bluuebunny/crossref_metadata_2025 huggingface dataset:
Articulación de los sistemas de justicia transicional en Colombia: la paz, la alternatividad penal y las víctimas como ejes fundamentales
Authors: Rúa Delgado Carlos Felipe
Published: April 2021

El nacimiento e implementación del Sistema Integral de Verdad, Justicia, Reparación y No Repetición dio como resultado el segundo sistema de materialización de justicia transicional en Colombia; el primero fue el Sistema de Justicia y Paz creado mediante la Ley 975 de 2005, en virtud de los Acuerdos de Ralito. Respecto a este último, se encuentran una serie de errores y dificultades que el mismo Estado pretendió subsanar con la expedición de la Ley 1448 de 2011, la cual implicó una resignificación del rol de las víctimas y, por otro lado, la inclusión de criterios de priorización y selección de juzgamiento a través de la Ley 1592 de 2012. Ante ello, el segundo de los sistemas pretendió no cometer los mismos errores acogiéndose a los preceptos señalados por la Corte Constitucional y la doctrina. No obstante, para comprender estos sistemas transicionales en Colombia, se hace necesario revisar el concepto mismo de la justicia transicional, y sus principios fundamentales como paz y justicia, así como las posibilidades de esta. Por lo anterior, en el presente artículo se pretende tanto describir como analizar la concepción bajo los que fueron estructurados los sistemas de justicia transicional y las instituciones y funcionamiento de cada uno propiamente dicho.
Geografia e arquitetura institucional da cooperacão ambiental brasileira na América do Sul
Authors: Pozzatti Ademar , Jorgielewicz Rogovschi Henrique
Published: April 2021

A partir das lentes da joint discipline que transpassa categorias de análise das disciplinas do Direito Internacional e das Relações Internacionais, a presente pesquisa radiografa a geografia e a arquitetura institucional da cooperação ambiental brasileira na América do Sul. Para radiografar a geografia, a pesquisa indaga onde esta cooperação está localizada, o que ela estabelece e quais são os atores cujos interesses a envolvem. Ao investigar a arquitetura, foca-se em entender como ela operacionaliza o seu conteúdo normativo, o que envolve compreender o papel do direito internacional em operar políticas públicas ambientais transversais a diversos Estados. A exploração documental analisa os regimes bilaterais na matéria, e, através de levantamento, sugere que esta cooperação é descentralizada e difusa, ao mesmo tempo que inova no seu modus operandi.
Ketones as Electrophile in Nitroaldol Reaction: Synthesis of β,β-Disubstituted- 1,3‑dinitroalkanes and Allylic Nitro Compounds
Authors: Gomes Alex , de Souza Douglas , Costa Jeronimo , Pereira Vera Lúcia
Published: April 2021

β,β-Disubstituted-1,3-dinitro compounds were obtained exclusively with an overall yield of 83% through a domino nitroaldol/elimination/1,4-addition process, when excess nitromethane was added to cyclohexanone or butanone using DBU (1,8-diazabicyclo[5.4.0]undec-7-ene), as a basic catalyst. On the other hand, β-nitroalcohols could be obtained in 30-84% yield, when nitromethane reacts with different aliphatic ketones in stoichiometric amounts, in the presence of catalytic amounts of K2CO3(s), Amberlyst®-A21 or TBAF.3H2O (tetra-n-butylammonium fluoride trihydrate)/THF (tetrahydrofuran). In addition, a new and versatile route to obtainment of allylic nitro compounds, by treatment of acetylated nitroalcohols and aldehydes in catalytic amounts of DBU or TBAF.3H2O, via a one-pot elimination/nitroaldol reaction sequence, was developed.
OUTSOURCING SERVICES TO SUPPORT THE ORGANIZATION'S TENDERING ACTIVITIES
Authors: Panfilova Elena Evgenevna
Published: April 2021

The article discusses issues related to the support of trading on electronic platforms by external intermediary companies. A list of key services in demand then protecting the interests of the organization within the framework of the public procurement system has been determined. The specifics of obtaining a bank guarantee against the security of a contract have been identified.
Novel Design Proposal for the Seismic Retrofit of Existing Buildings with Hybrid Steel Exoskeletons and Base Sliding Devices
Authors: Sancin Ljuba , Bedon Chiara , Amadio Claudio
Published: April 2021

Background:

Existing Reinforced Concrete (RC) structures and brittle buildings are often exposed to seismic events that may have significant resistance and displacement demand compared to their actual capacity. Accordingly, an optimal retrofit intervention can ensure enhanced and safe structural performances for them. Among the techniques that have been addressed for the retrofit of existing RC frames, steel exoskeletons can notoriously improve the seismic performance of existing buildings due to their input stiffness, ductility and resistance. In this paper, the attention is focused on the interaction of steel exoskeletons with RC frames and the consequent details to achieve a more effective design of the retrofit intervention.

Objective:

Based on parametric calculations, a new hybrid design concept that takes advantage of traditional steel exoskeletons with additional base sliding devices (at the foundation level of the RC frame to retrofit) is addressed in this paper.

Methods:

As shown through SDOF and 2D-MDOF calculations, the definition of the optimal operational conditions (and thus mechanical configurations) for the so-assembled hybrid solution can maximize the potential of the retrofit intervention, with marked benefits in terms of ductility, resistance, and overall efficiency, ensuring very low damage in the existing building.

Results:

Given that the used base sliders are bidirectional, it is expected that the proposed solution could be efficiently extended to 3D structures, once the exoskeleton systems are optimally designed along the two principal directions of the hybrid structure to retrofit.

Conclusion:

The potential of the hybrid approach is shown based on parametric analyses. Furthermore, general design recommendations are proposed for the hybrid solution.
Self-Reported Symptoms in a Cohort of Rheumatoid Arthritis and Systemic Lupus Erythematosus during the COVID-19 Quarantine Period
Authors: Salido Evelyn O. , Tee Cherica A. , Reyes Patrick W. C. , Reyes Heizel B. M. , Zamora Geraldine T. , Tee Michael L.
Published: April 2021

Background:

During the first three months of the COVID-19 pandemic in the Philippines, there was a supply shortage of hydroxychloroquine and methotrexate. Limited access to medication and the life changes resulting from the COVID-19 pandemic may predispose patients with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE) to disease flares.

Objective:

This study aimed to investigate self-reported symptoms of disease flares among patients with rheumatoid arthritis or systemic lupus erythematosus during the COVID-19 pandemic.

Methods:

A total of 512 completed online surveys from patients with SLE or RA were collected. The data included sociodemographic characteristics, self-reported physical symptoms, health service utilization, and availability of hydroxychloroquine and methotrexate.

Results:

Seventy-nine percent of respondents had lupus, while 21% had RA. One-third of the cohort had contact with their attending physician during the two-month quarantine period prior to the survey. Eighty-two percent were prescribed hydroxychloroquine and 23.4% were prescribed methotrexate; but 68.6% and 65%, respectively, had “irregular” intake of these medicines due to unavailability. The current health status was reported as good by 66.2%; 24% had no symptoms during the two-week period prior to the survey. The most common symptoms experienced were joint pain (51%), muscle pain (35%), headache (26.8%), and skin rash (19.1%). Five percent had a combination of these four most common symptoms. Irregular supply of hydroxychloroquine among patients with SLE (n=323) was associated with more frequent occurrence of muscle pain (40.6% vs 27.9%, p=0.03) or rash (27.4% vs 11.7%, p<0.001). Irregular supply of methotrexate among RA patients prescribed hydroxychloroquine and methotrexate (n=36) was associated with more frequent occurrence of joint pains with or without swelling (73.9% vs 38.5%, p=0.04). Irregular supply of hydroxychloroquine was associated with less frequent occurrence of dizziness (0 vs 66.7%, p<0.001) among RA patients (n=18).

Conclusion:

In our cohort of RA and SLE, the majority reported at least one symptom that may indicate disease flare. There was a significant association between the irregular supply of hydroxychloroquine or methotrexate with the presence of muscle pain, rash, or joint pains during the 14-day period prior to the survey.
Long-Term Visual, Refractive and Topographic Outcomes of KeraRings Combined with Accelerated Transepithelial Crosslinking for Management of Different Grades of Progressive Keratoconus: A Retrospective Cohort Study
Authors: Iqbal Mohammed , Mounir Amr , Abd-Elaziz Khaled , Said Omar M.
Published: April 2021

Purpose:

To evaluate long-term visual, refractive, and topographic outcomes of KeraRings intrastromal implantation combined with accelerated transepithelial cross-linking for management of different stages of progressive keratoconus.

Materials and Methods:

This retrospective cohort study included 70 eyes of 70 patients with Amsler-Krumeich grades 1 to 4 keratoconus. They were divided into two groups: group-A included 37 eyes with grades 1-2 keratoconus, and group-B included 33 eyes with grades 3-4 keratoconus. Both groups underwent combined Keraring implantation with TCXL treatment. The main outcome measures included the preoperative and postoperative visual acuity, refraction, keratometry readings, and pachymetry.

Results:

At postoperative month 60, group-B exhibited significantly higher values of all mean uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), sphere/cylinder/spherical equivalent/defocus equivalent (DEQ), and K1/K2/Kaverages/Kmax parameters compared to that of group A. However, group-A exhibited better stability of postoperative improvements. Keratoconus progression (KCP) was greater in group-B (45.5%) than group-A (10.8%). Two eyes revealed segments' migration while one eye showed tunnel vascularization and opacification with segments' migration.

Conclusion:

The diagnostic criteria of preoperative-KCP are not adequate for the diagnosis of postoperative-KCP following ICRS implantation. UDVA and K average posterior seemed to be more sensitive parameters than K max in documenting early postoperative-KCP. We suggest that deterioration of UDVA≥0.10 log MAR and/or K average posterior ≥0.25 D are highly suspicious of post-ring implantation keratoconus progression (PR-KCP). The occurrence of two of the following parameters: Kmax≥0.50 D, Kaverageanterior≥0.50 D, K average posterior ≥0.25 D, or pachymetry≥1.5% thinning, is diagnostic of PR-KCP. The occurrence of two or more of the following parameters: Kmax≥0.50 D, Kaverageanterior≥0.50 D, Kaverageposterior ≥0.25 D, pachymetry≥ 1.5% thinning or UDVA≥0.10 logMAR, is diagnostic of PR-KCP. We also suggest that Kmax≥0.75 D alone is diagnostic of PR-KCP.
Level Penggunaan Aspergillus Oryzae pada Fermentasi Kulit Ubi Kayu (Manihot Utilissima) Terhadap Kandungan HCN, TDN dan pH
Authors: Putri Grapevin Riviesa Azaela , Chuzaemi Siti
Published: April 2021

Tujuan dari penelitian ini adalah untuk mengetahui dan mengevaluasi pengaruh level penggunaan Aspergillus oryzae pada fermentasi kulit ubi kayu (Manihot utilissima) terhadap nilai kandungan HCN, TDN dan pH. Metode penelitian menggunakan Rancangan Acak Lengkap (RAL) dengan 4 perlakuan yang diulang 3 kali. Perlakuan terdiri dari P0 (kulit ubi kayu + Aspergillus oryzae 0% difermentasi 96 jam), P1 (kulit ubi kayu + Aspergillus oryzae 1% difermentasi 96 jam), P2 (kulit ubi kayu + Aspergillus oryzae 2% difermentasi 96 jam), dan P3 (kulit ubi kayu + Aspergillus oryzae 3% difermentasi 96 jam). Variabel yang diukur adalah kandungan HCN, TDN dan pH. Hasil penelitian menunjukkan bahwa level penggunaan konsentrasi Aspergillus oryzae memberikan memberikan pengaruh sangat berbeda nyata (P<0,01) terhadap HCN, TDN dan pH. Perlakuan terbaik didapatkan pada perlakuan P3 (kulit ubi kayu + Aspergillus oryzae 3% difermentasi 96 jam) dengan nilai HCN 55,82 mg/kg, TDN 72,92% dan pH 5,23. Kesimpulan dari penelitian ini adalah fermentasi kulit ubi kayu menggunakan konsentrasi Aspergillus oryzae 3% yang difermentasi selama 96 jam merupakan perlakuan terbaik untuk nilai pH dan meningkatkan nilai TDN serta menurunkan nilai HCN.
Challenges in the PFAS Remediation of Soil and Landfill Leachate: A Review
Authors:   Ragn Sells Treatment & Detox AB, Box 952, 191 29 Sollentuna, Sweden, Travar Igor , Uwayezu Jean Noel ,   Luleå University of Technology, Geosciences and Environmental Engineering, 971 87 Luleå, Sweden, Kumpiene Jurate ,   Luleå University of Technology, Geosciences and Environmental Engineering, 971 87 Luleå, Sweden, Yeung Leo W.Y. ,   Örebro University, School of Science and Technology, SE-701 82 Örebro, Sweden
Published: April 2021

The use of per-and poly-fluoroalkyl substances (PFAS) has resulted in the contamination of different environmental matrices. In EU countries, the sites contaminated with PFAS are usually remediated by excavating the soil and disposing of it in a landfill, as no in-situ or on-site techniques capable of treating large quantities of soil cost-effectively have been developed. Landfilling of PFAS-contaminated soil is one of the sources of PFAS in landfill leachate. In this paper, the physical and chemical treatment methods to remove PFAS from soils and landfill leachates are described. Among the challenges that may limit the remediation of contaminated sites, we highlight the lack of strict regulation of PFAS in soils, the cost, the ineffectiveness of some methods for the remediation of certain PFAS compounds, and the limitation of the environmental matrices.
The Influence of the COVID-19 Epidemic on Prevention and Vaccination Behaviors Among Chinese Children and Adolescents: Cross-sectional Online Survey Study
Authors: Hou Zhiyuan , Song Suhang , Du Fanxing , Shi Lu , Zhang Donglan , Lin Leesa , Yu Hongjie
Published: April 2021

Background

The COVID-19 epidemic and the related containment strategies may affect parental and pediatric health behaviors.

Objective

The goal of this study was to assess the change in children’s and adolescents’ prevention and vaccination behaviors amid China’s COVID-19 epidemic.

Methods

We conducted a cross-sectional online survey in mid-March 2020 using proportional quota sampling in Wuhan (the epidemic epicenter) and Shanghai (a nonepicenter). Data were collected from 1655 parents with children aged 3 to 17 years. Children’s and adolescents’ prevention behaviors and regular vaccination behaviors before and during the epidemic were assessed. Descriptive analyses were used to investigate respondents’ characteristics, public health prevention behaviors, unproven protection behaviors, and vaccination behaviors before and during the COVID-19 epidemic. Univariate analyses were performed to compare differences in outcome measures between cities and family characteristics, using chi-square tests or Fisher exact tests (if expected frequency was <5) and analyses of variance. Multivariate logistic regressions were used to identify the factors and disparities associated with prevention and vaccination behaviors.

Results

Parent-reported prevention behaviors increased among children and adolescents during the COVID-19 epidemic compared with those before the epidemic. During the epidemic, 82.2% (638/776) of children or adolescents always wore masks when going out compared with 31.5% (521/1655) before the epidemic; in addition, 25.0% (414/1655) and 79.8% (1321/1655) had increased their frequency and duration of handwashing, respectively, although only 46.9% (776/1655) went out during the epidemic. Meanwhile, 56.1% (928/1655) of the families took unproven remedies against COVID-19. Parent-reported vaccination behaviors showed mixed results, with 74.8% (468/626) delaying scheduled vaccinations and 80.9% (1339/1655) planning to have their children get the influenza vaccination after the epidemic. Regarding socioeconomic status, children and adolescents from larger families and whose parents had lower education levels were less likely to improve prevention behaviors but more likely to take unproven remedies. Girls were less likely than boys to always wear a mask when going out and wash their hands.

Conclusions

Prevention behaviors and attitudes toward influenza vaccination have improved during the COVID-19 epidemic. Public health prevention measures should be continuously promoted, particularly among girls, parents with lower education levels, and larger families. Meanwhile, misinformation about COVID-19 remains a serious challenge and needs to be addressed by public health stakeholders.
Assessing the Quality of Mobile Health-Related Apps: Interrater Reliability Study of Two Guides (Preprint)
Authors: Miró Jordi , Llorens-Vernet Pere
Published: April 2021

BACKGROUND

There is a huge number of health-related apps available, and the numbers are growing fast. However, many of them have been developed without any kind of quality control. In an attempt to contribute to the development of high-quality apps and enable existing apps to be assessed, several guides have been developed.

OBJECTIVE

The main aim of this study was to study the interrater reliability of a new guide — the Mobile App Development and Assessment Guide (MAG) — and compare it with one of the most used guides in the field, the Mobile App Rating Scale (MARS). Moreover, we also focused on whether the interrater reliability of the measures is consistent across multiple types of apps and stakeholders.

METHODS

In order to study the interrater reliability of the MAG and MARS, we evaluated the 4 most downloaded health apps for chronic health conditions in the medical category of IOS and Android devices (ie, App Store and Google Play). A group of 8 reviewers, representative of individuals that would be most knowledgeable and interested in the use and development of health-related apps and including different types of stakeholders such as clinical researchers, engineers, health care professionals, and end users as potential patients, independently evaluated the quality of the apps using the MAG and MARS. We calculated the Krippendorff alpha for every category in the 2 guides, for each type of reviewer and every app, separately and combined, to study the interrater reliability.

RESULTS

Only a few categories of the MAG and MARS demonstrated a high interrater reliability. Although the MAG was found to be superior, there was considerable variation in the scores between the different types of reviewers. The categories with the highest interrater reliability in MAG were “Security” (α=0.78) and “Privacy” (α=0.73). In addition, 2 other categories, “Usability” and “Safety,” were very close to compliance (health care professionals: α=0.62 and 0.61, respectively). The total interrater reliability of the MAG (ie, for all categories) was 0.45, whereas the total interrater reliability of the MARS was 0.29.

CONCLUSIONS

This study shows that some categories of MAG have significant interrater reliability. Importantly, the data show that the MAG scores are better than the ones provided by the MARS, which is the most commonly used guide in the area. However, there is great variability in the responses, which seems to be associated with subjective interpretation by the reviewers.
Online focus groups in qualitative health research amid COVID 19: A technical and quality assessment guide (Preprint)
Authors: Bawadi Hiba , Awaisu Ahmed , Mukhalalati Banan , Al-Jayyousi Ghadir Fakhri , Elshami Sarah , Ashfaq Shuja
Published: April 2021

UNSTRUCTURED

The current pandemic has intensified the challenges experienced when conducting face-to-face focus group discussions as consequences of quarantines and physical distancing. These challenges include suspending real time focus groups (FGs) in qualitative research, and a transition from the conventional approach to an online setting. The purpose of this article is to conduct a literature review about various online platform that can be used to conduct FGs in order to help qualitative researchers to select the platform through which they can conduct good quality, time-efficient, and cost-effective online focus group discussions in qualitative health-related research. An overview of the pros and cons of synchronous and asynchronous online FGs and examples from qualitative health-related research is provided in the article. This is followed by an investigation of available quality assessment criteria for qualitative research and proposing a set of quality criteria that can be applied when conducting online FGs. Finally, a technical guideline representing technical specifications and features of various platforms is illustrated to help researchers to utilize the platform that best addresses their research needs.
Deep Learning-Based Assistive Technology in Chest Radiograph Interpretation by Emergency Department Physicians: Prospective Study (Preprint)
Authors: Kim Ji Hoon , Han Sang Gil , Cho Ara , Shin Hye Jung , Baek Song-Ee
Published: April 2021

BACKGROUND

Interpretation of chest radiographs (CRs) performed by emergency department (ED) physicians is inferior to that by radiologists. Recent studies have investigated the impact of deep learning-based assistive technology on CR interpretation (DLCR), but its relevance to ED physicians remains unclear.

OBJECTIVE

This study aimed to investigate whether DLCR supports CR interpretation and clinical decision-making of ED physicians

METHODS

Seven ED physicians were used in a prospective study. CR interpretation and clinical decision-making were assessed based on 388 clinical cases, including detecting the target lesion with DLCR. Participant performance was evaluated by area under the receiver operating characteristics curve, sensitivity, specificity, and accuracy analyses; decision-making consistency was measured by kappa statistics.

RESULTS

There was a difference in performance between ED physicians working with and without DLCR (area under the receiver operating characteristics curve: 0.801, P<.001). Diagnostic sensitivity and accuracy of CR were higher for all ED physicians working with DLCR than for those working without it. The overall kappa value for decision-making consistency was 0.902 (95% CI: 0.884–0.920); concurrently, that for the experienced group was 0.956 (95% CI: 0.934–0.979) and that for the inexperienced group was 0.862 (95% CI: 0.835–0.889).

CONCLUSIONS

This study presents preliminary evidence that ED physicians using DLCR in a clinical setting perform better at CR interpretation than their counterparts who do not use this technology. DLCR use influenced clinical decision-making of inexperienced physicians more strongly than it did that of experienced physicians. These findings require prospective validation before DLCR can be recommended for use in routine clinical practice.

CLINICALTRIAL

none declared
Machine Learning-Based Personalized Pharmacological Treatment for Depressive Disorder: A Target Trial Emulation Study (Preprint)
Authors: Wu Chi-Shin , Yang Albert C. , Chang Shu-Sen , Chang Chia-Ming , Liu Yi-Hung , Liao Shih-Cheng , Tsai Hui-Ju
Published: April 2021

BACKGROUND

Developing personalized treatment is one way to improve treatment effectiveness for depressive disorder.

OBJECTIVE

This study was aimed to develop and validate the use of machine learning-based prediction models to select personalized pharmacological treatment for patients with depressive disorder.

METHODS

This study used Taiwan's National Health Insurance Research Database. Patients with diagnoses of depressive disorder between 2003 and 2012 were included in this study. The study outcome was treatment failure, which was defined as psychiatric hospitalisation, self-harm hospitalisation, emergency visits, or treatment change. Predictors included the patients’ demographic variables, clinical characteristics of depression, and medical and psychiatric comorbid conditions. Prediction models based on Super Learner algorithms were trained for the initial and the next-step treatment separately. The personalised treatment strategy was developed for choosing the drug with the lowest probability of treatment failure for each patient as the model-selected regimen. We emulated clinical trials to estimate the effect of personalised treatment.

RESULTS

The areas under the curve of the prediction model using Super Learner was 0·627 for the initial treatment and 0·751 for the next-step treatment. Patients treated with model-selected regimens had reduced treatment failure rates, with a 0·84-fold (95% confidence interval [CI] 0·82-0·86) decrease for the initial treatment and a 0·82-fold (95% CI 0·80-0·83) decrease for the next-step treatment.

CONCLUSIONS

Machine learning-based prediction models for depression outcomes had fair prediction accuracies. In emulating clinical trials, we found the model-selected regimen to be associated with a reduced treatment failure rate. Future randomised controlled trials should be conducted to investigate the effectiveness of the use of machine-learning algorithms in clinical practice.
Building a Composable Electronic Health Records System using Fast Healthcare Interoperability Resources (FHIR) web components (Preprint)
Authors: Oluwalade Bolu , Apte Shruti , Purkayastha Saptarshi
Published: April 2021

BACKGROUND

In the last decade, Electronic Health Records systems (EHRs) have been widely adopted in the United States because of the government's efforts. These efforts have led to the broad and rapid adoption of the EHR but with numerous usability and interoperability challenges. The disconnect between the clinical users' expectations from their EHRs and what is available in the EHRs is well-known.

OBJECTIVE

This study aimed to evaluate (1) the feasibility of a user-composable user interface (UI) for an EHR system using FHIR web components, (2) the user's ease of learning and ease of use of the assembled EHR's UI.

METHODS

We developed web components for the FHIR patient resource using the Polymer 3 library. The components were assembled by 19 subjects with a clinical background and past EHR use experience utilizing a drag and drop UI designer. We measured latent variables of "ease of learning" and "ease of use" through a 33-questions pre-validated survey from these subjects. Further, we conducted semi-structured interviews as per the sequential explanatory research design. The quantitative and qualitative data obtained from the survey and the semi-structured interviews were analyzed using the convergent parallel mixed method design. The quantitative data derived through the survey estimated the Structural Equation Modeling (SEM) latent variables tagged "ease of learning" and "ease of use" of the user interface.

RESULTS

About 88 percent (16 of 18) of the participants were confident or very confident about assembling the user components to form a user interface after watching a workflow video of the process, and 63 percent (12 of 19) of participants eventually completed the assembly process.
A partial least square structural equation modeling (PLS-SEM) analysis of the survey results showed that there is a significant positive effect (p =0.00) on the ease of learning of the assembling process and on ease of use of the system and vice versa. The qualitative analysis of the interview showed that more' easy to use' and 'easy to learn' themes appeared in the participants' responses (40.1%) than the "difficult to learn," "difficult to use," "too complex," and "cumbersome" themes combined appearing in 11.2 % of the combined themes.

CONCLUSIONS

It seems that the non-technical users can assemble an EHR user interface without little or no technical support. Moreover, a user-composed EHR user interface will improve EHR users' experience. Finally, web components based on FHIR resources can be developed and implemented into an EHR user interface.
Health-Related Quality of Life Among Pregnant Women With Pre-pregnancy Smoking and Smoking Cessation During Pregnancy in China: National Cross-sectional Study (Preprint)
Authors: Hu Kadi , Zou Shiqian , Zhang Casper JP , Wu Huailiang , Akinwunmi Babatunde , Wang Zilian , Ming Wai-Kit
Published: April 2021

BACKGROUND

Previous studies have hardly explored the influence of pre-pregnancy smoking and smoking cessation during pregnancy on the health-related quality of life (HRQoL) of pregnant women, which is a topic that need to be addressed. In addition, pregnant women in China constitute a big population in the largest developing country of the world and cannot be neglected.

OBJECTIVE

This study aims to evaluate the HRQoL of pregnant women in China with different smoking statuses and further estimate the association between pre-pregnancy smoking, smoking cessation, and the HRQoL.

METHODS

A nationwide cross-sectional study was conducted to determine the association between different smoking statuses (smoking currently, quit smoking, never smoking) and the HRQoL in pregnant women across mainland China. A web-based questionnaire was delivered through the Banmi Online Maternity School platform, including questions about demographics, smoking status, and the HRQoL. EuroQoL Group’s 5-dimension 5-level (EQ-5D-5L) scale with EuroQoL Group’s visual analog scale (EQ-VAS) was used for measuring the HRQoL. Ethical approval was granted by the institutional review board of the First Affiliated Hospital of Sun Yat-sen University (ICE-2017-296).

RESULTS

From August to September 2019, a total of 16,483 participants from 31 provinces were included, of which 93 (0.56%) were smokers, 731 (4.43%) were ex-smokers, and 15,659 (95%) were nonsmokers. Nonsmokers had the highest EQ-VAS score (mean 84.49, SD 14.84), smokers had the lowest EQ-VAS score (mean 77.38, SD 21.99), and the EQ-VAS score for ex-smokers was in between (mean 81.04, SD 17.68). A significant difference in EQ-VAS scores was detected between nonsmokers and ex-smokers (P<.001), which indicated that pre-pregnancy smoking does have a negative impact on the HRQoL (EQ-VAS) of pregnant women. Compared with nonsmokers, ex-smokers suffered from more anxiety/depression problems (P=.001, odds ratio [OR] 1.29, 95% CI 1.12-1.50). Among ex-smokers, the increased cigarette consumption was associated with a lower EQ-5D index (P=.007) and EQ-VAS score (P=.01) of pregnant women. Compared to smokers, no significant difference was found in the ex-smokers’ EQ-5D index and EQ-VAS score (P=.33).

CONCLUSIONS

Smoking history is associated with a lower HRQoL in pregnant Chinese women. Pre-pregnancy smoking is related to a lower HRQoL (EQ-VAS) and a higher incidence of depression/anxiety problems. Smoking cessation during pregnancy does not significantly improve the HRQoL of pregnant Chinese women. Among ex-smokers, the more cigarettes they smoke, the lower HRQoL they have during pregnancy. We suggest that the Chinese government should strengthen the education on quitting smoking and avoiding second-hand smoke for women who have pregnancy plans and their family members.
Особенности показателей церебральной оксиметрии при различных видах комбинированной анестезии у детей с врожденной хирургической патологией
Authors: Vlasov A.О.
Published: April 2021

Актуальность. В последнее десятилетие ближняя инфракрасная спектроскопия приобрела популярность в отделениях новорожденных. С учетом современного международного опыта в представленной работе проведена оценка особенностей церебральной оксиметрии у детей с врожденными пороками развития хирургического профиля при различных видах комбинированной анестезии. Цель исследования: оценить состояние церебральной оксигенации у новорожденных и младенцев с врожденными пороками развития при различных видах анестезиологического сопровождения. Материалы и методы. В ретроспективное исследование были включены 150 новорожденных и младенцев с врожденными пороками развития хирургического профиля в зависимости от анестезии (ингаляционное + региональное; ингаляционное + внутривенное и тотальное внутривенное обезболивание). Анализировались показатели церебральной оксиметрии по сравнению с показателями периферической сатурации, артериального давления, парциального напряжения СО2, О2 в крови, рН. Результаты. Минимальный показатель церебральной оксиметрии отмечен с левого полушария мозга у детей I группы — 50,57 ± 16,66, что может быть неблагоприятным прогностическим фактором в дальнейшем восстановлении и влиянии на когнитивные функции головного мозга ребенка. Через 1 час после операции дети I группы, получавшие комбинированную анестезию севораном с региональным обезболиванием, демонстрировали худшие показатели церебральной оксиметрии по сравнению с детьми II и III групп (rSO2 правого полушария в I группе — 56,84 ± 12,27, rSO2 левого полушария в I группе — 57,53 ± 13,32, р = 0,0001; 0,0028), в то время как различия в показателях II и III групп не выявлены (р = 0,4167; 0,4029). Выводы. Ближняя параинфракрасная спектрометрия зарекомендовала себя как простой, целесообразный и полезный метод контроля за состоянием насыщенности кислородом головного мозга. При выборе комбинированной анестезии ингаляционным методом с региональным обезболиванием у детей с врожденными пороками развития для проведения оперативного лечения следует более тщательно контролировать церебральную оксигенацию с дополнительным контролем периферической сатурации, артериального давления, парциального напряжения СО2, О2 в крови и рН.
Изменения липидного обмена в до- и послеоперационном периоде у больных с ожирением при лапароскопической холецистэктомии
Authors: Maisuradze A.O. , Chubuk I.V.
Published: April 2021

Актуальность. Изменение показателей липидного обмена в до- и послеоперационном периоде обусловлено частыми нарушениями метаболизма у людей с ожирением и особыми трудностями в подборе целесообразной терапии для данных пациентов. В свою очередь, причиной изменения метаболизма в организме является влияние определенной экстремальной ситуации — хирургического вмешательства. Цель: изучение изменения липидного обмена в до- и послеоперационном периоде у больных с ожирением при лапароскопической холецистэктомии. Материалы и методы. Исследованы 50 пациентов (средний возраст — 47,0 ± 1,5 года), которым проведено оперативное вмешательство по поводу острого холецистита методом лапароскопической холецист­эктомии. Пациенты были распределены на две группы: 1-я — с ожирением, 2-я — без ожирения. У всех пациентов исследованы уровни триглицеридов, общего холестерина, липопротеинов высокой плотности (ЛПВП), липопротеинов низкой плотности (ЛПНП), липопротеинов очень низкой плотности (ЛПОНП), проведено сравнение в дооперационном периоде и на 1-е и 5-е сутки послеоперационного периода. Результаты. Показатели липидного обмена в до- и послеоперационном периоде во всех группах имели допустимые колебания с учетом того, что у пациентов с ожирением значения липидного спектра сначала были повышены по сравнению с пациентами без ожирения. В послеоперационном периоде в 1-й группе на 1-е сутки отмечалось снижение концентрации триглицеридов (1,1 ± 0,6 ммоль/л) от начального уровня, общего холестерина (4,5 ± 0,3 ммоль/л), повышение уровня ЛПВП (1,5 ± 0,2 ммоль/л), снижение уровня ЛПНП (2,9 ± 0,2 ммоль/л) и ЛПОНП (1,0 ± 0,2 ммоль/л). Во 2-й группе показатели триглицеридов (0,6 ± 0,2 ммоль/л), общего холестерина (3,4 ± 0,1 ммоль/л), ЛПНП (1,9 ± 0,3 ммоль/л) и ЛПОНП (0,8 ± 0,2 ммоль/л) также имели тенденцию к снижению, отмечалось повышение уровня ЛПВП (1,6 ± 0,1 ммоль/л), но данные значения независимо от варьирования находились в пределах нормы. В 1-й группе у 3 пациентов наблюдались когнитивные нарушения, что было обусловлено значительным повышением уровня ЛПНП над ЛПВП и возможным развитием атеросклероза, которое могло привести к нарушению мозгового кровообращения. Выводы. После проведения исследования между двумя группами, в которых изучался липидный спектр, выявлено варьирование его показателей в обеих группах, что связано с особенностями метаболизма у таких пациентов и влияния хирургического стресса. Исходя из этого контроль и регулирование значений липидного профиля необходимо проводить у всех пациентов с дислипидемией, а у пациентов с ожирением нужно дополнительно учитывать факторы риска, сопутствующие заболевания и возможные осложнения.
Хроническая церебральная венозная дисфункция: взгляд на проблему
Authors: Kovalenko O.Ye. , Prityko N.G.
Published: April 2021

В статье представлен аналитический обзор результатов отечественных и зарубежных исследований по проблеме хронических нарушений мозгового венозного кровообращения, которым уделяют меньше внимания в сравнении с патологией артериальной системы из-за нечеткости проявлений, особенно ранних, анатомической изменчивости венозного русла даже у здоровых, сложности верификации диагноза и т.д. Когда баланс артериального притока и венозного оттока нарушается и это нарушение прогрессирует, развиваются необратимые изменения в других структурах полости черепа — в первую очередь страдает головной мозг (что согласуется с концепцией Монро — Келли). Хронические нарушения церебрального венозного кровообращения могут иметь разные причины и разную степень выраженности. Синдром хронической церебральной венозной дисфункции, терминологически принятый у нас, в некоторых странах рассматривается как хроническая венозная цереброспинальная недостаточность, что подчеркивает патогенетическую связь нарушений церебрального венозного кровотока с внечерепными венами, что, на наш взгляд, является логичным и обоснованным. Признание хронической цереброспинальной венозной недостаточности вызвало значительный интерес к изучению роли внечерепной венозной патологии и вариантов ее развития. Несмотря на то, что диагноз изначально был основан на допплерографической сонографии, пока не установлено диагностических способов визуализации, неинвазивных или инвазивных, которые могут служить золотым стандартом для выявления венозных отклонений, свидетельствующих о хронической цереброспинальной венозной недостаточности. Обсуждаются результаты ряда исследований, в частности, гипотезы о роли хронической цереброспинальной венозной недостаточности в патогенезе рассеянного склероза и многих сопутствующих клинических проявлений. Анализируется общность по патогенезу идиопатической внутричерепной гипертензии, болезни Меньера, синдрома спондилогенной вертебрально-базилярной недостаточности. Акцентируется внимание и на другом мнении ученых, которые повышение венозного кровенаполнения головного мозга и других образований полости головы при определенных условиях рассматривают как компенсаторную реакцию. Рассматриваются анатомо-физиологические особенности венозной системы черепной полости, обосновывающие клинические проявления венозной дисфункции, способы диагностики и лечения патологии. Обобщая вышесказанное отметим, что хроническое нарушение циркуляции венозной крови в полости черепа в значительной степени связано с проблемами внечерепного венозного кровотока и не только само по себе является достаточно характерным синдромокомплексом, который негативно влияет не только на неврологические функции за счет гипоксии мозга и метаболических изменений, ухудшает качество жизни, но и на течение или имеет патогенетическую связь с другими заболеваниями, в частности, может сопровождаться различным уровнем артериального давления.
CRISPR-Cas: краткий обзор
Authors: Sonmez Yusuf Ercin
Published: April 2021

CRISPR-Cas — это адаптивный иммунитет у прокариот против инфицирования вирусами и плазмидами. Массив CRISPR распознает посторонние последовательности агентов, а Cas уничтожает их. Используя эту систему, представляется возможным найти нежелательные последовательности в геноме и уничтожить или изменить их с помощью соответствующих инструментов. Эта система способна не только защитить себя от будущих инфекций, но и исправить врожденные патологии, которые могут повлечь канцерогенез или некоторые врожденные заболевания.
Роль метаболической терапии в лечении гипоксии паренхимы почек у детей с пиелонефритом, ассоциированным с недифференцированной дисплазией соединительной ткани
Authors: Lukyanenko N.S. , Kens K.A. , Dobrik O.A.
Published: April 2021

Цель: обосновать выбор и оценить эффективность применения метаболического лечебного комплекса (витамин Е и L-карнитин), направленного на уменьшение тканевой гипоксии и улучшение метаболических процессов в паренхиме почек в терапии острого пиелонефрита на фоне пузырно-мочеточникового рефлюкса как висцерального проявления недифференцированной дисплазии соединительной ткани у детей раннего возраста. Материалы и методы. Обследованы 67 детей с пиелонефритом и пузырно-мочеточниковым рефлюксом (ПМР), ассоциированным с недифференцированной дисплазией соединительной ткани (НДСТ), в возрасте от 3 месяцев до 3 лет. В контрольную группу вошли 65 детей раннего возраста с острым пиелонефритом, у которых после обследования не было выявлено ПМР и признаков НДСТ. Вторую группу контроля составили 40 соматически здоровых детей этого же возраста. С целью диагностики наличия недифференцированной дисплазии соединительной ткани всем детям в периоде ремиссии воспалительного процесса проводился тест на содержание оксипролина в моче. Определялись маркеры недифференцированной тканевой гипоксии паренхимы почек: тест на антикристаллобразующую функцию мочи и суточную экскрецию солей в моче по методике Ю.Е.Вельтищева и Э.А.Юрьевой. Исследовались маркеры морфофункционального состояния цитомембран почечного эпителия: проба на кальцификацию — наличие полярных липидов в моче и тест на наличие продуктов перекисного окисления липидов в моче. Детям раннего возраста с пиелонефритом, ПМР и НДСТ, в моче которых была установлена высокая экскреция оксипролина, в дополнение к протокольному лечению в периоде ремиссии воспалительного процесса был рекомендован прием в течение месяца комплекса витамина Е и L-карнитина в возрастных дозах, способного улучшать метаболические процессы в паренхиме почек. Результаты. После метаболической терапии с антигипоксантным и мембранопротекторным действием у обследованных детей наблюдалась значительная положительная динамика изучаемых маркеров тканевой гипоксии и мембранодеструкции паренхимы почек. Выводы. Выявлено положительное влияние метаболического комплекса (витамин Е и L-карнитин) в периоде ремиссии воспалительного процесса почек, который выразился в уменьшении степени тканевой гипоксии и мембранодеструкции, что подтверждает возможность уменьшения тканевой гипоксии у детей с пиелонефритом и пузырно-мочеточниковым рефлюксом, ассоциированным с недифференцированной дисплазией соединительной ткани, при применении витамина Е и L-карнитина в возрастных дозах в течение месяца и позволяет рекомендовать этим детям проведение метаболической терапии.
Потребности в энергетических затратах и белке у детей с хроническим заболеванием почек 2-5-й стадии и на диализе: рекомендации по клинической практике от Рабочей группы по нефрологическому питанию у детей
Authors: Authors No
Published: April 2021

No abstract
Выживаемость и летальность у гемодиализных больных
Authors: Sharapov О.N.
Published: April 2021

В данной статье представлен обзор литературы по проблеме сердечно-сосудистой смертности у больных хронической болезнью почек в терминальной стадии. В статье на основе зарубежной литературы освещены выживаемость и летальность больных гемодиализной популяции. Отмечается высокий процент летальных исходов, обусловленных сердечно-сосудистыми патологиями, у пациентов с терминальной почечной недостаточностью, которые получают заместительную почечную терапию. Подробно описывается влияние сердечно-сосудистых патологий на показатели выживаемости по данным национальных и международных почечных регистров. Приводятся данные по изучению структуры причины смерти пациентов на гемодиализе. Детально представлены факторы, влияющие на выживаемость и летальность у больных на гемодиализе, такие как курение, сохранность диуреза, ожирение, концентрация холестерина, уровень сывороточного калия и т.д. Отмечаются актуальность и необходимость изучения данной проблемы, которая диктует необходимость целенаправленных усилий на снижение смертности у диализных больных.
Decomposition of intended use of IPO proceeds: Evidence from Malaysia
Authors: Badru Bazeet Olayemi
Published: April 2021

The main objective of the study is to identify what Malaysian IPO issuers indicate as intended use of IPO proceeds and the use that has the highest amount of allocation. In order to achieve the objective of the study, a manual content analysis of 221 IPO prospectuses issued during the period of 2005-2015 were considered. Based on the manual content analysis, the data were analysed using descriptive statistics and analysis of variance (ANOVA). The results indicate that the three major intended uses of IPO proceeds in Malaysian IPO market are growth opportunities (53.90%), debt repayment (29.12%) and working capital (12.87%). However, growth opportunities and debt repayment have greater amount of allocation than working capital over the sample periods. Additionally results show that Malaysian IPO issuers expend more on capital expenditure and expansion rather than research and development in terms of growth opportunities. Further analysis in terms of the frequencies of number of IPO issuers indicate that number of issuers that have a designated amount for working capital (95%) supersede issuers in the growth opportunities group (90%). These results suggest that issuers can consider intended use of IPO proceeds information as a signal mechanism and potential investors can as well consider the information useful before making their investment decisions.
An Evaluation of the Antifungal and Antioxidant Activity of Pinus merkusii Bark Ethyl Acetate Extract
Authors: Masendra Masendra , Purba Brandon Aristo Verick , Lukmandaru Ganis
Published: April 2021

Pinus merkusii is the only species in the Pinaceae family to grow in Southeast Asia, including Indonesia, and serves as a source of wood and oleoresins. During the utilization of this pine, the bark is discarded as residue, however, this residue is possibly a potential source of antifungal and antioxidant agents, due to the polyphenol contents. This study, therefore, aims to investigate the antifungal and antioxidant compounds present in the bark of P. merkusii. The ethyl acetate extracts of Pinus merkusii were fractionated to obtain five fractions (Fr. A- Fr. E) and the bioactivity of each fraction was observed. Subsequently, the growth inhibition against Phanerochaete chrysosporium, was evaluated for antifungal activity, while DPPH (1,1-diphenyl-2-picrylhydrazyl) method was used to ascertain antioxidant activity. According to the GC-MS analysis, the ethyl acetate fractions contain triterpenoids and steroids as the dominant compounds as well as minor amounts of mono-sesquiterpenoids and hydrocarbons. The highest growth inhibition exhibited by Fr. C- Fr. E (>60%) indicates triterpenoids and steroids act as a fungal inhibitors. Meanwhile, the five fractions exhibited low antioxidant activity because the steroids and triterpenoids present are possibly ineffective DPPH inhibitors. Also, the antifungal and antioxidant activity R2 values were discovered to correlate 0.3, indicating a low positive correlation.