressive patients are necessary. Therefore, our study aimed to compare the frequency of codes related to depression in Zulliger R-optimized application in a group of depressive individuals with non-clinical group. The study included 86 participants, 43 depressive patients and 43 non-clinical patients. The Escala Baptista de Depressão (EBADEP-A) was used to identify depressive symptoms in the clinical group and Zulliger was administered with R-optimized application. To compare the groups, the t-test and magnitude of differences (d) were used. The results showed differences between groups in the variables Mixed Determinants, Sum of achromatic color responses, pure color responses (C), Mor and AG. We understood that Zulliger R-optimized application may be useful in understanding the functioning of the depressive subject.
Making a case for the combined use of SGLT2 inhibitors and GLP1 receptor agonists for cardiorenal protection
Authors: Sridhar Vikas S. , Dubrofsky Lisa , Boulet Jacinthe , Cherney David Z.
Published: September 2020

ABSTRACT Sodium glucose cotransporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1RA) were initially approved to improve glycemic control in the treatment of type 2 diabetes. Clinical trials have also demonstrated beneficial effects with regards to cardiovascular and renal parameters. Beyond improving glycemic control, these therapies promote weight loss and lower blood pressure when used individually, and in an additive manner when used together. Accordingly, taking advantage of complementary mechanisms of action with the combined use of these two classes of agents to further improve cardiorenal outcomes is conceptually appealing, but has yet to be explored in detail in clinical trials. In this review, we discuss proposed mechanisms for renal protection, clinical benefits, and adverse events associated with the individual and combined use of SGLT2 inhibitors and GLP-1RA. The management of type 2 diabetes has significantly changed over the last few years, moving away from solely glycemic control towards the concurrent management of associated comorbidities in a patient population at significant risk of cardiovascular disease and progression of chronic kidney disease. It is from this perspective that we seek to outline the rationale for the sequential and/or combined use of SGLT2 inhibitors and GLP-1RA in patients with type 2 diabetes.
O STF como árbitro da federação: uma análise empírica dos conflitos federativos em sede de ACO
Authors: Dantas Andrea de Quadros
Published: September 2020

Resumo O presente artigo analisa a jurisprudência federalista do Supremo Tribunal Federal (STF), enquanto Tribunal da Federação, em complemento aos estudos já existentes, restritos ao controle concentrado de constitucionalidade. Parte-se da pesquisa empírica de todas as ações cíveis originárias (ACOs) ajuizadas entre 05/10/1988 e 31/12/2019, totalizando 2.948 ações, para delimitar o conceito de conflito federativo construído pela Corte e como são solucionados os litígios diretos entre União e Estados. Tal estudo descreve a evolução jurisprudencial, identificando as partes e os temas que são potencialmente capazes de instaurar o denominado conflito federativo, comparando-a com os dados estatísticos coletados. Ao reduzir a análise dos dados tão somente às ações instauradas entre a União e os Estados, identificou-se que o conflito federativo reconhecido pelo STF é essencialmente um litígio fiscal, no qual se discute a redistribuição de recursos da União para os Estados. Por fim, ao constatar a elevada taxa de êxito dos Estados, foi possível demonstrar uma descentralização do federalismo provocada pela atuação do STF. Tal conclusão desafia o entendimento consolidado na doutrina federalista brasileira, o qual afirma haver uma tendência centralista na jurisprudência do STF, e introduz novas complexidades a serem analisadas a respeito do impacto da atuação do STF sobre o federalismo.
DISTINCT PHENOTYPE OF NON-ALCOHOLIC FATTY LIVER DISEASE IN PATIENTS WITH LOW LEVELS OF FREE COPPER AND OF CERULOPLASMIN
Authors: NUNES Vinicius S , ANDRADE Adriana R , GUEDES Ana L V , DINIZ Marcio A , OLIVEIRA Claudia P , CANÇADO Eduardo L R
Published: September 2020

ABSTRACT BACKGROUND: Copper deficiency has been linked to alterations in lipid metabolism and hepatic steatosis. Oxidative stress plays a role in the pathogenesis of non-alcoholic fatty liver disease (NAFLD). One of the enzymes that neutralize oxidative stress is Cu/Zn superoxide dismutase, which depends on the availability of adequate amounts of copper. OBJECTIVE: Correlate the levels of ceruloplasmin and of non-ceruloplasmin-bound copper (NCBC) with clinical, biochemical and histological parameters of non-alcoholic fatty liver disease (NAFLD) patients. METHODS: Data from 95 consecutively admitted NAFLD patients who underwent liver biopsy composed the groups based on ceruloplasmin levels lower than 25 mg/dL and on negative NCBC. The risk factors for NAFLD in each group were compared. RESULTS: Body mass index was lower in patients with ceruloplasmin <25 mg/dL (29.1±3.47 vs 32.8±6.24 kg/m2; P=0.005) as were the levels of LDL, HDL and total cholesterol, when compared with their counterparts with ceruloplasmin >25 mg/dL (101±38 vs 116±35 mg/dL, P=0.05; 43±9 vs 51±16 mg/dL, P=0.01; 174±43 vs 197±39 mg/dL, P=0.01, respectively). Mean serum ferritin levels were higher in the ceruloplasmin <25 mg/dL group (343±327 vs 197±190 ng/mL; P=0.02). Otherwise, patients with negative NCBC had higher HOMA-IR (8.2±14.7 vs 4.6±3.7; P=0.03). Age, gender, hypertension and diabetes showed no statistical difference. CONCLUSION: Patients with NAFLD had different clinical and biochemical markers according to the levels of NCBC and ceruloplasmin.
CAPACITY OF EXERCISE AND SURVIVAL IN PATIENTS WITH CIRRHOSIS WITH AND WITHOUT HEPATOPULMONARY SYNDROME AFTER LIVER TRANSPLANTATION
Authors: PEREIRA José Leonardo Faustini , GALANT Lucas Homercher , ROSA Luis Henrique Telles da , GARCIA Eduardo , BRANDÃO Ajácio Bandeira de Mello , MARRONI Cláudio Augusto
Published: September 2020

ABSTRACT BACKGROUND: Hepatopulmonary syndrome (HPS) is a complication associated with cirrhosis that may contribute to worsening exercise capacity and reduced survival after liver transplantation (LT). OBJECTIVE: To evaluate exercise capacity, complications and survival after LT in patients with cirrhosis and HPS and to compare these results with the results of patients with cirrhosis without HPS. METHODS: A prospective cohort study, consisting initially of 178 patients, of whom 90 underwent LT (42 with HPS and 48 without HPS). A previous evaluation consisted of the six-minute walk test (6MWT), an exercise test and manovacuometry. Those who underwent LT were evaluated for the mechanical ventilation time (MV), noninvasive ventilation (NIV) use, and survival two years after the procedure. In the statistical analysis, we used the Kolmogorov-Smirnov test, Student’s t-test, the linear association square test, and the Kaplan-Meier survival curve. The data were analyzed with the SPSS 16.00 program and considered significant at P<0.05. RESULTS: The HPS group demonstrated a lower peak of oxygen consumption (VO2peak) (14.2±2.3 vs 17.6±2.6) P<0.001 and a shorter distance walked on the 6MWT (340.8±50.9 vs 416.5±91.4) P<0.001 before LT compared with the non-HPS group. The transplanted patients with HPS remained longer hours in MV (19.5±4.3 vs 12.5±3.3) P=0.02, required more NIV (12 vs 2) P=0.01, and had lower survival two years after the procedure (P=0.01) compared with the transplanted patients without HPS. CONCLUSION: Patients with HPS had worse exercise capacity before LT, more complications and shorter survival after this procedure than patients without HPS.
ENDOSCOPIC PAPILLECTOMY FOR EARLY AMPULLARY NEOPLASTIC LESIONS - A CASE SERIES ANALYSIS
Authors: CATHCART JR Nelson Silveira , SOUZA Raquel Canzi Almada de , NODA Rafael William , TAGLIERI Eloy , ARDENGH José Celso , BONIN Eduardo Aimore
Published: September 2020

ABSTRACT BACKGROUND: Endoscopic papillectomy has been conceived as a less invasive therapeutic option for treatment of early neoplastic lesions located at the major duodenal papilla. OBJECTIVE: Evaluating patients with early ampullary lesions who underwent curative intent endoscopic papillectomy related to technical success (histopathological tumor margin assessment) and safety (adverse event rate). METHODS: A retrospective study including consecutive patients who underwent curative intent endoscopic papillectomy for demographic, histopathological and pre-/post-procedural clinical assessment. Endpoints were technical success (histopathological residual tumor assessment) and adverse events rates. RESULTS: A total of 21 medical records patients with a female predominance (13 cases, 61.9%) were included. The tumor was incidental in 8 (38%) cases. Negative residual tumor resection margin rate was 72% (15 cases); three of these cases confirmed high-grade dysplasia in the resected specimen, and six cases were invasive neoplasia. Tumoral recurrence was seen in two cases, and median follow-up time was 12 months, with a 23% loss rate (five patients). Six (28.5%) patients had adverse events, all of them early (bleeding and pancreatitis); none of them required surgical intervention and there was no mortality. CONCLUSION: Endoscopic papillectomy allowed for technical successful procedure with complete removal of ampullary neoplastic lesions in the majority of cases with acceptable adverse event rates. Recurrence rate should be carefully assessed in further studies. There was a recent increase in the number of procedures. There was also a low correlation between pre- and post-histopathological assessment regarding the presence of invasive carcinoma and adenoma with high grade dysplasia, with a predominance of superficial neoplastic adenomatous lesions.
DIAGNOSTIC ACCURACY OF ONE SAMPLE OR TWO SAMPLES QUANTITATIVE FECAL IMMUNOCHEMICAL TESTS FOR INTESTINAL NEOPLASIA DETECTION
Authors: MATTAR Rejane , MARQUES Sergio Barbosa , MINATA Maurício Kazuyoshi , SILVA-ETTO Joyce Matie Kinoshita da , SAKAI Paulo , DE MOURA Eduardo Guimarães Hourneaux
Published: September 2020

ABSTRACT BACKGROUND: Rectal bleeding is the most important symptom of intestinal neoplasia; thus, tests of occult blood detection in stools are widely used for pre neoplastic lesions and colorectal cancer (CRC) screening. OBJECTIVE: Evaluate the accuracy of OC-Sensor quantitative test (Eiken Chemical, Tokyo, Japan) at cut-off 10 µg Hb/g feces (50 ng/mL) in a cohort of subjects that had to undergo diagnostic colonoscopy, and if more than one sample collected in consecutive days would improve the diagnostic accuracy of the test. METHODS: Patients (mean age 56.3±9.7 years) that underwent colonoscopy prospectively randomly received one (1-sample FIT, FIT 1) or two (2-sample FIT, FIT 2) collection tubes. They collected the stool sample before starting colonoscopy preparation. Samples were analyzed by the OC-Auto Micro 80 (Eiken Chemical, Tokyo, Japan). The performance of FIT 1 and FIT 2 were compared to the colonoscopy findings. RESULTS: Among 289 patients, CRC was diagnosed in 14 (4.8%), advanced adenoma in 37 (12.8%), early adenoma in 71 (24.6%) and no abnormalities in 141 (48.8%). For FIT 1, the sensitivity for CRC was 83.3% (95%CI 36.5-99.1%), for advanced adenoma was 24% (95%CI 10.1-45.5%), with specificity of 86.9% (95%CI 77.3-92.9%). For FIT 2, the sensitivity for CRC was 75% (95%CI 35.6-95.5%), for advanced adenoma was 50% (95%CI 22.3-77.7%), with specificity of 92.9% (95%CI 82.2-97.7%). The positive likelihood ratios were 1.8 (95%CI 0.7-4.4 for FIT 1) and 7.1 (95%CI 2.4-21.4 for FIT 2) for advanced adenoma, and 6.4 (95%CI 3.3-12.3, for FIT 1) and 10.7 (95%CI 3.8-29.8, for FIT 2) for CRC. The negative likelihood ratio were 0.9 (95%CI 0.7-1, for FIT 1) and 0.5 (95%CI 0.3-0.9, for FIT 2) for advanced adenoma, and 0.2 (0.03-1.1, for FIT 1) and 0.3 (0.08-0.9, for FIT 2) for CRC. The differences between FIT 1 and FIT 2 performances were not significant. However, the comparison of the levels of hemoglobin in feces of patients of FIT 1 and FIT 2 showed that the differences between no polyp group and advanced adenoma and CRC were significant. CONCLUSION: The accuracy of OCR Sensor with 10 µg Hb/g feces cut-off was comparable to other reports and two-sample collection improved the detection rate of advanced adenoma, a pre neoplastic condition to prevent CRC incidence.
Fibroblast Growth Factor Receptor (FGFR) Inhibitors in Urothelial Cancer
Authors: Garje Rohan , An Josiah , Obeidat Mohammad , Kumar Kranthi , Yasin Hesham A. , Zakharia Yousef
Published: September 2020

Dysregulated fibroblast growth factor receptor (FGFR) signaling is associated with several cancers, including urothelial carcinoma. Preclinical studies with FGFR inhibitors have shown significant antitumor activity, which has led to clinical evaluation of multiple FGFR inhibitors. Recently, erdafitinib was approved by the U.S. Food and Drug Administration for advanced urothelial carcinoma with FGFR gene alterations as the first molecularly targeted therapy. Additional ongoing clinical trials with other types of FGFR inhibitors have shown encouraging results. This review summarizes the oncogenic signaling of FGFR alterations, completed and ongoing clinical trials of FGFR inhibitors, and resistance patterns.

Implications for Practice

Dysregulated fibroblast growth factor receptor (FGFR) signaling is associated with several cancers, including urothelial carcinoma. Preclinical studies with FGFR inhibitors have shown significant antitumor activity, which has led to clinical evaluation of multiple FGFR inhibitors. Most recently, erdafitinib was approved by the U.S. Food and Drug Administration for advanced urothelial carcinoma with FGFR gene alterations as the first molecularly targeted therapy. Additional ongoing clinical trials with other types of FGFR inhibitors have shown encouraging results. This review summarizes the oncogenic signaling of FGFR alterations, completed and ongoing clinical trials of FGFR inhibitors, and resistance patterns.
Patients’ Understanding of Oncology Clinical Endpoints: Environmental Scan and Focus Groups
Authors: Sullivan Helen W. , O'Donoghue Amie C. , Ferriola-Bruckenstein Kate , Tzeng Janice P. , Boudewyns Vanessa
Published: September 2020

Background

Understanding treatment options is important for patients with cancer and their caregivers. This may be difficult, however, because oncology treatments are often approved based on complex clinical endpoints. The study aimed to explore lay understanding of oncology clinical endpoints by assessing the definitions of clinical endpoints available online and gathering qualitative focus group data on cancer survivors’ and the general public's understanding of clinical endpoints.

Methods

We conducted an environmental scan to find Web sites accessible by a general audience that defined three clinical endpoints: overall survival, progression-free survival, and response rate. Next, we conducted a series of eight focus groups across the U.S. with cancer survivors (n = 36) and general population adults (n = 36).

Results

We found several online resources defining each endpoint; however, many of the definitions we identified used technical language that may not be easily understood by patients and caregivers. Few focus group participants were familiar with the technical terms for these endpoints. When presented with the endpoint terms and definitions, participants had misconceptions about treatment efficacy. Specifically, they tended to expect that all endpoints were a variation on living longer.

Conclusion

The results point to the need for more patient-friendly definitions of clinical endpoints developed with input from the general public and from patients with cancer.

Implications for Practice

As the number of oncology prescription drug approvals and the advertising of those drugs to consumers increase, it is timely and critical to understand how to discuss treatment benefits with patients. Patient-friendly definitions of common clinical endpoints, such as overall survival and progression-free survival, would help health care providers describe treatment benefits to patients. This research provides evidence regarding patients’ understanding of these endpoints and suggests definitions for additional research. This represents a first step in creating evidence-based patient-friendly language to describe clinical endpoints.
Approach to the Patient with COVID-19-Associated Thrombosis: A Case-Based Review
Authors: Chen Evan C. , Zon Rebecca L. , Battinelli Elisabeth M. , Connors Jean M.
Published: September 2020

Coronavirus disease 2019 (COVID-19) is a current global pandemic caused by the novel coronavirus SARS-CoV-2. Alongside its potential to cause severe respiratory illness, studies have reported a distinct COVID-19-associated coagulopathy that is characterized by elevated D-dimer levels, hyperfibrinogenemia, mild thrombocytopenia, and slight prolongation of the prothrombin time. Studies have also reported increased rates of thromboembolism in patients with COVID-19, but variations in study methodologies, patient populations, and anticoagulation strategies make it challenging to distill implications for clinical practice. Here, we present a practical review of current literature and uses a case-based format to discuss the diagnostic approach and management of COVID-19-associated coagulopathy.
Municipal solid waste management under Covid-19: challenges and recommendations
Authors: Vaverková Magdalena Daria , Paleologos Evan K , Dominijanni Andrea , Koda Eugeniusz , Tang Chao-Sheng , Małgorzata Wdowska , Li Qi , Guarena Nicolò , Mohamed Abdel-Mohsen O , Vieira Castorina S , Manassero Mario , O’Kelly Brendan C , Xie Qifeng , Bo Myint Win , Adamcová Dana , Podlasek Anna , Anand Uday M , Mohammad Arif , Goli Venkata Siva Naga Sai , Kuntikana Ganaraj , Palmeira Ennio M , Pathak Shalu , Singh Devendra Narain
Published: September 2020

Covid-19 is proving to be an unprecedented disaster for human health, social contacts and the economy worldwide. It is evident that SARS-CoV-2 may spread through municipal solid waste (MSW), if collected, bagged, handled, transported or disposed of inappropriately. Under the stress placed by the current pandemic on the sanitary performance across all MSW management (MSWM) chains, this industry needs to re-examine its infrastructure resilience with respect to all processes, from waste identification, classification, collection, separation, storage, transportation, recycling, treatment and disposal. The current paper provides an overview of the severe challenges placed by Covid-19 onto MSW systems, highlighting the essential role of waste management in public health protection during the ongoing pandemic. It also discusses the measures issued by various international organisations and countries for the protection of MSWM employees (MSWEs), identifying gaps, especially for developing countries, where personal protection equipment and clear guidelines to MSWEs may not have been provided, and the general public may not be well informed. In countries with high recycling rates of MSW, the need to protect MSWEs’ health has affected the supply stream of the recycling industry. The article concludes with recommendations for the MSW industry operating under public health crisis conditions.
Factors influencing the selection of a procurement route for UK off-site housebuilding
Authors: Agapiou Andrew
Published: September 2020

While there is a plethora of research into the perceived benefits of off-site construction systems and the barriers towards their adoption, there has been very little discussion of the procurement route selection factors for off-site residential projects in the UK Midlands region. This study sought to identify the factors that influence the selection of a procurement method for off-site housebuilding projects in the Midlands. The aim of the paper was to identify the critical factors influencing the procurement selection for off-site housebuilding developments through a survey of 157 construction professionals and housing developers using the relative importance index as a basis for analysis. A comparison between the most highly ranked factors for off-site manufacturing and those presented in the literature indicates that practitioners’ perceptions are largely aligned with those of traditional construction processes. The higher constructability of design and environmental sustainability have been shown to have a greater influence on the selection of the most appropriate procurement route for off-site housebuilding as compared to those applicable to traditional construction. The research findings can also help practitioners to develop a wider and deeper perspective of the criteria for selecting the appropriate procurement method for off-site residential projects at a regional level.
Can neutrophil-lymphocyte ratio and platelet-lymphocyte ratio be related with skeletal mass area in COPD patients with acute exacerbation?
Authors: YURT Sibel , TUNA Lale , ÇINARKA Halit , TOPTAŞ Mehmet , KARAPINAR Kemal , KIRKIL Gamze
Published: September 2020

Introduction:This study was designed to assess whether there is a relation between inflammatory biomarkers such as NLR, PLR and psoas muscle area (PMA) as a marker of sarcopenia in COPD pateints who admitted to the emergency department of our clinic. Method: Retrospectivly one hundred forty three COPD patients who had CT scan for any reason during hospital admission were included. Patient characteristics and clinical and laboratory data were evaluated retrospectively. Results:In our study, we performed the correlations between NLR, PLR and CRP, FEV1, FVC, FEV1/FVC, right PMA, left PMA, total PMA. NLR and PLR were positively correlated with CRP (r=0.60, p
O Uso do Drone de Baixo Custo em Aerofotogrametria e sua Aplicação na Perícia Ambiental Criminal
Authors: Cotomácio André Carrara , De Lima Bruno Lazzari
Published: September 2020

O presente estudo tem o objetivo evidenciar a possibilidade da obtenção de elementos técnicos de aplicação pericial com o uso da tecnologia de aquisição de imagens por meio de veículos aéreos não tripulados, a fim de se produzir relevante prova material por meio do laudo pericial criminal. Para tanto, foi utilizada uma aeronave remotamente pilotada (ARP), popularmente conhecida como drone, de baixo custo de aquisição, oportunizando a produção de um ortomosaico mediante processamento digital. Os resultados obtidos possibilitaram a caracterização da supressão de vegetação decorrente do parcelamento irregular do solo, sendo posteriormente discutidas as necessidades e limitações do uso de aeronaves de baixo custo para fotogrametria.
Cognitive adaptation of pre-service mathematics teachers in construction and reconstruction of quadrilateral relations
Authors: MUBARİK Mubarik , BUDİARTO Mega , SULAİMAN Raden
Published: September 2020

This is qualitative research aimed at exploring cognitive adaptation in the construction and reconstruction of quadrilateral relations. The participants were chosen using the Quadrilateral Relations Construction Test given to 20 pre-service mathematics teachers. Based on the test results, 4 types of quadrilateral relations are obtained, namely type 1, type 2, type 3, and type 4. Next, 1 pre-service mathematics teachers with type 1 (P1) and 1 pre-service mathematics teachers with type 2 (P2) are chosen as participants. Next, participants were given a Quadrilateral Relations Reconstruction Test then an in-depth interview was conducted. The data in this study were analyzed through data condensation, data display, and conclusion drawing. This result illustrated that having a scheme is not enough to successfully solve problems. One of the important factors that determine the success of problem solving is the success of cognitive adaptation process. Cognitive adaptation in the process of construction and reconstruction quadrilateral relations takes place through assimilation and accommodation. When the information obtained is in accordance with the scheme that is owned, the cognitive adaptation that occurs is called assimilation. Meanwhile, when the information obtained is not in accordance with the scheme owned, the adaptation that occurs is called accommodation. Thus, pre-service mathematics teachers must be trained to make cognitive adaptations in problem solving process.
Cross-Scale Linkages of Centralized Electricity Generation: Geothermal Development and Investor–Community Relations in Kenya
Authors: Klagge Britta , Greiner Clemens , Greven David , Nweke-Eze Chigozie
Published: September 2020

Based on a study of Kenya’s geothermal-energy development in Baringo-Silali, we explore how and with whom government actors and local communities in rural and peripheral areas interact when planning and implementing large-scale power plants. Starting from a comparison of decentralized and centralized energy systems, we demonstrate that the development of this large-scale infrastructure project and the associated investor-community relations are governed by various cross-scale linkages. To this end, we adapt the concept of cross-scale linkages from the literature on natural-resource governance to explore actors, rules, and practices at local, regional, national, and international levels.
Politics and (Self)-Organisation of Electricity System Transitions in a Global North–South Perspective
Authors: Rothfuß Eberhard , Boamah Festus
Published: September 2020

Dominant electricity systems are inevitably transitioning into new forms in terms of power generation mix, mode of energy system governance and vested interests, the extent of state and consumer/citizen participation in the energy system, and energy justice expectations in different geographies in the Global North and Global South. In this editorial to the thematic issue entitled Politics and (Self-)Organisation of Electricity System Transitions in a Global North–South Perspective, we discuss politics and (self)-organisation of (just) energy transitions to expose how messy, convoluted, and fluid future electricity system transitions can be in both the Global North and Global South.
COURT FEES RELATED TO THE COURT ORDER FOR THE COMPETENT AUTHORITIES OF FOREIGN STATES
Authors: Korotenko T.
Published: September 2020

The article explores the court fees related to the execution of court orders, which are addressed to the competent authorities of foreign states in civil cases with a foreign element. The Civil Procedure Code of Ukraine does not state that the costs associated with the execution of court orders, addressed to the competent authorities of foreign states, are court fees. Therefore, the questions on which of the above fees can be attributed to the courts fees and the procedure for their reimbursement are raised. The importance of clarifying these issues requires the application of the uniform approaches to such cases consideration in Ukrainian courts. It is determined as the main purpose of this article. The case-law shows that in most cases where a court needs to apply to a competent authority of a foreign state, the person concerned must pay for the certified translation of the statement of claim and the attached documents into the official language of the requested state and pay for service of documents. In our conclusions, we propose to divide the court fees associated with the execution of court orders addressed to the competent authorities of foreign states, depending on the procedural actions that are being carried out, and to include the fees associated with the execution of court orders addressed to the competent authorities of foreign states, to the fees associated with the case, namely to the fees associated with other procedural acts necessary to the case consideration or to prepare for its consideration, which will ensure the right of the interested party to reimburse such fees in future.
THE RIGHT TO HUMAN DIGNITY IN THE SYSTEM OF CONSTITUTIONAL RIGHTS OF UKRAINE AND GERMANY
Authors: Kosilova O.
Published: September 2020

The article analyzes human dignity as a legal category and fundamental natural human right. The place and role of the right to human dignity in the system of constitutional rights of Ukraine and Germany are compared. The scientific substantiation of the right to human dignity in Ukraine and Germany, its normative protection in both countries, is investigated. The approaches to defining and interpreting the right to human dignity in the practice of the Constitutional Court of Ukraine and the Federal Constitutional Court of Germany are compared.

The relationship between the right to human dignity and other human rights is determined, as well as the sphere of protection of this right. In particular, there are parallels between the right to life and the right to human dignity, and their relationship is determined. It is substantiated that the human life and dignity of each person enjoy the same constitutional protection regardless of the duration of the individual's physical existence.

It is established that among Ukrainian scholars there is no unified view of the right to dignity as a fundamental natural right. The right to human dignity in Ukraine is enshrined in the norms of constitutional, civil and criminal law. For the most part, the protection of the right to human dignity is correlated with the right to the protection of honour and goodwill. The right to human dignity and honour are not clearly distinguished. The legisla- tion of Ukraine does not contain a legal norm defining the concept of the right to human dignity. The case-law of the Constitutional Court of Ukraine in this area is not sufficiently developed and does not constitute a proper legal framework.

In Germany, the right to human dignity is a decisive and fundamental human right that is fundamental to all other rights. Human dignity is the supreme fundamental value and the root of all fundamental rights. The right to human dignity enshrined in Article 1 of the Constitution of the Fed- eral Republic of Germany defines it as an absolute value, which means that it cannot be restricted by any other norm, even by another fundamental right that follows from human dignity.
Journey to Ancestry: Reclaiming of Identity and Home in Toni Morrison’s Song of Solomon
Authors: Kakoti Jiban Jyoti
Published: September 2020

Journeys play a vital role in the lives of African Americans insofar as their quest for home in America is concerned. These journeys substantially contribute to their understanding of the impact of slavery and racism on themselves and their ancestors without which they are not in a position to materialize their dream for a viable home and identity. ‘Memory’ and ‘re-memory help them to evoke traumas that their ancestors had undergone and compare the same with their firsthand traumas in the present. These journeys thus enable them to get matured and knowledgeable so that they can adapt themselves to the new condition. The paper is an attempt to explore in a better way Toni Morrison’s representation of pain and pleasure of such journeys in her novel Song of Solomon, which enable her black characters to reconstruct their identities and regain self-esteem so that they find themselves in a position to make home possible.
ŞEBEKEYE BAĞLI FOTOVOLTAİK ÇATI SİSTEMİNİN KARŞILAŞTIRMALI PERFORMANS ANALİZİ
Authors: ÖZCAN Özge , İZGİ Ercan
Published: September 2020

Son zamanlarda, ülkedeki yüksek güneş enerji potansiyeli, ilerleyen ve gelişen fotovoltaik (PV) teknolojiler sayesinde, güneş enerjisi en cazip yenilenebilir enerji kaynağı olmaktadır. Her bir teknolojinin, verimde, fiyatta ve kullanılan malzemede yarattığı farklılıklardan dolayı çeşitli PV üreten sistemler vardır. Bu çalışmanın amacı Bursa’nın Osmangazi ilçesinde 1 MW şebekeye bağlı, mono-kristal, poli-kristal ve ince film üç fotovoltaik sistemin performans analizini sunmaktır. İlk olarak, fotovoltaik sistemin ayrıntılı gölge çalışması yapılarak, PV kurulumu için uygunluğu incelenmiştir. Gölge çalışması Google Sketchup ve PVsyst programları kullanılarak gerçekleştirilmiştir ve daha sonra üç PV teknolojisinin performansını simüle etmek, modellemek ve tahmin etmek için PVsyst ve PV*SOL programları kullanılmıştır. Performans değerlendirmesi için kullanılan parametreler dizi verimi, nihai verim, PV verimi ve performans oranı gibi faktörlerdir. Elde edilen performans analizi sonuçlarına göre, sırasıyla mono-kristal silikon, poli-kristal silikon ve ince film (CIS) sistemlerinin, yılda 1416 MWh 1202 MWh ve 1150 MWh elektrik üreteceği ön görülmüştür. Yıllık ortalama performans oranı, mono-kristal panel için %85, poli-kristal panel için %72.1 ve ince film için %70’dir. Sonuçlar, yıllık enerji üretimi poli-kristalden ve ince filmden daha yüksek olduğu için mono-kristalin performans oranı açısından daha iyi bir seçim olduğunu göstermektedir. Çalışmanın son aşamasında Türkıye’deki farklı iklim koşulları altında, mono-kristal fotovoltaik teknolojisi kullanılarak performans değerlendirilmesi yapılmıştır. Analizler sonucunda yüksek güneş radyasyon değerine sahip Antalya ili 1806 MWh PV enerji üretimiyle iyi performans gösterdiği anlaşılmıştır.
METHOD FOR DISTRIBUTION OF MICROBES FROM UTERINE CAVITY
Authors: Sadovsky P. T.
Published: September 2020

Recently, there has been a desire to trace the genital canal from a bacteriological point of view in both healthy and sick women; successively, studies of the vagina, cervical canal and uterine cavity were made, but the final results of these works did not prove the fate and ways of further spreading of the microbes found. In view of this, we were offered prof. Slavyansky to deal with this issue experimentally, namely: injecting pure cultures of pyogenic microbes into the uterine cavity of animals.
On the issue of ectopic pregnancy
Authors: Zabolotskiy A.
Published: September 2020

The variety of views on the diagnosis and treatment of ectopic pregnancy and the need to collect and process casuistic material in order to establish accurate recognition and indicate the best treatment methods in this way prompted the author to report the case he observed. But before the message, its author gives a short historical essay, in which he sets out the views of authors of different periods on ectopic pregnancy, briefly gives statistics on the frequency of ectopic pregnancy and the views of the authors on its etiology: blockage of the fallopian tubes (Fritsch, Virchow, Hecker) caused by inflammation, kinks and fixations, false membranes; postpartum diseases of the peritoneum, plaque in the tube (Leopold, Beck, Wyder), preventing the entry of the egg into the uterus; intramural uterine fibroids (Olshausen, Roth von Macdonald), which apparently prevented the entry of eggs into it; purulent diseases, probably (Martin), affect either the loss of the ciliary epithelium, which slows down the movement of the egg, or the infiltration of the walls, which reduces the lumen of the tube; short-term swelling of the mucous membrane of the tube, the lower position of the peritoneal end compared to the uterine end (Pallen Freund); underdeveloped (infantile) pipes with their bends, etc.
About castration in osteomalacia
Authors: Rutkovskiy A.
Published: September 2020

Osteomalacia is mainly reduced to changes in the bones - they lose their mineral substances and along with this, abrupt changes occur in the organic structure of bones and in the bone marrow - and the bone and bone marrow soften. Along with this, degenerative changes occur in the muscular system. The clinical picture is first expressed by pain in different parts of the skeleton, early fatigue, increased reflexes; then, with strong development, bone curvature, persistent catarrh of the respiratory and digestive tract; patients die with symptoms of insanity. The disease lasts from 1 to 10 years and affects mainly women who have already given birth. Neither poverty nor prolonged feeding seems to matter.
A rare case of a vesicovaginal fistula in its etiology
Authors: Pekarskaya A.
Published: September 2020

A 32-year-old healthy woman of regular build was admitted to the Marburg clinic with a vesicovaginal fistula.
A educación das mulleres no século XIX
Authors: De Gabriel Fernández Narciso
Published: September 2020

As mulleres quedaron excluídas inicialmente do sistema de instrución pública ideado polo liberalismo español. A exclusión inicial dará paso a unha inclusión parcial, orientada a formar as nenas para o desempeño das funcións de esposa e de nai. Os debates que se produciron en 1859 no Ateneo da Coruña e en 1892 no Congreso Pedagóxico Hispano-Portugués-Americano poñen de manifesto a hexemonía dun modelo educativo que pretendía consolidar o status de dependencia do sexo feminino. Pero nun e noutro escenario tamén se ouviron voces, como as de Antonio García Fuertes, Concepción Arenal e Emilia Pardo Bazán, que reclamaban con máis ou menos radicalidade unha educación para a autonomía. A figura de Rosalía de Castro, pola súa parte, constitúe un bo exemplo dos atrancos aos que se tiveron que enfrontar as mulleres que decidían converterse en escritoras.